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Biomedical subjects

R Varela Cives

Publications and source records attributed to R Varela Cives.

17 recordsLinked to original sources
PubMed2006

Endobronchial tuberculous granuloma in children.

Endobronchial tuberculosis is rare in children, in whom it is usually a complication of primary tuberculosis. Endobronchial involvement may adopt several forms, with granuloma being infrequent. Here we report on 10 cases of endobronchial tuberculous granuloma diagnosed and treated in our Paediatric Surgery Service between 1991 and 2004. In 2 cases the presentation was acute and constituted the first manifestation of TB; the remaining patients were undergoing treatment or had been treated for primary TB, and presented with clinical symptoms or radiological signs that led us to suspect endobronchial involvement. In all cases the granuloma was removed by bronchoscopy. Patients received conventional medical TB treatment, with corticoids for 4 weeks following granuloma removal. The clinical course was favourable in all cases and on follow-up we saw no complications. Endobronchial tuberculous granuloma should be borne in mind in children with symptoms or signs of airway obstruction and especially during the course of tuberculosis treatment.

Bronchial Diseases↗
PubMed2004

Handlebar hernia in children: two cases and review of the literature.

Localised traumatic abdominal hernias are rare. Most such hernias are due to the direct impact of the handlebars of a bicycle or motorcycle, with 20 cases reported to date in the English language literature, 12 in children. We report two new cases of handlebar hernia, in children aged 6 and 10 years. In both cases, physical examination revealed an area of contusion and bruising in the lower abdomen. However, the muscle defect was detected during the first examination in only one of the patients, and not until several days later in the other patient. Abdominal ultrasonography proved useful for diagnosis in both patients. Early surgical correction is necessary to prevent possible complications. This type of hernia should be borne in mind when evaluating children who have suffered abdominal trauma in a bicycle accident.

Athletic Injuries↗
PubMed1998

[Conservative treatment of neurogenic fecal incontinence. Our experience with children].

OBJECTIVE: The objective of this study was to present the use of retrograde colon enema in myelodysplasic patients with fecal incontinence. PATIENTS AND METHODS: Thirty-three patients, 16 males and 19 females, 5 to 22 years old (average age 11.9 years) with spina bifida and fecal incontinence which obliged them to use a diaper. Retrograde colon enema procedures were performed in all of them. RESULTS: With the use of the retrograde enema the best rectal emptying was achieved and kept 32 children (97%) diaper free after a follow-up period of more than two years. Only one girl (3%) needed pads because she was not able to defecate in an appropriate place after administering the enema. CONCLUSIONS: The retrograde enema is the best conservative treatment for children with neurogenic fecal incontinence. This method achieves good rectal emptying allowing the children to be diaper free, resulting in better social adaptation and integration.

Adolescent↗
PubMed1997

A retrospective analysis of ingestion of caustic substances by children. Ten-year statistics in Galicia.

UNLABELLED: We reviewed the case histories of 743 children seen at our hospital from 1981 to 1990 for suspected ingestion of caustic substances. Mean patient age was 27 months; 85% of patients were less than 3 years old. The male-to-female ratio was about 2:1. About 53% of patients were from urban environments. All ingestions appear to have been accidental. Of the 743 children, 20% presented oesophageal burns (11.8% first-degree, 3.1% second-degree and 2.7% third-degree). Alkaline products were ingested about 11 times more frequently than acid products. The substance ingested was bleach in 73% of cases. The most dangerous substances were dishwasher liquids/powders (59% of ingestions led to oesophageal burn), caustic soda (55%) and drain cleaners (55%). The caustic product was not in its original container in 75% of cases. Most accidents (58%) took place in the home. We did not detect any reliable predictive relationship between the presence of symptoms and signs and of oesophageal burns. Of the 743 patients, 5% developed oesophageal stricture and 3% required oesophageal dilatation. CONCLUSION: The incidence of accidents caused by the ingestion of caustic substances can only be reduced by broad-based preventive strategies, including enforcement of safe manufacturing practices and public education programmes. Most importantly, the containers for caustic household products should be cheap, small and childproof.

Accidents↗
PubMed1996

The influence of patency of the vaginal process on the efficacy of hormonal treatment of cryptorchidism.

UNLABELLED: To investigate the effects of patency of the vaginal process (processus vaginalis testis) on the efficacy of hormonal treatment of cryptorchidism, we carried out a blind, controlled, prospective study in which all patients underwent inguinal herniography. The sample comprised 310 boys with true cryptorchidism (244 unilateral, 66 bilateral) and without symptomatic hernia/ hydrocele or other pathologies. Patients age ranged from 8 months to 11 years 5 months. All patients were treated with human chorionic gonadotropin (twice-weekly intramuscular injections for 5 weeks; total dose 2500 IU for patients less than 1-year-old, 5000 IU for 1- to 6-year-olds, 10000 IU for 6- to 11-year-olds). Following treatment, 37% (139/376) of the testes descended. The incidence of descent was highest for testes initially in caudal positions. Considering only non patent (i.e., normal) vaginal processes, the incidence of testis descent was 49.5% (139/281); none of the 95 testes associated with a patent vaginal process descended in response to hormone treatment. CONCLUSION: Prior detection of patent vaginal process by inguinal herniography permits identification of a significant subset of patients for whom hormone treatment will be ineffective. Our data suggest that this predictive procedure is 100% reliable.

Child↗
PubMed1996

Uncommon case of gastrinoma in a child.

Gastrinoma is a kind of neuroendocrine tumor very rare in children. It can be described as solitary and has been reported in the liver and in the kidney; or as part of MEN type I (tumors of parathyroids, pancreatic islets and pituitary). We report here, a solitary and huge pancreatic gastrinoma in a young girl with a Zollinger-Ellison (Z-E) syndrome, whose diagnosis was delayed by misunderstanding of the symptoms.

Adolescent↗
PubMed1995

Gallbladder carcinoma in an achondroplastic boy.

Carcinoma of the gallbladder in an extremely rare tumor in childhood. We have found only five cases in the literature. Most of them were associated with an ethnic group - The Navajo Indians - who are known to have high incidence of gallbladder disease. We report here on the exceptional presence of this type of tumor in a child, who also had achondroplasia. This, as far as we can determine, is the first such case ever reported.

Achondroplasia↗
PubMed1993

[Pediatric fiber bronchoscopy. Apropos 55 children examined].

We present our experience with 55 children in which we performed flexible fiberoptic bronchoscopy (FFB) using an Olympus BF3C20 instrument and by using sedation and local anaesthesia or laryngeal mask airway. Indications for performing this procedure were stridor, opportunist or recurrent pneumonia, persistent atelectasis, a suspected foreign body, confirmation of endobronchial tuberculosis and evaluation of tracheostomy. In 70% of the cases, the diagnosis was made by the FFB and 14 cases were normal. One child with severe hypoxia presented respiratory arrest and need intubation. Our results suggest that FFB is safe, has advantages over rigid bronchoscopy, avoids general anaesthetic and with laryngeal mask airway is possible to perform in patients of every age.

Adolescent↗
PubMed1992

[Scrotal trauma in childhood].

Scrotal trauma has increase in frequency during recent years, largely as the result of sporting activities, physical aggressions and road accidents. Its importance lies in the likelihood of associated lesions of the testis and the spermatic cord. We report 41 cases of scrotal trauma. Thirty-seven cases were non-penetrating and four were penetrating (including a case of traumatic rupture of the testis). Nonsurgical treatment was applied in 30 cases (73.1%) and surgical treatment in 11 (26.8%). The diagnostic techniques employed included ultrasonography in 19 cases, gammagraphy in 10 cases, Doppler-effect ultrasonography in 2 cases and CAT in 2 cases. The decision to operate should be based on the clinical findings. Follow-up studies over 8-60 months were satisfactory in all cases, with no cases of testicular atrophy detected.

Adolescent↗
PubMed1991

Measurement of colonic transit time in children.

Transit times through the whole colon and its segments were measured in 10 healthy children and 14 children suffering constipation secondary to myelomeningocele. The subjects ingested radio-opaque markers on three successive days, and on the fourth a plain abdominal roentgenogram was taken using fast film. In the healthy children, total colonic transit time (mean +/- SD) was 37.8 +/- 6.2 h, with segmental times of 10.8 +/- 3.5 h for the right colon, 12.2 +/- 2.7 h for the left, and 14.7 +/- 2.1 h for the rectosigmoid; upper normal limits of 17.8 h for the right colon, 17.6 h for the left, 19.1 h for the rectosigmoid, and 50.2 h for the total colonic transit time were established. In the constipated children, the total transit time was 59.9 +/- 5.4 h, with segmental times of 15.9 +/- 2.3 h for the right colon, 18.9 +/- 2.3 h for the left, and 25.0 +/- 2.6 h for the rectosigmoid. The technique described is simple, is easy to use in clinical practice, and involves a lower radiation dose than other methods. It may prove useful for measurement of colonic transit time in suitable patients.

Adolescent↗
PubMed1988

[Evaluation of medical and surgical treatment of intestinal invagination in children].

Authors review 70 consecutive cases of intussusception treated from 1969 to 1984. Most patients (87.5%) were under one year, and male/female ratio was 2/1. Nutritional status was good as 75.7% were above 50 percentiles for age. There was a higher seasonal incidence in spring and summer. Most frequent presenting symptom were weeping/pain (87.1%), rectal bleeding (82.8%) and vomiting (78.5%). Typical symptomatology was present in only 48.5%. Plain X-ray of abdomen and ultrasonography are the best diagnostic aid (91.4% and 90%). Hydrostatic reduction was successful in 30.1% whereas 51 cases had to be operated with a resection rate of 27.5%. Half of the patients over two years had an organic leading point. Complications, 8.6% were related with age, clinical course and need for bowel resection.

Child↗
PubMed1982

[Osteosarcoma: 2d malignant tumor following treatment with radiotherapy].

The authors report a case of postirradiation osteosarcoma that appeared in a seven year old girl after having received radiation therapy for a soft tissue sarcoma. The latent period between the two malignancies was 5 and a half years and the apparently radiation-induced osteosarcoma developed within the radiation field of the primary tumor.

Bone Neoplasms↗