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Biomedical subjects

R Zilleruelo

Publications and source records attributed to R Zilleruelo.

5 recordsLinked to original sources
PubMedDate not supplied

[Pacemaker implants in children].

Complications and lethality related to pacemaker implants performed to 32 infants and children at a public cardiovascular center of Santiago, Chile, from december 1979 throughout december 1989 were retrospectively assessed. Indications for pacemaker implants were complete congenital atrioventricular block (n = 22; 69%), and post-surgical arrhythmias (n = 10; 31%). Replacement of pulse generator was necessary in 9 children after an average time of 5.5/12 years from the initial implant. Electrode fractures were detected in 4 cases of pacemaker's failure and raised stimulation threshold in one of such patients. Four patients of this series died along follow-up, only one death occurred in the immediate post-operatory period. The other 3 cases died several months after surgery due to causes not related to the pacemakers. The remaining 28 children are in good physical and emotional conditions.

Adolescent↗
PubMedDate not supplied

[Infant mortality due to heart disease in Chile 1988].

An analysis of infant's deaths caused by heart diseases in Chile during year 1988, was performed through a critical review of 5,598 death's certificates and 4,419 infant death audits. The mortality rates due to congenital cardiac defects were 177 per 100,000 liveborn (LB) and varied between 31.5 and 293.0 for 100,000 LB along the country's 26 health districts. In 69% of death's certificates and 25% of death audits, diagnoses were nonspecific regarding to the type of cardiac malformation, in 15% of deaths diagnostic orientation was incorrect and in 32% a clinical suspicion of congenital heart disease was raised by the primary physician but patients did not reach specialized treatment. One half of deaths occurred at general regional non specialized hospitals and 28% at hospitals of higher complexity. Of these late, 10% occurred after corrective or palliative surgery and 7% in patients considered to be inoperable.

Cardiovascular Diseases↗
PubMedDate not supplied

[Mitral valve disease in infants. Anatomical and functional evaluation by echocardiography].

To describe the incidence of mitral valve abnormalities among infants aged 0 to 24 months, their anatomic features, site of lesion, severity and associated heart defects, the records of 3,583 such patients submitted for bi-dimensional ultrasound and pulsed Doppler cardiac studies by presumptive heart disease were analyzed. Mitral valve abnormalities were thus detected in 88 of these cases, and were also documented by clinical examination (n: 88), heart catheterization and angiocardiography (n: 11), surgery (n: 17) and necropsy (n: 2). Seventy five cases had additional heart disease, most commonly aortic stenosis (27%), aortic coarctaction (26%) and ventricular septal defects (43%). Papillary muscle deformities at the subvalvar mitral apparatus were considered to be the most frequent mechanism for congenital mitral stenosis (100%), and annulus dilatation was the most frequent cause of mitral insufficiency (49%). Relative incidences of mitral valve stenosis and insufficiency among the whole studied sample were 0.5% and 1.48% respectively. There was a rough correlation between Doppler transmital gradient or regurgitation jet area and the corresponding mitral valve abnormality. This kind of noninvasively obtained data about mitral architecture and function seems to be a very useful and sensitive guide to define and manage this patients.

Cardiomyopathies↗
PubMedDate not supplied

[Serum digoxin in children treated with beta methyl digoxin].

Concentrations of serum digoxin were measured by the polarized immunofluorescence Abbot TDx11 method in 59 samples from 53 children under treatment with mean beta methyl digoxin doses of 8.9 +/- 2.0 micrograms.kg.day. The therapeutic range for serum digoxin concentration was estimated to be 0.9 to 2.25 ng/ml. Simultaneous Na, K and creatine serum concentrations were measured. In 36 samples mean serum digoxin level was 1.52 +/- 0.45 ng/ml -within therapeutic range- and in only one of these cases clinical evidence of toxicity was apparent. In 15 samples digoxin level was above the therapeutic range and 11 patients of this group (73%) showed clinical signs of toxicity, consisting in arrythmias (six cases: supraventricular in 5 patients, ventricular in one child) and gastrointestinal symptoms (eight patients). Six patients with digoxin levels over therapeutic range and signs of digitalis toxicity had coincidental acute renal failure, which in 4 cases was subclinical--in 2 of these late it was pre-renal- and, in spite of this, all were inadvertently given the usual dosage of beta methyl digoxin. Almost invariably there was clinical evidence of toxicity when digoxin serum levels were above 2.4 ng/ml, so established maximal therapeutic level at 2.25 ng/ml seems adequate. Signs of digitalis toxicity must be looked on systematically in children treated with such drugs. In the critically ill or in children with acute renal failure it is necessary to monitor serum digoxin concentration. Among the clinical signs of toxicity, gastrointestinal symptoms are more frequent in children. An oral dose from 7 to 10 micrograms.kg.day of beta methyl digoxin in recommended.

Acute Kidney Injury↗