ABSTRACT
BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for pseudomyxoma peritonei and appendix tumours are widespread in the world. It is unclear what should be the attitude in elderly patients. METHODS: This retrospective multicenter study collected the database from ten Spanish centers from Spanish Group of Peritoneal Cancer Surgery. The study period was between November 2002 and March 2014. Seventeen patients with age greater than or equal to 75 years with peritoneal carcinomatosis from pseudomyxoma peritonei and appendix tumours met the selection criteria for the study. Outcomes in terms of morbidity and mortality such as disease-free and overall survival were analyzed. RESULTS: Median PCI was 16 (range 6-39). Ten postoperative adverse events were detected in nine patients (44.4%). 28% were grade I-II and 17% were grade III-IV. Disease-free survival at 1 and 3 years was 67 and 44%, respectively. Overall survival at 1 and 3 years was 100 and 88%, respectively. Only cytoreduction was related to worst disease free survival after univariate (p = 0.007) and multivariate (OR 11.639, 95% CI 1.24-109.74, p = 0.03) analyses. Cytoreduction was related to the worst overall survival after univariate analysis (p = 0.046). CONCLUSION: Cytoreductive surgery and HIPEC for pseudomyxoma peritonei and appendix tumours in elderly patients it is a procedure with feasible postoperative morbi-mortality and survival outcomes. TRIAL REGISTRATION: researchregistry1587 (retrospectively registered).
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Appendiceal Neoplasms/therapy , Chemotherapy, Cancer, Regional Perfusion/mortality , Cytoreduction Surgical Procedures/mortality , Hyperthermia, Induced/mortality , Peritoneal Neoplasms/therapy , Pseudomyxoma Peritonei/therapy , Aged , Aged, 80 and over , Appendiceal Neoplasms/pathology , Combined Modality Therapy , Female , Follow-Up Studies , Humans , Male , Peritoneal Neoplasms/secondary , Prognosis , Pseudomyxoma Peritonei/pathology , Retrospective Studies , Survival RateABSTRACT
There are some historic facts about the "First Center for Voluntary Oral Rehydration" begun 1959 at Hospital Infantil de México (Children's Hospital) was clearly demonstrated useful, 508 infants with diarrhea were treated. 90.94% were cured and dehydration corrected. Antibiotics were not much useful. Oral rehydration is considered the method of choice to begin treatment of the patient with gastroenteritis.
Subject(s)
Fluid Therapy/history , Hospitals, Pediatric/history , Diarrhea, Infantile/history , Diarrhea, Infantile/therapy , History, 20th Century , Humans , Infant , Infant, Newborn , MexicoABSTRACT
This study is about the importance and mechanisms of the nosocomial infections, specially in newborn babies of the "Hospital General del Centro Médico La Raza del IMSS". We studied 461 newborns of which 53 (11.49%) developed one or more intrahospitalary infections. The rate of intra-hospital infections was 18.40%, mainly due by septicemia, infections of the surgical wounds, and respiratory tract infections. The gramnegative bacterias were predominant. Also were found Staphylococcus aureus and Staphylococcus epidermidis frequently. We give some preventive advice.
Subject(s)
Cross Infection/epidemiology , Cross Infection/microbiology , Hospital Departments , Humans , Infant, Newborn , Prospective Studies , Retrospective StudiesABSTRACT
The following is a preliminary report on 29 patients with mucoviscidosis. The study was conducted within the hospital and included clinical history, laboratory examinations and X-rays. The patient's ages ranged from four months to 20 years; 15 of them were males, 22 of them began their illness with respiratory symptomatology, 24 of them were previously hospitalized on one or more occasions. Bronchial secretions were examined for pathological and opportunistic bacteria. Pseudomonas and Staphylococcus aureus predominated and were found to be highly resistant to antibiotics. Mortality was high among the group: 13.7%.
Subject(s)
Cystic Fibrosis/complications , Adolescent , Adult , Child , Child, Preschool , Cystic Fibrosis/microbiology , Cystic Fibrosis/physiopathology , Female , Humans , Infant , MaleSubject(s)
Diarrhea, Infantile/therapy , Fluid Therapy/trends , Humans , Infant , Infant, Newborn , MexicoSubject(s)
Cecal Diseases/pathology , Malacoplakia/pathology , Sigmoid Diseases/pathology , Cecum/pathology , Child , Colon, Sigmoid/pathology , Humans , MaleABSTRACT
Se estudiaron 51 lactantes, 34 de los cuales eran eutroficos y 17 desnutridos de primer grado. Se compararon en ambos grupos los valores de calcio serico, fosforo, fosfatasa alcalina, proteinas totales y sus fracciones, y 25 hidroxicolecalciferol Se encontro diferencia significativa al comparar el fosforo serico, asi como la fosfatasa alcalina. Los valores promedio de 25 hidroxicolecalciferol fueron de 38.47 microgramo/l, semejantes a los senalados en la literatura. Se informa el hecho de que la fosfatasa alcalina puede encontrarse disminuida en el lactante desnutrido de primer grado
Subject(s)
Infant , Humans , Male , Female , Alkaline Phosphatase , Hydroxycholecalciferols , Phosphorus , Vitamin D DeficiencySubject(s)
Pregnancy , Infant, Newborn , Humans , Female , Pregnancy in Diabetics , Hyperparathyroidism , Hypocalcemia , Magnesium , PhosphorusSubject(s)
Giardiasis/epidemiology , Intestinal Diseases, Parasitic/epidemiology , Adolescent , Age Factors , Child , Child, Preschool , Female , Giardiasis/diagnosis , Giardiasis/etiology , Humans , Infant , Infant, Newborn , Male , Mexico , Retrospective StudiesABSTRACT
Mexico es considerado un pais de alto riesgo para contraer la giardiasis y en los ninos, la edad mas afectada es la etapa preescolar y escolar. Las manifestaciones clinicas varian desde pacientes asintomaticos hasta la presencia de la absorcion intestinal. El objetivo de nuestro estudio es analizar un grupo de pacientes con giardiasis intestinal para conocer su distribucion por sexo y edad, el cuadro clinico y respuesta al tratamiento. Posteriormente se revisa el tema de giardiasis intestinal destacando su fisiopatologia, metodos de diagnostico, tratamiento y medidas preventivas. Se analizaron en forma retrospectiva 100 casos de giardiasis intestinal, de un grupo de 512 pacientes reportados entre 1976 y 1980 en el Hospital de Pediatria. Los grupos de edades mas afectados fueron los preescolares y lactantes. La mitad de los pacientes estaban asintomaticos. Todos fueron tratados con metronidazol, pero no fue posible evaluar la respuesta al mismo debido a que mas de la mitad de los pacientes ya no regresaron a consulta
Subject(s)
Child, Preschool , Child , Humans , Giardiasis , Metronidazole , GiardiaSubject(s)
Cross Infection/diagnosis , Sepsis/diagnosis , Adolescent , Child , Child, Preschool , Cross Infection/etiology , Cross Infection/mortality , Female , Humans , Infant , Infant, Newborn , Male , Sepsis/etiology , Sepsis/mortalityABSTRACT
En este trabajo se hace hincapie en la importancia de las infecciones intrahospitalarias y se hacen consideraciones sobre los factores que influyen en las genesis de las septicemias. Se analizan 20 casos de septicemia de adquisicion intrahospitalaria tratando de correlacionar diferentes factores intrinsecos y extrinsecos del huesped con la causa de la septicemia se inicio despues de las 72 horas de estancia hospitalaria. Predominaron los germenes gramnegativos, en especial Klebsiella y Pseudomonas. La causa mas comun de ingresso fue la gastroenteritis y la existencia de desnutricion proteinocalorica avanzada.Predomino en los primeros meses de la vida. Todos estuvieron sometidos a diversas maniobras medicoquirurgicas, entre ellas laparotomias, venodisecciones, dialisis peritoneal y drogas inmunodepresoras. La letalidad en este estudio fue de 75%. Se encontro que la frecuencia de septicemias nosocomiales en el Hospital de Pediatria del Centro Medico Nacional del IMSS varia entre el 12.7% y el 14.0% de las infecciones intrahospitalarias
Subject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Humans , Male , Female , Cross Infection , Sepsis , Klebsiella , PseudomonasABSTRACT
This paper refers to the presence of atypical bacterial forms in the blood culture of 40 children who evolved with septicemia. Bacterial growth appeared in 18 (45%) patients in ordinary cultures. With hypertonic culture media 26 (65%) patients showed positive results. In 13 cases the reverted bacteria coincided with those isolated in ordinary culture media. In 12 patients (30%) whose cultures in normal media were negative, abnormal atypical bacterial forms were identified. Gram-negative bacteria predominated and Staphylococcus epidermidis was observed to develop with a certain frequency.
Subject(s)
L Forms/isolation & purification , Sepsis/microbiology , Child , Child, Preschool , Culture Media , Female , Humans , Infant , Infant, Newborn , Klebsiella/isolation & purification , Klebsiella Infections/microbiology , Male , Staphylococcal Infections/microbiology , Staphylococcus/isolation & purificationABSTRACT
The literature on serum lysozyme was reviewed and the normal values for this enzyme were analyzed in 40 healthy children (control group) and 40 children with a clinical diagnosis of septicemia. The patients were 1 to 18 months old and were hospitalized in the H.P. of the C.M.N., I.M.S.S. In 12 of these, the blood cultures developed bacteria, while 26 were negative. It was found that the normal values varied in healthy children from 5 to 24 microgram/ml. In the group of infected patients, the values varied from 4.4 to 53.3 microgram/ml. The group of healthy patients (control) was compared with the infected patients and a significantly difference was found (p less than 0.05), although in some infected children the readings for lysozyme were normal. In all patients, lysozyme returned to normal when the infection cleared. The mortality rate in this study was 15 per cent. It is concluded that in patients with severe infection, the levels of lysozyme in the serum may the elevated, while in patients with clinical signs of septicemia with positive blood cultures, there is a rise in lysozyme.
Subject(s)
Infant, Newborn, Diseases/enzymology , Muramidase/blood , Sepsis/enzymology , Bacteria/isolation & purification , Female , Humans , Infant , Infant, Newborn , Male , Sepsis/microbiologyABSTRACT
Considerations are made on diarrhea secondary to intestinal malabsorption of carbohydrates and on the diagnostic means available in our environment, among which are the reactive strip, the clinitest tablet, tolerance curves and research of intestinal enzymes. The quantification of exhaled hydrogen is mentioned as a diagnostic method, used by several other authors, and a review of the literature on the subject is made. Considerations are made on a hydrogen quantification in the breath of patients with a transitory lactose intolerance. 16 patients were studied, 15 of whom showed an increase in the exhaled H2. 32 children with diarrhea, free from lactose intolerance, were studied. The method used did not show a significant increase in the exhaled hydrogen. 27 patients showed no H2 in their breath. In 4 there was elimination of H2 (false positives). 17 diarrhea-free children were studied. A significant difference was found when comparing the children with diarrhea and lactose intolerance to the other two groups who were free from lactose-intolerance. It is considered that this method can be useful in the diagnosis of intolerance to lactose and other sugars.
Subject(s)
Hydrogen , Lactose Intolerance/diagnosis , Respiration , Chromatography, Gas/instrumentation , Diagnosis, Differential , False Positive Reactions , Female , Gastroenteritis/diagnosis , Humans , Infant , Infant, Newborn , MaleABSTRACT
Se estudiaron 40 ninos que cursaban con septicemia y se investigo la presencia de formas bacterianas atipicas en el hemolcultivo. Se observo crecimiento bacteriano en hemocultivo ordinario en 18 (45%) pacientes. Cuando se utilizo medio hipertonico, se logro el aislamiento de formas bacterianas atipicas en 26 (65%) casos. En 13 la bacteria revertida coincidio con la aislada en hemocultivo del medio ordinario. En 12 pacientes (30%) en los que el hemocultivo en medio normal fue negativo, se logro identificar formas bacterianas atipicas. Predonimaron las bacterias gramnegativas y se obervo con alguma frecuencia desarrollo de Staphylococcus epidermidis