[Gastroesophageal reflux in pediatric neurologic patients]. / Reflujo gastroesofágico en pacientes neurológicos pediátricos.

With the aim of evaluating the incidence of gastroesophageal reflux (GER) in neurologic pediatric patients with severe motor and/or psychiatric involvement, a retrospective study of 140 infants followed at the Neuropediatric Unit was realized. Forty-five patients (32.1%) had moderate to severe mental retardation (ms RR), 21 of these patients had associated tetraparetic cerebral palsy (T-CP). The rest of the infants presented variable degrees of neurologic involvement: 25 diplegic (D-CP), 27 hemiparetic (H-CP), 22 with slight mental retardation or borderline IQ without motor deficit (SMR), and 21 had attention deficit disorder with hyperactivity (ADD-H). The diagnosis of GER was based on clinical symptomatology and barium ingestion with fluoroscopy and/or esophagoscopy. GER was confirmed in 27 patients: 19 (90.5%) with T-CP, 6 (25%) with ms-MR and 2 (8%) with D-CP. The rest of the infants did not have GER. There was a very significant difference in the frequency of GER in the T-CP group with respect to the other groups (p < 0.001) and a significant difference in the ms-MR patients with respect to the other groups (p < 0.05). The treatment of GER was surgical in ten patients (37%), after failure of medical treatment in 8; exclusively medical treatment in 10 cases (37%) and postural and dietetic treatment in 7 (26%) patients. Good control of GER, resulting in an improvement in the quality of life, occurred in 90% of the patients treated surgically and only in 55% of the patients treated medically.(ABSTRACT TRUNCATED AT 250 WORDS)

[Central venous access in pediatric patients. A 6-year experience]. / Sistemas de acceso venoso central (SAVC) en pacientes pediátricos. Experiencia de seis años.

The need for an access to the venous system, in order to infuse chemotherapeutic treatments or parenteral nutrition, has increased the number of central venous access systems (CVAS) implanted in the past years. Between February 1985 and December 1990, 87 devices were implanted in 76 patients (from 11 months to 15 years of age), with a median function time of 349 days (range: 7 to 1887 days). The overall incidence of complications was 0.10 per 10 days of catheterization, with complication rates for infection and thrombosis of 0.02 and 0.03, respectively. Nineteen systems were removed because of complications and 11 because of completion of the treatment. Of the cases, 97.7% included a follow-up period. The present study confirms the advantages of these devices, with a long working life and a low complication rate, being a good alternative for chronically ill children requiring long-term and/or cyclic intravenous therapy.

[The role of leukotrienes and other eicosanoids in the response to an allograft. New perspectives on the control of rejection]. / Papel de los leucotrienos y otros eicosanoides en la respuesta al aloinjerto. Nuevas perspectivas en el control del rechazo.

The role of eicosanoids in the development of immune response may be important to the viability of the implanted organ, given their complicated interaction with lymphokines and monokines which regulate the response. Due to this reason, more experiments in vivo are necessary to provide a better understanding of the behaviour of these compounds. This would help to clearly determine the role of these substances in the immune response--more exactly, in the allogenic transplant rejection--creating new ways for its control.

[Carcinoid tumors. Carcinoid syndrome. Clinicopathologic and therapeutic aspects]. / Tumores carcinoides. Síndrome carcinoide. Aspectos clínico-patológicos y terapéuticos.

A review of the current state of carcinoid tumors is presented, with special attention to the diagnostic, pronostic and new therapeutic aspects. In spite of being a well known entity the diagnosis is difficult being confirmed only by pathologic findings. The current medical therapy and surgical options are described. New surgical alternatives--organ cluster transplantation--seems to be the definitive solution in metastatic disease.

[Technical update on subcutaneous implantable pumps for the treatment of liver metastasis]. / Actualizaciones técnicas en la implantación de cápsulas subcutáneas para tratamiento de las metástasis hepáticas.

The technique of implantation of catheters and pumps in the hepatic artery as well as its complications is analysed in 46 patients considered to have indications for this therapeutic mode. The principal use of the catheter is for regional chemotherapy.

[The use of subcutaneous cannules as a method of central venous access in pediatrics]. / La utilización de reservorios subcutáneos como método de acceso venoso central en pediatría.

We presents a series of 42 children, in whom subcutaneous ports were implanted for a prolonged venous access. Are described the technical aspects of implantation and maintenance are its usefulness in hospital practice, and apparent complications during its use thus presented in an attempt to prevent their occurrence.