[Severe primary congenital unilateral hydronephrosis. A review of 98 cases]. / Hidronefrosis congénita primaria unilateral grave en lactantes asintomáticos. Revisión de 98 casos.

INTRODUCTION: Currently, consensus is lacking on the indications for surgery in primary congenital unilateral hydronephrosis. OBJECTIVES: To analyze the clinical characteristics, treatment and outcome of severe asymptomatic primary congenital unilateral hydronephrosis (grades 3 and 4). PATIENTS AND METHODS: We performed a retrospective study of 98 neonates with severe primary congenital unilateral hydronephrosis. Diagnostic techniques consisted of ultrasound, renogram, and DMSA scan. RESULTS: The mean age at diagnosis was 24 days. The mean length of follow-up was 4 years. Forty-eight percent of cases were grade 3 and the remaining cases were grade 4. Fifty-six percent of the patients received conservative treatment. Forty-four percent underwent surgery. Surgical indications consisted of prolonged T1/2, reduced differential renal function and/or very severe hydronephrosis. The mean age at surgery was 5.5 months. In 94 % of the patients who received conservative treatment, hydronephrosis resolved spontaneously. In this group, renal parenchyma and renal function were normal in all patients except two. In 97 % of the patients who received surgical treatment, hydronephrosis was corrected or improved after pyeloplasty. At diagnosis, 19 kidneys had reduced function. In the postsurgical renogram, although T1/2 had markedly improved, 8 kidneys showed reduced function. DMSA performed in 63 patients belonging to both groups, outside the active phase of hydronephrosis, revealed 8 atrophic kidneys, 4 with moderately reduced renal size and function and 4 with scarring and normal renal size and function. During the study period, overall function was maintained in all patients and none developed hypertension. CONCLUSIONS: Severe congenital unilateral hydronephrosis resolves spontaneously in most patients. Consequently, clinicians increasingly adopt a conservative approach. The available diagnostic techniques cannot identify patients who will benefit from pyeloplasty. In general, accepted surgical indications are an increase in hydronephrosis and/or worsening of renal function. In our series, 15 % of the patients with hydronephrosis had an irreversible lesion of variable severity, which in some patients seemed to have developed during embryogenesis. Kidneys at risk of presenting a lesion were those that had grade 4 hydronephrosis.

Hidronefrosis congénita primaria unilateral grave en lactantes asintomáticos. Revisión de 98 casos / Severe primary congenital unilateral hydronephrosis. A review of 98 cases

Introducción Actualmente no existe consenso sobre las indicaciones de la intervención quirúrgica en la hidronefrosis congénita primaria unilateral. Objetivos Analizar las características clínicas, el tratamiento y la evolución de la hidronefrosis congénita primaria unilateral grave (grados 3 y 4) asintomática. Pacientes y métodos Estudio retrospectivo de 98 lactantes con dicha patología. Como técnicas diagnósticas se utilizaron la ecografía, el renograma y el 99mTc-ácido dimercaptosuccínico (DMSA). Resultados La edad media al diagnóstico es de 24 días y el tiempo medio de seguimiento, de 4 años. El 48 % eran hidronefrosis grado 3 y el resto grado 4. El 56 % recibieron tratamiento conservador. El 44 % fueron intervenidos. Las indicaciones quirúrgicas fueron: tiempo medio alargado, función renal diferencial disminuida y/o hidronefrosis muy grave. La edad media de intervención fue de 5,5 meses. El 94 % de los casos tratados de manera conservadora se resolvieron espontáneamente. En este grupo el parénquima y la función renales fueron normales en todos los casos menos en dos. En el 97 % de los tratados quirúrgicamente, la hidronefrosis se corrigió o mejoró tras la pieloplastia. Al diagnóstico, 19 riñones tenían una función disminuida. En el renograma postintervención, aunque el tiempo medio había mejorado llamativamente, había todavía 8 riñones con función disminuida. En un DMSA realizado en 63 pacientes pertenecientes a ambos grupos, fuera de la fase activa de la hidronefrosis, se detectó: 8 riñones atróficos, cuatro con tamaño y función renal disminuida de forma moderada y cuatro con cicatrices pero con tamaño y función normales. Durante el tiempo que duró el estudio todos los pacientes mantuvieron la función global y ninguno desarrolló hipertensión arterial. Conclusiones La hidronefrosis congénita unilateral grave es un proceso que cede espontáneamente en la mayoría de los casos, por lo que cada día son más los clínicos que adoptan una actitud conservadora en estos pacientes. Las técnicas diagnósticas disponibles no permiten predecir quiénes son los que se van a beneficiar de una pieloplastia. En general se acepta como indicaciones quirúrgicas el aumento de la hidronefrosis y/o el deterioro de la función renal. En nuestra serie el 16 % de las hidronefrosis tenían una lesión irreversible de mayor o menor intensidad que en algunos pacientes parecía haberse originado durante la embriogénesis. Las unidades renales en riesgo de presentar lesión renal son las que tienen una hidronefrosis de grado 4

Introduction Currently, consensus is lacking on the indications for surgery in primary congenital unilateral hydronephrosis. Objectives To analyze the clinical characteristics, treatment and outcome of severe asymptomatic primary congenital unilateral hydronephrosis (grades 3 and 4). Patients and methods We performed a retrospective study of 98 neonates with severe primary congenital unilateral hydronephrosis. Diagnostic techniques consisted of ultrasound, renogram, and DMSA scan. Results The mean age at diagnosis was 24 days. The mean length of follow-up was 4 years. Forty-eight percent of cases were grade 3 and the remaining cases were grade 4. Fifty-six percent of the patients received conservative treatment. Forty-four percent underwent surgery. Surgical indications consisted of prolonged T1/2, reduced differential renal function and/or very severe hydronephrosis. The mean age at surgery was 5.5 months. In 94 % of the patients who received conservative treatment, hydronephrosis resolved spontaneously. In this group, renal parenchyma and renal function were normal in all patients except two. In 97 % of the patients who received surgical treatment, hydronephrosis was corrected or improved after pyeloplasty. At diagnosis, 19 kidneys had reduced function. In the postsurgical renogram, although T1/2 had markedly improved, 8 kidneys showed reduced function. DMSA performed in 63 patients belonging to both groups, outside the active phase of hydronephrosis, revealed 8 atrophic kidneys, 4 with moderately reduced renal size and function and 4 with scarring and normal renal size and function. During the study period, overall function was maintained in all patients and none developed hypertension. Conclusions Severe congenital unilateral hydronephrosis resolves spontaneously in most patients. Consequently, clinicians increasingly adopt a conservative approach. The available diagnostic techniques cannot identify patients who will benefit from pyeloplasty. In general, accepted surgical indications are an increase in hydronephrosis and/or worsening of renal function. In our series, 15 % of the patients with hydronephrosis had an irreversible lesion of variable severity, which in some patients seemed to have developed during embryogenesis. Kidneys at risk of presenting a lesion were those that had grade 4 hydronephrosis

Estenosis hipertrófica de píloro en gemelos / Hypertrophic pyloric stenosis in twins

No disponible

Angiomiolipoma renal: un caso de difícil diagnóstico / Renal angiomyolipoma: a case with a difficult diagnosis

No disponible

Análisis de la repercusión de a través del Science Citation Index durante el período 1997-2001 / Analysis of the impact of Anales Españoles de Pediatría through the science citation index from 1997-2000

Objetivos: Describir el factor de impacto de ANALES ESPAÑOLES DE PEDIATRÍA desde el año 1997 hasta el 2001 e identificar los patrones de citación de la revista y las áreas temáticas de mayor repercusión. Métodos: Se recopilaron las citas recibidas en los artículos publicados en ANALES ESPAÑOLES DE PEDIATRÍA entre 1995 y 2000 mediante una búsqueda en SCISEARCH. De cada artículo fuente se recogieron las siguientes variables: año de publicación, autores, revista, país de publicación, idioma, especialidad/es, institución/es, residencia del primer firmante y área temática. El factor de impacto se calculó como el cociente entre las citas recibidas en 1 año por los artículos publicados en ANALES ESPAÑOLES DE PEDIATRÍA los 2 años anteriores entre el total de artículos publicados por ANALES ESPAÑOLES DE PEDIATRÍA en esos 2 años. Resultados: El factor de impacto de ANALES ESPAÑOLES DE PEDIATRÍA fue 0,052 en 1997, 0,080 en 1998, 0,101 en 1999, 0,089 en 2000 y 0,064 en 2001. Se aprecia un patrón de citaciones caracterizado por la dispersión de las revistas fuente, con una mayor proporción de las revistas nacionales de especialidades médicas (35,6%). El 62,8% de las citas recibidas procedían de autores españoles, aunque el índice de autocitación fue moderado (14,3%). Destaca una hegemonía de las áreas temáticas de neurología (16,9% de las citas recibidas), enfermedades infecciosas (16,2%) y neonatología (14,8%). Conclusión: ANALES ESPAÑOLES DE PEDIATRÍA posee un factor de impacto discreto, aunque superior al de otras publicaciones biomédicas incluidas en el Journal Citation Reports (AU)

[Analysis of the impact of Anales Españoles de Pediatría through the Science Citation Index from 1997-2000]. / Análisis de la repercusión de Anales Españoles de Pediatría a través del Science Citation Index durante el período 1997-2001.

OBJECTIVES: To quantify the impact factor of Anales Españoles de Pediatría from 1997 until 2000 and to identify the journal's citation patterns and the topics with the greatest impact. METHODS: SCISEARCH was used to locate citations of articles published in Anales Españoles de Pediatría between 1995 and 1999. The following data were collected for each article: year of publication, authors, journal, country of publication, language, specialty or specialties, institution(s), residence of the first author and topic. The impact factor was calculated as the ratio between citations received over 1 year by articles published in Anales Españoles de Pediatría in the two previous years and the total number of articles published by Anales Españoles de Pediatría over the 2 years under study. RESULTS: The impact factor of Anales Españoles de Pediatría was 0.052 in 1997, 0.080 in 1998, 0.101 in 1999, 0.089 in 2000 and 0.064 in 2001. Citations were found in a wide range of source journals. The greatest proportion (35.6 %) were found in Spanish medical journals. Citations were made mainly by Spanish authors (62.8 %) and self-citation was moderate (14.3 %). Topics related to neurology (16.9 % of the citations received), infectious diseases (16.2 %) and neonatology (14.8 %) had the greatest impact. CONCLUSION: The impact factor of Anales Españoles de Pediatria is modest, although higher than that of some other biomedical publications included in Journal Citation Reports.