[Pediatric surgery 2.0]. / Cirugía pediátrica 2.0.

New tools from the web are a complete breakthrough in management of information. The aim of this paper is to present different resources in a friendly way, with apps and examples in the different phases of the knowledge management for the paediatric surgeon: search, filter, reception, classification, sharing, collaborative work and publication. We are assisting to a real revolution on how to manage knowledge and information. The main charateristics are: immediateness, social component, growing interaction, and easiness. Every physician has clinical questions and the Internet gives us more and more resources to make searchs easier. Along with them we need electronic resources to filter information of quality and to make easier transfer of knowledge to clinical practice. Cloud computing is on continuous development and makes possible sharing information with differents users and computers. The main feature of the apps from the Intenet is the social component, that makes possible interaction, sharing and collaborative work.

Cirugía pediátrica 2.0 / Pediatric surgery 2.0

Las nuevas herramientas que ofrece la web suponen una auténtica revolución en la forma de gestionar la información. El objetivo de este artículo es presentar los diferentes recursos de forma sencilla, proponiendo aplicaciones y ejemplificando con casos concretos su uso en las diferentes etapas de la gestión de la información para el profesional de la cirugía pediátrica: búsqueda, filtro, recepción, clasificación y almacenamiento, compartir, trabajo colaborativo y publicación. Hemos llegado a una auténtica revolución en la forma de gestionar la información y el conocimiento. Las principales características son: inmediatez, componente social, posibilidad creciente de interacción web-usuario, gratuidad y sencillez de manejo. Cualquier médico presenta dudas clínicas con frecuencia. Internet ofrece cada vez más recursos que facilitan las búsquedas. Junto a los buscadores, son necesarios recursos electrónicos que ayuden a fi ltrar información de calidad y faciliten la traslación del conocimiento a la práctica. El almacenamiento de la información en "la nube" está en continuo desarrollo y mejora la posibilidad de compartir información entre diferentes ordenadores y usuarios. Una característica nuclear de las diferentes aplicaciones que ofrecen los nuevos recursos de Internet es el componente social, que permite interactuar, compartir y trabajar de forma colaborativa (AU)

New tools from the web are a complete breakthrough in management of information. The aim of this paper is to present different resources in a friendly way, with apps and examples in the different phases of the knowledge management for the paediatric surgeon: search, fi ter, reception, classification, sharing, collaborative work and publication.We are assisting to a real revolution on how to manage knowledge and information. The main charateristics are: immediateness, social component, growing interaction, and easiness. Every physician has clinical questions and the Internet gives us more and more resources to make searchs easier. Along with them we need electronic resources to filter information of quality and to make easier transfer of knowledge to clinical practice. Cloud computing is on continuous development and makes possible sharing information with differents users and computers. The main feature of the apps from the Intenet is the social component, that makes possible interaction, sharing and collaborative work (AU)

[Cystic adenomatoid malformation pulmonary: are we able to foresee its evolution?]. / Malformación adenomatoidea quística: somos capaces de prever su evolución?

The congenital pulmonary malformation are a rare entity in pediatric age. Between of them, the cystic adenomatoid malformation (MAQ) is the most ferquent entity, followed by pulmonary sequestration (SP) and the most rare broncogenic cyst. As a consequence of ultrasound and fetal magnetic resonance we are abble to diagnose earlier this patology. To know the clinical findings, the diagnosis, and the evolution, we have done a retrospective study of underwented MAQ at our hospital during the last 17 years, including such with late diagnosis as with prenatal diagnosis, and describing those presenting impredictable evolution or a different difficul diagnosis. We report four MAQ's cases. Three of them, about late diagnose: the first one evolutioned till malignant tumor, the second one with a supplementary lobe and third one with a wrong MAQ diagnose. The fourth one associated MAQ with a SP.

[Retrospective evaluation of carcinoid tumors of the appendix in children]. / Estudio retrospectivo del tumor carcinoide apendicular en niños.

Carcinoids of the appendix are rare in children. Usually diagnosed incidentally on histologic investigation following appendectomy for acute apendicitis. To investigate the significance of the diagnosis of appendiceal carcinoid tumors in children, we conducted a retrospective study in our institution. Between 1990 and 2007 a total of 1158 appendectomy were done. In four patients the diagnosis was appendiceal carcinoid. We studied treatment, follow-up and prognosis of this patients. Indicacion for appendectomy was acute pain in lower right quadrant. The median tumor diameter was lower than 1 cm and the appropriate treatment was appendectomy. The prognosis was excellent in all the patients.

Malformación adenomatoidea quística: ¿somos capaces de prever su evolución? / Cystic adenomatoid malformation pulmonary: Are we abble to foresee its evolution?

Las malformaciones congénitas pulmonares son una entidad rara en pediatría. Entre ellas, la malformación adenomatoidea quística(MAQP) es la entidad más frecuente, seguida del secuestro pulmonar(SP) y más raro del quiste broncogénico. Debido a la ecografía de alta definición y a la resonancia magnética fetal, somos capaces de diagnósticar estas entidades de forma más precoz. Para conocer la clínica, el diagnóstico y la evolución hemos realizado un estudio retrospectivo de las MAQ intervenidas en nuestro Centro durante 17 años tanto de diagnóstico tardío como prenatal, describiendo los que presentaron una evolución no previsible o un dificil diagnóstico diferencial. Presentamos cuatro casos de MAQ. Tres de ellos de diagnóstico tardío: el primero con evolución a tumor maligno, el segundo con un SP accesorio extralobar y el tercero con diagnóstico erróneo de MAQ. El cuarto caso asoció la MAQ con un SP (AU)

The congenital pulmonary malformation are a rare entity in pediatric age. Between of them, the cystic adenomatoid malformation (MAQ)is the most ferquent entity, followed by pulmonary sequestration (SP)and the most rare broncogenic cyst. As a consequence of ultrasound and fetal magnetic resonance we are abble to diagnose earlier this patology. To know the clinical findings, the diagnosis, and the evolution, we have done a retrospective study of underwented MAQ at our hospital during the last 17 years, including such with late diagnosis as with prenatla diagnosis, and describing those presenting impredictable evolution or a different difficult diagnosis. We report four MAQ’s cases. Three of them, about late diagnose: the first one evolutioned till malignant tumor, the second one with a suplementary lobe and third one with a wrong MAQ diagnose. The fourth one associated MAQ with a SP(AU)

Estudio retrospectivo del tumor carcinoide apendicular en niños / Retrospective evaluation of carcinoid tumors of the appendix in children

Los tumores carcinoides del apéndice son raros en la infancia. Habitualmente se diagnostican al realizar el estudio histológico del apéndice extirpado por un cuadro de apendicitis aguda. Para analizar la trascendencia clínica se ha realizado un estudio retrospectivo de niños diagnosticados de tumor carcinoide histológicamente confirmado tras realizar una apendicectomía. Entre 1990 y 2007se han realizado 1.158 apendicectomías con un total de 4 pacientes diagnosticados de carcinoide apendicular. Hemos estudiado el tratamiento, seguimiento y pronóstico de estos pacientes. La indicación de apendicectomía fue por dolor en el cuadrante inferior derecho del abdomen. La medida del tumor en todos ellos fue inferior a 1cm y el tratamiento definitivo fue la apendicectomía. El pronóstico ha sido excelente en todos los casos (AU)

Carcinoids of the appendix are rare in children. Usually diagnosed incidentally on histologic investigation following appendicectomy for acute apendicitis. To investigate the significance of the diagnosis of appendiceal carcinoid tumors in children, we conducted a retrospective study in our institution. Between 1990 and 2007 a total of 1158 apendicectomy were done. In four patients the diagnosis was appendiceal carcinoid. We studied treatment, follow-up and prognosis of this patients. Indicacion for appendicectomy was acute pain in lower right quadrant. The median tumordiameter was lower than 1cm and the appropiate tractament was appendicectomy. The prognosis was excellent in all the pacients (AU)

[Boix Ochoa's antireflux procedure returns patients to normalcy: 24 hour esophageal pH monitoring of 21 cases]. / La plastia de Boix Ochoa reconvierte al enfermo a la normalidad. Estudio pHmétrico de 21 casos.

A great controversy exist concerning the surgical management of gastroesophageal reflux (GER). It is well known that Nissen procedure produces a hypercorrection of the gastroesophageal competency and often a "gas bloat syndrome". On the other hand, the Boix Ochoa's technique is more physiological but corrects GER allowing the persistence of a "radiological" reflux. The aim of the study was to demonstrate the accuracy of this procedure. 287 pediatric patients were studied because of GER and abnormal barium upper gastrointestinal series. 24 hours esophageal pH monitoring was performed in all this patients and in 21 the results were clearly pathological. They were operated on and six months later were new evaluated with upper GI series and continuous 24 hours esophageal pH monitoring. The results were compared with those previous to operation and also with a control group. Statistical great significance was found between presurgical and postsurgical data, what determine the efficacy of the procedure. No statistical significance was found between postsurgical data and the control group, what means that Boix Ochoa's procedure resolve GER without hipercorrection.

[Postoperative pain in children: its assessment and treatment. Introduction]. / Dolor postoperatorio en el niño: valoración y tratamiento. Introducción.

An explication of the phylogeny of pain and its consequences, the difficulties involved in its measurement and the need to eliminate, reduce or control it, but always considering that it is usually an indication of an organic malfunction. There is also a discussion of the importance of pain on the mind and the effect of the mind on the perception of pain.

[Septic arthritis in children]. / La artritis séptica en el niño.

A review was made of 15 cases of septic arthritis in children. 13 of these cases corresponded to purulent arthritis, one to tuberculous arthritis and one to brucellar arthritis. All of them received diagnostic punction. Five joints received arthrotomy, by a washed-aspiration system. The antibiotic treatment was given approximately during for six weeks. We had two complications, die to a delayed diagnosis: one coxa valga and one capital femoral necrosis. It is important the insist on a early diagnosis and decompressive arthrotomy, specially in those cases in which the hip is the joint affected.

[Rib actynomycosis]. / Actinomicosis costal.

A unusual case of rib actynomycosis, observed several months after surgery for acute appendicitis in a 11 year boy is reported. Surgical excision of the affected segment of rib had to be implemented with lyncomycin in order to obtain the cure. Laboratory data are consistent with the above mentioned diagnosis.

[Neonatal functional intestinal obstruction of unknown etiology (author's transl)]. / Ileo funcional del recién nacido de etiología desconocida.

Three cases of newborn intestinal obstruction without obvious organic cause are reported. Narrow left colon (Davis's syndrome), small colon, megacystis and intestinal hypoperistaltism (Berdon's syndrome) and segmental bowel dilatation (Swenson's syndrome) were the diagnoses. Through a review of the literature a possible interrelationship among these three clinical entities at the level of an abnormal myenteric plexus neuronal function is discussed.