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Cir Pediatr ; 30(2): 83-88, 2017 Apr 20.
Artigo em Espanhol | MEDLINE | ID: mdl-28857530


INTRODUCTION: Dynamic compression system is the elective treatment for chondrogladiolar pectus carinatum. Nevertheless, its high cost poses a problem for its prescription in places where it is not subsidized. This article analyzes the experience of the Paediatric Plastic Surgery Service at a third grade hospital in the treatment of this deformity with a static compression system. MATERIALS AND METHODS: The study presents a descriptive, retrospective analysis of 30 patients with pectus carinatum treated with a static compression system. Furthermore, we describe the protocol of treatment used at our unit, and we analyse the satisfaction with bracing therapy, and its relation to therapeutic compliance. RESULTS: The study includes 28 boys and 2 girls. 93% of the patients presented a chondrogladiolar pectus carinatum. At the moment of finishing the study, 11 patients have completed the treatment, 14 still bracing, and 5 were lost in the follow-up. Satisfaction questionnaires were answered by 19 patients. CONCLUSION: Bracing therapy with static compression system is the treatment of choice for chondrogladiolar pectus carinatum in our unit, because of its effectiveness and lower price. Quality of life questionnaires show better marks in patients that are in the second phase of treatment.

Braquetes , Tratamento Conservador/métodos , Pectus Carinatum/terapia , Qualidade de Vida , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Cooperação do Paciente , Satisfação do Paciente , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento , Adulto Jovem
J Neuroeng Rehabil ; 13(1): 79, 2016 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-27590188


BACKGROUND: Hemineglect is frequent after right hemisphere stroke and prevents functional independence, but effective rehabilitation interventions are lacking. Our objective was to determine if a visual-acoustic alarm in the hemineglect arm activated by a certain discrepancy in movement of both hands can enhance neglect arm use in five tasks of daily living. METHODS: In this pre-post intervention study 9 stroke patients with residual hemineglect of the arm were trained for 7 days in five bimanual tasks of daily living: carrying a tray, button fastening, cutting food with knife and fork, washing the face with both hands and arm sway while walking. This was done through motion sensors mounted in bracelets on both wrists that compared movement between them. When the neglect-hand movement was less than a limit established by two fuzzy logic based classifiers, a visual-acoustic alarm in the neglect-hand bracelet was activated to encourage its use in the task. RESULTS: Both motion and function of the neglect hand improved during the seven days of training when visual-acoustic alarms were active but a worsening to baseline values occurred on day 8 and day 30 when alarms where switched off. Improvement was limited to vision-dependent tasks. CONCLUSIONS: Neglect-hand improvement with this approach is limited to bimanual activities in which an object is manipulated under vision control, but no short or long term learning happens.

Reabilitação do Acidente Vascular Cerebral/instrumentação , Atividades Cotidianas , Idoso , Braço/fisiopatologia , Feminino , Mãos/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Movimento , Acidente Vascular Cerebral/fisiopatologia
Acta pediatr. esp ; 74(2): 45-49, feb. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-150592


Introducción: El objetivo de este estudio es analizar a los pacientes remitidos a cirugía para practicar una frenotomía en el periodo neonatal y revisar su correcta indicación, ya que en la actualidad no existe consenso en el diagnóstico y tratamiento de la anquiloglosia. Material y métodos: Se realizó un estudio retrospectivo de 136 pacientes con anquiloglosia derivados a la consulta de cirugía plástica pediátrica. Se recogieron datos sobre la remisión a la consulta, problemas de lactancia y experiencia anterior y posterior a la intervención. Resultados: Los principales motivos de consulta se relacionaron con problemas en la técnica de lactancia materna (69 pacientes [65,7%]). El dolor durante la toma era el síntoma más habitual, aunque 33 pacientes (31,4%) no presentaban síntomas. En la mayoría de los casos, la remisión a cirugía la realizó el pediatra de zona (85 pacientes [80%]). El tipo más frecuente de anquiloglosia en la muestra fue el tipo II. Sólo se detectó 1 caso de recidiva. La ansiedad debida a la separación durante la frenotomía fue la experiencia negativa más frecuente entre las madres. Discusión: La falta de indicaciones establecidas para la frenotomía, así como la relativa facilidad de la aplicación de la técnica en la edad neonatal y el auge de las campañas de lactancia materna, está derivando en un exceso de indicación quirúrgica como tratamiento de la anquiloglosia. Debe promoverse la creación de guías que definan unos criterios adecuados de tratamiento, así como favorecer la remisión a la consulta de lactancia como un paso previo a la cirugía (AU)

Introduction: The aim of this study is to analyze patients referred to frenotomy surgery during neonatal period and to review their correct indication, as nowadays there is no consensus on the diagnosis and treatment of ankyloglossia. Material and methods: A retrospective study of 136 patients with ankyloglossia referred to pediatric plastic surgery. Data collection was based on the consultation, breastfeeding problems and experiences before and after intervention. Results: The main reasons to attend consultation were related to breastfeeding technique (69 patients [65.7%]), and pain in between takes the more frequent symptom, nevertheless 33 patients (31.4%) had no symptoms. In most cases, referral to surgery was done by the pediatrician (85 patients [80%]). The most common type of ankyloglossia in the sample was type II. Only one case of recurrence was detected. Separation anxiety during frenotomy was the most frequent negative experience among mothers. Discussion: The lack of guidelines established for frenotomy and the relative ease of application of the technique in the neonatal age and the rise of breastfeeding campaigns, is leading to an excess of surgical indication as treatment of ankyloglossia. To create guidelines defining an appropriate criteria of treatment should be promoted, and to facilitate referrals to lactation consultation as a step prior to surgery (AU)

Humanos , Masculino , Feminino , Recém-Nascido , Freio Lingual/patologia , Aleitamento Materno/efeitos adversos , Freio Lingual/cirurgia , Aleitamento Materno/métodos , Freio Lingual/diagnóstico por imagem , Estudos Retrospectivos , Transtornos da Lactação/cirurgia , Ansiedade de Separação/complicações , Inquéritos Epidemiológicos/métodos
Ann R Coll Surg Engl ; 97(5): e70-2, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26264106


Brunner's gland hamartoma (BGH) is a rare benign tumour of the duodenum. We present a case of duodenal obstruction caused by a BGH, which required surgical resection after a failed attempt at endoscopic removal.

Glândulas Duodenais/patologia , Neoplasias Duodenais/patologia , Obstrução Duodenal/patologia , Hamartoma/patologia , Idoso , Glândulas Duodenais/cirurgia , Neoplasias Duodenais/cirurgia , Obstrução Duodenal/cirurgia , Feminino , Hamartoma/cirurgia , Humanos
Arch Inst Cardiol Mex ; 68(3): 218-23, 1998.
Artigo em Espanhol | MEDLINE | ID: mdl-9810343


The purpose of this study is to describe a single-center experience in primary coronary angioplasty in 304 consecutive patients with acute myocardial infarction. Sixty-seven percent were men and 33% women, the mean age was 69 years. The time from onset to treatment was 3.5 hours, 14% had previous bypass surgery and 23% prior myocardial infarction, 11% arrived in cardiogenic shock. Coronary angiography showed multivessel disease in 56% of patients, 73% had TIMI 0-1 flow. Successful PTCA occurred in 95% and in hospital mortality was 6.5%. Primary coronary angioplasty is a successful reperfusion method in acute myocardial infarction and it is associated with low mortality even in high risk groups. The rates of success and major complications in this series are similar to other publications.

Angioplastia Coronária com Balão , Infarto do Miocárdio/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/métodos , Angioplastia Coronária com Balão/estatística & dados numéricos , Angiografia Coronária , Feminino , Mortalidade Hospitalar , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/mortalidade , Estudos Prospectivos , Recidiva , Fatores de Tempo
Arch Inst Cardiol Mex ; 63(2): 111-6, 1993.
Artigo em Espanhol | MEDLINE | ID: mdl-8503710


Ventricular dysfunction is the most common cause of in-hospital death in patients with acute myocardial infarction. When cardiogenic shock is manifested the mortality is very high. Seven patients with cardiogenic shock complicating acute myocardial infarction were treated with emergency coronary angioplasty. Four patients required cardiopulmonary resuscitation (CPR), 2 intraaortic balloon pump support and one femoro-femoral bypass pump support during the coronary angioplasty. The angiography success rate was 86%. Two patients died, one in the catheterization laboratory and the other one 24 hours later. The hospital mortality was 29%. Of the patients who survived 4 are in functional class I and one in functional class II (NYHA). Coronary angioplasty therapy in patients with cardiogenic shock complicating acute myocardial infarction plays a decisive role in the reduction of mortality.

Angioplastia Coronária com Balão , Infarto do Miocárdio/terapia , Choque Cardiogênico/terapia , Idoso , Angioplastia Coronária com Balão/métodos , Angioplastia Coronária com Balão/estatística & dados numéricos , Emergências , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/mortalidade , Estudos Retrospectivos , Choque Cardiogênico/etiologia , Choque Cardiogênico/mortalidade , Fatores de Tempo
Arch Inst Cardiol Mex ; 61(4): 351-6, 1991.
Artigo em Espanhol | MEDLINE | ID: mdl-1835349


Percutaneous transluminal coronary and renal angioplasty (PTA and Renal PTA) were performed during the same procedure in five of 100 patients who underwent PTCA between August 1989 and June 1990. All patients were male, with systemic hypertension (HT) with angina grade I to IV. The median age was 62 years (range 53 to 74). Three patients had controlled HT with 2 to 4 drugs and 2 were uncontrolled even after multiple antihypertensive treatment. Two patients were diabetic and the serum creatinine levels were normal except in one patient (1.9 mg/dL). Lesions more than 70% obstruction of luminal diameter were approached. Multivessel PTCA was done in one patient, multi-lesion in 2 and single lesion in other two. A total of 11 lesions were dilated, 4 in LAD, 5 in Cx and 2 in RCA (type A = 2, type B = 9). Complete revascularization was achieved in all cases. Five renal lesions were approached, 4 in the proximal third and one on the middle third. In 2 patients the blood pressure (BP) fell within normal limits without medication. In other 2 there was an improvement and were easily controlled with just one drug. One patient had no improvement and required multiple therapy to control it. The only complication observed was in a diabetic with previous abnormal serum creatinine who developed non-oliguric renal failure and returned to basal creatinine level at the third day post PTCA. In selected cases PTCA and renal PTA can be safely performed during the same procedure, with the advantage of cost reduction.

Angioplastia Coronária com Balão , Angioplastia com Balão , Artéria Renal , Idoso , Angioplastia com Balão/efeitos adversos , Angioplastia com Balão/métodos , Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/métodos , Doença das Coronárias/epidemiologia , Doença das Coronárias/terapia , Seguimentos , Humanos , Hipertensão/epidemiologia , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Recidiva , Indução de Remissão , Obstrução da Artéria Renal/epidemiologia , Obstrução da Artéria Renal/terapia
Arch Inst Cardiol Mex ; 61(4): 331-7, 1991.
Artigo em Espanhol | MEDLINE | ID: mdl-1953209


A select group of 26, class IV unstable angina patients that had multiple lesions or multivessel disease were treated with percutaneous transluminal coronary angioplasty (PTCA). Complete revascularization was the endpoint in all patients. Seventy lesions were dilated (mean = 2.6 lesions per patient). In the tandem multi-lesion group (13 patients) 2.23 lesions per patient were approached (Range 2-3) and in the multivessel disease group (13 patients) a mean of 3.15 lesions per patient were attempted (Range 2-6). An overall success rate of 96% per patient (25/26 patients) and 95.7% primary success per lesion were achieved with no mortality. We report the results of a select group of unstable angina patients with multi-lesion or multivessel disease who underwent PTCA. A careful performance was associated with high primary success in the high risk group achieving clinical and angiographic improvement.

Angina Instável/terapia , Angioplastia Coronária com Balão , Doença Aguda , Angina Instável/diagnóstico , Angina Instável/epidemiologia , Angioplastia Coronária com Balão/instrumentação , Angioplastia Coronária com Balão/métodos , Angiografia Coronária , Eletrocardiografia , Feminino , Seguimentos , Heparina/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva