ABSTRACT
In Pediatric Hospital, from the National Medical Center, of the Mexican Institute of Social Security were analyzed 96 histological pieces: 59 biopsies, 21 surgical material and 16 slides. There were showed the agreement rate between clinical diagnosis and the end histopathological report from the Pathology Department. The higher correlation rate were with biopsies (83%) and surgical material (81%) and the lowest rate were with slides samples (69%). There were not statistical difference in the 3 study groups (P greater than 0.05). The overall concordance with the clinical diagnosis were 82%. The overall concordance with the 3 study groups were 80%. It is concluded what agreement rate was satisfactory in biopsies and surgical material and the agreement rate measure is an actual parameter in evaluation of clinical competence and also in the evaluation of medical care quality.
Subject(s)
Diagnosis , Hospitals, Pediatric/standards , Quality of Health Care , Biopsy/standards , Biopsy/statistics & numerical data , Child , Diagnostic Errors , Diagnostic Techniques, Surgical/standards , Diagnostic Techniques, Surgical/statistics & numerical data , Evaluation Studies as Topic , Hospitals, Pediatric/statistics & numerical data , Humans , Mexico , Quality of Health Care/statistics & numerical data , Sensitivity and SpecificityABSTRACT
En un grupo de 41 pacientes estudiados con diagnostico de megacolon congenito, se encontro una relacion de 2:1 para el sexo masculino; el diagnostico se establecio de acuerdo a los datos clinicos, manometricos radiologicos y, en forma definitiva, de acuerdo a los hallazgos histologicos. En 24 pacientes se realizo la tecnica de Duhamel-Grob, con resultados satisfatorios en 22 y regular en 2. Las complicaciones mas frecuentes fueron estenosis de la anastomosis y absceso de la herida abdominal. La mortalidad global fue del 29%; estos pacientes fallecieron por septicemia antes de poder realizar el tratamiento quirurgico. De acuerdo a los resultados obtenidos, la tecnica de Duhamel-Grob para el tratamiento de la enfermedad de Hirschsprung es una de las mas adecuadas
Subject(s)
Infant, Newborn , Infant , Humans , Male , Female , Megacolon , Surgical Procedures, Operative , ColostomyABSTRACT
Intrathoracic tumors in pediatric ages are unfrequent. A review of 138 cases in patients under 15 years of age showed in the first place, the same as in adults, malignant neoplasms represented by pulmonary metastases. However, in those of primary localization, the histologically benign are more frequent. Out of 69 cases, such tumors came up to 78.2% and 47% of them were cystic malformations. Among malignant primary neoplasms, out of 30.4%, neuroblastoma showed 8.6%, diverse sarcomas were 8.6% and the epithelial type added up to 4.3%. The main symptoms were: frequent bronchopulmonary infections, obstructive respiratory insufficiency and vascular stasis. Radiological examinations are of great diagnostic aid, but a full clinical evaluation is always necessary. A surgical treatment removing the mass leads to radical recovery leaving limited sequelae. The comparative group of 69 cases with pulmonary metastases showed that neoplasms considered of embryonal type are practically always multiple and appear during the final stage of the disease. Surgery may be attempted when they are single and the primary has been removed; however, chemotherapy and radiotherapy are always necessary.
Subject(s)
Thoracic Neoplasms/epidemiology , Adenoma/epidemiology , Child , Child, Preschool , Diagnosis, Differential , Female , Fibroma/epidemiology , Hemangioma/epidemiology , Humans , Infant , Lung/pathology , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Lung Neoplasms/surgery , Male , Mexico , Neoplasm Metastasis , Neoplasms, Germ Cell and Embryonal/diagnosis , Neoplasms, Germ Cell and Embryonal/surgery , Neuroblastoma/epidemiology , Sarcoma/epidemiology , Teratoma/epidemiology , Thoracic Neoplasms/diagnosisABSTRACT
Forty newborns bearing several gastrointestinal conditions (congenital malformations, intestinal bypass, postinflammatory obstruction, malabsorption and enteritis) were treated with long-term integral parenteral nutrition. A solution made up of synthetic aminoacids, emulsion of lipids, glucose, electrolytes, vitamins, plasma and whole blood was perfused through a catheter introduced into central or peripheral veins. Temporal glucosuria and anemia were observed in some cases. In all but three cases urinary alpha amino nitrogen was normal. In some infected patients leucocytosis or leucopenia was found. After treatment, all patients showed adequate nutritional conditions, manifested by increase in body weight and healing of damaged tissues.
