ABSTRACT
Se presenta un programa educativo para la promoción de la lactancia materna, en formato CD-ROM, para que pueda ser utilizado tanto por los profesionales de la salud, en sus labores educativas, como por los propios usuarios (mujer y/o pareja). El programa también incluye un cuestionario de conocimientos que posibilita el feedback y ofrece direcciones de asociaciones de autoayuda y páginas web de interés (AU)
Subject(s)
Female , Male , Humans , Breast Feeding , Health Education , Computer-Assisted Instruction , CD-ROMSubject(s)
Esophagogastric Junction/surgery , Gastric Fundus/surgery , Gastroesophageal Reflux/surgery , Abnormalities, Multiple , Adolescent , Child , Child, Preschool , Female , Gastroesophageal Reflux/congenital , Gastrostomy , Humans , Infant , Infant, Newborn , Male , Methods , Mexico , Postoperative Complications/mortality , Recurrence , Retrospective StudiesABSTRACT
The authors present their experience in the management of 33 patients with esophageal atresia. Twenty-six of them were type III (fistula from the lower end of the esophagus); four cases were "H" type of fistula and three cases were type one (with no fistula). In the type III group (26 patients) the major associated malformations seemed to be the most important factor that contributted to the mortality rate. Birth weight and the age at the moment of the diagnosis, did not seem to influence the final outcome. In this group, 13 patients died (50% mortality), ten patients had major associated malformations, all of them died (100% mortality). 16 patients did not have associated malformations; from them, only three died (18% mortality). All the patients with type "H" malformations survived. All the patients with type I malformations underwent gastrostomy and a cervical esophagostomy. One patient died in the immediate postoperatory period. The second one underwent a successful colon interposition and the third one was lost from control.
Subject(s)
Esophageal Atresia/surgery , Child , Diagnosis, Differential , Esophageal Atresia/mortality , Esophageal Fistula/surgery , Female , Humans , MaleABSTRACT
The autors present their experience with nine cases of duodenal obstruction in newborns, admitted to this hospital between Janurary, 1972 and January, 1977. Six babies had duodenal atresia and three had stenosis. Two groups were formed based on the patient's weight: Group one (good prognosis) patients with weight above 2.500 g. Group two (poor prognosis) patient's weight under 2.500 g. All the patients of the first group survived and all the patients of the second died. The overall mortality was 4/9. All the patients from the second group (poor prognosis) also showed associated congenital malformations (esophageal atresia, multiple atresias, urological and cardiac disease). Even if the number of cases is not statistically significant, it seems that the weight of the baby and the associated malformations bear on the final outcome of these patients.
Subject(s)
Duodenal Obstruction/congenital , Infant, Newborn, Diseases , Duodenal Obstruction/surgery , Duodenum/surgery , Humans , Infant , Infant, Newborn , Infant, Newborn, Diseases/surgery , Jejunum/surgery , MethodsABSTRACT
Most of the case of intussuception are considered idiopathic, up to 90-95%. In only a small proportion of them an organic cause is identified. The authors reviewed their experience, including 80 cases of intussusception out of which, 14 showed an organic cause. Six cases were lymphomas, four lymphoid hyperplasia of the colon, two Meckel's diverticulum, one enteric cyst and one Henoch's purpura. An organic cause should be suspected in a child with intussusception who is older than the typical idiopathic intussusception age (6-8 months). Also in those cases with a history of a chronic intussusception.
Subject(s)
Intussusception/etiology , Child , Child, Preschool , Colonic Diseases/complications , Cysts/complications , Female , Humans , Hyperplasia , IgA Vasculitis/complications , Infant , Intestinal Diseases/complications , Lymphatic Diseases/complications , Lymphoma/complications , Male , Meckel Diverticulum/complicationsABSTRACT
Experience at the Hospital del Niño IMAN in choledochus cysts is reviewed in 13 patients with ages ranging from 3 months to 13 years. Nine were female patients and four were male. Seven cases were managed with cystoduodenostomy and six with cystojejunostomy using Roux's Y operation. Two patients from the cystoduodenostomy group died probably due to the serious hepatic lesion present before surgery and not to the surgical procedure itself. There were no deaths in the group with cystojejunostomy using Roux's Y operation and all patients are asymptomatic at 6 months to 5 years after surgery. Stress is made on the high incidence of cases in our country. Disadvantages of cystoduodenostomy due to the reflux of food contents of the biliary ducts, documented in these cases, are discussed. The possibility of a complete cyst resection is considered, based on reports of late malignancies and poor functioning of the anastomoses mentioned by other authors.
Subject(s)
Biliary Tract Diseases/surgery , Common Bile Duct/surgery , Cysts/surgery , Adolescent , Child , Child, Preschool , Evaluation Studies as Topic , Female , Humans , Infant , Infant, Newborn , Infant, Newborn, Diseases/surgery , Jejunum/surgery , Male , MethodsABSTRACT
The authors describe their experience in 778 patients under an ambulatory surgical program at the Hospital del Niño, IMAN. All were operated with general anesthesia; the child arrives in the morning to the hospital and is released in the afternoon. This report suggests that ambulatory surgery is a procedure which can be carried out in Mexican hospitals, saving time and money, since it decreases the number of beds in use; consequently, a better service can be provided. If it is duly fulfilled, the procedure is safe and an effective surgical care can be given to pediatric patients.
Subject(s)
Outpatient Clinics, Hospital , Surgical Procedures, Operative , Humans , Mexico , Organization and Administration , Outpatient Clinics, Hospital/standardsABSTRACT
This is a brief presentation of the way in which a large number of Mexican pediatric surgeons have been made from the beginning of this specialty at the Hospital Infantil de México to the present time, stressing the medical pediatric basis in pediatric surgery and on their lack of training in general surgery. Results are presented from a survey made among pediatric surgeons, highlighting the fact that the pediatric surgeon limits his role to only one type or surgery which always seems to be abdominal, disregarding vascular, gynecologic or urologic surgery. A noteworthy fact is that pediatric surgeons dedicate most of their time to medical pediatrics. A vicious circle in which the pediatric surgeon seems to have fallen in is presented. A series of steps are set forth to end this vicious circle such as improving training of pediatric surgery, establishing training objectives according to reality and avoiding frustration of those who are trained to operate on children and turn out dedicated to medical pediatrics.
Subject(s)
Education, Medical, Graduate , General Surgery/education , Pediatrics/education , Teaching , Education, Medical, Continuing , Internship and Residency , MexicoABSTRACT
The authors report their experience with ten major hepatic resections; six on the right lobe and four on the left. Six of the resected masses were hepatoblastomas, two were hamartomas, was a hemangioma, and the last one a pheochromocytoma of the right adrenal gland with invasion to the liver next from the affected site. The four patients with major hepatic resection of the left lobe are at present alive, ranging from two months to two years after surgery. Of the six patients with major resection of the right lobe, three died during surgery, another one died late post-operatively and one died a year after surgery from generalized metastasis of an hepatoblastoma. The sixth patient is alive with no complications, four months after surgery. The authors used two types of hepatic resections and they make some recommendations for achieving better results in this type of operation.
Subject(s)
Carcinoma, Hepatocellular/surgery , Liver Neoplasms/surgery , Adolescent , Child , Child, Preschool , Evaluation Studies as Topic , Female , Hepatectomy/methods , Humans , Male , Mexico , Postoperative Complications/mortalityABSTRACT
Forty nine pediatric patients with gastroesophageal reflux were studied retrospectively; this is a 4 years experience of Hospital del Niño, IMAN. All of them were treated in the same manner, which included barium gastrointestinal series, esophagoscopy, gastric secretion test. Nissen's funduplication was performed in all of them, plus gastrostomy in those cases having esophageal stenosis. Preoperatively, eight out of every ten patients had stenosis. From the entire series, one patient died. All of them were relieved from their gastroesophageal reflux. By the ninth day following operation, one patient suffered a gastric perforation. The authors make special considerations concerning the high number of cases per year, as compared with other series. Nissen's funduplication proved very efficient to prevent gastroesophageal reflux.
