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Las Palmas de Gran Canaria, Spain

Beltra Pico R.,Hospital Universitario Materno Infantil Of Canarias
Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica | Year: 2010

Excessive hand sweating, known as palmar hyperhidrosis, is a disabling disorder that starts during the childhood, and can have a strong negative impact on the quality of life of affected children, as they feel rejected by others due to their permanently damp hands, suffering during school activities, contact sports and daily games. Thoracoscopic sympathicolysis is easy to perform and has proven to be safe, with a short operating time. A review was performed on 48 children who underwent surgical treatment of palmar hyperhidrosis and answered a follow-up questionnaire to evaluate their level of satisfaction. Considering the final surgical results, the 48 patients were completely satisfied with the outcome of the operation. Significant complications or adverse effects were not detected. The primary palmar hyperhidrosis is a pathology that entails an important reduction in the quality of life of those who suffer it. With the results of this technique in hand, we recommend the endoscopic thoracic sympathicolysis procedure for the treatment of this pathology in paediatrics. The level of patient satisfaction was high. Source

Gonzalez Gonzalez N.L.,Hospital Universitario Of Canarias | Plasencia W.,Hospiten Global Care | Gonzalez Davila E.,University of La Laguna | Padron E.,Hospital Universitario Of Canarias | And 3 more authors.
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2013

Objective: To determine the effect of using customized vs. standard population birthweight curves to define large for gestational age (LGA) infants. Methods: We analyzed data obtained from 2,097 singleton pregnancies using three different methods of classifying newborn birthweight: standard population curves, British or Spanish customized curves. We recorded maternal characteristics, proportion of LGA newborns when using each method, percentage of LGA according to one method but not for the others, and concordance between the different methods. Results: The proportion of LGA newborns according to Spanish customized curves was significantly lower than that calculated using either standard general population birthweight curves or British curves (p < 0.001). A third (33.9%) of the infants classified as LGA according to the general population method were adequate for gestational age (AGA) when the Spanish customized curves were used, and 18.5% of non-LGA were LGA according to customized curves (p < 0.001). Concordance between the different models high, but on excluding AGA the concordance coefficient was low (Cohen's κ <0.4). Conclusions: The use of customized curves allows differentiation between constitutional LGA and cases of fetal overgrowth, leading to a decrease in the rate of both false-positives and negatives as well as the overall proportion of LGA babies. © 2013 Informa UK, Ltd. Source

Nicolaides K.H.,Kings College London | Syngelaki A.,Kings College London | Poon L.C.,Kings College London | De Paco Matallana C.,Hospital Universitario Virgen Of La Arrixaca | And 7 more authors.
American Journal of Obstetrics and Gynecology | Year: 2016

Background Preterm birth is the leading cause of neonatal death and handicap in survivors. Although twins are found in 1.5% of pregnancies they account for about 25% of preterm births. Randomized controlled trials in singleton pregnancies reported that the prophylactic use of progestogens, cervical cerclage and cervical pessary reduce significantly the rate of early preterm birth. In twin pregnancies, progestogens and cervical cerclage have been shown to be ineffective in reducing preterm birth. Objective The objective of this study was to test the hypothesis that the insertion of a cervical pessary in twin pregnancies would reduce the rate of spontaneous early preterm birth. Study Design This was a multicenter, randomized controlled trial in unselected twin pregnancies of cervical pessary placement from 20+0-24+6 weeks' gestation until elective removal or delivery vs. expectant management. Primary outcome was spontaneous birth <34 weeks. Secondary outcomes included perinatal death and a composite of adverse neonatal outcomes (intraventricular haemorrhage, respiratory distress syndrome, retinopathy of prematurity or necrotizing enterocolitis) or need for neonatal therapy (ventilation, phototherapy, treatment for proven or suspected sepsis, or blood transfusion). Analysis was by intention to treat. This trial is registered in the ISRCTN registry, number 01096902. Results A total of 1,180 (56.0%) of the 2,107 eligible women agreed to take part in the trial; 590 received cervical pessary and 590 had expectant management. Two of the former and one of the latter were lost to follow up. There were no significant differences between the pessary and control groups in rates of spontaneous birth <34 weeks (13.6% vs. 12.9%; relative risk 1.054, 95% confidence interval [CI] 0.787-1.413; p=0.722), perinatal death (2.5% vs. 2.7%; relative risk 0.908, 95% CI 0.553-1.491; p=0.702), adverse neonatal outcome (10.0 vs. 9.2%; relative risk 1.094, 95% CI 0.851-1.407; p=0.524) or neonatal therapy (17.9% vs. 17.2%; relative risk 1.040, 95% CI 0.871-1.242; p=0.701). A post hoc subgroup analysis of 214 women with short cervix (≤25 mm) showed no benefit from the insertion of a cervical pessary. Conclusion In women with twin pregnancy, routine treatment with cervical pessary does not reduce the rate of spontaneous early preterm birth. © 2016 Elsevier Inc. Source

Belik J.,University of Toronto | Gonzalez-Luis G.E.,Hospital Universitario Materno Infantil Of Canarias | Perez-Vizcaino F.,Complutense University of Madrid | Villamor E.,Maastricht University
Free Radical Biology and Medicine | Year: 2010

Isoprostanes are prostaglandin-like bioactive molecules generated via nonenzymatic peroxidation of lipid membrane-derived arachidonic acid by free radicals and reactive oxygen species. Their cognate receptors, biological actions, and signaling pathways are poorly understood. Aside from being sensitive and specific biomarkers of oxidative stress, E- and F-ring isoprostanes have important biological functions and likely mediate many of the disease-related pathological changes for which they are used as indicators. The biochemical pathways involved in isoprostane formation, their pathogenetic relevance to adult disease states, and their biological function are addressed. Developmentally, plasma and tissue content data show that isoprostane levels are highest during fetal and early neonatal life, when compared with adults. As such, the available data suggesting that isoprostanes play an important biological role, as well as possibly actively participate in the regulation of pulmonary vascular tone and the transition from fetal to postnatal life, are here reviewed. Lastly, the association between isoprostanes and certain neonatal clinical conditions is addressed. Although its existence has been recognized for almost 20 years, little is known about the critical importance of isoprostanes during fetal life and immediate neonatal period. This review is an attempt to bridge this knowledge gap. © 2009 Elsevier Inc. All rights reserved. Source

Cansino Campuzano A.,Hospital Universitario Materno Infantil Of Canarias
Pediatria Integral | Year: 2012

Acute bronchitis is a diagnosis that is often performed although its definition is unclear. In general, the term is used for acute bronchitis, acute respiratory infection in which the predominant symptom is cough, with or without expectoration. Its etiology is viral in most cases and the treatment is basically supportive measures. Bronchiolitis, a lower respiratory tract infection that mainly affects the small airways (bronchioles), is a frequent cause of illness and hospitalization in infants that causes a great demand for care in all levels of care, primary care and hospital. Its etiology is viral and respiratory syncytial virus (RSV) is the most frequently isolated. It occurs in epidemics during winter and early spring. In most cases follows a benign self-limiting, presenting the most severe in younger infants and those with some risk factor. The clinical diagnosis is supported by the epidemiological environment. There is great variability in the therapeutic management of bronchiolitis among pediatricians, primary care is based on supportive measures and the use of a test dose of an inhaled bronchodilator. Source

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