Browsing by Author "Harris, P"

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    Alteraciones polisomnográficas en lactantes con reflujo gastroesofágico
    (2003) Harris, P; Brockmann, P; Munoz, C; Mobarec, S; Mesa, T; Sanchez, I
    Background: Infant apnea is a common problem that conveys significant burden to families and physicians. Its temporal relationship with gastroesophageal reflex (GER) is controversial. Aim: To establish whether infants with GER of different magnitude: have a higher incidence of respiratory events than children without GER. Patients and Methods: 146 consecutive patients were evaluated with polisomnography (PSG) and with an esophageal pH probe. Those infants without GER episodes or with an esophageal pH below 4.0 in less than 5% of total sleep tune were considered as physiologic GER (Group I), between 5-10% as mild GER (Group II), and over 10% as severe GER (Group III). These groups were evaluated for demographic and polysomnographic characteristics. Results: There: were no differences in the demographic and global PSG characteristics neither in oxymetry, heart rate or electroen-cephalographic abnormalities. Group III infants bad a higher percentage of active sleep compared to infants of Group I (p < 0.05) and higher incidence of central pauses and apneas compared to infants of Group I (p < 0.05). Conclusions: The presence of severe GER may modify the sleep pattern in infants, increasing the percentage of active sleep. The presence of central peruses and apneas in infants with severe GER suggest an association between the inmaturity of the respiratory centers and the adaptation of the anti-reflux mechanisms.
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    Childhood tumors
    (W B SAUNDERS CO-ELSEVIER INC, 2000) Herrera, JM; Krebs, A; Harris, P; Barriga, F
    Pediatric solid tumors represent a distinct set of malignancies of embryonal origin whose incidence peaks in the first years of life. Specific genetic anomalies with pathogenic significance, which have helped to define the diagnosis better and to improve the prognosis of children with these tumors, recently have been discovered. Survival of children with solid tumors also has improved significantly because of effective multidisciplinary care, which, in this case, always involves chemotherapy and surgery. These favorable results require that children with these diseases are referred and treated at institutions that have multidisciplinary teams and the infrastructure and expertise for caring for these children. Diagnostic and therapeutic principles for the most common childhood solid tumors are discussed in this article, with an emphasis on surgical procedures.
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    Correlation between phenotype and genotype in a group of patients with cystic fibrosis
    (2002) Navarro, H; Kolbach, M; Repetto, G; Guirales, E; Harris, P; Foradori, A; Poggi, H; Sanchez, I
    Background: Cystic fibrosis (CF) is the most common lethal autosomic disease in Caucasians, with a global incidence of 1:3000 newborns. More than 900 mutations have been described, involving the Cystic Fibrosis Trains membrane Regulator (CFTR). The DeltaF508 mutation is present in 60% of alleles studied worldwide. Aim: To report 25 patients with cystic fibrosis in whom a genetic study was done. Material and methods: Twenty five patients (14 men, aged between 18 months and 25 years) with a diagnosis of cystic fibrosis based on clinical features plus two abnormal sweat tests are reported. The genetic study considered the 20 most common mutations in cystic fibrosis and was done in genomic DNA of peripheral lymphocytes, by polymerase chain reaction. Results: A mutation was found in 75% of analyzed alleles. DeltaF508 was present in 50% of cases (DeltaF508/DeltaF508 in 8 and DeltaF508/other in 11). When DeltaF508 was present, pancreatic insufficiency was always a feature and nutritional status was worse. Respiratory involvement was variable, both for homozygous and heterozygous cases. Other severe mutations such as W1282X and G542X were related to clinical manifestations similar to those found in DeltaF508 mutation. Diagnosis was made before six months of age in 12 patients. The clinical presentation was meconium dens and there was a family history of the disease in most cases. The majority of cases of early diagnosis presented severe mutation, but milder respiratory symptoms and lesser nutritional compromise at the time of assessment. Conclusions: Most patients studied had a severe cystic fibrosis mutation, which was associated with more severe respiratory, pancreatic and nutritional involvement. The early diagnosis of the disease, which would allow to improve the prognosis and the quality of life, must be emphasized.
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    Nature and extent of gastric lesions in symptomatic Chilean children with Helicobacter pylori-associated gastritis
    (WILEY, 2002) Guiraldes, E; Pena, A; Duarte, I; Trivino, X; Schultz, M; Larrain, F; Espinosa, MN; Harris, P
    Chile has one of the highest rates of gastric cancer in the world and most children and adolescents in the country are colonized by Helicobacter pylori. This study assessed the nature and extent of the gastric lesions in 73 consecutive patients aged 5-17 y, referred for upper gastrointestinal endoscopy. Their H. pylori-associated gastric pathology was characterized and these data were compared with their sociodemographic status. Endoscopic assessment was normal in 43 patients while in 30 there was a variety of mucosal lesions. Sixty patients (83%) had histological chronic gastritis of the antrum and in 45 (63%) the lesions also involved the gastric corpus; 90% of patients with chronic gastritis were colonized by H. pylori. Although most of these patients had epithelial erosions and dedifferentiation of the pit epithelium, atrophy and metaplasia were not found. Patients' socioeconomic status was inversely correlated with their rate of colonization by H. pylori (p < 0.005), the frequency of gastric lesions on endoscopy (p < 0.01) and the frequency of involvement of antral and corpus mucosa by chronic gastritis (p < 0.002). This latter feature was positively correlated with age (p < 0.001).
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    Proinflammatory cytokine expression in gastric tissue from children with Helicobacter pylori-associated gastritis
    (LIPPINCOTT WILLIAMS & WILKINS, 2001) Guiraldes, E; Duarte, I; Pena, A; Godoy, A; Espinosa, MN; Bravo, R; Larrain, F; Schultz, M; Harris, P
    Background: Helicobacter pylori infection of the gastric mucosa in humans is usually acquired early in life. The chronic inflammation that ensues involves the increased production of inflammatory cytokines. Published data on production of these mediators by gastric mucosa of H. pylori-infected children are few.