Pediatric testicular tumors: 10 years of clinical approach at the Antiguo Hospital Civil de Guadalajara.

José Antonio Gutiérrez-Ureña — 2024-03-01

Abstract. - Introduction: In recent decades, the prevalence of testicular cancer has increased. The prevalence of testicular cancer in children under 19 years of age worldwide represents the sixth position in terms of frequency. The estimated prevalence is 0.3-3.1, incidence 0.17-1.4 and mortality 0.02-0.1 per 100,000. Considering the increase in the prevalence of testicular cancer, we conducted this study with the intention of knowing the clinical characteristics, the diagnostic and therapeutic approach, as well as the incidence and mortality in our environment. Methods: A case series of pediatric patients attended from January 1, 2013 to January 1, 2023 at the Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde was carried out. Age, risk factors, clinical presentation, tumor markers (BHCG, AFP, LDH), imaging studies, therapeutic management, tumor size and histopathological study were reviewed. The data was collected by reviewing clinical records; these data were downloaded into the Office Excel program and transferred to SPSS version 25. Results: We analyzed the records of 11 pediatric patients who met the inclusion criteria, 4 patients had a testicular tumor and 7 patients had a paratesticular tumor, estimating an incidence of 0.15/100 000. The mean for age at diagnosis was 14 years with a deviation of 8 with respect to the mean, only 2 patients (18.18%) presented cryptorchidism as a risk factor, all patients presented increased testicular size at diagnosis, tumor markers were positive in 41.6% of the cases in which it was measured. Ultrasound was performed in all cases, the mean size of the masses was 3 cm, 1 patient presented benign histology, while 3 patients presented positivity to malignancy. Five orchiectomies were performed, one lumpectomy and five are still under follow-up and surveillance. Conclusion: testicular and paratesticular tumors are infrequent in pediatric age, nevertheless, understanding them is of great importance in order to make an early diagnosis and offer an individualized therapeutic approach, considering limiting radical orchiectomy to cases in which malignancy is suspected.

Medical-surgical and sociodemographic aspects in patients with gastroschisis in a Third Level Hospital in Mexico during the period 2018-2022.

Guillermo Yanowsky Reyes — 2024-05-13

Abstract: Introduction: Gastroschisis is a birth defect in which a hole in the abdominal wall (Belly) lateral to the umbilicus allows the infant's intestines to be exposed, in addition to other organs such as the stomach and liver. Objective: To obtain information on the medical-surgical approach to this congenital anomaly, identify aspects of probable risk in the demographic areas where the pregnant women reside, pathological and non-pathological personal history of the patients' mothers, newborns diagnosed with gastroschisis attended from January 2018 to January 2022 and drug addictions used in the perinatal period of the pregnant women. Method: descriptive, retrospective, retrospective, cross-sectional, observational, epidemiological cohort study. An analysis of the clinical records of the Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde of patients with a diagnosis of gastroschisis attended in January 2018 to January 2022 was performed. The data were collected in Microsoft Excel and SPSS 22 software. They were subsequently interpreted and analyzed by means of measures of central tendency and association. Results: A sample size of 48 patients was analyzed revealing that the prevalence of gastroschisis in the Antiguo Hospital Civil Fray Antonio Alcalde from 2018 to 2022 was 0.0089%. In addition, 83% success rate was observed in the treatment of patients with gastroschisis in pediatric surgery, with higher prevalence in male neonates (M=55.3%, F=22%), among others. A positive association was found with gastroschisis and exposure to environmental pollutants (OR=1.67), teenage mothers (OR=2) and ORH+ blood group (OR=1.29). The risks by demographic area according to their exposure and locality, 50% exposure to insecticides and 17% to polluting industries. The diagnosis of this malformation was made in 47% in the second trimester, 28% in the first trimester and 23% in the third trimester. Within the personal pathological and non-pathological history of the parents, no pathology of importance was identified. Surgical management was 59.2% with deferred closure and 40% with primary closure, medical management was for 100% of the patients and 16 of them required mechanical ventilation. Conclusion: According to the results obtained, the main positive relationship for presenting gastroschisis was the presence of a teenage mother and exposure to environmental pollutants in the studied sample.

Keywords: Gastroschisis, medical-surgical approach, risk factors, pregnancy, complications, demographics, teenage mother.

Horizon Interdisciplinary Journal

Pediatric testicular tumors: 10 years of clinical approach at the Antiguo Hospital Civil de Guadalajara.

Medical-surgical and sociodemographic aspects in patients with gastroschisis in a Third Level Hospital in Mexico during the period 2018-2022.