Club de revistas. Hidronefrosis fetal. Revisión sistemática.

van Eerde AM, Meutgeert MH, de Jong TP, Giltay JC. Vesico-ureteral reflux in children with prenatally detected hydronephrosis: a systematic review. Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology. 2007 Apr;29(4):463-469.

To investigate the value of prenatally detected hydronephrosis (PNH) as a prognostic factor for vesico-ureteral reflux (VUR). The MEDLINE database was searched for articles on PNH and VUR published between 1980 and 2004. A total of 18 studies were identified and reviewed for various aspects. Results were separated for primary and/or secondary VUR whenever possible, because of the different underlying pathogenic mechanisms. There was considerable variation between the different studies with respect to methodology and study design. One of the main discrepancies was the way in which postnatal abnormalities were ascertained: by postnatal ultrasound, voiding cystourethrogram (VCUG) alone, or combined or sequential ultrasound and VCUG. Taking these limitations into account, the published data showed there to be a mean prevalence of 15% for postnatal primary VUR after PNH. Of all patients with PNH, 53% had no postnatal anomalies, whereas 29% had other anomalies, such as duplex collecting systems. Of all infants with PNH, 15% had primary VUR proven postnatally and 53% had no other anomalies detected. We suggest a standardized protocol for future studies, to enable better comparison of follow-up protocols.

Disponible en www.citeulike.org

sccp/colombia

Club de revistas. Tratamiento médico de la urolitiasis en pediatría.

Alon US. Medical treatment of pediatric urolithiasis. Pediatric nephrology (Berlin, Germany). 2009 Nov;24(11):2129-2135. Leer más »

Club de revistas. Imagenología del trauma renal.

Kawashima A, Sandler CM, Corl FM, West OC, Tamm EP, Fishman EK, et al. Imaging of renal trauma: a comprehensive review. Radiographics : a review publication of the Radiological Society of North America, Inc. 2001 May;21(3):557-574. Leer más »

Club de revistas. Diagnóstico y manejo del epispadias.

Frimberger D. Diagnosis and management of epispadias. Seminars in pediatric surgery. 2011 May;20(2):85-90. Leer más »

Club de revistas. Epispadias

Frimberger D. Diagnosis and management of epispadias. Seminars in pediatric surgery. 2011 May;20(2):85–90. Available from: http://dx.doi.org/10.1053/j.sempedsurg.2011.01.003.

Epispadias is a rare diagnosis and most commonly described as a part of the bladder exstrophy complex. Epispadias is characterized by failure of the urethral plate to tubularize on the dorsum with the defect ranging from a glandular to a penopubic location. In addition, male patients demonstrate a dorsal chordee whereas female patients exhibit a bifid clitoris. The goal of surgical correction is the placement of the meatus in its anatomical position and the creation of functional genitalia with good cosmetic outcomes. Two different major reconstruction principals, the modified Cantwell-Ransley and the Mitchell Bagli repair, are used in specialized centers worldwide. Both procedures comprise the major principles of epispadias surgery but differ in timing and the extent of urethral mobilization. In addition, both techniques have advantages and specific risks involved, and reports from supporting institutions demonstrate favorable results. Regardless of the approach, the reconstruction should be performed by experienced surgeons.

Disponible en citeulike sccp

Circuncisión neonatal. Un artículo sobre la polémica y un video

El Dr. Ricardo Álvarez nos comparte este video sobre la técnica de la circuncisión neonatal. ¿Cuántos de ustedes la hacen?. Los invito a leer también este artículo reciente.

Circumcision Comes Under Attack in San Francisco

A S. Francisco group opposed to circumcision is one step closer to the city banning the practice after submitting 12,000 signatures to the local Department of Elections – nearly twice the required number – requesting a November ballot measure on the issue. If approved by voters, the law would classify circumcision of boys under the age of 18 as a misdemeanor carrying a maximum punishment of one year in prison and a $1,000 fine.

Both rabbis and legal experts across the United States have raised a collective eyebrow at the proposed ban, calling into question its constitutionality as a breach of religious freedom as guaranteed by the First Amendment.

“This is a tradition not only practiced by Jews, but by Muslims and members of secular society,” stated Rabbi Yosef Langer, director of Chabad-Lubavitch of S. Francisco. “Unfortunately, the Bay Area is renowned for people jumping on the bandwagon of anything that walks or crawls. To think that a very small faction of opponents [to circumcision] has gotten the attention of the entire community is preposterous.”

Circumcision, known as brit milah in Hebrew, has been a fundamental cornerstone of the Jewish people for the last 3,000 years, commanded in the Torah to be performed on the eighth day following birth. Muslims also practice circumcision when their sons are 13, tracing the ritual to Abraham’s son Ishmael. In the general population, a procedure similar to Jewish circumcision is commonly performed on infants in hospitals around the world.

But led by area resident Lloyd Schofield, 59, supporters of the ban call circumcision an act of physical abuse. They say it mutilates the body and inflicts excruciating pain upon men at their weakest and most vulnerable.

Rabbi Levi Heber, a Brooklyn mohel – or ritual circumciser – and director of the International Bris Association calls the charges outlandish.

“Circumcision attests to the everlasting covenant that G-d established with the Jewish people,” asserted the rabbi, whose Circumcision.net Web site promotes understanding and education about Jewish circumcision. “It is one of the most fundamental commandments to the Jewish people, religious and non-religious.

“Any attempt to restrict its practice would be a direct assault on the Jewish way of life and a blatant violation of religious freedom,” he added.

Constiutional Protection

Josh Davis, professor and associate dean for faculty scholarship at the University of S. Francisco School of Law, predicts the proposed ban will have a difficult time holding up under constitutional scrutiny, and not only because of its First Amendment implications.

“The right of parents to control the upbringing of children could also come into play,” said Davis, who cited the 1972 U.S. Supreme Court case Wisconsin v. Yoder, where the court ruled that the Amish community was not required to enroll its children in the public school system because it interfered with their religious beliefs. “An attack on the law might rest upon the precedent set by that case.”

Jerald F. Saval, a political scientist who taught constitutional law in the Massachusetts public school system for more than 30 years, said the law would likely be struck down because of the First Amendment’s Free Exercise Clause forbidding government intrusion into a group’s religious practices.

“Since the right of circumcision is such an integral part of Judaism where you cannot separate the practice from the belief, the First Amendment Free Exercise Clause would make that attempt [to outlaw it] in S. Francisco blatantly unconstitutional,” he explained.

Heber, who has been performing Jewish circumcisions since the late 1980’s, points to secular medical authorities who regard circumcision as a health-enhancing practice. But he is quick to point out that not all circumcisions are done in a way compliant with Jewish law.

Rabbinical authorities denounce hospital circumcisions, where a child is strapped to a table and his foreskin placed in a clamp. It can take several hours for the tissue to die in the procedure, whereas Jewish circumcisions are done in one swift motion using a very sharp knife to remove the foreskin.

For Heber, the issue is very simple: Jewish circumcision is in no way traumatic.

“Just because there are a few individuals that try to dress up this assault on the Jewish way of life in words that don’t have any basis doesn’t mean it’s the proper thing to do,” he said. “There should be an outcry against this effort.”

For his part, Langer remains hopeful that the city’s board of supervisors will reject the motion to place the ban on the fall ballot. But if it does not, he is ready to respond with educational and spiritual gusto.

“The Jewish community will unilaterally rise to the occasion and squash this absurdity,” the rabbi declared. “We have to stand unified and strong against the uninformed and the ignorant that are trying to uproot the covenant of Jewish life that’s been practiced from almost the beginning of time.”

Visión laparoscópica de la critorquidia

Dr. Carlos Melo Hernández

@ camelo@emcali.net.co, camelociruped@yahoo.com

Enlace en YouTube

Cirugía laparoscópica urológica pediátrica. Primer reporte.

Cirugía laparoscópica urológica pediátrica
Primer reporte
Abello Cristóbal, Cure Ricardo, Álvarez Ricardo.
Centro de Urología pediátrica del Caribe
Barranquilla, Colombia
www.cupec.net

Cirugía de hipospadias

Técnica de Snodgrass
Dr. Ricardo Álvarez
Barranquilla