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Paediatric surgery

Faisal Junejo, Mohammad Irfan Akhtar, Mohammad Hamid, Syed Shabbir Ahmed, Fauzia Minai, Muneer Amanullah
OBJECTIVE: To compare the intravenous boluses and intravenous continuous infusion of tranexamic acid (TXA) to reduce postoperative bleeding in cyanotic congenital heart disease surgeries. STUDY DESIGN: Single-blinded randomised clinical trial. PLACE AND DURATION OF STUDY: Anaesthesia Department, The Aga Khan University Hospital, Karachi, from July 2016 to April 2017. METHODOLOGY: Sixty patients of cyanotic congenital heart disease, undergoing either palliative or corrective surgery involving cardiopulmonary bypass (CPB), were recruited...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
H S Thakkar, I Yardley, D Kufeji
Introduction In 2015, the Royal College of Surgeons of England (RCS) commissioned the East Midlands Clinical Network to develop a set of guidelines for the management of paediatric torsion. Two quality measures identified were the provision of surgery locally where possible and 100% of explorations within three hours. We sought to assess the adherence to these quality measures within our referral network. Materials and methods Retrospective data were collected for all paediatric scrotal explorations performed within our centre between January 2014 and July 2016...
March 15, 2018: Annals of the Royal College of Surgeons of England
Attia Bari, Rehan Ahmed Khan, Ahsan Waheed Rathore
OBJECTIVE: To evaluate the perception of postgraduate residents about the clinical educational environment and to investigate the association of their perception with different specialities and years of residency. METHODS: The study was conducted in August 2016 at The Children's Hospital, Lahore, Pakistan, and comprised postgraduate residents who were asked to complete postgraduate hospital educational environment measure questionnaire. The residents' individual perception scores were calculated and the means of both individual domain and global score of the questionnaire were compared by different specialities and different levels of residency training year...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Tuo Pan, Dan Li, Shoujun Li, Jun Yan, Xu Wang
OBJECTIVES: Postoperative fluid overload is common in children after cardiac surgery, especially for those with right ventricular outflow tract obstruction, which is associated with poor outcomes. This study was conducted to investigate whether early peritoneal dialysis (PD) was associated with improved outcomes in these children at high risk of fluid overload. METHODS: Between January 2010 and January 2015, a total of 2555 consecutive patients with right ventricular outflow tract obstruction underwent anatomical repair...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
R Schneider, A Machens, C Sekulla, K Lorenz, F Weber, H Dralle
BACKGROUND: There are few data on intermittent and continuous intraoperative nerve monitoring (IONM) during thyroidectomy in children. METHODS: All children aged 18 years or younger who had standard thyroid operations using intermittent or continuous IONM between January 1998 and December 2016 were included in the study. The impact of age and type of IONM on basal amplitude, latency and complications after thyroidectomy were assessed. RESULTS: A total of 504 children were included in the study...
March 13, 2018: British Journal of Surgery
Venkataramana Kandi, Parimala Reddy Basireddy
Introduction Medical education involves training necessary to become a physician or a surgeon. This includes various levels of training like undergraduate, internship, and postgraduate training. Medical education can be quite complex, since it involves training in pre-clinical subjects (anatomy, physiology, biochemistry), the para-clinical subjects (microbiology, pathology, pharmacology, and forensic medicine), and a discrete group of clinical subjects that include general medicine, surgery, obstetrics and gynaecology, ear, nose and throat specialization, paediatrics, cardiology, pulmonology, dermatology, ophthalmology, and orthopaedics, and many other clinical specializations and super specialities (cardio-thoracic surgery, neurosurgery, etc...
January 5, 2018: Curēus
G Hong Ong, D K Benjamin Leong
Middle-aortic syndrome is a surgically curable cause of childhood hypertension. Open surgery is traditionally offered but with the advance of medical technology, endovascular approached is available in many country. Failure to control BP in open surgery is as low as 4.1% compares to 13% in endovascular approaches. However, mortality is 4% in open surgery almost 2 times higher than 2.3% in endovascular approach. This article presents a case of 10 years old child treated successfully without complication with endovascular balloon dilatation, as a first case of such disease in East Malaysia...
February 2018: Medical Journal of Malaysia
Sophie Ovesen, Michala Herskind Sejr, Peter Andersen
A 15-year-old girl was admitted to the paediatric ward due to abdominal pain, vomiting and diarrhoea. Her symptoms could not be explained by the clinical examinations, blood samples or ultrasound, but she had a history of tricho-phagia. A CT-scan showed gastric retention, and an endoscopy revealed a trichobezoar, which was removed by a laparotomy. Furthermore, a smaller bezoar and three perforations were found in the proximal part of the small intestine. The treatment of trichobezoars should include surgery as well as multidisciplinary involvement to prevent future trichophagia...
March 12, 2018: Ugeskrift for Laeger
Shoaib Hassan, Anjana Haridas, Venki Sundaram
BACKGROUND: Strabismus, or squint, can be defined as a deviation from perfect ocular alignment and can be classified in many ways according to its aetiology and presentation. Treatment can be broadly divided into medical and surgical options, with a variety of surgical techniques being available, including the use of adjustable or non-adjustable sutures for the extraocular muscles. There exists an uncertainty as to which of these techniques produces a better surgical outcome, and an opinion that the adjustable suture technique may be of greater benefit in certain situations...
March 12, 2018: Cochrane Database of Systematic Reviews
Blaise Hamel, May Wu, Elizabeth O Hamel, Dorsey M Bass, K T Park
Background: Severe colitis flare from ulcerative colitis (UC) or Crohn's disease (CD) may be refractory to corticosteroids and antitumour necrosis factor (TNF) agents resulting in high colectomy rates. We aimed to describe the utility of tacrolimus to prevent colectomy during second-line vedolizumab initiation after corticosteroid and anti-TNF treatment failure in paediatric severe colitis. Methods: A retrospective cohort analysis was performed between 1 October 2014 and 31 October 2016 at a single tertiary care centre...
2018: BMJ Open Gastroenterology
O Fernández-Concepción, M López Jiménez, C Valencia-Calderón, A Calderón-Valdivieso, A Recasén-Linares, L Reyes-Haro, C Vásquez-Ham
INTRODUCTION: There is sufficient evidence on the usefulness of surgery as a therapeutic alternative for patients with drug-resistant epilepsy; however this treatment is underutilized, especially in developing countries. METHODS: We describe the outcomes of epilepsy surgery in 27 paediatric patients at Hospital Baca Ortiz in Quito, Ecuador. Our analysis considered the following variables: reduction in seizure frequency, surgery outcome according to the Engel classification, improvement in quality of life, and serious complications due to surgery...
March 7, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
Bernar Tan Wen Sheng, Patrick Wong, Constance Teo Ee Hoon
INTRODUCTION: Recurrent respiratory papillomatosis results in hoarseness, stridor and airway obstruction. Management is surgical, with most surgeons using microdebrider or laser. Transoral robotic surgery (TORS) has been successfully utilised for the excision of oropharyngeal malignancies and paediatric airway surgery. This is the first case report of TORS being used for the excision of laryngeal papillomas. CASE REPORT: A 36 year old Chinese female was diagnosed with juvenile onset recurrent respiratory papillomatosis...
March 3, 2018: American Journal of Otolaryngology
Florencia Clément, Ayelen Martin, Marcela Venara, Maria de Luján Calcagno, Cecilia Mathó, Silvana Maglio, Mercedes García Lombardi, Ignacio Bergadá, Patricia A Pennisi
Nuclear localization of insulin-like growth factor receptor type 1 (IGF-1R) has been described as adverse prognostic factor in some cancers. We studied the expression and localization of IGF-1R in paediatric patients with gliomas, as well as its association with World Health Organization (WHO) grading and survival. We conducted a single cohort, prospective study of paediatric patients with gliomas. Samples were taken at the time of the initial surgery; IGF-1R expression and localization were characterized by immunohistochemistry (IHC), subcellular fractionation and western blotting...
March 9, 2018: Hormones & Cancer
Yang Liu, Weishuai Bian, Ping Liu, Xuefeng Zang, Xuyun Gu, Wei Chen
OBJECTIVES: Dexmedetomidine has been shown to decrease cardiac complications in adults undergoing cardiac surgery. Results from clinical trials of dexmedetomidine on outcomes following paediatric cardiac surgery are controversial. METHODS: We searched EMBASE, PubMed and Cochrane CENTRAL databases for randomized controlled trials comparing the effect of dexmedetomidine versus placebo or other anaesthetic drugs in paediatric patients undergoing cardiac surgery. The primary outcome was the duration of mechanical ventilation...
March 7, 2018: Interactive Cardiovascular and Thoracic Surgery
Ellen Wejde, Ann Nozohoor Ekmark, Pernilla Stenström
BACKGROUND: Topical oestrogen and manual separation are the main treatments for labial adhesions. The aim was to evaluate treatment of labial adhesions and compare the outcome of topical oestrogen treatment with that of manual separation. METHOD: All girls aged 0-12 years admitted to a tertiary centre for paediatric surgery for labial adhesions were included. The study design was dual: The first part was a retrospective chart review of the treatment success according to the medical charts...
March 8, 2018: BMC Pediatrics
Irene Pulido-Valdeolivas, David Gómez-Andrés, Juan Andrés Martín-Gonzalo, Irene Rodríguez-Andonaegui, Javier López-López, Samuel Ignacio Pascual-Pascual, Estrella Rausell
The Hereditary Spastic Paraplegias (HSP) are a group of heterogeneous disorders with a wide spectrum of underlying neural pathology, and hence HSP patients express a variety of gait abnormalities. Classification of these phenotypes may help in monitoring disease progression and personalizing therapies. This is currently managed by measuring values of some kinematic and spatio-temporal parameters at certain moments during the gait cycle, either in the doctor´s surgery room or after very precise measurements produced by instrumental gait analysis (IGA)...
2018: PloS One
Cristiana Garisto, Zaccaria Ricci, Lorenzo Tofani, Simona Benegni, Chiara Pezzella, Paola Cogo
BACKGROUND: Dexmedetomidine is a selective agonist of α2 receptors that induces hypnotic, sedative and mild analgesic effect. The aim of our study was to test the effects of dexmedetomidine in combination with opioids and benzodiazepines compared to benzodiazepine-opioids alone. METHODS: A randomized controlled trial was conducted. Patients (children >30 days and <24 months undergoing correction of complex congenital heart diseases -CHD-) were randomized to receive 0...
March 7, 2018: Minerva Anestesiologica
Chen Zhao, Qing Bi, Mingguang Bi
BACKGROUND: Treatment of a type II tibial eminence avulsion fracture was controversial. The aim of this study was to compare the clinical outcomes of a modified arthroscopic suture fixation versus conservative immobilization in treatment of this type fracture in immature population. METHODS: A total of 43 type II avulsion fractures of tibial intercondylar eminence in immature patients were retrospectively enrolled in the study. Twenty-two (13 males, 9 females) were treated with arthroscopic suture fixation and 21(12 males, 9 females) with conservative cast immobilization...
March 7, 2018: International Orthopaedics
Ben McNaughten, Caroline Hart, Stephen Gallagher, Carol Junk, Patricia Coulter, Andrew Thompson, Thomas Bourke
AIM: Differences in the gaze behaviour of experts and novices are described in aviation and surgery. This study sought to describe the gaze behaviour of clinicians from different training backgrounds during a simulated paediatric emergency. METHODS: Clinicians from four clinical areas undertook a simulated emergency. Participants wore SMI (SensoMotoric Instruments) eye tracking glasses. We measured the fixation count and dwell time on predefined areas of interest and the time taken to key clinical interventions...
March 7, 2018: Archives of Disease in Childhood
Mohammed Khalifa, Khalid Shreef, Mohammad Ahmad Al Ekrashy, Tarek Abdelazim Gobran
Background: Rectovestibular fistula (RVF) is the most common type of anorectal malformations in females. The need for a diverting colostomy during correction of defect has ignited a heated debate. In this study, we reviewed the girls with RVF that had been treated by either one or two stage procedure in the past 10 years in our institution to define whether one stage or two stage procedures is safer and more beneficial for the patients. Materials and Methods: Seventy girls with RVF that had been operated from January 2005 to January 2015 were studied retrospectively...
April 2017: African Journal of Paediatric Surgery: AJPS
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