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postoperative fever pediatric

Kaushik Shah, Madhu Sudan Agrawal, Dilip Kumar Mishra
INTRODUCTION: Percutaneous nephrolithotomy (PCNL) has undergone significant changes in recent years in the quest for improving efficacy and reducing morbidity. Newer minimally-invasive modalities of PCNL such as mini-PCNL, ultra-mini PCNL, and micro-PCNL have evolved with advancement in optics and technology. However, with these newer advancements, migration of small fragments produced with laser lithotripsy remains a concern, which may result in incomplete stone clearance. We describe a new technique of PCNL termed "Superperc", that utilizes suction to remove all the fragments and maintain one-way flow...
January 2017: Indian Journal of Urology: IJU: Journal of the Urological Society of India
Marzieh R Honardar, Jesus Rubio, Sanjay M Bhananker
Malignant hyperthermia (MH) is an extremely rare and life-threatening differential diagnosis of postoperative fever. We present an 8-month-old child scheduled for elective outpatient procedure who rapidly developed high fever, tachycardia, and respiratory acidosis shortly after transfer to the postanesthesia care unit. MH hotline expert recommended administering dantrolene, but there was no evidence of hypermetabolism or lactic acidosis. The patient remained clinically stable after admission to the pediatric intensive care unit and was discharged home the next day...
October 2016: International Journal of Critical Illness and Injury Science
Aaron D Seims, Lisa VanHouwelingen, Jessica Mead, Shenghua Mao, Amos Loh, John A Sandoval, Andrew M Davidoff, Jianrong Wu, Winfred C Wang, Israel Fernandez-Pineda
BACKGROUND: Laparoscopy offers many benefits to splenectomy, such as reduced incisional pain and shortened hospital duration. The purpose of this study is to evaluate procedural and outcome differences between multiport (MP) and reduced port (RP) splenectomy when utilized to treat children. PATIENTS AND METHODS: An institutional review board approved retrospective analysis of all consecutive laparoscopic total splenectomies performed at a single institution between January 2010 and October 2015 was conducted...
February 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Laura Mihaela Trandafir, Madalina Ionela Chiriac, Smaranda Diaconescu, Ileana Ioniuc, Ingrith Miron, Daniel Rusu
BACKGROUND: Recurrent fever syndrome, known as the Marshall syndrome (MS), is a clinical entity that includes several clinical features, such as: fever (39-40°C) that occurs repeatedly at variable intervals (3-8 weeks) and in episodes of 3 to 6 days, cervical adenopathy, pharyngitis, and aphthous stomatitis. The diagnosis of MS is one of exclusions; laboratory data is nonspecific and no abnormalities correlated with MS have been detected thus far. METHODS: The authors report the case of a 2-year-old girl admitted to a tertiary pediatric center for repeated episodes of fever with aphthous stomatitis and laterocervical adenopathy...
November 2016: Medicine (Baltimore)
Nicole Hubner, Jacob Charles Langer, Sari Kives, Lisa Mary Allen
STUDY OBJECTIVE: The aim of this study was to document the change in ovarian conservation rate after ovarian torsion as a result of continuous quality improvement (CQI) measures, and to determine factors that contribute to this outcome. DESIGN: A retrospective, uncontrolled before-and-after study. SETTING: An academic children's hospital. PARTICIPANTS: Female adolescents younger than 18 years with surgically confirmed ovarian torsion from April 1, 1988 to October 15, 2013; excluding cases from 2003 (intervention period)...
February 2017: Journal of Pediatric and Adolescent Gynecology
Veronica Carlini, Valeria Calcaterra, Nunzia Decembrino, Laura Rubert, Noemi Pasqua, Mattia Novario, Marco Lucioni, Marco Brunero, Gloria Pelizzo
In leukemic patients, appendectomy must be approached with caution because of the increased risk of complications. Fungal appendicitis is rare and only a few cases have been described in the literature, particularly in immunocompromised individuals in whom this infection can be fatal. We present 2 pediatric patients with acute myeloid leukemia, who developed appendicitis during the postchemotherapy neutropenic phase, while receiving antifungal prophylaxis. Fever was the first sign of infection. Laparoscopic appendectomy was performed without postoperative complications...
October 2016: Journal of Pediatric Hematology/oncology
Shaoguang Feng, Yuhui Qiu, Xiang Li, Huajun Yang, Chen Wang, Junjia Yang, Weiguang Liu, Aihe Wang, Xianming Yao, Xin-He Lai
PURPOSE: We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children. METHODS: Literature searches were conducted to identify studies having compared the laparoscopic splenectomy (LS) and open splenectomy (OS) for children. Parameters such as operative time, blood loss, length of postoperative stay, the removal of accessory spleens and postoperative complications including postoperative high fever, acute chest syndrome (ACS), and ileus were pooled and compared by meta-analysis...
March 2016: Pediatric Surgery International
Arkadi Yakirevitch, Assaf Arie Barg, Lev Bedrin, Adi Primov-Fever, Michael Wolf, Lela Migirov
The incidence of acute invasive fungal rhinosinusitis (AIFR) is rising due to more aggressive chemotherapy and longer survival of immunosuppressed patients. Early diagnosis and appropriate but nonmutilating surgical treatment are particularly problematic in the pediatric population. This study aimed to evaluate the outcome of surgery for pediatric AIFR. Medical records of children surgically treated for AIFR between 1998 and 2014 were reviewed. Diagnosis was based on both histopathological and microbiological confirmation...
2015: Pediatric Hematology and Oncology
David M Axelrod, Jeffrey A Alten, John T Berger, Mark W Hall, Ravi Thiagarajan, Ronald A Bronicki
Since the inception of the Pediatric Cardiac Intensive Care Society (PCICS) in 2003, remarkable advances in the care of children with critical cardiac disease have been developed. Specialized surgical approaches, anesthesiology practices, and intensive care management have all contributed to improved outcomes. However, significant morbidity often results from immunologic or infectious disease in the perioperative period or during a medical intensive care unit admission. The immunologic or infectious illness may lead to fever, which requires the attention and resources of the cardiac intensivist...
October 2015: World Journal for Pediatric & Congenital Heart Surgery
Izabela Pągowska-Klimek, Anna S Świerzko, Mateusz Michalski, Maciej Moll, Agnieszka Szala-Poździej, Anna Sokołowska, Wojciech R Krajewski, Maciej Cedzyński
We investigated MBL2 and MASP2 genotypes, serum MBL (mannose-binding lectin) levels and activities of its complexes with associated serine proteases (MASP-1, MASP -2), in relation to complications following cardiac surgery in 195 children. The incidence of SIRS was lower in patients carrying MBL2 A/O and O/O genotypes (p=0.024). Children with MBL levels <500ng/ml had a lower risk of SIRS (p=0.014) and fever (p=0.044). Median MBL concentration was higher in patients who developed SIRS (p=0.048) but lower in those with post-operative infections (p=0...
February 2016: Immunobiology
Onur Dede, Ahmet Ali Sancaktutar, Okan Baş, Mansur Dağgüllu, Mazhar Utangaç, Necmettin Penbegul, Haluk Soylemez, Namık Kemal Hatipoglu, Mehmet Nuri Bodakci, Yaşar Bozkurt, Murat Atar, Gülay Dede
This study aimed to investigate the effectiveness and reliability of micro-percutaneous nephrolithotomy (micro-PNL) for the management of kidney stones in pediatric patients. This retrospective study included 24 infants that underwent micro-PNL for renal stones between March 2012 and April 2015. The inclusion criteria included: age younger than 2 years, stone size <20 mm, absence of urinary tract malformations and active infection, and no coagulopathy. Stone-free rates were assessed one month postoperatively by ultrasonography (USG) and kidneys, ureters, bladder (KUB) radiography...
April 2016: Urolithiasis
Hua-Nan Luo, Si-Jing Ma, Hai-Li Guo, Zheng-Hui Wang, Xiao-Yong Ren
OBJECTIVES/HYPOTHESIS: To compare the different effects of bronchoalveolar lavage (BAL) with diverse combinations of lidocaine, epinephrine, and dexamethasone on pediatric patients with an inhaled tracheobronchial foreign body (TFB). STUDY DESIGN: Randomized controlled study. METHODS: Two hundred forty cases of pediatric patients with inhaled TFB were included in this study, and were randomly divided into four groups using three kinds of drugs for BAL, namely 0...
April 2016: Laryngoscope
Mark V Silva, Alison C Levy, Julia B Finkelstein, Jason P Van Batavia, Pasquale Casale
BACKGROUND: The necessity for urinary diversion with trans-anastomotic ureteral stenting during pyeloplasty is currently under debate. Performing a stentless repair could eliminate stent-related morbidity, including: stent migration, urinary tract infection, flank pain, and bladder spasms. In addition, there would be no need for a second procedure and associated anesthesia required for stent removal. This study describes the outcomes of robotic-assisted laparoscopic pyeloplasty without use of a ureteral stent...
August 2015: Journal of Pediatric Urology
Bo Xiao, Xin Zhang, Wei-Guo Hu, Song Chen, Yu-Hong Li, Yu-Zhe Tang, Yu-Bao Liu, Jian-Xing Li
BACKGROUND: Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged <3 years. METHODS: We reviewed 68 patients (80 renal units) aged <3 years between August 2006 and December 2014 in Peking University People's Hospital and Beijing Tsinghua Changung Hospital, including 36 renal units with a single stone, 6 with staghorn stones, 14 with upper ureteral stones, and 24 with multiple stones...
June 20, 2015: Chinese Medical Journal
Ahmed Abo-Elenain, Yousif Naiem, Hosam Hamedhosam-Eldin Hotmail Com, Mohamed Emam, Wagdi Elkashef, Ahmed AbdelRafee
INTRODUCTION: Neuroblastoma is the most common extracranial solid pediatric malignancy. The most common site is abdomen with predominance of suprarenal medulla. Infiltration of the tumour to the liver is rare. No cases were reported in the literature about the misdiagnosis of neuroblastoma as mesenchymal hamartoma in the liver. PRESENTATION OF CASE: We represent a rare case of neuroblastoma misdiagnosed as mesenchymal hamartoma in liver in a six-month-old female infant presented with fever and abdominal mass...
2015: International Journal of Surgery Case Reports
Ilker Ince, Ozgur Yoruk, Ali Ahiskalioglu, Mehmet Aksoy, Aysenur Dostbil, Mine Celik
OBJECTIVE: Tonsillectomy surgery is associated with severe postoperative pain that usually requires analgesics including opioids. Pain control is still a big problem after tonsillectomy surgery. We aimed to evaluate the efficacy of preemptive analgesia using montelukast for pediatric post-tonsillectomy pain management. This is the first-time use of montelukast in post-tonsillectomy pain. STUDY DESIGN: Double-blind, controlled-randomized study. SETTINGS: University teaching and research hospital...
August 2015: Otolaryngology—Head and Neck Surgery
Tomoru Miwa, Nakamasa Hayashi, Shunro Endo, Takayuki Ohira
A neuroendoscopic biopsy is a minimally invasive and useful procedure for the diagnosis and initial management of tumor-associated hydrocephalus. We describe the nationwide investigation of the current status of neuroendoscopic biopsy for intra- and paraventricular tumors in children, as well as the treatment of tumor-associated hydrocephalus in pediatric patients. The main items examined included the patient's age and sex, location of the tumor, pathological diagnosis, complications, treatment and efficacy of treatment of the tumor-associated hydrocephalus, and the dissemination during the postoperative course...
October 2015: Neurosurgical Review
W Gamal, E Moursy, M Hussein, A Mmdouh, A Hammady, M Aldahshoury
INTRODUCTION/BACKGROUND: Many authors reported their experience with supine PCNL in adult population comparing the outcome with prone PCNL and they found that the stone free rate and the operative time were in favor of prone PCNL with a lower patient morbidity among patients with supine PCNL. This encouraged us to perform supine PCNL in pediatric population. AN OBJECTIVE: In this study we evaluated the safety and efficacy of supine PCNL in pediatric population. STUDY DESIGN (SUBJECTS/PATIENTS/MATERIALS/METHODS): Between April 2011 and February 2014 a total of 27 children (6 girls and 21 boys) presented with renal calculi...
April 2015: Journal of Pediatric Urology
Esam A E Desoky, Ehab R ElSayed, Ahmed Eliwa, Mohamed Sleem, Waleed Shabana, Tamer Dawood, Mohamed Teleb, Salem Khalil
OBJECTIVE: To evaluate the safety and efficacy of pediatric percutaneous nephrolithotomy (PCNL) in the flank-free modified supine position (FFMSP). PCNL in the supine position is increasingly and successfully used in pediatric age group. Different modifications of supine positions have been described; however, the best supine position is not well established and remains a matter of debate. PATIENTS AND METHODS: This prospective study included 22 children presenting with single renal pelvis stone (2-3 cm) in the period between May 2012 and April 2014...
May 2015: Urology
Jonathan L Curtis, D Brandon Harvey, Scott Willie, Evan Narasimhan, Seth Andrews, Jake Henrichsen, Nicholas C Van Buren, Rajendu Srivastava, Jeremy D Meier
OBJECTIVE: (1) Review the reasons, timing, and costs for children presenting to the emergency department (ED) after adenotonsillectomy (T&A). STUDY DESIGN: Case series with chart review. SETTING: Tertiary care children's hospital. SUBJECTS AND METHODS: A standardized activity-based hospital accounting system was used to identify 437 children from an academic pediatric otolaryngology practice presenting to the ED after T&A from 2009 to 2012...
April 2015: Otolaryngology—Head and Neck Surgery
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