Analgesic Premedication in the Management of Ileocolic Intussusception

PEDIATRICS ◽  
1987 ◽  
Vol 79 (3) ◽  
pp. 432-434
Author(s):  
ROBERT J. TOULOUKIAN ◽  
JOSEPH B. O'CONNELL ◽  
RICHARD I. MARKOWITZ ◽  
NANCY ROSENFIELD ◽  
JOHN H. SEASHORE ◽  
...  

Hydrostatic reduction of ileocolic intussusception by barium enema is uniformly regarded as optimal management, with surgical treatment reserved for occasions when this is not successful and for other selected circumstances.1 In an attempt to maximize the success rate of hydrostatic reduction, we examined the effect of analgesic premedication on both the outcome for the barium study and the operative findings. MATERIALS AND METHODS The case records and radiographs of 76 children with ileocolic intussusception treated at the Yale-New Haven Hospital between Jan 1, 1974, and Dec 31, 1984, were reviewed for patient age, sex, seasonal incidence, presenting signs and symptoms, and results of hydrostatic reduction, as well as surgical treatment with operative findings, morbidity, and mortality.

PEDIATRICS ◽  
1960 ◽  
Vol 25 (4) ◽  
pp. 561-562
Author(s):  
THOMAS V. SANTULLI

THE ARTICLE by Robins and Plenk which appears in this issue of Pediatrics is representative of the experience on the operative and non-operative forms of treatment of intussusception in childhood which is being reported by many others. Although the series is too small to draw any valid conclusions, the authors have attempted to show that reduction by barium enema will save about a half of these patients a surgical procedure, and they have called our attention to the advantages and disadvantages of hydrostatic reduction. The treatment is still controversial and there is uncertainty regarding the proper role, if any, of hydrostatic reduction of intussusception. Some of the proponents of the surgical treatment still maintain that operation is the only form of treatment for all cases of ileocolic intussusception, while other authors are equally adamant in the use of hydrostatic pressure as the primary method of reduction.


2016 ◽  
Vol 23 (3) ◽  
pp. 179-184 ◽  
Author(s):  
Prakirthi Yerram ◽  
Shraddha Kansagra ◽  
Osama Abdelghany

Background Denosumab therapy is commonly used for the prevention of skeletal-related events in patients with bone metastasis. However, a common side effect of denosumab is hypocalcemia. Objective The aim of the study is to determine the incidence of hypocalcemia in patients receiving denosumab for prevention of skeletal-related events in bone metastasis and evaluate risk factors for developing hypocalcemia. Methods This was a retrospective medication use evaluation reviewing the incidence of hypocalcemia in patients receiving outpatient denosumab for prevention of skeletal-related events at Yale–New Haven Hospital. Additionally, various risk factors were reviewed to determine their risk of developing hypocalcemia. Results As per Common Terminology Criteria for Adverse Events v4.03, of the 106 patients included in the study population, 37 (35%) patients had an incidence of hypocalcemia within 30 days of denosumab administration. Fourteen patients (13.2%) had an incidence of grade 1, 13 patients (12.3%) had an incidence of grade 2 hypocalcemia, and 7 patients (6.6%) had an incidence of grade 3 hypocalcemia. Grade 4 hypocalcemia occurred in three (2.8%) patients. Calcium supplementation did not decrease the risk of developing hypocalcemia. Patients who had one or more episodes of acute kidney insufficiency were at a higher risk of developing hypocalcemia (odds ratio = 7.5 (95% confidence interval = 1.8–36.3), p = 0.001). Conclusion This study found that the overall incidence of hypocalcemia and severe hypocalcemia was higher than reported in clinical trials. Additionally, calcium supplementation did not have an effect on incidence of hypocalcemia, while patients who experienced acute kidney insufficiency while on denosumab had a higher likelihood of developing hypocalcemia.


PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 961-963
Author(s):  
RICHARD B. MINK ◽  
MURRAY M. POLLACK

Although issues concerning withdrawal and limitation of life support are commonly discussed,1-6 actual practices in pediatrics are largely unknown and are limited to neonatal intensive care unit (ICU) studies. In the neonatal ICUs at Yale-New Haven Hospital and at Hammersmith Hospital, 14% and 30%, respectively, of all deaths followed withdrawal of care.7,8 In adult ICUs, limitation and/or withdrawal of therapy is common,9 and in one investigation, resuscitation was not attempted immediately before ICU death in nearly two-thirds of cases.10 Nonetheless, many physicians believe that most hospital deaths occur only after all resuscitative attempts have failed,6,11,12 and others believe that resuscitative efforts neither are indicated nor desirable in many cases.1,13


PEDIATRICS ◽  
1948 ◽  
Vol 2 (2) ◽  
pp. 200-206
Author(s):  
AUGUSTA STUART CLAY

THIS study was made in the belief that family living and growth can be healthier if parents understand how mother and baby develop and what they need. Eleven mothers were visited weekly for two months before and after the birth of their firstborn to discover what guidance they wanted, what was offered, and what additional guidance was needed. The writer secured their cooperation by agreeing to work with them as a consultant, to interpret their point of view to the doctor, to explain medical instructions when permitted, and to teach the normal growth processes of mother and baby. Ten mothers were registered in the prenatal clinics of the New Haven Hospital; the eleventh had a private physician. They had no recorded problems beyond the needs of healthy pregnancy and they wanted to participate. Eight husbands agreed to take part in the study. The other three were overseas, but their wives reported for them. Backgrounds varied; 20 of the 22 had had college or high school education; all were between 18 and 32. None dropped out, and after the four months all asked for continued guidance. Cases were too few and the study too brief for statistical evidence. But problems were uncovered which needed to be considered and which have largely been neglected in routine obstetric and pediatric care. These parents wanted to learn—not in classes, but in the privacy of home—how to care for mother and baby without disrupting their accustomed way of living. All wanted the care and interest of one doctor for mother and one for baby. However, six women and five men preferred to talk with a consultant who was not a doctor, but who was affiliated with their doctors. The doctors seemed too busy for "little things" and "family affairs," and they saw so many doctors that they all seemed strangers. Once they felt sure that the consultant's interest was in themselves rather than in teaching them, they set the pace and pattern in the conference. There was no questionnaire, no probing, no set procedure. If they had any immediate interests or problems: job, move, presents, trips, in-laws, illness—these were discussed before they talked of pregnancy and baby.


2007 ◽  
Vol 125 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Antonio Paulo Durante ◽  
Sergio Tomaz Schettini ◽  
Djalma José Fagundes

CONTEXT AND OBJECTIVE: Association between neurological lesions and gastroesophageal reflux disease (GERD) in children is very common. When surgical treatment is indicated, the consensus favors the fundoplication technique recommended by Nissen, despite its high morbidity and relapse rates. Vertical gastric plication is a procedure that may have advantages over Nissen fundoplication, since it is less aggressive and more adequately meets anatomical principles. The authors proposed to compare the results from the Nissen and vertical gastric plication techniques. DESIGN AND SETTING: Randomized prospective study within the Postgraduate Surgery and Experimentation Program of Unifesp-EPM, at Hospital do Servidor Público Estadual (IAMSPE) and Hospital Municipal Infantil Menino Jesus. METHODS: Fourteen consecutive children with cerebral palsy attended between November 2003 and July 2004 were randomized into two groups for surgical treatment of GERD: NF, Nissen fundoplication (n = 7); and VGP, vertical gastric plication (n = 7). These were clinically assessed by scoring for signs and symptoms, evaluation of esophageal pH measurements, duration of the operation, intra and postoperative complications, mortality and length of hospital stay. RESULTS: The mean follow-up was 5.2 months; symptoms were reduced by 42.8% (NF) (p = 0.001) and 57.1% (VGP) (p = 0.006). The Boix-Ochoa score was favorable for both groups: NF (p < 0.001) and VGP (p < 0.042). The overall mortality was 14.28% in both groups and was due to causes unrelated to the surgical treatment. CONCLUSION: The two operative procedures were shown to be efficient and efficacious for the treatment of GERD in neuropathic patients, over the study period.


2011 ◽  
Vol 58 (4) ◽  
pp. 111-112 ◽  
Author(s):  
Milica Berisavac ◽  
Biljana Kastratovic-Kotlica ◽  
V. Tosic ◽  
N. Markovic ◽  
S. Ljustina ◽  
...  

Acute appendicitis in puerperium is often diagnosed too late, because clinical signs can be unrelaible. Abdominal wall rigidity is rarely noticed in puerpeium because of weak abdominal wall muscles, laboratory parameters are not enough relaible and atipycal appendix presentation makes difficulties in diagnosis3,4. Knowing clinical signs and symptoms of appendicitis, possible complications and their early detection, make a chance for a good surgical outcome. Measuring of axillar and rectal temperature can take confusion in, and prolong time until surgical treatment. Leucocytosis in puerperium is not valid for diagnosis. We report a case of patient in puerperium with high laboratory infection parameters. Diagnosis of appendicitis is made based on clinical signs and symptoms, that is proved intraoperatively and histologicaly. Appendectomy without perforation carries less risks for mother and fetus.


1997 ◽  
Vol 106 (9) ◽  
pp. 729-732 ◽  
Author(s):  
Daniel R. Seely ◽  
George A. Gates

Parosteal osteogenic sarcoma (POS) is an uncommon surface bone tumor, most often arising from the metaphyseal end of long bones. Involvement of the cranial bones is rare, with only 1 case of mastoid bone POS previously reported in the literature. Two patients with POS of the mastoid are presented, 1 followed up for 25 years after surgical treatment. The presenting signs and symptoms, as well as distinctive radiographic findings, are discussed. Histologic features are also described. Typically, cranial POS appears as a sessile, densely ossified surface growth with radiating bone spicules that blend with surrounding soft tissue. Treatment is en bloc resection, which is curative in most cases.


PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 900-906
Author(s):  
John M. Leventhal ◽  
Julia Hamilton ◽  
Susan Rekedal ◽  
Anna Tebano-Micci ◽  
Cynthia Eyster

To determine the value of using anatomically correct dolls in diagnostic interviews of young children suspected of being sexually abused, the records of 83 children who were less than 7 years of age and who were evaluated at Yale-New Haven Hospital because of a suspicion of sexual abuse were reviewed. The dolls were used in 60 cases (72%). When the dolls were used, children provided significantly more information than by interview alone about what had happened and about the identity of the suspected perpetrator. Children less than 3 years of age, however, were unable to provide details about the abuse despite the use of the dolls. The ratings of the likelihood that sexual abuse had occurred were based on all of the information in the case including that obtained through the diagnostic interview with the dolls. When these ratings were compared with the ratings based on evidence obtained solely from noninterview data, the likelihood of abuse was higher in 35% of the cases. It was concluded that substantially more information is provided by young children when anatomically correct dolls are used and that the likelihood of detection of abuse is increased when information from the child is included in the assessment.


2012 ◽  
Vol 2012 (nov22 2) ◽  
pp. bcr2012007466-bcr2012007466 ◽  
Author(s):  
J. Menke

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