scholarly journals Percutaneous Cystolithotripsy As A Reliable Modality To Treat Pediatric Vesiculolithiasis

2017 ◽  
Vol 14 (1) ◽  
pp. 18-20 ◽  
Author(s):  
Dipesh Kumar Gupta ◽  
S M Mishra
Keyword(s):  
Pediatric Population ◽  
Treatment Options ◽  
Mucosal Injury ◽  
Good Choice ◽  
Vesical Calculus ◽  
Bladder Stones ◽  
Pediatric Age Group ◽  
Hilly Region ◽  
Average Operative Time ◽  
Male Patients

Background: Primary vesical stones are common in children in underdeveloped and developing countries. The treatment options available for managing bladder calculi include transurethral cystolithotripsy, open cystolithotomy and shock wave lithotripsy (SWL). Although the majority of vesical calculi in adults can be treated by transurethral lithotripsy, this procedure is restricted in children due to the narrow caliber of the urethra. For this reason, percutaneous cystolithotripsy (PCCL) is a good choice as a safe and effective method for the treatment of bladder stones in children.Aim of the Study: The study was aimed to evaluate outcome of PCCL in pediatric population coming with vesiculolithiasis in our center.Materials and Methods: Pediatric age group patients diagnosed as vesical calculus were undertaken for PCCL. Ten patients who presented between November 2014 to December 2015, were included. The procedure was done under general anesthesia. After performing cystoscopy, suprapubic puncture was made and tract dilated up to 26 Fr. Nephroscope was used for visualization and pneumatic lithotripsy for fragmentation of the stone followed by removal of st nd all fragments. Perurethral and suprapubic catheters were placed at the end to be removed on 1 and 2 post operative day, respectively.Results: Median age of the patients was 5.5 (3-13) years. Majority were male patients from hilly region of western Nepal. Mean stone size was 15 mm. All patients were rendered stone free with average operative time of 32.2 minutes. Except one minor complication of mucosal injury patients were discharged after mean hospital stay of 3.9 days.Conclusion: Percutaneous suprapubic lithotripsy is a safe and effective method for the treatment of bladder stones in children. It is fast and associated with negligible complications.JNGMC Vol. 14 No. 1 July 2016, Page: 18-20

MANAGEMENT OF BLADDER STONE WITH HOLMIUM-YAG LASER AT KARDINAH HOSPITAL TEGAL

2020 ◽  
Vol 27 (1) ◽  
pp. 1-4
Author(s):  
Fatan Abshari ◽  
Zulfikar Ali
Keyword(s):  
General Hospital ◽  
Laser Energy ◽  
Major Complication ◽  
Mucosal Injury ◽  
Cross Sectional Study ◽  
Stone Size ◽  
Cross Sectional ◽  
Yag Laser ◽  
Bladder Stones ◽  
Large Size

Objective: Transurethral lithotripsy using Holmium-YAG laser has been reported to be beneficial in breaking up bladder stones with large size (>4cm in diameter) with lower risk of mucosal injury and hematuria. The aim of this study is to evaluate the utilization of Holmium-YAG laser for the management of bladder stones at Kardinah General Hospital, Tegal. Material & Methods: This is a cross-sectional study conducted from January 2017 to March 2017. Patient’s demography, which included age, sex, length of surgery, stone size, and laser’s energy count were recorded. Results: We included 120 patients in this study. Mean of patients age in this study was 51.93 years old with age range were 41-85 years old. Most of the patients were male (109 vs 11) with a mean size of stone 25.09 ± 3.04 mm. Length of surgery ranges from 15 to 75 minutes and mean energy of the laser 28.99 ± 19.34 kJ. There was 100% stone’s clearance following surgery with no major complication occurred. Conclusion: Holmium-YAG laser is effective in managing bladder stones at Kardinah General Hospital particularly for large size stones. Length of surgery and energy of laser used depend on the stone size in which bigger stone size is associated with longer surgery time and bigger laser energy needed.

The Frequency of Random Findings on Abdominal / Pelvis Computed Tomography in Pediatric Trauma Patients

2020 ◽  
Vol 16 ◽  
Author(s):  
Betül Tiryaki Baştuğ
Keyword(s):  
Computed Tomography ◽  
Incidental Findings ◽  
Pediatric Population ◽  
Pediatric Trauma ◽  
Trauma Patients ◽  
Injured Child ◽  
Level 3 ◽  
Male Patients ◽  
Clinically Significant ◽  
Discharge Summaries

Aims: In this study, we aimed to find the percentage of random pathologies and abdominopelvic region anomalies that are not related to trauma in pediatric patients. Background: An abdominal assessment of an injured child usually involves computed tomography imaging of the abdomen and pelvis (CTAP) to determine the presence and size of injuries. Imaging may accidentally reveal irrelevant findings. Objectives: Although the literature in adults has reviewed the frequency of discovering these random findings, few studies have been identified in the pediatric population. Methods: Data on 142( 38 female, 104 male) patients who underwent CTAP during their trauma evaluation between January 2019 and January 2020 dates were obtained from our level 3 pediatric trauma center trauma records. The records and CTAP images were examined retrospectively for extra traumatic pathologies and anomalies. Results: 67 patients (47%) had 81 incidental findings. There were 17 clinically significant random findings. No potential tumors were found in this population. Conclusion: Pediatric trauma CTAP reveals random findings. For further evaluation, incidental findings should be indicated in the discharge summaries.

scholarly journals Surgical Management of Pediatric Gastroesophageal Reflux Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Hope T. Jackson ◽  
Timothy D. Kane
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Surgical Management ◽  
Reflux Disease ◽  
Clinical Presentation ◽  
Pediatric Population ◽  
Treatment Options ◽  
Failure To Thrive ◽  
Solid Diet ◽  
Esophageal Sphincter

Gastroesophageal reflux (GER) is common in the pediatric population. Most cases represent physiologic GER and as the lower esophageal sphincter (LES) matures and a solid diet is introduced, many of these patients (>65%) experience spontaneous resolution of symptoms by two years of age. Those who continue to have symptoms and develop complications such as failure to thrive, secondary respiratory disease, and others are classified as having gastroesophageal reflux disease (GERD). Goals of GERD treatment include the resolution of symptoms and prevention of complications. Treatment options to achieve these goals include dietary or behavioral modifications, pharmacologic intervention, and surgical therapy. This paper will review the clinical presentation of GERD and discuss options for surgical management and outcomes in these patients.

scholarly journals Neurological manifestation of Vitamin D deficiency

2021 ◽  
pp. 430-432
Author(s):  
Saniya Sroa ◽  
Shweta Nair ◽  
Fehmida N ◽  
Amit Vatkar
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Pediatric Population ◽  
Pseudotumor Cerebri ◽  
Neurological Manifestation ◽  
Age Group ◽  
Pediatric Age Group ◽  
Pressure Headache ◽  
Common Deficiency ◽  
Visual Disturbances

Idiopathic intracranial hypertension, also known as pseudotumor cerebri, is a disorder with raised intracranial pressure, headache, papilledema, visual disturbances with a normal cerebrospinal fluid examination, and normal neuroimaging. It is rare in the pediatric population and may occur as a manifestation of underlying disorders. Vitamin D deficiency is a common deficiency in the pediatric age group. However, neurological manifestations are rare. Here, we present the case of a 5-year-old male child who presented with headache, vomiting, and hypertension; however, the neurological examination was normal but the neuroimaging was suggestive of pseudotumor cerebri. Appropriate investigations were done. The most likely cause of pseudotumor cerebri in this patient was the deficiency of Vitamin D. We have reported this case as pseudotumor cerebri is a rare neurological manifestation of Vitamin D deficiency.

Craniopharyngioma

2019 ◽  
pp. 207-216
Author(s):  
Lissa C. Baird
Keyword(s):  
Initial Treatment ◽  
Pediatric Population ◽  
Intraoperative Complications ◽  
Treatment Options ◽  
Benign Neoplasm ◽  
Tumor Control ◽  
Delayed Treatment ◽  
Pituitary Dysfunction ◽  
Treatment Morbidity

Pediatric craniopharyngioma is a histologically benign neoplasm with potential for malignant clinical behavior. Presenting vision and endocrine deficits are common, and the natural history carries unacceptable morbidity, including blindness, complete hypothalamic and pituitary dysfunction, and death. The goal of initial treatment for craniopharyngioma in the pediatric population should be permanent tumor control or cure in order to minimize morbidity from recurrent and progressive disease. Treatment-related morbidity is acute with surgical intervention and requires immediate postoperative endocrinological care. Radiotherapy is associated with delayed treatment morbidity, and long-term monitoring is critical. Inadequate tumor control after initial treatment will result in inevitable recurrence, with more complex and less effective treatment options and higher associated treatment morbidity. Unexpected intraoperative complications can be avoided with careful preoperative planning and good surgical technique.

scholarly journals Impact of Rhinovirus Infections in Children

Viruses ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 521 ◽  
Author(s):  
Silvia Vandini ◽  
Carlotta Biagi ◽  
Maximilian Fischer ◽  
Marcello Lanari
Keyword(s):  
Rna Virus ◽  
Pediatric Population ◽  
Treatment Options ◽  
Respiratory Morbidity ◽  
Upper Respiratory Tract ◽  
Direct Cell ◽  
The Subject ◽  
Upper Respiratory ◽  
Syncytial Virus ◽  
Tract Infections

Rhinovirus (RV) is an RNA virus that causes more than 50% of upper respiratory tract infections in humans worldwide. Together with Respiratory Syncytial Virus, RV is one of the leading causes of viral bronchiolitis in infants and the most common virus associated with wheezing in children aged between one and two years. Because of its tremendous genetic diversity (>150 serotypes), the recurrence of RV infections each year is quite typical. Furthermore, because of its broad clinical spectrum, the clinical variability as well as the pathogenesis of RV infection are nowadays the subjects of an in-depth examination and have been the subject of several studies in the literature. In fact, the virus is responsible for direct cell cytotoxicity in only a small way, and it is now clearer than ever that it may act indirectly by triggering the release of active mediators by structural and inflammatory airway cells, causing the onset and/or the acute exacerbation of asthmatic events in predisposed children. In the present review, we aim to summarize the RV infection’s epidemiology, pathogenetic hypotheses, and available treatment options as well as its correlation with respiratory morbidity and mortality in the pediatric population.

scholarly journals Use of Ceftolozane/Tazobactam for the Treatment of Multidrug-Resistant Pseudomonas aeruginosa Pneumonia in a Pediatric Patient with Combined Immunodeficiency (CID): A Case Report from a Tertiary Hospital in Saudi Arabia

Antibiotics ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 67 ◽  
Author(s):  
Ahmed Zikri ◽  
Kamal El Masri
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Pediatric Patient ◽  
Pediatric Population ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Beta Lactamase ◽  
Combined Immunodeficiency ◽  
Beta Lactam ◽  
Pharmacokinetic Profiles ◽  
Lactamase Inhibitor

Infections, with multidrug-resistant Pseudomonas aeruginosa, are a major concern in the pediatric intensive care unit, especially in immunocompromised patients. Some of these strains are resistant to all beta-lactams, including carbapenems, leaving very limited treatment options remaining. These options include aminoglycosides and colistin, both of which have poor pharmacokinetic profiles with significant toxicities. Newer beta-lactam/beta-lactamase inhibitor combinations offer additional novel options to treat such infections, given their good pharmacokinetic profiles and activity against multi-drug resistant strains. Ceftolozane/tazobactam is a novel cephalosporin/beta-lactamase inhibitor combination approved in 2014. The drug demonstrates good activity against multidrug-resistant P. aeruginosa strains, including those resistant to all other antibiotics. Ceftolozane/tazobactam is currently approved in adult patients 18 years and older only. There are very limited data on its pharmacokinetic profile and clinical utility in the pediatric population. We report the use of ceftolozane/tazobactam to successfully treat pneumonia caused by multidrug-resistant P. aeruginosa in a pediatric patient with combined immunodeficiency syndrome.

Bladder stones

2017 ◽  
Author(s):  
John Reynard ◽  
Ben Turney
Keyword(s):  
Treatment Options ◽  
Outlet Obstruction ◽  
Diagnostic Technique ◽  
Significant Degree ◽  
Benign Prostatic Enlargement ◽  
Bladder Stones ◽  
Pelvic Prolapse ◽  
Pathological Mechanism ◽  
Prostatic Enlargement ◽  
Underlying Pathology

The majority of bladder stones in Western practice are secondary to underlying pathology—bladder outlet obstruction due to benign prostatic enlargement in men and urethral obstruction from pelvic prolapse or cystocele in women, chronic infection in the neuropathic or augmented bladder, or in the neobladder. While the pathology of endemic bladder stones remains as it always was, the advent of augmentation cystoplasty and rising use of the neobladder after cystectomy has, through a different pathological mechanism, led to a rise in frequency of bladder stones. The mode of presentation of bladder stones and diagnostic technique are reviewed in this chapter. Treatment options are determined, to a significant degree, by the clinical context in which the stone arise, the major determinant of the approach to such stones being the calibre of the conduit (urethra or Mitrofanoff) through which access to the bladder is achieved.

scholarly journals How I treat relapsed acute lymphoblastic leukemia in the pediatric population

Blood ◽  
2020 ◽  
Vol 136 (16) ◽  
pp. 1803-1812 ◽  
Author(s):  
Stephen P. Hunger ◽  
Elizabeth A. Raetz
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Pediatric Population ◽  
Lymphoblastic Leukemia ◽  
Treatment Options ◽  
Survival Rates ◽  
Treatment Decision ◽  
Term Survival ◽  
Hematopoietic Stem ◽  
The Past

Abstract Relapsed acute lymphoblastic leukemia (ALL) has remained challenging to treat in children, with survival rates lagging well behind those observed at initial diagnosis. Although there have been some improvements in outcomes over the past few decades, only ∼50% of children with first relapse of ALL survive long term, and outcomes are much worse with second or later relapses. Recurrences that occur within 3 years of diagnosis and any T-ALL relapses are particularly difficult to salvage. Until recently, treatment options were limited to intensive cytotoxic chemotherapy with or without site-directed radiotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). In the past decade, several promising immunotherapeutics have been developed, changing the treatment landscape for children with relapsed ALL. Current research in this field is focusing on how to best incorporate immunotherapeutics into salvage regimens and investigate long-term survival and side effects, and when these might replace HSCT. As more knowledge is gained about the biology of relapse through comprehensive genomic profiling, incorporation of molecularly targeted therapies is another area of active investigation. These advances in treatment offer real promise for less toxic and more effective therapy for children with relapsed ALL, and we present several cases highlighting contemporary treatment decision-making.

scholarly journals Asthma Linked with Rhinosinusitis: An Extensive Review

2014 ◽  
Vol 5 (1) ◽  
pp. ar.2014.5.0083 ◽  
Author(s):  
Marianne Frieri
Keyword(s):  
Early Recognition ◽  
Pediatric Population ◽  
Treatment Options ◽  
The Elderly ◽  
The United States ◽  
Arachidonic Acid Metabolism ◽  
Airway Smooth Muscle Cells ◽  
Extensive Review ◽  
Immune Genes

Current literature related to asthma diagnosis, epidemiology, pathogenesis, and treatment linked with rhinosinusitis is important. Asthma is very heterogeneous; new theories and treatments are emerging. It is a growing epidemic among children and adults in the United States and the severity of asthma is caused by many factors such as lack of education, poor early recognition, decreased symptom awareness, improper medications, and phenotypic changes. Genetic variation, innate immune genes, those involved in tissue remodeling and arachidonic acid metabolism, and inflammatory mediators might contribute to the pathogenesis of chronic rhinosinusitis (CRS) linked with asthma. This extensive review addresses concepts of the burden of asthma and sinusitis, altered innate immunity, adaptive immunity, asthma remodeling, the airway epithelium, the role of airway smooth muscle cells, united allergic airway, genetics, an integral part in asthma, and CRS. In addition, the role of vitamin D in both asthma and CRS in the elderly and pediatric population, various treatment options, and exhaled nitric oxide are briefly addressed.

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