Intraoperative recurrent laryngeal nerve monitoring in unconventional thyroid surgery

The authors herewith present a case of a non-conventional use of endotracheal tube-based IONM in a second-stage total thyroidectomy for metastatic papillary cancer incidentally detected after OPHL Type IIa + ary left for SCC. The use of the IONM in such case was effective avoiding the RLN accidental injury.

Accident Compensation in Swiss and New Zealand Law: Some Selected Issues That Undermine the Purpose in Both Schemes

<p>This dissertation analyses selected issues that undermine the coherence and the purposes of the Swiss and New Zealand accident compensation schemes. Unlike other European states the Swiss accident compensation provides cover for non-work related accidental injury, which makes it a useful subject of comparison with the New Zealand accident compensation scheme which provides a comprehensive, no fault compensation scheme for personal injury. In undertaking a largely comparative approach the paper argues that both schemes have drifted away considerably from the original underlying purpose to provide compensation for work incapacity and, on the other hand, to restore the claimant to a level of work capacity as soon as possible. This thesis is illustrated by examining the vulnerability of the schemes to political change, the arbitrary dichotomy between incapacity to work caused by accidental injury and incapacity caused by sickness, the definitions of an accident in both schemes and the assessment of evidence. The paper finds that both schemes should be amended and suggests alternative approaches for each issue.</p>

Accident Compensation in Swiss and New Zealand Law: Some Selected Issues That Undermine the Purpose in Both Schemes

<p>This dissertation analyses selected issues that undermine the coherence and the purposes of the Swiss and New Zealand accident compensation schemes. Unlike other European states the Swiss accident compensation provides cover for non-work related accidental injury, which makes it a useful subject of comparison with the New Zealand accident compensation scheme which provides a comprehensive, no fault compensation scheme for personal injury. In undertaking a largely comparative approach the paper argues that both schemes have drifted away considerably from the original underlying purpose to provide compensation for work incapacity and, on the other hand, to restore the claimant to a level of work capacity as soon as possible. This thesis is illustrated by examining the vulnerability of the schemes to political change, the arbitrary dichotomy between incapacity to work caused by accidental injury and incapacity caused by sickness, the definitions of an accident in both schemes and the assessment of evidence. The paper finds that both schemes should be amended and suggests alternative approaches for each issue.</p>

P.122 The Pediatric Neuroirritability Management Protocol at the Stollery Children’s Hospital – Inspired by an Irritable Infant with GM3 Synthase Deficiency

Background: We describe an infant with a diagnosis of GM3 synthase deficiency, presenting with severe neuroirritability from birth. He required multiple admissions due to extreme agitation and caregiver burnout. Multiple pharmacological agents were tried, and the effect of each medication was modest and short-lasting at best. The literature on the management of neuroirritability in children with progressive genetic and metabolic conditions is sparse, and a neuroirritability management protocol has yet to be developed at our institution. Methods: We searched for relevant primary research and articles on PubMed. We reviewed the evidence of each pharmacological agent and added non-pharmacological strategies. We developed management guidelines for neuroirritability at our hospital. This protocol was reviewed by several pediatric neurologists and pediatric palliative care specialists at the Stollery and SickKids Hospitals. Results: We present the Pediatric Neuroirritability Management Protocol for the Stollery Children’s Hospital. Conclusions: Further study is required to assess whether this protocol can be adapted to treat irritability in the context of other neurological conditions such as hypoxic-ischemic encephalopathy and non-accidental injury. In addition, we will expand our guidelines to include other symptoms such as spasticity, dystonia, and autonomic dysfunction.

Paediatric orthopaedic surgery

This chapter outlines childhood growth and the physis and the management of paediatric fractures. The chapter also outlines the approach to the limping child or the child with a non-accidental injury. Conditions such as hip dysplasia, Legg–Calvé–Perthes disease, slipped upper femoral epiphysis, scoliosis and cerebral palsy are described in detail.

Use of Foley catheter in control of internal carotid hemorrhage during endoscopic endonasal surgery

Internal carotid artery (ICA) injuries during endoscopic endonasal surgery (EES) are rare life-threatening events. We describe a technique to manage ICA injuries based on the use of Foley catheters.A 26-year-old female underwent endoscopic transnasal trans-sphenoidal removal of pituitary adenoma. Cerebrospinal fluid leak occurred 4 days postoperatively. During repair procedure, accidental injury of ICA occurred. Emergency nasal packing through positioning of four Foley urologic catheters was successfully performed to stop bleeding. The patient did not report neurologic deficits.In author&rsquo;s opinion, Foley catheters are suitable to obtain immediate bleeding control since they are rapidly available and easily usable.

A review of pediatric femoral fracture patterns, surgical managements, and outcomes

<p class="abstract"><strong>Background: </strong>Femoral fractures are the most common pediatric orthopedic fractures that require hospitalization. The non-accidental injury should be suspected in early infancy and non-ambulatory children. Treatment of pediatric femoral fractures is widely variable and depends on intrinsic and extrinsic factors. This study presents pediatric femoral fracture epidemiology and outcomes and reviews the literature regarding best practices in pediatric femoral fractures.</p><p class="abstract"><strong>Methods:</strong> This retrospective study reviewed the clinical and radiological records of forty-sevens femur fractures in the pediatric age group from September 2020 until June 2021 in Prince Rashid bin AL Hassan Military Hospital in Jordan.</p><p class="abstract"><strong>Results:</strong> Males form 80.9% of patients. The mean age for the patients was equal to 6.70 years (±3.91). Falling is responsible for the majority of the injury. The middle femur shaft was fractured in 46.8%, and the pathological fracture was found in 17% of patients. Non-operative treatment by cast represents 42.6%. All fractures were healed at 7.90 weeks (±2.37).</p><p class="abstract"><strong>Conclusions: </strong>Pediatric femur fracture lacks standardized treatment. Nevertheless, most fractures healed with satisfactory results. Younger age groups are more likely to be treated non-operatively. Non-surgical treatment is more prone to shortening, angulation, and later return to weight-bearing and activity. Children older than eight years treated by plating demonstrated faster healing, return to full weight-bearing, and lower complication rate. </p>