European journal of pediatrics
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Late-presenting congenital diaphragmatic hernia (CDH) is often difficult to diagnose and delay in treatment is common. Seven patients were operated beyond the newborn period for left-sided Bochdaleck hernia. Their age ranged from 1 month to 9 years. ⋯ A careful analysis of chest films and searching for "connecting" bowel segments passing through the diaphragmatic defect may help to avoid incorrect diagnosis and undesirable delay in treatment. Confusion with pneumonia or pneumothorax can be diminished by placing a feeding tube and instillation of contrast material. Ultrasound should be used supportively in all suspected diseases of the diaphragm.
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This study presents a series of 34 sickle cell patients with one or more cerebrovascular accidents (CVA). Risk factors were studied in a subgroup of 19 patients whose clinical and biological characteristics were compared to those of a group of 444 sickle cell patients without CVA. ⋯ The risk of recurrence, neurological defects or death after subsequent CVA justify long-term transfusion treatment in patients presenting with a second CVA. However our study shows that 10 patients who were not transfused after their first CVA had no recurrences, (median follow up = 7.9 years; 2-18 years), providing a basis for discussion on the indications of long-term transfusion therapy for sickle cell patients presenting with their first CVA.
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To evaluate the effects of maternal haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome on the fetus and neonate we retrospectively investigated the outcome of 87 pregnancies. All women showed thrombocytopenia, elevated liver enzymes and haemolysis. None of them died. ⋯ Mean duration of admission was 51 days. HELLP syndrome is associated with poor perinatal outcome; the incidence of caesarean section is high and there is an increased risk for preterm birth and growth retardation. No specific neonatal pathology due to maternal HELLP syndrome was found.
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The management of boys with undescended testes appears to be an increasingly common problem. While Scorer (1964) [11] reported an incidence of 0.8% of undescended testes in boys of one year of age, a recent survey (Radcliffe Hospital, Oxford, 1986) [18] suggests the incidence has risen to as high as 1.6%. ⋯ Indeed, a review of the experience at The Children's Hospital of Philadelphia [12] of boys with bilateral undescended testes indicated a greater number of CNS abnormalities (P = 0.0000) than in boys with unilateral undescended testes (Table 1). Also consistent with bilateral cryptorchid testes representing the most severe end of the spectrum was the reported findings from that study that bilateral undescended testes also exhibit a significantly greater number of associated G-U anomalies (P = 0.0004).