European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
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Comparative Study
Portal venous gas detected by ultrasound differentiates surgical NEC from other acquired neonatal intestinal diseases.
The definite clinical diagnosis of acquired neonatal intestinal diseases (ANID) is a challenge, usually met by applying Bell's or, more recently, Gordon's classification. Both classifications incorporate radiological pneumatosis intestinalis (PI) as a cornerstone of the NEC diagnosis. However, PI may be absent or difficult to identify by abdominal X-ray. Portal venous gas detected by ultrasound (PVG-US) has been proposed as another characteristic of NEC, but its incidence in other entities of ANID remains unknown. ⋯ Screening for PVG-US and Gordon's classification are valid tools to differentiate between NEC and other ANID including SIP. Although an effect of these proposed diagnostic tools on treatment regimen and operative management has yet to be verified, the improvement in diagnosing ANID is certainly valuable.
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Randomized Controlled Trial
Use of a preoperative playroom to prepare children for surgery.
The aim of this study was to evaluate the efficacy of a playroom next to the operating room to reduce preoperative anxiety in children. ⋯ A preoperative playroom is a very effective method to reduce preoperative anxiety in children.
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Clinical Trial
Impact of Lodox Statscan on radiation dose and screening time in paediatric trauma patients.
As part of the primary investigation, polytrauma patients arriving at our emergency department are examined in accordance with the Advanced Trauma Life Support (ATLS) rules, using the new Lodox Statscan (LS) digital low-radiation imaging device. The aim of this study was to establish whether entrance and effective radiation doses using LS in children were comparable to those of paediatric Computed Radiography (CR) and to evaluate the duration of scanning for both techniques in young polytrauma patients. ⋯ LS scanning will probably be a useful diagnostic tool for a range of paediatric clinical indications in the future. But only the future will show whether LS will survive in the face of low-dose radiation CT scanners and magnetic resonance imaging devices that may eventually completely replace conventional radiography.
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Comparative Study
Intramedullary nailing for the treatment of dislocated pediatric radial neck fractures.
Pediatric radial neck fractures represent 5-10% of all elbow fractures. Open reduction allows anatomic fracture fixation but compromises the vulnerable blood supply of the radial head. Intramedullary nailing combines the advantages of closed reduction and stable internal fracture fixation. ⋯ The retrograde nailing technique for the treatment of dislocated fractures of the radial neck in pediatric patients is a simple, short and safe procedure.
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Type 6 physeal injuries, described by Rang as a displacement of the perichondrial ring usually caused by a lawn-mower scalping mechanism or a closed trauma to the distal femoral physis avulsed by the lateral collateral ligament, are extremely rare. This type of injury was later included in Salter and Harris' classification of physeal injuries as type 6. No large series of type 6 physeal injuries has been described in the literature. The aim of the study is to present a relatively large series of patients with this trauma and offer some new observations. ⋯ Although no larger series of type 6 physeal injuries has been described to date, it is clear that the mechanism of trauma has changed from earlier reports of open lawn-mower injuries to closed soccer and athletic sports fractures. Closed type 6 injuries are usually not or only minimally displaced and do not require surgery. Open fractures were associated with soft tissue loss; they were caused by scraping of the ankle (knee, elbow) by a car or bicycle wheel on a road surface or the result of a gunshot injury with the projectile destroying the peripheral portion of the physis.