European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift für Kinderchirurgie
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Parental presence during induction of anesthesia (PPIA) remains controversial and little is known about surgeons' attitudes toward this clinical practice. A questionnaire was mailed to all the United States (US) members of the Surgical Section of the American Academy of Pediatrics and all members of the British Association of Paediatric Surgeons. Questions were asked about attitudes toward PPIA in the operating room and the prevalence of such practice. ⋯ These differences in prevalence persisted after logistic-regression models were used to adjust for potential confounding demographic variables. We conclude that the attitudes and practice toward PPIA held by surgeons from the US and GB differ significantly. While a large percentage of the US sample agree that there are benefits in PPIA, only a minority report the routine use of PPIA in contrast to most respondents from GB who report PPIA as routine in their hospital.
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The association of appendicitis and blunt abdominal trauma (BAT) is an exceptionally rare occurrence with a few case reports in the literature. The main question whether this association is a result of causative or coincidental relationship has not been evaluated among children. A retrospective clinical study was performed to clarify the pathogenesis, incidence, clinical characteristics and outcome of appendicitis diagnosed in children during the hospitalization period following blunt abdominal trauma (BAT). ⋯ Full recovery was achieved in all patients following appendicectomy. Our incidence of 0.90% is statistically significantly higher than the highest incidence rate of appendicitis stated in the literature during childhood (t-test for population proportion, t = 2.892; p < 0.05). We emphasise the possibility of a causative relationship between appendicitis and BAT depending on the clinical characteristics, operative findings, statistically significant high incidence rate and literature review.
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The aim of this study is to evaluate the effect of the analgesic treatment currently used in children, and to identify if problems can be related to any particular routine or group of children. Analgesics administered pre-, per- and postoperatively were recorded, and intensity of pain during rest and movement and incidence and severity of side effects were measured four times postoperatively. Fifty-nine children aged 3 to 15 years undergoing miscellaneous operations participated. ⋯ During the study period 26 children reported at least one episode of unacceptable pain, while unacceptable pruritus, nausea or vomiting were observed in 18 children. It was not possible to relate the incidence of pain and side effects to any particular analgesic treatment or type of surgery, but groups of children that might need additional attention were identified. Even though improvements have been obtained, it is still a challenge to optimize the postoperative pain management of children, and when doing so attention should be paid not only to pain relief, but also to side effects of the administered analgesics.
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Since 1990 we have used systematically the scalp as donor site for split skin graft in children. The aim of this retrospective and prospective study is to analyse the results, advantages, disadvantages, complications and problems of this method. ⋯ Skin harvesting from the scalp in children can be recommended as first choice. The advantages, especially the rapid epithelialisation and the lack of visible scars, overcome the problems and the risks.
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Review Case Reports
Traumatic pneumatoceles in an infant: case report and review of the literature.
A female infant who was run over by a tractor was admitted to an outside trauma unit. In addition to severe intraabdominal injuries, she sustained blunt chest trauma. In the right lung she developed pneumatoceles 48 hours after the trauma which were misinterpreted as pneumothorax on repeated chest x-rays. ⋯ Compression of an elastic thorax is followed by a greatly increased negative intrathoracic pressure on chest rebound and this sequence of events causes bursting lesions of the lung resulting in traumatic intrapulmonary cysts, the so-called pneumatoceles. One must be aware that pneumatoceles can develop and initial diagnosis is difficult. Although usually uncomplicated, a pneumatocele that does not progressively become smaller can be a life-threatening complication of blunt chest trauma and surgical resection is recommended.