Journal of pediatric surgery
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Refractory chylothorax is a severe clinical issue, particularly in neonates. Conventional primary approach is based on diet with medium-chain fatty acids and/or total parenteral nutrition. In nonresponders, proposed second line treatments include chemical or surgical pleurodesis, thoracic duct ligation, pleuroperitoneal shunting and pleurectomy but none of these have been shown to be superior to other in terms of resolution rate and safety. Our aim is to report our experience on povidone-iodine use for chemical pleurodesis in newborn infants with chylothorax unresponsive to conservative treatment. Our aim is to report our experience on povidone-iodine use for chemical pleurodesis in newborn infants with chylothorax unresponsive to conservative treatment. ⋯ Our data suggest that povidone-iodine pleurodesis may be considered a safe and effective option to treat refractory chylothorax in newborns.
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There is no consensus on the optimal management of pediatric patients with suspected trauma brain injury and a normal head CT. This study characterizes the clinical outcomes of patients with a normal initial CT scan of the head. A retrospective chart review of pediatric blunt trauma patients who underwent head CT for closed head injury at two trauma centers was performed. ⋯ All patients with an initial GCS of 13-15 and no intracranial injury were eventually discharged to home with a normal neurologic exam and no patient required craniotomy. Not admitting those children with an initial GCS of 13-15, normal CT scan, and no other injuries would have saved 1.8 ± 1.5 hospital days per patient. Pediatric patients who have sustained head trauma, have a negative CT scan, and present with a GCS 13-15 can safely be discharged home without admission.
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Given the low mortality of pediatric patients diagnosed with thyroid disease, quality of life (QoL) after thyroid surgery is very important. To organize the best possible patient care we analyzed our experience with respect to QoL and clinical outcome. ⋯ Surgery for thyroid disease during childhood significantly affects QoL. However, QoL seems to improve with increasing age, and hemi-thyroidectomy has less negative effects on QoL than total thyroidectomy.