Journal of pediatric surgery
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Intestinal involvement in toxic epidermal necrolysis (TEN) has been identified only rarely. We report a case of TEN complicated by small bowel intussusception. The patient was a previously healthy 8-year-old boy who presented with TEN and extensive lesions, including up to 40% of the body surface area as well as conjunctival, oropharyngeal, respiratory, and genital mucosa. ⋯ During the postoperative clinical course, the patient was managed with total parenteral nutrition and local care of the skin and mucous membranes. Enteral feeding was introduced on the sixth postoperative day, and the child left the hospital 15 days after his admission. The association of TEN and small bowel intussusception has not been previously reported in the literature.
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Personal watercrafts (PWC), also known as jet skis, seadoos, and wave-runners have risen in popularity since their introduction in the 1970s. Hydrostatic rectal injury is a rare presentation of passengers thrown off a PWC. The perforation of the rectum is owing to the excessive hydrostatic force of water exerted through the anal canal. ⋯ The use of PWC in Canada is less common than in the US. However, it is steadily increasing, especially on local lakes. Education regarding potential injuries and prevention is recommended.
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In an effort to improve the reporting quality of clinical research, the Journal of Pediatric Surgery instituted specific reporting guidelines for authors beginning June 2006. This study was conducted to evaluate whether these guidelines improved reporting of observational studies. ⋯ The introduction of the Guidelines resulted in significant improvement in the quality of reporting in the Journal. The low cost vs the benefit suggests that the Guidelines can be an effective way to improve reporting quality in nonrandomized studies. We encourage further efforts to increase inclusion of reporting criteria as well as evaluation and improvement of the Guidelines. We suggest that editors of other surgical publications consider implementing analogous guidelines.
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The optimal therapy for intestinal failure (IF) is unknown. The results of a systematic, protocol-driven management strategy by a multidisciplinary team are described. ⋯ The institution of a multidisciplinary team and a protocol-driven strategy to prevent PNALD improves survival in IF. Further studies are recommended.
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Comparative Study Controlled Clinical Trial
First reported experience with intramuscular diaphragm pacing in replacing positive pressure mechanical ventilators in children.
Diaphragm pacing (DP) has been shown to successfully replace mechanical ventilators for adult tetraplegic patients with chronic respiratory insufficiency. This is the first report of DP in ventilator-dependent children. ⋯ Diaphragm pacing successfully replaced mechanical ventilators, which improves quality of life.