Journal of pediatric surgery
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To our knowledge, the prevalence of Systemic Inflammatory Response Syndrome (SIRS) in pediatric patients with appendicitis has not been previously investigated. Our specific aim was to determine the prevalence of SIRS at the time of presentation of pediatric patients with appendicitis. Additionally, we sought to determine if the presence of SIRS had any value in predicting their clinical outcomes. ⋯ Our study found a 31.1% prevalence of SIRS in pediatric patients presenting with appendicitis. Our results suggest these patients with SIRS have a significantly higher risk of having/developing an intraabdominal abscess (RR, 2.4; 95% CI: 1.6-3.6) and significantly longer LOS.
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Comparative Study Clinical Trial
Postoperative pain management in pediatric patients undergoing minimally invasive repair of pectus excavatum: the role of intercostal block.
There are no published data regarding value of intercostal block following pectus excavatum repair. Our aim was to evaluate the efficacy of intercostal block in children following minimally invasive repair of pectus excavatum (MIRPE). ⋯ Bilateral intercostal blocks following MIRPE are safe and easy to perform and can diminish postoperative opioid requirement. Double-blind randomized study is required to confirm the potential to diminish opioid related side effects.
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To analyze the development and innervation of bladder smooth muscle and lesions of the spinal cord in fetal rats with meningomyelocele (MMC) at different gestational ages and to investigate interactions between spinal cord lesions and bladder. ⋯ Bladder smooth muscle of fetal MMC rat seems morphologically normal in development, while the innervation of the bladder smooth muscle is markedly decreased centrally and peripherally. Astrocytosis appears at a later embryonic stage, which could be a concern in the nerve repair of the spinal cord.
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Median arcuate ligament syndrome (MALS) is a vascular compression syndrome with symptoms that overlap chronic functional abdominal pain (CFAP). We report our experience treating MALS in a pediatric cohort previously diagnosed with CFAP. ⋯ MALS was found to be more common in pediatric females than males. Laparoscopic release of the celiac artery can be performed safely in the pediatric population. Surgical release of the artery and resultant neurolysis resulted in significant improvement in the blood flow, symptoms, and overall QOL in this cohort. The overall improvement in QOL outcome measures after surgery leads us to conclude that MALS might be earlier diagnosed and possibly treated in patients with CFAP. We recommend a multidisciplinary team approach to care for these complex patients.
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To evaluate the pepsin and oxidative stress markers in exhaled breath condensate (EBC) in patients with gastroesophageal reflux disease (GERD). ⋯ Decreased levels of NOX in patients with GER disease suggest increased oxidative stress in airways of these patients.