Minerva pediatrica
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Case Reports
[Intraosseous route in pediatric emergencies. Description of 2 clinical cases and review of the literature].
The Authors describe the intraosseous administration of drugs and fluids in two patients: a preterm infant (gestational age 26 weeks, weight 850 g) with severe cardiopulmonary depression just after delivery, and a 15-day-old newborn with bronchopneumonia. The intraosseous infusion is safe and effective. ⋯ It is indicated in all emergency situations where a vascular access must be rapidly obtained and in whom other methods of access to the vascular system have failed. After a short review on the history of this old procedure, used for the first time in 1922 for blood transfusions, the Authors describe its physiology, technique, complications, and contraindications.
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Review
[Neonatal hepatic cholestasis with particular regard for the use of radioisotopes in its diagnosis].
The aim of this study was to assess the diagnostic sensitivity and specificity of hepatobiliary scintigraphy using a 99mTc-HIDA compound to differentiate intrahepatic cholestasis from extrahepatic forms during the first months of life. The tracer used was acid N-(2,6)-diethylacetanylido-iminodiacetic (diethyl-HIDA) with almost exclusively biliary excretion and a high concentration of radioactivity in the bile. Each neonate was injected with 0.5 mg/kg i.v. of the compound marked with a dose of 99mTc equivalent to 80-100 microCi/kg. ⋯ On the contrary, the absence of the intestinal excretion of the tracer is nor constantly associated with biliary atresia. This study has confirmed this finding in 10 cases of intrahepatic cholestasis (4 hypoplasias of the intrahepatic biliary tract, 3 thick bile syndromes, 3 cases of hepatitis due to cytomegalovirus). In conclusion, the Authors state that hepato-biliary scintigraphy represents a straightforward and non-invasive diagnostic method which enables the permeability of the biliary tract to be assessed in subjects with jaundice.
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Comparative Study
[Children and adolescents with epilepsy. Cognitive abilities, learning disorders and depression].
The authors studied some psychological and psychopathological problems in epileptic children and adolescents. 47 cases (range 6.6-16 ys), with well controlled seizures and learning difficulties, have been examined and compared with 80 children and adolescents with learning disorders. The analysis of anamnestic data about early minimal brain damage (MBD) differentiated 4 groups: with an without epilepsy, with and without MBD. ⋯ The depression symptoms are similar in these 2 groups and above all sustained by psychogenic pathogenesis. The authors conclude with a critical reflection on prejudices regarding children and adolescents with epilepsy.
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We consider the approach through the left external jugular vein v/s right external jugular vein (Heinbach-Ivey technique) for the placement of central venous catheters (Broviac Hickman type and others) in pediatric patients. Between January '84 and February '87, 65 central venous catheters were inserted using the Heinbach Ivey technique. ⋯ Between March '87 and November '88, 72 catheters were inserted through the left external jugular vein, only 5 through the left internal jugular vein, with a failure rate of 6%. Our data show that a more favourable anatomy makes easier and quicker the correct placement of a central venous catheter through a left external jugular vein approach.
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Comparative Study
[Postoperative complications of adenotonsillectomy].