La Pediatria medica e chirurgica : Medical and surgical pediatrics
-
To correlate the urge syndrome due to bladder overactivity and the lazy bladder syndrome, demonstrating that, at least in some cases, the lazy bladder may be the final stage of the evolution of an overactive bladder when associated with overactivity of the pelvic floor during micturition. ⋯ The transition from an overactive bladder to a hypocontractile one has been reported previously, but it has not been extensively investigated in children and its causes are largely hypothetical. In our cases this phenomenon occurred only in girls that, initially showed both detrusor urethral sphincter overactivity, therefore we can reasonably conceive that, at least in some cases, the lazy bladder syndrome may be due to prolonged and repeated high pressure bladder contractions opposed by a non relaxing sphincter that may lead to a progressive loss of the contractile properties of detrusor muscle fibres. The rather rapid shift observed in our patients might have been favoured by the use of anticholinergic medications.
-
The induction of anaesthesia for surgery is a stressful event for child. To treat pre-operative anxiety in children pharmalogical methods (premedication) and behavioural methods (the presence of parents during the induction of anesthesia) are used in combination with each other. The purpose of this investigation was to study the effect of two interventions to alleviate preoperative anxiety of 39 children who are undergoing minor surgery. We studied the influence of some psichological and social characteristics of child and parents on operative period. ⋯ Mother's presence during induction resulted of paramount importance. This study shows that the premedication alone is not effective. Some social-demographical factors of the parents have influence.
-
Between 0,7-3% of pediatric patients may require resuscitation during hospital stay. The physicians of the Pediatric Intensive Care Unit of the C. O. ⋯ The plan consisted of: the drawing up of a PI 34-Procedure; the preparation and implementation of a training course for doctors and nurses; the purchase of 12 emergency-trolleys according to the Broselow Pediatric Resuscitation Measuring Tape and the implementation of a specific system for the emergency-call. Precise duty for anesthesiologists and intensivists is the emergency- planning and management, in order to diffuse the medical knowledge needed to assist patients requiring vital functions support. The management of the intra-hospital pediatric emergencies is strictly dependent on the training of the staff, based on a specific support algorithm, and specific equipment for the different ages.
-
Distribution of the population and the need of centralized care of critically ill children make pediatric transport an important issue. This highly complex act is often performed by not adequately trained staff. This paper focuses on the different phases of pediatric transport: admission to Emergency Department, stabilization, transport preparation, transport period, arrival at admitting centre. Each centre should develop its own protocol and activate a surveillance system.