Cirugía pediátrica : organo oficial de la Sociedad Española de Cirugía Pediátrica
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Abdominal ultrasonographic study is a part of the acute abdominal pain diagnosis protocol in our hospital. As an internal quality assessment, we performed a six-month prospective study, including those patients who meet one of these requirements: 1st the reason for attendance being non-traumatic abdominal pain 2nd an abdominal ultrasonography achieved at the hospital. Collected data included: demographic characteristics, presenting sign and symptoms, test results, ultrasonography, final diagnosis and treatment. ⋯ Ultrasound examination, for acute appendicitis, had a sensitivity of 94.8%, specificity of 98.8%, positive predictive value of 97.3% and negative predictive value of 97.8%. Abdominal ultrasonography has showed usefulness for surgical pathology discrimination in acute abdominal pain. When ultrasonography is inconclusive, clinical follow-up and periodical ultrasonography results in a positive change in management and treatment.
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Tumors diagnosed during the first month of life are infrequent: 0.5 to 2% of all childhood neoplasms. This is an interesting group of tumors because their type, relative incidence, natural history and response to treatment differ from those seen in older children. ⋯ Diagnosis of congenital tumors is performed earlier in recent years due to the wide use of prenatal ultrasound. Their natural history is more benign than in other age groups, except for CNS tumors and very large or obstructing tumors. The histological patern is not determinant of the outcome. Complete surgical excision is the treatment of choice, most cases not need adjuvant chemotherapy. We ought to pass this message on to our colleagues in prenatal diagnosis, so parents get reliable information.
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Epidemiological analysis of main factors affecting multiple trauma in children in our environment. ⋯ Traffic related injuries are the main cause of multiple trauma in children. The severity and high mortality of these injuries make imperative polytonal education systems and the use of restraining devices.
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Comparative Study
[Post-surgical paediatric pain: Nursing- PCA vs continuous I.V. infusion of tramadol ].
To evaluate the efficiency in the control of the post-surgical paediatric pain of the combination of a weak opioid [tramadol (T)] and an NSAID (paracetamol), comparing its administration through "Nursing-PCA" (NCA) techniques or through continuous i.v. infusion. ⋯ The combination of tramadol and paracetamol through "Nursing PCA" has turned out to be an efficient method in the treatment of the post-surgical pain in little children and those whose are in their lacteal period. It is a possible alternative of the continuous infusion of Morphine in these patients.
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Soft tissue sarcomas are rare mesenchymal neoplasms that constitute less than 10% of all pediatric malignancies. Half of these are rhabdomyosarcomas, the remaining 50% have a varied and heterogenous histologic and clinical patterns (fibrosarcoma, synovial cell sarcoma, extraskeletal Ewing's sarcoma, angiosarcoma, liposarcoma, leiomyosarcoma, ...). The purpose of this work is to evaluate our clinical experience with soft tissue sarcomas in uncommon sites over the past 10 years in order to delimitate the prognostic factors in survival and modalities of treatment. ⋯ The impact of surgical resectability on outcome in these tumors has been clearly demonstrated over other factors like histologic appearance. Distant metastasis are infrequent but local recurrence are a constant in all cases with incomplete surgical resection. Based on those facts we could advanced an adequate approach to this kind of neoplasms: 1) wide complete surgical resection is mandatory; 2) radiotherapy will only be necessary if margins of resection cannot control the local disease, and 3) chemotherapy have not clearly demonstrated his benefits as adjuvant therapy in clinical group I lesions but his employ is recommended in all cases because of the poor prognosis due to local recurrence.