Three years' experience with ketamin in paediatric odontostomatology is reported. A comparison is made between the disadvantages and advantages of this anaesthetic by comparison with fluothane.

Age Factors↗

PubMedDate not supplied

[Urethro-vesical-vas deferens reflux as a cause of acute scrotum].

The Authors reviewed 159 children who underwent surgical therapy for "acute scrotum", and they consider that the torsion of the appendix testis is the most common cause of the syndrome in children. On the other hand the orchi-epididymitis is very rare in paediatric age. About the incidence and etiopathogenesis of orchi-epididymitis is reported the revision of the literature; in particular is described the condition of the urethro-vesical-deferential reflux causing a chemical or infective orchi-epididymitis.

Acute Disease↗

PubMedDate not supplied

[The diagnosis of gastroesophageal reflux in childhood: a comparison between echography and pH measurement].

Gastroesophageal reflux (GER) is a very common event in childhood. Therefore we must use an exact and nontraumatizing test to differentiate between physiologic and pathologic conditions. Sonography appears to be a methodology endowed with these particularities. The aim of our study was to evaluate the diagnostic efficacy of Ultrasound (US) in comparison with a very precise test: the pH monitoring. We studied, by both methodologies, 76 children with suspected GER. Compared to pH-metry data, sonography showed a diagnostic sensitivity of 88,46% and a specificity of 58,33%. Therefore US appears to be an efficacious and innocuous test both in the screening and in the follow-up of patients with GER.

Child↗

PubMedDate not supplied

[Extralobar pulmonary sequestration in children: presentation of a case].

The pulmonary sequestration is an anatomical condition with as isle of pulmonary tissue independent from tracheobronchial tree. This tissue has an independent artery originated from aorta. Anatomically we can have two types of sequestration. The first is the condition of an isle of pulmonary tissue included without any separation in the lobe; this condition in named intra-lobar sequestration. On the other hand we have a second condition with an isle of independent pulmonary tissue surrounded with independent pleura; the last one is named extra-lobar sequestration. In the present article the authors describe a case of extralobar sequestration in a two years old girl. The symptoms presented by the girl were hyperpyrexia, tough and recurrent bronchopulmonary infections. The girl underwent surgery removal of sequestration. The authors describe their experience, the importance of symptomatology and the anatomo-pathologic characteristics of this lesions.

Age Factors↗

PubMedDate not supplied

[Conservative treatment of post-traumatic periduodenal hematoma: presentation of a clinical case and review of the literature].

The authors describe a case of post-traumatic hematoma of the duodenum in a two years old child. This is a very rare condition in paediatric age, but with the increasing incidence of traumatic pathology it can be predicted an increase of this condition. The duodenal hematoma can be treated either with surgical approach or with conservative treatment. The authors discuss the characteristics of the pathology, the etiopathogenetic mechanism, and propose the same classification adopted by some french authors. The type of lesion indicates the adequate therapy; in particular in the case report (type 1) a conservative treatment is adopted. The laboratory parametres are significative but none is diagnostic. In the present case the amylasemia is not elevated until two weeks after the trauma. Very important for diagnosis are T.C., roentgenography and echotomography, the last one can be easily used for the control of the resolution of the hematoma. The conservative treatment is based on nasogastric suction and parenteral nutrition; although the role of nonoperative treatment is emphasized, the importance of careful assessment for signs of peritonitis or enlarging tender mass cannot be overlooked.

Accidents, Traffic↗

PubMedDate not supplied

[Neuroblastoma metastatic to the skull. Radiologic aspects and therapeutic problems].

Clinical-radiological findings, treatment and prognosis of cranial involvement in 19 cases of neuroblastoma stage IV have been considered. The most frequent clinical features were periorbital ecchymosis and intracranial hypertension. The radiographic aspects, graduated according to the type of the lesion, showed a close correlation with clinical findings and sometimes preceded them. Computerized tomography, carried out in 12 cases, was more reliable than plain films in identifying the site and extent of cranial lesions and the presence of cerebral extensions, as occurred in 2 patients. The presence of cranial involvement at diagnosis was an unfavorable prognostic sign. The 19 children were treated in various ways so that firm conclusions cannot be drawn, but cranial radiotherapy in combination with chemotherapy appeared to be more efficacious than chemotherapy alone.

Combined Modality Therapy↗

PubMedDate not supplied

[Prognostic significance of osseous lesions in acute lymphoblastic leukemia in children].

Full skeletal survey was performed on 54 children presenting over a 6-year period (1973-1979) with acute lymphoblastic leukaemia (ALL). Findings that were considered attributable to leukaemia included metaphyseal bands, osteolytic lesions and periosteal reactions. One or more of these roentgenographic findings was observed in 24 children (44%). The mean duration of remission and of survival was much shorter in cases with multiple bone involvement (3 or more lesions) than in those where bone involvement was absent or limitated at 1 or 2 bone lesions.

Bone Neoplasms↗

PubMedDate not supplied

[Further experience with the use of gastrointestinal segments in bladder reconstruction in the complex of exstrophy-epispadias].

It is a matter of discussion if bladder augmentation should or should not utilize in the treatment of exstrophy-epispadias complex. When staged functional bladder reconstruction is adopted in the most difficult cases, or when one desires to avoid early and/or subsequent urinary diversions, sometimes a bladder enhancement could be necessary. The indications should be: a progressive damage to the upper urinary tract, after bladder closure at birth, due to a very small, no compliant detrusor plate (this is a rare condition: only one case in our series); a bladder capacity < or = 80 mls at the time of bladder neck reconstruction (this is a frequent but questionable condition: three cases in our series); a progressive damage of the upper urinary tract after bladder neck reconstruction (this is an unexpected, but not rare condition: 3 cases in our series); during every undiversion procedure (bladder augmentation is nearly mandatory during undiversion in cloacal or bladder exstrophies previously diverted: 4 cases in our series). In our experience, 12 bladder augmentations (in 11 patients, over 85 cases we observed) were done at median age of 8 years and 5 months. Different intestinal segments have been used: the sigmoid colon, the ileo-cecal portion, an ileal tract and the stomach. Follow-up ranges from 11 years to 12 months; until now, we observed few surgical complications: a bowel obstruction in one patient, a left ureteral partial stenosis at level of the anastomosis with the gastric patch wall in another patient and bladder lithiasis in 5 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

[Magnetic resonance imaging and hypothalamo-hypophyseal disorders in children: morpho-functional and etiologic aspects].

In recent years magnetic resonance (MR) has improved the diagnostic accuracy of the study of the sellar area. In patients with growth hormone deficiency, particularly when associated with other hormonal defects, MR has identified the picture characterized by posterior lobe ectopia, non-visible stalk, hypoplasia of the anterior lobe and presence of intrasellar CSF (empty sella). The latter is not exclusive of growth hormone deficient patients, but can be found also in children with disorders of puberty. Although a certain relationship between pituitary height and growth hormone secretion has been described, it is usually difficult to find a clear association between pituitary dimensions and function of the gland. The theory supporting the congenital origin of the above mentioned abnormalities, which may be part of midline abnormalities, is currently sustained by most Authors. In diabetes insipidus the posterior lobe may or may not be visible and a thickened stalk has been found in patients with disease duration of less than 2 years. In disorders of puberty morphological abnormalities of the sellar area are rare. In girls with precocious puberty the pathological findings described are hamartoma of the tuber cinereum, empty sella and pituitary height increased for age. There seems to be a certain relationship between gonadotropin secretion and pituitary dimensions.

Adolescent↗