[Contribution of a new catheter for epidural analgesia in infants].
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Biomedical subjects
Publications and source records attributed to G Terrier.
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UNLABELLED: Continuous epidural analgesia is an common technique in neo-natal surgery. It will be possible with a fitting material. Principal indications are: omphalocele, gastroschisis, oesophagol atresia an diagphragmatic hernia. TECHNIQUE: our protocol has been approved by the Regional Ethical Committee and informed written consent has been obtained from parents. General anaesthesia was induced and children were placed in lateral position. After skin preparation, the interspace L 3-L 4 has been punctured to identify the epidural space by loss of resistance. An epidural catheter (19 to 27 G) has been placed. 0.5 ml.kg-1 of 0.25% bupivacaine have been immediately injected, followed by a continuous injection of 0.3 ml.kg-1h-1 of the same bupivacaine. Epidural has been kept for four to five days. ADVANTAGES: very good analgesia; abdominal and vascular pressures decreased; to wean from respirator very quickly. No accident was founded.
An extramucosal pylorotomy was performed in infants with hypertrophic pyloric stenosis made possible by laparoscopic progress. After performing six cases by laparoscopy, the authors describe what precautionary measures must be taken for the pneumoperitoneum, the instruments utilized, and the advantages of this technique. It appears very likely that laparoscopic pyloromyotomies will become a widespread practice in the future.
Introduction of present-day sinonasal endoscopy and progress in endonasal surgery under endoscopic guidance of endoscopy provide for anatomical exploration of the anterior part of the ethmoid bone, which is the crosspoint of the facial sinus draining paths. We propose to present here a simple and logical scheme of the topographical anatomy of the ethmoid bone. Classification of the ethmoidal cells allows to define the structures, whereby appropriate nomenclature may be adopted and certain confusions avoided. Thus, each cell within particular cell groups acquires a specific designation based on its draining paths and location in relation to basal lamellae. Endoscopic analysis also deserves being described in some length, since the panoramic view afforded by currently used optics modifies the image ans requires that the observer develop an "endoscopic eye". We draw attention to the endoscopic anatomical fine points in the crucial area of the bullar "circus". These landmarks come in as necessary guides in surgical practice.
A case of retroperitoneal appendicular abscess due to Eikenella corrodens is reported. This facultative anaerobe is normally found on the respiratory and intestinal mucosa and may be responsible for opportunistic infections. Culture is difficult and growth is slow. There have been few previous reports of the localization reported herein. A limp was the first manifestation of the infection. The differential diagnosis and pathophysiology of this symptom are discussed.
One hundred children were prophylactically treated with 15 mg/kg-1 of metronidazole immediately before appendicectomy and retrospectively compared with 100 other patients without any antibioprophylaxis. No statistically significant difference was found between the two groups as regards age, weight, sex and macroscopic appearance of the appendix. The overall incidence of complications was 1% in the antibioprophylactic group and 9% in the control group. Furthermore, a single pre-operative intravenous dose of metronidazole was as effective as conventional antibioprophylaxis.
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Colonic atresia it's a rare congenital pathology. Urgent intestinal derivation it's a safety surgical procedure that could defer definitive surgical intervention with all security. In type I Colonic Atresia, plastic enlargement with diaphragm's resection can be an alternative surgical procedure. Authors report the treatment and the evolution in two newborns that underwent this intervention with two and seven years follow-up.
An isocratic reversed-phase ion-pair liquid chromatography with UV detection at 350 nm for the determination in human plasma of floctafenin (F) and its three main metabolites--floctafenic acid (FA), hydroxyfloctafenin (HOF), and hydroxyfloctafenic acid (HOFA)--is reported. Analytes and internal standard were extracted from acid plasma into ethyl acetate, and this organic phase was evaporated to dryness. This extraction yielded plasma drug recoveries of greater than 72%. Using 1 ml of plasma, the lower quantification limit was 0.05 microgram ml-1 with excellent linearity up to 0.8 microgram ml-1 for HOF and HOFA and up to 4.0 micrograms ml-1 for F and FA. The reproducibility and the selectivity of the method for several drugs thought likely to be administered in conjunction with F, were demonstrated. This method has been successfully applied to a pharmacokinetic study with a single 10 mg kg-1 oral dose in ten children.
One hundred children were prophylactically treated with 15 mg/kg-1 of metronidazole immediately before appendicectomy and retrospectively compared with 100 other patients without any antibioprophylaxis. No statistically significant difference was found between the two groups as regards age, weight, sex and macroscopic appearance of the appendix. The overall incidence of complications was 1% in the antibioprophylactic group and 9% in the control group. Furthermore, a single pre-operative intravenous dose of metronidazole was as effective as conventional antibioprophylaxis.
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An ultrastructural study was performed on 34 biopsy samples of the sinusal mucosa in 28 patients who were investigated for chronic sinusitis. Twelve specimens with normoplastic sinusitis and eighteen with hyperplastic sinusitis were studied. Four normal specimens served as controls. The incidence of ultrastructural ciliary abnormalities was 2%. Morphological changes of dynein arms have not been observed in the present study. Compound cilia were found in approximately 2/3 of the studied cases. Microtubular abnormalities occurred in roughly 50%. The observed abnormalities, also seen in the control group, were independent on the sinusitis type and could not been correlated with mucociliary transport. Their significance is discussed.
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