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At least 1,567 records · Page 87Linked to original sources
PubMed1982

A new orthopedic fixation method in the treatment of bladder extrophy.

Extreme diastasis of the pubis and malalignment of both ilium and hip joints are always associated with the absence of infraumbilical structures and with the failure of the anterior bladder wall to close. Therefore, for a successful cure of extrophy, the pelvic ring has to be repaired, at the time of or a few days prior to the surgical cure of the bladder. The repair of the pelvis, when executed in poor aseptic conditions, results in difficult nursing problems, and fails due to the lack of convenient fixation. For these reasons, we transformed Bartons tongues into an external fixator which enhanced and improved the controlled contention of the "vertical bilateral posterior osteotomy" of the pelvis. When a two stage procedure is decided on, the modified Bartons tongues do not interfere with the urologic surgery, and in addition, the nursing problems are alleviated. Although we have used our modified Bartons tongues in only three cases, our methodology is of low enough risk for it to be reported at this time.

Bladder Exstrophy↗
PubMed1982

Carcinoma of the sigmoid: a complication of ureterosigmoidostomy.

The case of a 58-year-old man who had carcinomatous change in the sigmoid colon many years after ureterosigmoidostomy prompted the authors to review the French and English literature on the subject. They found 47 cases in addition to their own, and noted a dramatic increase in the last 10 years, even though ureterosigmoidostomy is now seldom used. The latency of this complication makes it pertinent today. In the hope of determining the etiology of the complication, the authors studied the relation between the initial lesion for which the diversion was carried out and the nature of the colonic tumour that ensued, and have attempted to draw some conclusions. None of the current theories of pathogenesis seem satisfactory. By underlying the early clinical manifestations, the authors attempt to promote earlier diagnosis and better chances of survival for patients with carcinoma of the colon after ureterosigmoidostomy.

Adenocarcinoma↗
PubMed1995

Latex hypersensitivity in children: clinical presentation and detection of latex-specific immunoglobulin E.

OBJECTIVE: To better understand the clinical characteristics, diagnosis, and possible prevention of immediate hypersensitivity reactions to latex in a hospitalized, pediatric patient population. METHODS: We performed a retrospective case analysis of the first 35 patients with latex allergy evaluated by our service over a 2-year period at our institution. Characteristics of patients and clinical reactions were analyzed and the presence of latex-specific immunoglobulin E was assessed using in vitro methods. In a limited group of patients, the success of strict environmental control and premedication with steroids and antihistamines was evaluated for the prevention of latex allergic reactions. RESULTS: The majority of our patients had life-threatening reactions. In previous reports, most pediatric patients underwent reactions in the perioperative period and belonged to two well-recognized "high-risk" patient groups (spina bifida and genitourinary malformations). In our series, 21 patients (60%) had reactions outside of the operating room setting, and 14 patients (40%) had primary diagnoses outside of the previously recognized "high-risk" groups. Many patients had a history of multiple surgical procedures, and a history of a surgical procedure in the first year of life was very common. A pre-existing clinical history of latex allergy was present in only 18 of the 35 patients, and a severe or life-threatening allergic reaction was the presenting feature of latex allergy in 11 of the 35 patients. Using in vitro assays, we were able to detect latex-specific immunoglobulin E in the sera of all but two of our patients. Latex gloves and latex-containing intravenous sets were common triggers for reactions. When exposure to latex occurs systemically, as through an intravenous line, premedication with steroids and antihistamines may fail to protect against anaphylaxis. CONCLUSIONS: Our experience indicates that the incidence of latex hypersensitivity in children is increasing, that the circumstances (patient profile, hospital location, route of exposure) in which life-threatening reactions may occur are more broad than previously reported, and that a better understanding of both environmental sources of latex antigens and host responses to latex exposure are needed for improved prevention of serious reactions.

Adolescent↗
PubMed1976

[Recto-sigmoid carcinoma after uretero-sigmoidostomy. One case, with a review of the literature (author's transl)].

A case of recto-sigmoid adenocarcinoma, developing 25 years after bilateral uretero-sigmo dostomy for extrophia vesicae in a 29 year old man. A study of the literature emphasises the long delay before its appearance, the gastrointestinal nature of the tumour and its grave prognosis. The pathogenesis of this lesion is unknown at present, and consideration should be given to the effects of urine on the digestive mucosa and the role of a possible inflammatory granuloma, but also the possibility of a urinary tract origin, despite the apparent histological contradiction.

Adenocarcinoma↗
PubMed1993

Fetal abdominal wall defects.

Abdominal wall defects are frequently detected prenatally. Optimal management requires identification of the type of lesion and a careful search for associated chromosomal and structural anomalies. For cases with lethal associated abnormalities, elective termination may be offered. Preterm delivery should be considered for fetuses with gastroschisis who have evidence of ongoing intestinal damage, as evidenced by bowel dilatation and thickening, although objective selection criteria are still being developed. There is currently no convincing evidence to support routine cesarean delivery in fetuses with abdominal wall defects. Most infants with abdominal wall defects should be born at a perinatal center, where neonatal and surgical expertise is immediately available. In every case, prenatal diagnosis should lead to parental counseling and decision-making by a multidisciplinary team consisting of obstetricians, neonatologists, and pediatric surgeons.

Abdominal Muscles↗