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Background

There is a lack of studies addressing the occurrence of negative intraoperative findings (that is the absence of intussusception) after an unsuccessful hydrostatic reduction of an ileocolic intussusception. The aim of this study is to determine the incidence of negative intraoperative findings after unsuccessful hydrostatic reduction of ileocolic intussusception.

Methods

We conducted a multicentre retrospective study of all children aged 0–18?years treated for ileocolic intussusception from January 1, 2010 to December 31, 2015 in 9 Dutch hospitals. Primary outcome measure was the percentage of children without an intussusception during surgical exploration after unsuccessful hydrostatic reduction.

Results

In the study period 436 patients were diagnosed with an ileocolic intussusception. Of these, 408 patients underwent hydrostatic reduction of an ileocolic intussusception. 112 patients (27.5%) underwent surgery after an unsuccessful hydrostatic reduction. In 13 (11.6%) patients no intraoperative evidence of intussusception was found. Patients who underwent surgical intervention after unsuccessful hydrostatic reduction were significantly younger than patients who had a successful hydrostatic reduction; there was no gender difference.

Conclusion

A substantial number of children (11.6%) underwent a laparotomy after unsuccessful hydrostatic reduction in whom no intussusception was found intraoperatively. We suggest initiating laparoscopy instead of laparotomy when surgery is necessary.

Level of evidence

Level II.  相似文献   
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A widely used indicator for cultural class is strongly related to a lower body mass index (BMI): cultural capital measured as ‘highbrow' taste. This study’s objective was to theorise and measure aspects of cultural class that are more plausibly linked to low BMI, and subsequently explore their relevance. Building on Bourdieusian theory we derive four of those aspects: ‘refinement’ (valuing form and appearance over function and substance), ‘asceticism’ (self-imposed constraints), ‘diversity’ (appreciation of variety in and of itself) and ‘reflexivity’ (reflexive deliberation and internal dialogue). Using standardised interviews with 597 participants in the Dutch GLOBE study in 2016, we subsequently demonstrate: (i) newly developed survey items can reliably measure four aspects of cultural class: ‘asceticism’, ‘general refinement’, ‘food refinement’ and ‘reflexivity’ (Cronbach’s alphas between 0.67–0.77); (ii) embodied/objectified cultural capital (i.e. ‘highbrow’ taste) was positively associated with general refinement, food refinement and reflexivity, whereas institutionalised cultural capital (i.e. education) was positively associated with asceticism and reflexivity; (iii) asceticism, general refinement, reflexivity, but not food refinement, were associated with a lower BMI; (iv) asceticism, general refinement and reflexivity together accounted for 52% of the association between embodied/objectified cultural capital and BMI, and 38% of the association between institutionalised cultural capital and BMI.  相似文献   
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Lately, experts have turned to historical evidence to uncover the default mode of our sleep pattern. Even though there are some notable exceptions, most historians use a qualitative methodology based on scattered evidence in diaries, letters, novels, medical treatise and other literary sources. To provide fresh perspective in the debate, the present article develops a more quantitative approach. Drawing fresh evidence from early modern criminal records – viz the eyewitness reports of the Hoge Vierschaer or the local criminal court in Antwerp – we are able to debunk some classic stereotypes about premodern sleep patterns. Data reveal that most 18th‐century Antwerpers slept fewer hours than we would expect, slumbered in a monophasic way and rarely if ever took a nap during the day. Moreover, the start and end of sleep were less attuned to the solar cycle than we would imagine. Last but not least, the pattern also shows some fascinating weekly and seasonal variations.  相似文献   
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This study investigated the clinical efficacy of a bonded resin composite restoration with and without cuspal coverage for the treatment of painful, cracked teeth. Patients in a private dental practice who presented with complaints were selected. Inclusion criteria were sensitivity to cold, biting and a clinically-visible crack after removal of the existing restoration. All 40 teeth were restored with a three-step total etch system (Phosphoric acid/Clearfil SA primer/PhotoBond), 20 with cuspal coverage and 20 without. Patients were interviewed at one week, five weeks and six months regarding the presence of pain. In addition, the teeth were clinically examined after six months to reveal any sensitivity. At one week, patients reported that 12 teeth (30%) were free of pain and 28 teeth (70%) still had symptoms. At five weeks, patients reported that 25 teeth (62.5%) were free of pain and 13 teeth (32.5%) still had symptoms. Two teeth (5%) needed endodontic treatment after two and five weeks. At six months, patients reported that 30 teeth (75%) were functioning without any complaints. Upon clinical examination, only 20 teeth (50%) were free of symptoms. No statistically significant difference between the results of the teeth treated with and without cuspal coverage could be shown (Fischer's exact test at p<0.05).  相似文献   
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Mucosal lesions in the oral cavity, identical to oral lichen planus (OLP), as a consequence of contact with in particular dental silver amalgam may be due to an allergic reaction to mercury or, possibly, a toxic effect on the oral mucosa. Substitution of amalgam preferably by gold--unless sensitisation to gold exists--often results in remission, which sustains a pathogenic role of amalgam in OLP. Substitution of amalgam should be considered if the mucosal lesions correspond topographically to the restorations and epicutaneous patch testing results in a positive reaction on mercury.  相似文献   
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