Perioperative anxiety in children

Objectives & Aim: The purpose of this investigation was to examine children’s anxiety across the perioperative setting. Background: Although several studies have examined preoperative anxiety in children, few researchers have illustrated perioperative anxiety; that is, anxiety in children throughout the pre and postoperative continuum. Methods: Participants were 261 children ages 2–12. Anxiety was rated prior to surgery, immediately after surgery, and for 2 weeks at home following surgery. Results: Low child sociability and high parent anxiety predicted perioperative anxiety. Perioperative anxiety was related to postoperative pain and negative postoperative behavioral change. Conclusions: Identification and prevention of anxiety in children can help prevent negative outcomes following surgery.     

Absence of triradius d on the palms of normal people

Absence of the digital triradius d is a very rare phenomenon, previously only reported in abnormal XXXXY males. During the past few years the anomaly has been found on the palms of three normal females, namely a young English woman and two sisters in the Nicobar Islands in the Indian Ocean. These cases are described and illustrations of the palmar dermatoglyphics presented.     

Effects of therapeutic suggestion in children undergoing general anesthesia: a randomized controlled trial

Objectives and aim: The goal of this randomized controlled trial was to examine the effect of intraoperative positive therapeutic suggestion on postoperative nausea and vomiting (PONV) in children undergoing general anesthesia and otolaryngological surgery. Background: Because of the high incidence of PONV following otolaryngological surgery and its negative impact on recovery, researchers have examined various nonpharmacological interventions to target this phenomenon. To date, the effectiveness of therapeutic suggestion has not been studied in children. Methods: Participants were 67 children undergoing tonsillectomy and adenoidectomy and their mothers. Children received a standardized anesthetic procedure and were randomly assigned to one of three interventions administered under general anesthesia: therapeutic suggestion, story (prosody control), or standard operating room noise. Children, parents, and healthcare personnel were blinded to group assignment. Nausea and vomiting were recorded in the postanesthesia care unit (PACU) and for the first 3 days at home. Results: Results demonstrated a decrease in nausea severity across the first 3 days, F_2,49 = 10.37, P < 0.001, but no group differences in nausea severity in the PACU (F_2,49 = 0.87, P = 0.43) or at home (F_2,49 = 0.80, P = 0.46). There were also no group differences in vomiting episodes in the PACU (χ² (2) = 1.25, P > 0.05) or at home (F_2,49 = 1.59, P = 0.21). Conclusions: In this blinded controlled trial, therapeutic suggestion delivered intraoperatively did not impact children’s PONV. However, because this is the first study of this kind, replication may be needed.     

Digital Polarized Light Dermoscopy of Clinically Nonpigmented Dermal Nevi

BACKGROUND: Hand-held dermoscopy improves the malignant/benign excision ratio for melanocytic lesions. Much has been described about its use in pigmented lesions; however, the use of dermoscopy in clinically nonpigmented lesions is less well studied. Existing studies have used a combination of traditional immersion dermoscopy and polarized light dermoscopy. This is the first study, to our knowledge, to strictly use digital polarized light dermoscopy for the evaluation of clinically nonpigmented, biopsy-proven dermal nevi. OBJECTIVE: The goal of this study was to describe the dermoscopic features of clinically nonpigmented, biopsy-proven dermal nevi using digital polarized light images. METHODS AND MATERIALS: The dermoscopic features of 32 histopathologically confirmed, clinically nonpigmented, dermal nevi were evaluated. Images were obtained with a digital camera equipped with an epiluminescence microscopy attachment (polarized light); no liquid interface was used. RESULTS The most frequent dermoscopic feature of 32 clinically nonpigmented, biopsy-proven dermal nevi was brown pigment (78%) followed by white areas (53%), comma-shaped vessels (50%), hair (47%), hairpin vessels (22%), comedolike openings (22%), and dotted vessels, respectively (19%). CONCLUSIONS: The most common dermoscopic features (using polarized light) of clinically nonpigmented, biopsy-proven dermal nevi are brown pigment, white areas, comma-shaped vessels, and hair.     

Sleep in middle childhood — A longitudinal study of sleep problems in a large sample of Dunedin children aged 5-9 years

Complaints of sleeping difficulties in a large group of New Zealand children were studied prospectively over four years from 5 to 9 years of age. No association was found between sleeping difficulties and the sex, intelligence, or educational attainments of the child. Mothers who described their child as anxious or who were poor sleepers themselves, tended to report sleeping problems in their child more frequently. There was no association between sleeping problems and teacher ratings of behaviour problems. Children who reported sleep problems also tended to report other problems. There was low agreement between parents and children. Only 0.3% of the total sample had a problem which persisted over the whole period.     

Cryotherapy for lentigo maligna

Eleven patients, 10 with lentigo maligna (LM) and one with lentigo maligna melanoma (LMM), were treated with cryotherapy. The symptoms cleared in all patients except one with LM. There were recurrences in four patients and three cleared with further treatment.