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21.
22.
《Revista espa?ola de anestesiología y reanimación》2022,69(8):502-505
Effective management and control of peri- and postoperative pain in hip surgery is essential in order to minimize the use of opioids and their adverse effects. Effective regional analgesia for hip pain is made particularly challenging by the complex innervation of the hip joint. Standard regional techniques can be associated with complications, including incomplete anesthesia, hypotension, or lower limb weakness. We present the case of a 5-year-old girl with a history of infantile cerebral palsy who underwent bilateral varus derotation osteotomy and adductor tenotomy due to paralytic dislocation. She received bilateral PENG block and femoral cutaneous nerve block - a simple technique that covers all the nerves involved in the sensory innervation of the joint capsule without the need for multiple injections. 相似文献
23.
Baher Husain Christian Kuehne Christian Waydhas Ulrike Lewan Claudia Ose Dieter Nast-Kolb Steffen Ruchholtz 《European Journal of Trauma》2006,32(6):548-554
Abstract
Background: Does there exist a difference in the outcome of severely injured children and severely injured healthy adults?
Methods: The data of 1,566 severely injured patients, treated between May 1998 and December 2002 in our emergency department of the
University Essen/Germany, were analyzed. Patients with an injury severity score (ISS) > 24 were included in the present study.
Patients younger as 18 (17) years were located to the children group c. Patients aged 18 and up to the age of 54 were included
in the adult group a.
Results: Fifty-four children and 252 adults met the selection criteria. ISS and the Glasgow coma scale (GCS) before intubation were
not statistically different in both groups. Seriously injured children stayed significantly shorter on the intensive care
unit, required significantly less ventilator days. Furthermore, the incidence of single organ failure (SOF) and multiple organ
failure (MOF) was significantly lower in the children group. Mortality in the children group (29.6%) was lower than that in
the adult group (33.7%). There was no death due to MOF in the children group as compared to 2.4% (n = 6) in the adults.
Conclusion: The incidence of SOF and MOF was significantly lower in the children group although there was no difference in ISS, GCS and
injury patterns. The prognosis of severely injured children was found to be better than those of adults. Moreover, there was
no death due to MOF in the children group. 相似文献
24.
25.
Ian F. Dunn Pankaj K. Agarwalla Alexander M. Papanastassiou William E. Butler Edward R. Smith 《Child's nervous system》2007,23(10):1191-1194
Objective Approximately 10% of patients with neurofibromatosis I (NFI) patients will have central nervous system (CNS) tumors. The most
common of these are hypothalamic–optic gliomas, followed by brainstem and cerebellar pilocytic astrocytomas. While isolated
pilocytic astrocytomas in NFI are well described, the appearance of multiple pilocytic astrocytomas in an individual patient
is less common. The most frequent combination in NFI patients with more than one pilocytic astrocytoma is optic tract/hypothalamic
and brainstem. Other combinations are exceedingly rare; multiple pilocytic astrocytomas have only been reported once in the
cerebral hemispheres in a patient with NFI. This report presents the first documented case, to our knowledge, of multiple
pilocytic astrocytomas in the cerebellum of a patient with NF1.
Methods Case report.
Conclusion The finding of multiple cerebellar pilocytic astrocytomas in a patient with NF1 is important because it expands the spectrum
of presentations for patients with NF1 and also highlights specific diagnostic and therapeutic challenges faced by the treating
physicians. The genetic and molecular basis of NF1 is reviewed. Strategies of diagnosis and treatment outlined here are relevant
to both patients with NF1 and all patients with multiple posterior fossa tumors. 相似文献
26.
B. S. Sharma Sumit Sinha V. S. Mehta A. Suri Aditya Gupta A. K. Mahapatra 《Child's nervous system》2007,23(3):327-333
Object Intracranial aneurysms are rare in children and have different epidemiological, clinical, and morphological characteristics
and outcome from those in adults.
Materials and methods We analyzed demographic, clinical, radiologic features, treatment, and outcome in 55 patients <18 years of age, treated from
Jan 1995 through December 2005.
Results Intracranial aneurysms in children below 18 years constituted 4% of all intracranial aneurysms. Internal Carotid artery (ICA)
bifurcation was the commonest location. About half of the aneurysms were complex. Three-fourth of the patients required surgical
treatment. Two patients died, constituting 5% mortality. Two patients (5%) had poor outcome, whereas the majority (90%) had
a favorable outcome.
Conclusions Pediatric aneurysms have male predominance, higher incidence of clinical features of mass effect or seizures, high incidence
of large, traumatic/mycotic aneurysms, associated illnesses and ICH/IVH and hydrocephalus, better Hunt and Hess grades at
presentation, ICA bifurcation as the commonest site, and better outcome than their adult counterparts. 相似文献
27.
Jean de Ville de Goyet Raymond Reding Viktoria Hausleithner Jan Lerut Jean-Bernard Otte 《Transplant international》1995,8(4):280-285
This paper describes a quick procedure for cadaveric liver graft retrieval during multiple organ harvesting. The technique is based on minimal preliminary dissection, absence of in situ direct portal perfusion, and en bloc removal of the liver and pancreas, with an aortic patch encompassing the coeliac trunk and superior mesenteric artery. The results of 110 pediatric liver transplantations with 109 organs harvested using this technique are reported. There were no graft harvesting injuries. The liver graft primary nonfunction rate was 4.5% (5/110). The 3-month retransplantation rate was 10%. The actual patient survival rates were 93% at 3 months and 90% at 1 year; actual graft survival rates were 85.5% and 78%, respectively. The technique described was at least as safe as conventional procedures. A major advantage of the procedure is its flexibility, which allows for the easily combined procurement of other organs (whole pancreas and intestine). 相似文献
28.
William M. Chadduck Duc H. Duong John M. Kast David J. Donahue 《Child's nervous system》1995,11(10):579-583
Cerebellar hemorrhage is a devastating condition with morbidity and mortality related not only to the etiology of the hemorrhage, but also to the timing of the intervention. Sixteen consecutive pediatric patients with acute cerebellar hemorrhages are presented: 6 had vascular abnormalities, 3 had tumors, and 2 had hemorrhages of unknown etiology. Thirteen of the 16 patients survived with only 1 of the 13 having persistent vegetative state as a neurologic outcome. Six of 8 patients presenting in a moribund condition had good outcomes, and 3 of 4 patients presenting with fixed and dilated pupils also had good outcomes. Thus, in contrast to adults, rapid evaluation by CT scanning, followed by the judicious use of ventricular drainage and prompt surgical treatment, have resulted in favorable outcomes in pediatric patients despite their poor clinical presentations. None of the neonates having cerebellar hemorrhages required surgical intervention; their courses could be followed clinically and with transfontanel ultrasound.Presented as a poster at the 14th Congress of the European Society for Paediatric Neurosurgery, Lyon, France, 21–23 September 1994, and the XXII Annual Meeting of the International Society for Pediatric Neurosurgery, Birmingham, UK, 25–28 September 1994 相似文献
29.
P. E. Wallemacq Raymond Reding Etienne M. Sokal Jean Ville de Goyet Stéphane Clement de Clety Véronique Van Leeuw Marc De Backer Jean-Bernard Otte 《Transplant international》1997,10(6):466-470
Pediatric liver transplant recipients constitute a population characterized by a particularly unpredictable and poor bioavailability
of cyclosporin (CyA). Even though several adult studies show that the new oral formulation of CyA, Neoral (NEO), produces
better bioavailability and blood level predictability, few data describe its pharmacokinetics in children. We performed a
complete analysis of the pharmacokinetics of NEO in ten small children after primary liver transplantation. Three pharmacokinetic
profiles were set up with data obtained from tests taken during i. v. administration of CyA, after the first oral NEO dose,
and after the last NEO dose before discharge from the hospital. The mean half-lives obtained were 8.1, 7.7, and 6.9 h, respectively,
and the bioavailabilities were 22 % and 21 % for the first and last NEO doses. A large interpatient variability was observed.
This was due, in part, to episodes of diarrhea that interfered with the pharmacokinetic evaluation and, in part, to the variability
of post-transplant hepatic function. There was a good correlation between CyA trough levels and their related AUCs for both
NEO profiles (r = 0.93 and r = 0.74, respectively). We conclude that, even though the pediatric OLT population remains more unpredictable than that of
adults, NEO has a relatively rapid half-life and a remarkably improved bioavailability.
Received: 29 November 1996 Received after revision: 10 April 1997 Accepted: 15 May 1997 相似文献
30.
敖伟 《实用医学影像杂志》2004,5(6):323-325
目的 分析空气灌肠治疗小儿肠套叠的各种影响因素。方法 对117例确诊肠套叠的患儿,采用双腔气囊外接压力计或不接压力计,在X线透视下行空气灌肠。结果 117例中,完全复位92例(78%),复位失败17例(14.5%),不完全复位8例(6%)。结论 空气灌肠是治疗小儿肠套叠的重要方法,其影响复位成功与否的因素,主要有套入时间、类型、复位方法等。 相似文献