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Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Any hospital surgical process generates anxiety in the patient. Especially if they are pediatric patients. The case presented is the result of an agreement between the Hospital 12 de Octubre from Madrid, the Faculty of Psychology of the UNED, and an Innova-Docencia project of the Complutense University of Madrid, in collaboration with Theodora Foundation and Medicina TV. It shows a CSR experience in the aforementioned Hospital, which aims to convert the perception of the traumatic situation of a surgical intervention into a positive experience for children and adolescents. An experience in which communication is the fundamental tool. The audiovisual narration of a story transforms the child's perception of the surgical process. Thanks to the viewing of a video in which some clowns narrate the story of "Lucas and the magic thread", and to the decoration of walls and ceilings, furniture and doors, in the corridors and rooms leading to the operating room, the child is able to perceive the whole process as a journey that he always makes accompanied by Lucas. All this is intended to reduce the anxiety of the pediatric patient and his family, as well as to reduce the pain sensation the patient feels. In short, achieve that the hospital surgical process is perceived by the pediatric patient as a positive experience. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Médica Peruana is the property of Colegio Medico del Peru and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To evaluate hemostasis preoperatively, a directed clinical history and physical examination are indicated, and the use of routine coagulation being recommended when there is some indication, and not routine; Objective: the present study aims to know the usefulness of PT and APTT in the preoperative assessment of coagulopathies in scheduled minor and outpatient surgeries. Methods: A prospective, observational study was conducted in a tertiary surgical hospital; We select patients undergoing minor and outpatient procedures, excluding those with comorbidities, surgical risk of high bleeding, or with medication that interferes with coagulation. Results: 69 patients were recruited, the clinical history and the directed physical examination were applied, identifying 1 patient suspected of coagulation disorder (later discarded); 218 complementary tests were performed: 69 routine (PT, APTT, blood count) and 149 non-routine (arbitrarily indicated), obtaining mean values in normal ranges and not being able to identify or rule out coagulation disorders with them, but observing 21% (15 cases) abnormal results (false positives), which additionally led to behaviors to confirm or correct these values, ranging from repeating the test to transfusing blood products; generating a global average cost of 102 Bs. per patient, without a benefit or change in clinical or surgical behavior. Conclusion: the study established that routine preoperative screening tests have little utility and are little cost-beneficial in the assessment of the hemostasis for minor or outpatient procedures, compared to a history and directed physical examination; its indication being appropriate when there are abnormal findings in the physical examination and clinical history or based on concomitant diseases. [ABSTRACT FROM AUTHOR]

Introduction. Physical violence with powder-gun and non-powder weapons in the pediatric population has increased in recent decades. The objective of this study was to describe the characteristics of pediatric victims of violence with powder-gun and non-powder weapons in a third-level hospital in Mexico. Methods. This is a retrospective study of the cases of pediatric victims by powder-gun and/or non-powder weapons treated in the Pediatric Surgery Service of the Hospital Civil de Guadalajara Fray Antonio Alcalde. The period analyzed was from June 2017 to June 2019. The information from the clinical records was analyzed and the clinical characteristics of the victims, the affected topographic area and the treatment provided were described. Results. A total of 21 cases were registered, most of the population was male and they had 12-14 years old. Powder-gun injuries were predominant. The most affected bodily areas were the abdomen and thorax. Suturing the wound was the most common procedure done, and thoracostomy was second. No mortality was recorded. Conclusion. Child violence is a social, family and health problem that must be addressed and eradicated. [ABSTRACT FROM AUTHOR]

Background/aim: Despite different regional anesthesia techniques used to provide intraoperative and postoperative analgesia in pediatric patients, the analgesic effectiveness of peripheral nerve blockades with minimal side effect profiles have not yet been fully determined. We aimed to compare the efficacy of ultrasound-guided transversus abdominis plane (TAP) block, quadratus lumborum (QL) block, and caudal epidural block on perioperative analgesia in pediatric patients aged between 6 months and 14 years who underwent elective unilateral lower abdominal wall surgery. Materials and methods: Ninety-four patients classified under the American Society of Anesthesiologists physical status classification system as ASA I or ASA II were randomly divided into 3 equal groups to perform TAP, QL or Caudal epidural block using 0.25% of bupivacaine solution (0.5 ml kg-1). Results: Postoperative analgesic consumption was highest in the TAP block group (P < 0.05). In the QL block group, Pediatric Objective Pain Scale (POAS) scores were statistically significantly lower after 2 and 4 h (P < 0.05). The length of hospital stay was significantly longer in the caudal block group than the QL block group (P < 0.05). Conclusion: We suggest that analgesia with ultrasound-guided QL block should be considered as an option for perioperative analgesia in pediatric patients undergoing lower abdominal surgery if the expertise and equipment are available. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Morgagni-Larrey hernia (HML) represents a rare pathology, only 3% to 5% of all diaphragmatic hernias, being significantly associated with other congenital anomalies. The repair of the HML with the involvement of the total thickness of the anterior abdominal wall with extracorporeal U-shaped points under direct vision fixed to subcutaneous tissue represents an option accessible to the trained surgeon that allows maximum repair force and adequate control during the placement of stitches. This technique has also been shown to be well tolerated by the patient with minimum analgesia requirements after the first 24 hours with good recovery and short in-hospital stay. CLINICAL CASE: We present a patient operated with this technique in a specialty hospital. [ABSTRACT FROM AUTHOR]

Tumors in pediatrics are a group of rare pathologies by definition. Histological diagnosis of these tumors is rare, therefore, there are no standardized treatment protocols. The objective of this study was to describe the casuistry of infrequent tumors in a reference hospital in western Mexico. Material and Methods. It was a retrospective study carried out in the Pediatric and Pediatric Surgery services of the Hospital Civil de Guadalajara Fray Antonio Alcalde. All clinical records of individuals who had a diagnosis of infrequent tumors in the period from 2017 to 2019 were analyzed. Descriptive statistics were used, in which age, sex, tumor lineage, imaging findings, type of treatment and mortality were described. Results. In the search for records, there were a total of 112 pediatric patients diagnosed with tumors; Of these, twenty-five (22.3%) had infrequent tumors. The majority (n = 14, 56%) were women. According to sex, in the cases of female patients, the most frequent tumors were ovarian tumors and hepatoblastoma (n = 5, 20% each); while, in the male sex, they were hepatoblastoma and testicular tumors. In 96% (n = 24) of the cases, surgical treatment was given. Only one case died (4%); Death occurred during the surgical procedure. Discussion. Tumors in the pediatric age represent a real challenge for the pediatrician and the pediatric surgeon. The active participation of a trained multidisciplinary team is required to improve the care of pediatric patients affected by these tumors. The late diagnosis of these tumors is associated with an increase in morbidity and mortality. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira de Anestesiologia is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Chilena de Urologia is the property of Sociedad Chilena de Urologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Total multimodal intravenous or Opioid free anesthesia has been used since the 90`s in which the notion of multimodal anesthesia was introduced as an «opioid sparing technique» and aimed to improve analgesia through the use of drugs with synergistic effects, improving not only the efficiency but also the security of anesthetic management. In the last decade it has had a major upgrade, mainly in adult patients. However, to our knowledge, its application has not been studied in pediatric patients. The esophageal diseases affecting children that most often need a colo-esophageal graft as a therapeutic measure, are esophageal atresia when anastomosis is not posible and long segment corrosive strictures with failure to dilation treatment. coloesophagic interposition, along with advances in the pharmacological management of opioid-free techniques have reduced perioperative morbidity and mortality and have freed the patient in general and the graft in particular from side effects caused by this group of analgesics. This anesthetic technique is used to achieve adequate and early restoration of gastrointestinal motility and graft perfusion, along with preventing recurrence and minimum eventualities and/or respiratory complications, such as described in this case report. [ABSTRACT FROM AUTHOR]

Much is known with regard to education and conformity of residents of all medical surgical disciplines, particularly since the implementation of the Plan Unico de Especializaciones Médicas. However, for pediatric surgeon little has been investigated. Objective: To evaluate the opinion of recently graduated pediatric surgeons with respect to the institution where they were formed, their teachers, their evaluation processes and themselves. Methods: A questionnaire was given to recently graduated pediatric surgeons in order to obtain information about the institutions where they were trained, their teachers, and evaluations of themselves. Results. Universidad Nacional Autónoma de México and the Instituto Politécnico Nacional had the highest number of graduates the highest college grades average. Slightly over half of them said their training was excellent as residents. However 18 of the total reported that they lacked training in some disciplines. Conclusions. Even with some contradictions, the most valuable finding of the study was the need to promote interchanges with rotations in other institutions. [ABSTRACT FROM AUTHOR]

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The pediatric population presents fear, separation anxiety and hostility toward surgical events, so that the use of preanesthetic medication for anxiolysis is indicated. Dexmedetomidine has advantages in comparison with other anti-anxiety drugs for their easy storage and presentation. Methodology: Patients applied to between 2 and 10 years dexmedetomidine dose of 2 µg/kg intranasally or orally, through monitoring Modified Observer's Assessment of Alertness/Sedation Scale (MOAA/SS) scale event one hour prior to surgery, and 10, 20, 30, 40, 50 and 60 minutes at the end, then compared average test values t Student. Study design: Experimental, comparative, prospective, longitudinal. Results: The administration of dexmedetomidine both orally and intranasally produce adequate sedation and similar to 60 minutes. Intranasal administration produces adequate sedation even at 30 minutes. Conclusions: The hemodynamic safety in both directions is suitable for a dose of two micrograms per kilogram faster sedation intranasally. [ABSTRACT FROM AUTHOR]

Over the past two years there has been increased interest in promoting research in anesthesia as an integral part of academic anesthesia practice in Colombia. The Colombian Symposium on Research in Anesthesia (organized by the Colombian Society of Anesthesiology and the Society of Anesthesiology and Reanimation of Antioquia) formulated and published guidelines to promote this effort. Despite these efforts, pediatric anesthesia is still a subspecialty in which very little research is done. In this opinion article we discuss why and how to promote research in pediatric anesthesia in Colombia. [ABSTRACT FROM AUTHOR]

Background: Gastroesophageal reflux after congenital diaphramatic hernia surgical correction occurs in up to 89 % of patients, out of which 20 to 30 % will require surgical management. Identification of risk factors for the development of this complication might allow for a Nissen fundoplication to be performed at the sime surgical time in those requiring it. The purpose of this research was to identify those factors in children with diaphragmatic hernia surgery. Methods: A case-control study was conducted, where patients with diaphragmatic hernia surgery treated between 2006 and 2011 were included. Patients with severe gastroesophageal reflux were regarded as the cases, whereas those who did not develop it over the 1-year follow up were the controls. Results: Nine patients developed severe gastroesophageal reflux after the diaphragmatic hernia surgery. A large size of the hernia, it containing 4 or more organs, 10 days or more of ventilatory support requirement after the surgery or high mechanical ventilation variables significantly increased the risk for the development of severe gastroesophageal reflux. Conclusions: Presurgical risk factors such as large hernias or hernias containing more than 4 organs might suggest the convenience of conducting a fundoplication at the same time of the diaphramatic hernia surgical correction. [ABSTRACT FROM AUTHOR]

Introduction. Pneumonia associated with mechanical ventilation is the most common nosocomial infection sand aleading cause of death in intensive care units. This results in a high morbidity and mortality and increased hospital length of stay which affects the costs of medical care Objective. To determine the incidence of pneumonia associated with mechanical ventilation in the hospitalized population in the Intensive Care Unit of the Central Military Hospital Pediatrics. Material and methods. This is a descriptive, retrospective and transversal study. Case records of patients admitted to the intensive care Unit of a Pediatric from September 2010 to August 31, 2011, which required mechanical ventilation and who met inclusion criteria. We calculated the cumulative incidence of ventilator associated pneumonia and incidence rate per 1,000 days fan. Results. We studied 31patients assisted withmechanical ventilation, the cumulative incidence of pneumonia associated with mechanical ventilation was 12.9%, with an incidence rate of 8 per 1,000 ventilator days, and there was a 50% mortality in patients with a diagnosis of pneumonia associated with mechanical ventilation. [ABSTRACT FROM AUTHOR]

Background: As the treatment of acute appendicitis involves excision it is common for the patient to ask for the smallest possible postsurgical scar. One available strategy is the transumbilical approach. Objective: To describe the clinical characteristics and surgical outcomes of pediatric patients scheduled for transumbilical appendectomies. Methodology: A prospective study of 424 consecutive patients in terms of short-term operative outcomes. Results: The average surgery time was 22 minutes. 95.8% of patients had satisfactory postoperative evolution. 1.4% underwent surgery to drain a residual intracavitary abscess, and 0.2% had surgical site infection without other complications. Conclusion: The transumbilical approach for the treatment of appendicitis is a minimally invasive alternative for all acute appendicitis states and result in decreased surgical time, shorter postoperative stays, lower incidence of complications, and greater conformity with the aesthetic results [ABSTRACT FROM AUTHOR]

Among the lower leg reconstructive techniques, the reverse sural neurocutaneous flap is a well known technical option, with little experience reported in infants. Our aim is the pesentation and analysis of 10 cases of pediatric patients in which we used the reverse sural flap. We follow a retrospective, descriptive and observational study that includes all patients under 16 years who received a reverse sural flap reconstruction within the period between March 2004 and April 2010 at the Centenario Hospital Miguel Hidalgo in Aguascalientes, México. The study included 10 cases with mean age 10 years (range 3 to 15 years), 6 males and 4 females. The mechanism of trauma in 6 cases were motorcycle injury, car crash in 2 patients, 1 case of bicycle injury, and 1 injury by fire arm. The affected areas were foot dorsal area in 5 cases, calcanea in 4 cases and 1 external ankle injury. The average diameter of the affected areas was 8.8 cm. Three patients had minor postoperative complications, 2 distal epidermolysis and 1 partial dehiscence of the flap. There were no serious complications or flap loss. Favorable results were obtained in 100% of patients at the end of the follow up. In our opinion, the technique of lower leg reconstruction, specifically for foot lesions, with sural neurocutaneous flap of reverse flow is an effective treatment option for pediatric patients. [ABSTRACT FROM AUTHOR]

Introduction: One of the primary aspects of pediatric anesthesia is airway management. Because of the anatomic differences, this population is more vulnerable to adverse effects produced by the devices designed for their management. Many of the anatomic descriptions are based on knowledge developed mainly as a result of cadaveric dissections. Imaging of the pediatric airway has been available for almost a decade, and it has shown that the glottis is the narrowest portion and that the larynx is more cylindrical than tapered. These findings impact the selection of airway management devices. Methods: The new anatomic concepts pertaining to the pediatric airway were reviewed, and the advantages and disadvantages of the use of cuffed or uncuffed endotracheal tubes were analyzed. Results and conclusions: The enhanced knowledge of the pediatric anatomy permits the use of devices suitable to the characteristics of the individual airway. The development of cuffed tubes for pediatric practice is advancing rapidly, although there is no current consensus for their use. However, publications coincide on the need to standardize designs and to measure cuff pressure. [ABSTRACT FROM AUTHOR]

Rhabdomyomas are the most common cardiac tumours in children. They are strongly associated with tuberous sclerosis disease. They usually regress spontaneously but sometimes they need surgical intervention because the children symptoms due to tumour location. We described here two neonates with tuberous sclerosis diagnosis and big cardiac rhabdomyomas in unusual situation. [ABSTRACT FROM AUTHOR]

Proper airway management is a challenge for every anesthesiologist. During a shift in the emergency room, a difficult airway often appears both in cases of trauma and medical pathology. The tracheotomy cannula is a device suited to ensure airway opening of patients with obstruction or lesion of the upper respiratory tract. In this medical case, a 7 year old female child is admitted at the emergency service with an episode of respiratory distress caused by rupture of a silver tracheotomy cannula, previously implanted due to a submandibular tumoral lesion. This is a rare case with little investigation in international medical literature The case was approached with interdisciplinary management including Pediatric surgery and Pulmonology with satisfactory outcome. [ABSTRACT FROM AUTHOR]

Copyright of Iatreia is the property of Universidad de Antioquia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Esophageal atresia is a relatively common congenital malformation of unknown etiology consisting of a lack of continuity of the esophagus with or without communication to the airway. The condition occurs in 1/2500--4500 live births. If the patient does not receive surgical treatment, this defect may lead to death. Abnormalities associated with esophageal atresia are present in ~50% to 60% of patients and include urinary tract and digestive, cardiac and musculoskeletal systems. Esophageal atresia is perhaps one of the classic pediatric surgical diseases and important developments have been reported in recent years regarding survival. This achievement is related to the specialized care provided in neonatal intensive care units (NICU) and the use of parenteral nutrition as well as improvement of anesthetic and surgical techniques. Currently, mortality in esophageal atresia patients is an indicator of the quality of care in NICUs. Postoperatively, overall prognosis is good because mortality is low in the absence of other associated malformations. This article synthesizes the general aspects that should be offered to all newborns suspected of having esophageal atresia, indicating the importance of a multidisciplinary approach to achieve the best results in this group of patients. [ABSTRACT FROM AUTHOR]

The surgical findings in 24 children with abdominal trauma are presented the average age of the injured patients was 9 years, six were women and 18 men, most of them were injuries by common cause was motor vehicles accidents in 12, 8 of them had splenic injuries followed by liver injury in 6. The splenectomie were done in six and in other three were done the bowel resection. Two cases had complications. [ABSTRACT FROM AUTHOR]

Our goal is to demonstrate that the use of osseointegrated materials allows us to achieve a proper fixation of auricular prosthesis with a minimum degree of morbidity in children from 6 years without antecedent of reconstruction and in cases in which other reconstructive methods have failed We introduce the experience of auricular reconstruction with osseointegrated implants in the National Institute of Pediatrics, México DF, from January 2007 to November 2009. Patients are selected from the age of 6, but mainly those in which other techniques have not had adequate results from the aesthetic point of view, and in those in which reconstruction started in late way (between 12-17 years), using more complicated autologous tissue and with less time to finish the reconstructive procedures before the age of 18 years. We present auricular malformations reconstructed in our hospital; some of these children had been treated from birth for this cause (up to 17 years); patients in which the aesthetic results with autologous tissue, Medpore® implants or tissue expansion have not been satisfactory or cases in which two or more techniques have been used for the same patient, presenting high morbidity and unacceptable esthetic results. Also, patients 9 years old who suffered this procedure as first intention. For us all of these cases have had an excellent aesthetic results with a 100% patient satisfaction. Auricular reconstruction with osseointegrated implants, is an internationally accepted procedure for those patients with individual characteristics that determine the type of reconstruction as well as the experience of the physician, but in our particular case, for patients with failure of the traditional techniques such as autologous tissue or alloplastic materials and those with lately reconstruction, provides an excellent choice with very good results from the aesthetic point of view and satisfaction for the patient, with little or no morbidity. [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Cirugía Oral y Maxilofacial is the property of Sociedad Espanola de Cirugia Oral y Maxilofacial (SECOM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: In the 80s it was shown that laparoscopic surgery was fully applicable to pediatric patients and this has generated many of the conventional techniques, are reproduced by minimally invasive approaches. Despite this, even generated controversy over its aplicabalidad and development in daily practice, for this reason we have the objective to know the opinion of national pediatric surgeons on its perception of minimally invasive surgery. Material and Methods: A study of opinion, prospective, transversal and descriptive by applying a standard questionnaire applied to national pediatric surgeons for a total of 126 pediatric surgeons surveyed, in which data were collected general perception of training, satisfaction and future of minimally invasive surgery. The reliability of responses was established with the Person test, in which values less than 0.5 were considered significant. Results: Among the results obtained for 68% of respondents are from the region of the country centrooccidente. 93% of surveyed pediatric surgeons develop minimally invasive approach, of which 35% are between 5 and 10 years of experience as surgeons. 91% made less than five surgeries per week without supervision, and 31% of surgeons believed that perform in a minimally invasive unit is the best choice for training in this modality. Group of surgeons who do not practice laparoscopy, 55% consider it of little use. Conclusions: 1) The general view is that the community has an enthusiasm pediatric surgeons open to these approaches, and define a greater increase in satisfaction as pediatric surgical specialists to develop minimally invasive surgery.2) Laparoscopic surgery in our environment is widely accepted by pediatricians pirujanos group, which follows a progressive and positive developments in this area of surgery in our country, so in the coming years, should encourage the appropriate tutorial training of surgeons in training, since it is a complex approach that requires particular skills. 3) We consider the objective standardization of work plans in order to develop the skills of minimally invasive surgery baselines for residents and surgeons the skills of experienced surgeons. 4) Robotic surgery should be to promote regular, capitalizing on the growing interest in this area. [ABSTRACT FROM AUTHOR]

Introduction. Hypertrophic pyloric stenosis is the most common condition requiring abdominal surgical intervention during first weeks of life. The etiology is unknown and the diagnosis is based on a clinical picture characterized by the patient being the first-born male child presenting with projectile vomiting. The pathognomonic finding is a palpable "olive" mass in the upper abdomen. Material and method. During a 24-months period a 147 children were treated for hypertrophic pyloric stenosis. There were 120 (87.1%) boys and 27 girls. For several symptoms a Pearson correlation was applied and T student for pre and postoperative platelet count. Results. The age range at diagnosis was 16 to 120 days (median 82.0 days). The time between onset and hospital admission was 2 to 84 days (median 24 days). According gestation, 78 (53.1%) patients was born in first place and 49 in second; 135 (91.9%) infants had blood group 0. More than 75% of patients had preoperative thrombocytosis and postoperative platelet count normalization had a p<0.0001. Conclusion. Frequently appears in the first-born male child with blood group 0. Increased platelet count is a good "marker" of infantile pyloric stenosis and postoperative normalization was considered as evidence of therapeutic effectiveness. [ABSTRACT FROM AUTHOR]

The use of central venous catheters (CVC) in pediatric patients has implayed a great advance in modern medicine. Their use has allowed the development of new techniques, diagnostic and specialized treatments. Vascular access is one of the most common procedures currently performed by pediatric surgeons. It is used for hemodynamic monitoring, metabolic and nutritional support, fluid administration, chemotherapy, prolonged use of antibiotic, blood transfusion, and samples. The most common complications include: pneumothorax, infections, arterial punction, and hemothorax The use of thoracoscopy for hemothorax drainage, and coagulation of the bleeding vessel with electrocautery or harmonic scalpel, is a useful and safe alternative, which entails faster recovery time and minimal postoperative pain. [ABSTRACT FROM AUTHOR]

Epiploic appendicitis is caused by torsion or spontaneous thrombosis of the draining veins of the epiploic appendages. This condition can mimick a variety of acute surgical abdomen. It is an extremely rare entity in childhood. We present the case of a 10 year old boy, with clinical signs of acute appendicitis. Surgery was performed. During an exploratory laparotomy, several blind peduncular fatty lesions were identified adhering to the cecum's serosa, which were dissected and resected. A prophylactic appendectomy was performed. The patient had a favorable outcome. [ABSTRACT FROM AUTHOR]

Extracorporeal circulation (EC) was initiated 50 years ago for allowing open-heart surgery in order to fix congenital and acquired heart abnormalities in children and adults. The blood pump, based on rolls or centrifugal force impeller, drives blood through a gas exchange membrane, called oxygenator, primed with heparin to interfere formation of blood clots. Complications of cardiac surgery related to EC has been associated to many factors such as immunological system activation due to blood contact with non-endothelial covered surfaces in the EC circuit, oxygen free radical generation stimulated by aortic clamping and reperfusion ischemia, hemolisis due to shear stress on blood cells, microemboli generation eventually passing to peripheral circulation, heparin anticoagulation and problems derived from its neutralization at the end of surgery, hemodilution due to great volume of infused solutions and hemoderivates administration.The surgical trauma and the EC procedure stimulate the hypothalamus-hypophysial-adrenal axis to release vasopressin, catecholamines, cortisol, acute phase proteins, pro- and anti-inflammatory cytokines. Activation of formerly described neurohumoral and cellular mechanisms are known as the systemic inflammatory response syndrome (SIRS). In pediatric patients, 24% may present surgical complications due to EC use for blood perfusion; their risk of hemorrhage is higher because some have preexisting blood coagulation disturbances, particularly the ones with cianogenic heart abnormalities linked to thrombocytopenia, reduction of some coagulation factors and enhanced fibrinolisis. Adults who underwent myocardial revascularization without extracorporeal blood pumping show less mortality and adverse events rate. In cardiac surgery, atrial natriuretic peptide and brain natriuretic peptide, both neurohormones synthetized in heart tissue, have emerged as reliable assays for prediction of immediate and short-term postoperatory cardiovascular complications. [ABSTRACT FROM AUTHOR]

Little is known about Noma or Cancrum Oris Disease. This entity affects to children with chronic malnutrition, poor oral hygiene, poor environmental sanitation and debilitating concurrent illness. There is general consensus that noma starts as gingivitis. The acute stage responds readily to antibiotic treatment. The sequelae after healing include variable functional and aesthetic impairments, which require reconstructive surgery. We report 3 cases of mandibular ankylosis. Preoperative examination revealed mandibular dismorphism, fusion of maxilla and mandible and ankylosis of the temporomandibular joint. Orthopantography and Computed Thomography scan (TCS) were very useful in planning surgery. The surgical treatment performed consisted in ankylotic bone resection in all cases, accompanied with condrocostal graft reconstruction in one case. All patients continued postoperatively with an intensive physiotherapy. Clinically all patients showed an improvement in eating, chewing and speaking, obviously due to good occlusion. Low collaboration with the mandibular rehabilitation was the most common problem. [ABSTRACT FROM AUTHOR]

Introduction. Pain is a subjective symptom very deficient to asses its value, numerous studies had been made in adults, but less interpreted and comprehended in surgically intervened numbers and children in whom common analgesic drugs are indicated in low doses and sometimes not administered. Material and Methods. A prospective and transversal study was made in four hospitals, to acknowledge the management of postsurgical pain in children, we reviewed 50 clinical records in each hospital, with 24 to 48hs background of surgery, with variable of type of surgery surgeon, pain medication prescribed, dose, verify administration, and how the pain was valued in each patient, searching for differences regarding one hospital to other. Results. We reviewed 76 females and 124 male patients, with a mean age of 4 years, seventeen were numberings, 67% were mayor surgery and 65.5% were emergency operations. The analgesics preserved were metamizol, paracetamol in low doses, and not fulfilling the administration In 68 cases the analgesic was indicated for necessary reasons and no newborns received medications he all four hospitals there were no descriptive of the presence nor type of pain. Conclusions. Postsurgical pain causes suffering, prolongs hospital stay and sideeffects may vary. Even though graphic scales for pain value exits, there are not being used and are not a part of the clinical chart. Many nurses and medical staff in training are under qualified to asses and attend pain and other medical specialty's do not describe the pain characteristics, surely our results showed what in the majority of our hospitals is offering and perhaps in Latin America, and may consider in to establish pain clinics and to train and sensibilize medical and nurse staff to offer a proper treatment. [ABSTRACT FROM AUTHOR]

Copyright of Innovación Tecnológica is the property of Instituto de Informacion Cientifica y Tecnologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Innovación Tecnológica is the property of Instituto de Informacion Cientifica y Tecnologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Gastric volvulus is a rare entity, only 15-20% of the cases occur in this age group. There are reports in children from day one of life up to 15 years old. The aim of this paper is to present a rare case of gastric volvulus in a child, and review of the literature. Clinic case: We report the case of a 8 year old patient who developed a gastric volvulus in the consult of the pediatrician. The clinical features of an 8 years old masculine and the surgical treatment such as gastrectomy and esophageal sustitution were reviewed with a good outcome in one year and a half of follow up. Gastric volvulus is rare. Surgical intervention is indicated. [ABSTRACT FROM AUTHOR]

Introduction: The lipoblastoma is a rare benign tumor with only nine cases reported with presentation in the face and neck. Originates from embryonic cells fats to continue their proliferation in the postnatal period. The age of presentation average is three years and usually occur in limbs and trunk. Clinical presentation and radiation may be similar to that of linfagioma, however, it is important to reach preoperative diagnosis because the lipoblastoma can resected without functional consequences. Clinical case: a Patient of the female sex of a year four months of age, which began its clinical picture in April 2006 to the three months of life, with the presence of mass supraclavicular left approximately 8 x 7 cms, not painful, not adhering to deep planes of consistency soft, with image studies (US and TAC ) It was diagnostic as linfagioma, so it is administered OK 432 on three occasions, in spite of which the mass increased in size, so that decides its surgical resection . The specimen measured 21 x 15 x 9 CMS and weight 1300 grs. With evolution postoperative satisfactory. Discussion: The appearance of clinical lipoblastoma neck has several similarities with the linfagioma quistico; age, location in region later cervical and consistency. However handling is very different from what is important to note the patterns to achieve and thus help to the pediatric surgeon to improve the results in the handling of both entities. A lipoblastoma has an excellent prognosis despite its size, and the high rate of growth and its trend limited to invade neighboring tissue. [ABSTRACT FROM AUTHOR]

There are several surgical techniques described for cleft palate reparing, from uni or bipediculated flaps to Z-plastias, without finding the ideal one. We propose a new technique with minimal incisions, to get better results, less morbidity and less early or delayed complications. Since 1998 we have used the technique of palatoplasty with minimal incisions in 336 children, 195 (58%) girls and 141 (42%) boys, with an average age of 18 months (6 to 36 months), diminishing risk of bleed and fibrosis, surgical time and reducing hospitalisation. In the postoperatory, did not appear bleed, the percentage of wound open and secondary fistula was 5% and 332 cases (96%) were handled like ambulatory procedures. As a conclusion, we present an easy surgical technique, with an smaller reported percentage of fistula and less morbidity. [ABSTRACT FROM AUTHOR]

Choanal atresia is a congenital defect caused by persistence of the bucopharyngeal membrane. It may be uni or bilateral. Treatment consists in surgical opening of the choana. A retrospective review of patients operated for choana atresia between January 1990 and September 2007 was done. There were 7 patients; only 6 were included in this paper. The age at surgery varied from 1 month to 12 years; there were three boys. Bilateral atresia was present in 3 patients and unilateral in the other 3. Surgical procedure was transnasal microscopic approach in three of the patients, and endoscopic in the rest. Stenting was done in 5 patients in a first procedure. Post-surgical stenosis occurred in 4 patients. One patient required two surgical procedures, and one procedure in three patients to maintain permeability of the choana. We conclude that choanal atresia is a rare defect and that surgical outcome with the use of stents in our institution has favorable similar results to those reported in the literature. [ABSTRACT FROM AUTHOR]

Introduction: The minimally invasive surgery (MIS) is effective and safe for performing diagnostic and surgical procedures in a cavity or space previously insufflated with carbonic gas. With the technological advances it is possible to apply in children of a 1.1 kgs with extension to all pediatric surgical procedures Material and Methods: Over a 6 months period we included five children for underwent pancreatectomy, diaphragmatic placation ,closure of a persistent duct arterious , lobectomy and Kimura anastomosis with MIS using instruments of 3 and 5 mm for patients from 4 to 9 kgs weight and ages ranged from 1 to 20 months Results: All procedures were completed, there were no complication. The time to start feeding and the in hospital stay was decreased Conclusions: The MIS in surgical neonatal pathology is safe, effective and associated with the same benefit as that seen in older patients. [ABSTRACT FROM AUTHOR]

No other congenital deformity has the potential to alter the face form as perceivably as it makes a cleft lip and palate. The middle third of the face is altered and it represents a great challenge for plastic surgeon. We propose the vertical closing of the skin after miorraphy forming a line and trying to appear like the filtrum column that was not formed in the cleft lip. We report the result in children operated on our Service of Plastic Surgery at the Instituto Nacional de Salud, México DF, from january 1998 to december 2006, total 837 patients. Surgical technique consisted of the closing of cleft lip in vertical way. Total number of 837 patients was composed by 310 female and 527 male, 13% (n=109) presenting bilateral cleft. As a result, 95% of the patients (n= 795) had a suitable aesthetic result; it did not appear immediate postoperative complications and only a patient reported wound deshicience. We consider as advantages of the technique: a scar line that seems the column of the cleaved filtrum, an anatomical dissection of the skin (lines of tension) and the fact that we can avoid those incisions that cross the filtrum or the nasal ala, with less visible scar. [ABSTRACT FROM AUTHOR]

Introduction: Intraarticular injuries of pediatric patients have a different approach to that of adult patients. Part of this problem lies in minimizing children's symptoms by parents as well as physicians thinking they are less prone to injuries that require surgical management. Arthroscopy has helped in diagnosing these injuries, but the use of this method could be over used. We present a correlation of clinical diagnosis and arthroscopic findings. Material and methods: We conducted a transversal retrolective study in «Hospital Central Sur Petroleos Mexicanos». We compared clinical diagnoses vs. arthroscopic findings in a group of patients younger than 18 years operated on from June 1995 to February 2005. Results: One hundred and thirty one patients were operated on, and subdivided in two groups: younger that 13 years and older that 13 years, 42% preoperative and postoperative diagnoses correlated in the first group, and 46% for the second group. Conclusion: Arthroscopic surgery is useful in achieving better diagnostic precision, as well as it gives us the opportunity to specifically treat knee injuries in pediatric patients. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the results of our technique of laparoscopic gastropexy in children with gastric volvulus. methods: The files of all children with gastric volvulus operated with a laparoscopic gastropexy in two Swiss medical institutions were analyzed. Results: Fifteen children were included in our study. Range of age was between 1 and 11 months. Main symptoms included sudden postprandial crying, probably related to abdominal pain, vomiting and irritability. In three patients, apneic episodes associated with cyanosis, pallor and hypotonia were recorded. In all cases the diagnosis was established with upper GI series. Organo-axial gastric volvulus was present in all cases. Laparoscopic gastropexy was performed with an 8 mmHg CO2-pneumoperitoneum using 3 mm instruments and a 4 or 5 mm telescope. Our technique includes 3 steps: 1) esophagofundopexy; 2) phrenofundopexy; 3) anterior gastropexy. Average time of surgery was 60 minutes. One conversion was performed. Follow-up ranged from 1 month to 7 years. To date, all patients are free of symptoms. Conclusion: Our technique of laparoscopic gastropexy is a good option in children with gastric volvulus. [ABSTRACT FROM AUTHOR]

Minimally invasive surgery (MIS) in children's forefoot is a technique that permits minimum tissue trauma assisted by fluoroscopic control. We evaluated the results of this modality of surgery in problems such as: claw toes, hallux valgus, exostosis, hammer toe, and bunionectomy. We had a complication for using the procedure with more revolutions per minute (rpm), which remind us of the importance of using 2000-8000 rpm. We found that it is not commendable to make hypercorrections, due it increases they risk of recurrence. MIS is an excellent option in forefoot deformity correction in children leaving minimal scars and preserving the physis. [ABSTRACT FROM AUTHOR]