Search results for "RICS"

Is Nephron Sparing Surgery Justified in Wilms Tumor With Beckwith-Wiedemann Syndrome or Isolated Hemihypertrophy?

2016

Background Patients with Beckwith–Wiedemann syndrome (BWS) or isolated hemihypertrophy (HH) treated for a Wilms tumor (WT) carry an increased risk of developing metachronous lesion. There are no guidelines on precise indications for nephron sparing surgery (NSS) in unilateral WT (UWT). The objective of this retrospective study was to delineate the indications of NSS in patients with BWS/HH treated for WT and to evaluate their outcome. Procedure All cases of BWS/HH treated for a WT according to SIOP protocols from 1980 to 2013 were reviewed. Patients were divided into two groups (G): isolated UWT (G1) and bilateral lesions (G2) with two subgroups: bilateral tumors suspected of malignancy (G2…

Acid-Base Balance after Continent Urinary Diversion in Childhood – Risk of Imbalance Despite Medication

2010

Purpose Continent urinary-intestinal diversion can lead to alterations of the acid-base balance, acutely and chronically, the latter possibly causing bone demineralization. Annual check-ups have therefore been recommended for decades. Material and Methods At our institution, 89 children underwent continent urinary diversion by ileocecal pouch or bladder substitution between 1984 and 2006. In 58 of these patients (age 3-17 y., median 13.9 y.), we performed a minimum of 3 (range 3-23, median 6.2) consecutive annual blood-gas analyses over a follow-up period of up to 23 years (median 11.0) after surgery. At a base excess (BE) (as marker of the acid-base-balance) value below -2.5 mmol/l, treatm…

Vitamin B12 Deficiency in Children after Continent Urinary Diversion by Mainz Pouch Technique

2010

Purpose MAINZ pouch I urinary diversion provides a high-capacity, low-pressure reservoir. The use of terminal ileum can cause a decrease of vitamin B12 levels. Symptoms caused by vitamin B12 deficiency are rare, but some are irreversible, therefore annual check-ups are recommended. In this study the vitamin B12 levels in the above patients were analyzed in retrospect. Material and Methods The ileocecal segment was used for urinary tract reconstruction in > 80 children ≤17 years of age. B12 levels were determined at various time points within up to 21 years after surgery in 63 patients (8 with ileocecal bladder substitution, 55 continent cutaneous diversion). B12 values below 200pg/ml were c…

MP-16.10

2006

Radical Surgery in Children and Adolescents with Rhabdomyosarcoma of the Lower Urinary Tract Using Orthotopic Bladder Substitution and Heterotopic Ur…

2008

Abstract Purpose Children with rhabdomyosarcoma(RMS)of the bladder/prostate can be treated by radical or organ sparing surgery both in combination with chemotherapy ± radiation therapy. In this retrospective study we analyzed the outcome with special attention to radical surgery and urinary diversion (UD). Material and Methods 24/32 patients with RMS of the genitourinary tract had RMS of the bladder (n=14) or prostate (n=10). 8 patients were stage II, 11 stage III and 5 stage IV. In 18/24 with RMS of the bladder/prostate, radical surgery and urinary diversion was performed. 3 had chemotherapy only, 2 in combination with radiotherapy. One patient underwent partial cystectomy. For UD: uretero…

Arteriovenous fistula of the vertebral artery in a female infant with hypotonia and cephalocorporal disproportion

2010

Background:  Congenital arteriovenous fistulas are exceptional in childhood and imply a therapeutic challenge. Case report: A 9-month-old female infant was studied for cephalocorporal disproportion, hypotonia, progressive muscular atrophy and hyperreflexia. Computed tomography of the brain and electroencephalography were normal. Electromyographic patterns suggested proximal myopathic involvement. A continuous murmur with systolic reinforcement was audible in the neck. Angioresonance detected intracranial aneurysmal dilatations behind the bulbo-medullary junction and cerebral panangiography evidenced a direct vertebrovertebral fistula with extra- and intra-cranial varices and extreme medulla…

Available Instruments to Assess Pain in Infants

2021

Pain assessment in newborns and infants is challenging for clinicians. Although behavioral and behavioral-physiological scales are validated pain assessment instruments, their use in this age group has significant limitations. In this review, we summarize the methods currently available for assessing pain in neonates and infants. It is possible that these pain detection methods are also useful for assessing the quality of anesthesia and analgosedation in these populations. Further research should be aimed at confirming the usefulness of these tools in infants and identifying additional pain assessment options for clinical practice.

Parenting stress and impact of illness in parents of children with coeliac disease

2013

Coeliac disease (CD) is a chronic disease which could stress patients and their family. Although, poor attention has been paid to the quality of life in CD children and to the functioning of families with CD children. The study aims to evaluate the parenting perception of the CD impact and the parenting distress level. A group of 74 parents of CD children compiled the Impact Childhood Illness Scale and the Parenting Stress Index which is also compiled by 74 parents of health children. The assessment does not reveal a significant impact of CD on patient’s personal life although some critical areas emerged. Results evidenced an higher level of parenting stress in parents of CD children than p…

Could audiovisual training be used to improve cognition in extremely low birth weight children?

2011

Aim: To study whether a dyslexia remediation programme, Audilex, improves cognition in extremely low birth (ELBW) children. Methods: Six-year-old ELBW children were allocated to a 5-week training with Audilex or playing control computer games. Before and after intervention, auditory event-related brain potentials (ERP) to sound changes were recorded and reading related skills assessed. Primary outcome was the mismatch negativity (MMN) component of ERP. Secondary outcomes were Audilex Test (ability to perform the Audilex games), the reading skills after the intervention and 2 years later. Of eligible children, 39 (54%) consented and 22 (30%) completed the protocol. Results: The MMN responses…

Asthma in the elderly

2010

Asthma is frequent among older people. Nevertheless, under-recognition, misdiagnosis and under-treatment are still relevant issues. We aim to provide an overview of epidemiology of asthma in the elderly, and a thorough description of its pathology and clinical presentation, with special emphasis on the distinction of late versus early-onset asthma. We also discuss selected treatment topics of special interest for older patients, such as compliance with therapy and ability with the inhalers, which are basic to the success of the prescribed therapy. Finally, we suggest that multidimensional geriatric assessment of older asthmatics could help in tailoring the therapy to the individual needs a…