33 research outputs found
Pre-pubertal Presentation of Peritoneal Inclusion Cyst Associated with Congenital Lower Extremity Venous Valve Agenesis
Low intraabdominal pressures are recommended for laparoscopic procedures in patients with lower extremity venous valve agenesis
Case series of variable acute appendicitis in children with sars-cov-2 infection
Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.This case series study consists of six children, aged 5–16 years, admitted to a centralized tertiary paediatric hospital serving a population of 1.9 million with acute appendicitis in the setting of SARS-CoV-2 infection. From the beginning of the pandemic in March 2020 until August 2021, 121 COVID-19-positive children were admitted to the hospital. A total of 49 (40.5%) of these patients presented with gastrointestinal symptoms, of which six were diagnosed with acute appendicitis. Five underwent an appendectomy, while one was treated conservatively. To date, it has been reported that appendicitis may have a plausible association with SARS-CoV-2 infection in children. With COVID-19 cases rising, every medical specialist, including all paediatric surgeons, must be ready to treat common acute diseases with SARS-CoV-2 infection as a comorbidity. Providers should consider testing for this infection in paediatric patients with severe gastrointestinal symptoms. Non-surgical treatment of acute appendicitis in children may gain new importance during and after the COVID-19 pandemic. Further studies are needed to prove the link of causality between COVID-19 and acute appendicitis in children.publishersversionPeer reviewe
European expert recommendations on clinical investigation and evaluation of high‐risk medical devices for children
Several high-risk medical devices for children have become unavailable in the European Union (EU), since requirements and costs for device certification increased markedly due to the EU Medical Device Regulation. The EU-funded CORE-MD project held a workshop in January 2023 with experts from various child health specialties, representatives of European paediatric associations, a regulatory authority and the European Commission Directorate General Health and Food Safety. A virtual follow-up meeting took place in March 2023. We developed recommendations for investigation of high-risk medical devices for children building on participants' expertise and results of a scoping review of clinical trials on high-risk medical devices in children. Approaches for evaluating and certifying high-risk medical devices for market introduction are proposed
European expert recommendations on clinical investigation and evaluation of high-risk medical devices for children.
Several high-risk medical devices for children have become unavailable in the European Union (EU), since requirements and costs for device certification increased markedly due to the EU Medical Device Regulation. The EU-funded CORE-MD project held a workshop in January 2023 with experts from various child health specialties, representatives of European paediatric associations, a regulatory authority and the European Commission Directorate General Health and Food Safety. A virtual follow-up meeting took place in March 2023. We developed recommendations for investigation of high-risk medical devices for children building on participants' expertise and results of a scoping review of clinical trials on high-risk medical devices in children. Approaches for evaluating and certifying high-risk medical devices for market introduction are proposed
Pectus excavatum, pectus carinatum and other forms of thoracic deformities
This review article covers the spectrum of congenital thoracic wall
deformities along with their historical background. Willital′s
classification divides these deformities into 11 types - funnel chest
(4 types), pigeon chest (4 types), and combination of funnel and pigeon
chest, chest wall aplasia and cleft sternum. Records of patients at our
center comprised 90% depression deformities, 6% protrusion deformities,
3% combined depression-protrusion deformities and 1% other forms. Mild
forms of abnormalities warrant the wait- and-watch approach during the
first 4-5 years. The deformities manifest primarily during the pubertal
spurt often with rapid progression with subjective complaints like
dyspnea, cardiac dysthesia, limited work performance and secondary
changes. Operative correction in young adults is more favorable in mild
cases. The Willital technique has been the standard technique for the
correction of pectus excavatum, pectus carinatum and other combined
forms of deformities at our center with excellent long term results.
The Nuss procedure and the Pectus Less Invasive Extrapleural Repair
(PLIER) technique for pectus excavatum and pectus carinatum have also
been described in this article. Surgical correction for Poland′s
syndrome is reserved for patients with severe aplasia of the ribs with
major depression deformity. Sternal defects including various types of
ectopia cordis are discussed. Even after surgical correction, there is
significant reduction in the total capacity and inspiratory vital
capacity of the lungs, probably a result of the decreased compliance of
the chest wall. However, the efficiency of breathing at maximal
exercise improves significantly after operation
DOME-SHAPED PATCH OFFERS OPTIMAL BIOMECHANICS FOR REPAIR OF LARGE DEFECTS IN CONGENITAL DIAPHRAGMATIC HERNIA
The surgical management of congenital diaphragmatic hernia (CDH) using biomaterials is still not clearly understood. A neonate with a large left-sided CDH and severe pulmonary hypoplasia was offered surgical closure of the defect using a polytetrafluoroethylene (PTFE) patch on the 12th day after birth. The infant presented with a recurrence 2.5 months later as an emergency with intestinal herniation in the thorax manifesting in the form of a mechanical ileus. The recurrence was managed using a cone-shaped PTFE patch with tension-free approximation to the residual diaphragm and ribs. Six months after the second repair, the infant presented a second recurrence detected during a regular follow-up examination. The second recurrence was managed with a dome-shaped PTFE and polypropylene (PP) patch (composite prosthetic) which offered the advantage of providing a larger volume for the accommodation of the intestinal viscera. The follow-up examinations over the past 12 months have been uneventful