Azygos vein cannulation after catheterisation of the left internal jugular vein in a toddler

Central venous catheterisation is routinely performed in paediatric patients to facilitate therapeutic management when long-Term vascular access is needed. Misplacement of the catheter tip in thoracic vessels other than the superior vena cava has been described, along with related complications. Hereby, a case of a 15-month-old child is presented with a fully functional Hickman catheter introduced via the left internal jugular vein. The tip of the catheter was misplaced into the azygos vein. Intraoperative spot fluoroscopic images and anatomical explanations for the course of the catheter are presented. An understanding of the aetiology of the radiological appearance may help to increase recognition of such cases and avoid complications. © © BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ

Parental health literacy in the pediatric surgical setting

Health literacy (HL) in the pediatric setting has been associated with poor health outcomes and plays an important role in the existing health disparities. Low parents'/caregivers' HL influences health outcomes mainly in chronically ill children. Trying to identify the role of HL in the pediatric surgical and dentistry setting, we conducted a review of the relevant literature. The paucity of studies and the heterogeneity of the methodology do not lead to specific results. The need for more and larger studies in the field is evident and crucial in order to ameliorate the quality of surgical care in pediatric patients. Copyright © Celsius

Nurses' knowledge, attitudes and behavior toward Deaf patients

Background Deaf sign language users experience severe health disparities which could be decreased with the modification of some factors associated with health professionals' attitudes, knowledge and behaviors. Relevant research referring to nurses is almost inexistent. Objective This study aimed to examine Greek nurses' knowledge, attitudes and practices toward Deaf people and determine the factors that influence these parameters. Methods The sample consisted of 200 randomly selected nurses working in 2 public hospitals and 2 public health centers in Attica, Greece. Data was collected from November 2010 to May 2011, using a questionnaire inquiring for demographics, previous contact with Deaf people or other people with disabilities, relevant education, practices, feelings and self-efficacy for caring for Deaf patients, knowledge and attitudes toward them and interest in being educated in such issues. Results A lack of relevant knowledge and education was observed. Relevant education was found to be positively correlated with knowledge (rho = 0.225, p = 0.003). Self-efficacy was found to be positively correlated with the contact with Deaf people score (rho = 0.358, p < 0.001). The participants who have avoided caring for Deaf patients had a statistically significantly lower mean score of self-efficacy (p < 0.001). No correlation was found between the contact and knowledge scores and between relevant education or contact and attitudes. The majority (64.8%) were interested in attending a relevant educational program. Conclusions Our findings support that appropriate educational programs, including contact with Deaf people, could contribute to the improvement of nurses' knowledge and behavior toward Deaf people and would be welcomed by the majority. © 2015 Elsevier Inc. © 2015 Elsevier Inc. All rights reserved

Does Law Impose a Certain Code of Morality? Examples from Medical and Nursing Practice and Health Policy

The fact that dictates of law and those of morality will often coincide is widely acceptable. However, the question whether law exists or should exist to impose one particular code of morality or not may receive many different responses. Following these two concepts over different cases and scenes in the health care sector leads to the conclusion that this question could not receive a curt answer. Law should be parallel to human morality to an extent. But, morality has a subjective dimension. The common content of morality within a community is the basis for the communityrsquos legal framework. Even when law does not impose morality directly, it may refer to morality indirectly, referring for example to morals or to morality, to good faith, to bona fide and the like. Arguments and examples in this article establish the opinion that law is asked to apply morality to an extent, but this should not be used to supplant communal norms, cultural or religious beliefs, mainly when these sides of morality are not contrary to the universally common morality

Reversal of Experimental Posthepatectomy Liver Failure in Pigs: A New Application of Hepatocyte Bioreactors

Postoperative liver failure remains a major cause of morbidity and mortality after extensive hepatectomies. This study aims to evaluate the effectiveness of a hepatocyte bioreactor in the treatment of experimental post-hepatectomy liver failure. Our experimental model included a combination of a side-to-side portacaval shunt, occlusion of the hepatoduodenal ligament for 150 min, 70% hepatectomy, and reperfusion. Following the development of liver failure, 12 pigs were randomized into a control group (n = 6) and a treatment group (n = 6). Both groups underwent extracorporeal perfusion through a plasma separation device, a membrane oxygenator, and two parallel bioreactors. In the latter group, the bioreactors were loaded with 10 billion fresh hepatocytes, isolated from a donor pig. Following hepatocyte treatment, all animals were maintained for 24 h under mechanical ventilation, with intravenous fluid and glucose supplementation. Hemodynamic parameters, intracranial pressure, and biochemical parameters were measured. Liver biopsies were obtained during the 24-h autopsy. The extracorporeal circuit was well-tolerated hemodynamically. Treated animals had lower intracranial pressure compared with controls (at 24 h, 15 ± 3.1 vs. 22 ± 3.5 mm Hg, P = 0.006). Plasma ammonia in treated animals was lower compared with controls at 12 h (100 ± 29 vs. 244 ± 131 μmol, P = 0.026). Liver histological study showed decreased necrosis and increased regeneration activity in treated animals compared with controls. Treatment through an extracorporeal hepatocyte bioreactor attenuates brain edema and improves histological and functional parameters of the liver remnant of pigs with posthepatectomy liver failure. © 2010, the Authors. Artificial Organs © 2010, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc

Correction: Evolving Trends in the Management of Acute Appendicitis During COVID-19 Waves: The ACIE Appy II Study (World Journal of Surgery, (2022), 46, 9, (2021-2035), 10.1007/s00268-022-06649-z)

In the original online version of this article Oreste Claudio Buonomo’s family name was misspelled. The original article was corrected