81 research outputs found
The early diagnosis of acute abdominal emergencies in infancy and early childhood
It is not generally appreciated that acute abdominal emergencies are common in infancy and early childhood. Although chemotherapy and antibiotics, improved techniques in pre- and post-operative care, and better anaesthesia have been reponsible for a steady and reassuring decline in the annual mortality rate from these emergencies, there is still much room for improvement. The reduction in mortality has not equalled that found in adults, and disconcerting facts are the alarming death rate from neonatal obstructions still prevalent in many centres, the frequency of irreducible intussusception, and the persistently high fatality-rate from acute appendicitis in children under the age of 5 years.It is the purpose of this paper to ascertain the causes of the higher mortality figures in small children, and to consider the distinctive clinical features of the commoner conditions which present as acute abdominal emergencies in childhood. The data, which are based mainly on personal experience, are correlated with the views expressed in current literature and illustrated by an analysis of 314 abdominal emergencies treated in our Children's Surgical Department during the 2-year period January 1953 to December 1954
The management of Wilms' tumour
This report is based essentially on 45 patients with Wilms' tumour treated during the period 1951 - 1967 with comments on a modified regime in 20 patients treated since 1968.During the period 1951 - 1967 the standard treatment was nephrectomy and radiotherapy; cy:oxics were added from 1959. The over-all long-term survival was 42%, but all infants under the age of 1 Year have survived. Cytoxics increased the over-all survival rate from 19% to 55%. Although we aimed at giving post-operative irradiation only, 10 patients received pre-operarve therapy because of the enormous size of their tumours and/or malnutrition. Eight of these patients have survived.In view of the above, all patients, excepting infants under 1 year, have received pre- and postoperative X-ray therapy since 1968. We have also modified the cytoxic regime and all patients have been given repeated courses of actinomycin 0, while those with metastases or recurrence have also received vincristine. The over-all survival rate to date is 60%
The management of Wilms' tumour
Th:s report is based essentially on 45 patients with Wilms' tumour treated during the period 1951 - 1967 with comments on a modified regime in 20 patients treaed since 1968. During the period 1951 - 1967 the standard treatment was nephrec:omy and radiotherapy; cy:oxics were added from 1959. The overall long-term survival was 42%, but all infants under the age of 1 Year have survived. Cytoxics increased the over-all survival rate from 19% to 55%. Although we aimed at giving pos~operative irradiation only, 10 patients received pre-operarve therapy because of the enormous size of their tumours and/or malnu:rit1on. Eight of these patients have survived. In view of the above, all patients, excepting infants under 1 year, have received pre- and postoperative X-ray therapy since 1968. We have also modified the cytoxic regime and all patien~s have been given repeated courses of actinomycin 0, while those with metastases or recurrence have also received vincristine. The over-all survival rate to date [s 60%
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