Undescended testes in children

Kriptorhizam (nespušten testis), izostanak jednog ili obaju testisa u normalnom skrotalnom položaju, može biti kongenitalan ili stečen. Kongenitalni, primjetljiv već pri rođenju, nastao je zastojem (intraabdominalno, ingvinalno ili visoko skrotalno) testisa na njegovom normalnom putu spuštanja. Kongenitalni kriptorhizam jedna je od najčešćih kongenitalnih anomalija (4% zdrave terminske novorođenčadi i oko 45% nedonoščadi). Kriptorhični testisi, ako dugo ostanu u abnormalnom položaju, prolaze kroz određene histološke promjene, a koje dovode do smanjene plodnosti i povećanog rizika za razvoj malignih tumora testisa. Stoga je preporuka kirurško liječenje završiti do navršenih 12, najkasnije 18 mjeseci života. Cilj ovog rada bio je utvrditi pratimo li mi te smjernice. Proučavali smo razdoblje od 2011. do 2020. godine. U istraživanje je uključeno 598 djece, a koja su u vrijeme operacije bila u dobi od 0 do 18 godina života. Jednostrano nespušteni testis imalo je 413 (69,1%) djece, od čega 245 desno, a 168 lijevo. Bilateralni kriptorhizam je imalo 158 (26,4%) djece koja su operirana u istom aktu i još 27 (4,5%) djece, kod kojih je prvo operirana jedna strana, a naknadno i druga. U prvih 16 mjeseci života operirano je 110 (18,4 %) sve djece koja su analizirana u ovom radu. U prve tri godine života operirano je 279 (46,7%), a do polaska u školu 431 (72%) djece. Prosječna dob djece pri obavljanju orhidopeksije bila je 57,8 mjeseci. Nema značajne razlike bilo da se radilo o jednostranom ili obostranom kriptorhizmu. Kroz čitavo razdoblje praćenja (deset godina) nema razlike prosječne starosti djece, niti se zamjećuje tendencija pada. Valja zaključiti kako se tek mali broj djece operira unutar prvih 18 mjeseci života, a zabrinjava izostanak tendencije smanjenja životne dobi u vrijeme zahvata u promatranom razdoblju.Cryptorchidism (undescended testicle), the absence of one or both testicles in the normal scrotal position, can be congenital or acquired. Congenital, noticeable already at birth, is caused by the stagnation (intraabdominal, inguinal or high scrotal) of the testis on its normal path of descent. Congenital cryptorchidism is one of the most common congenital anomalies, occurring in 4% of healthy term newborns and about 45% of premature babies. Cryptorchid testicles, if they remain in an abnormal position for a long time, go through certain histological changes, which lead to reduced fertility and an increased risk for the development of malignant testicular tumors. Therefore, it is recommended to complete the surgical treatment by 12, at the latest 18 months of age. The aim of this paper was to determine whether we follow these guidelines. We studied the period from 2011 to 2020. A total of 598 children were included in this study, who were between 0 and 18 years old at the time of the operation. Out of the total number of children, 413 (69.1%) had unilateral undescended testicles, of which 245 were on the right and 168 on the left side. Bilateral cryptorchidism was present in 158 (26.4%) children who were operated on in the same act and another 27 (4.5%) children who were operated on one side first and then on the other., One hundred and ten(18.4%) children analyzed in this paper were operated in the first 16 months of life. In the first three years of life, 279 (46.7 %) children were operated , and by the time they started school, 431 (72 %) children. The average age of the children when orchidopexy was performed was 57.8 months. There is no significant difference considering whether it was unilateral or bilateral cryptorchidism. Throughout the entire monitoring period (ten years), there was no difference in the average age of the children, nor was there a tendency of decline. It can be concluded that only a small number of children are operated on within the first 18 months of life, and the absence of a tendency to decrease the age at the time of surgery in the observed period is worrying

FRONTAL, AXILLARY AND TYMPANIC TEMPERATURE MEASUREMENTS IN CHILDREN

Svrha ovoga prospektivnog istraživanja, provedenog u jednom istraživačkom centru, bila je usporediti vrijednosti tjelesne temperature izmjerene dvjema metodama: standardnim staklenim termometrom u aksilarnoj regiji i infracrvenim temperaturama timpanične i frontalne regije u afebrilne djece. Studija obuhvaća 345-ero afebrilne djece životne dobi od 4 do 16 godina, koja su radi elektivnog zahvata boravila na odjelu dječje kirurgije. Temperature su mjerene u 1000 navrata simultano aksilarno, u slušnom kanalu i frontalno. Koristili smo se dvama različitim infracrvenim termometrima; jednom vrstom za timpaničnu, drugom za frontalnu temperaturu. Aksilarna temperatura definirana je kao standard i mjerena je klasičnim staklenim termometrom. Svaki je pacijent bio izložen konstantnoj temperaturi okoliša minimalno 10 minuta prije simultanog mjerenja temperatura. Prosječna frontalna temperatura bila je 36,9 ± 0,38 °C i jednaka je aksilarnoj tempera­turi, 36,9 ± 0,16 °C. Prosječna timpanična temperatura bila je 36,3 ± 0,98 °C. Srednja je razlika timpanične i aksilarne temperature –0,4 °C. Izmjereni niz timpaničnih temperatura u skupini naših ispitanika ima trostruko veću disperziju nego frontalni niz i pet puta veću nego aksilarne temperature. Aksilarne temperature, mjerene klasičnim staklenim termometrom, imaju najmanju disperziju izmjerenih vrijednosti, slijede frontalne temperature mjerene infracrvenim termometrom, a najmanje su pouzdane izmjerene timpanične temperature.The purpose of this study was to compare the results of body temperature measurements obtained by standard axillary thermometers with the results of infrared tympanic and frontal skin thermometry in afebrile children. This study comprises a single-center, prospective comparison trial. A total of 345 afebrile children aged 4 to 16 years hospitalized in the pediatric surgery department for elective surgery were included. One thousand axillary, tympanic and frontal measurements were obtained and compared. We used two different infrared thermometers in this study; one type measured the tympanic temperature, the other the temperature on the forehead. The axillary temperature measured with the glass thermometer was set as the standard. Each patient was exposed to a constant environmental temperature for a minimum of 10 min before simultaneous temperature measurements. The mean frontal temperature 36.9± 0.38 °C was equal to the axillary temperature 36.9± 0.16 °C. The mean tympanic temperature was 36.3 ± 0.98 °C. The mean difference between the tympanic and axillary temperatures was –0.4 °C. The tympanic temperature had a threefold greater dispersion than frontal and a fivefold greater dispersion than axillary temperature. The results of this study suggest that the axillary temperature measured with glass thermometer has the least dispersion. Somewhat less reliable is the frontal temperature measured with infrared thermometer. The least reliable is tympanic temperature measurement

FRONTAL, AXILLARY AND TYMPANIC TEMPERATURE MEASUREMENTS IN CHILDREN

Svrha ovoga prospektivnog istraživanja, provedenog u jednom istraživačkom centru, bila je usporediti vrijednosti tjelesne temperature izmjerene dvjema metodama: standardnim staklenim termometrom u aksilarnoj regiji i infracrvenim temperaturama timpanične i frontalne regije u afebrilne djece. Studija obuhvaća 345-ero afebrilne djece životne dobi od 4 do 16 godina, koja su radi elektivnog zahvata boravila na odjelu dječje kirurgije. Temperature su mjerene u 1000 navrata simultano aksilarno, u slušnom kanalu i frontalno. Koristili smo se dvama različitim infracrvenim termometrima; jednom vrstom za timpaničnu, drugom za frontalnu temperaturu. Aksilarna temperatura definirana je kao standard i mjerena je klasičnim staklenim termometrom. Svaki je pacijent bio izložen konstantnoj temperaturi okoliša minimalno 10 minuta prije simultanog mjerenja temperatura. Prosječna frontalna temperatura bila je 36,9 ± 0,38 °C i jednaka je aksilarnoj tempera­turi, 36,9 ± 0,16 °C. Prosječna timpanična temperatura bila je 36,3 ± 0,98 °C. Srednja je razlika timpanične i aksilarne temperature –0,4 °C. Izmjereni niz timpaničnih temperatura u skupini naših ispitanika ima trostruko veću disperziju nego frontalni niz i pet puta veću nego aksilarne temperature. Aksilarne temperature, mjerene klasičnim staklenim termometrom, imaju najmanju disperziju izmjerenih vrijednosti, slijede frontalne temperature mjerene infracrvenim termometrom, a najmanje su pouzdane izmjerene timpanične temperature.The purpose of this study was to compare the results of body temperature measurements obtained by standard axillary thermometers with the results of infrared tympanic and frontal skin thermometry in afebrile children. This study comprises a single-center, prospective comparison trial. A total of 345 afebrile children aged 4 to 16 years hospitalized in the pediatric surgery department for elective surgery were included. One thousand axillary, tympanic and frontal measurements were obtained and compared. We used two different infrared thermometers in this study; one type measured the tympanic temperature, the other the temperature on the forehead. The axillary temperature measured with the glass thermometer was set as the standard. Each patient was exposed to a constant environmental temperature for a minimum of 10 min before simultaneous temperature measurements. The mean frontal temperature 36.9± 0.38 °C was equal to the axillary temperature 36.9± 0.16 °C. The mean tympanic temperature was 36.3 ± 0.98 °C. The mean difference between the tympanic and axillary temperatures was –0.4 °C. The tympanic temperature had a threefold greater dispersion than frontal and a fivefold greater dispersion than axillary temperature. The results of this study suggest that the axillary temperature measured with glass thermometer has the least dispersion. Somewhat less reliable is the frontal temperature measured with infrared thermometer. The least reliable is tympanic temperature measurement

Timpanična, frontalna i aksilarna temperatura u djece [Frontal, axillary and tympanic temperature measurements in children]

The purpose of this study was to compare the results of body temperature measurements obtained by standard axillary thermometers with the results of infrared tympanic and frontal skin thermometry in afebrile children. This study comprises a single-center, prospective comparison trial. A total of 345 afebrile children aged 4 to 16 years hospitalized in the pediatric surgery department for elective surgery were included. One thousand axillary, tympanic and frontal measurements were obtained and compared. We used two different infrared thermometers in this study; one type measured the tympanic temperature, the other the temperature on the forehead. The axillary temperature measured with the glass thermometer was set as the standard. Each patient was exposed to a constant environmental temperature for a minimum of 10 min before simultaneous temperature measurements. The mean-frontal temperature 36.9 ± 0.38 °C was equal to the axillary temperature 36.9 ± 0.16 °C. The mean tympanic temperature was 36.3 ± 0.98 °C. The mean difference between the tympanic and axillary temperatures was -0.4 °C. The tympanic temperature had a threefold greater dispersion than frontal and a fivefold greater dispersion than axillary temperature. The results of this study suggest that the axillary temperature measured with glass thermometer has the least dispersion. Somewhat less reliable is the frontal temperature measured with infrared thermometer. The least reliable is tympanic temperature measurement