Wandering spleen with a ten-time twisted vascular pedicle

Torsion of a wandering spleen is a rare cause of acute abdomen in children, usually diagnosed with color-Doppler ultrasonography and enhanced computed tomography. We report a pediatric case of torsion of wandering spleen

Hypertrophic Pyloric Stenosis: 10 Years' Experience with Standard Open and Laparoscopic Approach

Purpose: Hypertrophic pyloric stenosis (HPS) is the most common cause of gastric obstruction in newborns. Extra-mucosal pyloromyotomy can be performed through a small laparotomy or laparoscopy. The aim of this study was to compare the two surgical techniques. We also analyzed the incidence of HPS in infants in the last 10 years in relation to the demographic trend of our province.Methods: We analyzed all the cases of HPS treated at our Unit between January 2010 and December 2019. The data were obtained from operating systems. Data about the demographic trends, in particular, the number of births and the population residing in the province of Verona from 2010 to 2019, were also retrieved.Results: During the study period, 60 patients were treated for HPS and met the inclusion criteria. Of these, 56 males and 4 females with an average age of 38 +/- 14 days at surgery were included. No differences were found in terms of the duration of surgery, post-operative complications, duration of hospitalization, and weight at the time of surgery. The only statistically significant data was the chlorine level in cases with and without post-operative vomiting (97 +/- 3.5 vs. 102 +/- 3.3 mmol/L, p<0.05). There was a lower incidence of HPS from 2014 to 2019; however, there was no significant evidence regarding the correlation between this and the reduced birth rate recorded in the province of Verona during the same period.Conclusion: Although laparoscopic pyloromyotomy is a highly complex procedure, it is a feasible alternative to the classic open technique

C-Reactive Protein Monitoring and Clinical Presentation of Fever as Predictive Factors of Prolonged Febrile Neutropenia and Blood Culture Positivity after Autologous Hematopoietic Stem Cell Transplantation—Single-Center Real-Life Experience

Background: Febrile neutropenia (FN) is a medical emergency that requires urgent evaluation, timely administration of empiric broad-spectrum antibiotics and careful monitoring in order to optimize the patient’s outcome, especially in the setting of both allogeneic and autologous hematopoietic stem cell transplant (ASCT). Methods: In this real-life retrospective study, a total of 49 consecutive episodes of FN were evaluated in 40 adult patients affected by either multiple myeloma (thirty-eight) or lymphoma (eleven), following ASCT, with nine patients having fever in both of the tandem transplantations. Results: Febrile neutropenia occurred a median of 7 days from ASCT. Median duration of FN was 2 days, with 25% of population that had fever for at least four days. Ten patients had at least one fever spike superior to 39 °C, while the median number of daily fever spikes was two. Twenty patients had positive blood cultures with XDR germs, namely Pseudomonas aeruginosa and Klebsiella pneumoniae, present in seven cases. ROC analysis of peak C-reactive protein (CRP) values was conducted based on blood culture positivity and a value of 12 mg/dL resulted significant. Onset of prolonged fever with a duration greater than 3 days was associated with the presence of both a peak number of three or more daily fever spikes (p = 0.02) and a body temperature greater than 39 °C (p = 0.04) based on odds ratio (OR). Blood culture positivity and peak CRP values greater than 12 mg/dL were also associated with prolonged fever duration, p = 0.04, and p = 0.03, respectively. The probability of blood culture positivity was also greater in association with fever greater than 39 °C (p = 0.04). Furthermore, peak CRP values below the cut-off showed less probability of positive blood culture (p = 0.02). Conclusions: In our study, clinical characteristics of fever along with peak CRP levels were associated with a higher probability of both prolonged fever duration and positive blood culture, needing extended antibiotic therapy

Single port surgery in pediatric age: report of first 300 cases

In recent years, evolution of surgery has led to laparoscopy and then to single port surgery. In pediatric age, few papers have been published about single port procedures; in particular, no one has described the use of the Octoport device. We present our exeprience using a new device

Degradation of 1,2-dichloroethane in real polluted groundwater by using enriched bacterial consortia in aerobic and anaerobic laboratory-scale conditions

The aim of this work was to gain insights about the feasibility of chlorinated solvents removal through biostimulated and bioaugmented biological processes in laboratory-scale permeable reactive barriers (PRBs) under anaerobic and aerobic conditions. The experimental plant consisted of two Plexiglas cylindrical columns filled with silica sand and fed with real groundwater contaminated by chlorinated solvents (mainly 1,2-dichloroethane, 1,2-DCA, at a concentration of 20 mg l-1). Column A simulated a PRB containing poly-β-hydroxybutyrate (PHB) powder as electron donor and worked under anaerobic conditions; in Column B an inlet air flow rate ensured aerobic conditions. Both columns were inoculated with dechlorinating bacterial consortia obtained by enrichment cultures from the same contaminated groundwater. Results from Column A showed that PHB can be fermented and used as a slow-releasing carbon source for sustaining reductive dechlorination, as revealed by acetate production up to 267 mg l-1 and 100% 1,2-DCA removal. The microbial community detected in Column A at the end of the experimental period was mainly enriched in sulfate reducing bacteria that could act as both fermenting and dechlorinating agents. Column B showed a slight lower 1,2-DCA removal efficiency (98%) likely related to the establishment of aerobic (co)metabolic processes