Post-operative Dressing for Paediatric Hypospadias Repair

The optimal dressing is still unclear, despite hypospadias being one of the most prevalent surgical operations. Children’s dressing for hypospadias surgery was searched on PubMed as “dressing for hypospadias,” “postoperative dressing for pediatric hypospadias,” and “dressing AND hypospadias.” Experimental studies, animal studies, reviews, letters, and repetitive publications were excluded from the study. By evaluating these reviewed publications, factors affecting hypospadias dressing, such as surgeon, country, dressing type, characteristics, and why it is preferred, will be revealed. As a result, 17 articles were examined, and the advantages of each were established by examining the results. The type of hypospadias, the surgeon’s choice, and its ease of removal stand out as the crucial factors in treating hypospadias in children, along with the degree of development of the nation

The positioning performance of low-cost GNSS receivers in the Precise Point Positioning method

Satellite-based positioning, which started being developed in the mid-1960s for military purposes, is now used in almost every area. For the studies single and/or double frequency receivers are used. The cost of a receiver and antenna couple that have capable of high coordinate accuracies ranges from $3000 to$15000. With the production of Original Equipment Manufacturer (OEM) receivers, the cost of satellite-based location determination decreases to approximately one in 10 for the civilian user compared to the operations performed with geodetic receivers and antennas. However, although these receivers collect data in multi-Global Navigation Satellite System (GNSS) and frequencies, the accuracy of the coordinate values estimated is not as high as geodetic receivers and antennas. Therefore, it is necessary to carry out an accuracy study to obtain information about which studies can be used in. In this study, measurements were made at the UZEL point located on the roof of the Yıldız Technical University Geomatics Engineering Department by using the ZED-F9P-02B OEM multi GNSS receiver and ANN-MB L1/L2 multi-band GNSS patch antenna. The performance of the test results has been examined by comparing the results from CSRS(Canadian Spatial Reference System)-PPP with the coordinates of the UZEL point. As a result of the comparison, the difference between the coordinate determined with collected 3.5 hr data and the coordinates of the UZEL point has been determined as – 1.4 cm, 2.8 cm, and 9.3 cm in the East, North, and Height directions, respectivel

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

An interesting and rare cause of post-operative intussusception: Roux limb intussusception

Intussusception is a common disease in children. Most intussusception is idiopathic and approximately 1% develops postoperatively. We present a case of a 6-year-old male patient who underwent surgery for a type 1 common bile duct cyst. In his post-operative 2nd month, the patient presented with a complaint of abdominal pain after eating, but his pain was not accompanied by nausea or vomiting. No pathological findings were evident in the examination or an abdominal X-ray of the patient. Intussusception was detected by ultrasonography and computed tomography. We wanted to introduce this interesting intussusception that originated from the Roux limb that was not seen before

Ovarian masses in infant-juvenile age.

The appropraite surgical treatment to pediatric patients with ovarian lesions are heterogeneous and ovarian preservation is desirable in children. The aim of this study is to the discuss findings related to a set of patients who were operated on for ovarian lesions

Syntheses, spectral, thermal and structural characterization of dinuclear and polynuclear copper(II) orotate complexes, [Cu-2(HOr)(2)(H2O)(4)] and [Cu(mu-HOr)(ba)(2)](n)

SOYLU, SERKAN M/0000-0002-8440-1260; YESILEL, Okan Zafer/0000-0002-2284-1578;WOS: 000268994200026The novel catena-poly-mu-orotatobis(butylamine)copper(II), [Cu(mu-HOr)(ba)(2)](n) (1), and diaqua(orotato)copper(II), [Cu-2(HOr)(2)(H2O)(4]) (2), complexes have been prepared and characterized by elemental analysis, magnetic measurements, FT-IR spectroscopy, EPR spectroscopy, thermal analysis and X-ray diffraction. Both complexes crystallize in the monoclinic space group, C2/c in 1 and P2(1)/n in 2. In the complexes, the copper(H) ion is chelated by a deprotonated pyrimidine nitrogen atom and a carboxylate oxygen atom of the orotate. While the coordination sphere around Cu(II) is completed by two N atoms from butylamine groups and a carboxylic O atom in the axial position from a neighboring molecule in 1, the square-planar environment of Cu(II) is completed by two water atoms and one axial position is occupied by the carbonyl oxygen atom from the symmetry related molecule in 2. The coordination sphere should be described as a square pyramid and (4+1)-geometry in 1 and 2, respectively. While complex I shows a polymeric arrangement, compound 2 has a dimeric arrangement. The non-covalent Cu(II)-pi binding force is very important for stabilizing the crystal structure of 2. The thermal decomposition of the complexes has been predicted by the help of thermal analysis (TG, DTG and DTA). (C) 2009 Elsevier Ltd. All rights reserved

Central serous chorioretinopathy probably associated with isotretinoin in a keratoconus patient

Gokcinar, Nesrin Buyuktortop/0000-0001-7795-5188WOS: 000441541300016PubMed: 30119816

Corneal and conjunctival sensitivity in rosacea patients

Ornek, Nurgul/0000-0003-3068-1831; usta, gulsah/0000-0002-0065-4384WOS: 000383719900007PubMed: 26949355Purpose: To assess corneal and conjunctival sensitivity in rosacea patients. Methods: A total of 55 patients with rosacea and 37 control subjects participated in the study. Corneal and conjunctival sensitivity was determined by Cochet-Bonnet esthesiometer. Subjective symptoms of ocular dryness were evaluated using Ocular Surface Disease Index (OSDI). Schirmer's I test (ST), tear breakup time (tBUT) and ocular surface staining with fluorescein were carried out to measure objective signs. Results: The mean corneal and conjunctival sensitivity did not differ significantly between rosacea patients and controls (all p > 0.05). Schirmer's I test and tBUT were significantly reduced (p = 0.004 for OD and p < 0.001 for OS) and grade of ocular surface staining was significantly high (p = 0.018 for OD and p = 0.038 for OS) in rosacea patients. Corneal and conjunctival sensitivity did not show significant correlation with ST, tBUT, ocular surface staining (Oxford Schema), duration of rosacea and OSDI score. Conclusions: Corneal and conjunctival sensitivity did not change significantly in rosacea