Appendicite acuta in et\ue0 pediatrica: livello di acido 5-idrossindolacetico urinario per la diagnosi precoce

Background: L\u2019appendicite acuta rappresenta tutt\u2019ora la pi\uf9 frequente urgenza addominale anche in et\ue0 pediatrica. Non esiste un singolo test laboratoristico altamente sensibile e specifico che possa da solo discriminare l\u2019appendicite acuta dalla altre cause di dolore addominale in et\ue0 pediatrica. L\u2019appendice \ue8 ricca di cellule serotoninergiche (cellule enterocromaffini). Durante il processo infiammatorio la serotonina viene rilasciata e rapidamente metabolizzata a livello epatico in acido 5-idrossi indolacetico (5-HIAA) e successivamente secreto nelle urine. Methods: 5-HIAA \ue8 stato dosato tramite HPLC nel campione urine spot di 99 pazienti, di cui 45 femmine (et\ue0 media 129 \ub1 31 mesi) e 54 maschi (et\ue0 media 117 \ub1 27 mesi), ricoverati presso il reparto di Chirurgia Pediatrica di Verona con quadro clinico compatibile con appendicite acuta. Conclusion: la determinazione dell\u20195-HIAA urinario pu\uf2 diventare un test pratico e non invasivo per la diagnosi precoce di appendicite acuta. Ulteriori studi clinici sono tuttavia necessari per raccogliere ulteriori informazioni su questo test.Background: Acute appendicitis is the most common abdominal emergency also in childhood. There is no reliable single laboratory marker that we can use to detect early inflammation of the appendix. The appendix contains serotoning-producing cells. During the inflammation process serotonin is released and converted to 5-HIAA (5 hydroxy indole acetic acid). Methods: urinary 5-HIAA was measured by HPLC in the spot urine of 99 children, 45 female (mean age 129 \ub1 31 months) and 54 male (mean age117 \ub1 27 months), who present acute abdominal pain suspected to be acute appendicitis, in the Department of Pediatric Surgery of Verona. Conclusion: spot urine 5-HIAA determination may be a practical and non-invasive method in the early diagnosis of acute appendicitis. Clinical studies are necessary for further information about this test

Intussusception due to a cecal duplication cyst: a rare cause of acute abdomen. Case report

The Authors describe a case of acute abdomen in a child with a intestinal intussusception due to a cecal duplication cys

Intraoperative double-J stent insertion in children with scintigraphic impaired renal function and obstructive urinary tract malformation.

Aim: Ureteral double-J (DJ) stents are frequently used in modern urologic practice. At present the role of stents in urological and surgical practice and their efficacy in paediatric age are not yet clear. The aim of this study is to evaluate advantages and efficacy of ureteral stents, correlating clinical and radiological data with the permanence of stent in situ. Methods: Between July 1999 and July 2004 surgery with ureteral stenting was performed on 24 consecutive patients aged between 2 and 13.5 months with scintigraphic impaired renal function due to an obstructive urinary tract malformation. During the study the performance and the efficacy of indwelling stent have been evaluated through clinical and radiological variables: pre-, intra-, and post stenting blood tests, ultrasonographic and scintigraphic parameters were also evaluated. Results: The stent insertion was useful to improve renal parenchymal thickness and renal growth. No correlation was found between improved blood tests and scintigraphic values. The improvements of clinical and radiological data were strictly correlated with the time of stenting (>3 months). Conclusion: The insertion of DJ stents as long-term internal urinary diversion is useful and safe. Late complications related to the use of stents are not frequent

Report preliminare sulla validità dell’estratto speciale di cranberry ad alta titolazione in polifenoli con vitamina c nella prevenzione delle IVU da Coli in bambini con severe uropatie

Gli Autori descrivono la loro esperienza relativa al trattamento conservativo del VUR in età pediatric

Neonatal independent predictors of severe NEC

Necrotizing enterocolitis (NEC) is a severe neonatal disease. The present study aimed to identify factors predisposing the development of severe forms of NEC. METHODS: This retrospective study examined NEC patients in a single centre between 2002 and 2015. Data concerning clinical characteristics, therapeutic management as well as short-term outcomes were collected. We compared the patients receiving successful medical treatment and those requiring surgical intervention. Patients who underwent surgery were distinguished in three subcategories. Bivariate and multivariate analyses were used for the statistical analysis. RESULTS: We identified 155 patients in the study period. 102 were treated conservatively and 53 required surgery. 8 received a primary peritoneal drainage, 31 received a drainage and a subsequent laparotomy and 14 received a laparotomy. Multivariate regression analysis identified a lower risk for surgery with a later onset and higher serum pH values, whereas an increased risk with higher C reactive Protein (CRP) levels at the onset. Pneumatosis intestinalis was identified as a protective factor. Overall mortality was 6.4%, with higher percentage in surgical NEC. CONCLUSION: This study suggests that a later onset is a protective sign for the progression to surgery, whereas lower pH values and higher CRP levels are prognostic factors associated with the need for surgery. The line of treatment involving explorative laparotomy in case of perforation seems to be rewarded by low morbidity and mortality rate

Ductal carcinomain situ in a 15-yrs-old boy with ginecomastia: a case report

Ductal carcinoma in situ (dcis) in a young man is rarely reported. Our patient, a 25-year-old man, presented with apparent symptomatic unilateral gynecomastia. He has a strong history of cancer on both the maternal and paternal sides of his family, including breast and lung (maternal) and melanoma, colon, and pancreatic (paternal). His mother tested negative for BRCA1 and BRCA2. There is no information on paternal genetic testing.The patient was treated with left subcutaneous mastectomy. Upon histologic review of the sample, concurrent gynecomastia and dcis were discovered. To date, only 4 cases of gynecomastia and dcis have been described in younger male patients. Because only 30%\u201350% of patients with dcis eventually develop invasive cancer in the subsequent 10\u201320 years, dcis prevalence in the general population may be higher than predicted. This case underscores the importance of family history in any patient presenting with a breast mass. Patients must be made aware of the risk, however small it may be, and physicians must remain cautious of cancer in young men with gynecomastia

Secondary omental torsion in children: a report of two cases and review of the literature.

The Authors describe a case of omental torsion in pediatric ag