O PRINCÍPIO EDUCATIVO DA PRODUÇÃO ASSOCIADA: UM OLHAR A PARTIR DA ORGANIZAÇÃO COLETIVA DOS TRABALHADORES E DA GESTÃO DEMOCRÁTICA DO PROCESSO DE TRABALHO

Trata-se de revisão teórica que objetiva sistematizar a categoria princípio educativo da produção associada, pautando-se nos conceitos pedagogia da produção associada e cultura do trabalho elaborados por Tiriba e, nos estudos sobre as condições para uma gestão democrática do processo de trabalho e o conceito de organização coletivista de produção associada desenvolvidos por Faria. O princípio educativo que se realiza nas organizações coletivistas de produção associada sob uma gestão democrática do processo de trabalho possibilita, a partir da aprendizagem coletiva na e pela práxis, forjar uma nova cultura do trabalho e estabelecer novas concepções de trabalho, de vida e de mundo

Zastosowanie midazolamu w zakładzie radiologii pediatrycznej : sedacja płytka przed diagnostycznymi badaniami obrazowymi

Background: The aims of the study were to evaluate the usefulness of midazolam administration for sedation prior to some diagnostic examinations in children and to present the requirements and rules for sedation in departments of pediatric radiology. Material/Methods: From Oct. 2001 to Aug. 2005, two hundred children were investigated after conscious sedation with midazolam. The examinations were: voiding cystourethrography (129), voiding sonocystography (64), barium enema (3), ultrasonography (1), urography (1), X-ray of facial bone (1), and brain CT (1). The children's age-range was 4 months to 13 years 9 months. The decision for sedation was based on conversation with the child and/or parents, their experience with previous examinations, emotional status of the child, and exclusion of contraindications (renal insufficiency, hepatic failure, respiratory/circulatory insufficiency, allergy to benzodiazepines in anamnesis). Midazolam was given orally in a dose of 0.5 mg/kg body weight, 15-20 minutes before examination (already at the department of pediatric radiology). The parents were informed of the possible side effects and what to do after the procedure. Results: All diagnostic procedures with conscious sedation were well tolerated by the children and accepted by the parents. The parents with experience from previous diagnostic procedures indicated that they would want their child to have midazolam again if the examination needed to be repeated. No significant complications were observed in the children receiving midazolam and few adverse effect on voiding during cystourethrography. In three children (2.5, 3, and 5 years old), paradoxical reactions occurred (psychomotor agitation) which disappeared spontaneously after some minutes and had no influence on the procedure. Conclusions: Application of midazolam for conscious sedation diminished anxiety and discomfort from diagnostic procedures and short anterograde amnesia protected the child's mind from painful experience. Conscious sedation should be widely used in children in whom exact psychological preparation is impossible, and anxiety before examination can make it difficult or inaccessible

Image quality and radiation doses of volumetric 320-row computed tomography angiography with prospective electrocardiogram-gating in the assessment of coronary arteries in neonates and infants

Background: Diagnostic imaging of coronary arteries is required in neonates and infants suspected of congenital or acquired coronary artery anomalies and in pre- and postoperative assessment of complex congenital heart diseases (CHD). Aim: Our study aimed to evaluate the image quality of volumetric 320-row computed tomography angiography (CTA) with prospective electrocardiogram (ECG)-gating for coronary arteries in neonates and infants with heart diseases,  analyze factors influencing image quality and assess a radiation dose related to the procedure. Methods: The study included 110 CTA performed in neonates and infants with CHD. Results: CTA was performed in 37 girls and 73 boys at a median (interquartile range [IQR]) age of 3.0 (0.5–5.0) months, median (IQR) body weight of 5 (3.66–6.5) kg, and median heart rate (HR) of 133 (92–150) beats per minute. The orifices of the left coronary artery were visible in 100% of CTA, the orifices of the right coronary arteries were visible in 96%, whereas all coronary segments were assessable in 45% of CTA. Patients with non-diagnostic segments were significantly younger, median (IQR) age of 2.0 (0.21–5.00) months, had lower body weight of 4.6 (3.45–6.07) kg and faster HR of 136.5 (120–150) beats per minute (P <0.05) than patients with diagnostic image quality in all segments (4.0, 2–6 months, 6.0, 4.2–7 kg, and 130; 110–150 beats per minute, respectively; P <0.05). Conclusions: CTA performed with volumetric 320-row prospective ECG-gating allows for good visibility of the coronary arteries with an acceptable radiation dose. Children aged >15 days, with body weight >4.85 kg and HR <130 beats per minute are good candidates for excellent quality non-invasive CTA of all segments of coronary arteries

An unusual oesophageal foreign body in neonate : case report

Background: Foreign bodies in the esophagus in children are usually swallowed accidentally during play. An oesophageal foreign body in neonate is rare and thus the diagnostic work-up may be difficult. Case Report: We present a case of an 8-day-old baby with symptoms of oesophageal obstruction. An unusual foreign body was found. Conclusions: Foreign bodies in neonate's esophagus are rare; non-accidental action should be suspected. Atypical clinical and radiological symptoms may cause diagnostic difficulties

Przerzut o wyglądzie ropnia w płucach 10-letniego chłopca : opis przypadku

Background: Malignant pulmonary tumours in children are very rare; the majority are metastases. Nonspecific radiographic findings of these abnormalities are challenging and may delay the final diagnosis and treatment. Case Report: A 10-year-old boy was admitted to our hospital because of the clinical and radiographic symptoms and signs of pneumonia with abscess formation in the left lower lobe. After initial improvement on antibiotic therapy, a significant deterioration of the patient's condition was observed, together with progression in radiographic examinations. The patient was treated surgically and transferred to the Haematology and Oncology Department with a final diagnosis of pulmonary metastasis of clear cell sarcoma. Conclusions: Radiographic findings of metastatic diseases may mimic non-neoplastic pulmonary conditions. A lack of specific clinical symptoms and a confusing radiographic pattern in our patient with clear cell sarcoma lung metastasis caused serious diagnostic difficulties

Intussusception in children : hydrostatic reduction under US guidance : own experience

Background: Intussusception in children is a common abdominal emergency. Recent years have brought a new promising method of nonsurgical invagination treatment, hydrostatic reduction under sonographic (US) guidance. The major advantage of this method is lack of the ionized radiation. The aim of our study is to asses the safety and effectiveness of hydrostatic reduction under US guidance used as a first choice method of invagination treatment in our department. Material/Methods: From July 2006 to December 2007, 33 procedures of hydrostatic reduction under US guidance were performed in 27 children, aged from 7 months to 6 years and 10 months. The procedure was performed in US room by radiologist and surgeon with the use of self-constructed set for saline enema. The sedation of patient was routinely performed. Results: The initial procedure was effective in 23 patients (pts) (85%). In 5 pts the recurrence of intussusception occurred and in 3 of them next attempt of the reduction was successful. In 4 cases the initial procedures failed, and those children were operated. Total amount of 6 pts underwent an operation. We do not observe any complications connected with the procedure. Conclusions: Hydrostatic reduction of children intusussception under US-guidance is safe and effective method. Our initial results meet the recommended limits of successful reduction rates. It encouraged us to evaluation and further implementation of this method. Water enema is a first choice method of invagination treatment in our hospital

Atypical imaging features of adrenal gland lesions in children : report of three cases and review of literature

Background: The differential diagnosis of adrenal pathology depends on the child's age and imaging findings. Case Report: Three children without clinical symptoms of neoplasm, with an adrenal lesion discovered on diagnostic ultrasound imaging. Laboratory tests for neoplasm were negative. The final diagnosis was based on histopathological examinations after surgical resection. Conclusions: 1. The value of diagnostic imaging and laboratory tests in differential diagnosis of adrenal gland lesions is limited. 2. Malignant tumors of adrenal glands should be taken into account in children. 3. Surgical resection should be considered in diagnostic algorithm of adrenal gland masses. 4. The final diagnosis is always based on histopathological examination

Right hepatic vein injury after blunt abdominal trauma in a 12-year-old boy : case report

Background: Blunt abdominal trauma in children is one of the most frequent causes of hospitalization. We present a rare case of traumatic liver injury. Case report: A 12-year-old boy was admitted to the Surgery Department after a bicycle fall and handlebar impact injury to the right infracostal area. At admission he was stable, with no abnormalities, except for a subcutaneous hematoma found in the injured area. Abdominal ultrasound examination revealed free intraperitoneal fluid. Computed tomography (CT) revealed irregular branching laceration of the right superior hepatic segments with extension into the hepatic veins. No active extravasation of contrast material was seen. On the next day, because of the deterioration of the patient’s condition, CT examination was repeated and revealed focal extravasation of contrast material in the portal hilum, posterior to the gallbladder. An injury of the right hepatic vein was found on laparotomy. Conclusions: Hepatic vein injury is a rare but very serious complication after blunt liver trauma and it is an indication for surgical treatment. Diagnostic imaging is essential for therapeutic decisions, but its value is sometimes limited. The precise analysis of injury mechanism and localization may be very helpful. CT is currently the modality of choice for the evaluation of blunt liver trauma. If an active bleeding is suspected the delayed scans seem to be recommended