Pediatric Ultrasound Appendicitis Score for the Diagnosis of Acute Appendicitis to Reduce Computed Tomography Scan Utilization.

Background: Acute appendicitis is one of the most common reasons for pediatric surgical consultation in the emergency room. Although acute appendicitis is a clinical diagnosis, the use of imaging in the emergency department to assist with the diagnosis is very common. Ultrasound is frequently utilized in pediatrics because of the radiation risks associated with computed tomography (CT) scan.

Spontaneous Retroperitoneal Methicillin-Resistant Staphylococcus aureus Abscess in a Pediatric Patient.

Retroperitoneal abscesses are relatively uncommon in infants and children. They carry a high rate of morbidity due to insidious onset and pose a diagnostic challenge. Here we report a case of spontaneous retroperitoneal methicillin-resistant (MRSA) infection in a two-year-old patient.

Opioid stewardship in pediatric surgery: Approaching zero.

Introduction: In response to the opioid epidemic, we hypothesized that adequate pain control can be achieved with few, if any, opioid prescriptions at discharge following pediatric surgical procedures.

Methods: All records for patients 0-15 years old who underwent pediatric surgical operations from December 2017 through May 2018 were reviewed. Opioids prescriptions, emergency department (ED) visits, and hospital readmissions were recorded.

Tracheal tube tip displacement during laparoscopy in children*.

The risk of endobronchial intubation during laparoscopy because of displacement of the tip of the tracheal tube is a well known problem in adults. Laparoscopy in children is increasingly performed, but there are no data available regarding the above problem. We prospectively studied 46 children aged 2 months to 15.

Impact of carbon dioxide versus air pneumoperitoneum on peritoneal cell migration and cell fate.

Background: Postoperative systemic immune function is suppressed after open abdominal surgery, as compared with that after minimally invasive abdominal surgery. As a first line of defense, peritoneal macrophages (PMo) and polymorphonuclear neutrophil granulocytes (PMNs) are of primary importance in protecting the body from microorganisms. Previous studies have shown changes in these cell populations over time after open versus laparoscopic surgery.

Early peritoneal macrophage function after laparoscopic surgery compared with laparotomy in a mouse mode.

Background: The authors previously demonstrated postoperative preservation of the immune function measured by delayed-type skin reaction and tumor growth after laparoscopic surgery, as compared with laparotomy. For further elucidation of the origin of the demonstrated immune preservation, peritoneal macrophage (PMo) function was investigated 1 h after different surgical procedures.

Methods: Female NMRI mice were divided into five groups: anesthesia only, abdominal skin incision, laparotomy, peritoneal carbon dioxide (CO2) insufflation, and peritoneal air insufflation.

Dorsal flexion of head and neck for rigid oesophagoscopy--a caution for hidden foreign bodies dropped into the epipharynx.

A 32-month-old girl presented with a swallowed coin in the mid-oesophagus verified by chest radiography. Rigid oesophagoscopy was performed under general anaesthesia with muscle paralysis and tracheal intubation with dorsal flexion of the head and neck. The coin could be grasped using 'optical forceps'.

Endothelin receptor remodeling induces the portal venous hyper-response to endothelin-1 following endotoxin pretreatment.

The purpose of this study was to determine the changes in endothelin (ET) receptor subtype expression and their functional significance after endotoxin pretreatment. Rats were pretreated with lipopolysaccharide (LPS) or sterile saline (control). After 24 h, liver samples were homogenized and competitive receptor binding assays were performed.

A novel mutation in the anti-müllerian hormone gene as cause of persistent müllerian duct syndrome.

Unlabelled: Persistent müllerian duct syndrome is a relatively rare inherited defect of sexual differentiation characterised by failure of regression of the müllerian ducts in males. In affected individuals, uterus and tubes are present because of defects of synthesis or action of anti-müllerian hormone (AMH), normally produced by the Sertoli cells of the testis. Patients are normally virilised, although mono- or bilateral cryptorchidism may be present.

Comparison of the stress response after laparoscopic and open cholecystectomy.

Background: We designed a prospective controlled animal study to compare the stress response induced after laparoscopic and open cholecystectomy.

Methods: Twelve female pigs (20-25 kg body weight) were anesthetized with ketamine, pentobarbital, and fentanyl. The animals were randomized into the following four groups: control (C), pneumoperitoneum with CO(2) at 14-15 mmHg (P), laparoscopic cholecystectomy (LC), and open cholecystectomy (OC).

Cell-mediated immune response is better preserved by laparoscopy than laparotomy.

Background: This study compares the effects of carbon dioxide pneumoperitoneum versus laparotomy on cellular-mediated immune response in a murine model.

Methods: Sixty-eight female C3H/He mice were sensitized to keyhole limpet hemocyanin (KLH) and to a mouse mammary carcinoma cell line (MC2) before surgery. Animals were randomized into 4 groups: group I, anesthesia (control); group II, pneumoperitoneum with carbon dioxide; group III, extraperitoneal wound; group IV, laparotomy.

The infantile inguinal hernia - a bilateral disease?

Controversy continues whether exploration of the contralateral, asymptomatic side should routinely be performed since Rothenberg and Barnett stated in 1955 that a contralateral hernia is present in three out of four children presenting with a symptomatic unilateral inguinal hernia (IH). In our institution, hernia operations are performed on the symptomatic side only, the exception being male infants under 1 year of age with a left-sided IH. To verify our concept and to evaluate the frequency of contralateral hernial development, the medical records of all infants under 1 year of age operated upon between 1984 and 1988 were reviewed and the children followed through December 1996.

Immune response: effects of operative stress in a pediatric model.

Purpose: The purpose of this study is to delineate the effect of different operative procedures on the cell-mediated immune response in a pediatric animal model using the delayed type hypersensitivity (DTH) skin test.

Methods: Sprague Dawley rats (1 week old) were sensitized against keyhole limpet hemocyanin (KLH). Animals were challenged 2 weeks later by an intradermal injection of KLH (0.

Increased mediastinal pressure and decreased cardiac output during laparoscopic Nissen fundoplication.

Background: Laparoscopic Nissen fundoplication (LNF) is gaining popularity. Although the hemodynamic effects of the typical pneumoperitoneum have been studied, the additional consequences of the hiatal dissection necessary for LNF have not.

Methods: Seven female pigs were anesthetized, intubated, and ventilated with a volume ventilator and hemodynamic and mechanical pressure monitoring devices were placed.