[Streptococcus pneumoniae endocarditis in a child: a case report].

Introduction: the incidence of invasive infections caused by pneumococcus (Streptococcus pneumoniae) has declined since generalized vaccination with pneumococcal conjugated vaccine, but it is still a prevalent pathogen in children. Amongst pneumococcal invasive infections, IE (infectious endocarditis) is rare, with an incidence between 1 and 7%.

Case Report: We describe the case of a previously healthy 4 year old boy, who had received one dose of 10-valent pneumococcal conjugate vaccine who presents with fever, a new heart murmur and heart failure.

Rehabilitation and exercise oncology program: translating research into a model of care.

Introduction: The Rehabilitation and Exercise Oncology model of care (ActivOnco) was established to optimize cancer survivorship through exercise prescription and active lifestyle promotion, providing a transition of care from hospital to community. Patients having any cancer diagnosis, stage of disease, and treatment were eligible for evaluation and exercise prescription upon deterioration of performance status. The team of professionals included hospital-based physiotherapists proactively screening for rehabilitation needs, loss of functional independence, and exercise eligibility, plus exercise specialists in a community-based Wellness Centre to provide follow-up or direct access for post-treatment or non-complex patients.

Staged laparoscopic-assisted endorectal pull-through for long segment Hirschprung's disease and total colonic aganglionosis.

Aim: Recently laparoscopic endorectal pull-through (LERPT) has been widely performed for treatment of Hirschsprung's disease (HD) as a one stage procedure. In long segment aganglionosis (LSA) and in case of total colonic aganglionosis (TCA) a staged procedure can be preferred. The authors report their experience in the staged LERPT for LSA and TCA.

Versatility of one-trocar surgery in children.

Background/purpose: One-trocar surgery (OTS) includes all video-surgical techniques performed using a single 10-mm port and an operative scope. These techniques can be completely endoscopic or endoscopic assisted. Since 1997, OTS has become the approach of choice in our institution for a variety of laparoscopic, retroperitoneoscopic, and thoracoscopic operations.

Delayed upper gastrointestinal bleeding after laparoscopic treatment of forme fruste choledochal cyst.

Unlabelled: Delayed upper gastrointestinal (UGI) bleeding after surgery is a catastrophic event with high mortality unless diagnosed early. In this paper, report a case of massive UGI bleeding 1 month after the laparoscopic treatment of a forme fruste choledochal cyst (FFCC).

Case Report: A 8-year-old girl presented at our attention because of acute pancreatitis.

Retroiliac double ureters in duplex system: incidental retroperitoneoscopic diagnosis.

Retroiliac ureter is a rare congenital anomaly. In this paper, we present a case in which retroiliac double ureters were incidentally found during a retroperitoneoscopic nephroureterectomy procedure in a 5-year-old boy with dysplastic right kidney in duplex system and ureterocele. Ureters were both in the retroiliac artery position.

One-trocar transumbilical laparoscopic-assisted management of Meckel's diverticulum in children.

Purpose: Transumbilical laparoscopic-assisted intestinal surgery using only "one trocar" is a very minimal invasive procedure. The authors present their experience for the management of Meckel's diverticulum.

Materials And Methods: Between January 2001 and December 2004, 9 transumbilical laparoscopic-assisted procedures were performed for Meckel's diverticulum.

Laparoscopic versus open appendectomy in children: a retrospective comparative study of 2,332 cases.

Aim: The laparoscopic treatment of paediatric appendicitis remains controversial, especially in the presence of complications. This study evaluated the outcomes of open appendectomy (OA) and laparoscopic appendectomy (LA) by analysing the data from a multicentre study.

Methods: The authors retrospectively reviewed a series of 2,332 appendectomies (1,506 LA and 826 OA) performed in children and adolescents (median age 8 years) in 9 different centres of paediatric surgery.

Thoracoscopic surgery in the management of pediatric malignancies: a multicentric survey of the Italian Society of Videosurgery in Infancy.

Background: Few reports have elucidated the role of minimally invasive surgery (MIS) for pediatric malignancies. This study aimed to review the results of a multicenter study on the management of thoracic tumors in children using MIS.

Methods: A 5-year retrospective review of all MIS procedures for the treatment of pediatric malignancies performed in seven centers belonging to the Italian Society of Videosurgey in Infancy is reported.

Italian multicentric survey on laparoscopic spleen surgery in the pediatric population.

Background: Some technical aspects of laparoscopic spleen surgery still are debated, although efforts have been made to standardize them. The position of the patient, the approach to the spleen, vessel identification and division, and spleen extraction can vary from center to center.

Methods: This retrospective muticentric study led by the Società Italiana di Videochirurgia Infantile (SIVI) examined indications, surgical details, and complications of laparoscopic spleen surgery in the pediatric population during a 5-year period.

Retroperitoneoscopic varicocelectomy in children and adolescents.

Background/purpose: In the pediatric population the failure rate of sclerotherapy for the treatment of varicocele has been reported to be up to 35%. Therefore, the aim of our study was to evaluate the efficacy of retroperitoneoscopic varicocelectomy (RV) in children and adolescents.

Methods: A total of 97 patients were operated on for left-sided varicocele using the retroperitoneoscopic approach between January 1999 and July 2003.

Laparoscopic management of nonpalpable testes: a multicenter study of the Italian Society of Video Surgery in Infancy.

Purpose: Diagnostic laparoscopy has changed the surgical approach to nonpalpable testes (NPT). The aim of this study was to determine the value of laparoscopy in managing patients with NPT and to suggest guidelines for the interpretation of laparoscopic findings. The authors report the results of a multicenter study of the Italian Society of Video Surgery in Infancy on laparoscopic management of NPT.

In memoriam: Celso-Ramon Garcia, M.D. (1922-2004), reproductive medicine visionary.

This article traces the career of Celso-Ramon Garcia (1922-2004), noted physician, educator, and internationally renowned pioneer in the field of reproductive endocrinology. His work helped to formulate oral contraceptives used by millions of women throughout the world. Garcia's research collaborators included Gregory Pincus and John Rock, who together finalized the landmark clinical data needed to secure initial FDA approval for "the pill" in 1960.

Complications of pediatric urological laparoscopy: mistakes and risks.

Purpose: We evaluate the results and complications of laparoscopic urological procedures in children.

Materials And Methods: In a 3-year period 4,350 laparoscopic procedures were performed at 8 Italian centers of pediatric surgery. We analyzed only the data of urological procedures for a total of 701 laparoscopic operations on patients 1 month to 14 years old.

Gamete donation and anonymity: disclosure to children conceived with donor gametes should be optional.

To force potential parents to tell their child of his/her genetic origin as a requirement for admission into an infertility programme is both wrong and discriminatory. In addition, comparing the practice of using donor gametes to conceive a child with adoption is incorrect for a number of reasons. In this article we make the argument that mandatory disclosure is both inappropriate and intrusive, and the presently available data do not justify a rigid position.

One-trocar surgery: a less invasive videosurgical approach in childhood.

Background/purpose: Laparoscopic techniques and instruments are evolving to lessen the invasiveness of this surgical approach. The authors present their experience with the videosurgical approach using only 1 trocar.

Methods: Between October 1997 and January 2000 the authors performed 59 videosurgical procedures using a 1-trocar approach (mean age, 11.

Results and complications of laparoscopic surgery for pediatric varicocele.

Background: The aim of this study was to evaluate the results and complications of laparoscopic varicocelectomy in children.

Methods: Over a 36-month period, 211 children underwent laparoscopic treatment of varicocele. Their ages ranged between 6 and 17 years; the varicocele was located on the left side in 209 cases (99.

The fallopian tube and reproductive health.

The fallopian tube is the essential link between the ovary and the uterus. Its transport mechanisms are now reasonably well understood and include orderly ovum transfer by the fimbria, and ovum/preembryo retention, with transport to the uterus on the third postovulatory day. Sperm/tube interaction ensures a reservoir and storage/activation system at the tubal isthmus.

Bronchopulmonary segmental lavage with Surfaxin (KL(4)-surfactant) for acute respiratory distress syndrome.

We performed a trial to assess the safety and tolerability of sequential bronchopulmonary segmental lavage with a dilute synthetic surfactant (Surfaxin) in 12 adults with ARDS. Patients received one of three dosing regimens in which aliquots of Surfaxin were administered via a wedged bronchoscope to each of the 19 bronchopulmonary segments. Suctioning was performed 10-30 s after instillation of individual aliquots.

Efficacy of superovulation and intrauterine insemination in the treatment of infertility. National Cooperative Reproductive Medicine Network.

Background: Induction of superovulation with gonadotropins and intrauterine insemination are frequently used to treat infertility. We conducted a large, randomized, controlled clinical trial of these treatments.

Methods: We studied 932 couples in which the woman had no identifiable infertility factor and the man had motile sperm.