Back Pain in a Pediatric Emergency Department: Etiology and Evaluation.

Objectives: Back pain is an uncommon chief complaint in the pediatric emergency department (ED). However, there are serious underlying conditions requiring prompt diagnosis and treatment. While the etiology is usually benign, variation exists in the evaluation.

Symptom-Guided Emergency Department Discharge Instructions for Children With Concussion.

Objectives: The objective was to evaluate the use and utility of a novel set of emergency department discharge instructions (DIs) for concussion based on a child's ongoing symptoms: symptom-guided DIs (symptom DIs). Differences in clinical outcomes were also assessed.

Methods: A convenience sample of 114 children aged 7 to 17 years presenting to an urban pediatric emergency department with a complaint of concussion was assembled.

Training residents in laparoscopic colorectal surgery: is supervised surgery safe?

Background: Colorectal resections are increasingly performed laparoscopically, and training in laparoscopic resections in the Netherlands has shifted from a post-residency fellowship to training in residency. The question remains if this supervised surgery affects short-term patient outcome.

Methods: Between January 2010 and July 2014, 523 consecutive patients, who underwent laparoscopic colorectal resection, were selected from a prospective single-center database.

Advanced colorectal cancer resulting in acute bowel obstruction during pregnancy; a case report.

Introduction: Abdominal pain is frequently found in the pregnant population; however life-threatening pathology such as colorectal cancer does occur rarely. As such, intestinal obstructions are usually attributed to pregnancy-related issues. We present the case of a young woman with an acute bowel obstruction caused by advanced colorectal carcinoma.

Abdominal CT Does Not Improve Outcome for Children with Suspected Acute Appendicitis.

Introduction: Acute appendicitis in children is a clinical diagnosis, which often requires preoperative confirmation with either ultrasound (US) or computed tomography (CT) studies. CTs expose children to radiation, which may increase the lifetime risk of developing malignancy. US in the pediatric population with appropriate clinical follow up and serial exam may be an effective diagnostic modality for many children without incurring the risk of radiation.

Objective pain assessment after ureteral reimplantation: comparison of open versus robotic approach.

Introduction: While open ureteral reimplantation is the gold standard of surgical intervention for vesicoureteral reflux (VUR), minimally invasive approaches offer the potential benefits of decreased postoperative pain, improved cosmesis, and shorter hospital stay and convalescence. Studies comparing open and minimally invasive surgery with respect to postoperative pain in children have been inconclusive.

Objective: We sought to compare postoperative pain in children undergoing open versus robotic ureteral reimplantation by using age-appropriate, validated pain assessment scales.

Laparoscopic sentinel lymph node identification in patients with colon carcinoma using a near-infrared dye: description of a new technique and feasibility study.

Background: After promising results were obtained from studies in large animals, a technique using indocyanine green (ICG) is being introduced for sentinel lymph node (SLN) biopsy in colon cancer patients.

Subjects And Methods: Colon cancer patients without clinical signs of metastatic disease, presenting at the VU University Medical Center (Amsterdam, The Netherlands) or Kennemer Gasthuis (Haarlem, The Netherlands), were asked to participate in the study. During laparoscopy, a subserosal injection of 2.

DISCLOSE : DISsection of CLusters Obtained by SEries of transcriptome data using functional annotations and putative transcription factor binding sites.

Background: A typical step in the analysis of gene expression data is the determination of clusters of genes that exhibit similar expression patterns. Researchers are confronted with the seemingly arbitrary choice between numerous algorithms to perform cluster analysis.

Results: We developed an exploratory application that benchmarks the results of clustering methods using functional annotations.

Transanal resection for villous adenomas using the Fansler proctoscope.

Benign rectal tumours represent a frequently occurring condition that often requires surgical treatment. In the literature, Transanal Endoscopic Microsurgery (TEM) has claimed a position as the gold standard for this kind of transanal surgery. In this study, we evaluate the results in a series of 34 patients who underwent a transanal resection after an extensive pre-operative work-up, using the Fansler proctoscope.

FIVA: Functional Information Viewer and Analyzer extracting biological knowledge from transcriptome data of prokaryotes.

Unlabelled: FIVA (Function Information Viewer and Analyzer) aids researchers in the prokaryotic community to quickly identify relevant biological processes following transcriptome analysis. Our software assists in functional profiling of large sets of genes and generates a comprehensive overview of affected biological processes.

Availability: http://bioinformatics.

[Acute abdomen caused by a large vesical cystine calculus].

A 73-year-old man underwent an emergency laparotomy because of acute abdominal pain and a palpable mass in the lower abdomen. A giant vesical calculus was found which had perforated the bladder, small intestine and sigmoid colon due to pressure necrosis. The stone had a length of 11.

Sentinel node staging in colon carcinoma: value of sentinel lymph node biopsy with radiocolloid and blue staining.

Background: Nodal staging accuracy is important in the prognosis and selection of patients for chemotherapy. This prospective study aims to assess the feasibility and accuracy of the sentinel lymph node procedure (SNP) using radiocolloid and blue dye in colon carcinoma.

Methods: In 56 patients, lymphatic mapping was accomplished by means of intraoperatively injecting patent blue and nanocoll subserosally around the tumour.

Abdominal rectovaginopexy: modified technique to treat constipation.

Purpose: We noted the combination of obstructed defecation or constipation and fecal incontinence, the poor results of abdominal rectopexy for constipation, and the well-known risk of postoperative induction of constipation after rectopexy. We developed a new operation to treat patients with constipation or fecal incontinence (with a concomitant rectocele, internal rectal intussusception, enterocele at dynamic defecography, or all three) or both. This new rectopexy technique avoided dorsolateral mobilization of the rectum and did not endanger the hypogastric nerves and pelvic autonomic nerves.

Novel approach to combined defaecation and micturition disorders with rectovaginovesicopexy.

Background: This study was conducted to investigate the results of rectovaginovesicopexy (RVVP) in patients with combined defaecation and micturition disorders. RVVP was developed from a standard procedure for different forms of defaecation disorders (the rectovaginopexy (RVP)). It is only a limited extension to the RVP and results in elevation of all three pelvic compartments.

Surgical treatment and role of dynamic defecography after ileal pouch-anal anastomosis: technical solutions to a difficult problem.

Purpose: Patients with an ileal pouch-anal anastomosis may develop impaired evacuation of the pouch. A new surgical approach and the role of dynamic defecography in such patients are highlighted.

Methods: Five patients with ileal pouch-anal anastomosis were assessed clinically and with dynamic defecography before and after reoperation.

Reoperation for a symptomatic double gallbladder.

A case of a complicated postoperative course after laparoscopic cholecystectomy in which, ultimately, gallbladder duplication was suspected and confirmed at laparotomy is described. The diagnostic tools, differential diagnosis, and therapy are discussed. After open cholecystectomy patients' complaints dissolved.

Endosonography of the anal sphincter after ileal pouch-anal anastomosis. Relation with anal manometry and fecal continence.

Purpose: The aim of the present study was to visualize supposed defects of the internal anal sphincter after ileal pouch-anal anastomosis (IPAA) by anal endosonography and to relate these findings with anal manometry and fecal continence.

Methods: We investigated 23 patients, visualized the sphincter complex by anal endosonography, and quantified the anatomic changes of the sphincter. Anal resting and squeezing pressures as well as length of the anal canal were determined by anal manometry.

Protective effect of blood transfusions on postoperative recurrence of Crohn's disease in parous women.

In order to determine the effect of perioperative blood transfusions (BT) on the recurrence of Crohn's disease after primary surgery we reviewed the medical histories of 148 patients with Crohn's disease, 62 males and 86 females (49 non-parous and 37 parous females). Eighty-seven patients received perioperative BT. Overall, perioperative BT showed no effect on recurrence.

Protective effect of blood transfusions on postoperative recurrence of Crohn's disease in parous women.

Background: Perioperative blood transfusion (BT) appeared to have adverse effects on survival after surgery for malignant tumors while pretransplantation BT suppressed allograft rejection. Interest grew in the effect of BT on postoperative recurrence of Crohn's disease.

Study Design And Methods: To determine the effect of perioperative BT on the recurrence of Crohn's disease after primary surgery, the medical histories of 148 patients with Crohn's disease, 62 males and 86 females (49 nonparous and 37 parous), were reviewed.

Abdominal incisions for operations on the colon and rectum.

The magnitude of extirpative operations of the colon and rectum, advanced by improved supportive measures, may be increased by decreasing the extent of transverse abdominal incisions. The right colon can be removed with facility through a transverse incision across the left upper abdomen.A left upper transverse incision, plus either an oblique or a Cherney incision, is preferable to a long vertical incision.