Pediatric hemodialysis access.

Pediatric hemodialysis access is a demanding field. Procedures are infrequent, technically challenging, and associated with high complication and failure rates. Each procedure affects subsequent access and transplants sites.

Use of Magnets as a Minimally Invasive Approach for Anastomosis in Esophageal Atresia: Long-Term Outcomes.

The majority of esophageal atresia (EA) patients undergo surgical repair soon after birth. However, factors due to patient characteristics, esophageal length, or surgical complications can limit the ability to obtain esophageal continuity. A number of techniques have been described to treat these patients with "long-gap" EA.

Silver-impregnated hydrofiber dressing followed by delayed surgical closure for management of infants born with giant omphaloceles.

Objective: We successfully employed silver-impregnated hydrofiber dressing for management of giant omphaloceles (GO) followed by delayed surgical closure.

Study Design: Between 2005 and 2008, eight consecutive GO infants were cared for at Driscoll Children's Hospital. Four patients had additional congenital anomalies including Beckwith-Wiedemann (n = 1), tetralogy of Fallot (n = 1), pulmonary hypoplasia (n = 1), and ruptured omphalocele (n=1).

Yolk sac tumor of the ovary in a young girl with tuberous sclerosis: A case report and review of the literature.

•We reported the first tuberous sclerosis patient with an ovarian yolk sac tumor.•Although angiomyolipoma is a common benign tumor in TS patients, abdominal malignancies must be considered.

Management of preterm giant sacrococcygeal teratoma (GSCT) with an excellent outcome.

Infants born with a giant sacrococcygeal teratoma (GSCT; >10 cm) have high mortality. Risk factors for mortality include increased tumor vascularity, high cardiac output, rapid growth, diagnosis before 20-week gestation, delivery before 30-week gestation, hydrops, low birth weight, Apgar less than 7 at 5 min and polyhydramnios. We present the case of a 28-week infant born with a GSCT (15 × 12 × 16 cm) and all of these risk factors.

Eculizumab induces long-term remission in recurrent post-transplant HUS associated with C3 gene mutation.

A 15-year-old male patient developed atypical hemolytic uremic syndrome (aHUS) at 16 months of age leading to end-stage renal disease. The family history was suggestive of autosomal dominant aHUS, and he was more recently found to have a C3 heterozygous gene mutation (1835C>T mutation in exon 14, which determines the amino-acidic substitution R570W) with no other complement abnormalities. He had two renal transplants, the first at 2.

Nonoperative management of a giant omphalocele using a silver impregnated hydrofiber dressing: a case report.

The surgical management of a giant omphalocele is challenging. Many cannot be closed at birth and must initially be managed nonoperatively with a topical agent to facilitate epithelialization. We report the case of a term, 1-day-old female neonate with a giant omphalocele treated initially with a hydrofiber dressing containing silver (Aquacel Ag; ConvaTec Inc, Skillman, NJ) and then with delayed primary closure.

Endoscopic management of recurrent congenital tracheoesophageal fistula: a review of techniques and results.

Objective: Recurrent tracheoesophageal fistula (TEF) is a difficult problem in both diagnosis and management. Revision open repair with thoracotomy is challenging and has a significant associated morbidity. Because of the technical difficulty and the substantial morbidity, several authors have suggested and implemented endoscopic management.

To drain or not to drain: a single institution experience with neonatal intestinal perforation.

Aims: The optimal surgical treatment for extremely-low-birth-weight (ELBW) neonates with pneumoperitoneum is controversial. This study aimed to identify clinical factors associated with two known causes of pneumoperitoneum-necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP), and assesses the treatment outcome with primary peritoneal drainage (PPD) vs. laparotomy.

Closing arguments for gastroschisis: management with silo reduction.

Background: There are two approaches to close gastroschisis. Primary closure (PC) is reduction and fascial closure; silo closure (SC) places viscera in a preformed-silo and reduces the contents over time. We have shifted from PC to SC.

Relapse in schizophrenia: costs, clinical outcomes and quality of life.

Background: Relapse is one of the most costly aspects of schizophrenia.

Aims: To compare costs, clinical outcomes and quality of life for patients who experienced relapse in schizophrenia with a control group who did not relapse.

Method: Patients were randomly selected from current psychiatric case-loads drawn from urban and suburban areas of Leicester.

Ageing and public satisfaction with the health service: an analysis of recent trends.

One possible explanation for the positive relationship between age and public and user views of health care is that it reflects a generational effect and this relationship has changed over the last decade or so. The analysis carried out in this report examines the relationship between ageing and levels of satisfaction with the health service in the UK using pooled data from the British Social Attitudes Survey, 1983-99. At the descriptive level there is strong evidence of a positive trend between age and satisfaction with general practice and hospital services, and for how the NHS is run but not for NHS primary dental services.