New onset of multiple organ dysfunction after receiving long-term high-dose piperacillin for outpatient treatment of osteomyelitis.

Toxic side effects of piperacillin occur in many organ systems and may be cumulative dose related. We report a patient receiving long-term high-dose piperacillin to accommodate convenient outpatient intravenous therapy of osteomyelitis. He developed life-threatening multiorgan dysfunction on day 20 of piperacillin administration after 49 days of antibiotics, suggesting a likely adverse drug reaction.

Ureteral tailoring: a comparison of wedge resection with infolding.

A retrospective analysis of 44 consecutive pediatric ureteral reimplantations in 42 patients (51 ureters reimplanted) is presented, in which the ureter was tapered by infolding or wedge resection. Few postoperative complications occurred and the results were essentially comparable for the 2 groups, although slightly more postoperative ureteral obstruction occurred in the wedge resection group. Over-all success rate (no postoperative reflux and no obstruction) was 95% for the infolded group and 90% for wedge resection group.

Pyeloplasty in the young infant.

The urgency, safety and benefits of performing pyeloplasty during the first weeks of life currently are being questioned. We reviewed our experience with 114 pyeloplasties in 103 infants and young children performed between 1983 and 1987. The 34 patients who underwent an operation before they were 3 months old were compared to 69 operated upon after 3 months.

Pulmonary valvuloplasty as an alternative to surgery in the pediatric patient: implications for nursing.

Recent innovations in the use of balloon catheters to dilate stenosis have made it possible to successfully perform balloon valvuloplasty (BV) on stenotic intracardiac valves. BV is fast becoming the treatment of choice for isolated valvular pulmonary stenosis (IVPS) in pediatric patients. IVPS and other obstructive lesions involving the right ventricle and pulmonary arteries occur in 25% to 30% of all persons with congenital heart disease.

Hemangioma of the right ventricle causing outflow tract obstruction.

A 3 1/2-year-old child had a murmur of pulmonary stenosis. Echocardiography and cardiac catheterization revealed a pulmonary infundibular obstruction. Magnetic resonance imaging of the heart demonstrated a mass in the interventricular septum.

Recurrent intramedullary enterogenous cyst of the cervical spinal cord.

Intramedullary enterogenous cysts of the cervical spinal cord are rare. We report a case of symptomatic recurrence of this type of cyst 8 years following its original surgical treatment.

Neurologic outcome following pediatric resuscitation.

This study reports the survival rate and short-term neurologic outcome of children who sustained cardiac arrests at Henrietta Egleston Hospital for Children, a pediatric teaching hospital. A commonly held belief in pediatric centers has been that children tolerate the insult of cardiac arrest better than adults. Cardiac arrest was defined as the need for external or internal cardiac compressions.