We report our
flexible ureteroscopic experience in children with von Willebrand disease (vWd).
Patients and Methods: A review of a prospectively maintained database of stone patients was performed. Children with a bleeding diathesis were identified. Stone burden, operative SB273005 mouse access, intraoperative complications, postoperative complications, stone-free status, and perioperative medical management were evaluated.
Results: During a 7-year period, a total of five children with a bleeding disorder underwent 7 ureteroscopic and 10 cystoscopic procedures for urinary calculi. The mean patient age was 72.4 months (range 49-123 mos) at the time of the procedure. There were three boys and two girls. Mean follow-up was 29.7 months (range 8-79 mos). Mean stone burden
was 6.1mm (range 3-14 mm) with an average of 1.3 stones per patient. Four patients were known to have vWd before surgical intervention and were pretreated with desmopressin acetate. AZD7762 solubility dmso The remaining patient was found to have vWd based on significant bleeding after ureteral stent placement. No ureters were actively dilated. Flexible ureteroscopy was performed in all cases regardless of stone location. Stone clearance was 100% (7/7). Complications occurred in 6% of procedures (1/17).
Conclusions: Ureteroscopy is a safe and efficacious modality in the management of urolithiasis in children with a bleeding abnormality. Perioperative medical management of the bleeding diathesis may help reduce complications.”
“Common atrioventricular canal (CAVC) is a common congenital heart lesion resulting from a defect in development of the endocardial
cushions during early embryogenesis. Depending on the type of defect, CAVC can encompass a spectrum of lesions ranging from partial atrioventricular (AV) canal to complete AV canal. We describe a case of CAVC with unique anatomy in a 4-month-old male infant with Down syndrome.”
“Objective: Vacuum-assisted closure (VAC) therapy has been shown to be effective at reducing bacterial counts in wounds until definitive bony coverage. However, there is continued debate over timing and type of definitive wound STI571 research buy coverage even with VAC therapy application.
Methods: From 2004 to 2009, 32 patients with Gustilo type IIIB open tibia fractures were initially treated with VAC therapy were included. The number of debridements, length of treatment with VAC dressing, definitive wound coverage management, and length of hospital stay, flap-related complications, and time to radiographic fracture healing were recorded.
Results: The mean Injury Severity Score was 17.3 +/- 2.0. All wounds closed after being treated with the primary VAC closure. The mean interval between the initial injury and definitive intervention was 10.9 days +/- 0.3 days. Twenty of 27 patients (74%) underwent rotational muscle flaps; four received free muscle flaps and three only with split-thickness skin grafts for definitive wound coverage.