Vol 6, No 4 (2016)
Original Study Articles
PROVISION OF EMERGENCY CARE TO CHILDREN
Abstract
There is limited representation of pediatric aspects of the activity produced by the national services of emergency medicine in specialized literature. The article reveals the amount of children among the affected ones under various emergency conditions, pediatric anatomy and physiology, a rational way to render medical care to children in the system of medical and evacuation support, necessity and effectiveness of organizational forms of doctors’ involvement at different stages of medical evacuation. The data are prepared using the terms of modern directives.
6-12
REMOTE RESULTS OF TREATMENT OF THE NEWBORNS WITH SACROCOCCYGEAL TERATOMAS
Abstract
The article presents the results of treatment of sacrococcygeal teratomas in newborns from 2001 to 2015. 10 newborns were operated in total; 8 of them had antenatal pathology. Complications in the early postoperative period were observed in 2 cases. Only 1 patient had an immature teratoma found during a histological examination of the removed tumor. In 2 cases the malignization was found in the remote period, the patients had high AFP values at control. Thus, during our study the malignant course of sacrococcygeal teratoma was revealed in 30% of cases.
63-66
THE FIRST EXPERIENCE OF XENON ANESTHESIA IN PATIENTS WITH INFANTILE CEREBRAL PALSY
Abstract
Introduction. The article analyzes the experience of using xenon anesthesia combined with epidural block in children with cerebral palsy and spastic dysplegia when performing the lower extremity surgeries.
Materials and methods. The study included 15 children for whom the central hemodynamics parameters, peculiarities of anesthesia and the course of early postoperative period were determined. The obtained data were compared with the results of retrospective studies in the group of children obtaining anesthesia using propofol and neuroaxial blockade.
Results. Our study showed that xenon anesthesia was accompanied by a considerable increase of stroke volume and cardiac index compensating for the depressive influence of neuroaxial blockade on hemodynamics. After xenon is failed to be delivered to the breathing circuit, fast restoration of spontaneous respiration and consciousness occurred.
Conclusion. Xenon anesthesia is characterized by a stable hemodynamic profile and fast comfort awakening which makes it possible to use it in children with cerebral palsy.
67-77
STRUCTURAL CHANGES IN THE INTESTINAL WALL IN IMPLEMENTATION OF THE SYNDROME OF INTESTINAL DYSMOTILITY IN CHILDREN WITH GASTROSCHISIS
Abstract
The authors presented the results of histopathological and immunohistochemical studies using autopsy material (22 newborns who died of gastroschisis). According to the results, in all the cases inflammation of the parietal and visceral peritoneum were of productive, proliferative and fibroplastic origin. In the majority of cases, an acute purulent inflammation with formation of abscesses at the level of the eviscerated intestinal loops was revealed.
In some cases the acute inflammation process was manifested through leukocytic erosive and abscessed inflammatory exudative fibrinous lesions at the level of the parietal and visceral peritoneum involving the entire intestinal wall in the process. The presence of only one mainly circular muscular layer was a peculiar feature found in the eviscerated intestinal loops with the external muscular layer undergoing regional hypoplasia or aplasia.
Results of the conducted study helped the authors to determine the combination of neuromuscular structural changes of the eviscerated intestinal loops and find the relation of the implementation of the intestinal motility stable disturbances in newborns with gastroschisis.
13-19
THE FIRST EXPERIENCE OF ANORECTAL MANOMETRY IN CHILDREN
Abstract
The article presents the first results of using a modern method of functional examination of the large intestine and pelvic floor muscles in children or high-resolution anorectal manometry. 60 children aged 7 months to 17 years were examined in total (34 children had underwent different surgeries on the intestine and anorectal area due to Hirschsprung disease and anorectal malformations, 26 of them had not undergone any surgery). Apart from high-resolution anorectal manometry the children had routine anorectal profilometry and sphincterometry; no sedation was applied.
The authors noted that high-resolution anorectal manometry has wider possibilities in diagnostics of defecation disturbances in children as compared with routine methods. Usage of functional methods of the examination in children alongside with clinical and instrumental examination enables to reveal the condition requiring surgical correction. The method was proved effective in dynamic examination of children undergoing rehabilitation following intestinal surgery as the conducted procedures and manipulations could be conducted effectively.
High-resolution anorectal manometry was used for the first time to reveal the symptoms of obstructive (dyssynergic) defecation in many children both after the surgeries and in those not operated explaining the reasons for chronic constipation in the children and requiring a fundamentally new approach to their treatment.
The new method is a perspective trend in complex treatment of children with defecation disturbances. Use of high-resolution anorectal manometry in pediatric colopractology will enable to optimize the therapeutic and diagnostic schemes and rehabilitation programs for patients in future.