Early experience with totally implantable venous access port system for pediatric cancer patients

Background and Aim of work: vascular access in children receiving chemotherapy often poses an important problem. The irritating drugs used destroy peripheral veins, leading to a progressive decrease of available surface vessels. This can delay or prevent the administration of a planned therapy. Several methods of venous access have been developed, from arteriovenous fistula to indwelling right atrial silicon rubber catheters. Totally implanted devices, consisting of a subcutaneous inaction port attached to a silicon catheter, have been tried for those children. We are reporting here our early experience to assess the efficiency of this device

Patients and Method: between February 2001 and February 2004, 28 devices were placed in 28 patients with solid neoplasm or hematologic malignancy. All the catheters were inserted by cut down of the subclavian veins. The age of the patients ranged from 6 months 12 years old. Follow up period ranged from 4 to 20 months

Results: we did not have any early complication of insertion. System obstruction was the most frequent late complication. The mean life of the implanted system was 288 days

Conclusion: totally implanted devices roved safe 6 efficient venous access. Implantation should be performed by experienced surgeon. Obstruction is the most common complication 6 nay be prevented by adequate information and training of the users

Serum Cytokine Levels in Neonatal Sepsis

The Serum, cytokines level may be elevated in neonatal sepsis and the magnitude of its elevation may be related to the severity of illness and mortality. The aim of this study is to evalute tumour necrosis factor alpha and interleukin-6 serum levels in the diagnosis and prognosis of neonatol sepsis Tumour necrosis factor-alpha and interleukin-6 serum levels are determined in 24 newborn infants with positive blood culture [group I] 23 new born infants with suspected sepsis group [II] and 15 newborn as control [group III]. The serum cytokines levels are measured on admission and 48 hours after admission. The serum cytokine levels TNF alpha and IL6 are significantly elevated in neonates with sepsis their levels are significantly higher in died than survived cases and are related to the severity of illness. Their significant decreament with the proper therapy is of good prognostic value. The combination of TNF alpha and IL6 determinations appears to be alpha good predictor of neonatal sepsis