Uso rutinario del dispositivo antimigratorio Accordion para prevenir la retropulsión de cálculos ureterales durante la litotripsia intracorpórea con laser Holmium: ¿se justifica su uso? / Routine use of Accordion® antimigratory device for preventing the retropulsion of ureteral stones during intracorporeal lithotripsy with holmium laser: is it justified?

Evaluar el impacto del dispositivo Accordion® (Percsys, Palo Alta, CA) en la prevención de la migración de cálculos ureterales. Materiales y Métodos: Un total de 68 pacientes con cálculos ureterales fueron evaluados en este estudio caso-control. 34 fueron destinados al grupo I (grupo Accordion®) y 34 al grupo II (grupo control). Como objetivo primarios se evaluó la diferencia en tiempo de fragmentación durante el procedimiento. Objetivos secundarios evaluados fueron el tiempo operatorio total, tasa de éxito en la fragmentación del cálculo, requerimiento de catéter ureteral posterior al procedimiento y complicaciones perioperatorias. Resultados: Ambos grupos de pacientes resultaron comparables en término de variables demográficas y características de la litiasis. El tiempo de fragmentación intraoperatoria fue similar entre los grupos (25 minutos en el grupo I vs 24 minutos en el grupo II; p=0,94). No fue encontrada ninguna diferencia estadísticamente significativa en tiempo operatorio total (45 minutos en el grupo I vs 50 minutos en el grupo II; p =0,67) o tasa de éxito en la fragmentación (100 por ciento grupo I vs 97 por ciento grupo II). El análisis multivariado demostró una disminución significativa en la necesidad de instalación de catéter doble J al término del procedimiento con el uso de Accordion durante la ureteroscopía (OR 0.24; CI 0,07-0,90; p=0.034).Conclusión: Ambos grupos en nuestro estudio se comportaron de manera similar con respecto a los resultados inmediatos de la ureteroscopía. La disminución en la necesidad de instalación de un catéter doble J y el costo asociado a éste constituyen un argumento a favor de utilizar el dispositivo Accordion®...

To evaluate the impact of Accordion® (Percsys, Palo Alto , CA) device in preventing stone migration. Methods: A total of 68 patients with ureteral stones were evaluated in this case control study, 34 in group I (Accordion group) and 34 in group II (control group) . As primary outcome we evaluated difference in fragmentation time during the procedure. Secondary outcomes were total operative time, stone free rates, postoperative ureteral catheter requirement and perioperative complications. Results: Both groups of patients were comparable in terms of demographics variables and stone characteristics. Intraoperative fragmentation time was similar between groups (25 minutes for group I vs 24 minutes for group II; p=0,94). No statistically significant difference were found in total operative time (45 minutes for group I vs 50 minutes for group II; p =0,67) or stone free rates (100 percent group I vs 97 percent group II). Multivariate model showed a significant decrease in the need to install a double J catheter at the end of the procedure with the use of Accordion during ureteroscopy (OR 0.24; CI 0,07 -0,90; p=0.034).Conclusions: Both groups in our study behaved similarly with respect to immediate outcome of ureteroscopy. The decrease in the installation of double J stent and the cost associated with it constitutes an argument in favor of the use of Accordion device...

Hazards of multiple magnet ingestion in children; a case report

Foreign body ingestion is relatively common in the paediatric population and most object pass through the gastrointestinal tract spontaneously. With the popularity of small magnetic toys, there have been numerous reports of magnet ingestion with morbidity and even mortality. We report a case of 3-years old boy who presented with clinical features of subacute intestinal obstruction with no history of foreign body ingestion. On exploratory laparotomy, he was found to have multiple small bowel perforations due to two small magnets. Magnets were removed and perforations repaired. The aim of this report is to aware paediatricians of the importance of early surgical referral in case of magnet ingestion, to prevent severe complications

Effectiveness of the nursing health program for mothers with children undergoing bronchoscopy

Foreign Body Aspiration [FBA] is considered a serious and potentially-lethal threat to the health of children aged from 6 months to 4 years. The golden standard for diagnosing and managing this condition is rigid open tube bronehoseopy. Mothers and caregivers should be informed and educated about health guidelines in order to reduce morbidity and mortality caused by the foreign body aspiration. This paper aims at evaluating the effectiveness of a nursing health program for mothers with children undergoing bronehoseopy through assessing their knowledge, practice and attitude to develop and implement the nursing health program to meet mothers' needs. Quasi experimental design was conducted during the period of three months in 2010 to evaluate the effectiveness of a nursing health program on a non-random convenience sample of 80 mothers selected from a governmental hospital located in Amman city, Jordan. The researchers developed an interviewing questionnaire which was used as a pre- and post test to assess knowledge, practice and attitudes of the care provided by mothers during the incident of the foreign body aspiration and after the bronehoseopy procedure. Then, the researchers developed and implemented a nursing health program followed by a post test to track changes for the purpose of evaluating the effectiveness of the health program. The most common presenting symptoms were a combination of cough [93.75%] and difficulty of breathing [81.25%]. The most frequently-aspirated foreign bodies were organic material such as seeds and nuts followed by non-organic material i.e., coins accounting for [26.2%, 16.5%, and 20%], respectively. There were statistical significant improvements [P<0.01] in mothers" knowledge, practice, and attitude on the post-test scores. There is an urgent need to educate mothers with the safety precautions and chocking prevention measures to minimize the risk of FBA