Hemodynamic monitoring using PiCCO system in a 10 months old infant suffering from serious burn injury.

In this study, authors present a case report of a 10 months old patient with burn injuries involving 20.5 % body surface area, grades 2a and 2b. According to the continuous monitoring of hemodynamic parameters by PiCCO (Pulsion Medical Systems, Munich, Germany), fluid therapy was successfully managed. Despite of an increasing EVLWI (extravascular lung water index) it was possible to preserve the child from lung edema and subsequent artificial lung ventilation by the early targeted therapeutic interventions. Moreover, the study analyzes the possibilities and indications of less invasive hemodynamic monitoring supplied by PiCCO in children (Tab. 2, Fig. 3, Ref. 7). Full Text (Free, PDF) www.bmj.sk.

Penile block in children, our first experience.

Penile block has been in use in penile surgery as a technique for perioperative analgesia for 25 years. The authors reintroduced penile block on the Department of Paediatric Anaesthetics and Intensive Care at the University Children's Hospital in Bratislava, Slovakia in June 2004 after 8 years. This prospective open observational study presents their experience with penile block for elective penile surgery in 96 paediatric patients (Tab. 3, Ref. 14).

Ciprofloxacin in treatment of nosocomial meningitis in neonates and in infants: report of 12 cases and review.

Twelve cases of neonatal and infant nosocomial meningitis treated with intravenous ciprofloxacin in doses of 10 to 60 mg/kg/day are described. Four neonates were 21 to 28 days old and eight infants were 2 to 6 months old. Six presented with Gram-negative meningitis: Escherichia coli (2), Salmonella enteritidis (1), Acinetobacter calcoaceticus (1), two with two organisms, and (H. influenzae plus Staphylococcus epidermidis, Acinetobacter spp. plus S. epidermidis), and six were attributable to Gram-positive cocci (four S. aureus and two Enterococcus faecalis). Ten cases were cured. In two cases, reversible hydrocephalus appeared that responded to intraventricular punctures. In seven children, no neurologic sequellae appeared after a 2- to 4-year follow-up. One neonate had relapse of meningitis 3 months later and was ultimately cured, but developed a sequellae of psychomotoric retardation. Follow-up varied from 27 months to 10 years. Current published case reports from Medline on quinolone use in meningitis in neonates and infants are reviewed.

Nosocomial meningitis in children after ventriculoperitoneal shunt insertion.

This study reviews 33 cases of ventriculoperitoneal shunt (VPS) meningitis among 415 children after 540 shunt insertions within 8 y, in 9 paediatric intensive care units from 5 centres in Slovakia. The incidence of VPS meningitis was 6.3% per insertion. The most common organisms isolated from cerebrospinal fluid (CSF) and shunt were coagulase-negative staphylococci (52.8%), followed by Staphylococcus aureus (13.1%) and Pseudomonas aeruginosa (7.5%). Seven of 15 assessed risk factors were significantly associated with VPS meningitis, compared with non-VPS meningitis: prior meningitis with hydrocephalus (15.1 vs 1.5%, p < 0.015), perinatal pathology (51.1 vs 1.5%, p < 0.001), very low birthweight (66.6 vs 16.2%, p < 0.001), polymicrobial nosocomial meningitis (30.3 vs 5.9%, p < 0.002), S. aureus (21.2 vs 7.3%, p < 0.05), coagulase-negative staphylococci (84.8 vs 30.9%, p < 0.001) and P. aeruginosa and Acinetobacter calcoaceticus (30.3 vs 4.5%, p < 0.001) in aetiology.

[A rational diagnostic program for hypertension in children]. / Racionálny diagnostický program hypertenzie u detí.

Early screening of subjects liable to develop cardiovascular diseases is one of the main tasks of preventive cardiology of child age. The authors present a rational programme for the screening and diagnostic of hypertension in children, its aim being to differentiate primary and the most frequent secondary forms of hypertension; this will create prerequisites for its adequate treatment (non-pharmacological and pharmacological) as well as for dispensarization. Review.

Treatment of renal hypertension in children by captopril.

Nine children aged 2 months to 13 (mean 6.6) years with renal hypertension were treated with captopril. The treatment lasted for 1.5 to 14 months. Maintenance doses ranged between 1 and 5 mg/kg/day. Good effect was achieved with captopril in children with normal renal function and in mild renal insufficiency. In patients with end-stage renal disease when dialysis failed to maintain normal body water captopril was ineffective.

Pediatrical case histories analyzed by means of a computer.

The authors present their first version of the formation of anamnestic case histories (family, personal, epidemiological, and social) by means of a conversation between the physician and the computer. During the recording a set of the means of expression is used, this allows for an exhaustive compilation and recording of various types of case histories. The means of expression called variables make up the questionnaire sentence. The case histories- conversations about them, are presented by the algorithm of the questionnaire in logical sequences which permit suprabound jumps off to other linkages. The created complexes-sentences are verified as a whole and then recorded. Portions of different types of case histories are demonstrated in this paper together with their possible side jumps. The possibilities of computer analysis lie in repeated recording, corrections, in the formation of statistical analyses of various data and, in the future, also in the formation of differential diagnostic considerations with the assistance of computers.