Is Autologous Blood Transfusion cost effective in Adolescent Idiopathic Scoliosis?

The purpose of this study has been to evaluate the use of preoperative autologous blood donation (PABD) in the surgical treatment of adolescent idiopathic scoliosis (AIS). The surgical records of 37 AIS patients, Lenke type 1, were reviewed. Patients were classified according to whether they had entered the PABD (Program of Autologous Blood Donation) (25 patients) or had been rejected to join (12 patients non-donors). Both groups were comparable. All but one of the PADB patients (96%) as compared to only 2 non-donors patients (16.7%) required post-operative transfusion. Moreover, 12 of the PABD patients (48%) did not require the whole stored blood. At discharge both groups had similar haemoglobin levels. The risk of transfusion was much higher in the PABD group. The patients in this group received blood even with high haemoglobin levels (>8 g/dl). Furthermore, 31.4% of the collected blood was never used. Therefore, PABD resulted in an increase in procedure costs and lead to unnecessary blood transfusions.

[Essential bone cyst of the calcaneus in children. Report of three cases]. / Quiste óseo esencial de calcáneo en el niño. Presentación de tres casos.

OBJECTIVE: The purpose of this study was to analyze the properties of essential bone cyst of the calcaneus in childhood, as well as its evolution, and differences with regard to adults. PATIENTS AND METHODS: The cases of children with a diagnosis of essential bone cyst of calcaneus in last sixteen years in the pediatric orthopedic unit of San Carlos Clinic have been reviewed. We evaluated the information regarding the clinical history and the radiological and histological date as well as the therapy result with esteroid intracavity therapy and curettage and bone grafting. The radiologic score was done following Södergard criteria and the posttreatment follow-up with Neer's score. RESULTS: The mean age of the patients was 10.3 years. Two of the patients had recurrent heel pain for more than six months. Treatment consisted in intracavitary esteroid in two cases and curettage and bone grafting in all three cases, in two of the cases because of failure of esteroid therapy and in the other because of an atypical X-ray image. In all cases the histological stady identified the existence of a characteristic membrane conective tissue. The postsurgery follow-up a period of half four years has been satisfactory. CONCLUSIONS: The essential bone cyst of the calcaneous is exceptional localization in children, frequently symptomatic and resistant to the esteroid intracavitaria contrary to what happens with the essential bone cyst of other localizations and with the essential bone cyst of the calcaneus in the adults. The recurrent heel pain and atipical X-ray image are surgery indications.

[Amniotic band syndrome]. / Síndrome de las bandas amnióticas.

The amniotic band syndrome is a collection of malformations of unclear etiopathogenesis and wide clinical significance. In this article, the characteristics of a series of eight children suffering from this syndrome are presented. Furthermore, the different aspects of the syndrome, the proposed etiologic theories, prenatal and postnatal diagnoses, and the therapeutic possibilities, from genetic counseling to surgical intervention, are discussed.