Trends in the seasonal variation of paediatric fractures.

PURPOSE: The incidence of paediatric fractures is known to peak during the summer as a consequence of unsupervised physical activity. A more sedentary lifestyle is a potential cause for changes in paediatric seasonal fracture frequency and severity. The aim of this study was to evaluate the current seasonal variations of paediatric fractures in order to determine resource allocation in hospitals, community clinics and prevention programs. METHODS: A single institutional review of historical data of all patients aged 0 to 16 years that were diagnosed with fractures between April 2014 and July 2017 in the emergency department of a level 3 orthopaedic trauma centre was conducted. In all, 3484 fractures were reviewed, of which 2991 were included. We stratified fractures according to patients' variants and the hour, day and month with respect to holidays, weekends and weather. RESULTS: While the fracture rate on school days was 6.62 per day, the fracture rate during the summer vacation was 4.45 (p < 0.01). Hot weather was correlated with low fracture rates. The peak hours of admission were 12:00 to 13:00 and 18:00 to 22:00, with more moderate differences during non-school periods. CONCLUSION: The local seasonal variation of paediatric fractures has a bimodal distribution, with similar nadirs during both summer and winter. These rates might reflect a shift to a more sedentary lifestyle during the summer vacation. The presented data can assist in improving the value of injury prevention measures and medical resources allocation. LEVEL OF EVIDENCE: II.

Peutz-Jeghers colonic tumour in a newborn.

The authors refer a case report of the Peutz-Jeghers tumour localised in transverse colon found during a systematic clinical examination of the 4-day-old newborn, without any signs of intestinal occlusion. The end-to-end colic resection was made. Post-operative course was without any complications. The observation is rarely due to the tumour's atypical localisation as well as its presence in the newborn.

[Role of laparoscopic surgery in the treatment of abdominal pain in children]. / Miesto laparoskopickej chirurgie v liecbe bolestí brucha u detí.

Principal indications of the coelioscopy in pediatric surgery is the laparoscopic appendectomy. In compare with classic techniques it has several advantages but as well as some limitations. During decision about eventual laparoscopic intervention in children is important to take into the consideration personal and material facilities of the unit or hospital for pediatric coelioscopic interventions, their accessibility as well as longer operating time and higher price of the operation. It is amoral to use the laparoscopic appendectomy as a method of teaching surgeon and team to the technique. The authors consider the laparoscopic exploration of the peritoneal cavity with subsequent appendectomy to be a very suitable technique for examination and treatment of pre-pubertal and pubertal girls or young women with chronic or repeated abdominal pain of the uncertain origin, however, its indication in indubitable acute appendicitis of a boy is questionable.

Flexible stable intramedullary pinning technique in the treatment of pediatric fractures.

We report our 12 years' experience with the treatment of 308 fractures of the long bones in children using the flexible stable intramedullary pinning technique (FSIMP). This technique is a simple, rapid, and reliable procedure with minimal complications. It assures correct reposition and sufficient stable fixation of fragments, needs only small incisions, and most of all, allowed early mobilization of a child, thus avoiding long hospitalization and permitting his rapid normal activity and return to the school. The results are very encouraging for children up to age 5 years. The age limit is caused by the volume of the intramedullary space.

Population movements and prospects for development in South Lebanon.

"This study aims at clarifying the relationship between population movements and planning for regional development in South Lebanon. It includes an account of these movements, their different paths and destinations and the causes that led to both voluntary and forced emigration from the South, which has suffered from the deterioration of its natural resources and lost a large proportion of its human resources. The study analyses the repercussions of these movements on the condition of the inhabitants of this region. It aims at focussing attention on the magnitude of the emigration phenomena with a view to arresting the trend and its ensuing dangers." Migration to foreign countries and to other parts of Lebanon is considered.