RESUMO
The purpose of this report is to analyse the long-term outcome in hydrocephalic children treated by shunt insertion, in particular their psycho-intellectual development and quality of life. We studied 46 patients aged 3 - 21, who had been operated on in the Department of Paediatric Surgery of the Medical University of Bialystok between 1982 - 2000 and had had ventriculo-peritoneal shunts inserted during their first year of life. Data from anamnesis and medical documentation were analysed. Age-appropriate psychomotor development and IQ tests were carried out: Wechsler Intelligence Scale for Children, Revised (WISC-R) (for children between the ages of 6 and 16), Wechsler Adult Intelligence Scale, Revised (WAIS-R PL) (for adults), Brunet-Lezine psychometric scale (early childhood), and Terman-Merril intelligence scale (children younger than 3). The final IQs were above 90 in 30 % of children, between 70 and 90 in 24 %, between 50 and 70 in 26 %, and lower than 50 in 20 %. 69 % of patients presented with neurological deficits and visual or auditory deficits were found in 22 %. Integration into normal schools was possible for 58.7 % of the children, one of whom is now a second year medical student. A relationship between shunt malfunction and the children's development was observed. An essential aspect of caring for hydrocephalic children is their rehabilitation and integration into society. Early physical rehabilitation, stimulation of psychological development, and continued monitoring by a paediatric surgeon to ensure proper functioning of the shunts will improve the independence of such children in their families and among their peers.
Assuntos
Hidrocefalia/cirurgia , Qualidade de Vida , Derivação Ventriculoperitoneal , Adolescente , Adulto , Criança , Pré-Escolar , Educação Inclusiva , Humanos , Hidrocefalia/reabilitação , Masculino , Desempenho PsicomotorRESUMO
Polyvalent Pseudomonas aeruginosa vaccine, prepared at the Institute of Hematology from 10 hospital strains isolated from burn wounds, was administered to 32 children with extensive and deep burns. The vaccine was well tolerated. The vaccine produced a high degree of the immunity against Pseudomonas aeruginosa infection. Agglutinin serum titre increased significantly. Vaccination either prevented or inhibited the infection of burn wounds with Pseudomonas aeruginosa in all immunized children. The symptoms of Pseudomonas aeruginosa infection usually disappeared following one or two vaccinations. Bacteriemia caused by P. aeruginosa was not observed in 31 out of 32 children. In the remaining child transient bacteriemia was noted. No septicemia caused by P. aeruginosa was seen. Due to the high efficiency of the polyvalent P. aeruginosa vaccine all burned children with burns exceeding 10% of the total body surface should by vaccinated to prevent the life-threatening infections with Pseudomonas aeruginosa.