Fact or myth? Pain reduction in solvent-assisted removal of adhesive tape.

OBJECTIVE: To determine if solvent-assisted tape removal reduces pain when compared with dry tape removal. METHOD: A double-blinded comparative study was performed, in which commonly used solvents, namely water, alcohol, peanut oil, sunflower oil, and Leukotape remover (BSN medical), were applied to six zinc oxide adhesive tapes (Leukoplast, BSN medical), 10 cm long, 2.5 cm wide that had been placed on the volar side of each forearm of adult volunteers. One tape was left dry. Pain was measured using a visual analogue scale (VAS) and statistically analysed. RESULTS: There were no statistically significant differences in VAS pain scores between the used substances when compared with the dry tape (p=0.39). The use of oil (peanut and sunflower) caused remains of adhesive to occur significantly more often (p<0.05). CONCLUSION: Applying substances to ease pain associated with the removal of adhesive tapes does not lead to a reduction of pain when compared with dry tape. CONFLICT OF INTEREST: None.

[Cyclic vomiting in children]. / Kinderen die cyclisch braken.

Two girls aged 13 and 10 suffered from recurrent episodes of severe vomiting. After excluding underlying pathological conditions the diagnosis of cyclic-vomiting syndrome was made. They were treated by intravenous fluid suppletion and drugs such as propranolol, pizotiphene, diclophenac, granisetron, lorazepam and pantoprazole. Eventually they recovered. Cyclic-vomiting syndrome is probably a common but often not recognised syndrome. It should be considered in all children with multiple episodes of vomiting. It is characterized by the sudden occurrence and spontaneous disappearance of symptoms followed by a completely symptom-free interval. The incidence has been estimated to be as high as 2% in some populations of school children. The syndrome is often not diagnosed if the episodes are mild and diagnosed late if the symptoms are severe. To avoid too many investigations the suggested diagnostic protocol can be followed. Prophylactic therapy with anti-migraine medication should be attempted, notably with propranolol, early in the course of the disease.

Laparoscopic approach to surgical management of ovarian cysts in the newborn.

With the improvement of imaging techniques as well as the trend toward routine antenatal ultrasound scanning, the intrauterine diagnosis of fetal ovarian cysts is encountered more frequently. The authors describe the laparoscopic approach to the management of ovarian cysts. This approach is tolerated well by infants, and it may overcome the controversy between conservative and early surgical management by facilitating the subtle transition from diagnostic to therapeutic means, with salvation of the ovary whenever possible.

The effect of posterior sagittal anorectoplasty and its variants on lower urinary tract function in children with anorectal malformations.

The effect of posterior sagittal anorectoplasty (PSARP) and its variants on lower urinary tract function was investigated urodynamically in 32 patients with anorectal malformations. In 27 patients urodynamic evaluation was performed before and after surgery and in 4 it was done postoperatively only. One child was clinically assessed with no postoperative urodynamic study. Minor postoperative changes in the specific preoperative urodynamic pattern were observed in 4 cases but the changes did not seem to be related to surgery. In 3 boys with rectourethral fistulas detrusor failure consistent with autonomic denervation was noted postoperatively. Standard posterior sagittal anorectoplasty was performed in 1 of the 3 boys and posterior sagittal anorectoplasty combined with additional transabdominal procedures was done in the other 2. In general our findings suggest that posterior sagittal anorectoplasty and its variants do not affect lower urinary tract function unless these surgical techniques are combined with major transabdominal procedures and extensive retrovesical dissection.

Treatment of giant omphalocele by enlargement of the abdominal cavity with a tissue expander.

Even in the absence of major associated anomalies, treatment of giant omphaloceles is difficult primarily because of the disproportion between the large volume of the omphalocele and the small volume of the intraabdominal cavity. The case of a child is presented in whom conservative treatment had to be abandoned. Reduction of the omphalocele contents and closure of the defect was successfully accomplished after a 19-day period of enlargement of the abdominal cavity by means of an intra-abdominally placed tissue expander.

Infantile myofibromatosis: an unusual presentation and a review of the literature.

An infant with an unusual presentation of Infantile Myofibromatosis (IM) is presented. Massive involvement of the pelvic region complicated the delivery and precluded meaningful therapy. The literature is reviewed.

Ultrasound findings in post-operative jejunojejunal intussusception.

The case is reported of an 11-year-old boy, who developed bowel obstruction after surgical exploration of a kidney transplant. An ultrasound study showed a jejunojejunal intussusception.

Diagnosis of upper-abdominal infections by In-111 labeled leukocytes with Tc-99m colloid subtraction technique.

In 65 patients suspected of upper-abdominal inflammatory disease, indium-111 leukocyte scintigraphy was combined with a Tc-99m(Sn)colloid scan by computer-assisted subtraction. In 84% of these cases, a definite diagnosis would not have been possible without this method of subtraction. Accuracy was found to be 80%, sensitivity 93%, and specificity 59%. False-positive results were due either to noninfectious inflammatory lesions with accumulation of leukocytes or to some pitfalls in the subtraction technique itself.

111Indium-labelled leucocyte scintigraphy in the diagnosis of inflammatory disease--first results.

In 61 patients, 66 scans were performed with 111In-labelled autologous leucocytes to evaluate this method in the diagnosis of inflammatory disease. All scintigraphic results were compared with clinical, operative or postmortem findings. In the first 20 examinations in 19 patients, 2 scintigrams were true positive, 9 true negative one of false positive, whereas 9 scintigrams had to be considered as false negative. These false negative results were probably due to loss of viability of the labelled cells. A modified labelling technique, in which a much lower concentration of oxine was used, was employed for a further 46 examinations in 42 patients. Twenty-four scintigrams were true positive and 22 true negative, while no false positive or false negative results were observed. These results suggest that this modified technique is useful in the diagnosis of inflammatory disease.