The study aimed to determine relevant radiographic lines and angles of children's elbow.
A retrospective cross-sectional study.
Tertiary pediatric trauma center.
X-rays of healthy children's elbows ...0-18 years of age in whom the radiographic image of the elbow in 2 projections was read without signs of fracture and possible indirect signs of fracture, whereas the exclusion criterion was a clearly visible poor image projection.
Gender, age patients were divided into 6 groups-group 1 (0-3 years), group 2 (4-6 years), group 3 (7-9 years), group 4 (10-12 years), group 5 (13-15 years), group 6 (16-18 years), side, intersection of the radiocapitellar line in the anteroposterior (AP) projection, intersection of the radiocapitellar line in the lateral projection, intersection of the anterior humeral line, Baumann angle, carrying angle, lateral capitellohumeral angle, shaft condylar angle, intersection of the coronoid line and radioulnar overlap.
Two hundred elbows were evaluated. The radiocapitellar line in AP and lateral projections passed through the middle third of the capitellum in 74.5% and 93%, respectively. The anterior humeral line passed through the middle third of the capitellum in 88.5% of cases. When observing the proportion of radiocapitellar lines passing through the middle third of the capitellum in the AP, with increasing age an increasing proportion of lines pass through the middle third of the capitellum from 8.3% in group 1 (0-3 years) to 94.1% in group 6 (16-18 years), P = 0.001 and lateral projection (from 50% in group 1%-100% in group 6, P = 0.023) and anterior humeral line (from 25% in group 1%-100% in group 6, P = 0.0001). The mean Baumman angle, carrying angle, lateral capitellohumeral angle, shaft condylar angle were 71.59 degrees, 10.97 degrees, 50.84 degrees, and 55.31 degrees, respectively. With age, the shaft condylar angle records the greatest increase (from 41.6 degrees in group 1-68.2 degrees in group 6, P = 0.000). A correlation was observed between Baumann angle and carrying angle (r = -0.674) and between Baumann angle and radioulnar overlap (r = 0.542).
Considering the anatomical variability of children's elbow, radiologic measurements and their interpretation, in the context of timely diagnostics, must be approached with great caution, especially in younger age groups, because it is with them that the largest proportion of lines and angles do not follow established principles.
Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
First of all, it should be borne in mind that lateral rotation is present in as many as a third of cases, which, according to classical principles, can only worsen the degree of torsion and further ...endanger testicular tissue 2. Since this is a subjective method, we have witnessed from the literature and from personal practice that even after a normal color Doppler ultrasound finding, we can have residual torsion 6. For the period from admission to the hospital to scrotal exploration, we believe that in children, testicular preservation by scrotal cooling is a sufficient non-invasive method 7.CRediT authorship contribution statement Marko Bašković: Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Resources, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing.
The COVID-19 pandemic has forced healthcare systems around the world to adopt telemedicine at an unprecedented rate.
Visits to telemedicine have increased to provide access and maintain continuity of ...care. Internet access has almost become
a necessity, and new technologies allow for the easy flow of data from patient to doctor and vice versa. Doctors of all specialties
were forced to adapt to the pandemic and emerging conditions. The provision of surgical services and the learning ability of
surgeons are particularly disrupted, and the pediatric surgical community is not exempt. During the pandemic, telemedicine
proved to be a viable and safe technique for providing health services. In an environment of a health system that is constantly
facing a shortage of resources, effective telemedicine placement can come with a high benefit-cost ratio and quality of care,
while ensuring patient satisfaction.
COVID-19 (coronavirus disease 2019) in children is relatively mild, so it is easy to make a misdiagnosis in the early stages if it presents only with respiratory symptoms. At the time of the ...pandemic, testing for SARS-CoV-2 is important in all paediatric patients who have fever and acute abdominal pain with diarrhoea or vomiting, to differentiate acute COVID-19 or possible multisystem inflammatory syndrome in children (MIS-C) from acute appendicitis, and thus avoiding unnecessary surgery. On the other hand, early accurate diagnosis and consequent appropriate surgical and antibiotic treatment of appendicitis are important because they can prevent complications such as abscess formation and other postoperative complications. Delayed diagnosis can lead to significant morbidity that can outweigh the damage caused by COVID-19 alone. The fact that at the time of the COVID-19 pandemic radiological examination also has its limitations and can very often show a false-positive finding in children with MIS-C must also be taken into account. It is very important that paediatric surgeons are aware of the gastrointestinal manifestations of acute COVID-19 or MIS-C, and are able to distinguish this new entity from the surgical pathologies it often mimics.
Background: Hypertrophic pyloric stenosis is a condition in newborns in which the hypertrophic pyloric muscle causes gastric obstructive symptoms of progressive vomiting leading to hypochloremic ...hypokalemic metabolic alkalosis. The main aim of the research was to assess whether, based on the acid-base status, we can distinguish newborns who vomit due to pylorostenosis, compared with newborns who vomit for other unspecific reasons. Methods: The electronic records of patients in the hospital information system treated under the diagnosis Q40.0 (Congenital hypertrophic pyloric stenosis) (n = 69/included in the study = 53) in the period from 1 January 2014 to 1 January 2022 were reviewed retrospectively. For the purposes of the control group, the electronic records of patients treated in the emergency department with a diagnosis of R11.0 (Nausea and vomiting) (n = 53) without an established cause were randomly reviewed. In addition to the main aim, other research outcomes were to determine differences between groups in the following variables: duration of symptoms, family history, birth (preterm, term, post-term), birth weight, weight during examination, difference between birth weight and weight during an examination, type of vomiting, the thickness of the muscle wall and its length, and to calculate whether there is a correlation between the thickness and length of the pylorus muscle and the duration of vomiting in relation to variables from acid-base status. Results: In relation to the variables of interest between the groups, statistically significant differences were observed in the duration of symptoms (Mdn 4 vs. 2 days, p = 0.002), weight at examination (Mean 3880 vs. 4439 g, p = 0.001), difference in weight between birth and examination (Mean 374 vs. 1010 g, p < 0.0001), and type of vomiting (explosive 45 vs. 22, p = 0.023). In the acid-base status between the groups, a statistically significant difference was recorded for pH (Mdn 7.457 vs. 7.422, p < 0.0001), bicarbonate (Mdn 25 vs. 23 mmol/L, p = 0.000), total carbon dioxide (Mdn 25 vs. 24 mmol/L, p = 0.011), base excess (Mdn 0.8 vs. −1.3 mmol/L, p = 0.000), potassium (Mdn 5 vs. 5.3 mmol/L, p = 0.006), ionized calcium (Mdn 1.28 vs. 1.31 mmol/L, p = 0.011), and glucose (Mdn 4.5 vs. 4.9 mmol/L, p = 0.007). Regardless of the group, the correlations between the duration of vomiting (r = 0.316, p = 0.021 vs. r = 0.148, p = 0.290) and the thickness (r = 0.190, p = 0.172) and length (r = 0.142, p = 0.311) of the pylorus muscle in relation to pH did not exist or were weak. Conclusions: In a world where radiological methods are not equally available everywhere, with promising acid-base indicators, prospective multicenter studies and meta-analyses must be pursued in the future in order not to miss the possible much greater diagnostic potential of acid-base status.
