Anterior mediastinal abscesses (MAs) due to a non-traumatic etiology are extremely rare in childhood and only 13 such cases have been reported in the literature. We report a 5-year-old male child with disseminated staphylococcal infection and a large non-traumatic anterior MA, who had a successful recovery after surgical drainage of the abscess.
Introduction: There is no established evidence to support the use of drains after total knee arthroplasty (TKA). The aim of our study was to compare the requirement for blood transfusion after primary total knee arthroplasty with and without the use of closed suction drains and cost analysis of performing routine blood group and save.
The authors report an 8-yr-old boy who presented with hypertension, psychosis, and visual disturbances due to a left adrenal phaeochromocytoma which was excised. After 4 years, the child developed multifocal phaeochromocytomas in the left suprarenal area, right adrenal gland, and left para-aortic region. The tumors were excised along with re-implantation of normal adrenal tissue from the right adrenal into the omentum. The course of the disease and the family history were suggestive of von Hippel-Lindau (VHL) disease.
The United Kingdom (UK) Covid-19 pandemic has led to unique changes in the operation of the National Health Service (NHS) including within trauma and orthopaedics. This has led to a significant impact on the NHS ability to provide hip fracture care and sustain emergency surgery. This has led to local hip fracture services changing operations to provide more sustainable care and significant impacts on best practice tariffs. Data was collected using the National Hip Fracture Database data submitted by UHL and split into two cohorts – Pre Covid-19 and Post Covid-19. Data has been collected for 67 consecutive patients in April 2019 (Pre Covid-19) and 87 consecutive patients in April 2020 (Post Covid-19) as of 4th May after the introduction of the Covid-19 measures locally. Data has been collected on demographics- age and sex, ASA, admission time, time of operation, 30 day mortality and length of stay. The average time to theatre in the pre Covid-19 cohort was 27.3 hours and in the post Covid-19 cohort was 45.1 hours. This is an increase of 65.2%. All patients in the pre Covid-19 cohort were operated on and 4 in the post Covid-19 were conservatively managed. However, there were no significant effects on 30 day mortality or length of stay. In conclusion, the measures taken due to the Covid-19 pandemic had a profound impact on the care of hip fracture patients with significant delays in time to theatre. As a result, it is clear that the measures influenced practice at UHL and the best practice tariffs were not met.
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