Risk factors for CLABSI in pediatric cancer patients with a TIVAP may be related to the severity of the child's condition at catheter insertion. Insertion of the catheter before chemotherapy and unfavorable conditions such as malnutrition and bone marrow aplasia can increase the risk of CLABSI. Protocols must be revised and surveillance increased over the first 10 weeks of treatment.
Pseudoamniotic band syndrome (PABS) is an iatrogenic complication that causes entanglement of fetal parts in a constrictive sheet of detached or ruptured amniotic membrane after an invasive procedure, namely amniocentesis, amnioreduction or septostomy in twins. The incidence and risk factors for PABS after fetoscopy-guided laser have not been documented [Winer et al.: Am J Obstet Gynecol 2008;198:393.e1–393.e5]. We report a case of monochorionic biamniotic twin pregnancy submitted to selective fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome at 16 weeks of gestation. The procedure was complicated by the death of one of the fetuses at 24 weeks of gestation. Moreover, the surviving twin was diagnosed postnatally with pseudoamniotic band syndrome, presenting with affected limbs. The newborn was submitted to surgical correction of these lesions with a successful outcome and was discharged on day 15.
The chance of success was greater when patients were sedated for catheterization. There was a greater chance of complications related to insertion of the catheter when percutaneous subclavian central venous catheterization was performed by less experienced physicians, and it would be prudent to designate those central venous catheterizations that present greater risk to surgeons with greater experience.
Non-surgical procedures for the diagnosis of pediatric abdominal non-Hodgkin's lymphoma are an effective option with low morbidity rate, allowing an earlier resumption of a full diet and chemotherapy initiation. Furthermore, non-surgical procedures should also be considered for obtaining tumor samples from patients with extensive disease.
OBJETIVOS: avaliar a eficácia do tratamento não cirúrgico em crianças que desenvolveram abscessos intra-cavitários pós-apendicectomia, no Instituto Materno Infantil de Pernambuco, Recife, Brasil, e comparar os resultados obtidos com dois esquemas antimicrobianos (Cefoxitina versus Amicacina com Metronidazol) utilizados. MÉTODOS: o estudo corresponde ao período de janeiro de 1997 a janeiro de 2000 no qual 427 crianças foram apendicectomizadas; 41 delas desenvolveram abscessos intra-cavitários sendo 39 incluídas no estudo. O diagnóstico dos abscessos intra-cavitários baseou-se em sinais clínicos e exames complementares. RESULTADOS: A incidência de abscessos intra-cavitários pós-apendicectomias foi de 9,6%. 89,7% dos pacientes obtiveram sucesso com o tratamento. Não houve diferença entre os percentuais de cura obtidos com os dois esquemas antimicrobianos. CONCLUSÕES: o tratamento não cirúrgico de abscessos intra-cavitários pós-apendicectomias, baseado na antibioticoterapia endovenosa é uma opção segura e eficaz. Os esquemas antimicrobianos com Cefo-xitina e associação de Amicacina com Metronidazol têm eficácia semelhantes. A associação Amicacina com Metronidazol é recomenda pelo seu menor custo.
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