The response rate of the survey was 38% and 25% for APA and ADARPEF members, respectively. Forty-one percent of APA members reported a reduced use of albumin containing solutions following the publication of the Cochrane report compared to eight percent in the ADARPEF group (P < 0.0001). Albumin continues to be the most frequently used plasma expander in premature babies and neonates, whereas many colleagues use alternative colloids in infants and older children. A clear difference was observed in the 1-12-year-old age group between APA members favouring the use of gelatines and ADARPEF members who instead frequently use hetastarch solutions. ADARPEF members appeared to have a slightly more restrictive attitude towards blood transfusion and also reported more widespread use of erythropoetin (56% versus 9%, P < 0.0001) and predilution techniques (40% versus 23%, P < 0.04) compared with APA members. Regarding intraoperative maintenance solutions, a large proportion of both APA and ADARPEF members still use high concentrations of glucose intraoperatively, even in older children.

Pain persisted up to three months after minor surgery for breast cancer in 40% of patients with mostly a neuropathic component (61%).

An evaluation of totally implanted venous access systems inserted in 163 consecutive children with cancer is reported. From 1988 to 1994, 180 subcutaneous ports were inserted in children more than 1 year old. Initial diagnosis was acute leukaemia (n=79), non-Hodgkin's lymphoma (n=33), and solid tumour (n=51 (Arch Dis Child 1995; 72: 325-329)

Background There is a paucity of data on cardiovascular sequelae of asymptomatic/mildly symptomatic SARS-Cov-2 infections (COVID). Objectives The aim of this prospective study was to characterize the cardiovascular sequelae of asymptomatic/mildly symptomatic COVID-19 among high/elite-level athletes. Methods 950 athletes (779 professional French National Rugby League (F-NRL) players; 171 student athletes) were included. SARS-Cov-2 testing was performed at inclusion, and F-NRL athletes were intensely followed-up for incident COVID-19. Athletes underwent ECG and biomarker profiling (D-Dimer, troponin, C-reactive protein). COVID(+) athletes underwent additional exercise testing, echocardiography and cardiac magnetic resonance imaging (CMR). Results 285/950 athletes (30.0%) had mild/asymptomatic COVID-19 [79 (8.3%) at inclusion (COVID(+)prevalent); 206 (28.3%) during follow-up (COVID(+)incident)]. 2.6% COVID(+) athletes had abnormal ECGs, while 0.4% had an abnormal echocardiogram. During stress testing (following 7-day rest), COVID(+) athletes had a functional capacity of 12.8 ± 2.7 METS with only stress-induced premature ventricular ectopy in 10 (4.3%). Prevalence of CMR scar was comparable between COVID(+) athletes and controls [COVID(+) vs. COVID(−); 1/102 (1.0%) vs 1/28 (3.6%)]. During 289 ± 56 days follow-up, one athlete had ventricular tachycardia, with no obvious link with a SARS-CoV-2 infection. The proportion with troponin I and CRP values above the upper-limit threshold was comparable between pre- and post-infection (5.9% vs 5.9%, and 5.6% vs 8.7%, respectively). The proportion with D-Dimer values above the upper-limit threshold increased when comparing pre- and post-infection (7.9% vs 17.3%, P = 0.01). Conclusion The absence of cardiac sequelae in pauci/asymptomatic COVID(+) athletes is reassuring and argues against the need for systematic cardiac assessment prior to resumption of training (clinicaltrials.gov; NCT04936503).

Hypoplastic left heart syndrome (HLHS), a complex congenital heart disease, is the most common lethal cardiac defect in neonates. Its treatment includes cardiac transplantation and/or surgical palliation. Associated extracardiac congenital abnormalities are exceptional. We report the case of a neonate with HLHS and anorectal atresia who required urgent surgical management to relieve intestinal obstruction. The surgery was successfully performed under spinal anaesthesia.