https://www.pediatrmedchir.org/pmc/issue/feedLa Pediatria Medica e Chirurgica2024-02-22T13:50:17+00:00Teresa Carrarateresa.carrara@pagepress.orgOpen Journal Systems<p><strong>La Pediatria Medica e Chirurgica </strong>(Medical and Surgical Pediatrics) publishes original papers in the field of basic science, clinical and laboratory research pertinent to medical and surgical pediatrics.</p> <p>In addition to Original Articles, <strong>La Pediatria Medica e Chirurgica </strong>(Medical and Surgical Pediatrics) welcomes Editorials (on invitation), Brief Reports, Letters to the Editor and Book Reviews as well. All manuscripts are critically assessed by external and/or in-house experts in accordance with the principles of peer review. Manuscripts must be written in English or Italian.</p>https://www.pediatrmedchir.org/pmc/article/view/33053º National Congress of the Italian Society of Paediatric Surgery | Naples, 21-23 September 20232023-11-13T15:50:31+00:00The Editorsinfo@pagepress.org<p>53º Congresso Nazionale Società Italiana di Chirurgia Pediatrica | Napoli, 21-23 settembre 2023</p>2023-11-13T00:00:00+00:00Copyright (c) 2023 the Author(s)https://www.pediatrmedchir.org/pmc/article/view/329The hidden burden of Pediatric urology in Sub-Saharan Africa: an analysis of hospital admission data from three East African Health Centres2024-01-23T20:49:39+00:00Alessandro Calistisanca46@gmail.comDiaaeldinn Yaseen Salmandiaayaseen@gmail.comKibreab Belaykiblem@yahoo.comAndrea Momboandymombo4@gmail.comBoniphace Tresphorytresphoryboniphace694@gmail.comGiovanni Giulianigiovannigiuliani1977@gmail.comMartina Sertorimartina.sertori01@universitadipavia.itGian Battista Parigigianbattista.parigi@unipv.it<p>Specialist facilities for children are still unavailable in some Sub-Saharan African contexts. It is the case of pediatric urology, whose recent advances are still largely unshared. Prenatal diagnosis of urinary abnormalities (CAKUT) is largely unknown. Early recognition and referral of Undescended testis (UDT), Hypospadia, bladder exstrophy epispadias complex, ambiguous genitalia, stone disease, and tumours are uncommon in rural areas. Missed diagnosis is not uncommon and delayed management is associated with poor outcomes. We present a cross-sectional, descriptive study about the epidemiology of Pediatric urological admissions to three sub-Saharan East African Hospitals. All the urological cases between 0-18 years referred to three distinct East African Hospitals over 124 weeks were considered. Prevalence of different groups of diseases, age, and mode of presentation were reported. We found 351 cases (M/F 127/24) out of 2543 surgical referrals (13%). Seventy percent of cases were Hypospadias and UDT. Fifty percent of UDT were beyond 6, and most Hypospadias were between 4 and 7 yrs. CAKUT had a very low prevalence (4.84%), and about 50% of Wilms Tumours came too late to be resectable. In many African contexts, urology is still a tiny portion of the pediatric surgical workload compared to the 25% of European and American reports. There are also differences in the epidemiology of genitourinary conditions. A hidden burden of diseases may be presumed, remaining undiagnosed due to the shortage of specialist facilities.</p>2024-01-23T00:00:00+00:00Copyright (c) 2024 the Author(s)https://www.pediatrmedchir.org/pmc/article/view/328Outcomes of delayed chest closure after congenital heart surgery in neonates2024-02-22T13:50:17+00:00Meletios Kanakismeletis_kanakis@yahoo.grGeorge Samanidisgsamanidis@yahoo.grKyriaki Kolovousandykolovou@gmail.comSotirios Katsaridis katsaridisdoc@yahoo.grAthina Maria Saitath.sait@gmail.comGeorgios Kourelisgkourelis@yahoo.grNicholas Giannopoulosgiannick@otenet.grDimitrios Bobosdimitriosbobos@gmail.com<p>We present the outcomes of delayed chest closure in neonates who underwent congenital heart surgery under cardiopulmonary bypass. Eighty-one consecutive neonatal patients (age ≤ 28 days) with congenital heart diseases who underwent heart operations and after surgery, chest remained open in the intensive care unit until DCC. Correction of transposition of the great arteries pathology was the most common surgical procedure (48.1% of patients). Median sternal closure time from surgery was 3 (2-4) days. Median age of neonates was 9 (5-12) days. In addition, in 4 cases (4.9%) there was secretion from the surgical site after DCC and after taking cultures, in 2 (2.4%) of the cases a pathogen was identified. Multivariable linear regression analysis (adjusted to gender and CPB) showed that only the age-predicted the sternum closure time (β=-0.09, 95%CI: - 0.16 to -0.02, p=0.02). In-hospital mortality was 6 (7.4%) patients. Although the DCC in neonates who underwent CHD surgical correction was related to a high mortality rate, only the age of neonates predicted the sternum closure time in the ICU.</p>2024-02-22T00:00:00+00:00Copyright (c) 2024 the Author(s)https://www.pediatrmedchir.org/pmc/article/view/327Spontaneous resolution and the role of endoscopic surgery in the treatment of primary obstructive megaureter: a review of the literature2023-12-19T13:56:16+00:00George Vlad Isacgeorge.isac@drd.umfcd.roGabriela Mariana Danilagabriela.militaru15@gmail.comSebastian Nicolae Ionescunsionescu@yahoo.com<p>The megaureter accounts for almost a quarter of all urinary tract dilations diagnosed in utero and is the second leading cause of hydronephrosis in newborns, following pyeloureteral junction obstruction. The current standard treatment for progressive or persistent, symptomatic primary obstructive megaureter is ureteral anti-reflux reimplantation, which can be associated with ureteral remodeling or plication. Due to the associated morbidity, postoperative recovery challenges, and the complications that may arise from the open surgical approach, there has been a natural inclination towards validating new minimally invasive techniques. This study reviews the literature, extracting data from three major international databases, from 1998 to 2022. Out of 1172 initially identified articles, only 52 were deemed eligible, analyzing 1764 patients and 1981 renal units. Results show that 65% of cases required surgical intervention, with minimally invasive techniques constituting 56% of these procedures. High-pressure endoscopic balloon dilation was the preferred endourologic technique. The degree of ureterohydronephrosis is considered one of the factors indicating the need for surgery. There is an inverse relationship between the diameter of the ureter and the likelihood of spontaneous resolution. Conditions such as renal hypoplasia, renal dysplasia, or ectopic ureteral insertion strongly indicate a poor prognosis. Endoscopic surgical techniques for treating primary obstructive megaureter can be definitive, firstline treatment options. In selected cases, they might be at least as effective and safe as the open approach, but with advantages like quicker recovery, fewer complications, shorter hospital stays, and reduced costs.</p>2023-12-19T00:00:00+00:00Copyright (c) 2023 the Author(s)https://www.pediatrmedchir.org/pmc/article/view/326Follow-up study of three cases of congenital microgastria2023-12-15T13:21:27+00:00Sara Ugolinisara.ugolini@mft.nhs.ukChiara Oregliochiara.oreglio@unifi.itKarl Christian Walshkarl.walsh@mft.nhs.ukAntonino Morabitoantonino.morabito@unifi.it<p>Current knowledge on congenital microgastria is limited due to its extreme rarity, and the paucity of nutritional and quality of life follow-ups. Patients affected by congenital microgastria cases followed at out center were screened, and general and nutritional status were evaluated at follow-up visits through validated questionnaires. Three cases were included: one patient died because of a complex syndromic picture where microgastria was imperatively approached conservatively. The remaining cases underwent Hunt-Lawrence at 2 and 17 months. After 2 years and 27 years postoperatively, both patients are on full oral intake. The 28-yearold patient did not reach a BMI higher than 18. She rated her quality of life as unimpacted, with a Gastrointestinal Quality of Life Index of 111. In the other case, parents reported about their 2-yearold child an Infant Gastrointestinal Symptom Questionnaire of 13, corresponding to “no distress”. Our findings confirm the literature trend supporting the role of early surgery in microgastria to improve outcomes. We presented the nutritional status and quality of life in two cases of congenital microgastria operated according to Hunt-Lawrence at a 2-year and 27-year distance, which is the longest follow-up reported to date.</p>2023-12-15T00:00:00+00:00Copyright (c) 2023 the Author(s)https://www.pediatrmedchir.org/pmc/article/view/323Presentations of bladder exstrophy in a resource-limited setting and the role of Mainz II continent diversion for late referrals or failed primary closures: a multicentric report2023-08-29T15:05:55+00:00Alessandro Calistisanca46@gmail.comKibreab Belaykiblem@yahoo.comAndrea Momboandymombo4@gmail.comFaisal Abdelgalil Nugudfaisalnugud2@yahoo.comDiaaeldinn Yaseen Salmandiaayaseen@gmail.comPierluigi Lelli Chiesapierluigi.lellichiesa@gmail.com<p>Primary closure techniques that have been updated and longterm follow-up for CBE (classic bladder exstrophy) may be out of reach for many patients living in resource-limited settings. Late referrals to medical care and primary closures that lack the necessary skills and facilities for comprehensive treatment are still common. Alternative and long-term surgical solutions may improve the lives of these unfortunate patients. During surgical outreach missions, patients with CBE, either non-operated or with a previous unsuccessful bladder closure, who were referred from vast under-resourced rural areas to three Eastern African hospitals, were studied. The following information is provided: mode of presentation, clinical history, diagnostic workout, management, and outcome. There were 25 cases (M/F ratio 17/8) ranging in age from two days to twenty years. Five of the seventeen patients who were not treated (35%) were under 120 days old and eligible for primary closure in a qualified tertiary center when one was available in the country. There were twelve late referred cases (ranging from 120 days to 20 years). Between the ages of ten months and twelve years, eight children arrived following a failed primary closure. In all of them, the bladder plate was too altered to allow closure. Following a preoperative diagnostic workout, a Mainz II continent internal diversion was proposed to fourteen patients with acceptable bowel control and postponed in the other three. Three cases were lost before treatment because parents refused the procedure. Twelve cases ranging in age from three to twenty years (mean seven years) were operated on. Eight people were followed for a total of 53.87 months (range: 36-120). Except for three people who complained of occasional night soiling, day and night continence were good. The average voiding frequency during the day was four and 1.3 at night. There was no evidence of a metabolic imbalance, urinary infection, or significant upper urinary tract dilatation. Two fatalities could not be linked to urinary diversion. Four patients were not followed up on. Due to the limited number of specialist surgical facilities, CBE late referral or failed closure is to be expected in a resource-limited context. In lieu of the primary closure, a continent internal diversion will be proposed and encouraged even at the level of a non-specialist hospital to improve the quality of life of these unfortunate patients. It is recommended that patients be warned about the procedure’s potential long-term risks, which will necessitate a limited but regular follow-up.</p>2023-08-29T00:00:00+00:00Copyright (c) 2023 the Author(s)https://www.pediatrmedchir.org/pmc/article/view/31952nd National Congress of the Italian Society of Paediatric Surgery | Ancona, 20-22 October 20222023-03-29T07:19:38+00:00The Editorsfabio.chiarenza@aulss8.veneto.it<p>52º Congresso Nazionale della Società Italiana di Chirurgia Pediatrica | Ancona, 20-22 ottobre 2022</p> <p> </p>2023-03-29T00:00:00+00:00Copyright (c) 2023 the Author(s)https://www.pediatrmedchir.org/pmc/article/view/318Two-balloon epistaxis catheter to ensure vaginal patency in a complex case of vaginoplasty for vaginal agenesis: a case report2023-11-27T15:33:04+00:00Chiara Costantinichiaracostantini6@gmail.comFederica Fatifedes.fati@gmail.comElisa Panielisa.pani@apss.tn.itFabio Berettafabio.beretta@apss.tn.itSilvia Bisoffisilvia.bisoffi@aopd.veneto.itGiosuè Mazzerogiosue.mazzero@apss.tn.itElisa Negrielisa.negri@apss.tn.itClara Revetriaclara.revetria@apss.tn.itHamid R. Sadrihamidreza.sadri@apss.tn.itEnrico Ciardinienrico.ciardini@apss.tn.it<p>Congenital vaginal atresia is a rare anomaly of the female genital tract. Many vaginoplasty procedures have been described, but the postoperative risk of vaginal stenosis remains a challenge. We report a case of isolated distal vaginal agenesis in a patient with neurological impairment where the use of an “alternative” dilator was needed. An 11-year-old girl with Down syndrome was admitted to the Emergency Department complaining of pelvic pain. The clinical evaluation showed a hard and painful pelvic mass associated with an imperforate hymen. Abdominal ultrasound and pelvic MRI were suggestive for hematometrocolpos and absence of the lower third segment of the vagina. Vaginoscopy confirmed the diagnosis of congenital vaginal agenesis. The patient then underwent a laparoscopic-assisted vaginoplasty. Considering the difficult management of the postoperative period, an epistaxis catheter was used as a vaginal stent and dilator. The use of an epistaxis catheter to provide adequate vaginal patency after vaginoplasty can be an alternative solution especially in those cases where calibrations with dilators are difficult or not tolerated.</p>2023-11-27T00:00:00+00:00Copyright (c) 2023 the Author(s)https://www.pediatrmedchir.org/pmc/article/view/317The effectiveness of mental health nursing promotive and preventive model on protective factors, risk factors and adolescents’ mental health2023-03-28T09:20:53+00:00Ni Made Dian Sulistiowatibudianna_keliat@yahoo.comBudi Anna Keliatbudianna_keliat@yahoo.comRaden Irawati Ismailbudianna_keliat@yahoo.comBesral Besralbudianna_keliat@yahoo.comI Ketut Dian Lanang Trianabudianna_keliat@yahoo.com<p>Adolescents are at risk in experiencing mental health problems if the risk factors owned are more than the protective factors. This study aims to identify the effectiveness of Mental Health nursing promotive and preventive models on protective factors, risk factors and Adolescents’ Mental Health. This research was with quasi-experiment, design employed randomization control group pre and post-test design conducted on 240 adolescents, which was divided into both groups equally. The study found that protective factors (self-esteem, family relationship, and prosocial ability) has increased after intervention model by 10.2%; 4.4%; 15.7%, respectively, risk factors (bullying behavior, anxiety, emotional problems, behavioral problems, and peer problems) has decreased after the intervention model by 9.8%; 26.1%; 25.9%; 17.5%; 22.4%, respectively. The model also increased the adolescents’ mental health after intervention model by 14.9%. The mental health nursing promotive and preventive model is effective to increase the mental health of adolescents by 21.3%. Mental health nursing’ promotive and preventive model could be used as basic needs to implement early detection regarding mental health of adolescents in the UKS scope and involving teachers’ role, as well as parents in maintaining mental health.</p>2023-03-28T00:00:00+00:00Copyright (c) 2023 the Author(s)https://www.pediatrmedchir.org/pmc/article/view/316Effectiveness of web-based play therapy intervention in supporting the development of children with attention deficit/hyperactivity disorder2023-03-28T09:20:57+00:00Lina Budiyartitufahati@ui.ac.idNur Agustinitufahati@ui.ac.idHappy Hayatitufahati@ui.ac.idRia Utami Panjaitantufahati@ui.ac.idNuraini Hakimtufahati@ui.ac.id<p>The high prevalence of children with Attention Deficit/ Hyperactivity Disorder (ADHD) in Indonesia has become a concern for nursing because ADHD might emerge as neurological developmental problems if not treated early through appropriate intervention. This study aims to determine the effectiveness of web-based play therapy on the emotional, behavioural and social development of school-age children with ADHD. This study employs a quasi-experimental non-equivalent control group design with purposive sampling technique, and 126 children with ADHD (patients at a psychiatric hospital in Indonesia) as participants. The results show that play therapy is an effective intervention for the emotional, behavioural and social development of school-age children with ADHD (p = 0.048, p = 0.030, p = 0.030; α= 0.05). This study is recommended as a reference for optimising nursing care for children with ADHD using information technology in the form of web-based play therapy designed in line with the fundamentals of intervention for children with ADHD, using attractive features and flexible access.</p>2023-03-28T00:00:00+00:00Copyright (c) 2023 the Author(s)