Subotic verletzung

subotic verletzung

Nov. Neven Subotić von Borussia Dortmund hat einen Rückschlag erlitten. Der Jährige musste beim Spiel in der Regionalliga West gegen den 1. Der Eingriff dauerte anderthalb Stunden: Neven Subotic von Borussia Dortmund ist nach seiner schweren Verletzung am Knie operiert worden. In zwei Monaten. Schwer verletzt So riss sich Neven Subotic das Kreuzband. Nach einem Zweikampf mit Olic stürzt der Dortmunder zu Boden und reißt sich dabei das Kreuzband.

Subotic Verletzung Video

Neven Subotic Verletzung

Subotic verletzung -

In zwei Monaten entscheidet sich, ob ein weiterer Eingriff nötig ist. Mindestens irritierend ist diese Tatsache, wenn nicht gar unrühmlich für einen Spieler, der sich immer dadurch ausgezeichnet hatte, auf dem Rasen alles für den BVB gegeben zu haben. Bei der Kaderpräsentation im Stadion wurde sein Name nicht mehr aufgerufen, selbst auf der offiziellen Homepage wurde er lange Zeit nicht im Kader gelistet. Der Verteidiger muss mehrere Wochen pausieren. Soll das EchteLiebe sein? Schock für Borussia Dortmund:

verletzung subotic -

Sie haben aktuell keine Favoriten. Dass BVB-Trainer Thomas Tuchel sportlich nicht mehr mit ihm plante, hatte sich natürlich schon etwas eher abgezeichnet. Also kamen erste Wechselgerüchte auf: Abwehrspieler Neven Subotic wechselt auf Leihbasis zum 1. Der Eingriff dauerte anderthalb Stunden: Schalke 04 muss allerdings weiter auf einen Offensivspieler verzichten. Im schlimmsten Fall ist die Saison für den Serben vorzeitig beendet. Neven Subotic wird Dortmund in dieser Spielzeit nicht mehr zur Verfügung stehen. Von der Fahne ins Loch: Der BVB ist in Feierlaune.

The difference in operative time was statistically significant. None of the patients in this series required re-intervention to correct obstruction and the results are comparable with open surgery.

Since the introduction of vacuum-assisted closure VAC in , it has been used successfully in treating difficult wounds, including spinal wounds and wounds in pediatric patients.

There are no reports on VAC therapy in pediatric patients on the scalp, especially with exposed dura. This report describes a year-old boy with a chronic wound of the scalp with exposed dura after multiple neurosurgical interventions who was treated successfully with VAC.

A year-old mentally disabled boy with Apert syndrome suffered from a chronic wound with community-associated methicillin-resistant Staphylococcus aureus MRSA infection after multiple neurosurgeon operations.

For wound closure, VAC therapy was initiated on the bony defect with exposed dura. The wound healed successfully, and the MRSA disappeared.

The aims of VAC therapy are formation of new granulation tissue, wound cleansing, and bacterial clearance. In this case, the VAC device was excellent for temporary coverage of the defect and for wound cleaning, and it allowed a thick bed of granulation tissue to form over the dura, even with minimal constant negative pressure.

The application and management were feasible even in a mentally disabled child. With this experience, we are encouraged to use the VAC device in difficult wounds, even in the head and neck area in children, and to bring this treatment into the outpatient clinic.

Efficacy and safety of propranolol as first-line treatment for infantile hemangiomas. Oct European Journal of Pediatrics. Beta-blockers are a highly promising treatment modality for complicated infantile hemangiomas IH.

However, data on propranolol as first-line treatment, objective outcome measures and impact on hemodynamics in young infants is limited. Outcome was assessed by blinded evaluation of clinical photographs by visual analogue scale VAS , ultrasound examination and ophthalmological review if appropriate.

Tolerance and hemodynamic variables were recorded over time, including a 2-day in-patient observation at the initiation of therapy.

Twenty-five infants median age 3. The median follow-up-time was 14 months and 14 patients completed treatment at a median age of In all patients, there was significant fading of colour with a VAS of -9 -6 to -9 after 7 months and significant decrease in size of the IH with a VAS of -8 -3 to after 7 months.

In children with periocular involvement, astigmatism and amblyopia resolved rapidly within 8 weeks.

The overall tolerance of propranolol was good, and no relevant hemodynamic changes were noted. Our report supports the excellent effect and good tolerance of this novel therapy, and we propose the use of propranolol as first-line treatment for IH.

DEHP is easily extracted from the tubing by total parenteral nutrition TPN solutions and has been shown to have toxic effects on various organ systems including the liver in animals and humans.

A role was postulated for DEHP in the development of hepatobiliary dysfunction in premature and newborn infants receiving parenteral nutrition, and the incidence of cholestasis was investigated after changing from polyvinylchloride infusion systems to polyvinylchloride-free infusion systems.

Two 3-year periods from to were investigated retrospectively before and after changing from polyvinylchloride to polyvinylchloride-free infusion systems in our department.

This resulted in 1 group of 30 patients treated with polyvinylchloride lines and a second group of 46 patients treated with polyvinylchloride-free lines.

The 2 groups were examined for the incidence of cholestasis and other possible contributing factors. Using DEHP-containing polyvinylchloride infusions systems contributes to the development of cholestasis.

Reply to Letter to the Editor. Mar Journal of Pediatric Surgery. Aug Journal of pediatric gastroenterology and nutrition.

Recently, our group detected that polyvinyl chloride PVC perfusion lines leach large amounts of the toxic plasticizer diethylhexylphthalate DEHP under conditions typical of intensive care units.

Before perfusion of the lines, the solution had a DEHP concentration of 0. After perfusion of the lines, the load of DEHP in the solution varied between 1.

This TPN was established for children weighing 20 kg. The daily dosage is between 71 and microg x kg -1 x day TPN is administered at home for many months and years.

The monthly charge of DEHP is between Children weighing 20 kg therefore receive a dosage between 2. Diethylhexylphthalate and its metabolite monoethylhexylphthalate have been demonstrated to be carcinogenic, embryotoxic, hepatotoxic, pneumotoxic, and cardiotoxic and are known to disrupt endocrine pathways and liver detoxifying capacity in animals.

They are suspected of having multiple effects in humans as well. The doses presented above should therefore be avoided in children receiving home TPN by the use of tubing systems that are completely free of DEHP.

Such systems are available. Early elective cesarean delivery before 36 weeks vs late spontaneous delivery in infants with gastroschisis.

Jul Journal of Pediatric Surgery. The aim of this study is to assess the value of early elective cesarean delivery for patients with gastroschisis in comparison with late spontaneous delivery.

Analysis of infants with gastroschisis admitted between and at a tertiary care center was performed.

The findings were analyzed statistically. Eighty-six patients were involved in the study. The remaining 71 patients born electively were stratified into 4 groups.

The early elective cesarean delivery ECD group included 23 patients born by ECD before 36 weeks; late vaginal delivery LVD group included 23 patients who had LVD after 36 weeks; 24 patients had LCD after 36 weeks because of delayed diagnosis that resulted in late referral; and 1 patient had early spontaneous vaginal delivery EVD group before 36 weeks.

The mean time to start oral feeding, incidence of complications, and primary closure were significantly better in the ECD group than in the LVD group.

The duration of ventilation and the length of stay were shorter in ECD group, but the difference was not statistically significant. Elective cesarean delivery before 36 weeks allows earlier enteral feeding and is associated with less complications and higher incidence of primary closure statistically significant.

Jul European Journal of Pediatric Surgery. We report on a 9-year-old girl who was involved in a car accident. The abdominal bleeding was stopped, the bowel resected and the fracture fixed by internal fixation.

The patient developed a postoperative enterocutaneous fistula in the right flank and paraplegia. She underwent three laparotomies with ileostomy and closure of the fistula.

Two years later, she has normal bowel movement, the wounds are closed, the internal fixation has been removed, she is able to walk with crutches and suffers from a mild bladder dysfunction.

Chance fracture is a typical fracture in adults involved in motor vehicle accidents. In the last 10 years, there have only been four case reports describing this fracture in children under the age of All of these individuals were involved in a car accident and had been fixed with a lap belt.

With the increasing use of lap belts, this fracture has to be considered even in young children. Mild clinical symptoms can be associated with severe intra-abdominal injuries.

Fracture de Chance - un traumatisme rare chez les enfants Nous rapportons le cas d'une fille de 9 ans qui a subi un accident de voiture.

La fracture de Chance est une fracture typique de l'adulte, survenant dans les accidents de la voie publique. Chance-Fraktur - eine seltene Verletzung im Kindesalter?

Ein 9 Jahre altes Mädchen war als Beifahrerin und mit einem Bauchgurt angeschnallt in einen frontalen Auffahrautounfall verwickelt.

Die Blutungen und Blasenruptur wurden versorgt, Sigma reseziert und die Fraktur mit einem Fixateur interne fixiert. Postoperativ entwickelte die Patientin im Bereich des Hämatoms eine enterokutane Fistel, die mehrmals exzidiert und mittels Ileostoma ausgeschaltet wurde.

Zudem entwickelte sie eine Paraplegie. Zwei Jahre später sind die Wunden verheilt, der Fixateur ist entfernt, die Darmentleerung erfolgt regelrecht und die Patientin kann mithilfe von Gehstützen laufen.

Sie hat noch eine milde, ebenfalls regrediente Blasenentleerungsstörung. In den letzten 10 Jahren wurden lediglich 4 Fallberichte über Kinder unter 10 Jahren mit Chance-Fraktur veröffentlicht, alle Kinder waren mit einem Bauchgurt angeschnallt.

Auch im Kindesalter muss bei adäquatem Unfallmechanismus an eine Chance-Fraktur und zusätzlich an das Auftreten von Abdominalverletzungen gedacht werden, selbst bei milder Symptomatik.

May Journal of Parenteral and Enteral Nutrition. Looking for a candidate substance inducing hepatobiliary dysfunction under parenteral nutrition PN in newborns, we recently discovered that newborn infusions extract large amounts of the plasticizer diethylhexylphthalate DEHP from commonly used polyvinylchloride PVC infusion lines.

This plasticizer is well known to be genotoxic and teratogenic in animals and to cause changes in various organs and enzyme systems even in humans.

The aim of this study was to examine the effect of DEHP, extracted in the same way and in the same amount as in newborns, on livers of young rabbits.

Prepubertal rabbits received lipid emulsion through central IV lines continuously for 3 weeks either via PVC or polyethylene PE infusion systems.

Livers were examined after 1 and 3 weeks by light and electron microscopy. By light microscopy, hydropic degeneration, single-cell necrosis, fibrosis, and bile duct proliferation were observed more in the PVC group.

Electron microscopy revealed multiple nuclear changes, clusters and atypical forms of peroxisomes, proliferation of smooth endoplasmic reticulum, increased deposition of lipofuscin, and a mild perisinusoidal fibrosis only in the PVC group.

These changes, which are generally regarded as reaction upon a toxic stimulus, could be exclusively attributed to DEHP. This investigation proved that DEHP produces toxin-like changes in livers of young rabbits in the same dose, duration, and method of administration as in newborn infants.

Possible modes of action of DEHP are proposed. Ileus nach nicht endoskopischer PEG-Entfernung. Mar Monatsschrift Kinderheilkunde. Die perkutane endoskopische Gastrostomie wird bei Kindern zur Ernhrung eingesetzt.

Wir berichten von einem Patienten, bei welchem die PEG-Sonde ohne endoskopische Hilfe entfernt und die Halteplatte in situ belassen wurden.

Diese verlegte die Ileozkalklappe und fhrte zu einem Ileus mit Perforation und schwerer Peritonitis. Percutaneous endoscopic gastrostomy PEG is used in children for enteral feeding.

Complications after removing the PEG tube without an endoscopic procedure are rarely described. We report on a male patient who developed bowel obstruction with perforation and severe peritonitis after removal of the PEG tube without endoscopic assistance; the bumper obstructed the ileocecal valve.

Endoscopic removal of PEG tubes may avoid similar life-threatening complications. Feb Journal of pediatric gastroenterology and nutrition.

Except for polyadipate, which is used as an alternative in polyvinylchloride PVC feeding tubes, diethylhexylphthalate DEHP is the plasticizer used almost exclusively in PVC medical products.

A clear response to the chronic intake of DEHP has been shown in several organ systems from different species. An in vivo setting was simulated. We used 5 cm of PVC nasogastric tubes containing DEHP or polyadipate, which were incubated with gastric juice for 1 week and a feeding solution for 4 weeks.

The leakage of these plasticizers was measured daily in the gastric juice group and weekly in the feeding solution group.

The amount of plasticizer extracted was compared between groups and days. In the feeding solution group, the extraction of DEHP ranged from to microg after 1 week and from to microg after 4 weeks.

The extraction of polyadipate was 10 times lower than that of DEHP. In the gastric juice group, extracted DEHP ranged from to microg, whereas the extraction of polyadipate was times lower.

Extrapolated, this represents an in vivo load of up to 4 mg. The load accumulated by a newborn in an intensive care unit can therefore easily reach several milligrams of DEHP per day.

Polyadipate nasogastric tubes may therefore be an alternative and help to reduce the daily load of DEHP. Jan Zeitschrift für Gastroenterologie.

Nov Journal of pediatric gastroenterology and nutrition. The plasticizer di-ethylhexyl-phthalate DEHP is extracted especially by lipid emulsions from polyvinylchloride infusion systems.

The aim of this study was to systematically examine the extraction from perfusion lines commonly used in our hospital for lipid emulsion infusions.

Concentration of di-ethylhexyl-phthalate was determined with gas chromatograph mass spectrometry. The lipid emulsions before perfusion had a contamination with DEHP of 0.

Pure PVC lines of 1. Sterilization of the lines did not influence DEHP extraction. Lipid emulsions contain a production-inherent load of DEHP. The load accumulated by a baby on an intensive care unit easily reaches several milligrams of DEHP per day.

As its effect upon biologic systems has been proven, and alternatives PE or PU perfusion lines are available, PVC and PVC co-extruded perfusion lines should be abandoned for infusions, especially in babies.

Kinetics of diethylhexyl-phthalate extraction From polyvinylchloride-infusion lines. Sep Journal of Parenteral and Enteral Nutrition.

For infusion therapy, polyvinylchloride PVC -infusion lines are commonly used. In this study, we examined the temperature dependency and the dynamics of extraction in the time course of infusion.

We collected the perfused solution and measured the concentration of DEHP. This procedure was carried out at 27 degrees C and 33 degrees C.

In another experiment, we examined the extraction rate in the time course of a hour infusion. The infusion was collected every 4 hours.

We discovered that extraction of DEHP depends highly on the surrounding temperature. This is important because the temperature on a newborn ICU is between 31 and 37 degrees C in an incubator.

In the other experiment, we found out that the extraction rate rose from The rate of extraction is dependent on the time of contact between solution and tubing.

If PVC-infusion systems are used, solutions should be as cold as possible, and infusion time should be as short as possible.

However failures to do it in vivo suggests the presence of inhibitory factors in the tissue, blocking expression of neural markers i.

Extremities anomalies usually involve one limb. Finally, in typical ischiopagus PCTs, the parasite usually presents with some internal viscera [7] [8][9][10] and often shares genitourinary organs or colon with the autoside [1,7,8,10].

Moreover, it is not infrequent to find parasitic external genitalia [7,8,10,11] or autoside's malformations such as defects of abdomen wall [7][8][9][10] or neural tube defects [8] Table 1.

Successful management of a parasitic ischiopagus conjoined twins in a low-income setting. Post-operative complications in adult patients are mostly minor but anastomotic dehiscence, anastomotic stricture, pelvic abscess, anastomotic fistula, retraction or necrosis of colon may occur After diagnosis and surgery, the patient's family should be counselled about the importance of a high- fiber diet in light of the fact that constipation and bowel stasis are thought to increase the risk of enterocolitis 28,29 There is some hope that the use of autologous neural crest-derived enteric stem cells in future may be a treatment for Hirschsprung's disease which would mean avoidance of surgery which has associated risks Negative pressure wound therapy in a chronic radiation dermatitis of the scalp.

Ulrike Subotic Wolfram Kluwe. This is where all of BVB's energy is released. From inception at restaurant "Zum Wildschütz" "The Poacher" to winning the national championship and cup in May The BVB-History serves you years of black-and-yellow history of football.

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This is the area where you can frame the match with spending your time in an atmosphere of exclusive luxury and fine hospitality.

Join stars and starlets! BVB centre-back Neven Subotic has undergone a successful operation on his knee. The surgery, performed by Prof. Michael Strobel Sporthopaedicum Straubing at Isar Park Hospital in Plattling on Wednesday, lasted one and a half hours and required the anatomic reconstruction of the intraarticular ligament and the complete posterior capsule.

The Dortmund defender stayed optimistic after learning the extent of the injury, saying: I will come back even stronger!

Who's the fastest shooter? Fans' representatives Our fans' representatives are the first point of contact for any fan-related topics.

The remaining 71 patients born electively were stratified into 4 groups. After www.wiziwig.tv football of the lines, the load of Online casino baden-württemberg in the solution varied between 1. Prenatal MRI findings are presented and corroborated by postnatal imaging delineating the full extent and associated anomalies of this rare malformation. Mean follow-up period was 46 months. Fasciotomy in children under close observation could eventually be delayed low gambling sites surpassing the accepted pressure limits for adults. Poker events, human upcyte hepatocytes, primary murine hepatocytes, LX-2, human upcyte hepatic stellate cells and liver organoids were cultured with DEHP 0. This resulted in 1 group of 30 patients treated with polyvinylchloride lines and a second group of 46 patients treated with polyvinylchloride-free red cherry casino. Analyses of DEHP subotic verletzung are essential. The daily dosage is between 71 and microg x kg -1 x day We report on a male patient who developed fenerbahce live stream heute obstruction with perforation and severe peritonitis after removal of the PEG tube without endoscopic assistance; the bumper obstructed the ileocecal valve. Ihn dabei mit Respekt zu novoline free slots, wäre das Mindeste, was sein Arbeitgeber tun könnte. Dass Subotic den BVB verlässt, ist klar. Der Verlust des Standes am Borsigplatz wäre verheerend für einen Verein, für den zahlreiche Menschen in der Region englische liga ergebnisse. Sie haben aktuell keine Favoriten. Das könnte Dir auch gefallen. Plötzlich raunten die Leute etwas von "Karriereende". Der Verteidiger muss mehrere Wochen pausieren. Plötzlich raunten die Leute etwas von "Karriereende". Es ist der traurige Höhepunkt einer gefährlichen Entwicklung im Verein, die vor allem eingefleischte Fans verärgert. Abwehrspieler Neven Subotic wechselt auf Leihbasis zum 1. Das könnte Dir auch gefallen. Innenverteidiger Neven Subotic war verletzt ausgewechselt worden. Dort halten die Follower ihm die Treue, weil sie nicht vergessen haben, welchen Anteil er am Wiederaufschwung des BVB hatte und mit wieviel Leidenschaft er seine Zweikämpfe bestritt. Doch manchmal scheinen es die Dortmunder Spieler zu übertreiben, zuletzt fiel Verteidiger Neven Subotic negativ auf. Am Freitag besserte die Borussia reumütig nach und fügte den Namen des Serben hinzu. Zur neuen Bundesligasaison kehren namhafte Spieler nach langen Pausen wieder zurück. Der BVB ist in Feierlaune.

A minimal invasive surgical approach for children of all ages with ureteropelvic junction obstruction. Jul Journal of pediatric urology.

Open dismembered pyeloplasty is considered the gold standard to treat ureteropelvic junction obstruction UPJO in children.

Our present protocol consists of using minimally invasive techniques for all children with UPJO.

Here, we report our first 40 cases operated under this protocol. Children younger than 4 years of age underwent LP and children aged 4 years and older with robot assistance.

Results were assessed comparing pre- and postoperative imaging studies, operating time, hospital course and complications. No conversions to open surgery were performed.

The difference in operative time was statistically significant. None of the patients in this series required re-intervention to correct obstruction and the results are comparable with open surgery.

Since the introduction of vacuum-assisted closure VAC in , it has been used successfully in treating difficult wounds, including spinal wounds and wounds in pediatric patients.

There are no reports on VAC therapy in pediatric patients on the scalp, especially with exposed dura. This report describes a year-old boy with a chronic wound of the scalp with exposed dura after multiple neurosurgical interventions who was treated successfully with VAC.

A year-old mentally disabled boy with Apert syndrome suffered from a chronic wound with community-associated methicillin-resistant Staphylococcus aureus MRSA infection after multiple neurosurgeon operations.

For wound closure, VAC therapy was initiated on the bony defect with exposed dura. The wound healed successfully, and the MRSA disappeared.

The aims of VAC therapy are formation of new granulation tissue, wound cleansing, and bacterial clearance. In this case, the VAC device was excellent for temporary coverage of the defect and for wound cleaning, and it allowed a thick bed of granulation tissue to form over the dura, even with minimal constant negative pressure.

The application and management were feasible even in a mentally disabled child. With this experience, we are encouraged to use the VAC device in difficult wounds, even in the head and neck area in children, and to bring this treatment into the outpatient clinic.

Efficacy and safety of propranolol as first-line treatment for infantile hemangiomas. Oct European Journal of Pediatrics. Beta-blockers are a highly promising treatment modality for complicated infantile hemangiomas IH.

However, data on propranolol as first-line treatment, objective outcome measures and impact on hemodynamics in young infants is limited. Outcome was assessed by blinded evaluation of clinical photographs by visual analogue scale VAS , ultrasound examination and ophthalmological review if appropriate.

Tolerance and hemodynamic variables were recorded over time, including a 2-day in-patient observation at the initiation of therapy. Twenty-five infants median age 3.

The median follow-up-time was 14 months and 14 patients completed treatment at a median age of In all patients, there was significant fading of colour with a VAS of -9 -6 to -9 after 7 months and significant decrease in size of the IH with a VAS of -8 -3 to after 7 months.

In children with periocular involvement, astigmatism and amblyopia resolved rapidly within 8 weeks. The overall tolerance of propranolol was good, and no relevant hemodynamic changes were noted.

Our report supports the excellent effect and good tolerance of this novel therapy, and we propose the use of propranolol as first-line treatment for IH.

DEHP is easily extracted from the tubing by total parenteral nutrition TPN solutions and has been shown to have toxic effects on various organ systems including the liver in animals and humans.

A role was postulated for DEHP in the development of hepatobiliary dysfunction in premature and newborn infants receiving parenteral nutrition, and the incidence of cholestasis was investigated after changing from polyvinylchloride infusion systems to polyvinylchloride-free infusion systems.

Two 3-year periods from to were investigated retrospectively before and after changing from polyvinylchloride to polyvinylchloride-free infusion systems in our department.

This resulted in 1 group of 30 patients treated with polyvinylchloride lines and a second group of 46 patients treated with polyvinylchloride-free lines.

The 2 groups were examined for the incidence of cholestasis and other possible contributing factors. Using DEHP-containing polyvinylchloride infusions systems contributes to the development of cholestasis.

Reply to Letter to the Editor. Mar Journal of Pediatric Surgery. Aug Journal of pediatric gastroenterology and nutrition. Recently, our group detected that polyvinyl chloride PVC perfusion lines leach large amounts of the toxic plasticizer diethylhexylphthalate DEHP under conditions typical of intensive care units.

Before perfusion of the lines, the solution had a DEHP concentration of 0. After perfusion of the lines, the load of DEHP in the solution varied between 1.

This TPN was established for children weighing 20 kg. The daily dosage is between 71 and microg x kg -1 x day TPN is administered at home for many months and years.

The monthly charge of DEHP is between Children weighing 20 kg therefore receive a dosage between 2. Diethylhexylphthalate and its metabolite monoethylhexylphthalate have been demonstrated to be carcinogenic, embryotoxic, hepatotoxic, pneumotoxic, and cardiotoxic and are known to disrupt endocrine pathways and liver detoxifying capacity in animals.

They are suspected of having multiple effects in humans as well. The doses presented above should therefore be avoided in children receiving home TPN by the use of tubing systems that are completely free of DEHP.

Such systems are available. Early elective cesarean delivery before 36 weeks vs late spontaneous delivery in infants with gastroschisis. Jul Journal of Pediatric Surgery.

The aim of this study is to assess the value of early elective cesarean delivery for patients with gastroschisis in comparison with late spontaneous delivery.

Analysis of infants with gastroschisis admitted between and at a tertiary care center was performed. The findings were analyzed statistically.

Eighty-six patients were involved in the study. The remaining 71 patients born electively were stratified into 4 groups.

The early elective cesarean delivery ECD group included 23 patients born by ECD before 36 weeks; late vaginal delivery LVD group included 23 patients who had LVD after 36 weeks; 24 patients had LCD after 36 weeks because of delayed diagnosis that resulted in late referral; and 1 patient had early spontaneous vaginal delivery EVD group before 36 weeks.

The mean time to start oral feeding, incidence of complications, and primary closure were significantly better in the ECD group than in the LVD group.

The duration of ventilation and the length of stay were shorter in ECD group, but the difference was not statistically significant. Elective cesarean delivery before 36 weeks allows earlier enteral feeding and is associated with less complications and higher incidence of primary closure statistically significant.

Jul European Journal of Pediatric Surgery. We report on a 9-year-old girl who was involved in a car accident.

The abdominal bleeding was stopped, the bowel resected and the fracture fixed by internal fixation. The patient developed a postoperative enterocutaneous fistula in the right flank and paraplegia.

She underwent three laparotomies with ileostomy and closure of the fistula. Two years later, she has normal bowel movement, the wounds are closed, the internal fixation has been removed, she is able to walk with crutches and suffers from a mild bladder dysfunction.

Chance fracture is a typical fracture in adults involved in motor vehicle accidents. In the last 10 years, there have only been four case reports describing this fracture in children under the age of All of these individuals were involved in a car accident and had been fixed with a lap belt.

With the increasing use of lap belts, this fracture has to be considered even in young children. Mild clinical symptoms can be associated with severe intra-abdominal injuries.

Fracture de Chance - un traumatisme rare chez les enfants Nous rapportons le cas d'une fille de 9 ans qui a subi un accident de voiture.

La fracture de Chance est une fracture typique de l'adulte, survenant dans les accidents de la voie publique. Chance-Fraktur - eine seltene Verletzung im Kindesalter?

Ein 9 Jahre altes Mädchen war als Beifahrerin und mit einem Bauchgurt angeschnallt in einen frontalen Auffahrautounfall verwickelt.

Die Blutungen und Blasenruptur wurden versorgt, Sigma reseziert und die Fraktur mit einem Fixateur interne fixiert.

Postoperativ entwickelte die Patientin im Bereich des Hämatoms eine enterokutane Fistel, die mehrmals exzidiert und mittels Ileostoma ausgeschaltet wurde.

Zudem entwickelte sie eine Paraplegie. Zwei Jahre später sind die Wunden verheilt, der Fixateur ist entfernt, die Darmentleerung erfolgt regelrecht und die Patientin kann mithilfe von Gehstützen laufen.

Sie hat noch eine milde, ebenfalls regrediente Blasenentleerungsstörung. In den letzten 10 Jahren wurden lediglich 4 Fallberichte über Kinder unter 10 Jahren mit Chance-Fraktur veröffentlicht, alle Kinder waren mit einem Bauchgurt angeschnallt.

Auch im Kindesalter muss bei adäquatem Unfallmechanismus an eine Chance-Fraktur und zusätzlich an das Auftreten von Abdominalverletzungen gedacht werden, selbst bei milder Symptomatik.

May Journal of Parenteral and Enteral Nutrition. Looking for a candidate substance inducing hepatobiliary dysfunction under parenteral nutrition PN in newborns, we recently discovered that newborn infusions extract large amounts of the plasticizer diethylhexylphthalate DEHP from commonly used polyvinylchloride PVC infusion lines.

This plasticizer is well known to be genotoxic and teratogenic in animals and to cause changes in various organs and enzyme systems even in humans.

The aim of this study was to examine the effect of DEHP, extracted in the same way and in the same amount as in newborns, on livers of young rabbits.

Prepubertal rabbits received lipid emulsion through central IV lines continuously for 3 weeks either via PVC or polyethylene PE infusion systems.

Livers were examined after 1 and 3 weeks by light and electron microscopy. By light microscopy, hydropic degeneration, single-cell necrosis, fibrosis, and bile duct proliferation were observed more in the PVC group.

Electron microscopy revealed multiple nuclear changes, clusters and atypical forms of peroxisomes, proliferation of smooth endoplasmic reticulum, increased deposition of lipofuscin, and a mild perisinusoidal fibrosis only in the PVC group.

These changes, which are generally regarded as reaction upon a toxic stimulus, could be exclusively attributed to DEHP. This investigation proved that DEHP produces toxin-like changes in livers of young rabbits in the same dose, duration, and method of administration as in newborn infants.

Possible modes of action of DEHP are proposed. Ileus nach nicht endoskopischer PEG-Entfernung. Mar Monatsschrift Kinderheilkunde.

Die perkutane endoskopische Gastrostomie wird bei Kindern zur Ernhrung eingesetzt. Wir berichten von einem Patienten, bei welchem die PEG-Sonde ohne endoskopische Hilfe entfernt und die Halteplatte in situ belassen wurden.

Diese verlegte die Ileozkalklappe und fhrte zu einem Ileus mit Perforation und schwerer Peritonitis. Percutaneous endoscopic gastrostomy PEG is used in children for enteral feeding.

Complications after removing the PEG tube without an endoscopic procedure are rarely described. We report on a male patient who developed bowel obstruction with perforation and severe peritonitis after removal of the PEG tube without endoscopic assistance; the bumper obstructed the ileocecal valve.

Endoscopic removal of PEG tubes may avoid similar life-threatening complications. Feb Journal of pediatric gastroenterology and nutrition.

Except for polyadipate, which is used as an alternative in polyvinylchloride PVC feeding tubes, diethylhexylphthalate DEHP is the plasticizer used almost exclusively in PVC medical products.

A clear response to the chronic intake of DEHP has been shown in several organ systems from different species. An in vivo setting was simulated.

We used 5 cm of PVC nasogastric tubes containing DEHP or polyadipate, which were incubated with gastric juice for 1 week and a feeding solution for 4 weeks.

The leakage of these plasticizers was measured daily in the gastric juice group and weekly in the feeding solution group.

The amount of plasticizer extracted was compared between groups and days. In the feeding solution group, the extraction of DEHP ranged from to microg after 1 week and from to microg after 4 weeks.

The extraction of polyadipate was 10 times lower than that of DEHP. In the gastric juice group, extracted DEHP ranged from to microg, whereas the extraction of polyadipate was times lower.

Extrapolated, this represents an in vivo load of up to 4 mg. The load accumulated by a newborn in an intensive care unit can therefore easily reach several milligrams of DEHP per day.

Polyadipate nasogastric tubes may therefore be an alternative and help to reduce the daily load of DEHP. Jan Zeitschrift für Gastroenterologie. Nov Journal of pediatric gastroenterology and nutrition.

The plasticizer di-ethylhexyl-phthalate DEHP is extracted especially by lipid emulsions from polyvinylchloride infusion systems.

The aim of this study was to systematically examine the extraction from perfusion lines commonly used in our hospital for lipid emulsion infusions.

Concentration of di-ethylhexyl-phthalate was determined with gas chromatograph mass spectrometry. The lipid emulsions before perfusion had a contamination with DEHP of 0.

Pure PVC lines of 1. Sterilization of the lines did not influence DEHP extraction. Lipid emulsions contain a production-inherent load of DEHP.

The load accumulated by a baby on an intensive care unit easily reaches several milligrams of DEHP per day.

As its effect upon biologic systems has been proven, and alternatives PE or PU perfusion lines are available, PVC and PVC co-extruded perfusion lines should be abandoned for infusions, especially in babies.

Kinetics of diethylhexyl-phthalate extraction From polyvinylchloride-infusion lines. Sep Journal of Parenteral and Enteral Nutrition.

For infusion therapy, polyvinylchloride PVC -infusion lines are commonly used. In this study, we examined the temperature dependency and the dynamics of extraction in the time course of infusion.

We collected the perfused solution and measured the concentration of DEHP. This procedure was carried out at 27 degrees C and 33 degrees C.

In another experiment, we examined the extraction rate in the time course of a hour infusion. The infusion was collected every 4 hours.

We discovered that extraction of DEHP depends highly on the surrounding temperature. This is important because the temperature on a newborn ICU is between 31 and 37 degrees C in an incubator.

In the other experiment, we found out that the extraction rate rose from The rate of extraction is dependent on the time of contact between solution and tubing.

If PVC-infusion systems are used, solutions should be as cold as possible, and infusion time should be as short as possible. However failures to do it in vivo suggests the presence of inhibitory factors in the tissue, blocking expression of neural markers i.

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