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Blood transfusion and elective surgery, a paediatric urologic series
ABSTRACTS
G E N E R A L CONSIDERATIONS BACTERIAL INFECTION IN THE FETUS AND NEWBORN. Pamela A. Davies. Arch. Dis. Child. 46:1-1971. This detailed review article is comprehensive and merits reading by all pediatric surgeons interested in the care of the newborn infant. More than 380 references are quoted.-D. G. Young. EFFECT OF ASPIRIN, SODIUM SALICYLATE, AND ACETAMINOPHEN ON BLEEDING. A. H.
Sutor, E. ]. W. Bowie, and C. A. Owen. Mayo Clin. Proc. 46:178 (March), 1971.
The effect of aspirin, sodium salicylate, and aeetaminophen on hernostasis was tested in 15 patients. The authors were able to measure the time, pattern, and intensity of bleeding from skin punctures, They found that sodium salicylate and acetaminophen did not alter hemostasis in the majority of normal subjects. However, they did find that the overall administration of 650 nag of aspirin interfered somewhat with normal hemostasis within 70 min. after ingestion. Half of the subjects tested showed a significant increase in bleeding time after ingestion of aspirin and three-fourths of the subjects tested lost at least four times as much blood. Many mechanisms have been suggested for the cause of the increased bleeding when taking aspirin. However, one of the most convincing and striking abnormalities is the effect of aspirin on platelet aggregation. --M. Gilbert
495
during and after the operation. No complications of transfusion were noted. The preoperative and postoperative blood loss was estimated and it appears that those transfused had a higer peroperative blood loss than those not transfused. This is a retrospective survey and the author concludes that in the light of present knowledge the number of transfusions given to this group of children could have been reduced by a least half.-H. B. Eckstein CLINICAL EXPERIENCE WITH AUTOSUTURE INSTRUMENTS. Felicien M. Steichen. Surgery 69:609-616 (April), 1971 Currently used autosuture instruments are described and their clinical Use critically assessed and illustrated.-W. K. Sieber CHROMOSOMAL ABNORMALITIES OF THE E GRouP AND SURGICAL ANOMALIES IN
NEONATES. Jay L. Gros[eld, Stella B. Kontras, and Annemarie Sommer. Surgery 69: 451-455 (March), 1971. Four infants with chronaosomal abnornialities and congenital defects, including esophageal atresia, died early in the postoperative period. Since autosomal trisomy and monosomy of E-group chromosomes are usually incompatible with long survival, particularly when associated with gastrointestinal anomalies, should such a diagnosis be confirmed by prompt chromosomal studies, "observation alone may be justifiable therapy." - W . K. Sieber METHOD OF EVALUATING CHILDREN WITH
BLOOD TRANSFUSIONAND ELECTIVESURGERY, A PAEDIATRICUROLOGICSERIES. 1. S. R6. Z. Kinderchir., 9:9-15, 1970. The author reviews 97 children who underwent 103 operations for vesico-ureteric reflux using the method of Politano and Leadbetter. Seventy-seven of these were unilateral and 9.6 were bilateral procedures. Monolateral reimplantation was supplemented with a bladder neck operation in 15 cases. Only 49 of the 103 operations were performed without any per- or postoperative blood transfusion. Sixty-nine tranfusions were given in the remaining 54 cases, with 32 receiving blood during the operation, 10 only in the postoperative period, and 12 both
HODGKIN'S DISEASE. P. R. Exelby. CA 21:95 (March, April), 1971. Hodgkin's disease in children can be controlled by megavoltage radiotherapy if every focus of involvement is detected and treated. The procedure in evaluating patients with Hodgkin's disease is to have a complete physical examination and a complete history. A lymph node biopsy is then pOrformed to establish a histological diagnosis. Routine laboratory work is done, including tests on renal function and liver function and a bone-marrow biopsy and smear. The X rays routinely taken are a chest X ray, intravenous pyelogram, lymphangiography, inferior venacavagram, and a skeIetal survey.
G E N E R A L CONSIDERATIONS BACTERIAL INFECTION IN THE FETUS AND NEWBORN. Pamela A. Davies. Arch. Dis. Child. 46:1-1971. This detailed review article is comprehensive and merits reading by all pediatric surgeons interested in the care of the newborn infant. More than 380 references are quoted.-D. G. Young. EFFECT OF ASPIRIN, SODIUM SALICYLATE, AND ACETAMINOPHEN ON BLEEDING. A. H.
Sutor, E. ]. W. Bowie, and C. A. Owen. Mayo Clin. Proc. 46:178 (March), 1971.
The effect of aspirin, sodium salicylate, and aeetaminophen on hernostasis was tested in 15 patients. The authors were able to measure the time, pattern, and intensity of bleeding from skin punctures, They found that sodium salicylate and acetaminophen did not alter hemostasis in the majority of normal subjects. However, they did find that the overall administration of 650 nag of aspirin interfered somewhat with normal hemostasis within 70 min. after ingestion. Half of the subjects tested showed a significant increase in bleeding time after ingestion of aspirin and three-fourths of the subjects tested lost at least four times as much blood. Many mechanisms have been suggested for the cause of the increased bleeding when taking aspirin. However, one of the most convincing and striking abnormalities is the effect of aspirin on platelet aggregation. --M. Gilbert
495
during and after the operation. No complications of transfusion were noted. The preoperative and postoperative blood loss was estimated and it appears that those transfused had a higer peroperative blood loss than those not transfused. This is a retrospective survey and the author concludes that in the light of present knowledge the number of transfusions given to this group of children could have been reduced by a least half.-H. B. Eckstein CLINICAL EXPERIENCE WITH AUTOSUTURE INSTRUMENTS. Felicien M. Steichen. Surgery 69:609-616 (April), 1971 Currently used autosuture instruments are described and their clinical Use critically assessed and illustrated.-W. K. Sieber CHROMOSOMAL ABNORMALITIES OF THE E GRouP AND SURGICAL ANOMALIES IN
NEONATES. Jay L. Gros[eld, Stella B. Kontras, and Annemarie Sommer. Surgery 69: 451-455 (March), 1971. Four infants with chronaosomal abnornialities and congenital defects, including esophageal atresia, died early in the postoperative period. Since autosomal trisomy and monosomy of E-group chromosomes are usually incompatible with long survival, particularly when associated with gastrointestinal anomalies, should such a diagnosis be confirmed by prompt chromosomal studies, "observation alone may be justifiable therapy." - W . K. Sieber METHOD OF EVALUATING CHILDREN WITH
BLOOD TRANSFUSIONAND ELECTIVESURGERY, A PAEDIATRICUROLOGICSERIES. 1. S. R6. Z. Kinderchir., 9:9-15, 1970. The author reviews 97 children who underwent 103 operations for vesico-ureteric reflux using the method of Politano and Leadbetter. Seventy-seven of these were unilateral and 9.6 were bilateral procedures. Monolateral reimplantation was supplemented with a bladder neck operation in 15 cases. Only 49 of the 103 operations were performed without any per- or postoperative blood transfusion. Sixty-nine tranfusions were given in the remaining 54 cases, with 32 receiving blood during the operation, 10 only in the postoperative period, and 12 both
HODGKIN'S DISEASE. P. R. Exelby. CA 21:95 (March, April), 1971. Hodgkin's disease in children can be controlled by megavoltage radiotherapy if every focus of involvement is detected and treated. The procedure in evaluating patients with Hodgkin's disease is to have a complete physical examination and a complete history. A lymph node biopsy is then pOrformed to establish a histological diagnosis. Routine laboratory work is done, including tests on renal function and liver function and a bone-marrow biopsy and smear. The X rays routinely taken are a chest X ray, intravenous pyelogram, lymphangiography, inferior venacavagram, and a skeIetal survey.