C-reactive protein: what to expect after bony hip surgery for nonambulatory children and adolescents with cerebral palsy

Bony hip reconstruction surgery in children with severe cerebral palsy is associated with high complication rates, usually postoperative chest and urinary tract infections. C-reactive protein (CRP) level is commonly used as an indication of infection; an understanding of its normal postoperative trends is crucial to allow early identification of abnormal levels and possible infection. Our aim was to describe the trends in CRP following bony hip surgery in children who had an uneventful postoperative course, on the basis that the children for whom CRP does not follow this course are likely to have a bacterial infection. A retrospective review was performed of 155 children with CP having bony hip surgery between 2012 and 2016. The median age was 9.9 years (interquartile range: 6.6–12.7). One hundred (64.5%) patients had a Gross Motor Function Classification System rating of V. All CRP levels measured in routine postoperative care were recorded, and medical records were examined for postoperative infective complications. The CRP levels of patients with clinically proven infections were excluded in order to describe what to expect in the absence of infection. Mean CRP peaked on the third postoperative day at 81 mg/l in those who had no postoperative infection. Twenty-five (16.1%) patients had a postoperative infection; their mean CRP was higher on all postoperative days and peaked at 128 mg/l on the third postoperative day. An understanding of the normal posto...
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: CEREBRAL PALSY Source Type: research

Related Links:

CONCLUSIONS: rich-fiber food consumption, fluids intake and anticonvulsant polytherapy were associated with the stool characteristics of children with cerebral palsy and chronic constipation. PMID: 31830793 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Myiasis is a disease caused by the invasion of tissues by the larvae of flies. Herein, we present 2 cases of this disease. Case 1: a 47-year-old male patient with diabetes mellitus, hypertension, malnutrition, and mental disorders was hospitalized for sequelae of stroke. The intraoral examination revealed poor hygiene and the presence of an ulcerated lesion with a whitish border in the left upper lip mucosa showing larvae with wriggling movement. Case 2: an 11-year-old male patient diagnosed with cerebral palsy and West syndrome.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
This case report describes a 12-year-old child diagnosed with cerebral palsy who was attended in the dental service in October 2012 with a chief complaint of caries. The dental history revealed that the child had difficulty in opening his mouth, chewing, and swallowing. In the intraoral examination, the patient had an atretic palate, fibrous gingiva, gingival bleeding, malocclusion, and presence of calculus in the supra and subgingival regions and presented epilepsy and low weight. In the complementary examinations, blood pressure was checked and the blood count was read.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
Oral myiasis is a condition caused by the invasion of fly larvae in body tissues. This work aims to notify a clinical case of an oral myiasis in the oral cavity. The patient is 12 years old, male, white, and a carrier of cerebral palsy. He was attended by public health care presenting releasing of larvae through the vestibular face and in adjacent palatine next to elements 12 and 13. The clinical examination verified lack of hygiene, caries, necrotic ulceration, acute inflammation, exhaling fetid smell, bleeding in anterosuperior region, and larvae in this area.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
CONCLUSIONS: The nursing staff is a key and decisive factor in the diagnosis, early reference for treatment and monitoring of the evolution of urinary disorders in children with CP. It is not indicated to start a toilet training program in children with CP, without having previously ruled out a urinary tract infection. PMID: 31475673 [PubMed - in process]
Source: Archivos Espanoles de Urologia - Category: Urology & Nephrology Tags: Arch Esp Urol Source Type: research
Discussion Gastrostomy tubes (GT or GTubes) have been used to support patients for about a century. They are placed between the abdominal skin and the stomach either percutaneously or surgically. The tubes can be a standard long tube with either a bumper or inflatable balloon internally and externally they have a retention piece to hold the GT in place. A button or low profile tube are similar but extend just beyond the skin. Reasons for GT placement include: Nutritional support Hydration maintenance Medication management Aspiration avoidance Gastric stasis decompression Obstruction bypass Quality of life improvement for...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Authors: Cichos KH, Lehtonen EJ, McGwin G, Ponce BA, Ghanem ES Abstract INTRODUCTION: Orthopaedic surgeons are wary of patients with neuromuscular (NM) diseases as a result of perceived poor outcomes and lack of data regarding complication risks. We determined the prevalence of patients with NM disease undergoing total joint arthroplasty (TJA) and characterized its relationship with in-hospital complications, prolonged length of stay, and total charges. METHODS: Data from the Nationwide Inpatient Sample from 2005 to 2014 was used for this retrospective cohort study to identify 8,028,435 discharges with total jo...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
While frequency, urgency, incontinence, urinary tract infections (UTIs) and urinary retention are commonly reported urologic manifestations in children with cerebral palsy (CP), there is not much known regarding the incidence of vesicoureteral reflux (VUR) in these children. Likewise, there are few reports regarding the videourodynamic findings in children with CP and more specifically, in those who have associated VUR. In order to better define the incidence of VUR in children with CP and its association, if any, with particular types of neurogenic bladder dysfunction, we reviewed and report on our experience in these children.
Source: The Journal of Urology - Category: Urology & Nephrology Authors: Tags: Pediatrics: Urinary Tract Infection & Vesicoureteral Reflux Source Type: research
ConclusionSixty-four percent of patients who underwent surgical correction of neuromuscular scoliosis developed postoperative fever. Postoperative fever was sign of infection in 32.7% of patients and urinary tract infection was the most frequent finding. Only 15.2% of fever diagnostic workup tests were positive. Diagnostic urine tests account for 70% of the positive diagnostic workup. The routine use of blood cultures for the assessment of postoperative fever in such population should be avoided due to the low rate of positive tests and the associated high cost.
Source: European Spine Journal - Category: Orthopaedics Source Type: research
We reported a surge in the use of augmented reality in healthcare at the end of 2016, with the trend continuing in 2017. Notably, Microsoft’s HoloLens was successfully used for spinal surgery applications by a surgical navigation company named ...
Source: Medgadget - Category: Medical Devices Authors: Tags: Exclusive Source Type: blogs
More News: Cerebral Palsy | Children | Orthopaedics | Pediatrics | Urinary Tract Infections