La Pediatria Medica e Chirurgica http://pediatrmedchir.org/index.php/pmc <p><strong>La Pediatria Medica e Chirurgica&nbsp;</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&nbsp;</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> en-US <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="http://creativecommons.org/licenses/by-nc/4.0/" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> francesca.baccino@pagepress.org (Francesca Baccino) tiziano.taccini@pagepress.org (Tiziano Taccini) Wed, 26 Sep 2018 00:00:00 +0200 OJS 3.1.1.0 http://blogs.law.harvard.edu/tech/rss 60 Pseudoarthrosis of second metatarsal fracture http://pediatrmedchir.org/index.php/pmc/article/view/205 <p>Metatarsal fractures make up the greatest portion of foot fractures in children. Most of them are treated with closed reduction and non-weightbearing cast immobilization.Usually, these fractures heal uneventfully and delay union and pseudoarthrosis are rare. We report a case of a 10-year-old child with non-union of the second metatarsal following a traumatic fracture, caused by an accident 10 months before, and treated successfully by osteosynthesis with plate and screws. Good clinical outcome was achieved at 2 years follow-up.</p> Jessica Zanovello, Barbara Bertani, Redento Mora, Gabriella Tuvo, Mario Mosconi, Luisella Pedrotti ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/205 Fri, 19 Oct 2018 15:24:56 +0200 Transscrotal orchidopexy for palpable cryptorchid testis: follow-up and outcomes http://pediatrmedchir.org/index.php/pmc/article/view/191 <p>We retrospectively reviewed the results of transscrotal orchidopexy in the surgical management of palpable testis. From January 2014 to June 2017, 130 male children with a total of 140 palpable undescended testes (UDT) underwent transscrotal orchidopexy. The charts were retrospectively reviewed for demographic data, preoperative position and mobility of the testis, patency of the peritoneal vaginal duct (PVD), and post-operative complications. The resting position of the testis and its traction towards the scrotum were assessed before surgery and under anaesthesia. The mean age of the patients was 4.6 years. The position of the testis assessed at surgery was in most cases at the external inguinal ring (62.8%), at the neck of the scrotum (15.7%), in the inguinal canal (12.8%), or in an ectopic position (8,5%). A PVD was found in 66 testes (47.1%). Two surgical cases required an inguinal incision. In each patient, the postoperative course was unremarkable. The testicle at 1-year follow-up was in a scrotal position in 134 cases, but 6 patients required a second surgical intervention for re-ascent of the testis. No testicular atrophy or inguinal hernias were observed. Transscrotal orchidopexy is a simple and effective procedure for the treatment of palpable UDT. The incidence of complications is low and manageable, with rapid postoperative recovery and early resumption of normal activities.</p> Alfonso Papparella, Giovanni Cobellis, Laura De Rosa, Carmine Noviello ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/191 Wed, 03 Oct 2018 11:59:45 +0200 Clinical side effects after oral administration of palm oil and Alchornea cordifolia decoction in a child http://pediatrmedchir.org/index.php/pmc/article/view/152 <p><em>Alchornea cordifolia</em> is known to be a plant with a variety of medicinal properties and is quoted by many traditional healers to treat a variety of medicinal problems in the Democratic Republic of Congo. However, very little is known about its potential toxicity. We report the case of a 9-year-old boy referred for assessment of suspected bronchial troubles without a history of atopic disease or drug allergy who developed dyspnea, dysphagia, asthenia and lingual ulcers within 30 minutes after nasal and oral administration of decoction of palm oil associated with <em>A. cordifolia</em> leaves in water. In the present report, adverse effects of <em>A. cordifolia</em> therapy may be related to the mixtures of active compounds that they contain and can cause the symptoms observed in our patient. These findings call for caution in the use of <em>A. cordifolia</em> especially in children.</p> Paulo Muntu Bunga, Jephté Bambi Nzita, Gerry Mubungu, Sophie Nyembo Mangaza, Nono Joelle Seudjip, Michel Ntetani Aloni ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/152 Wed, 26 Sep 2018 12:08:16 +0200 Transient femoral nerve palsy in spica cast treatment for developmental dysplasia of the hip http://pediatrmedchir.org/index.php/pmc/article/view/200 <p>A 4 months and half female child come to our attention for congenital dislocation of the left hip, previously treated in another hospital with abduction bracing, without satisfactory results. After progressive longitudinal bilateral traction, closed reduction under general anesthesia was performed and a spica cast was applied in the so-called<em> human position</em>. The patients remained in the spica cast for 6 weeks and then the plaster cast was renewed in narcosis for another 6 weeks. Once the second cast has been removed left femoral nerve palsy was detected. Orthopaedic treatment was interrupted and in 3 months the nerve completely recovered, while the hip was still stable. We followed the child regularly since then, she is now five years old, she is totally asymptomatic, X-rays shows a residual acetabular dysplasia, with no sign of avascular necrosis.</p> Luisella Pedrotti, Barbara Bertani, Gabriella Tuvo, Redento Mora, Mario Mosconi, Federica De Rosa ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/200 Wed, 26 Sep 2018 12:00:00 +0200 Robotic removal of Müllerian duct remnants in pediatric patients: our experience and a review of the literature http://pediatrmedchir.org/index.php/pmc/article/view/182 <p>Persistent Müllerian duct syndrome is a disorder of sexual development, which features a failure of involution of Müllerian structures. An enlarged prostatic utricle is a kind of Müllerian duct remnant (MDR) with a tubular shaped structure communicating with the prostatic urethra. Treatment is aimed at relieving symptoms when present, preserve fertility and prevent neoplastic degeneration. We describe 3 cases of successful robot assisted-removal of symptomatic MDRs. The first case came to our attention for pseudo-incontinence; the other two for recurrent urinary tract infections. The patients have not presented such symptoms anymore on follow-up. We then reviewed existent literature on authors who have recently investigated the main issues concerning MDRs and have attempted a roboticassisted approach on them. Robot-assisted laparoscopy can be considered a valid, safe and effective minimally-invasive technique for the primary treatment of prostatic utricle.</p> Mario Lima, Michela Maffi, Niel Di Salvo, Giovanni Ruggeri, Michele Libri, Tommaso Gargano, Hubert Lardy ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/182 Wed, 30 May 2018 17:33:38 +0200 Kearns-Sayre syndrome is genetically and phenotypically heterogeneous http://pediatrmedchir.org/index.php/pmc/article/view/193 <p>Not available.</p> Josef Finsterer, Sinda Zarrouk-Mahjoub ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/193 Tue, 29 May 2018 11:40:49 +0200 Torsion of huge epididymal cyst in a 16-year-old boy: case report and review of the literature http://pediatrmedchir.org/index.php/pmc/article/view/162 <p>Epididymal cysts (ECs) are relatively common in adults, rare in children. Normally their treatment is conservative. They may be situated anywhere in the organ, frequently in the region of the head. Torsion of these cysts is extremely rare in both children and adults, causing acute scrotal swelling. The diagnosis is intraoperative. A 16-year-old boy was referred to our Divisional Clinic by the treating physician for scrotal swelling appeared 4 months earlier. Absence of a history of minor scrotal trauma. Ultrasonography showed a 40×50 mm fluid-filled right para-testicular mass. We performed surgery finding a large black cyst connected to the head of the epididymis with 720°-degrees rotation. Histology revealed an acquired EC. The particularity of our case is due to the absence of symptoms in association with a big EC twisted of 720° degrees. This is the only case reported in literature. All patients with EC torsion reported presented symptoms related to acute scrotum.</p> Cosimo Bleve, Maria Luisa Conighi, Valeria Bucci, Lorenzo Costa, Salvatore Fabio Chiarenza ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/162 Tue, 29 May 2018 11:22:03 +0200 Robot-assisted thoracoscopic repair of a late-onset Bochdalek hernia: a case report http://pediatrmedchir.org/index.php/pmc/article/view/173 Bochdalek hernia (BH) is a major malformation that consists of a postero-lateral diaphragmatic defect through which abdominal contents can migrate into the thorax. It is most commonly a neonatal pathology associated with significant morbidity and mortality. Rarely, this type of congenital diaphragmatic hernia (CDH) presents later in life, some even in adulthood. Indications for surgery are not clear even though the majority of authors, being aware of the possible severe complications, recommend surgical correction in all cases. Many surgical approaches have been tried for this pathology, both open (laparotomic or thoracotomic) and minimally invasive (laparoscopic or thoracoscopic). We report a case of a late-onset BH corrected with a robot-assisted thoracoscopic procedure. The use of robotic technology for CDH has never been described to date. Mario Lima, Niel Di Salvo, Sara Ugolini, Michele Libri, Giovanni Ruggeri ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/173 Fri, 25 May 2018 11:32:43 +0200 Laparoscopic treatment of symptomatic simple renal cysts in children: single-center experience http://pediatrmedchir.org/index.php/pmc/article/view/168 Simple renal cysts, although common in adults, are rare in children. They are usually discovered incidentally in the course of the study of other urinary tract symptoms, although they are not always asymptomatic. Renal cysts can be classified as being either simple or complex. The purpose of this review is to present our case series of simple symptomatic renal cysts treated with laparoscopy. Nineteen patients with symptomatic renal cysts (6 to 13.5 cm) were referred to our institution between January 2006 and January 2017. They comprised 12 (40.5%) females and seven (59.5%) males, aged 8 to 15, with a mean age of 12.2 years. Of these patients, nine had previously been treated unsuccessfully by ultrasound-guided aspiration/alcoholization with 95%-ethanol, between 9 and 13 months prior to the laparoscopy. Five patients had undergone one treatment and four had undergone two treatments. All of the patients were treated by laparoscopic threetrocar deroofing. The cysts were opened and the wall excised using scissors and a monopolar hook. In most cases, to better handle the edges of the cyst and obtain a better grip, a needle was used to aspirate a small amount of fluid (used for cytological examination). The wall of the cyst was excised, the cyst edges were sealed, and the perirenal fat was placed on the bottom of the cyst (wadding technique). The mean operating time was 95 minutes (range 50- 150). The postoperative course was uneventful for all of the patients. The hospital stay ranged from one to three days. All of the patients were asymptomatic following the treatment. At a mean follow-up time of 3.6 years, none of the patients had experienced a recurrence. Renal function, as assessed by a MAG3 renal scintigraphy scan, was well-preserved in all of the patients, and all of them undergo an annual ultrasound scan. Antonio Marte, Lucia Pintozzi ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/168 Thu, 24 May 2018 15:01:43 +0200 Functional gastrointestinal disorders in newborns: nutritional perspectives http://pediatrmedchir.org/index.php/pmc/article/view/198 Functional gastrointestinal disorders (FGIDs) definition in children has changed over the years trying to facilitate clinicians, because the diagnostic process is complicated by the interpretation variability of symptoms described by children or by their caregivers for newborns and toddlers. This review refers to the Rome IV classification system, drafted in 2016. FGIDs pathophysiology is multifactorial and still poor understood, with limitations for the therapeutic process, which results often in unnecessary and alternative treatments trying to reduce the relevant caregiver distress, but with increased costs for families and for the National Health Service. This study reports the most recent evidence-based treatments for FGIDs in newborns: though in most cases the first action is an educational and behavioral intervention, reassuring caregivers about the transient and self-limiting natural history of FGIDs, there is now more evidence to recommend probiotics in some infant FGIDs. Roberto Bellù, Manuela Condò ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 http://pediatrmedchir.org/index.php/pmc/article/view/198 Wed, 23 May 2018 12:09:05 +0200