-Newborn and 14-day-old piglets (in a developmental stage equivalent to that of a 3-month-old infant) compensate sustained hypoxemia by increasing cardiac performance. -This compensation can be maintained for only roughly 30 min. -Newborn piglets free from hypoxemia are able to tolerate the stress of anesthesia, artificial respiration, and operation significantly longer than those with additional hypoxemia. -14 day-old piglets without hypoxemia are not able to tolerate the stress of anesthesia, artificial respiration, and operation longer than those with additional hypoxemia. -The reactions of the cardiovascular system to anesthesia, artificial respiration, and operation in present or absent additional hypoxemia are qualitatively identical and are also identical in time in the newborn hypoxic, the 14-day-old hypoxic, and normoxic animals, whereas they appear significantly later in newborn control piglets.
Circulatory adaptation to hypoxaemia was studied under anaesthetic and surgical conditions in 10 newborn (age 8-42 h, weight 850-1800 g) and 8 two-week-old piglets (12-16 days, 1400-3600 g). Arterial PO2 was lowered from 60-100 mmHg to 30-40 mmHg by reducing FiO2 (concentration of oxygen during inspiration) at otherwise constant conditions; control studies were performed under the same standard conditions maintaining normoxaemia during the whole experiment in 8 newborn and 8 two-week-old piglets of comparable weight.
Internal hernias are rarely diagnosed. Most of the times they are found at laparotomy when complications and their symptoms (for instance palpable tumour, abdominal pain, vomiting and ileus) require surgical treatment. We present a case of an eleven-year-old boy who was admitted to our hospital because of acute abdominal pain. Appendectomy brought only temporary relief of pain. Subsequent laparotomy yielded the diagnosis of left-sided paraduodenal hernia.
See also: Stellungnahme zur Publikation ,,Die Therapie der kindlichen anorektalen Inkontinenz unter besonderer Berücksichtigung eines Biofeedback-Trainings"Klin Padiatr 1989; 201(02): 129-129DOI: 10.1055/s-2007-1025288
Regarding the great number and the possible consequences for the patient it's surprising that there is almost no discussion concerning wrong diagnoses in medicine. Based on the experience of a working team at a center for general pediatric surgery we tried to recognize the most common mechanisms leading to wrong or insufficient diagnoses. For better illustration we describe the histories of six patients; in their cases the diagnostic errors could probably have been avoided by an exact examination procedure. One way to decrease pitfalls in daily medicin life seems to be the reflexion upon the errors and try to minimize them and their sources.
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