Evaluation of the frequency of childhood hospitalization due to thermal injuries in the Provincial Polyclinical Hospital in Torun, Poland, 2007-2011.

INTRODUCTION: Burns constitute the most common and severe injuries suffered in childhood. OBJECTIVE: The study was aimed at providing a retrospective analysis of the etiology, location, extent and depth of burns, as well as treatment methods and length of hospital stay. MATERIAL AND METHODS: A retrospective analysis of 508 cases of children treated due to a thermal injury between 1 January 2007 31 December 2011 was conducted at the Department of Paediatrics, Urology and Paediatric Surgery, Children's Hospital, L. Rydygier Provincial Hospital in Torun, Poland. RESULTS: The sample group included more boys (58.9%) than girls (41.1%). The most numerous group comprised children aged 1-2 years (44.5%). Burns were largely suffered at home (91.9%). Injuries were largely caused by thermal burns (99.2%). Half of the children sustained injury to one body area (51.4%), while every third sufferer (37.9%) was affected by burns to body parts prone to trigger shock. Burns up to 5% of the Total Body Surface Area (TBSA) were suffered by half (51.2%) of the children. Most of the patients underwent conservative treatment (89.4%). CONCLUSIONS: Burns were mostly suffered by children at 1-2 years of age, with boys prevailing over girls. Injuries were largely suffered at the child's family home, in the afternoon or evening, while the child was in the care of the parents. Scalds, caused by hot liquid, constituted the most frequent type of injury. The most numerous group of affected children comprised burns to limb areas, and thorax with limbs, with the TBSA of up to 5%. The great majority of the patients underwent conservative treatment, with a hospitalization period of up to 3 days.

Tissue Factor and Tissue Factor Pathway Inhibitor in the Wound-Healing Process After Neurosurgery.

OBJECTIVES: The aim of the study was to assess the concentrations of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in the blood of patients with a postoperative wound after neurosurgery. METHOD: Participants included 20 adult patients who underwent neurosurgery because of degenerative spine changes. The concentration of TF and TFPI in the patients' blood serum was measured 3 times: before surgery, during the first 24 hr after surgery, and between the 5th and 7th days after surgery. The control group comprised 20 healthy volunteers similar to the patient group with respect to gender and age. RESULTS: A statistically significant difference was observed between TF concentration at all three measurement time points in the research group and TF concentration in the control group (p = .018, p = .010, p = .001). A statistically significant difference was found between TFPI concentration at the second time point in the research group and TFPI concentration in the control group (p = .041). No statistically significant within-subject difference was found between TF concentrations before and after surgery. A statistically significant within-subject difference was found between TFPI concentrations within 24 hr after surgery and 5-7 days after surgery (p = .004). CONCLUSION: High perioperative concentrations of TF indicate not only the presence of thrombophilia but also the importance of TF in the wound-healing process. Perioperative changes in TFPI concentrations are related to its compensatory influence on hemostasis in thrombophilic conditions.

The use of central venous lines in the treatment of chronically ill children.

Treatment of chronic diseases in children is a special medical problem. Maintaining constant access to the central vascular system is necessary for long-term hemato-oncological and nephrological therapies as well as parenteral nutrition. Providing such access enables chemotherapic treatment, complete parenteral nutrition, long-term antibiotic therapy, hemodialysis, treatment of intensive care unit patients, monitoring blood pressure in the pulmonary artery and stimulation of heart rate in emergency situations as well as treatment of patients suffering from complications, especially when chances of access into peripheral veins are exhausted. Continuous access to the central vascular system is desirable in the treatment of chronically ill children. Insertion of a central venous catheter line eliminates the unnecessary pain and stress to a child patient accompanying injection into peripheral vessels. In order to gain long-term and secure access to the central venous system, respecting the guidelines of the Center for Disease Control and Prevention contained in the updated 'Guidelines for the Prevention of Intravascular Catheter-Related Infections' is necessary.