Pediatric case of a penetrating lumbar spinal injury

PURPOSE

Penetrating spinal injuries are generally extremely rare and are seldom encountered in pediatric patients. The non-compliance of pediatric patients with physical examination can sometimes delay diagnosis and treatment. Here, we present a case of a child who had a fall and suffered penetrating spinal trauma due to a small glass fragment.

CASE REPORT

A penetrating foreign body was detected in the lumbar spinal region of a 2-year-old patient with complaints of increased restlessness on physical activity followed by difficulty in walking. The patient was operated on and followed up without any complications in the perioperative and late postoperative periods.

CONCLUSION

A detailed physical examination is necessitated in the pediatric age group because of insufficient anamnesis. The high number of patients per physician, especially in societies having a low socioeconomic standard, prevents detailed examinations, and unnecessary examinations may cause delays in diagnosis. However, one must note that the skin findings of pediatric patients can be very helpful, especially in pediatric neurosurgery, and examination should not be neglected.

Reliability and Quality of Online Patient Education Videos for Spina Bifida

AIM

There is a growing trend among patients and their families to seek medical information online. Among the world's most popular websites, YouTube is ranked second. Our aim was to assess the reliability and quality of YouTube videos on spina bifida.

METHODS

Researchers searched the YouTube platform using 3 search keywords in February 2022. These were spina bifida, spina bifida treatment, and spina bifida surgery. The content of the first 35 videos for each search term was evaluated using the DISCERN scale. Two independent neurosurgeons with 6 years of experience in pediatric neurosurgery evaluated the content of the videos.

RESULTS

Of the total 105 videos, 58 met the inclusion criteria and were evaluated. Of these videos, 3 (6.5%) received a score between 3-4. This suggests that the video is reliable but missing important information. Only 1 (2.1%) of the videos had a mean score of >4, which refers to a high-quality source of information. It has been found that the popularity of the video was not correlated with whether it is broadcast by health professionals or whether it has surgical content. The correlation between video popularity and DISCERN score was not significant (p=0.361/0.401 based on the number of views; p=0.459/0.606 based on the number of likes).

DISCUSSION

Based on the results of this study, patients and their families will generally encounter low-quality educational content on YouTube when searching for information about spina bifida. Since videos on spina bifida are insufficient, we recommend to universities, hospitals, and academic societies publish reliable video education content to support and optimize patient education, in line with approved tools such as DISCERN.

Choroid Plexus Papilloma and Factor XIII Deficiency: Case Report

Factor XIII deficiency is a rare hemorrhagic disorder that can cause spontaneous intracranial hemorrhage and bleeding after surgery. The diagnosis of factor XIII deficiency is difficult before surgical interventions, because coagulation parameters are normal in these patients. Important clinical findings are postsurgical bleeding and recurrent spontaneous intracranial hematomas. These findings should raise the clinical suspicion of factor XIII deficiency. Therefore, diagnosis of factor XIII deficiency is very important for neurologists and neurosurgeons in terms of reducing mortality and morbidity. We present an 8-month-old female patient who developed subdural hematoma after ventriculoperitoneal shunt surgery but not bleeding after choroid plexus papilloma due to FXIII deficiency.

[Arterial hypertension as a risk factor in the cardiovascular complications of diabetes mellitus]

Diabetic patients suffer from atherosclerosis and its complications more frequently and at an earlier stage than nondiabetic people. The factors predisposing diabetics to premature arteriosclerosis are not fully clarified. Data from a 5-year follow-up of 617 diabetics, 376 non-insulin dependent (NIDDM) and 241 insulin-dependent (IDDM), attending the Hospital de Clínicas José de San Martín at Buenos Aires city are reported. By the WHO criteria 55% of NIDDM and 29% of IDDM had hypertension. Hypertension was significantly (p less than 0.01) more common among NIDDM than among IDDM patients after adjustment for age, sex and obesity. The incidence of angor pectoris, acute myocardial infarction and heart failure was significantly greater in hypertensive patients of both types of diabetes than in the respective normotensive group. No sex differences were observed in both diabetic groups in the incidence rates of coronary heart disease. Overt diabetic nephropathy and diabetic retinopathy were more frequent in hypertensives than in normotensives of both groups of diabetics. Even though 63% of hypertensive patients with NIDDM and 57% with IDDM received antihypertensive treatment only 36% and 24% respectively had their blood pressure well controlled. Acute myocardial infarction was the most frequent cause of death in both NIDDM and IDDM hypertensive people.