Objective: To assess the relationship between early laboratory parameters, disease severity, type of management (surgical or conservative) and outcome in necrotizing enterocolitis (NEC). Study design:Retrospective collection and analysis of data from infants treated in a single tertiary care center (1980 to 2002). Data were collected on disease severity (Bell stage), birth weight (BW), gestational age (GA) and pre-intervention laboratory parameters (leukocyte and platelet counts, hemoglobin, lactate, C-reactive protein).Results: Data from 128 infants were sufficient for analysis. Factors significantly associated with survival were Bell stage (P<0.05), lactate (P<0.05), BW and GA (P<0.01, P<0.001, respectively). From receiver operating characteristics curves, the highest predictive value resulted from a score with 0 to 8 points combining BW, Bell stage, lactate and platelet count (P<0.001). At a cutoff level of 4.5 sensitivity and specificity for predicting survival were 0.71 and 0.72, respectively.Conclusion: Some single parameters were associated with poor outcome in NEC. Optimal risk stratification was achieved by combining several parameters in a score.

Objective: Use of a CO 2 laser for cutting and coagulation during circumcision has been reported to give excellent results, and tissue glue has been reported to have advantages over sutures for approximation of wound edges. Most previous studies have focused on the comparison between use of a CO 2 laser and scalpel, or between tissue glue and sutures. This study compares results and complications between the combined use of a CO 2 laser and tissue glue, and standard surgical techniques for circumcision. Subjects and methods: Thirty boys were divided into two groups. Group 1 (n = 17) underwent circumcision using a scalpel with approximation of the wound edges using chromic catgut sutures. Group 2 (n = 13) underwent circumcision using a CO 2 laser with approximation of the wound edges using tissue glue. Patient age, indications for surgery, operation time, wound swelling, bleeding, wound infection, local irritation, pain score, and cosmetic appearance were recorded.Results: Group 1 (scalpel+sutures) had a significantly longer operation time (p = 0.011), a higher rate of local irritation (p = 0.016), and poorer cosmetic appearance (p < 0.001) than Group 2 (laser+glue). Bleeding occurred in one patient in Group 1 only. There were no significant differences in pain score, wound infection rate, or the cost of surgery between the two groups (p > 0.05). Conclusions:The combined use of a CO 2 laser and tissue glue has advantages over standard surgical techniques for circumcision, with a significantly shorter operation time, lower rate of local irritation, and better cosmetic appearance. The cost of surgery is similar in both groups.Ziel: Über die hervorragenden Ergebnisse bei der Verwendung des CO 2 -Lasers zum Schneiden und Koagulieren während der Beschneidung wurde bereits berichtet. Ebenso wurde über die Vorteile des Einsatzes von Gewebekleber im Vergleich zu Nähten zur Fixierung der Wundränder berichtet. Die meisten bisher publizierten Studien haben sich auf den Vergleich zwischen der Verwendung eines CO 2 -Lasers und herkömmlicher operativer Techniken mittels Skalpell bzw. zwischen Gewebekleber und Nahtmaterialien konzentriert. Die vorliegende Studie vergleicht die Ergebnisse und Komplikationen zwischen dem kombinierten Einsatz eines CO 2 -Lasers und Gewebekleber mit chirurgischen Standardtechniken zur Beschneidung. Patienten und Methoden: Dreißig Jungen wurden in zwei Gruppen eingeteilt. In Gruppe 1 (n = 17) wurde die Beschneidung mittels Skalpell und Verwendung von Chrom-Catgutnähten durchgeführt; in Gruppe 2 (n = 13) kam der CO 2 -Laser in Kombination mit Histoacryl ® -Gewebekleber zum Einsatz. In beiden Gruppen wurden Brought to you by | New York University Bobst Library Technical Services Authenticated Download Date | 10/10/15 10:52 PM 228 A. Mungnirandr et al.: Combined use of CO 2 laser and tissue glue in circumcision Patientenalter, Indikation für den chirurgischen Eingriff, Operationszeit, Auftreten von Wundschwellungen, Blutungen, Wundinfektion oder lokaler Reizung, SchmerzScore und kosmetisches Erscheinung...

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