Central venous catheter (CVC) repair in intestinal failure (IF) pediatric patients
Children with IF depend on long term use of CVCs for minimal energy requirements for growth. A common complication is line breakage.
A prospective constructed database of all pediatrics patients with CVC dependency was utilized to assess whether repair of a broken CVC line is associated with an increased colonization rate/infection, and therefore loss.
"Repair of a central venous catheter in the pediatric population with intestinal failure does not lead to on increased rated of CVC infections".
Laparoscopic adjustable gastric banding (LAGB) for obesity in adolescents
It appears two years post LAGB for obesity that body weight loss is substantial (49.2%) with most post obesity related comorbidities (glucose intolerance, hypertension and sleep apnea) resolving within one year and with few serious adverse events. Post-operative patients have improved Quality of Life and social and psychological status.
Current practice in the management of slipped capital femoral epiphysis (SCFE)
Though SCFE is quite rare it is one of the most important pediatric hip disorders seen in pediatrics practice. Accurate diagnosis and immediate treatment appears critical to prevent complications. Twenty percent of children have bilateral involvement which presents radiographically with the femoral head being displaced posteriorly and inferiorly in relation to the femoral neck.
While the standard treatment for SCFE is internal fixation, recently academic surgeons, in order to reduce the chances of osteoarthritis and osteonecrosis, are using the surgical hip dislocation approach, fully threaded cannulated screws and open capsular decompression (depending on hip stability) more frequently.
A study of the differing psychological & clinical presentations between boys & girls (619 boys & girls; ages 6-18) who presented to an Emergency Department with a diagnosis of, & treatment for an eating disorder was undertaken.
Boys presenting to the Emergency Department for treatment of an eating disorder present earlier, are younger, are less likely to have a diagnosis of anorexia or bulimia, and are more likely to be non-white. Girls tend to have more severe ED pathology (weight, eating, restraint and shape concerns) and mood disorders.
Continuing abdominal pain in children with Functional Abdominal Pain (FAP)
"A significant proportion of children with Functional Abdominal Pain develop chronic pain".
A study of 76 children (7-10 years of age) who presented for treatment of FAP examined, 18-24 months later child anxiety and/or pain-stool relations as a function of the presence of ongoing abdominal pain.
It appears that children's baseline anxiety is not related to the persistence or frequency of ongoing abdominal pain. Patients with symptoms of Irritable Bowel syndrome however continue to experience abdominal pain.
Factors in post relapse survival (PRS) in children with nonmetastatic localized osteosarcoma
"Osteosarcoma is the most common type of bone cancer in children and young adults". While it can occur in any bone, it is most frequently found in the long bones of the arms and legs.
A retrospective analysis to identify factors that influence post relapse survival utilized 31 children (median age at diagnosis 13.7 years) treated with complete response for nonmetastatic high-grade osteosarcoma and followed to first relapse (16 months; range 3-36 months)
Achievement of a second complete remission and a histological response to first-line treatment are independent variables that are significantly associated with post relapse survival.