HealthFusion June 2014 B  

August 27, 2014   Vol. V, Issue 35
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Intraluminal fluid-a predictor of recurrent appendicitis following acute conservatively treated appendicitis.  

While a calcified appendicolith on abdominal CT imaging in a patient with a past history of appendicitis appears to enhance the likelihood of recurrent appendicitis, risk factors for recurrence remain unclear.


A study of 125 children whose initial appendicitis was successfully managed non-operatively (19% of whom developed recurrent appendicitis within 12 months), indicates that on follow up only intraluminal appendiceal fluid is an independent predictor during the initial episode, of recurrence.


Journal of Pediatric Surgery  


See Related Video: Recurrent Appendicitis in Children 

Helicobacter pylori resistance to clarithromycin.   

Very little population-based/regional data exists for the USA for pediatric H. pylori resistance to clarithromycin. In Europe fluorescence in situ hybridization and DNA probe assays are available to identify H. pylori 23SrRNA mutations associated with resistance. At the moment this is not clinically available in the USA.


A USA study which identified the 23SrRNA gene of H. pylori on archived H. pylori-infected gastric biopsies by polymerase chain reaction (PCR) amplification and sequencing indicates that in the USA 50% of gastric biopsies for H. pylori may be clarithromycin resistant.


Journal of Pediatric Gastroenterology and Nutrition



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Operative & non-operative management of High-Grade Spondylolisthesis in children


Spondylolisthesis is the forward (anterolisthesis) or backward (retrolisthesis) slipping of one vertebrae on an adjacent one, that occurs usually at the base of the spine,from a number of causes. It can lead to a deformity of the spine, narrowing of the spinal canal and compression of exiting nerve roots. It is easily diagnosed by plain lateral x-rays and is graded (Grades I to V) according to the percentage of slip. The optimal management of high-grade (III-V) spondylolisthesis in the growing child is controversial as surgical interventions result in >10% risk of complications/neurologic injury.


A study of 49 patients (mean age 12.6 years) treated either surgically or non-operatively for high grade spondylolisthesis and followed to age 20.1 years (mean) finds no outcome differences between the groups. Non-operative "watchful waiting" in a minimally/asymptomatic child appears safe.


Journal of Pediatric Orthopedics
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The "weekend effect" in pediatric surgery 


A study using the Nationwide Inpatient Sample and the Kids Inpatient Database identified 112,064 similar children (<18 years of age) admitted for a common, urgent surgical procedure over a weekend vs. a week day (327,393), finds that more patients on the weekend die, receive a blood transfusion and/or suffer a procedural complication. 


Journal of Pediatric Surgery 

Online social networking in adolescence & psychosocial functioning.   


Data collected and analyzed of 10,930 adolescents aged 14-17 years (form 6 European countries) on usage of social networking sites (SNS) indicates that 70% use online communication tools.  

40% spend 2 hours or more daily on SNS and this in young adolescents (14.9-15.9 years) results in more internalizing problems, lower academic scores and less physical activity. Interestingly, in older adolescents heavy SNS use appears to be of value with offline social competence.


Journal of Adolescent Health

The adenoids & tonsils in children with renal transplantation. 


A study comparing the incidences of adenoidectomy and tonsillectomy of normal and renal transplant children indicates that patients who receive a renal transplant are at significantly greater risk of adenotonsillar hyperplasia requiring surgery (especially males and young recipients).


Journal of Pediatric Nephrology

Pearl of the Week 


To understand the heart and mind of a person, look not at what he has already achieved, but at what he aspires to do.  

-Kahlil Gibran


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