Anal sepsis in children (usually infant boys) ranges from perianal abscess to fistula-in-ano. Many are treated conservatively. Older children with anal sepsis more frequently require surgery.
Children older than 2 years of age who present with anal abscess appear best treated with incision and drainage- with few recurrences or fistula formation. Fistulae are successfully treated with fistulotomy (complex fistulae are uncommon).
Over-the-counter topical creams, lotions and patches to relieve muscle and joint pain may cause serious burns (frequently within 24 hours of use) warns the FDA following a review of 43 such cases. Burns included first-second-third-degree burns from the menthol, methyl salicylate, capsaicin (singly or in combination) found in these products. Some patients require hospitalization.
American pediatric surgical association (APSA) management & outcome review of necrotizing enterocolitis (NEC)
While many studies exist outlining the medical treatment of necrotizing enterocolitis, the optimal surgical management remains a challenge. The APSA evaluated a variety of published (and unpublished) sources to answer a number of questions pertaining to the prevention and surgical care of NEC.
It appears that there is NEC literature to support:
The prophylactic use of probiotics in preterm infants <2,500gms.
Breast milk usage is recommended when possible.
There is no clear evidence to support:
Delayed initiation or slow advancement of feeds.
Peritoneal drainage versus laparotomy for NEC perforation.
Enterostomy versus primary anastomosis after resection.
Any particular link of antibiotic treatment to prevent recurrence.
A study of 545 children whose epilepsy could not be adequately controlled with medication and who underwent cerebral resective surgery, (including 10 hemispherotomies) and subsequently followed for 7 years indicates that 55.5% of children were seizure free. Best results appear to be found after functional hemispherotomy and temporal lobe resection. 71% of the children/parents reported improved cognitive and psychosocial functioning.
Resective surgery appears to be a valuable adjunct therapy for difficult to medically manage epilepsy.
Association between temperament at 1.5 yrs. & obesogenic diet at 3 & 7 yrs
It appears that anxious dependent (internalizing), as well as hyperactive, aggressive (externalizing) infants are more likely to consume sweet drinks and foods, and less fruits and vegetable daily at 3 and 7 years of age. Active, sociable (surgent) infants appear more likely to consume significantly more fruits/vegetables daily at similar ages.
Early child temperament is a risk factor for obesogenic diet consumption later in childhood.
107 children (6-18 years of age) and 72 parents were seen by a pediatrician randomly wearing one of three different outfits (casual, semiformal, formal) and were subsequently interviewed regarding their preference. Children's' (0-6 years) behavior was observed during their examination.
Parents and children 6-18 years of age apparently prefer, and maintain their trust in pediatricians who dress casually. Pediatrician dress has no apparent effect on small children.