August 5, 2015
Volume VI, Issue No. 31

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Irreducible inguinal hernia in children

Approximately 80-90% of inguinal hernias appear to occur in boys, more commonly on the right side. In 10% of cases they occur bilaterally.


A study involving 1,882 boys and girls post-hernioraphy indicates that 1.6 % (median age 12 months) had an irreducible hernia (failed manual reduction by surgeon of an incarcerated hernia under sedation). In males small bowel is more frequently found in the hernia sack; in females, a prolapsed ovary. Laparoscopic and open surgical techniques complement each other.


Journal of Pediatric Surgery

Adolescents' perception of risk and benefits of conventional cigarettes, E-cigarettes and Marijuana

Rates of adolescent cigarette use have remained constant while the use of E-cigarettes and Marijuana appear to be increasing.


A study of 24 adolescent boys and girls form Northern California assessed through 6 small group discussions indicates that adolescents learn from multiple sources about the negative consequences of using cigarettes and describe few benefits from its use. Conversely however, they receive less and often incorrect information about E-cigarettes and marijuana risks which results in their describing a number of positive and/or ambivalent reactions to their use.


Journal of Adolescent Health


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Surgical treatment of Active Amniotic Band Syndrome (ABS)

ABS is a relatively uncommon congenital fetal abnormality in which a wide range of clinical deformities may be found from simple ring constrictions of lower limb extremities to major head, face, and internal organ defects. Early amnion rupture and/or vascular disruption are thought to be the likely causes of the strands.


This study describes the surgical management of lower extremity active amniotic band syndrome causing progressive edematous enlargement of the distal foot with vascular insufficiency in 2 children (age 3 months and 4 weeks respectively) where the limbs were at risk for amputation. Radical excision of the constriction with removal of overgrown skin and soft tissue appears at follow up to result in a fully functional foot.


Journal of Pediatric Orthopedics



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Henoch-Schönlein purpura (HSP) nephritis - long term outcomes.

"HSP is a common cause of pediatric renal disease in children representing 10-15% of pediatric glomerulonephritis".


A renal biopsy long-term outcome study of 142 children (2-10.5 years of age) with HSP nephritis presenting at 7.2 years (mean) of age, found significant proteinuria (>0.5g/l) in 19% after 3 years following biopsy, 32% after 5 years and 21% after 10 years.


There appears to be no correlation between proteinuria risk, the initial histological lesion or the treatment utilized in HSP nephritis (though early treatment with angiotensin-converting enzyme inhibitors/receptor blockers appears to result in less subsequent proteinuria).


Acta Paediatrica

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Clostridium difficile infection in children
Clostridium difficile infection in children

Risk factors for recurrent Clostridium difficile infection in children (CDI)


A nested case-control study of 30 children with recurrent CDI (diagnosed by tcdB polymerase chain reaction - PCR which identifies one of the primary toxins) and 94 non-recurrent CDI patients, indicates that malignancy and tracheostomy tube dependence appear to be major risk factors for recurrent CDI.


Journal of Pediatrics

Oral zinc supplements for acute dehydrating diarrhea  


From a study of 134 children 5-12 years of age hospitalized with acute dehydrating diarrhea who randomly received either a 40 mg oral zinc sulfate table or a placebo for 14 days, it appears that zinc supplementation does not improve time taken for rehydration, duration of hospitalization or subsequent recurrences of diarrhea.


Acta Paediatrica

Effect of delayed cord clamping on neurodevelopment at 4 years of age


Delayed clamping of the newborn cord prevents iron deficiency at 4-6 months of age (among other beneficial effects) which may promote neurodevelopment.


A 4 year follow-up of a randomized clinical trial of 263 full-term infants born after early (<10secs) or late (>180secs) cord clamping, from a group of low-risk pregnancies and assessed at 4 years of age by full-scale IQ (WPPSI-III), "Movement Assessment Battery" (Movement ABC) and parental recorded child's development and behavior (using Ages and Stages Questionnaire) scores, indicates that while delayed cord clamping does not appear to improve IQ, it does improve scores in fine-motor and social domains (especially in boys).


JAMA Pediatrics

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