Miami, FL
July 18, 2018
Volume IX | Issue No. 29
Early vs late surgical management of complicated appendicitis in children
"Complicated appendicitis (perforation of the appendix, empyema or abscess formation and fecal peritonitis) is common in children, yet the timing of surgical management remains controversial."
A retrospective review of 8,840 children with complicated appendicitis treated with either early (immediate) or late appendectomy indicates that at 1 year follow-up children undergoing late appendectomy are more likely to have had at least 1 complication compared to those being operated on early.
This study confirms earlier studies that suggest early operative management of complicated appendicitis is optimal.
See video HERE & HERE
Do substantial BMI reduction episodes have an impact on final height? 
From 2 nationally representative longitudinal samples of 6,572 Swedish children examined for final height and any BMI reduction episode of either <5%, <10% or a BMI reduction of 10% or more, it appears that as a group (independent of age/BMI at start of reduction episode) there is no evidence that a substantial BMI reduction episode results in final height change.
Predicting inflammatory bowel disease (IBD) in children with abdominal pain and diarrhea by stool testing for Calgranulin-C vs. Calprotectin
A comparison of 2 stool biomarkers, Calgranulin-C and Calprotectin to predict IBD presenting with chronic abdominal pain and diarrhea, indicates that both are excellent in predicting IBD and are useful as indicators for endoscopy.
Childhood Obesity Facts 
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"Let's talk about dating" - promoting discussion about adolescent dating and early romantic relationships
Initiating dating and romantic relationships is a unique and meaningful experience for an adolescent." Nearly half of 8 th graders have already had one date; this milestone is important for the development of the skills needed to maintain healthy adult relationships. Many clinicians follow the guidelines provided by the American Academy of Pediatrics on how to ask questions about sex to both parents and teenagers, however there is less specific information for guidance about discussing dating and relationships.

While specific research on discussing/managing early romantic relationships is lacking, this article provides helpful hints for clinicians. It should be read by all.
Video Feature
Adolescent Relationships
Adolescent Relationships
Reevaluating fasting for procedural sedation

"Procedural sedation is widely administered by a variety of practitioners to facilitate painful or frightening procedures in children." Guidelines recommend a minimum fasting period to minimize the risk of pulmonary aspiration. These guidelines (two hours for clear liquids; four hours or longer for breast milk, six hours or longer for cow's milk, infant formula or a light meal) usually mimic those for elective general anesthesia. Compliance carries a cost to the child, family and healthcare delivery system. In the Emergency Department (ED) many children require procedures urgently despite non- compliance with elected fasting guidelines.
A multicenter prospective observational study of 6,183 ED children undergoing procedural sedation indicates that 53% are non-compliant with standard elective fasting guidelines and are no more likely to vomit or experience other adverse events. ED experience consistently fails to identify any measurable consequence from fasting non-compliance during procedural sedation.
See related video HERE, HERE and HERE
Nutritional status and physical activity

A study of the nutritional status (BMI, body fat content) and physical activity level (PAL) of 150 female students(10-18 years of age) from 3 Polish ballet schools indicates that 18% have a lower BMI and 15.6% a lower average body fat content than normal. Most girls report a high level of physical activity (>15 hours of exercise per week).

Young ballet school dancers (aged 10-15 years) particularly require special attention to nutrition.

Videoconferencing for lactation consultation

" Suboptimal breast feeding duration and exclusivity rates are a public health concern." Identifying/targeting specific barriers to optimal breast feeding outcomes by utilizing effective intervention tools would be valuable.
A cross- sectional online study of mothers at least 18 years of age with an infant aged <4 months, from 27 randomly selected States who received remote lactation consultation using videoconferencing indicates that younger mothers in particular view videoconferencing for lactation consultation as useful.
New anesthesia offering helps cardiac patients recover faster and with less pain
New anesthesia offering helps cardiac patients recover faster and with less pain
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