Nov. 25, 2015
Volume VI, Issue No. 47

Usefulness of gastric biopsy-based real-time Polymerase Chain Reaction (PCR) for the diagnosis of helicobacter pylori infection in children
Gastric biopsy-based quantitative real-time PRC was investigated against a reference method to assess its usefulness to identify helicobacter pylori infection.

H. pylori PCR positivity is a more precise test than routine standard testing.

Rates of complications after newborn circumcision performed in a well-baby nursery, Special Care Nursery (SCN) and Neonatal Intensive Care Unit (NICU)
A retrospective chart review of >7,000 circumcisions performed on infants in a well-baby nursery, SCN or NICU examining circumcision-related complications indicates:

1.    Overall complication rate is low - 0.67% (0.07% acute; 0.6% late).
2.    Babies in a SCN/NICU are at increased risk.

Serum Cancer Antigen 125 (CA-125) level and perforation in acute appendicitis
Serum CA-125 is a glycoprotein antigen normally expressed in tissues derived from Coelomic epithelia (ovary, peritoneum, stomach, colon, pleura, pericardium and kidney) and is apparently elevated in 90% of women with ovarian cancer. Elevated levels have also been described as a biomarker of many nonmalignant conditions including pelvic inflammatory disease.

A study examining the relationship between serum levels of CA-125 and acute appendicitis/perforation indicates that serum CA-125 levels are significantly higher in those acute appendicitis patients who have either perforated or who have a gangrenous appendix.



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Diagnosing Traumatic Brain Injury (TBI)

A prospective study examined the performance of serum glial
fibrillary acidic protein (GFAP) (apparently a specific predictor of acute disruption of the blood-brain barrier and destruction of astroglial cells) in 197 children with blunt head trauma, Glasgow Coma Scores 9-15 and the presence of TBI on CT brain scan.

It appears that in children of all ages with blunt head trauma, raised levels of GFAP measured within six hours of injury is associated with traumatic intra-cranial lesions on brain CT.

Video Feature
Osteochondritis Dissecans (OCD)
Osteochondritis Dissecans (OCD)
Results of surgical management of Osteochondritis Dissecans (OCD) of the ankle in pediatric and adolescent patients

"OCD is a joint disorder in which cracks form in the articular cartilage and underlying subchondral bone", from blood deprivation (of unknown cause), trauma (or both) or other factors, causing pain, swelling and "locking" of the joint during movement etc. Diagnosis is usually confirmed by identifying the necrosis of subchondral bone, loose fragments (or both) on x-ray, CT scan or MRI. Treatment of choice (surgical or non-surgical) remains controversial as data on the operative management of OCD of the ankle in adolescents is non-extensive.

A retrospective chart review of 109 ankles in 100 patients (75 female, 25 male) mean age 14.3 years, surgically treated for OCD and followed for 3.3 years (median) indicates a high overall rate of reoperation (27%), though 82% of respondents appear satisfied with their outcomes and 84% return to sport.

Lung function in adult survivors of very low birth weight (VLBW) with and without bronchopulmonary dysplasia (BPD)

On lung function testing VLBW infants continue to have airway obstruction and air trapping as adults (25 years of age) particularly if they have previously had BPD.

Physicians' lack of adherence to pediatric lipid screening guidelines
"New NHLBI/AAP guidelines strongly recommend universal cholesterol screening between the ages of 9 and 11 and again between 17 and 21 years of age". Selective screening with a fasting lipid profile (FLP) is recommended for children >2 years of age with a positive history of lipid and cholesterol disorders and/or premature heart disease in close family members, and any child with a condition that increases his/her risk of
cardiovascular disease with or without a family history.
Records of 298 children who received well-child care at age 11 years were reviewed and patients were stratified by guideline-defined dyslipidemia risk.

Results indicate:
1.   Of children assigned to a high-risk subgroup only 50% receive lipid screening.
2.   Among screened children, a history of obesity and parental history of dyslipidemia are significantly associated with lipid testing.
Lipid screening rates are low for all children including those at high risk for dyslipidemia.
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