Sex education and contraceptive use
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While there may be some conflicting reports, a recent study examining the association between receiving education on topics commonly included in sex education classes before age 18 years (e.g. abstinence, sexually transmitted diseases, HIV/AIDS, etc.) and contraceptive use in heterosexually active young males (15-20 years of age), indicates that the larger the number of sex education topics covered, the greater the likelihood of dual-partner contraceptive use.
Comprehensive sex education appears to be the most effective way of promoting safe sex among adolescents males.
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Bacterial osteomyelitis (BO) or non-bacterial osteitis (NBO) in children
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A prospective study evaluated 657 children (over a 5 years period) mostly diagnosed with BO or NBO to identify epidemiologic, clinical and radiological characteristics.
It appears that BO occurs in younger male patients, presents with fever, elevated inflammatory markers, local swelling and a shorter course of symptoms, compared to those children with NBO (females clinically well with pain and multifocal lesions).
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Inguinal orchidopexy/intra-abdominal testes and laparoscopic surgery
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Orchidopexy (orchiopexy) is surgery to move an undescended testes and permanently fix it in the scrotum. It is usually performed before 18 months of age. A study of 21 patients (mean age 21 months) with non-palpable intra-abdominal testes (NPIT) reviewed all ultra-sonographs; if the testes was not detected laparoscopic exploration was performed (if testes was found surgery continued through an inguinal incision). Follow-up occurred at 1 week and 1, 3 and 6 months.
It appears that while there is no perfect surgical technique without complications laparoscopic inguinal orchidopexy is a safe, reliable and successful surgical procedure for the management of NPIT and should be preferred to a technique that requires vascular division with a greater likelihood of testicular atrophy.
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Risk factors for pulmonary hypertension in children/young adults
It appears that in addition to Idiopathic, chromosomal/genetic disorders, congenital heart defects, congenital diaphragmatic hernia and acute and chronic pulmonary connective tissue disease or sickle cell anemia etc., a Swedish review (402 maternal and infant data) indicates that children and young adults born preterm (pathogenesis unclear) are at increased risk of developing pulmonary hypertension.
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Mode of delivery and risk of Celiac Disease (CD)
A study group evaluated infants (431) genetically predisposed to developing Celiac Disease (at least one first-degree relative affected with CD) and mode of delivery. All had human leukocyte antigen genotyping at 15 months of age, CD serologic screening at 15, 24, 36 months and at 5, 8, 10 years of age. Serologically positive patients underwent intestinal biopsy.
Mode of delivery in children genetically predisposed to
Coeliac Disease DOES NOT appear to influence the risk of developing CD.
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Information needs and preferences of parents considering treatment of child anxiety
Childhood anxiety disorders are not only common but also cause severe childhood impairment (failure at school, social and family dysfunction) and distress. Typically starting early in childhood they follow a fluctuating, chronic course into adulthood. Children born to anxious parents are more likely to be anxious (genetic and environmental factors involved).
To optimize management of children with anxiety states, a group of 93 parents were recruited to identify their preferences for sources/amounts of information needed and decision-making involvement.
It appears that parents prefer evidence/best available written information regarding childhood anxiety states (not usually available in most outpatient/office clinics); that internet sources would be welcomed (particularly regarding psychosocial and medication treatments) and a collaborative decision-making model of care would be preferred.
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Video Feature
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| Pediatric Anxiety Disorders |
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Sacral nerve stimulation (SNS)/antegrade continuous enemas (ACE) for severe childhood constipation
SNS involves implantation of a subcutaneous stimulator which delivers low amplitude electrical stimulation via the sacral nerve (accessed via S3 foramen) which modulates the nerves and muscles of the pelvic floor. It has been used in children with severe constipation after failed conservative treatment.
ACE (through a cecostomy/appendicostomy tube) may be used with significant benefit in children with severe fecal incontinence, severe constipation resistant to laxatives or enemas and in children with spinal cord problems.
A prospective study of 22 patients (median age 12 years) which evaluated the efficacy of SNS in children with constipation treated with ACE indicates that SNS significantly improves ACE usage with many children being able to have their ACE access closed within 2 years.
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The Blood and Marrow Transplant Program at
Nicklaus Children's Hospital's Cancer Center has successfully transplanted bone marrow from a mother who is only a half match donor to her young daughter utilizing a technique that requires specialized doses of chemotherapy prior to and after the transplant. Nicklaus Children's is one of the few pediatric programs to offer the technique.
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