A recent study has shown that lubiprostone is effective and has good tolerability as a pharmacotherapy for children and adolescents, offering a potential shift in the treatment approach for pediatric functional constipation (FC). This study’s findings were published in the Journal of Pediatric Gastroenterology and Nutrition.

This single-blinded, randomized controlled trial included 280 patients (aged 8-18 years) with FC. These patients were randomly assigned to receive either a weight-based lubiprostone dose (n = 140) or conventional laxatives (n = 140), which included bisacodyl, lactulose, or sodium picosulfate, for a duration of 12 weeks. Subsequently, a 4-week posttreatment follow-up was carried out.

The lubiprostone group demonstrated an improvement in constipation in 91.4% (128 patients) when compared to 34.3% (48 patients) in the conventional therapy group and persisted even after treatment discontinuation. Additionally, within 48 hours of starting the medication, one quarter of the lubiprostone group experienced their first spontaneous bowel movement. Throughout the last 4 weeks of therapy and the subsequent 4 weeks of follow-up, 75.7% of the lubiprostone group maintained a Bristol stool form of 3 or 4 compared to 35.7% (50 patients) in the conventional therapy group. No life-threatening adverse drug reactions were reported, and no patients discontinued treatment due to adverse effects.

Thus, it can be concluded that lubiprostone may be a well-tolerated and effective pharmacotherapy for children and adolescents, presenting a promising alternative in the management of pediatric functional constipation (FC).

A recent study demonstrated that the combination of lung ultrasound (LUS) and procalcitonin (PCT) proved to be a safe approach for treating bacterial pneumonia (BP), as it avoided the use of radiation and did not result in any additional costs. This study’s findings were published in the European Journal of Medical Research.

In this blinded, randomized clinical trial, a total of 194 children under the age of 18 with suspected bacterial pneumonia (BP) were enrolled. Among them, 96 children were randomly assigned to the experimental group (EG) and 98 children to the control group (CG). The randomization was based on whether lung ultrasound (LUS) or chest X-ray (CXR) was performed as the initial imaging test. The patients were then classified into three groups: 1) those with LUS/CXR results not suggestive of BP and PCT levels below 1 ng/mL, for whom no antibiotics were recommended; 2) those with LUS/CXR results suggestive of BP, inspite of the PCT value, for whom antibiotics were recommended; and 3) those with LUS/CXR results not suggestive of BP but with PCT levels above 1 ng/mL, for whom antibiotics were also recommended.

Out of the 194 patients, the image test did not suggest the presence of BP in 75 individuals with a PCT level below 1 ng/ml. 29/52 in the experimental group and 11/23 in the control group did not receive antibiotics. The image test indicated the presence of BP in 101 patients. 34/34 patients in the experimental group and 57/67 patients in the control group were prescribed antibiotics. Notably, there were statistically significant differences between the groups when the PCT level was below 1 ng/ml (p = 0.01). In 18 patients, the image test did not suggest BP, but their PCT level was above 1 ng/ml, and all of them were administered antibiotics. Additionally, a total of 0.035 mSv radiation per patient was avoided, and there was a 77% reduction in CXR per patient. The use of LUS did not result in a significant increase in costs.

Thus, it can be concluded that the utilization of LUS in conjunction with PCT was demonstrated to be a reliable strategy in the treatment of BP, without the necessity of radiation exposure or incurring additional costs.

A recent study showed that dexmedetomidine, either on its own or combined with magnesium sulfate (MgSO4), played a therapeutic role in preventing junctional ectopic tachycardia (JET) in pediatric patients following congenital heart surgery. This study’s findings were published in the Paediatric Anaesthesia journal.

A total of 120 children under the age of 5, who were scheduled for corrective acyanotic cardiac surgeries, were randomly divided into three groups. The first group, Group MD (Dexmedetomidine-MgSO4 group), received dexmedetomidine 0.5 μg/kg intravenously over a period of 20 minutes after induction. This was followed by an infusion of 0.5 μg/kg/h for 72 hours, along with a 50 mg/kg bolus of MgSO4 upon aortic cross-clamp release. The administration of MgSO4 continued for 72 hours postoperatively at a dose of 30 mg/kg/day. The second group, Group D (the dexmedetomidine group), received the same dexmedetomidine as the MD group, but instead of MgSO4, they were given normal saline. The third group, Group C (control group), received normal saline instead of dexmedetomidine and MgSO4. The primary outcome of the study was the incidence of JET, while the secondary outcomes included monitoring hemodynamic parameters, extubation time, ionized Mg levels, vasoactive-inotropic score, duration of stay in the post-cardiac care unit (PCCU) and hospital, as well as perioperative complications.

Group MD and Group D demonstrated a significant reduction in the incidence of JET when compared to Group C. During rewarming and in the ICU, Group MD exhibited significantly higher levels of ionized Mg compared to Groups D and C. Throughout the surgery and in the ICU, Group MD displayed a better hemodynamic profile in comparison to Group D and Group C. The predictive indexes were significantly more favorable in Group MD than in Groups D and C including factors such as extubation time, PCCU, and hospital stay.

The above study demonstrated that dexmedetomidine, whether administered alone or in conjunction with MgSO4, demonstrated efficacy in preventing JET in pediatric patients who underwent congenital heart surgery.

According to a recent study, supine percutaneous nephrolithotomy (PCNL) is a safe and effective method for treating pediatric kidney stones, with fewer postoperative complications observed. Additionally, the operation time and hospital stay were shorter in supine PCNL when compared to prone PCNL. This study’s findings were published in the Urolithiasis journal.

This randomized study included patients with lower pole stones larger than 1 cm, stones larger than 1.5 cm in the pelvis, midpole, upper pole, or multiple locations, and those who did not respond to ESWL or whose family preferred mini-PCNL as the primary treatment. A total of 144 patients underwent PCNL (68 patients had supine PCNL and 76 had prone PCNL).

After surgery, Clavien grade 1 complications occurred in seven patients in the prone position, while only one patient experienced such a complication in the supine position. The mean duration of the prone PCNL procedure was 119.88 ± 28.32 minutes, whereas the mean duration for supine PCNL was 98.12 ± 14.97 minutes. In terms of hospitalization, patients who underwent prone PCNL stayed for an average of 3.56 ± 1.12 days, while those who had supine PCNL stayed for an average of 3.00 ± 0.85 days.

From the above study, it can be concluded that supine PCNL is a safe and effective method, presenting fewer postoperative complications, a shorter operation time, and a shorter hospitalization period when compared to prone PCNL.