Supine percutaneous nephrolithotomy vs prone percutaneous nephrolithotomy in the treatment of pediatric kidney stones

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.

Prognostic scoring system for Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in children

A recent study suggests that a prognostic scoring system identified three high risk groups in children with statistically significant differences in survival curves based on the baseline characteristics that helped in risk prediction. The findings of this study were published in the journal, Pediatric Blood & Cancer.

This multicenter retrospective study included 264 children, aged 0-14 years who were diagnosed with Epstein-Barr virus (EBV)-associated hemophagocytic lymphohistiocytosis (EBV-HLH). The pediatric population was randomly divided into two groups: derivation (n=185) and verification (n=79). In order to establish a prognostic scoring system for death events, risk predictors were investigated using a Cox regression model during the follow-up period. Chronic active EBV infection (CAEBV) history, plasma EBV-DNA copy number, pulmonary infection hemorrhage of digestive tract, and hypoxemia prognostic scoring system (CEPHO-PSS) were developed which demarcated patients into low-risk (0-1 points), middle-risk (2-3 points), and high-risk (4-8 points) groups.

At the end of the study, the three risk groups showed survival curves with statistically significant differences. Receiver operating characteristic (ROC) and calibration curves in the derivation and verification cohorts, respectively, were used for internal and external verification of CEPHO-PSS, confirming good accuracy and applicability.

Thus, it can be concluded that the CEPHO-PSS may identify three risk groups in children with statistically significant differences in survival curves. This may help clinicians to check for risk prediction.

Maralixibat improves health-related quality of life in pediatric patients with Alagille Syndrome

A recent study demonstrated that the ileal bile acid transporter inhibitor maralixibat improves health-related quality of life (HRQoL) in children with Alagille syndrome. This study was published in The Journal of Pediatrics.

The ICONIC trial was a phase 2 study, having a 4-week double-blind, placebo-controlled, randomized drug withdrawal period. The study included 27 children having Alagille syndrome with moderate-to-severe pruritus. From baseline to week 48, the treatment response to maralixibat was noted using Itch-Reported Outcome (Observer) score. The HRQoL was assessed based on the certain scale scores that included Pediatric Quality of Life Inventory Generic Core, Family Impact, and Multidimensional Fatigue scale scores.

At week 48, twenty patients attained an Itch-Reported Outcome (Observer) treatment score response. The mean (SD) change in Multidimensional Fatigue score was higher was higher for responders over non-responders. The Pediatric Quality of Life Inventory Generic Core and Multidimensional Fatigue scores showed smaller and non-statistically significant point estimates.

Based on the results of the study, it can be concluded that maralixibat shows significant improvement in pruritis, thereby enhancing the quality of life in the affected children.

Sustained and moderating effects of a behavioural sleep intervention for autistic children

A recent study suggests that the Sleeping Sound intervention showed sustained improvements in child sleep among autistic children. The study’s findings were published in the Journal of Autism and Developmental Disorders.

This was a randomized controlled trial which included 150 autistic children aged 5-13 years, who had sleep problems. They were randomized either to the Sleeping Sound intervention or Treatment as Usual (TAU).

At the 12-month follow-up, the caregivers of the children reported a greater reduction in sleep problems in the Sleeping Sound group when compared to the TAU group. Those children who were taking sleep medication, children with greater autism severity, and children of parents who were not experiencing psychological distress showed greater long-term benefits with the intervention. Based on the above results, it can be concluded that Sleeping Sound intervention may show sustained improvements in child sleep.