Effects of Timing to Diagnosis and Appendectomy in Pediatric Appendicitis.

Objectives: Prospectively follow pediatric appendicitis patients to assess outcomes and rates of appendiceal perforations relative to duration of symptomatology and appendectomy timing.

Methods: Data were collected on the duration of symptomatology to diagnosis and from diagnosis to appendectomy. Symptomatology duration was evaluated in 24-hour increments, and diagnosis to appendectomy was evaluated in 3-hour intervals.

The Frequency of Postreduction Interventions After Successful Enema Reduction of Intussusception.

Objectives: The objective was to determine the frequency of postreduction, hospital-level interventions among children with successful reduction of ileocolic intussusception and identify factors that predict the need for such interventions.

Methods: This was a retrospective cross-sectional study of children who underwent successful enema reduction for ileocolic intussusception at a single emergency department. Hospital-level interventions were included if they occurred within 24 hours of reduction and were further classified as either major (recurrence or possible perforation) or minor (imaging for suspected recurrence or administration of parenteral narcotics or antiemetics).

Intussusception: clinical presentations and imaging characteristics.

Objective: The objectives of this study were to determine the prevalence of clinical findings associated with intussusception based on age and to evaluate the test characteristics of the presence of air in the ascending colon on abdominal radiographs and the effectiveness of ultrasound in diagnosing intussusception.

Methods: This was a retrospective cohort study via chart review at a tertiary care center from January 2002 to December 2008. All children, aged 0 to 17 years, were identified with intussusception by International Classification of Diseases, Ninth Revision diagnostic coding.

Management of the child after enema-reduced intussusception: hospital or home?

Background: Standard practice has been to admit children for an observation period after enema-reduced intussusception. However, the utility of such routine practice has not been clearly justified.

Study Objectives: The main objective was to determine the rate and timing of recurrent intussusception after successful enema reduction and describe any associated complications.

Using appendicitis scores in the pediatric ED.

Study Objective: The aims of the study were to prospectively evaluate the Alvarado and Samuel (pediatric appendicitis score [PAS]) appendicitis scoring systems in children and determine performance based on sex.

Methods: Children with abdominal pain concerning for appendicitis were recruited. Nine parameters evaluated by the scores were documented before imaging/surgery consultation.

Brain oxygen utilization is unchanged by hypoglycemia in normal humans: lactate, alanine, and leucine uptake are not sufficient to offset energy deficit.

During hypoglycemia, substrates other than glucose have been suggested to serve as alternate neural fuels. We evaluated brain uptake of endogenously produced lactate, alanine, and leucine at euglycemia and during insulin-induced hypoglycemia in 17 normal subjects. Cross-brain arteriovenous differences for plasma glucose, lactate, alanine, leucine, and oxygen content were quantitated.