Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials.

Objective: Tinea capitis, a common pediatric infection in the United States, is caused mainly by Trichophyton species and affects many urban children. Although the current treatment of choice is oral griseofulvin, terbinafine has been shown to be variably effective in several comparative, randomized trials. The purpose of this study was to perform a meta-analysis of randomized, clinical trials comparing the efficacies of oral terbinafine and oral griseofulvin for the treatment of childhood tinea capitis.

Superstition and post-tonsillectomy hemorrhage.

Objectives/hypothesis: The objective was to determine whether post-tonsillectomy hemorrhages occur more frequently in redheaded children, in patterns of threes, on Friday-the-13th days, or with the full moon.

Study Design: Case-control analysis.

Methods: The authors performed multiple statistical analyses of all children undergoing tonsillectomy at Temple University Children's Medical Center (Philadelphia, PA) during a 29-month period.

Occult contralateral congenital cholesteatoma: is the epidermoid formation theory enough?

Bilateral congenital cholesteatomas are rare entities. Nine cases have been previously described in the literature. Many different etiologies for the development of congenital cholesteatoma have been proposed.

Pseudoaneurysms of the superficial temporal artery: treatment options.

Objectives: Pseudoaneurysms of the superficial temporal artery present as slowly growing masses of the face or scalp. They may arise as a result of infection or autoimmune disease but most commonly are sequelae of blunt, penetrating, or surgical trauma. We describe their clinical presentation and differential diagnosis and compare several treatment options.

Laparoscopic appendectomy in children can be done as a fast-track or same-day surgery.

Background: Laparoscopic surgery has reduced the length of hospital stay for common operations like cholecystectomy, gastric fundoplication, and appendectomy. We have noticed a reduction in length of hospital stay for children undergoing laparoscopic appendectomy. We, therefore, looked at our data to assess whether laparoscopic appendectomy in children could be performed as fast-track or same-day surgery (< or = 24-hour postoperative stay).

Worldwide distribution of Waardenburg syndrome.

To clarify the multiracial occurrence of Waardenburg syndrome, we present a case series and literature review. A computerized review of the English-language literature was conducted to assess the distribution of reported occurrences of Waardenburg syndrome in populations around the world. We detail the clinical features of 2 family cohorts: one of Western European origin and the other from South Asia.

Two-stage removal of an impacted foreign body with an epoxied anchor.

A stone impacted in a child's external auditory canal had defied all conventional means of removal. It was extracted successfully after attachment of a specially formed metal anchor with epoxy glue. The technique of and rationale for this approach are discussed.

Metastatic intracranial abscesses of bronchopulmonary origin.

Intracranialabscesses are serious, life-threatening infections despite recent advances in diagnosis and treatment. We report the case of a child with metastatic brain abscesses and a chronic, sharp foreign body of the bronchus. Its presentation and endoscopic appearance and the microbiology of the abscesses are detailed.

Glandular hypospadias repair.

Glandular hypospadias represents approximately 15% of the hypospadias variants seen. This article will examine common surgical approaches applicable to the child with glandular hypospadias. Hypospadias repairs discussed in this article will include urethromeatoplasty, MAGPI, the GAP procedure, MIV glans plasty, urethral advancement procedure, and parameatal based flap variants, including the Mathieu and Barcat procedures.

Anesthesia in a child with Rett syndrome: a case report and literature review.

Rett syndrome is an increasingly diagnosed syndrome in young children who appear normal at birth and develop normally until 6 to 18 months of age, when developmental milestones fail to be reached. The syndrome appears only in girls and therefore it is thought to be an X-linked dominant trait that is lethal in the male. This is a case report and literature review of anesthesia in a child with Rett syndrome.

C-reactive protein in febrile children 1 to 36 months of age with clinically undetectable serious bacterial infection.

Objective: To determine the diagnostic properties of quantitative C-reactive protein (CRP) associated with clinically undetectable serious bacterial infection (SBI) in febrile children 1 to 36 months of age.

Methods: Febrile children presenting to a pediatric emergency department (ED) with ages ranging from 1 to 36 months, temperatures > or =39 degrees C, and clinically undetectable source of fever were enrolled in this prospective cohort study. Demographic information, ED temperature, duration of fever, and clinical evaluation using the Yale observation scale were recorded at the time of the initial evaluation.

Isolated intrathoracic presentation of Mycobacterium avium complex in an immunocompetent child.

Mycobacterium avium complex (MAC) is a rare cause of isolated intrathoracic disease in the immunocompetent child; delays in diagnosis and treatment are common. The current case is an 11-month-old girl with symptoms, signs, and radiographic findings of bronchial obstruction. Comparison of this case to the literature revealed that there is a characteristic presentation of intrathoracic MAC infection in immunocompetent children (children aged 3 years or less, without exposure to Mycobacterium tuberculosis, presenting with clinical and radiographic evidence of bronchial obstruction) that should increase our index of suspicion for this diagnosis.

Universal newborn hearing screening in an inner-city, managed care environment.

Objectives/hypothesis: Universal neonatal hearing screening (UNHS) programs aim to identify and treat educationally significant hearing loss in the first months of life. Several states have mandated UNHS for all newborns. Such programs have been successful in small, homogeneous populations.

Evaluation of physical abuse in children.

Family physicians who are involved in the care of children are likely to encounter child abuse and should be able to recognize its common presentations. A history that is inconsistent with the patient's injuries is the hallmark of physical abuse. A pattern of physical findings, including bruises and fractures in areas unlikely to be accidentally injured, patterned bruises from objects, and circumferential burns or bruises in children not yet mobile, should be viewed as suspicious for child abuse.

First branchial cleft cyst excision with electrophysiological facial nerve localization.

Objective: To assess the safety and efficacy of surgical excision of selected first branchial cleft cysts using electrophysiological rather than anatomical location of the facial nerve.

Design: Retrospective review of consecutive surgical procedures by a single surgeon, using a consistent technique during a 9-year period.

Setting: Tertiary pediatric medical center.

Adenoidectomy with laser or incisional myringotomy for otitis media with effusion.

Objective: To compare the effectiveness of CO2 laser myringotomy to incisional myringotomy at the time of adenoidectomy for refractory otitis media with effusion (OME).

Study Design: Controlled retrospective consecutive case series.

Methods: All children undergoing myringotomy and adenoidectomy for OME in the spring of 1999 had 1.

Prospective application of a protocol for selective nonsurgical management of suspected orbital subperiosteal abscesses in children.

Goodwin et al (1982) and Souliere et al (1990) have proposed a protocol for the selective nonsurgical management of suspected orbital subperiosteal abscesses. This protocol has been routinely applied by the Temple Pediatric Otolaryngology and Ophthalmology services since 1990. During this period, children with computed tomography and physical examination findings consistent with orbital subperiosteal abscesses and visual acuity better than 20/60 were treated with intravenous antibiotics rather than immediate surgery.

Pediatric tonsillectomy with bipolar electrosurgical scissors.

Purpose: The optimal technique for pediatric tonsillectomy remains a hotly debated topic. The speed and superior hemostatic properties of electrosurgical dissection must be weighed against the greater tissue preservation and more rapid healing of cold dissection techniques.

Materials And Methods: We have used a new surgical device, bipolar electrosurgical scissors, in 30 consecutive pediatric tonsillectomies.

Electrosurgery in the head and neck.

Electrosurgery is widely used in the practice of otolaryngology-head and neck surgery. Despite its popularity, few training programs give formal education in the optimal use of electrosurgical instruments. This article reviews the history, physics, and tissue effects of these commonly used devices.