Quick Literature Updates Ep 26

Hello pediatric surgery family, I'm Em Gdy from Cincinnati Children's Hospital Medical Center, and today our team is gonna deliver the articles that you should know about. We have 3 papers today, but don't have much time, so let's start. Our first paper titled Appendicectomy versus Antibiotics for Acute uncomplicated Appendicitis in Children, an Open label International multi-enter randomized non-inferiority trial by Saint Peter et al. This paper is summarized by Lizzie Lee, a physician associate by profession and a member of our team here at Cincinnati Children's dedicated to creating content for pediatric surgery. Recent literature has been supporting treating appendicitis with antibiotics rather than surgery. This is a multi-center randomized trial in Canada, the US, Finland, Sweden, and Singapore that investigated whether antibiotic treatment is inferior to appendicectomy by comparing failure rates for the two options. They found that 34% of children treated with Antibiotics eventually required surgery within a year compared to only 7% in the surgery group. While there were no deaths in either group, children in the antibiotic group had a higher risk of mild to moderate adverse events. The key takeaway is that antibiotics were not as effective as surgery for treating non-perforated appendicitis in children, as it did not meet the threshold for non-inferiority. Our second paper is Vactal screening in newborns with anorectal malformations, an opportunity to optimize screening practices at gynecologic and spinal conditions and utilize a new acronym by SH et al. And this paper is summarized by Alex Halpern. He is a research fellow at Children's National and collaborates with us to produce these article reviews. To try and answer this question, Zoo Aal used the PIS database and performed a multi-institutional cohort study of all ARM patients between 2016 and 2022. The rates of actual diagnoses across all hospital encounters were 45.4% vertebral spinal, 77.4% cardiac, 10.2% TEF, 39, 0.9% renal and 15.7% limb. 25.8% of female patients had a congenital gynecologic malformation diagnosed. So it seems like the most common anomalies associated with ARMs are cardiac, vertebrospinal, renal, and gynecologic. Due to this, the authors suggest changing the Vacto acronym to Vector Gs. Let's move to the last paper of the day. International Consensus Criteria for Pediatric sepsis and septic Shock by Schlappbach et al. This paper is summarized by Cecilia Jhena. She's one of the previous research fellows at Cincinnati Children's Hospital. This is a worldwide study with a Delphi consensus process that aimed to update the definitions of sepsis and septic shock. After multiple analysis, they came up with a Phoenix sepsis score that included variables in cardiovascular function, respiratory function, coagulation, and neurological function. This helped the author correlates the definition with an actual mortality rate. So for sepsis, the definition is suspected infection plus 2 points in the Phoenix sepsis score, and septic shock is sepsis plus cardiovascular dysfunction that is seen when we have 1 point in the cardiovascular variable of the Phoenix sepsis score. Sepsis mental mortality of 7.1%, whereas septic shock imply 10.8 to 33.5% according to the research settings. Thank you for listening. Please check the link in the description below to read each paper. We hope you liked this episode. Please follow Stay Current MD on social media. Give us a rating, and subscribe to our YouTube channel. And don't forget to download the Stay Current app on the App Store or Play Store for tons of content.