Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

Purpose: Gastrostomy granulomas frequently occur in pediatric patients with gastrostomy tubes, yet there is a notable lack of comprehensive data on the efficacy and safety of various treatment modalities. Commonly used treatments, such as silver nitrate, are often painful and require frequent clinic visits, posing challenges for patients and families. Additionally, research on home-based treatments is limited, despite their potential to offer more convenient and less painful alternatives. This study addresses the need for well-designed comparisons of different treatment options. Methods: We conducted a prospective, open-label study at the Children’s Hospital of San Antonio, enrolling 36 pediatric patients aged 6 months to 17 years with gastrostomy tubes.Patients were randomized into two groups: one treated with topical silver nitrate and the other with table salt, excluding those on chemotherapy or with immunologic disorders.Granuloma sizes were measured at the study’s start with blinded physicians analyzing photographs to assess size reduction, and parent satisfaction surveys were conducted to evaluate treatment acceptability and side effects. Results: The median reduction in granuloma size was significantly greater in the table salt group (3.12 mm) compared to the silver nitrate group (2.25 mm) (Wilcoxon p-value=0.04).Parental satisfaction and confidence were high in both groups, with minor, self-limited skin irritation reported as a side effect. Conclusion The study suggests that table salt could be a feasible, non-inferior, and costeffective alternative to silver nitrate for treating gastrostomy granulomas in pediatric patients. Further research with a larger sample size is necessary to validate these findings.

OBJECTIVE: To describe the demographic and clinical characteristics of patients with glaucoma managed at private and government institutions in the Philippines between 2009 and 2014.

METHODS: A research team from two private and two government institutions in the Philippines reviewed the case records of 1246 patients seen who met the following criteria: intraocular pressure of >21 mmHg, optic nerve and nerve fiber layer abnormalities, and visual field defects. For bilateral cases, we selected the eye with worse glaucoma parameters.

RESULTS: There were 600 and 646 patients in the private and government groups (mean age at presentation, 60.51 and 55.88 years), respectively, with the majority being Filipino (91%). Patients with visual acuity (VA) of 20/20 to 20/40 were more frequently observed in private centers (58.7% vs. 41.3%), while a VA worse than counting fingers was more frequently observed in government centers (66.1% vs. 33.9%). Within-group analysis showed that primary angle-closure glaucoma was the most frequent glaucoma subtype in both private (27.3%) and government institutions (37.8%). In between-group analysis showed the following to be more common in private than government centers: primary open-angle glaucoma (61.3% vs. 38.7%), normal-tension glaucoma (63.9% vs. 36.1%), ocular hypertension (92.3% vs. 7.7%), and glaucoma suspects (80.4% vs. 19.6%) while government institutions registered a larger number of primary angle-closure glaucoma (59.8% vs. 40.2%) and secondary glaucoma (70.3% vs. 29.7%) cases. Medical treatment using a single drug and multiple drugs was employed for 245 (23%) and 825 (77%) patients, respectively. Within-group analysis showed that laser iridotomy and trabeculectomy were the most commonly performed laser and surgical procedures in both institution types.

CONCLUSION: There is a contrasting profile of glaucoma between clinical institutions in the Philippines with openangle glaucoma being more predominant in private centers while closed-angle glaucoma and secondary glaucoma being more frequent in government centers. Our findings may provide important preliminary information that can aid future health studies or training programs.

The recognition of epileptic seizures in newborns is challenging as neonates exhibit a variety of paroxysmal motor phenomena, some epileptic but others not. The distinction, frequently requiring video-EEG monitoring, is crucial for management. Causes are often multi-factorial, specific to country/region, and change over time. Hypoxia-ischemia and infection are still common in both developed and developing countries. Venous and arterial strokes are being increasingly recognized. Treatable conditions, including inborn errors of metabolism, must be anticipated and considered early in the course. Etiology is the principal determinant of outcome. Management is based on uncontrolled studies and expert opinions. Information on neonatal seizures is reviewed, and suggestions for management provided. Phenobarbital remains the first anti-epileptic drug of choice, worldwide. Pharmacogenetic information and hepatic or renal dysfunction will influence doses of all drugs. The toxicity of excipients present in intravenous medicines should be kept in mind, especially when infusions are given to critically ill neonates. Therapeutic trials with pyridoxine or ideally pyridoxal phosphate, folinic acid and biotin should be considered early, if seizures are intractable. The management of electrographic seizures without clinical seizures needs critical study. When anti-epileptic drug treatment is required, maintenance should be for a short duration if seizures are of an acute symptomatic nature.
Anticonvulsants ; therapeutic use ; Diagnosis, Differential ; Electroencephalography ; Humans ; Infant, Newborn ; Seizures ; diagnosis ; drug therapy ; etiology

Brain Stem ; physiology ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; etiology ; Movement Disorders ; etiology ; Myoclonus ; etiology ; Reflex, Abnormal ; Reflex, Startle ; Tremor ; etiology

No abstract available.
Erythrocytes*

No abstract available.
Erythrocytes*