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Introduction Pigtail catheter (PGC) insertion due to spontaneous pneumothorax (SPT) in the pediatric population has increased markedly in the last years. However, only few studies examined its efficacy in terms of length of hospitalization, rate of complications, and especially pain management comparing to large bore catheter (LBC) insertion. We sought to compare analgetic drug consumption, efficacy, and complication rate between PGC and LBC in children with SPT. Materials and Methods This is a single-center retrospective study of pediatric patients that were admitted to the Schneider Children's Medical Center between 2013 and 2021 with a diagnosis of SPT. The following data were collected: type of drainage (PGC or LBC), duration of drainage, length of hospitalization, number of X-rays, complication rate, surgery during hospitalization, readmission due to SPT, and pain management. Results Seventeen PGC and 23 LBC were inserted in our study. No differences were noted in terms of hospitalization length, tube reposition or replacement, and recurrence of SPT between the groups. Patients with PGC underwent less X-rays comparing to the LBC group (3 X-rays vs. 5, median, p < 0.005). Oral analgesic use in terms of length of therapy was significantly lower in the PGC group than in the LBC group (1 vs. 3+ days, median, p < 0.05). There was no major complication in this cohort. Conclusion PGC is an effective, safe, and less painful alternative compared with a LBC for the drainage of SPT in children. [ABSTRACT FROM AUTHOR]

Introduction: Correct diagnosis of acute appendicitis may sometimes be challenging. The Negative appendectomy rate (NAR) has declined in the recent years in Europe and USA, in part due to better diagnostic imaging tools. The aim of this study was to examine the rates of negative appendectomy in our institution, investigate trends in its incidence, and identify possible predicting factors. Methods: A retrospective cohort study, including all patients younger than 18 years of age who underwent an appendectomy between 2007 and 2021 in a single tertiary medical center. Data regarding patient's demographics, laboratory and imaging results, pathological results and clinical outcome were collected. Results: Between 2007 and 2021, a total of 3937 pediatric patients underwent appendectomy due to a working diagnosis of acute appendicitis. Overall, 143 patients (3.6%) had normal appendix on pathological examination. However, in the last 5 years, the rate of normal appendix was 1.9%, together with an increased rate of pre‐operative imaging (from 40% to nearly 100%). Conclusion: Low NAR under 2% is an achievable benchmark in the era of accessible pre‐operative imaging. In unequivocal cases, a secondary survey that includes repeated physical examination, blood work and imaging is recommended and may result in near‐zero rates of NAR. [ABSTRACT FROM AUTHOR]

We depict an uncommon presentation of rubber toy ingestion which remained impacted in the esophagus for months, gradually eroding the mucosa, and ultimately causing a traumatic acquired tracheoesophageal fistula., (© 2024 Wiley Periodicals LLC.)

Background: ChatGPT has demonstrated notable capabilities and has gained popularity in various medical tasks, including patient education. This study evaluates the content and readability of ChatGPT's responses to parents' questions about congenital anomalies., Methods: Information on four congenital anomalies (congenital diaphragmatic hernia, esophageal atresia and tracheoesophageal fistula, anorectal malformation, and gastroschisis) was assessed. Seven questions frequently asked by parents were posed for each anomaly, and responses generated by GPT-4 were compared to online information sheets from three top pediatric medical centers. Two senior pediatric surgeons, blinded to the source, evaluated the answers based on accuracy, comprehensiveness, and conciseness. Reading time and readability of the answers were also assessed., Results: ChatGPT answered all 28 questions, while online information sheets varied in completeness. ChatGPT's responses were rated significantly higher regarding full accuracy, comprehensiveness, and conciseness compared to the online information sheets (p < 0.00001, <0.00001, 0.0002, respectively). Despite having longer reading times and more challenging to read, ChatGPT's responses were more precise and detailed., Conclusions: ChatGPT outperforms online information sheets in providing accurate, comprehensive, and concise answers about congenital anomalies. This positions ChatGPT as a beneficial supplementary resource in pediatric healthcare. Future research should explore real-world applications and usability among parents., Level of Evidence: Level III., Competing Interests: Conflict of interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Historically, neuroblastoma has been diagnosed by surgical open biopsy (SB). In recent decades, core needle biopsy (CNB) has replaced surgical biopsy due to its safe and adequate method of obtaining tissue diagnosis., Aim: Our study aimed to assess the effectiveness of CNB in obtaining tissue diagnosis for neuroblastoma and evaluate its safety profile in terms of post-operative complications, in comparison to SB., Methods: A retrospective cohort study, including all patients younger than 18 years who were diagnosed with neuroblastoma from 2012 until 2022 in a single tertiary medical center. Patients' demographics, tumor size and location, pathological results, and clinical outcomes were collected., Results: 79 patients were included in our study: 35 biopsies were obtained using image-guided CNB and 44 using SB. Patients' and tumor characteristics including age, gender, tumor volume, and stage were similar in both groups. The biopsy adequacy rate in the CNB group was 91% and 3 patients in this group underwent repeated biopsy. The safety profile in the CNB group was similar to the SB group., Conclusions: CNB is a safe method and should be considered the first choice for obtaining tissue diagnosis when feasible due to its high adequacy in terms of tumor histopathological features., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)