A recent study titled “Antimicrobial Resistance and Urinary Tract Infection Recurrence” sought to further investigate the relationship of antibiotic use and antibiotic resistance among children with vesicoureteral reflux. The paper, published in Pediatrics by the American Academy of Pediatrics (AAP), shows that although resistance was more common among children on antibiotic prophylaxis, antibiotic resistance decreased the longer the children stayed on prophylaxis.
This surprising finding suggests that children who require extended prophylaxis may not be at as high a risk of resistant infection as commonly thought.
It’s estimated that one in three children with recurrent urinary tract infections have vesicoureteral reflux (VUR), a urological condition where urine flows backwards from the bladder to the kidney.
Though the condition’s management has evolved, the question of which treatment is the preferred one — and specifically, whether urologists should continue to turn to endoscopic injections of dextranomer/hyaluronic acid copolymer (Dx/HA, aka Deflux) — remains a source of debate.
With over 75 percent of children diagnosed with cancer surviving into adulthood, more and more parents ask questions about the quality of life survivors can expect in the future, including: Will my child be able to have children down the road?
They’re right to be concerned. The therapies that are so effective at saving children’s lives can themselves cause a host of problems that don’t manifest until years later. These late effects of cancer treatment include particularly harsh impacts on fertility.
“Cancer treatment impairs ovarian function by reducing the number of eggs in them,” says Elizabeth Ginsburg, MD, a fertility specialist at Brigham and Women’s Hospital who collaborates with Lisa Diller, MD, the chief medical officer of Dana-Farber/Boston Children’s Cancer and Blood Disorders Center. “It’s as though it pushes the ovaries further down the age curve. So while a woman who has survived childhood cancer may be 20 years old, her ovaries act like they’re 35 or 40.”
Boys are not exempt from these concerns. “Boys are at the same relative risk for infertility due to treatment,” says Richard Yu, MD, PhD, who works on male infertility in the Boston Children’s Department of Urology. “The same chemotherapy and radiation treatments that affect the ovaries can also wipe out the sperm stem cells in the testes.” …Read More
Robotic assisted laparoscopic partial nephrectomy can be safely and effectively performed in pediatric patients for renal tumors while preserving renal function. Classically, cases such as the two described below have been managed with an open, invasive approach or by radical nephrectomy. These two cases, cared for in collaboration with specialists from Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, demonstrate the effectiveness of renal preservation using robotic assisted laparoscopic surgery applied for renal masses in two different pediatric patients. …Read More