JPGN Journal Club: April 2024

JPGN Journal Club is again here for you! No, no point in all that applause, although we’re grateful: Remember, we can’t hear it. As always, we’re glad to be back and we hope that you’re glad to have us back. Dr Jake Mann has chosen for today from Aliment Pharmacol Ther, by Ricciuto et al., Oral vancomycin is associated with improved inflammatory bowel disease clinical outcomes in primary sclerosing cholangitis-associated inflammatory bowel disease (PSC-IBD) :  A matched analysis from the Paediatric PSC Consortium.  And the consortium? Centres, 54 ; PSC patients, 1,362 ; PSC-IBD patients, 1061 ; PSC patients studied, 113. In matched cohorts, vancomycin recipients’ endoscopic and clinical-biochemistry indices of IBD improved substantially over control; no mention of how “liver numbers” responded. Fewer bacteria, less inflammation: Seems reasonable enough.   Closer to ESPGHAN home is Jake’s next selection – from J Pediatr Gastroenterol Nutr – Lacaille et al., Awareness, referral and age at Kasai surgery for biliary atresia in Europe :  A survey of the Quality‐of‐Care Task Force of ESPGHAN.  Between 2015 and 2019, what referral patterns did 26 European hepatology centres see for 785 children with extrahepatic biliary atresia (EHBA)? Detection of jaundice by age 2wk to 3wk, with referral, is the goal – the reality, 55d (8wk ! ), hepatic portoenterostomy at age 61d, just past the 60d end of the period during which one can reasonably hope for good results.  Education campaigns thus far seem ineffective.  How to improve them? Also surveyed, 392 French paediatricians, a 20% response rate: Has introduction of stool-colour cards changed your handling of infantile cholestasis? Do you use the cards, do you feel that you understand cholestasis in infants? The faintly bilious answers, perhaps tinged with Gallic scepticism: Possibly ; Yes ; and . . . Frankly, no.  Too early to say if referral in France, and portoenterostomy results, will improve – card distribution, était-il battre l’eau avec un baton?

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