This is a detailed description of the use of the physical and chemical properties of Coca-cola to remove oesophageal obstruction. The authors are careful to discuss issues of patient safety but suggest this technique for use in particular circumstances.

Oesophageal food impaction in achalasia treated with Coca-Cola and nifedipine

In this case report the authors describe the endovascular approach to a tibial artery aneurysm in a young patient. Aneurysms are unusual in this age group and this less invasive approach is a useful alternative to the standard surgical technique.

True posterior tibial artery aneurysm in a young patient: surgical or endovascular treatment?

The American Academy of Pediatrics’ journal ‘Pediatrics’ has made public its New Year’s resolutions in an editorial called “The Next Generation of Pediatrics”.

First LR, Moyer VA, Puskarz J. The Next Generation of Pediatrics. PEDIATRICS. 2010 1;125(1):193-194.

In it they announce the relaunch of case reports with some excellent selection criteria namely reports that:

“(1) challenge an existing clinical or pathophysiological paradigm; (2) provide a starting point for novel hypothesis-testing, clinical research; and/or (3) offer a clinical “lesson” that may allow pediatric colleagues to provide improved care.”

Dr Jeffrey Malatack, associate editor, will direct the online case report collection after their 1 year “sabbatical” from the journal.

This is encouraging news for those of us who believe that case reports are a valuable source of early evidence and education.

What value is there in broader, more comprehensive collections of case reports BMJ Case Reports? Often challenging cases can span disciplines or, especially in diseases familiar to paediatricians, present at different ages such as in adulthood.

We look forward to more publications and increasing enthusiasm for Case Reports.

“A British six-year-old boy has become the first person in the world to have a heart valve widened using an MRI scan for guidance rather than X-ray imaging.”

http://news.bbc.co.uk/1/hi/health/8448787.stm

The catheters for the pulmonary valvuloplasty were stiffened with glass fibre instead of the usual steel wire. Being able to monitor with MRI means less radiation and additional information about soft tissues during the procedure.

This case report is of a young man with an abnormal chest X-Ray. The workup by the authors led to the diagnosis of a rare disease which they then discuss and give an update on the diagnosis and management.

Incidental finding of Castleman’s disease in an asymptomatic young adult

The authors of this case report highlight the unusual association of CHARGE and MDS in a child. It is a well written short report that may be an early indication of an association and interesting pathological link. However, as the authors point out, the association in this particular patient may simply be coincidence.

The co-existence of CHARGE and myelodysplastic syndrome in a child

In this concise and well written case report the authors raise an important question. Could vaccination be causing serotypic drift result in more severe infections as the general population become exposed to unseen serotypes of S.pneumonia

Tension pneumatocoele in a child with an empyema

This case describes a relatively unusual cause of cavernous sinus thrombosis which is one of those conditions that is ideal for educationally combining applied anatomy and pathology. The report is clear and educational and is an important reminder of a rare but devastating condition.

Sudden onset proptosis secondary to cavernous sinus thrombosis from underlying mandibular dental infection

There are reports of a case of an infant with botulism in Scotland.

“A 16-week-old baby boy is fighting for his life after being diagnosed with botulism.

Logan Douglas was admitted to hospital in Edinburgh where doctors spotted signs of the rare disease and ordered a test.

Health protection experts said there had not been a report of an infant with botulism in Scotland since 1983.”

UK Press Association 4th November

A rapid genome analysis that took only 10 days helped make the correct diagnosis in a critically ill 5 month old Turkish boy.

http://opa.yale.edu/news/article.aspx?id=6988

“In a dramatic illustration of the power of emerging genetic technologies, Yale University researchers have reported making a clinical diagnosis for the first time using comprehensive DNA sequencing of all the protein-coding genes in the genome. The information changed the course of treatment of a baby boy suffering from symptoms of dehydration thousands of miles away in Turkey.

The new approach to DNA sequencing used by Yale researchers and described online Oct. 19 in the Proceedings of the National Academy of Sciences is called whole exome sequencing because it selectively analyzes the 1 percent of the genome that contains genes that code for proteins. This approach has the potential to lead to dramatic new insights into almost every human disease and, as cost of the technology decreases, will be commonly used in clinical settings, predicted Richard Lifton, senior author of the paper and Sterling Professor and chair in the Department of Genetics and professor of internal medicine.”