Detection of group C rotavirus in infants with extrahepatic biliary atresia

The purpose of this retrospective study was to examine liver tissue from patients with cholestatic disease for the presence of group C rotavirus RNA. The reverse transcriptase-polymerase chain reaction (PCR) for genes 5 and 6 was used, and the PCR products were subjected to liquid hybridization with a 32P-labeled probe. A second amplification with nested primers was also used. Samples from 32 subjects (20 with biliary atresia or choledochal cyst and 12 controls) were tested. Ten of 20 biliary atresia patients were positive for group C rotavirus RNA; no controls were positive (P < .003). Three of the positive patients were positive for both genes 5 and 6. Six of the 10 had > 1 sample that was positive. These data suggest a possible relationship between group C rotavirus and extrahepatic biliary atresia in the 10 patients in whom virus RNA was detected.

Nursing case management for children with failure to thrive

The case management approach is described for children with nonorganic failure to thrive in the pediatric tertiary care setting. An advanced practice nurse facilitated the organization of a planning committee, the construction of a care path, and the evaluation of the case management model. A 4-day care path is presented to show staff nursing functions in the nurse case manager role. Special issues are discussed for developing care paths for organic-based failure to thrive where parent reports can help guide health care interventions.

Enlarged gastric folds in association with Campylobacter pylori gastritis

Enlarged gastric folds in pediatric patients are uncommon. Fifteen patients with upper gastrointestinal (GI) tract symptoms of chronic epigastric abdominal pain, vomiting, or hematemesis underwent radiologic upper GI barium studies and were found to have Campylobacter pylori gastritis at endoscopic biopsy. Seven patients (47%) with C pylori gastric disease had radiologic evidence of enlarged folds. There was no clinical or pathologic evidence of Ménétrier disease. Therefore, C pylori gastritis should be considered in the differential diagnosis of children with upper GI tract symptoms and radiologic evidence of enlarged folds.