JPGN Journal Club December 2023: Pediatric Insulin Resistance, Acute Hepatitis, and Intrapyloric Botulinum Toxin Therapy

Today we are not only speaking with Kassel’s best, Dr Andreas Jenke, but also with Dr Jake Mann, pride of Birmingham and the Channel Islands – that’s right, double trouble. We say thank you and goodbye to Andreas, thank you and hello to Jake, who is stepping into Andreas’ shoes as primary Journal Club discussant. Andreas leads off with Predicting Insulin Resistance in a Pediatric Population With Obesity, a JPGN article from Portugal, by Daniela Arauj́ o and colleagues, using non-invasive parameters to identify children at increased metabolic-syndrome risk and thereby perhaps opening restricted-prescription gateways for early pharmacologic intervention. Jake is next up at bat, with a non-JPGN entry (Hepatology Communications) from Sagar Mehta et al. at Toronto’s Hospital for Sick Children – Severe Acute Hepatitis of Unknown Etiology in a Large Cohort of Children, a look at the recent purported worldwide spike in numbers of such patients. Was it really all about adeno-associated virus infection ? The tiller then returns to Andreas, who steers us safely into port aboard Peter Osgood and co-workers’ Intrapyloric Botulinum Toxin Injection for Refractory Nausea and Vomiting in Pediatric Patients, again in JPGN, from Chicago and Cleveland – will you follow these authors’ lead when confronted with what well may be functional disorders ? Both the discussants appraise the articles – why are they important ? How could they be better ? What might come next in these corners of our field ? – two perspectives for one in this podcast, and an interesting change from the approach employed thus far. What do you think ? Should Jake invite guest co-discussants now that he is in charge ? Let us know : Comments on a postcard, please (sorry, wrong century ! By e-mail), via the ESPGHAN main office.