Background and Objectives. The aim of this study is to determine the prevailing microbiota in samples from pediatric patients with acute appendicitis, as well as evaluate the antibacterial sensitivity of the isolated microorganisms, comparing the data obtained with the clinic’s antibacterial therapy guidelines. Materials and Methods. The study group consisted of 93 patients between the ages of 7 and 18. All patients underwent a laparoscopic or conventional appendectomy. The children were hospitalized with signs and symptoms suggestive of acute appendicitis. Microbiological cultures from the appendix and abdominal cavity were collected intraoperatively. Results. E. coli was identified in most cases irrespective of the clinical presentation of acute appendicitis. Most strains were susceptible to ampicillin and amoxicillin/clavulanic acid. Five strains of E. coli produced extended spectrum beta-lactamase (ESBL). Pseudomonas aeruginosa (P. aeruginosa) was the second most commonly isolated causative agent. Furthermore, it was common in cases of acute complex appendicitis. Most strains of P. aeruginosa were resistant to amoxicillin/clavulanic acid, ertapenem, ampicillin and cefotaxime, yet were susceptible to ceftazidime. Regardless of the clinical presentation, the samples yielded mixed isolates. Conclusion. E. coli is the main causative agent of acute appendicitis in the pediatric population displaying susceptibility to various antibiotics. P. aeruginosa was more prevalent in cases of acute complex appendicitis. P. aeruginosa isolates were susceptible to ceftazidime; however, they were resistant to cefotaxime, which should, therefore, be removed from guidelines for empirical antibacterial treatment of acute appendicitis due to phenotypic resistance of P. aeruginosa. We recommend antibiotics with distinct implementation to avoid antibiotic resistance.

Life-threatening complications (LTCs) and negative results of surgical treatments often go unreported. Minimally invasive repair of pectus excavatum (MIRPE) represents a procedure with a low incidence of adverse outcomes. However, 15 potentially fatal cases of MIRPE-related heart injury have been published. We report a case of cardiac perforation (CP) during MIRPE. A 12-year-old female was admitted for elective repair of a severe asymmetric pectus excavatum. Preoperative computed tomography showed a Haller index of 4.9. MIRPE was performed under bilateral video-assisted thoracoscopy. After the placement of the pectus bar, cardiac arrhythmias, hypotension and bilateral hemothorax occurred. Emergency thoracotomy without pectus bar removal showed CP. The wound sites were repaired and the pectus bar was eventually successfully implanted. The patient was discharged on postoperative day 11. After 10 months, she remains asymptomatic. Reporting rare complications is essential for accurate calculations of the true prevalence of LTCs, maintaining high alertness in pediatric surgeons.

Gut microbiota are defined as the microbial population of the intestines. They include various types of bacteria which can influence and predict the existence or onset of some specific diseases. Therefore, it is a common practice in medicine to analyze the gut microbiota for diagnostic purposes by analyzing certain measurable biochemical features associated with the disease under investigation. However, the evaluation of all the data collected from the gut microbiota is a labor-intensive process. Machine learning algorithms may be a helpful tool to identify the hidden patterns in gut microbiota for the detection of disease and other classification problems. In this study, we propose a deep neural model based on 1D-CNN to detect cardiovascular disease using bacterial taxonomy and OTU (Operational Taxonomic Unit) table data. The developed method is compared to classical machine learning algorithms, regression, boosting algorithm and a deep model, TabNet, developed for tabular data and obtained outperforming classification results. The proposed method is robust and well adapted to taxonomy data in tabular form. It can be easily adapted to detect other diseases by using taxonomy data.

Congenital pulmonary airway malformations (CPAM) are rare lung anomalies increasingly detected through prenatal imaging. Management of asymptomatic patients remains controversial, particularly regarding imaging strategy, timing of surgery, and malignancy risk. We report a four-patient case series treated at a regional pediatric surgical center between February and June 2025, representing an increased local incidence. All patients were asymptomatic postnatally and underwent thoracic computed tomography at a mean age of 13 months. Elective thoracoscopic lower lobectomy was performed in all cases at a mean age of 18.3 months. Histopathology revealed CPAM type 2 in three patients and CPAM type 4 in one asymptomatic child. Two postoperative pneumothoraces required temporary drainage; no long-term complications occurred. Our findings support elective thoracoscopic resection for confirmed CPAM. The detection of CPAM type 4 highlights the limitations of radiologic subtype differentiation, supporting early surgery in asymptomatic patients. We propose a management algorithm applicable to secondary centers.