Rabeprazole was effective and safe in 1- to 11-year-old children with GERD.

Rabeprazole was effective in maintaining endoscopic/histologic healing during a 24-week maintenance period in children with endoscopically proven GERD. The clinical effect and safety profile were largely similar across dose groups.

To describe what is to our knowledge the first reported case of lead poisoning from ingested fishing sinkers in an 8-year-old boy for whom whole bowel irrigation and colonoscopy were required. Literature Review: All relevant literature on plumbism from other swallowed foreign bodies, including curtain weights, bullets, shot, and other unusual sources, is reviewed and discussed. Conclusions: Lead screening is advocated in any child presenting with a history of pica or foreign-body ingestion, especially presentations involving abdominal pain, weight loss, and emesis. Conservative management of retained foreign bodies containing lead is not recommended with persistently high lead levels. Medical and surgical intervention should be considered.

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Objective: Recently, oral vancomycin prophylaxis (OVP) has been suggested for the prevention of Clostridium difficile infection (CDI). We conducted a systematic review and meta-analysis to investigate the efficacy and safety of this approach. Design: Systematic review and meta-analysis. Methods: We conducted a computerized search of MEDLINE, EMBASE, and Cochrane databases from inception to March 2019 for publications investigating OVP for CDI prevention. Results were screened for eligibility. Relevant data were extracted and analyzed. Publication bias was assessed using the Egger test. Results: Ultimately, 8 retrospective studies and 1 prospective study examining 2174 patients, published between 2016 and 2019 were included in the review. OVP was associated with decreased CDI (odds ratio, 0.263; 95% confidence interval, 0.13–0.52) with considerable heterogeneity (I2 = 61%). Meta-regression showed that total daily dose of OVP correlated with CDI, explaining 100% of heterogeneity between studies. Furthermore, 3 studies evaluated the risk of vancomycin-resistant enterococci (VRE) infection after OVP and found no significant increase. Conclusion: Our results suggest that OVP might decrease CDI rates in at-risk populations, although this conclusion should be interpreted with caution. Higher daily doses of OVP might increase CDI. Although the use of OVP in high-risk patients may reduce CDI, this suggestion has yet to be validated by prospective blinded randomized controlled trials.