Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision.

The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report's conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non-US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

[Appendicitis and appendectomy in children in Reykjavik Hospitals in 1996 and 2006]. / Botnlangabólga og botnlangataka hjá börnum á sjúkrahúsum í Reykjavík 1996 og 2006.

INTRODUCTION: Appendicitis is a common disease and can be life-threatening if not adequately treated. Studies have shown that if less than 20% of appendices removed are normal it indicates missing or delaying the diagnosis of appendicitis, resulting in an increased incidence of perforation. The purpose of this study was to analyze appendicitis in children during two separate time periods in the pediatric wards of the hospitals in Reykjavík and to increase our knowledge of appendicitis in children in the country. MATERIALS AND METHODS: Patients entering this study are two groups of 100 children (< or =16 years) consecutively undergoing appendectomy in the Reykjavik hospitals, one group in 1996 and the other in 2006. Data on sex, age, clinical symptoms and treatment was obtained from patients records. The impression of the surgeon at time of operation on the inflammation of the removed appendix was compared with results of histopathology analysis. All histopathology slides from appendices from 2006 were re-evaluated. The parameters in open appendectomies were compared to those in laparoscopic appendectomies. The two study periods were compared. RESULTS: The proportion of normal appendices was similar in both periods of the study, 18% in 2006 and 20% in 1996. The appendices were more often normal in female patients (p<0.05) and the large majority of those were removed by laparoscopic surgery. Perforation was present in 17% of inflamed appendices in both study groups. The time from patients arrival to hospital until surgery surpassed 10 hours in only one case in each study group. A discrepancy between the surgeon's assessment and the pathology result was noted only once in 2006 and in one additional case was the histopathological diagnosis altered following re-evaluation of the pathology slides. DISCUSSION: The proportion of non-inflamed appendices in appendectomies in children in Reykjavik is in accordance with that reported elsewhere and perforation is not common. There is a good concordance between surgical and pathological assessment with regard to inflammation of the appendices.

[The results of surgical treatment for cryptorchidism at Landspitalinn, 1970-1993.].

OBJECTIVE: Cryptorchidism is a common congenital genito-urological anomali in males with increased risk of infertility and testicular cancer. In this retrospective study the results of operations for undescended testis at Landspitalinn University Hospital were reviewed with special emphasis on patients diagnosed with testicular cancer later in life. MATERIAL AND METHODS: The study includes 593 males with undescended testis who were operated on between 1970 and 1993. Information was gathered from hospital records, including birth-weight, age at diagnosis and operation, localization of the testes and complications to surgery. Information on patients diagnosed with testicular cancer was aquired from the Icelandic Cancer Registry. RESULTS: The average birth-weight was 3461 g, including 58 boys (10%) with low birth-weight (