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Seminars in Pediatric Surgery

journal
https://www.readbyqxmd.com/read/29548358/advances-in-perioperative-quality-and-safety
#1
Kathryn T Anderson, Rachel Appelbaum, Marisa A Bartz-Kurycki, KuoJen Tsao, Marybeth Browne
For decades, safe surgery focused on intraoperative technique and decision-making. The traditional hierarchy placed the surgeon as the leader with ultimate authority and responsibility. Despite the advances in surgical technique and equipment, too many patients have suffered unnecessary complications and suboptimal care. Today, we understand that the conduct of safe and effective surgery requires evidence-based decision-making, multifaceted treatment approaches to prevent complications, and effective communication in and out of the operating room...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29548357/patient-engagement-to-enhance-recovery-for-children-undergoing-surgery
#2
Kurt F Heiss, Mehul V Raval
For over 20 years enhanced recovery protocols (ERPs) have been used to decrease the physiologic stress and inflammation of surgery using evidence-based principles. ERPs include optimizing patient preparation, creating less trauma using minimally invasive anesthetic and surgical techniques, and regular audit of outcomes. A critical aspect of ERPs is patient engagement in all phases of care, which facilitates effective team function and focused oversight of patient flow through the system. Counseling extends beyond traditional review of surgical risks and benefits, by creating clear daily patient goals, establishing pain management plans, optimizing nutrition, and defining criteria for discharge...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29548356/operating-room-efficiency
#3
David H Rothstein, Mehul V Raval
The operating room is the financial hub of any hospital, and maximizing operating room efficiency has important implications for cost savings, patient satisfaction, and medical team morale. Over the past decade, manufacturing principles and processes such as Lean and Six Sigma have been applied to various aspects of healthcare including the operating room. Although time consuming, process mapping and deep examinations of each step of the patient journey from pre-operative visit to post-operative discharge can have multiplicative benefits that extend from cost savings to maintaining the focus on improving quality and patient safety...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29548355/ambulatory-pediatric-surgery
#4
Andrew B Nordin, Sohail R Shah, Brian D Kenney
Ambulatory pediatric surgery has become increasingly common in recent years, with greater numbers of procedures being performed on an outpatient basis. This practice has clear benefits for hospitals and healthcare providers, but patients and families also often prefer outpatient surgery for a variety of reasons. However, maximizing the potential opportunities requires critical attention to patient and procedure selection, as well as anesthetic choice. A subset of outpatient procedures can be performed as single visit procedures, further simplifying the process for families and providers...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29548354/preoperative-anesthesia-evaluation
#5
Joseph D Tobias
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatric patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29548353/preface
#6
EDITORIAL
Mehul V Raval, David H Rothstein
No abstract text is available yet for this article.
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29548352/importance-of-patient-and-family-satisfaction-in-perioperative-care
#7
Kristen A Calabro, Mehul V Raval, David H Rothstein
As healthcare systems increasingly shift focus toward providing high-quality and high-value care to patients, there has been a simultaneous growth in assessing the patient's experience through patient-reported outcomes. Along with well-known patient reported outcomes such as health-related quality of life and current health state, patient satisfaction can be a valuable assessment of quality. Patient and family satisfaction measures not only affect a patient's clinical course and influence overall patient compliance, but are increasingly used to gauge physician performance and guide reimbursement...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29548351/creating-a-safer-operating-room-groups-team-dynamics-and-crew-resource-management-principles
#8
Derek Wakeman, Max R Langham
The operating room (OR) is a special place wherein groups of highly skilled individuals must work in a coordinated and harmonious fashion to deliver optimal patient care. Team dynamics and human factors principles were initially studied by the aviation industry to better understand and prevent airline accidents. As a result, crew resource management (CRM) training was designed for all flight personnel to create a highly reliable industry with a commitment to a culture of safety. CRM has since been adapted to health care, resulting in care improvement and harm reduction across a wide variety of medical specialties...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29548350/telemedicine-in-the-perioperative-experience
#9
Aaron P Lesher, Sohail R Shah
Telemedicine, the remote diagnosis and treatment of patients by means of technology, provides an alternative means for patients to gain access to health care services. Telemedicine is a general term that includes the use of various communication technologies, including telephone, email, or videoconferencing. Telemedicine has the potential to reduce inefficiencies in the delivery of healthcare, diminish patient travel and wait times, and increase access to specialists for patients in rural settings. We review the use of telemedicine in the perioperative phase of care for pediatric surgical patients, their caregivers, and surgical providers, including pre-operative assessments, and post-operative follow-up...
April 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275819/stem-cell-therapy-in-necrotizing-enterocolitis-current-state-and-future-directions
#10
Natalie A Drucker, Christopher J McCulloh, Bo Li, Agostino Pierro, Gail E Besner, Troy A Markel
Stem cell therapy is a promising treatment modality for necrotizing enterocolitis. Among the many promising stem cells identified to date, it is likely that mesenchymal stem cells will be the most useful and practical cell-based therapies for this condition. Using acellular components such as exosomes or other paracrine mediators are promising as well. Multiple mechanisms are likely at play in the positive effects provided by these cells, and further research is underway to further elucidate these effects.
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275818/neurodevelopmental-considerations-in-surgical-necrotizing-enterocolitis
#11
Jamie R Robinson, Clark Kennedy, Kyle J van Arendonk, Alyssa Green, Camilia R Martin, Martin L Blakely
The majority of surviving infants with surgical necrotizing enterocolitis (NEC) will have some degree of neurodevelopmental impairment. The impact of specific medial and surgical treatments for infants with severe NEC remains largely unknown but is being actively investigated. It is incumbent upon all providers caring for these infants to continue to focus on long term neurodevelopmental outcomes and to develop more widespread methods of neurodevelopmental assessment.
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275817/anemia-red-blood-cell-transfusions-and-necrotizing-enterocolitis
#12
REVIEW
Akhil Maheshwari, Ravi M Patel, Robert D Christensen
In the past 15 years, multiple clinical studies have identified a temporal association between red blood cell (RBC) transfusions and necrotizing enterocolitis (NEC). With some variability, most of these studies indicate that up to one-third of all cases of NEC involving very low-birth weight infants may occur within 24-48h after receiving a RBC transfusion. There is also evidence that the risk of such transfusion-associated NEC may be higher in infants transfused with the greatest severity of anemia. In this article, we summarize the clinical evidence pertaining to these issues; specifically, the contribution of RBC transfusions, and the contribution of severity of underlying anemia, to the pathogenesis of a type of NEC potentially termed, "transfusion/anemia-associated NEC...
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275816/probiotics-and-necrotizing-enterocolitis
#13
Ravi Mangal Patel, Mark A Underwood
In this review, we summarize existing knowledge regarding the effects of probiotics on necrotizing enterocolitis (NEC). We review the role of the microbiome in NEC and pre-clinical data on mechanisms of probiotic action. Next, we summarize existing randomized controlled trials and observational studies of probiotics to prevent NEC. We also summarize findings from several recent meta-analyses and report a new cumulative meta-analysis of probiotic trials. Finally, we review data from cohorts routinely using commercially available probiotics...
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275815/human-milk-and-necrotizing-enterocolitis
#14
Aloka L Patel, Jae H Kim
NEC is a multifactorial disease that occurs when multiple risk factors and/or stressors overlap, leading to profound inflammation and intestinal injury. Human milk feedings, both from the infant's mother and donor human milk, have been associated with reductions in NEC in preterm infants. This article will review the protective factors in human milk, clinical studies of human milk and NEC, and practices to enhance human milk use in neonatal intensive care units.
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275814/changing-the-paradigm-of-defining-detecting-and-diagnosing-nec-perspectives-on-bell-s-stages-and-biomarkers-for-nec
#15
REVIEW
Sheila M Gephart, Phillip V Gordon, Alexander H Penn, Katherine E Gregory, Jonathan R Swanson, Akhil Maheshwari, Karl Sylvester
Better means to diagnose and define necrotizing enterocolitis are needed to guide clinical practice and research. Adequacy of Bell's staging system for clinical practice and clarity of cases used in NEC clinical datasets has been a topic of controversy for some time. This article provides reasons why a better global definition for NEC is needed and offers a simple alternative bedside definition for preterm NEC called the "Two out of Three" rule. Some argue that biomarkers may fill knowledge gaps and provide greater precision in defining relevant features of a clinical disease like NEC...
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275813/the-science-and-necessity-of-using-animal-models-in-the-study-of-necrotizing-enterocolitis
#16
Guillermo J Ares, Steven J McElroy, Catherine J Hunter
Necrotizing enterocolitis (NEC) remains one of the highest causes of mortality and of acute and long-term morbidity in premature infants. Multiple factors are involved in the pathophysiology of NEC including the immaturity of the immune system and the complex changing composition of the intestinal microbiome. This is compounded by the fact that the premature infant should ideally still be a developing fetus and has an immature intestinal tract. Because these complexities are beyond the scope of studies in single-cell cultures, animal models are absolutely essential to understand the mechanisms involved in the pathophysiology of NEC and the effects of inflammation on the immature intestinal tract...
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275812/development-of-the-necrotizing-enterocolitis-society-registry-and-biorepository
#17
Matthew W Ralls, Samir K Gadepalli, Karl G Sylvester, Misty Good
Necrotizing enterocolitis (NEC) is a devastating disease affecting premature infants. New advances in diagnostic and treatment options are desperately needed. Accordingly, the NEC Society initiated a research collaborative with a group of investigators dedicated to advancing the state of NEC-associated knowledge. Recent advances in high-content molecular interrogation and bio-computation (e.g., genomics, transcriptomics, proteomics, and metabolomics) can provide new insights from afflicted infants with NEC, however, individual centers do not have sufficient cases to conduct these studies independently...
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275811/enhancing-nicu-parent-engagement-and-empowerment
#18
Erin Umberger, Jennifer Canvasser, Sue L Hall
Within the neonatal intensive care unit (NICU), parent engagement and empowerment are of critical importance, particularly when infants are at risk of developing severe complications, such as necrotizing enterocolitis (NEC). Stakeholders within the NICU, including the fragile patients, families, clinicians, staff, and administration, benefit when parents are a valued member of their baby's care team. The 2017 NEC Symposium explored the experiences of families whose infants were impacted by NEC, the barriers to effective partnership, and promising solutions...
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275810/necrotizing-enterocolitis-pathophysiology-from-a-historical-context
#19
REVIEW
David Hackam, Michael Caplan
Necrotizing enterocolitis (NEC) continues to afflict approximately 7% of preterm infants born weighing less than 1500g, though recent investigations have provided novel insights into the pathogenesis of this complex disease. The disease has been a major cause of morbidity and mortality in neonatal intensive care units worldwide for many years, and our current understanding reflects exceptional observations made decades ago. In this review, we will describe NEC from a historical context and summarize seminal findings that underscore the importance of enteral feeding, the gut microbiota, and intestinal inflammation in this complex pathophysiology...
February 2018: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/29275809/preface-the-nec-society
#20
EDITORIAL
Troy A Markel, Mark A Underwood
No abstract text is available yet for this article.
February 2018: Seminars in Pediatric Surgery
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