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Pediatric gastrostomy

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https://www.readbyqxmd.com/read/29224755/factors-associated-with-30-day-all-cause-hospital-readmission-after-tracheotomy-in-pediatric-patients
#1
Helena Yu, Mary Rose Mamey, Christopher J Russell
OBJECTIVE: To determine factors associated with post-tracheotomy hospital readmission within 30 days of discharge. METHODS: Children 18 years and younger who underwent tracheotomy at Children's Hospital Los Angeles (CHLA) between 1/1/2005 and 12/31/2013 with at least 30 days of follow-up at CHLA were identified through ICD-9 procedure codes. Patient characteristics and covariates were obtained by linking manual chart review and administrative data. We used multivariate logistic regression to identify the independent association between risk factors and the primary outcome of 30-day all-cause same-hospital readmission...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29222827/responding-to-parental-requests-for-life-sustaining-treatment%C3%A2-relational-potential-revisited
#2
Aaron Wightman, Jennifer Cobelli Kett, Benjamin Wilfond
One of the most challenging situations for pediatric clinicians is responding to parental requests for life-sustaining medical therapies for a child with profound neurodevelopmental disabilities. These therapies (e.g. intravenous medications and fluids, gastrostomy tube feeds, dialysis, tracheostomy, and/or mechanical ventilation) offer the possibility for the child to live, at home or in a facility, for months or years as opposed to experiencing their imminent death. While relatively rare, the tension surrounding these requests can be exceptionally high, as illustrated by the cases of Baby K, Baby Joseph, Jahi McMath, Charlie Gard, and many others from our own experience...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29219857/a-literature-review-of-percutaneous-endoscopic-gastrostomy-dealing-with-complications
#3
Hatice Pars, Hicran Çavuşoğlu
Sufficient energy and essential nutrients are vital for normal growth and development in childhood. Ideally, nutrition should be provided orally. However, if the gastrointestinal system is functional, enteral tube feeding can be used when nutritional requirements cannot be provided orally, thus providing nutritional benefits and enabling positive disease management in pediatric patients. Postoperative care in children allows monitoring of the position and functionality of the tube; performing nutrition intolerance, growth, hydration, and nutritional assessments; and performing metabolic and complication follow-ups...
December 6, 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/29201636/laryngotracheoesophageal-cleft-type-3-and-severe-laryngotracheomalacia-delayed-surgical-repair-a-treatment-challenge-with-an-excellent-outcome
#4
Ahmad Khaleghnejad, Saeed Sadr, Seyyed Ahmad Tabatabaei, Nazanin Farahbakhsh, Payman Dabirmoghaddam, Saeed Saadat Mansori
Laryngotracheoesophageal clefts (LTEC) are rare malformations which involve the upper respiratory and digestive tract. Surgical repair should be undertaken promptly to maintain a secure airway and prevent serious pulmonary aspiration. This paper reports the first case of LTEC type 3 with severe laryngotracheomalacia that was brought to Mofid children's hospital in late infancy with a poor health status. Delayed defect correction was our team strategy for the patient when she had achieved good weight gain. At the age of 22 months in collaboration with the pediatric surgical and otolaryngologist team, the repair of the laryngeal cleft was done with lateral open approach method...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29180216/pediatric-gastrostomy-tubes-and-techniques-making-safer-and-cleaner-choices
#5
Cabrini Sutherland, Benjamin Carr, Kassia Zalewski Biddle, Marcus Jarboe, Samir K Gadepalli
BACKGROUND: Gastrostomy tube placement is a common procedure that can be accomplished with a variety of techniques, each with its attendant complications. In an effort to standardize practice at our institution, we retrospectively evaluated complications including early dislodgement requiring operative repair, leaks, and granulation tissue to determine the optimal technique. MATERIALS AND METHODS: A retrospective cohort study (June 2008-July 2014) evaluating children (<18) receiving gastrostomy tubes was completed...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29162216/treatment-regimens-by-pediatric-nephrologists-in-children-with-congenital-nephrogenic-diabetes-insipidus-a-mwpnc-study%C3%A2
#6
Cynthia D'Alessandri-Silva, Melinda Carpenter, John D Mahan
BACKGROUND: Congenital nephrogenic diabetes insipidus (NDI) is a rare genetic disorder affecting urinary concentration. Clinicians have varied medication regimens as well as nutritional plan approaches for these children. MATERIALS AND METHODS: An electronic survey was distributed to member pediatric nephrologists of the Midwest Pediatric Nephrology Consortium via email (n = 179). Questions included types of drugs prescribed, factors contributing to drug choice, common drug combinations given, and dietary/failure to thrive interventions used...
November 22, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29119032/cytomegalovirus-associated-duodenal-ulcer-and-duodenitis-in-a-malnourished-pediatric-patient
#7
Rachel Bernard, Ghanim Aljomah, Emily Klepper, Elizabeth McDonough
Cytomegalovirus (CMV) duodenitis is a rare occurrence, especially in pediatric patients. A thirteen-month-old female presented to the Emergency Department for a febrile seizure. She was incidentally admitted for severe malnutrition with an initial workup remarkable for only a slight elevation in her ALT at 48. The patient was found to have an oral aversion requiring nasogastric tube feeds for adequate caloric intake. She continued to fail to gain weight and underwent an EGD that demonstrated a duodenal ulcer...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28988288/effects-of-mechanical-complications-on-radiation-exposure-during-fluoroscopically-guided-gastrojejunostomy-exchange-in-the-pediatric-population
#8
Kevin S H Koo, Joseph Reis, Jodi Manchester, Gulraiz Chaudry, Brian Dillon
The purpose of the article is to evaluate the effects of mechanical complications, such as clogging or coiling, of gastrojejunostomy tubes on radiation exposure during exchange in the pediatric population. In this HIPAA-compliant and IRB-approved study, we retrospectively reviewed procedural records for patients undergoing gastrojejunostomy (GJ) tube exchange during a 4-month period in 2014. Success of the procedure, specifications of the tube, age, and sex of the patient as well as radiation exposure during the procedure were included...
October 7, 2017: Dysphagia
https://www.readbyqxmd.com/read/28983677/reduced-dose-c-arm-computed-tomography-applications-at-a-pediatric-institution
#9
Michael Acord, Sphoorti Shellikeri, Seth Vatsky, Abhay Srinivasan, Ganesh Krishnamurthy, Marc S Keller, Anne Marie Cahill
BACKGROUND: Reduced-dose C-arm computed tomography (CT) uses flat-panel detectors to acquire real-time 3-D images in the interventional radiology suite to assist with anatomical localization and procedure planning. OBJECTIVE: To describe dose-reduction techniques for C-arm CT at a pediatric institution and to provide guidance for implementation. MATERIALS AND METHODS: We conducted a 5-year retrospective study on procedures using an institution-specific reduced-dose protocol: 5 or 8 s Dyna Rotation, 248/396 projection images/acquisition and 0...
December 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28983551/association-of-enrollment-in-an-aerodigestive-clinic-with-reduced-hospital-stay-for-children-with-special-health-care-needs
#10
Swathi Appachi, Anne Banas, Lisa Feinberg, Douglas Henry, Diane Kenny, Nathan Kraynack, Amy Rosneck, John Carl, Paul Krakovitz
Importance: Children with special health care needs (CSHCN) have disproportionate health care utilization. Previous studies have demonstrated that a primary medical home improves health care outcomes for this population. Objective: To elucidate if enrollment in a multidisciplinary aerodigestive clinic improves outcomes and reduces health care costs by decreasing admissions and inpatient days. Design, Setting, and Participants: A retrospective medical record review of 113 patients with aerodigestive disorders enrolled in a pediatric multidisciplinary clinic from June 2009 to December 2013 was performed...
November 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28969523/postoperative-feeding-regimens-after-laparoscopic-gastrostomy-placement
#11
Eric H Rosenfeld, Kirea Mazzolini, Annalyn DeMello, Yangyang R Yu, Timothy C Lee, Bindi Naik-Mathuria, Mark V Mazziotti, Sohail R Shah
PURPOSE: The objective of this study was to evaluate postoperative feeding regimens after laparoscopic gastrostomy placement and their effect on outcomes. METHODS: Children 18 years of age or younger, who underwent laparoscopic gastrostomy placement at a tertiary-care academic children's hospital between January 2014 and October 2016, were reviewed. Data collected included patient characteristics, postoperative feeding regimen, and clinical outcomes. Statistical analysis was performed using Chi-square, Fisher's exact, and Wilcoxon Rank-Sum tests...
November 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28964285/pediatric-leukodystrophies-the-role-of-the-otolaryngologist
#12
Emily Kay-Rivest, Léticia Khendek, Geneviève Bernard, Sam J Daniel
BACKGROUND: Leukodystrophies consist of degenerative neurogenetic diseases often associated with comorbidities that extend beyond the neurological system. Despite their impacts on patients' quality of life and risks of complications, head and neck symptomology is poorly reported in the literature. The objective of this study was to identify and quantify the main head and neck complaints among a cohort of patients diagnosed with leukodystrophies and define the role of the otolaryngologist as part of a multidisciplinary team for treating these patients...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28954047/comparative-study-on-gastrostomy-and-orally-nutrition-of-children-and-adolescents-with-tetraparesis-cerebral-palsy
#13
Thaisa Barboza Caselli, Elizete Aparecida Lomazi, Maria Augusta Santos Montenegro, Maria Angela Bellomo-Brandão
BACKGROUND: Gastrostomy tube feeding (GTF) is indicated for children with feeding difficulties due to tetraspastic cerebral palsy, although there are no definitive conclusions about the benefits of GTF. OBJECTIVE: To compare nutritional status and diet of pediatric patients with tetraparesis cerebral palsy who are fed by GTF with those fed orally (PO). METHODS: A transversal and descriptive study on 54 patients with spastic tetraparesis was held...
September 21, 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28942656/use-of-self-expanding-nitinol-stents-in-the-pediatric-management-of-refractory-esophageal-caustic-stenosis
#14
Verónica Alonso, Devicka Ojha, Harsha Nalluri, Juan Carlos de Agustín
BACKGROUND: The treatment of recurrent esophageal stricture secondary to the ingestion of a caustic agent is an arduous task. Self-expanding esophageal stents may be an alternative to repeated endoscopic esophageal dilations. CASE REPORT: We present the case of a two-year-old male with a severe and long esophageal stricture successfully treated by the combination of dilations and stent placement. After five months of serial pneumatic dilations, three self-expanding nitinol stents internally coated with silicone were introduced through a gastrostomy, covering the entire esophagus...
October 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28839386/gastric-trichobezoars-in-children-surgical-overview
#15
Alisha Gupta, Deepak Mittal, Maddur Srinivas
BACKGROUND: Development of trichobezoars in children is primarily a psychiatric issue more than a pediatric surgical ailment. A definite history of trichotillomania and trichophagia may or may not be elicited. Surgical removal is required in patients presenting with huge bezoars. Psychiatric follow-up is of utmost importance to avoid recurrence. MATERIALS AND METHODS: Records of children who were diagnosed and managed for the presence of gastric trichobezoars were retrospectively reviewed...
April 2017: International Journal of Trichology
https://www.readbyqxmd.com/read/28817750/the-surgeon-on-service-model-for-timely-economically-viable-inpatient-care-of-tracheostomy-patients-in-academic-pediatric-otolaryngology
#16
Jennifer M Lavin, James W Schroeder, Dana M Thompson
Importance: The traditional practice model for pediatric otolaryngologists at high-volume academic centers is to simultaneously balance outpatient care responsibilities with those of the inpatient service, emergency department, and ambulatory care clinics. This model leads to challenges with care coordination, timeliness of nonemergency operative care, and consistent participation in care and consultation at the attending surgeon level. The "surgeon on service" (SOS) model-where faculty members rotate to manage the inpatient service in lieu of outpatient responsibilities-has been described as one method to address this conundrum...
October 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28738121/incidence-risks-and-types-of-infections-in-pediatric-long-term-care-facilities
#17
Lisa Saiman, Philip Maykowski, Meghan Murray, Bevin Cohen, Natalie Neu, Haomioa Jia, Gordon Hutcheon, Edwin Simpser, Linda Mosiello, Luis Alba, Elaine Larson
Importance: The population of infants, children, and adolescents cared for at pediatric long-term care facilities is increasing in complexity and size and thus consumes substantial health care resources. Infections are a significant cause of morbidity and mortality in this population, but few recent data describe their incidence and effects. Objectives: To describe the types of infections diagnosed in residents of pediatric long-term care facilities, calculate infection rates, and identify risk factors for respiratory tract infections (RTIs)...
September 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28727947/definitions-and-clinical-guidance-on-the-enteral-dependence-component-of-the-avoidant-restrictive-food-intake-disorder-diagnostic-criteria-in-children
#18
Terence Michael Dovey, Markus Wilken, Clarissa Isabel Martin, Caroline Meyer
The aim of the current article is to offer definitive guidance on weaning children who are reliant on nasogastric/gastrostomy feeding tubes. To date, no internationally recognized definitions or principles for interventions exist, and clinics have been reliant on creating their own unique intervention criteria. To achieve the aim, 2 goals are set out within the current article. The first goal was to definitively define the process of tube weaning. To achieve this, both tube dependency and oral eating also required definitions...
July 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28723982/assessment-of-nutritional-status-of-children-and-adolescents-with-spastic-quadriplegic-cerebral-palsy
#19
Thaisa Barboza Caselli, Elizete Aparecida Lomazi, Maria Augusta Santos Montenegro, Maria Angela Bellomo-Brandão
BACKGROUND: Due to several factors, such as gastrointestinal's diseases and difficulty in feeding, children with Spastic Quadriplegic Cerebral Palsy tend to present nutritional deficits. OBJECTIVE: To assess the nutritional status of pediatric patients with Spastic Quadriplegic Cerebral Palsy according to reference curves for this population and with the measures of folds and circumferences, obtained by the upper arm circumference and triceps skin fold. METHODS: The data were obtained from: knee-height, estimated height, weight, upper arm circumference, and triceps skin fold...
July 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28699409/review-of-the-effectiveness-of-enteral-feeding-in-pediatric-oncology-patients-formula-see-text
#20
Kaleena Trimpe, Michele R Shaw, Marian Wilson, Mel R Haberman
Enteral supplementation for nutritional support in pediatric oncology patients remains nonstandardized across institutions and between providers. Pediatric oncology patients frequently fail to meet their growth curve percentiles, lose weight, and/or are malnourished due to both the oncologic process as well as side effects from chemotherapy and radiation treatments. Methods of increasing weight include enteral feeding (nasogastric, nasoduodenal/jejunal, or gastrostomy), parenteral intravenous feeding, and oral supplementation...
November 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
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