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https://www.readbyqxmd.com/read/29125442/long-term-outcomes-after-surgical-treatment-of-pediatric-neurogenic-thoracic-outlet-syndrome
#1
Jennifer Hong, Jared M Pisapia, Zarina S Ali, Austin J Heuer, Erin Alexander, Gregory G Heuer, Eric L Zager
OBJECTIVE Neurogenic thoracic outlet syndrome (nTOS) is an uncommon compression syndrome of the brachial plexus that presents with pain, sensory changes, and motor weakness in the affected limb. The authors reviewed the clinical presentations and outcomes in their series of pediatric patients with surgically treated nTOS over a 6-year period. METHODS Cases of nTOS in patients age 18 years or younger were extracted for analysis from a prospective database of peripheral nerve operations. Baseline patient characteristics, imaging and neurophysiological data, operative findings, and outcomes and complications were assessed...
November 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29120450/apnea-bradycardia-and-desaturation-spells-in-premature-infants-impact-of-a-protocol-for-the-duration-of-spell-free-observation-on-interprovider-variability-and-readmission-rates
#2
P Chandrasekharan, M Rawat, A M Reynolds, K Phillips, S Lakshminrusimha
OBJECTIVE: To study the impact of implementing a protocol to standardize the duration of observation in preterm infants with apnea/bradycardia/desaturation spells before hospital discharge on length of stay (LOS) and readmission rates. STUDY DESIGN: A protocol to standardize the duration of in-hospital observation for preterm infants with apnea, bradycardia and desaturation spells who were otherwise ready for discharge was implemented in December 2013. We evaluated the impact of this protocol on the LOS and readmission rates of very low birth weight infants (VLBW)...
November 9, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29119824/an-innovative-health-care-delivery-model-for-children-with-medical-complexity
#3
Anne Elizabeth Glassgow, Molly A Martin, Rachel Caskey, Melishia Bansa, Michael Gerges, Mary Johnson, Monika Marko, Kenita Perry-Bell, Heather J Risser, Peter J Smith, Benjamin Van Voorhees
Children with medical complexity (CMC) account for a disproportionate share of pediatric health-care utilization and cost that is largely attributable to long hospitalizations, frequent hospital readmissions, and high use of emergency departments. In response, the Centers for Medicare and Medicaid Services Health Care Innovation Center supports the development and testing of innovative health-care payment and service delivery models. The purpose of this article is to describe the CMS-funded coordinated health care for complex kids (CHECK) program, an innovative system of health-care delivery that provides improved, comprehensive, and well-coordinated services to CMC...
September 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29115709/safety-of-discharge-for-children-with-cancer-and-febrile-neutropenia-off-antibiotics-using-absolute-neutrophil-count-threshold-values-as-a-surrogate-marker-for-adequate-bone-marrow-recovery
#4
Matthew E Campbell, Debra L Friedman, Daniel E Dulek, Zhiguo Zhao, Yi Huang, Adam J Esbenshade
BACKGROUND: Febrile neutropenia (F&N) is common among pediatric oncology patients. However, there is a lack of clarity regarding parameters whereby such patients have demonstrated adequate bone marrow recovery for hospital discharge and empiric antibiotic discontinuation. PROCEDURE: A retrospective review was performed for 350 episodes of F&N occurring at a single institution between 2007 and 2012 in pediatric oncology patients who were afebrile for 24 hr and had no bacterial source identified...
November 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29111083/postoperative-outcomes-in-vedolizumab-treated-pediatric-patients-undergoing-abdominal-operations-for-inflammatory-bowel-disease
#5
Amy L Lightner, Chung Sang Tse, D Dean Potter, Christopher Moir
INTRODUCTION: Recent studies have found vedolizumab to be an independent predictor of increased rates of postoperative complications and surgical site infections (SSIs) in adults with inflammatory bowel disease (IBD), but studies in the pediatric surgical population are lacking. We sought to determine the 30-day postoperative infectious complication rate among pediatric IBD patients who received vedolizumab within 12weeks of a major abdominal operation. METHODS: A retrospective chart review was performed on pediatric IBD patients who underwent an abdominal operation between 5/20/2014 and 6/1/2017...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29109837/comparing-plastic-surgery-and-otolaryngology-management-in-cleft-care-an-analysis-of-4-999-cases
#6
Kevin T Jubbal, Dmitry Zavlin, Shola Olorunnipa, Anthony Echo, Edward P Buchanan, Larry H Hollier
Care for patients with cleft lip and palate is best managed by a craniofacial team consisting of a variety of specialists, including surgeons, who are generally plastic surgeons or otolaryngologists trained in the United States. The goal of this study was to compare the surgical approaches and management algorithms of cleft lip, cleft palate, and nasal reconstruction between plastic surgeons and otolaryngologists. We performed a retrospective analysis of the American College of Surgeons' National Surgical Quality Improvement Program Pediatric database between 2012 and 2014 to identify patients undergoing primary repair of cleft lip, cleft palate, and associated rhinoplasty...
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29108843/outcomes-following-elective-resection-of-congenital-pulmonary-airway-malformations-are-equivalent-after-3-months-of-age-and-a-weight-of-5-kg
#7
Brian C Gulack, Harold J Leraas, Brian Ezekian, Jina Kim, Christopher Reed, Obinna O Adibe, Henry E Rice, Elisabeth T Tracy
PURPOSE: Resection of congenital pulmonary airway malformations (CPAMs) is often performed to reduce the risk of recurrent infection and malignant transformation. However, there is substantial variation in the timing of resection. This study was performed to determine the association of age and weight on outcomes following elective resection of CPAMs. METHODS: The American College of Surgeons National Surgical Quality Improvement Program-Pediatric database from 2012 to 2014 was queried for infants undergoing elective resection of a CPAM...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29106922/measuring-anatomic-severity-in-pediatric-appendicitis-validation-of-the-american-association-for-the-surgery-of-trauma-appendicitis-severity-grade
#8
Matthew C Hernandez, Stephanie F Polites, Johnathon M Aho, Nadeem N Haddad, Victor Y Kong, Humza Saleem, John L Bruce, Grant L Laing, Damian L Clarke, Martin D Zielinski
OBJECTIVE: To assess whether the American Association for the Surgery of Trauma (AAST) grading system accurately corresponds with appendicitis outcomes in a US pediatric population. STUDY DESIGN: This single-institution retrospective review included patients <18 years of age (n = 331) who underwent appendectomy for acute appendicitis from 2008 to 2012. Demographic, clinical, procedural, and follow-up data (primary outcome was measured as Clavien-Dindo grade of complication severity) were abstracted...
October 26, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29103790/laparoscopic-gastroesophageal-dissociation-in-neurologically-impaired-children-with-gastroesophageal-reflux-disease
#9
Jonathan H DeAntonio, Dan W Parrish, Shannon F Rosati, Claudio Oiticica, David A Lanning
PURPOSE: Neurologically impaired children with severe gastroesophageal reflux disease (GERD) are a challenging group of patients. We theorized that a laparoscopic gastroesophageal dissociation (LGED) may decrease reflux-related readmissions and healthcare visits, and improve quality of life (QOL) for them and their caregivers. METHODS: A retrospective review was performed on our pediatric patients that underwent an LGED along with a caregiver survey from 2013 to 2017...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29103787/a-prospective-same-day-discharge-protocol-for-pediatric-appendicitis-adding-value-to-a-common-surgical-condition
#10
Yangyang R Yu, Carolyn M Smith, Kimberly K Ceyanes, Bindi J Naik-Mathuria, Sohail R Shah, Adam M Vogel, Kathleen E Carberry, Jed G Nuchtern, Monica E Lopez
PURPOSE: Standardized clinical pathways for simple appendicitis decrease length of stay and result in cost savings. We performed a prospective cohort study to assess a same day discharge (SDD) protocol for children with simple appendicitis. METHODS: All children undergoing laparoscopic appendectomy for simple appendicitis after protocol implementation (February 2016 to January 2017) were assessed. Length of stay (LOS), 30-day resource utilization (ED visits and hospital readmissions), patient satisfaction, and hospital accounting costs for SDD were compared to non-SDD patients...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29101224/readmission-after-pediatric-mental-health-admissions
#11
Jeremy Y Feng, Sara L Toomey, Alan M Zaslavsky, Mari M Nakamura, Mark A Schuster
BACKGROUND AND OBJECTIVES: Reducing readmissions is a major health care system goal. There is a gap in our understanding of pediatric readmission patterns after mental health (MH) admissions. With this study, we aimed to characterize the prevalence of readmissions after MH admissions, to identify patient-level factors and costs associated with readmissions, and to assess variation in readmission rates across hospitals. METHODS: Using the 2014 Healthcare Cost and Utilization Project all-payer Nationwide Readmissions Database, we conducted a retrospective cohort analysis of 253 309 admissions for 5- to 17-year-olds at acute-care hospitals in 22 states...
November 3, 2017: Pediatrics
https://www.readbyqxmd.com/read/29097611/trends-in-intravenous-antibiotic-duration-for-urinary-tract-infections-in-young-infants
#12
William W Lewis-de Los Angeles, Cary Thurm, Adam L Hersh, Samir S Shah, Michael J Smith, Jeffrey S Gerber, Sarah K Parker, Jason G Newland, Matthew P Kronman, Brian R Lee, Thomas V Brogan, Joshua D Courter, Alicen Spaulding, Sameer J Patel
OBJECTIVES: To assess trends in the duration of intravenous (IV) antibiotics for urinary tract infections (UTIs) in infants ≤60 days old between 2005 and 2015 and determine if the duration of IV antibiotic treatment is associated with readmission. METHODS: Retrospective analysis of infants ≤60 days old diagnosed with a UTI who were admitted to a children's hospital and received IV antibiotics. Infants were excluded if they had a previous surgery or comorbidities, bacteremia, or admission to the ICU...
November 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/29050888/influence-of-discharge-timing-and-diagnosis-on-outcomes-of-pediatric-laparoscopic-cholecystectomy
#13
Sarah B Cairo, George Ventro, Holly A Meyers, David H Rothstein
BACKGROUND: This study evaluated the influence of discharge timing (same day versus other) on 30-day hospital readmissions after laparoscopic cholecystectomy in pediatric patients. Wound complication and readmission rates also were evaluated among patients with different operative indications. METHODS: The database of the National Surgical Quality Improvement Program-Pediatric (2012-2015) was queried for patients <18 years old who underwent laparoscopic cholecystectomy...
October 16, 2017: Surgery
https://www.readbyqxmd.com/read/29046387/congenital-heart-surgery-on-in-hospital-mortality-in-trisomy-13-and-18
#14
MULTICENTER STUDY
Katherine A Kosiv, Jeffrey M Gossett, Shasha Bai, R Thomas Collins
BACKGROUND AND OBJECTIVES: Congenital heart disease (CHD) is common in trisomy 13 (T13) and trisomy 18 (T18), but surgical repair has not been offered in most centers. Data on outcomes of congenital heart surgery (CHS) for T13 and T18 are lacking. We sought to determine the impact of CHS on in-hospital mortality in T13 and T18. METHODS: Data from the 2004 to 2015 Pediatric Health Information System database were used to identify inpatients with T13 or T18 and CHD...
November 2017: Pediatrics
https://www.readbyqxmd.com/read/29037795/the-burden-of-hospital-readmissions-among-pediatric-patients-with-inflammatory-bowel-disease
#15
Edward L Barnes, Bharati Kochar, Millie D Long, Christopher F Martin, Seth D Crockett, Joshua R Korzenik, Michael D Kappelman
OBJECTIVE: To evaluate the burden and predictors of hospital readmissions among pediatric patients with inflammatory bowel disease using the Nationwide Readmissions Database. STUDY DESIGN: We performed a retrospective cohort study using 2013 Nationwide Readmissions Database. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify patients <18 years with diagnoses of ulcerative colitis (UC) or Crohn's disease (CD)...
October 13, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29032703/the-use-of-telepsychiatry-to-provide-cost-efficient-care-during-pediatric-mental-health-emergencies
#16
John F Thomas, Douglas K Novins, Patrick W Hosokawa, Christina A Olson, Dru Hunter, Alison S Brent, Gerard Frunzi, Anne M Libby
OBJECTIVE: This study evaluated a videoconference-based psychiatric emergency consultation program (telepsychiatry) at geographically dispersed emergency department (ED) sites that are part of the network of care of an academic children's hospital system. The study compared program outcomes with those of usual care involving ambulance transport to the hospital for in-person psychiatric emergency consultation prior to disposition to inpatient care or discharge home. METHODS: This study compared process outcomes in a cross-sectional, pre-post design at five network-of-care sites before and after systemwide implementation of telepsychiatry consultation in 2015...
October 16, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29027867/unplanned-readmission-within-90-days-after-pediatric-neurosurgery
#17
Silky Chotai, Bradley S Guidry, Emily W Chan, Katherine D Sborov, Stephen Gannon, Chevis Shannon, Christopher M Bonfield, John C Wellons, Robert P Naftel
OBJECTIVE Readmission and return to operating room after surgery are increasingly being used as a proxy for quality of care. Nearly 60% of these readmissions are unplanned, which translates into billions of dollars in health care costs. The authors set out to analyze the incidence of readmission at their center, to define causes of unplanned readmission, and to determine the preoperative and surgical variables associated with readmissions following pediatric neurosurgery. METHODS A total of 536 children who underwent operations for neurosurgical diagnoses between 2012 and 2015 and who were later readmitted were included in the final analysis...
October 13, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29025957/admissions-to-acute-care-within-30-and-90-days-of-discharge-home-from-a-pediatric-post-acute-care-hospital
#18
Jane E O'Brien, Helene M Dumas, Maria A Fragala-Pinkham, Jay G Berry
OBJECTIVES: Of all hospitalized children, those with medical complexity have the highest likelihood of hospital readmission. Post-acute hospital care could potentially help stabilize the health of these children. We examined the frequency of acute care hospital admissions after discharge home from a post-acute care hospital (PACH). METHODS: A retrospective cohort analysis of 448 children with medical complexity discharged from a PACH from January 1, 2010, to December 31, 2015, with the main outcomes of acute care hospital readmissions 0 to 30 and 31 to 90 days after discharge home from a PACH...
October 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28985855/safety-of-perioperative-ketorolac-administration-in-pediatric-appendectomy
#19
Hibbut-Ur-Rauf Naseem, Robert Michael Dorman, George Ventro, David H Rothstein, Kaveh Vali
BACKGROUND: Recent studies in adults undergoing gastrointestinal surgeries show an increased rate of complications with the use of ketorolac. This calls into question the safety of ketorolac in certain procedures. We sought to evaluate the impact of perioperative ketorolac administration on outcomes in pediatric appendectomy. METHODS: The Pediatric Health Information System database was queried for patients aged 5-17 y with a primary diagnosis of appendicitis and a primary procedure of appendectomy during the period 2010-2014...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28984751/bla-oxa48-gene-microorganisms-outbreak-in-a-tertiary-children-s-hospital-over-3-years-2012-2014-case-report
#20
Rafael Herruzo, Guillermo Ruiz, Veronica Perez-Blanco, Sara Gallego, Eduardo Mora, Maria Jose Vizcaino, Felix Omeñaca
RATIONALE: Carbapenem-resistant Enterobacteriaceae are an emerging problem in children. Nosocomial spread remains the principal risk factor for acquisition of these microorganisms. PATIENTS CONCERNS: We describe an outbreak of Klebsiella pneumoniae OXA48 (KOXA48) in a tertiary children's hospital during the years 2012 to 2014, as well as the preventive measures put in place in colonized and infected cases. DIAGNOSES: We studied, "in vitro," the KOXA48 susceptibility to antiseptics and surface disinfectants...
October 2017: Medicine (Baltimore)
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