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Pediatric surgery

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https://www.readbyqxmd.com/read/27935164/kaolin-activated-thromboelastography-and-standard-coagulation-assays-in-cyanotic-and-acyanotic-infants-undergoing-complex-cardiac-surgery-a-prospective-cohort-study
#1
Alessandra Rizza, Zaccaria Ricci, Chiara Pezzella, Isabella Favia, Giovina Di Felice, Marco Ranucci, Paola Cogo
BACKGROUND AND AIMS: Several studies report the use of thromboelatography (TEG) to monitor coagulation in pediatric cardiac surgery. The aim of this study was to compare baseline and intraoperative TEG, TEG-functional fibrinogen, and standard coagulation assays in children with cyanotic and acyanotic congenital heart disease (CHD) undergoing cardiac surgery. METHODS: This is a prospective observational study of 63 children aged <24 months undergoing cardiac surgery with cardiopulmonary bypass (CPB)...
December 9, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27933716/risks-and-treatment-strategies-for-de-novo-hepatitis-b-virus-infection-from-anti-hbc-positive-donors-in-pediatric-living-donor-liver-transplantation
#2
Chong Dong, Wei Gao, Nan Ma, Chao Sun, Wei-Ping Zheng, Kai Wang, Zhong-Yang Shen
The aim of this study was to analyze the incidence and risk factors of de novo HBV infection in pediatric patients receiving living donor liver transplants (LDLT) from HBcAb-positive donors, and to explore its treatment strategies. The data of 101 pediatric recipients receiving LDLT in Tianjin First Central Hospital between September 2006 and December 2012 were retrospectively analyzed. The HBV markers were regularly tested before and after the surgery, including HBsAb, HBsAg, HBeAg, HBeAb, and HBcAb. The median follow-up period was 25...
December 9, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27933438/acoustic-radiation-force-impulse-arfi-elastography-in-the-evaluation-of-renal-parenchymal-stiffness-in-patients-with-ureteropelvic-junction-obstruction
#3
Hatice Arioz Habibi, Rumeysa Yasemin Cicek, Sedat Giray Kandemirli, Emel Ure, Ayse Kalyoncu Ucar, Mine Aslan, Salim Caliskan, Ibrahim Adaletli
PURPOSE: To investigate the role of acoustic radiation force impulse (ARFI) elastography in the detection of renal parenchymal damage in kidneys with and without ureteropelvic junction obstruction (UPJO). METHODS: Twenty-five pediatric patients with a diagnosis of UPJO who underwent surgery and 15 pediatric patients with conservatively managed UPJO were prospectively evaluated with ARFI elastography. Sixteen healthy volunteers constituted the control group. Shear wave velocity (SWV) measurements in the upper, mid, and lower poles of the affected kidney were performed...
December 8, 2016: Journal of Medical Ultrasonics
https://www.readbyqxmd.com/read/27931471/guideline-on-management-considerations-for-pediatric-oral-surgery-and-oral-pathology
#4
(no author information available yet)
No abstract text is available yet for this article.
October 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/27930764/decision-making-quality-in-parents-considering-adenotonsillectomy-or-tympanostomy-tube-insertion-for-their-children
#5
Paul Hong, Erin Maguire, Mary Purcell, Krista C Ritchie, Jill Chorney
Importance: Shared decision making is a process in which clinicians and patients make health care decisions in a collaborative manner using the most up-to-date evidence, while considering patient values and preferences. Shared decision making is thought to have a positive influence on the decision-making process in medicine. Objective: To describe the level of decisional conflict and decisional regret experienced by parents considering surgery for their children and to determine relations among decisional conflict, decisional regret, and shared decision making...
December 8, 2016: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/27930564/effects-of-intraoperative-dexmedetomidine-with-intravenous-anesthesia-on-postoperative-emergence-agitation-delirium-in-pediatric-patients-undergoing-tonsillectomy-with-or-without-adenoidectomy-a-consort-prospective-randomized-controlled-clinical-trial
#6
Jun-Li Cao, Yu-Ping Pei, Jing-Qiu Wei, Yue-Ying Zhang
Postoperative emergence agitation/delirium (POED) is a common complication in pediatric surgery patients, which increases the risk of developing postoperative airway obstruction and respiratory depression. This study aims to investigate the safety and efficacy of intraoperative infusion of dexmedetomidine (DEX) and its effects on POED in pediatric patients undergoing tonsillectomy with or without adenoidectomy.Sixty patients scheduled for tonsillectomy with or without adenoidectomy, aged 2 to 8 years, were randomly allocated into 2 groups (n = 30)...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27930515/usefulness-of-the-maximum-rate-of-pressure-rise-in-the-central-and-peripheral-arteries-after-weaning-from-cardiopulmonary-bypass-in-pediatric-congenital-heart-surgery-a-retrospective-analysis
#7
Jung-Won Kim, Ji-Yeon Bang, Chun Soo Park, Mijeung Gwak, Won-Jung Shin, Gyu-Sam Hwang
The maximum rate of pressure rise (dP/dtmax) in radial artery has been proposed as a noninvasive surrogate of aortic dp/dtmax, reflecting left ventricular (LV) contractility in children. The aim of this study was to investigate relationship between aortic and radial dp/dtmax at weaning from cardiopulmonary bypass (CPB) and usefulness of these indices for estimating postoperative outcomes in pediatric congenital heart surgery.Aortic and radial arterial pressure waveforms were analyzed simultaneously during weaning from CPB in 29 congenital heart surgery...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27930278/for-love-not-money-the-financial-implications-of-surgical-fellowship-training
#8
Paul M Inclan, Adam S Hyde, Michael Hulme, Jeffrey E Carter
Surgical residents cite increased income potential as a motivation for pursuing fellowship training, despite little evidence supporting this perception. Thus, our goal is to quantify the financial impact of surgical fellowship training on financial career value. By using Medical Group Management Association and Association of American Medical Colleges physician income data, and accounting for resident salary, student debt, a progressive tax structure, and forgone wages associated with prolonged training, we generated a net present value (NPV) for both generalist and subspecialist surgeons...
September 2016: American Surgeon
https://www.readbyqxmd.com/read/27928843/systemic-inflammatory-response-syndrome-after-pediatric-congenital-heart-surgery-incidence-risk-factors-and-clinical-outcome
#9
Martin Boehne, Michael Sasse, André Karch, Friederike Dziuba, Alexander Horke, Torsten Kaussen, Rafael Mikolajczyk, Philipp Beerbaum, Thomas Jack
BACKGROUND: Systemic inflammatory response syndrome (SIRS) is frequent after cardiac surgery, but data on its incidence and perioperative risk factors are scarce for children with congenital heart disease. METHODS: SIRS incidence within 72 hours following cardiac surgery was evaluated in a secondary analysis of children enrolled to a treatment-free control group of a randomized controlled trial. Intraoperative parameters were investigated for their association with SIRS using multivariable fractional polynomial logistic regression models...
December 7, 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27928719/correlation-between-quality-of-life-and-functional-outcomes-in-operated-children-with-anorectal-malformations-using-the-krickenbeck-consensus
#10
V Shankar Raman, Sandeep Agarwala, Veereshwar Bhatnagar
OBJECTIVE: To correlate the functional outcomes in children operated for anorectal malformations (ARM) using the Krickenbeck consensus and their quality of life (QOL). METHODS: Thirty-three children operated at a tertiary care Pediatric surgery centre were studied 2 y after completion of all the surgeries and if more than 3 y of age. The functional stooling outcomes, type of anomalies and surgical procedures were tabulated using the Krickenbeck classification. The QOL questionnaire consisted of five parameters (Social habit, school attendance, daily activity, relation to peers and feeling) and the scoring ranged between 0 and 12: Good (8-12), Fair (5-7) and Poor (0-4)...
December 8, 2016: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27927545/does-planned-staging-for-posterior-only-vertebral-column-resections-in-spinal-deformity-surgery-increase-perioperative-complications
#11
Jeffrey L Gum, Lawrence G Lenke, David Bumpass, Johnny Zhao, Patrick Sugrue, Isaac Karikari, Ra'Kerry Rahman, Leah Y Carreon
STUDY DESIGN: Propensity-matched case control. OBJECTIVES: To compare the perioperative complication rate between single- and two-stage posterior-only VCRs (2-pVCR). SUMMARY OF BACKGROUND DATA: A vertebral column resection (VCR) for severe spinal deformity is a technically challenging and lengthy procedure with a potentially high complication rate. Planned staging has an advantage of distributing operative time into 2 smaller, more manageable, intervals...
March 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927517/management-of-spinal-implants-in-acute-pediatric-surgical-site-infections-a-multicenter-study
#12
Michael P Glotzbecker, Jaime A Gomez, Patricia E Miller, Michael J Troy, David L Skaggs, Michael G Vitale, John M Flynn, Kody K Barrett, Gregory I Pace, Brittany N Atuahene, Daniel J Hedequist
STUDY DESIGN: A retrospective review of patients who underwent posterior spinal fusion (PSF) and returned within 90 days with an acute infection. OBJECTIVES: The study motive is to identify and understand the risk factors associated with failure of retaining spinal implants and failure to treat acute infection. BACKGROUND: The natural history of early surgical site infection (SSI) (less than 3 months) after PSF is not known and removing the implants early after PSF risks pseudarthrosis and deformity progression...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927516/preoperative-mrsa-screening-in-pediatric-spine-surgery-a-helpful-tool-or-a-waste-of-time-and-money
#13
Scott J Luhmann, June C Smith
OBJECTIVES: To review the use of preoperative screening for Staphylococcus aureus for all pediatric spine procedures that was instituted at our facility in a multimodal approach to decrease the frequency of postoperative wound infections. SUMMARY OF BACKGROUND DATA: Four years ago at our facility, a multimodal approach to decrease the frequency of postoperative infections after pediatric spine surgery was instituted. METHODS: A single-center, single-surgeon pediatric spine surgery database was queried to identify all patients who had preoperative S...
July 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927507/sacral-alar-iliac-fixation-in-pediatric-deformity-radiographic-outcomes-and-complications
#14
Amit Jain, Khaled M Kebaish, Paul D Sponseller
STUDY DESIGN: Retrospective case series. OBJECTIVES: To assess the radiographic outcomes and complications of sacral-alar-iliac (SAI) fixation in children. SUMMARY OF BACKGROUND DATA: Pelvic fixation in children undergoing spinal deformity surgery can be challenging because of complex anatomy, compound biomechanical forces at the lumbosacral junction, and poor bone quality. METHODS: Radiographic and clinical records of 80 consecutive patients aged 18 years or younger who underwent posterior spinal fusion surgery with SAI fixation by one pediatric orthopedic surgeon and who had a minimum 2 years of follow-up (mean follow-up: 3...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27927504/does-the-type-of-metal-instrumentation-affect-the-risk-of-surgical-site-infection-in-pediatric-scoliosis-surgery
#15
Margaret L Wright, David L Skaggs, Hiroko Matsumoto, Regina P Woon, Ashley Trocle, John M Flynn, Michael G Vitale
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the association of implant metal composition with the risk of surgical site infection (SSI) following pediatric spine surgery. SUMMARY OF BACKGROUND DATA: SSI is a well-described complication following pediatric spine surgery. Many risk factors have been identified in the literature, but controversy remains regarding metal composition as a risk factor. METHODS: This was a retrospective study of patients who underwent posterior spinal instrumentation procedures between January 1, 2006, and December 31, 2008, at three large children's hospitals for any etiology of scoliosis and had at least 1 year of postoperative follow-up...
May 2016: Spine Deformity
https://www.readbyqxmd.com/read/27926758/association-between-surgeon-scorecard-use-and-operating-room-costs
#16
Corinna C Zygourakis, Victoria Valencia, Christopher Moriates, Christy K Boscardin, Sereina Catschegn, Alvin Rajkomar, Kevin J Bozic, Kent Soo Hoo, Andrew N Goldberg, Lawrence Pitts, Michael T Lawton, R Adams Dudley, Ralph Gonzales
Importance: Despite the significant contribution of surgical spending to health care costs, most surgeons are unaware of their operating room costs. Objective: To examine the association between providing surgeons with individualized cost feedback and surgical supply costs in the operating room. Design, Setting, and Participants: The OR Surgical Cost Reduction (OR SCORE) project was a single-health system, multihospital, multidepartmental prospective controlled study in an urban academic setting...
December 7, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27926673/guideline-for-c1-lateral-mass-and-c2-pedicle-screw-choices-in-children-younger-than-6-years
#17
Daoyang Fan, Ruipeng Song, Min Zhang, Ruimin Bai, Yue Li, Zhen Zhang, Han Wu, Yuqiang Wang, Liang Zhao, Wenfei Gao, Hui Dong, Wensheng Liao, Yilin Liu, Yi Zhang, Limin Wang, Weidong Wang
STUDY DESIGN: Prospective study. OBJECTIVE: To analyze the most feasible choice of C1 lateral mass (C1LM) and C2 pedicle (C2P) screw in upper cervical surgeries for children younger than 6 years. SUMMARY OF BACKGROUND DATA: The C1LM and C2P screw technique is a stable cervical vertebrae internal fixation method in upper cervical surgery. Some tomographic studies have indicated the feasibility of insertion of C1LM and C2P screws in children...
December 6, 2016: Spine
https://www.readbyqxmd.com/read/27926352/3d-laparoscopy-in-neonates-and-infants
#18
Yury Kozlov, Konstantin Kovalkov, Vladimir Nowogilov
BACKGROUND: This study focuses on the successful application of three-dimensional (3D) laparoscopic surgeries in the treatment of congenital anomalies and acquired diseases in the young pediatric population. The purpose of this scientific work consists in highlighting the spectrum, indications, applicability, and effectiveness of 3D endosurgery in children. METHODS: Our experience is based on 110 endosurgical procedures performed in neonates and infants in the 3D format between January 2014 and May 2015...
December 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27925243/hemodiafiltration-a-technique-for-physiological-correction-of-priming-solution-in-pediatric-cardiac-surgery-an-in-vitro-study
#19
Pankaj Garg, Arvind Kumar Bishnoi, Kartik Patel, Vivek Wadhawa, Jigar Surti, Atul Solanki, Komal Shah, Sanjay Patel
Pediatric cardiopulmonary bypass (CPB) circuit invariably requires priming with packed red blood cells (PRBCs). Metabolic composition of stored PRBCs is unphysiological and becomes worse with increasing duration of storage. It is recommended to correct these abnormalities before initiation of CPB. We tested the hypothesis that hemodiafiltration of the prime with 0.45% saline is sufficient for reducing the metabolic load and reaching a physiologic state. In an in vitro study, 100 mL of blood each from 45 units of PRBCs stored for 3-20 days were used for priming the 45 neonatal CPB circuits...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27924390/technical-standardization-of-laparoscopic-repair-of-morgagni-diaphragmatic-hernia-in-children-results-of-a-multicentric-survey-on-43-patients
#20
Ciro Esposito, Maria Escolino, Francois Varlet, Amulya Saxena, Sabine Irtan, Paul Philippe, Alessandro Settimi, Mariapina Cerulo, Holger Till, Francois Becmeur, George W Holcomb
BACKGROUND: This study aimed to standardize the surgical correction technique of congenital Morgagni diaphragmatic hernia (CMDH), analyzing the results of an international multicentric survey. METHODS: The medical records of 43 patients (29 boys, 14 girls) who underwent laparoscopic repair of CMDH in 8 pediatric surgery units in a 5-year period were retrospectively reviewed. Their average age was 3.3 years. Ten patients (23.2%) presented associated malformations: 9 Down syndrome (20...
December 6, 2016: Surgical Endoscopy
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