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https://www.readbyqxmd.com/read/29111082/safety-culture-among-pediatric-surgeons-a-national-survey-of-attitudes-and-perceptions-of-patient-safety
#1
Loren Berman, Shawn Rangel, Adam Goldin, David Skarda, Madelene Ottosen, David Bliss, Patricia Valusek, Mary Fallat, KuoJen Tsao
PURPOSE: Improving the culture of safety within health care is an essential component of preventing errors and improving overall health care quality. The purpose of this study was to characterize the attitudes and perceptions of patient safety among pediatric surgeons. METHODS: We conducted a cross-sectional online survey of American Pediatric Surgery Association members. Survey items assessed surgeons' knowledge, attitudes, and perceptions of patient safety. We performed descriptive statistics and evaluated associations between respondent characteristics and survey responses...
October 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29079244/surgical-techniques-for-repair-of-atraumatic-tibialis-anterior-tendon-ruptures-a-report-of-two-cases
#2
Romy Patel, Lawrence Fallat
Tendon ruptures of the foot and ankle are overwhelmingly due to direct or blunt force trauma; however, spontaneous tendon ruptures have been less commonly documented in the published data. Surgical techniques for the repair of atraumatic ruptures differ from those for acute traumatic ruptures owing to the delayed patient presentation. Spontaneous tendon ruptures usually result from predisposing factors that have compromised the structural integrity of the tendon before the rupture occurs. We present 2 cases of atraumatic rupture of the tibialis anterior tendon, each repaired using a different surgical technique...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28974346/retrospective-analysis-of-the-akin-osteotomy
#3
Steven M Douthett, Nathan K Plaskey, Lawrence M Fallat, John Kish
Hallux abductovalgus is one of the most common deformities addressed by foot and ankle surgeons. Surgically, it can be approached using a wide variety of procedures. After performing the first metatarsal osteotomy, the final step is often to realign the great toe in a rectus position. This is performed with an osteotomy of the proximal phalanx. The Akin osteotomy is a medially based closing wedge osteotomy of the proximal phalanx. When executing the osteotomy, the goal is not only to correct abduction, but also to keep the lateral cortex intact, which allows it to act as an additional point of fixation...
September 30, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28599967/challenging-surgical-dogma-in-the-management-of-proximal-esophageal-atresia-with-distal-tracheoesophageal-fistula-outcomes-from-the-midwest-pediatric-surgery-consortium
#4
Dave R Lal, Samir K Gadepalli, Cynthia D Downard, Daniel J Ostlie, Peter C Minneci, Ruth M Swedler, Thomas H Chelius, Laura Cassidy, Cooper T Rapp, Deborah Billmire, Steven Bruch, R Carland Burns, Katherine J Deans, Mary E Fallat, Jason D Fraser, Julia Grabowski, Ferdynand Hebel, Michael A Helmrath, Ronald B Hirschl, Rashmi Kabre, Jonathan Kohler, Matthew P Landman, Charles M Leys, Grace Z Mak, Jessica Raque, Beth Rymeski, Jacqueline M Saito, Shawn D St Peter, Daniel von Allmen, Brad W Warner, Thomas T Sato
PURPOSE: Perioperative management of infants with esophageal atresia and tracheoesophageal fistula (EA/TEF) is frequently based on surgeon experience and dogma rather than evidence-based guidelines. This study examines whether commonly perceived important aspects of practice affect outcome in a contemporary multi-institutional cohort of patients undergoing primary repair for the most common type of esophageal atresia anomaly, proximal EA with distal TEF. METHODS: The Midwest Pediatric Surgery Consortium conducted a multicenter, retrospective study examining selected outcomes on infants diagnosed with proximal EA with distal TEF who underwent primary repair over a 5-year period (2009-2014), with a minimum 1-year follow up, across 11 centers...
June 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28476385/surgical-management-of-fifth-metatarsal-diaphyseal-fractures-a-retrospective-outcomes-study
#5
Patrick Thompson, Vivek Patel, Lawrence M Fallat, Robert Jarski
Fifth metatarsal diaphyseal fractures are a common injury treated by foot and ankle surgeons. The limited data on this specific fracture type has promoted nonoperative treatment with immobilization. The primary objective of the present study was to record the radiographic healing time of fifth metatarsal diaphyseal fractures after surgical intervention and present the specific fracture characteristics. The medical records of a series of 64 patients with surgically managed fifth metatarsal diaphyseal fractures were retrospectively reviewed...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28343661/variability-in-surgical-management-of-benign-ovarian-neoplasms-in-children
#6
Dani O Gonzalez, Jennifer N Cooper, Jennifer H Aldrink, Geri D Hewitt, Mary E Fallat, Peter C Minneci, Katherine J Deans
BACKGROUND/PURPOSE: Although most pediatric ovarian neoplasms are benign and may be treated with ovary-sparing surgery (OSS), consensus is lacking on the optimal surgical approach. We aimed to determine the proportion of pediatric benign ovarian neoplasms managed with OSS and to assess variability in management across hospitals and specialties. METHODS: Using the Pediatric Health Information System, we studied patients aged 6-21 years treated in 2006-2014 for a benign ovarian neoplasm with oophorectomy or OSS...
June 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28235647/pediatric-trauma-assessment-and-management-database-leveraging-existing-data-systems-to-predict-mortality-and-functional-status-after-pediatric%C3%A2-injury
#7
Katherine T Flynn-O'Brien, Mary E Fallat, Tom B Rice, Christine M Gall, Michael L Nance, Jeffrey S Upperman, David M Gourlay, John P Crow, Frederick P Rivara
BACKGROUND: Efforts to improve pediatric trauma outcomes need detailed data, optimally collected at lowest cost, to assess processes of care. We developed a novel database by merging 2 national data systems for 5 pediatric trauma centers to provide benchmarking metrics for mortality and non-mortality outcomes and to assess care provided throughout the care continuum. STUDY DESIGN: Trauma registry and Virtual Pediatric Systems, LLC (VPS) from 5 pediatric trauma centers were merged for children younger than 18 years discharged in 2013 from a pediatric ICU after traumatic injury...
May 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28103120/compassionate-options-for-pediatric-ems-cope-addressing-communication-skills
#8
Aaron W Calhoun, Erica R H Sutton, Anita P Barbee, Beth McClure, Carrie Bohnert, Richard Forest, Peter Taillac, Mary E Fallat
INTRODUCTION: Each year, 16,000 children suffer cardiopulmonary arrest, and in one urban study, 2% of pediatric EMS calls were attributed to pediatric arrests. This indicates a need for enhanced educational options for prehospital providers that address how to communicate to families in these difficult situations. In response, our team developed a cellular phone digital application (app) designed to assist EMS providers in self-debriefing these events, thereby improving their communication skills...
May 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27993359/perioperative-management-and-outcomes-of-esophageal-atresia-and-tracheoesophageal-fistula
#9
Dave R Lal, Samir K Gadepalli, Cynthia D Downard, Daniel J Ostlie, Peter C Minneci, Ruth M Swedler, Thomas Chelius, Laura Cassidy, Cooper T Rapp, Katherine J Deans, Mary E Fallat, S Maria E Finnell, Michael A Helmrath, Ronald B Hirschl, Rashmi S Kabre, Charles M Leys, Grace Mak, Jessica Raque, Frederick J Rescorla, Jacqueline M Saito, Shawn D St Peter, Daniel von Allmen, Brad W Warner, Thomas T Sato
BACKGROUND/PURPOSE: Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a rare congenital anomaly lacking contemporary data detailing patient demographics, medical/surgical management and outcomes. Substantial variation in the care of infants with EA/TEF may affect both short- and long-term outcomes. The purpose of this study was to characterize the demographics, management strategies and outcomes in a contemporary multi-institutional cohort of infants diagnosed with EA/TEF to identify potential areas for standardization of care...
August 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27940682/definitions-and-assessment-approaches-for-emergency-medical-services-for-children
#10
REVIEW
Susan Fuchs, Mark Terry, Kathleen Adelgais, Marlene Bokholdt, Jane Brice, Kathleen M Brown, Arthur Cooper, Mary E Fallat, Katherine E Remick, Keith Widmeier, Wendy Simon, Melissa Marx
Pediatric Life Support (PLS) courses and instructional programs are educational tools developed to teach resuscitation and stabilization of children who are critically ill or injured. A number of PLS courses have been developed by national professional organizations for different health care providers (eg, pediatricians, emergency physicians, other physicians, prehospital professionals, pediatric and emergency advanced practice nurses, physician assistants). PLS courses and programs have attempted to clarify and standardize assessment and treatment approaches for clinical practice in emergency, trauma, and critical care...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27856009/redefining-ladd-s-path
#11
Mary E Fallat
Inspiration and innovation go hand in hand. Throughout history tragedies, including those personal and life altering, have inspired susceptible minds to find innovative ways to educate and tackle difficult problems. This address is first about origins. It weaves the story of how incredible individuals and events have shaped similar circumstances into not only our profession of pediatric surgery beginning with William E. Ladd, but also the emergency and trauma care system in this country. The address circles back to look at the past and future of our profession of pediatric surgery...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27555352/intraneural-lipoma-of-the-tibial-nerve-a-case-report
#12
Tarin B Krzywosinski, Adam L Bingham, Lawrence M Fallat
Intraneural lipomas, neurofibrolipomas, lipofibromatous hamartomas, and perineural lipomas are subsets of hamartomas that typically present as fibroadipose, soft tissue masses within the epineurium of a nerve. Several cases involving intraneural lipomas of the median nerve in the upper extremity have been reported; however, owing to the lesion's rare incidence in the foot and ankle, only a select few cases involving the superficial peroneal nerve have been reported. We present the first case of a tibial nerve intraneural lipoma in a 42-year-old female with a follow-up period of 2 years...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27426912/using-shared-decision-making-tools-to-improve-care-for-patients-with-disorders-of-sex-development
#13
REVIEW
Kathleen Graziano, Mary E Fallat
No abstract text is available yet for this article.
August 2016: Advances in Pediatrics
https://www.readbyqxmd.com/read/27191190/family-centered-practice-during-pediatric-death-in-an-out-of-hospital-setting
#14
Mary E Fallat, Anita P Barbee, Richard Forest, Mary E McClure, Katy Henry, Michael R Cunningham
OBJECTIVE: To understand effective ways for EMS providers to interact with distressed family members during a field intervention involving a recent or impending out-of-hospital (OOH) pediatric death. METHODS: Eight focus groups with 98 EMS providers were conducted in urban and rural settings between November 2013 and March 2014. Sixty-eight providers also completed a short questionnaire about a specific event including demographics. Seventy-eight percent of providers were males, 13% were either African American or Hispanic, and the average number of years in EMS was 16 years...
November 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27097620/an-approach-to-the-management-of-pleural-empyema-with-early-video-assisted-thoracoscopic-surgery-and-early-transition-to-oral-antibiotic-therapy
#15
Claudia M Espinosa, Mary E Fallat, Charles R Woods, Kathryn E Weakley, Gary S Marshall
Practice variation exists in the management of children with bacterial pneumonia complicated by empyema. The success of video-assisted thoracoscopic surgery (VATS) versus chest tube insertion for drainage and fibrinolysis may be dependent on the stage of disease. There is little published experience with early transition to oral (PO) antibiotics, and many children are treated with intravenous (IV) antibiotics at home. To describe a cohort of children with pneumonia and empyema in a primarily rural state managed with early VATS and transition to PO antibiotics...
April 2016: American Surgeon
https://www.readbyqxmd.com/read/27027471/understanding-the-operative-experience-of-the-practicing-pediatric-surgeon-implications-for-training-and-maintaining-competency
#16
Fizan Abdullah, Jose H Salazar, Colin D Gause, Samir Gadepalli, Thomas W Biester, Kenneth S Azarow, Mary L Brandt, Dai H Chung, Dennis P Lund, Frederick J Rescorla, John H T Waldhausen, Thomas F Tracy, Mary E Fallat, Michael D Klein, Frank R Lewis, Ronald B Hirschl
IMPORTANCE: The number of practicing pediatric surgeons has increased rapidly in the past 4 decades, without a significant increase in the incidence of rare diseases specific to the field. Maintenance of competency in the index procedures for these rare diseases is essential to the future of the profession. OBJECTIVE: To describe the demographic characteristics and operative experiences of practicing pediatric surgeons using Pediatric Surgery Board recertification case log data...
August 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/26985786/guidance-document-for-the-prehospital-use-of-tranexamic-acid-in-injured-patients
#17
Peter E Fischer, Eileen M Bulger, Debra G Perina, Theodore R Delbridge, Mark L Gestring, Mary E Fallat, David V Shatz, Jay Doucet, Michael Levy, Lance Stuke, Scott P Zietlow, Jeffrey M Goodloe, Wayne E VanderKolk, Adam D Fox, Nels D Sanddal
Tranexamic acid (TXA) is being administered already in many prehospital air and ground systems. Insufficient evidence exists to support or refute the prehospital administration of TXA, and results are pending from several prehospital studies currently in progress. We have created this document to aid agencies and systems in best practices for TXA administration based on currently available best evidence. This document has been endorsed by the American College of Surgeons-Committee on Trauma, the American College of Emergency Physicians, and the National Association of EMS Physicians...
September 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/26872522/surgical-outcomes-for-resection-of-the-dorsal-exostosis-of-the-metatarsocuneiform-joints
#18
Vaishnavi Bawa, Lawrence M Fallat, John P Kish
A retrospective case series testing the efficacy of surgical resection of the dorsal exostosis deformity of the metatarsocuneiform joints was performed. Surgery was performed in 26 consecutive patients (28 feet), in whom previous conservative therapy had failed. All 26 patients had bursitis at the level of the dorsal exostosis deformity. The patients were separated into 2 groups: group 1, those with bursitis and neuritis before surgery (n = 13; 46.4%), and group 2, those with bursitis without neuritis (n = 15; 53...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/26452704/variability-in-the-structure-and-care-processes-for-critically-injured-children-a-multicenter-survey-of-trauma-bay-and-intensive-care-units
#19
MULTICENTER STUDY
Katherine T Flynn-O'Brien, Leah L Thompson, Christine M Gall, Mary E Fallat, Tom B Rice, Frederick P Rivara
PURPOSE: Evaluate national variation in structure and care processes for critically injured children. METHODS: Institutions with pediatric intensive care units (PICUs) that treat trauma patients were identified through the Virtual Pediatric Systems (n=72). Prospective survey data were obtained from PICU and Trauma Directors (n=69, 96% response). Inquiries related to structure and care processes in the PICU and emergency department included infrastructure, physician staffing, team composition, decision making, and protocol/checklist use...
March 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/26277242/empty-toe-phenomenon-a-rare-presentation-of-closed-degloving-injury-of-the-foot
#20
Adam L Bingham, Lawrence M Fallat
Traumatic degloving injuries of the lower extremity are commonly diagnosed by soft tissue deficits and separation of soft tissue planes. The management of open degloving injuries is well documented with established treatment protocols. Because closed degloving injuries of the lower extremity are so rare, the protocol management is not well established. Unlike open degloving injuries, evidence of soft tissue injury and detachment of the tissue planes can be subtle. Owing to the rarity of these injuries, little has been described regarding the long-term outcomes...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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