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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
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
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
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
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
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...
December 5, 2016: Journal of Pediatric Surgery
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
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
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
Kathleen Graziano, Mary E Fallat
No abstract text is available yet for this article.
August 2016: Advances in Pediatrics
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
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
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
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
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
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
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
Boyd J Andrews, Lawrence M Fallat, John P Kish
The chevron osteotomy is a popular procedure used for the correction of moderate hallux abducto valgus deformity. Fixation is typically accomplished with Kirschner wires or bone screws; however, in cystic or osteoporotic bone, these could be inadequate, resulting in displacement of the capital fragment. We propose using a locking plate and interfragmental screw for fixation of the chevron osteotomy that could reduce the healing time and decrease the incidence of displacement. We performed a retrospective cohort study for chevron osteotomies on 75 feet (73 patients)...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Alper Deveci, Serdar Yilmaz, Ahmet Firat, Ahmet Ozgur Yildirim, Ozdamar Fuat Oken, Murat Gulcek, Ahmet Ucaner
BACKGROUND: Tailor's bunion is a deformity of the fifth toe, and its concomitance with hallux valgus (HV) is defined as splayfoot deformity. Treatment is focused on the HV deformity in splayfoot, and the tailor's bunion deformity can be overlooked. The frequency of HV concomitant with tailor's bunion in splayfoot has not been reported in the literature. METHODS: A retrospective evaluation was performed to detect the existence of tailor's bunion deformity in 203 patients (376 feet) treated for HV...
May 2015: Journal of the American Podiatric Medical Association
Kate A McCracken, Mary E Fallat
Disorders of sexual development (DSDs) are relatively rare congenital conditions in which the development of the chromosomal, gonadal, or anatomic sex is atypical. Some conditions may not manifest until puberty or adulthood. The examination and workup of either an infant or an older patient with suspected DSD should be directed and performed systematically by a multidisciplinary team. Ideally, the team will include those with not only an interest in DSD but also experience with this group of patients. This article will briefly orient the reader to the conditions and decisions that may have been made during infancy, childhood, and adolescence and then focus on the challenges that may accompany transitioning the care of DSD patients from pediatric to adult surgeons and specialists to enable appropriate decisions and care...
April 2015: Seminars in Pediatric Surgery
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