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https://www.readbyqxmd.com/read/29017725/appropriateness-of-a-pediatric-specific-enhanced-recovery-protocol-using-a-modified-delphi-process-and-multidisciplinary-expert-panel
#1
Heather L Short, Natalie Taylor, Kaitlin Piper, Mehul V Raval
PURPOSE: Despite Enhanced Recovery After Surgery (ERAS) protocols demonstrating improved outcomes in a wide variety of adult surgical populations, these protocols are infrequently and inconsistently being used in pediatric surgery. Our purpose was to develop a pediatric-specific ERAS protocol for use in adolescents undergoing elective intestinal procedures. METHODS: A modified Delphi process including extensive literature review, iterative rounds of surveys, and expert panel discussions was used to establish ERAS elements that would be appropriate for children...
September 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28988685/socioeconomic-disparities-affect-survival-in-malignant-ovarian-germ-cell-tumors-in-aya-population
#2
L V Bownes, L L Stafman, I I Maizlin, M Dellinger, K W Gow, A B Goldin, M Goldfarb, M Langer, M V Raval, J J Doski, J G Nuchtern, S A Vasudevan, E A Beierle
BACKGROUND: Malignant ovarian germ cell tumors (MOGCTs) are a rare form of ovarian malignancy. Socioeconomic status (SES) has been shown to affect survival in several gynecologic cancers. We examined whether SES impacted survival in adolescent and young adults (AYAs) with MOGCT. MATERIALS AND METHODS: The National Cancer Data Base was used to identify AYAs (aged 15-39 years) with MOGCT from 1998 to 2012. Three SES surrogate variables identified were as follows: insurance type, income quartile, and education quartile...
October 5, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28930050/tattooing-or-not-a-review-of-current-practice-and-outcomes-for-laparoscopic-colonic-resection-following-endoscopy-at-a-tertiary-care-centre
#3
François Letarte, Mitch Webb, Manoj Raval, Ahmer Karimuddin, Carl J Brown, P Terry Phang
BACKGROUND: Because small colonic tumours may not be visualized or palpated during laparoscopy, location of the lesion must be identified before surgery. The aim of this study was to evaluate the effectiveness of the current recommendation of endoscopic tattooing of lesions prior to laparoscopic colonic resections. METHODS: All consecutive patients who underwent elective laparoscopic resection for a colonic lesion at a single tertiary institution between 2013 and 2015 were identified for chart review...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28752820/variation-in-preoperative-testing-and-antireflux-surgery-in-infants
#4
Heather L Short, Nikolay P Braykov, James E Bost, Mehul V Raval
BACKGROUND: Despite the availability of objective tests, gastroesophageal reflux disease (GERD) diagnosis and management in infants remains controversial and highly variable. Our purpose was to characterize national variation in diagnostic testing and surgical utilization for infants with GERD. METHODS: Using the Pediatric Health Information System, we identified infants <1 year old diagnosed with GERD between January 2011 and March 2015. Outcomes included progression to antireflux surgery (ARS) and use of relevant diagnostic testing...
July 28, 2017: Pediatrics
https://www.readbyqxmd.com/read/28733452/chronic-hypertension-increases-aortic-endothelial-hydraulic-conductivity-by-upregulating-endothelial-aquaporin-1-expression
#5
Jimmy Toussaint, Chirag Bharavi Raval, Tieuvi Nguyen, Hadi Fadaifard, Shripad Joshi, George Wolberg, Steven Quarfordt, Kung-Ming Jan, David S Rumschitzki
Numerous studies have examined the role of aquaporins in osmotic water transport in various systems, but virtually none have focused on the role of aquaporin in hydrostatically driven water transport involving mammalian cells save for our laboratory's recent study of aortic endothelial cells. Here, we investigated aquaporin-1 expression and function in the aortic endothelium in two high-renin rat models of hypertension, the spontaneously hypertensive genetically altered Wistar-Kyoto rat variant and Sprague-Dawley rats made hypertensive by two-kidney, one-clip Goldblatt surgery...
November 1, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28678998/association-of-same-day-discharge-with-hospital-readmission-after-appendectomy-in-pediatric-patients
#6
Sarah B Cairo, Mehul V Raval, Marybeth Browne, Holly Meyers, David H Rothstein
Importance: Appendectomy is the most common abdominal operation performed in pediatric patients in the United States. Studies in adults have suggested that same-day discharge (SDD) after appendectomy is safe and does not result in higher-than-expected hospital readmissions. Objective: To evaluate the influence of SDD on 30-day readmission rates following appendectomy for acute appendicitis in pediatric patients. Design, Setting, and Participants: This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program-Pediatric database to evaluate 30-day readmission rates among pediatric patients who underwent an appendectomy for acute, nonperforated appendicitis...
July 5, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28655398/a-survey-of-pediatric-surgeons-practices-with-enhanced-recovery-after-children-s-surgery
#7
Heather L Short, Natalie Taylor, Mitali Thakore, Kaitlin Piper, Katherine Baxter, Kurt F Heiss, Mehul V Raval
PURPOSE: Enhanced Recovery After Surgery (ERAS) protocols have been shown to improve outcomes in adult abdominal surgical populations. Our purpose was to survey pediatric surgeons' opinions regarding applicability of individual ERAS elements to children's surgery. METHODS: A survey of the American Pediatric Surgical Association was conducted electronically. Using a 5-point Likert scale, respondents rated their willingness to implement 21 adult ERAS elements in an adolescent undergoing elective colorectal surgery...
June 17, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28624059/exploring-regional-variability-in-utilization-of-antireflux-surgery-in-children
#8
Heather L Short, Wanzhe Zhu, Courtney McCracken, Curtis Travers, Lance A Waller, Mehul V Raval
BACKGROUND: There is significant variation surrounding the indications, surgical approaches, and outcomes for children undergoing antireflux procedures (ARPs) resulting in geographic variation of care. Our purpose was to quantify this geographic variation in the utilization of ARPs in children. METHODS: A cross-sectional analysis of the 2009 Kid's Inpatient Database was performed to identify patients with gastroesophageal reflux disease or associated diagnoses. Regional surgical utilization rates were determined, and a mixed effects model was used to identify factors associated with the use of ARPs...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28584510/evaluation-of-mandibular-condylar-changes-in-patients-following-orthognathic-surgery-a-retrospective-study
#9
Vikas Aneja, Rushik Raval, Parul Aneja, K K Rai, Sumit Agarwal, Satyapal Chuadhary
BACKGROUND: Condylar resorption as a cause of relapse after orthognathic surgery is well known. Several authors have presented evidence of the relation between orthognathic surgery and condylar remodeling and resorption. This study was done to appraise the condylar changes along with the form and function following orthognathic surgery, as well as to assess what factors may have contributed to the problems. METHODOLOGY: A diagnosis of progressive condylar resorption (PCR) was made by comparison of preoperative and postoperative radiographs (cephalometric radiograms), as well as clinical evaluations...
January 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/28545764/implementation-of-an-enhanced-recovery-protocol-in-pediatric-colorectal-surgery
#10
Heather L Short, Kurt F Heiss, Katelyn Burch, Curtis Travers, John Edney, Claudia Venable, Mehul V Raval
PURPOSE: Enhanced recovery protocols (ERPs) have been shown to improve outcomes in adult surgical populations. Our purpose was to compare outcomes before and after implementation of an ERP in children undergoing elective colorectal surgery. METHODS: A pediatric-specific colorectal ERP was developed and implemented at a single center starting in January 2015. A retrospective review was performed including 43 patients in the pre-ERP period (2012-2014) and 36 patients in the post-ERP period (2015-2016)...
May 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#11
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28457339/optimal-surgical-technique-in-spontaneous-pneumothorax-a-systematic-review-and-meta-analysis
#12
REVIEW
Christopher L Sudduth, Julia K Shinnick, Zhi Geng, Courtney E McCracken, Matthew S Clifton, Mehul V Raval
BACKGROUND: Numerous thoracoscopic techniques have been used in the management of primary spontaneous pneumothorax (PSP), including wedge resection, pleurectomy, pleural abrasion, chemical pleurodesis, and staple line covering. The purpose of this systematic review was to compare outcomes for the most commonly reported techniques. MATERIALS AND METHODS: A systematic literature search looking at pneumothorax recurrence rate, length of stay, and chest tube duration after surgery was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the PubMed database...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28391975/evaluation-of-endorectal-ultrasound-erus-and-mri-for-prediction-of-circumferential-resection-margin-crm-for-rectal-cancer
#13
COMPARATIVE STUDY
Catherine Tsai, Cameron Hague, Wei Xiong, Manoj Raval, Ahmer Karimuddin, Carl Brown, P Terry Phang
ERUS and MRI are used for preoperative imaging of rectal cancer. Here, we compare ERUS and MRI for accuracy of CRM prediction at mid- and distal rectal locations. In retrospective review, 20 rectal cancer patients having TME surgery had both ERUS and MRI preoperatively: 8 mid rectum and 12 in distal rectum. Predicted CRM by ERUS and MRI were compared to TME pathology. Overall, predicted CRM was 6.5 ± 3.6 mm by ERUS, 7.7 ± 5.0 mm by MRI, and 6.0 ± 4.6 mm by pathology. Overall, correlation coefficients to pathology were 0...
May 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28343665/defining-the-association-between-operative-time-and-outcomes-in-children-s-surgery
#14
Heather L Short, Helene B Fevrier, Jonathan A Meisel, Matthew T Santore, Kurt F Heiss, Mark L Wulkan, Mehul V Raval
INTRODUCTION: Prolonged operative time (OT) is considered a reflection of procedural complexity and may be associated with poor outcomes. Our purpose was to explore the association between prolonged OT and complications in children's surgery. METHODS: 182,857 cases from the 2012-2014 NSQIP-Pediatric were organized into 33 groups. OT for each group was analyzed by quartile, and regression models were used to determine the relationship between prolonged OT and complications...
March 20, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28297082/blood-product-utilization-in-human-upper-extremity-transplantation-challenges-complications-considerations-and-transfusion-protocol-conception
#15
Jay S Raval, Vijay S Gorantla, Jaimie T Shores, W P Andrew Lee, Raymond M Planinsic, Marian A Rollins-Raval, Gerald Brandacher, Karen E King, Joseph E Losee, Joseph E Kiss
BACKGROUND: Upper-extremity transplantation (UET) is a reality. Immunologic, functional, and graft survival outcomes have been encouraging. However, these complex reconstructions have unique considerations that pose distinct challenges. Transplant programs have reported morbidity and mortality due to significant intraoperative blood losses, but similar data are scant during other phases of recovery. We report experience from two centers on complete blood component demands and utilization with UET...
March 2017: Transfusion
https://www.readbyqxmd.com/read/28102287/crotalus-atrox-venom-preconditioning-increases-plasma-fibrinogen-and-reduces-perioperative-hemorrhage-in-a-rat-model-of-surgical-brain-injury
#16
Cherine H Kim, Devin W McBride, Ronak Raval, Prativa Sherchan, Karen L Hay, Eric C K Gren, Wayne Kelln, Tim Lekic, William K Hayes, Brian S Bull, Richard Applegate, Jiping Tang, John H Zhang
Perioperative bleeding is a potentially devastating complication in neurosurgical patients, and plasma fibrinogen concentration has been identified as a potential modifiable risk factor for perioperative bleeding. The aim of this study was to evaluate preconditioning with Crotalus atrox venom (Cv-PC) as potential preventive therapy for reducing perioperative hemorrhage in the rodent model of surgical brain injury (SBI). C. atrox venom contains snake venom metalloproteinases that cleave fibrinogen into fibrin split products without inducing clotting...
January 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28039511/increased-morbidity-and-mortality-in-cardiac-patients-undergoing-fundoplication
#17
Heather L Short, Curtis Travers, Courtney McCracken, Mark L Wulkan, Matthew S Clifton, Mehul V Raval
BACKGROUND: Infants with congenital cardiac disease (CCD) often require gastrostomy tube placement (GT) and need antireflux procedures, such as fundoplications. Our purpose was to compare morbidity/mortality rates among infants with CCD undergoing GT, fundoplication, or both. METHODS: Using the NSQIP-Pediatric, we identified 4070 patients <1-year-old who underwent GT and/or fundoplication from 2012 to 2014. 2346 infants (58%) had CCD categorized as minor, major or severe...
May 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28032713/arthroscopic-retrieval-of-over-100-loose-bodies-in-shoulder-synovial-chondromatosis-a-case-report-and-review-of-literature
#18
REVIEW
Pradyumna Raval, Ashish Vijayan, Arpit Jariwala
Synovial chondromatosis is a rare and benign condition of unknown cause. It is also known as synovial osteochondromatosis. It is characterized by involvement of the synovial tissue, which lines various joints of our body. Initial symptoms range from pain in the joint, locking of the joint at times, especially the knee, to arthritis of the joint that is a late feature of this condition. Although large joints such as the knee are commonly affected, involvement of the shoulder joint is a rare occurrence. Historically an open arthrotomy was preferred for removal of loose bodies coupled with a thorough synovectomy...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/27849676/platelet-transfusion-in-critical-care-and-surgery-evidence-based-review-of-contemporary-practice-and-future-directions
#19
REVIEW
Eric W Etchill, Sara P Myers, Jay S Raval, Adnan Hassoune, Anirban SenGupta, Matthew D Neal
Thrombocytopenia is prevalent in critical care, surgical, and trauma settings. Despite the fact that a significant proportion of these patients receive platelet transfusion during their hospital course, much work remains to be done with regard to development of platelet transfusion guidelines. Given the wide variety of platelet transfusion practices and the frequency with which patients present with thrombocytopenia, it is paramount to understand standards of care and to identify deficiencies that may exist...
May 2017: Shock
https://www.readbyqxmd.com/read/27842957/clinical-validity-and-relevance-of-accidental-puncture-or-laceration-as-a-patient-safety-indicator-for-children
#20
Heather L Short, Kurt F Heiss, Mark L Wulkan, Mehul V Raval
PURPOSE: Accidental puncture or laceration (APL) has been endorsed as a patient safety indicator and is being used to compare hospital performance and for reimbursement. We sought to determine the positive predictive value (PPV) of APL as a quality metric in a pediatric population. METHODS: We retrospectively reviewed all cases that met APL administrative criteria over 5years in a quaternary pediatric hospital system. Events were categorized as false positive (FP) or true positive (TP)...
January 2017: Journal of Pediatric Surgery
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