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https://www.readbyqxmd.com/read/28238307/comparing-pyloromyotomy-outcomes-across-canada
#1
Alexander C Ednie, Ofer Amram, Nadine Schuurman, Natalie L Yanchar
BACKGROUND: Changing patterns of referral and management of hypertrophic pyloric stenosis (HPS) in North America have recently been described. Comfort with perioperative management, anesthesia, and corrective surgery have been cited as reasons for these changes. Our primary objective was to assess pyloromyotomy outcomes between different hospital types across Canada. The secondary objective was to geospatially map all pyloromyotomies to identify regions of higher HPS incidence across Canada...
January 28, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28230608/specialized-imaging-and-procedures-in-pediatric-pancreatology-a-north-american-society-for-pediatric-gastroenterology-hepatology-and-nutrition-clinical-report
#2
Tom K Lin, David M Troendle, Daniel B Wallihan, Bradley Barth, Victor L Fox, Douglas S Fishman, Veronique D Morinville
OBJECTIVES: An increasing number of children are being diagnosed with pancreatitis and other pancreatic abnormalities. Dissemination of the information regarding existing imaging techniques and endoscopic modalities to diagnose and manage pancreatic disorders in children is sorely needed. METHODS: We conducted a review of the medical literature on the use of the following imaging and procedural modalities in pediatric pancreatology: transabdominal ultrasonography (TUS), computed tomography (CT), magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and endoscopic retrograde cholangiopancreatography (ERCP)...
March 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28217718/pediatric-perioperative-stress-responses-and-anesthesia
#3
Koichi Yuki, Erika Matsunami, Kazumasa Tazawa, Wei Wang, James A DiNardo, Sophia Koutsogiannaki
Surgical stress responses cause an array of endocrinological, metabolic and immunological changes in patients. The landmark studies in the 1980s showed that adequate anesthesia dramatically improved the outcomes of pediatric surgical patients by attenuating stress hormonal responses, pointing out the harm of 'inadequate' anesthesia. Subsequent studies questioned the role of administering very high-dose anesthetics to further attenuate stress responses. Here we review the feature of surgical stress responses in pediatric patients including their difference from those in adult patients...
2017: Translational Perioperative and Pain Medicine
https://www.readbyqxmd.com/read/28211128/staged-intraperitoneal-brachytherapy-and-hyperthermic-intraperitoneal-chemotherapy-in-an-adolescent-novel-anesthetic-challenges-for-pediatric-anesthetists
#4
Andrew D Weatherall, Tristan R Bennett, Mark Lovell, Winnie Fung, Jonathan de Lima
Newer techniques that have found a place in cancer management in adults are offered far less commonly in pediatric patients. We present a case of a patient with recurrent Wilms' tumor managed with a novel combination of cytoreductive surgery, intraperitoneal brachytherapy, and subsequent hyperthermic intraperitoneal chemotherapy. Each stage presents challenges that the pediatric anesthetist is unlikely to have faced before. Such cases require flexibility and thorough planning to manage the combination of major surgery, remote anesthesia with brachytherapy and hyperthermic chemotherapy with its potential for metabolic derangement, significant fluid shifts, analgesic care, and potential exposure of staff to cytotoxic agents...
February 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28183549/hypocapnia-measured-by-end-tidal-carbon-dioxide-tension-during-anesthesia-is-associated-with-increased-30-day-mortality-rate
#5
Philippe Dony, Michele Dramaix, Jean G Boogaerts
STUDY OBJECTIVE: To evaluate the relationship between intraoperative end-tidal carbon dioxide (etco2) values and clinical outcomes with special attention on 30-day postoperative mortality and secondarily on hospital length of stay (LOS). DESIGN: Retrospective, observational study. SETTING: Surgical theaters of the University Hospital Center of Charleroi. PATIENTS: Five thousand three hundred seventeen patients ASA I-IV undergoing various surgical procedures (except pediatric and cardiac surgery) under general anesthesia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28181385/hemodynamic-profile-and-behavioral-characteristics-during-induction-of-anesthesia-in-pediatric-patients-with-attention-deficit-hyperactivity-disorder
#6
Richard S Cartabuke, Joseph D Tobias, Julie Rice, Dmitry Tumin
AIM: There is no consensus regarding the administration of stimulant drugs preoperatively, particularly in pediatric patients diagnosed with ADHD. The primary objective of the current study was to assess differences in blood pressure and heart rate before and after induction of anesthesia between patients on chronic amphetamine or methylphenidate therapy who receive their normal dose preoperatively compared to patients in whom the prescribed medication was withheld. Secondary objectives were to assess the anxiety level during the induction of anesthesia and the effect of premedication with midazolam...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28181199/an-examination-of-disparities-in-pediatric-pain-management-centered-on-socioeconomic-factors-and-hospital-characteristics
#7
Franklin B Chiao, Alan Wang
INTRODUCTION: Very little is known about pediatric pain management resource differences. In contrast, disparities in pain management within the adult population are known to exist. This research examined whether significant differences exist between hospitals in the state of New York and what factors impact these pain resources. METHODS: The study was approved by the institutional review board. A questionnaire was sent to the anesthesia/pediatric/pain directors of every hospital in the state of New York via SurveyMonkey...
February 8, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28130755/prevention-and-therapy-of-pediatric-emergence-delirium-a-national-survey
#8
Christopher Huett, Torsten Baehner, Felix Erdfelder, Claudia Hoehne, Christian Bode, Andreas Hoeft, Richard K Ellerkmann
INTRODUCTION: Although pediatric emergence delirium (ED) is common, preventive and therapeutic pharmacological treatment is the matter of an international controversial discussion and evidence on different options is partially vague. OBJECTIVE: We therefore examined clinical routine in prevention strategies and postoperative therapy of ED with respect to clinical experience in pediatric anesthesia. METHODS: A web-based survey was developed investigating routine management (prevention and treatment) of ED, facility structure, and patient population...
January 28, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28130577/radiological-evaluation-of-tube-depth-and-complications-of-prehospital-endotracheal-intubation-in-pediatric-trauma-a-descriptive-study
#9
T Simons, T Söderlund, L Handolin
PURPOSE: Pediatric prehospital endotracheal intubation (PHETI) is a difficult and rarely performed procedure that remains the gold standard for prehospital airway management when ventilation and/or anesthesia is required, but high complications rates, including malposition continue to concern. We reviewed the experience in our institution of pediatric intubations with particular emphasis on the position of the endotracheal tube (ETT) tip within the trachea and related complications. METHOD: Intubated pediatric patients presenting directly from the scene to our level 1 trauma center, between 2006 and 2014, were included in our study...
January 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28127171/knowledge-attitude-and-practices-of-dental-surgeons-in-managing-child-patients
#10
Aisha Wali, Talha Mufeed Siddiqui, Rabia Khan, Kanza Batool
: The aim of the study was to evaluate the knowledge, attitude, and practices of dental surgeons in the city of Karachi providing treatment to pediatric patients. A cross-sectional study was conducted to evaluate the knowledge, attitude, and practices of dental surgeons in the city of Karachi providing treatment to pediatric patients. A cluster-sampling technique was used and 200 dental surgeons from six different dental institutions were selected. A self-constructed questionnaire was distributed to the dental surgeons that comprised 20 closed-ended questions...
October 2016: International Journal of Clinical Pediatric Dentistry
https://www.readbyqxmd.com/read/28121757/the-perinatal-birth-environment-communication-strategies-and-processes-for-adherence-to-a-standardized-guideline-in-women-undergoing-second-stage-labor-with-epidural-anesthesia
#11
Samantha A Sommerness, Rebecca Gams, Phillip N Rauk, Ananta Bangdiwala, Daniel V Landers, Melissa D Avery, Charles Hirt, Kristi Miller, Amy Millar, Suzin Cho, Andrea Shields
Key to any perinatal safety initiative is buy-in and strong leadership from obstetric and pediatric providers, advanced practice nurses, and labor and delivery nurses in collaboration with ancillary staff. In the fall of 2007, executives of a large Midwestern hospital system created the Zero Birth Injury Initiative. This multidisciplinary group sought to eliminate birth injury using the Institute of Healthcare Improvement Perinatal Bundles. Concurrently, the team implemented a standardized second-stage labor guideline for women who choose epidural analgesia for pain management to continue the work of eliminating birth injuries in second-stage labor...
January 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28119992/development-and-feasibility-of-a-real-time-clinical-decision-support-system-for-traumatic-brain-injury-anesthesia-care
#12
Taniga Kiatchai, Ashley A Colletti, Vivian H Lyons, Rosemary M Grant, Monica S Vavilala, Bala G Nair
BACKGROUND: Real-time clinical decision support (CDS) integrated with anesthesia information management systems (AIMS) can generate point of care reminders to improve quality of care. OBJECTIVE: To develop, implement and evaluate a real-time clinical decision support system for anesthetic management of pediatric traumatic brain injury (TBI) patients undergoing urgent neurosurgery. METHODS: We iteratively developed a CDS system for pediatric TBI patients undergoing urgent neurosurgery...
January 25, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28100415/a-10-year-trend-of-dental-treatments-under-general-anesthesia-of-children-in-taipei-veterans-general-hospital
#13
Yung-Pan Chen, Chun-Yi Hsieh, Wen-Ting Hsu, Fu-Ya Wu, Wen-Yu Shih
BACKGROUND: General anesthesia (GA) as a pediatric dental procedure is a well-established method of behavior management. However, studies of pediatric dentistry under GA have mostly focused on handicapped patients, and various retrospective studies in Taiwan have mainly reviewed only a limited number of years. The purpose of the present study was to report trends in pediatric dental treatment performed under GA over the past 10 years. METHODS: A retrospective review of the hospital records of patients receiving dental treatment under GA from 2006 until 2015 was performed...
January 16, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28099323/anesthesia-and-databases-pediatric-cardiac-disease-as-a-role-model
#14
David F Vener, Sara K Pasquali, Emad B Mossad
Large data sets have now become ubiquitous in clinical medicine; they are particularly useful in high-acuity, low-volume conditions such as congenital heart disease where data must be collected from many centers. These data fall into 2 categories: administrative data arising from hospital admissions and charges and clinical data relating to specific diseases or procedures. In congenital cardiac diseases, there are now over a dozen of these data sets or registries focusing on various elements of patient care...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28094480/anesthetic-complications-during-general-anesthesia-without-intravenous-access-in-pediatric-ophthalmologic-clinic-assessment-of-5216-cases
#15
Chun W Hung, Lauren Licina, David H Abramson, Vittoria Arslan-Carlon
BACKGROUNDː General anesthesia utilizing inhalational agents without intravenous (IV) access for minor procedures is controversial1. Eliminating IV access increases efficiency and patient satisfaction; however, the ability to introduce rapid acting medications into the circulation during an unanticipated emergency becomes challenging. The objective of this study was to examine complication risk following pediatric ophthalmologic examinations under anesthesia (EUA) without IV placement. METHODSː A retrospective review of consecutive pediatric patients who underwent EUA for retinoblastoma management was performed from 2004 to 2014...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28079584/the-development-and-implementation-of-cognitive-aids-for-critical-events-in-pediatric-anesthesia-the-society-for-pediatric-anesthesia-critical-events-checklists
#16
Anna Clebone, Barbara K Burian, Scott C Watkins, Jorge A Gálvez, Justin L Lockman, Eugenie S Heitmiller
Cognitive aids such as checklists are commonly used in modern operating rooms for routine processes, and the use of such aids may be even more important during critical events. The Quality and Safety Committee of the Society for Pediatric Anesthesia (SPA) has developed a set of critical-event checklists and cognitive aids designed for 3 purposes: (1) as a repository of the latest evidence-based and expert opinion-based information to guide response and management of critical events, (2) as a source of just-in-time information during critical events, and (3) as a method to facilitate a shared understanding of required actions among team members during a critical event...
March 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28072737/the-efficacy-of-dexmedetomidine-remifentanil-versus-dexmedetomidine-propofol-in-children-undergoing-flexible-bronchoscopy-a-retrospective-trial
#17
Hongquan Zhang, Baojun Fang, Wenjing Zhou
Flexible bronchoscopy has been more and more used for diagnosis and management diseases of respiratory system in pediatrics. Previous studies have reported that remifentanil (RF) and propofol are safe and effective for flexible bronchoscopy in adults, however, there have no trials evaluate the efficacy of DEX-RF versus dexmedetomidine-propofol in children undergoing flexible bronchoscopy.We divided 123 children undergoing flexible bronchoscopy with DEX-RF or dexmedetomidine-propofol into 2 groups: Group DR (n = 63, DEX infusion at 1...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28057843/diphenhydramine-for-acute-extrapyramidal-symptoms-after-propofol-administration
#18
James Sherer, Tomas Salazar, Kevin B Schesing, Shannon McPartland, Jeffrey Kornitzer
Extrapyramidal symptoms are an uncommon but well-recognized side effect after the administration of general anesthesia in patients without a significant neurologic history. Several case reports implicate propofol as the likely causative agent producing these symptoms, which include ballismus, dystonia, choreoathetosis, and opisthotonus. Currently, there is no clear consensus on first-line treatment of these symptoms. In each of the published cases, anticholinergic medications and benzodiazepines were central to initial management, although the speed and extent of symptom resolution were variable...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28042274/effectiveness-of-behavioral-modification-techniques-with-visual-distraction-using-intrasulcular-local-anesthesia-in-hearing-disabled-children-during-pulp-therapy
#19
Kausar Sadia Fakhruddin, Mehmet Omer Gorduysus, Hisham El Batawi
OBJECTIVE: Assessing the effectiveness of behavioral modification techniques in combination with visual distraction with/without video eyewear using computerized delivery system-intrasulcular (CDS-IS) during the application of local anesthetic in hearing-impaired pediatric patients undergoing pulp therapy of primary molars. MATERIALS AND METHODS: This randomized, crossover clinical study includes 15 children (7 boys and 8 girls), mean age was 6.1 years. Children were randomly distributed into two groups (Group A, n = 7; Group B, n = 8)...
October 2016: European Journal of Dentistry
https://www.readbyqxmd.com/read/28031981/drug-delivery-biomaterials-and-nanomedicine-an-interview-with-daniel-s-kohane
#20
Daniel S Kohane
Daniel Kohane speaks to Francesca Lake, Managing Editor: Obtaining his MD and PhD in Physiology from Boston University (MA, USA), Dan Kohane went on to complete residencies in Pediatrics at Boston Children's Hospital (MA, USA) and Anesthesiology at Massachusetts General Hospital (USA), followed by a fellowship in Pediatric Critical Care at Boston Children's Hospital. He is currently a Professor of Anesthesia at Harvard Medical School (MA, USA) and a Senior Associate in Pediatric Critical Care at Boston Children's Hospital, where he directs the Laboratory for Biomaterials and Drug Delivery...
September 2016: Future Science OA
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