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https://www.readbyqxmd.com/read/28719390/total-pancreatectomy-with-islet-autotransplantation-recent-updates-and-outcomes
#1
Yoshitaro Shindo, Mazhar A Kanak
PURPOSE OF REVIEW: Total pancreatectomy with islet autotransplantation (TPIAT) is a reliable therapy to retain endocrine function, to alleviate pain and improve quality of life in adult and pediatric patients suffering from refractory chronic pancreatitis and recurrent acute pancreatitis. Recently, an expansion of indications to include benign and malignant pancreatic disease has been suggested. Improved methods for evaluating the functional quality of islets and predicting transplant outcome have been discussed...
July 14, 2017: Current Opinion in Organ Transplantation
https://www.readbyqxmd.com/read/28688994/comparison-of-30-day-emergency-department-bouncebacks-after-pediatric-versus-adult-urologic-surgery
#2
Courtney L Shepard, Julian Wan
INTRODUCTION: More pediatric patients seem to present to the emergency department (ED) for non-urgent matters after urologic procedures than adult patients. Under new and expanding healthcare reform, pediatric urologists may be penalized for these visits. We compare our 30-day postoperative bounceback rates to the ED and the acuity of the concerns in these populations. MATERIALS AND METHODS: All urology consults at our institution are maintained on a prospectively tracked database...
June 20, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28610706/ultrasound-guided-bilateral-rectus-sheath-block-vs-conventional-local-analgesia-in-single-port-laparoscopic-appendectomy-for-children-with-nonperforated-appendicitis
#3
Caroline Maloney, Michelle Kallis, Ibrahim Abd El-Shafy, Aaron M Lipskar, John Hagen, Michelle Kars
INTRODUCTION: Despite its minimally invasive approach, laparoscopic surgery can cause considerable pain. Regional analgesic techniques such as the rectus sheath block (RSB) offer improved pain management following elective umbilical hernia repair in the pediatric population. This effect has not been examined in laparoscopic single-incision surgery in children. We sought to compare the efficacy of bilateral ultrasound-guided RSB versus local anesthetic infiltration (LAI) in providing postoperative pain relief in pediatric single-incision transumbilical laparoscopic assisted appendectomy (TULA) with same-day discharge...
June 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28608417/otolaryngology-practice-patterns-in-pediatric-tonsillectomy-the-impact-of-the-codeine-boxed-warning
#4
Julie L Goldman, Craig Ziegler, Elizabeth M Burckardt
OBJECTIVES/HYPOTHESIS: To determine if otolaryngologists at a single children's hospital were adherent to the boxed warning for codeine use in post-tonsillectomy patients and the implications for practice patterns. STUDY DESIGN: Case series with chart review. METHODS: Charts from all patients undergoing adenotonsillectomy at a single children's hospital from January 1, 2010 through December 31, 2015 were analyzed and stratified according to date (pre- or post-boxed warning) and practitioner type (academic otolaryngologists [AO] vs...
June 13, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28545764/temporary-removal-implementation-of-an-enhanced-recovery-protocol-in-pediatric-colorectal-surgeryimplementation-of-an-enhanced-recovery-protocol-in-pediatric-colorectal-surgery
#5
Heather L Short, Kurt F Heiss, Katelyn Burch, Curtis Travers, John Edney, Claudia Venable, Mehul V Raval
The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
May 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28529914/characteristics-of-postintensive-care-syndrome-in-survivors-of-pediatric-critical-illness-a-systematic-review
#6
Elizabeth A Herrup, Beth Wieczorek, Sapna R Kudchadkar
AIM: To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome (PICS) in adults, including physical, neurocognitive and psychological morbidities. METHODS: A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Library, PsycINFO, and CINAHL using controlled vocabulary and key word terms to identify studies reporting characteristics of PICS in pediatric intensive care unit (PICU) patients...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28377023/percutaneous-ultrasound-guided-vs-intraoperative-rectus-sheath-block-for-pediatric-umbilical-hernia-repair-a-randomized-clinical-trial
#7
Cristen N Litz, Sandra M Farach, Allison M Fernandez, Richard Elliott, Jenny Dolan, Nikhil Patel, Lillian Zamora, Paul M Colombani, Nebbie E Walford, Ernest K Amankwah, Christopher W Snyder, Paul D Danielson, Nicole M Chandler
BACKGROUND: Regional anesthesia is commonly used in children. Our hypothesis was that percutaneous ultrasound-guided (PERC) rectus sheath blocks would result in lower postoperative pain scores compared to intraoperative (IO) rectus sheath blocks following umbilical hernia repair. METHODS: A single-institution randomized blinded trial was conducted in pediatric patients undergoing elective umbilical hernia repair. The primary outcome was mean postoperative Wong-Baker pain score...
June 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28367289/comparison-of-single-dose-nalbuphine-versus-tramadol-for-postoperative-pain-management-in-children-a-randomized-controlled-trial
#8
Naeem Liaqat, Sajid Hameed Dar
BACKGROUND: Acute postoperative pain control in children is an essential component of postoperative care, particularly in daycare procedures. Giving patients continuous narcotic analgesics can be risky; however, a single dose may be sufficient. METHODS: This study used a prospective, randomized controlled design and was conducted at the Pediatric Surgery Unit, Services Hospital, Lahore. In total, 150 patients who underwent inguinal herniotomy (age range: 1-12 years) were randomly assigned to two groups: group A (nalbuphine) and group B (tramadol)...
April 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28293866/hidden-incision-endoscopic-surgery-hides-trocar-placement-for-pediatric-robotic-pyeloplasty-comparison-to-traditional-port-placement
#9
Yaejee H Hong, W Robert DeFoor, Pramod P Reddy, Marion Schulte, Eugene A Minevich, Brian A VanderBrink, Paul H Noh
Robotic assisted laparoscopy pyeloplasty (RALP) has been associated with shorter recovery, less pain and improved cosmesis. To minimize visible scars, the hidden incision endoscopic surgery (HIdES) trocar placement has been previously developed. Our aim was to compare outcomes between the HIdES and traditional port placement (TPP) for pediatric RALP. A retrospective study was performed on patients under 15 years of age who underwent RALP at a single institution between August 2011 and November 2013. Patient demographics, intraoperative details, narcotic administration, and complications were reviewed...
March 14, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28238111/use-of-fentanyl-in-adolescents-with-clinically-severe-obesity-undergoing-bariatric-surgery-a-pilot-study
#10
Janelle D Vaughns, Victoria C Ziesenitz, Elaine F Williams, Alvina Mushtaq, Ricarda Bachmann, Gisela Skopp, Johanna Weiss, Gerd Mikus, Johannes N van den Anker
BACKGROUND: The number of obese pediatric patients requiring anesthesia is rapidly increasing. Although fentanyl is a commonly used narcotic during surgery, there are no pharmacokinetic (PK) data available for optimal dosing of fentanyl in adolescents with clinically severe obesity. MATERIALS AND METHODS: An institutional review board-approved exploratory pilot study was conducted in six adolescents aged 14-19 years undergoing bariatric surgery. Mean total body weight (TBW) and mean BMI were 137...
June 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28114786/a-non-narcotic-pathway-for-the-management-of-postoperative-pain-following-pediatric-robotic-pyeloplasty
#11
Ziho Lee, Marion Schulte, W Robert DeFoor, Pramod P Reddy, Brian A VanderBrink, Eugene A Minevich, Zachary Liss, Katherine Corbyons, Paul H Noh
PURPOSE: The purpose of this study is twofold: first, to describe the non-narcotic pathway (NNP) for the management of postoperative pain after robotic pyeloplasty (RP); second, to compare perioperative outcomes for children undergoing RP whose postoperative pain was managed with and without the NNP. PATIENTS AND METHODS: A retrospective review was performed on 96 consecutive patients from October 2011 to December 2015 who underwent RP by three primary surgeons at a single pediatric institution...
March 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28087135/surgical-site-infection-related-to-use-of-elastomeric-pumps-in-pectus-excavatum-repair-lessons-learned-from-root-cause-analysis
#12
Nadja Apelt, Joshua Schaffzin, Christina Bates, Rebeccah L Brown, Marc Mecoli, Senthilkumar Sadhasivam, Victor Garcia
BACKGROUND: Pectus excavatum repair (PEX) is among the most painful thoracic procedures performed. Continuous peripheral nerve blockade (CPNB) is known to be efficacious in optimizing pain control while limiting narcotic use in adult thoracic procedures. It was introduced in May 2015 as a bridge to oral pain control in children undergoing PEX. Consequently, the surgical site infection (SSI) rate increased from 2.7% to 27.7%. METHODS: SSI surveillance followed national guidelines...
January 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28079605/delirium-in-critically-ill-children-an-international-point-prevalence-study
#13
MULTICENTER STUDY
Chani Traube, Gabrielle Silver, Ron W Reeder, Hannah Doyle, Emily Hegel, Heather A Wolfe, Christopher Schneller, Melissa G Chung, Leslie A Dervan, Jane L DiGennaro, Sandra D W Buttram, Sapna R Kudchadkar, Kate Madden, Mary E Hartman, Mary L deAlmeida, Karen Walson, Erwin Ista, Manuel A Baarslag, Rosanne Salonia, John Beca, Debbie Long, Yu Kawai, Ira M Cheifetz, Javier Gelvez, Edward J Truemper, Rebecca L Smith, Megan E Peters, A M Iqbal O'Meara, Sarah Murphy, Abdulmohsen Bokhary, Bruce M Greenwald, Michael J Bell
OBJECTIVES: To determine prevalence of delirium in critically ill children and explore associated risk factors. DESIGN: Multi-institutional point prevalence study. SETTING: Twenty-five pediatric critical care units in the United States, the Netherlands, New Zealand, Australia, and Saudi Arabia. PATIENTS: All children admitted to the pediatric critical care units on designated study days (n = 994). INTERVENTION: Children were screened for delirium using the Cornell Assessment of Pediatric Delirium by the bedside nurse...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28002386/should-grade-of-solid-organ-injury-determine-need-for-hospitalization-in-children
#14
Jillian Walsh, Pierre Schmit, Natalie Yanchar
BACKGROUND: Management of solid organ injuries (SOI) in children is often predicated on radiologic grade of injury. Hypothesizing that grade may not necessarily determine hospitalization need, we investigated factors associated with hospitalization in cases of isolated SOI in children. METHODS: Retrospective review of all cases admitted to one pediatric trauma centre over 10 yrs revealed 86 cases with SOI established by computed tomography (CT) scan upon admission...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27867308/effect-of-n-methyl-d-aspartate-receptor-antagonist-dextromethorphan-on-opioid-analgesia-in-pediatric-intensive-care-unit
#15
RANDOMIZED CONTROLLED TRIAL
Mohammed Naeem, Hala Al Alem, Ali Al Shehri, Majed Al-Jeraisy
Objective. Pain control is an essential goal in the management of critical children. Narcotics are the mainstay for pain control. Patients frequently need escalating doses of narcotics. In such cases an adjunctive therapy may be beneficial. Dextromethorphan (DM) is NMDA receptor antagonist and may prevent tolerance to narcotics; however, its definitive role is still unclear. We sought whether dextromethorphan addition could decrease the requirements of fentanyl to control pain in critical children. Design. Double-blind, randomized control trial (RCT)...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/27842790/otolaryngology-concerns-for-illicit-and-prescription-drug-use
#16
REVIEW
Nathan J Gonik, Martin H Bluth
Concern for illicit and restricted drug use in otolaryngology is similar to other surgical specialties with a few notable exceptions. Many illicit drugs are consumed transnasally. Repeated nasal exposure to stimulants or narcotics can cause local tissue destruction that can present as chronic rhinosinusitis or nasoseptal perforation. Further, the Food and Drug Administration has taken a stance against codeine for pediatric patients undergoing adenotonsillectomy. They have identified an increased risk of death postoperatively with these medications...
December 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27831525/narcotic-and-antidepressant-use-and-hospital-readmission-rates-in-children-with-functional-abdominal-pain
#17
Kathleen J Holland, William E Bennett
Functional abdominal pain is a common presentation in the pediatric population, and it carries a large financial and emotional burden. The objective of this study was to describe the association between the use of narcotics and antidepressants and hospital readmission in children admitted for abdominal pain without an organic cause. We analyzed data from the Pediatric Health Information System database. A multivariate logistical regression model was used to assess the association between medication type and hospital readmission rates within 30 and 90 days...
November 8, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27798391/pain-management-for-sickle-cell-disease-in-the-pediatric-emergency-department-medications-and-hospitalization-trends
#18
Chantel Cacciotti, Sarah Vaiselbuh, Eleny Romanos-Sirakis
The majority of emergency department (ED) visits and hospitalizations for patients with sickle cell disease (SCD) are pain related. Adequate and timely pain management may improve quality of life and prevent worsening morbidities. We conducted a retrospective chart review of pediatric patients with SCD seen in the ED, selected by sickle cell-related ICD-9 codes. A total of 176 encounters were reviewed from 47 patients to record ED pain management and hospitalization trends. Mean time to pain medication administration was 63 minutes...
October 23, 2016: Clinical Pediatrics
https://www.readbyqxmd.com/read/27757429/surgeon-driven-neurophysiologic-monitoring-in-a-spinal-surgery-population
#19
Michael Pickell, Stephen M Mann, Rajesh Chakravertty, Daniel P Borschneck
BACKGROUND: This is a prospective observational study examining the use of a surgeon-driven intraoperative neurophysiologic monitoring system. Intraoperative neurophysiologic monitoring is becoming the standard of care for spinal surgeries with potential post-operative neurologic deficits. This standard applies to both adult and pediatric spinal surgery, but a shortage of appropriately trained and certified technologists and physiologists can compromise monitoring capabilities in some centers...
September 2016: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/27627568/patterns-of-poisoning-in-urban-and-rural-children-a-single-center-study
#20
Elżbieta Pac-Kożuchowska, Paulina Krawiec, Agnieszka Mroczkowska-Juchkiewicz, Beata Mełges, Agnieszka Pawłowska-Kamieniak, Katarzyna Kominek, Dorota Gołyska
BACKGROUND: Poisoning among children is a current issue in pediatrics. The pattern and risk factors of poisoning are heterogeneous and vary within the same country. OBJECTIVES: The aim of the study was to analyze the determinants in the incidence and nature of poisoning between urban and rural children, in order to identify children at higher risk. MATERIAL AND METHODS: The study entailed a retrospective analysis of the medical records of 848 children admitted to the Department of Pediatrics at the Medical University of Lublin, Poland, due to exposure to poison from July 2008 to December 2012...
March 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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