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Pediatric surgery quality

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https://www.readbyqxmd.com/read/28437787/a-comparison-of-three-different-volumes-of-levobupivacaine-for-caudal-block-in-children-undergoing-orchidopexy-and-inguinal-hernia-repair
#1
Vesna Marjanovic, Ivana Budic, Marija Stevic, Dusica Simic
OBJECTIVE: The aim of this study was to compare the efficacy of three different volumes of 0.25% levobupivacaine caudally administered on the effect of intra- and post-operative analgesia in children undergoing orchidopexy and inguinal hernia repair. SUBJECTS AND METHODS: Forty children, aged 1 to 7 years, American Society of Anesthesiologists (ASA) physical status I and II, were randomized into 3 different groups according to the applied volumes of 0.25% levobupivacaine: group 1 (n=13): 0...
April 23, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28430703/evidence-based-recommendations-for-pediatric-orthopaedic-practice
#2
Kishore Mulpuri, Emily K Schaeffer, H Kerr Graham, Mininder S Kocher, James Sanders, Ira Zaltz
BACKGROUND: Evidence-based medicine has become the cornerstone to guide clinical practice decision-making. Evidence-based medicine integrates the strongest available evidence with clinical expertise to make decisions about clinical care. The quality of the evidence depends upon the soundness of the study methodology to allow for meaningful interpretation of the clinical results. The purpose of this review is to analyze the methodological design and clinical findings of published pediatric orthopaedic studies to determine their ability to change or influence clinical practice...
April 20, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28413303/role-of-interferential-therapy-in-children-with-fecal-incontinence-postanorectal-malformation-surgeries
#3
Prince Raj, Yogesh Kumar Sarin, Prachi Raj
BACKGROUND: Anorectal malformation (ARM) is one of the most common pediatric surgical problems dealt in day-to-day practice. Although the outcome of surgery has improved a great deal over the last three decades fecal incontinence (FI) is still a common long-term morbidity that affects the quality of life of these patients. Bowel wash (BW) program with pelvic floor exercise are standard care of management for these patients. This study was undertaken to assess the role of interferential therapy (IFT) along with BW compared to BW alone in the management of FI...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28411414/laser-interstitial-thermotherapy-litt-in-epilepsy-surgery
#4
REVIEW
Christian Hoppe, Juri-Alexander Witt, Christoph Helmstaedter, Thomas Gasser, Hartmut Vatter, Christian E Elger
Besides other innovative stereotactic procedures (radiofrequency thermocoagulation, focused ultrasound, gamma knife) laser interstitial thermotherapy (LiTT) provides minimally invasive destruction of pathological soft tissues which could be especially relevant for epilepsy surgeries involving adult and pediatric patients. Unlike standard resections, no craniotomy is required; just a tiny borehole trepanation is sufficient. Damage to cortical areas when accessing deep lesions can be minimized or completely avoided, and treating epileptogenic foci near eloquent or even vital brain areas becomes possible...
April 6, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28410089/mortality-and-morbidity-after-laparoscopic-surgery-in-children-with-and-without-congenital-heart-disease
#5
David I Chu, Jonathan M Tan, Peter Mattei, Andrew T Costarino, Joseph W Rossano, Gregory E Tasian
OBJECTIVES: To determine the risk of morbidity and mortality after laparoscopic surgery among children with congenital heart disease (CHD). STUDY DESIGN: Cohort study using the 2013-2014 National Surgical Quality Improvement Program-Pediatrics, which prospectively collected data at 56 and 64 hospitals in 2013 and 2014, respectively. Primary exposure was CHD. Primary outcome was overall in-hospital postoperative mortality. Secondary outcomes included 30-day mortality and 30-day morbidity (any nondeath adverse event)...
March 3, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28408715/postoperative-infection-in-developing-world-congenital-heart-surgery-programs-data-from-the-international-quality-improvement-collaborative
#6
Amitabh Chanchal Sen, Debra Forbes Morrow, Rakhi Balachandran, Xinwei Du, Kimberlee Gauvreau, Byalal R Jagannath, Raman Krishna Kumar, Jennifer Koch Kupiec, Monica L Melgar, Nguyen Tran Chau, Gail Potter-Bynoe, Orlando Tamariz-Cruz, Kathy J Jenkins
BACKGROUND: Postoperative infections contribute substantially to morbidity and mortality after congenital heart disease surgery and are often preventable. We sought to identify risk factors for postoperative infection and the impact on outcomes after congenital heart surgery, using data from the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing World Countries. METHODS AND RESULTS: Pediatric cardiac surgical cases performed between 2010 and 2012 at 27 participating sites in 16 developing countries were included...
April 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28399908/using-cone-beam-ct-to-assess-the-upper-airway-after-surgery-in-children-with-sleep-disordered-breathing-symptoms-and-maxillary-mandibular-disproportions-a-clinical-pilot
#7
Noura A Alsufyani, Michelle L Noga, Manisha Witmans, Irene Cheng, Hamdy El-Hakim, Paul W Major
BACKGROUND: The surgical excision of anatomic obstructions such as adenoids, palatine or lingual tonsils are commonly performed in children with sleep disordered breathing (SDB). Imaging studies measuring airway changes post-surgery in the SDB pediatric population are scarce, rarely addresses the nasal cavity, and are based on global measures (e.g. volume) that do not represent the complexity of the upper airway anatomy. The purpose of this pilot is to test the feasibility in using cone beam CT (CBCT) to analyze the nasal and pharyngeal airway space post-surgery using meaningful methods of analyses, and correlating imaging findings with clinical outcomes in children with SDB symptoms and maxillary-mandibular disproportion...
April 11, 2017: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#8
Christopher A Iobst, Matthew Stillwagon, Deidre Ryan, Eric Shirley, Steven L Frick
BACKGROUND: Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28375446/quality-of-life-in-children-who-have-undergone-fundoplication-surgery-for-the-treatment-of-gastroesophageal-reflux-disease-a-review-of-literature
#9
S Pilli, A Jiwane, U Krishnan
Health-related quality of life (QOL) in children is not just related to physical symptoms but also how a disease impacts them psychosocially-mental, emotional, behavioral, and school functioning, all of which contribute to the growth and development of a child. A chronic disease, such as gastroesophageal reflux disease (GERD) characterized by troublesome symptoms and complications, can significantly impair a child's QOL. This makes it vital that treatment options aim at addressing this. Fundoplication, the surgical treatment for GERD, is one of the most common upper gastrointestinal surgeries performed by pediatric surgeons...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28375436/a-national-audit-of-colonic-interposition-for-esophageal-replacement
#10
R A Fisher, E A Griffiths, F Evison, R C Mason, J Zylstra, A R Davies, D Alderson, J A Gossage
Esophageal replacement by colonic interposition is an uncommon procedure. This study sought to identify the frequency of this operation in England, identify techniques and associated problems, and also assess health-related quality of life (HR QOL) from the two largest centers performing this procedure. Hospital Episode Statistics were used to identify patients and centers undertaking colon interposition between March 2001 and March 2015. An online survey of UK consultants discussed methods and experience. HR QOL was assessed using the Short Form 36(SF-36v2) with additional gastrointestinal questions...
May 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28362185/reoperations-within-48-hours-following-7942-pediatric-neurosurgery-procedures
#11
Anil K Roy, Jason Chu, Caroline Bozeman, Samir Sarda, Michael Sawvel, Joshua J Chern
OBJECTIVE Various indicators are used to evaluate the quality of care delivered by surgical services, one of which is early reoperation rate. The indications and rate of reoperations within a 48-hour time period have not been previously reported for pediatric neurosurgery. METHODS Between May 1, 2009, and December 30, 2014, 7942 surgeries were performed by the pediatric neurosurgery service in the operating rooms at a single institution. Demographic, socioeconomic, and clinical characteristics associated with each of the operations were prospectively collected...
March 31, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28359099/pediatric-obesity-assessment-treatment-and-prevention-an-endocrine-society-clinical-practice-guideline
#12
Dennis M Styne, Silva A Arslanian, Ellen L Connor, Ismaa Sadaf Farooqi, M Hassan Murad, Janet H Silverstein, Jack A Yanovski
Cosponsoring Associations: The European Society of Endocrinology and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society. Objective: To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity. Participants: The participants include an Endocrine Society-appointed Task Force of 6 experts, a methodologist, and a medical writer. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence...
March 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28352637/neurostimulation-for-fecal-incontinence-after-correction-of-repair-of-imperforate-anus
#13
Alexandre Bougie, Nathalie McFadden, Sandeep Mayer, Michel Lebel, Ghislain Devroede
We are reporting the case of a 32-year-old female who had suffered from fecal incontinence (FI). She was born with an imperforate anus and a recto-vaginal fistula; she underwent repair at 6 mo of age. At 29 years of age, she was still fecally incontinent despite extensive pelvic floor reeducation. A magnetic resonance imaging and an anal electromyography were performed. Because her symptoms were considered to be probably due to extra-sphincteric implantation of the neo-anus, a redo was performed of the recto-neo-anal intra-sphincteric anastomosis...
March 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28350952/future-advances-in-spine-surgery-the-aospine-north-america-perspective
#14
Michael G Fehlings, Christopher S Ahuja, Thomas Mroz, Wellington Hsu, James Harrop
This focus issue highlights state-of-the-art techniques, equipment, and practices in the modern era of spine surgery while providing a glimpse into the next generation of patient care. A broad range of topics are presented to cover the full spectrum of the field. Degenerative diseases are discussed in a series of 3 articles on (1) pathophysiology, management, and surgical approaches to degenerative cervical myelopathy; (2) novel approaches to degenerative thoracolumbar disease (eg, interspinous process spacers, minimally invasive/endoscopic approaches); and (3) animal models and emerging therapeutics in degenerative disk disease...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28350561/reducing-pediatric-sternal-wound-infections-a-quality-improvement-project
#15
Claudia Delgado-Corcoran, Charlotte S Van Dorn, Charles Pribble, Emily A Thorell, Andrew T Pavia, Camille Ward, Randall Smout, Susan L Bratton, Phillip T Burch
OBJECTIVES: To evaluate whether a quality improvement intervention reduces sternal wound infection rates in children after cardiac surgery. DESIGN: This is a pre- and postintervention quality improvement study. SETTING: A 16-bed cardiac ICU in a university-affiliated pediatric tertiary care children's hospital. PATIENTS: All patients undergoing cardiac surgery via median sternotomy from January 2010 to December 2014 are included...
March 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28346589/comparison-of-antibiotic-therapy-and-appendectomy-for-acute-uncomplicated-appendicitis-in-children-a-meta-analysis
#16
Libin Huang, Yuan Yin, Lie Yang, Cun Wang, Yuan Li, Zongguang Zhou
Importance: Antibiotic therapy for acute uncomplicated appendicitis is effective in adult patients, but its application in pediatric patients remains controversial. Objective: To compare the safety and efficacy of antibiotic treatment vs appendectomy as the primary therapy for acute uncomplicated appendicitis in pediatric patients. Data Sources: The PubMed, MEDLINE, EMBASE, and Cochrane Library databases and the Cochrane Controlled Trials Register for randomized clinical trials were searched through April 17, 2016...
March 27, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28343935/blood-derived-products-in-pediatrics-new-laboratory-tools-for-optimizing-potency-assignment-and-reducing-side-effects
#17
REVIEW
Jean Amiral, Jerard Seghatchian
Neonates and children can develop rare bleeding disorders due to congenital/acquired coagulation Factor deficiencies, or allo-immune/autoimmune complications, or can undergo surgeries at high haemorrhagic risk. They then need specialized transfusion of blood components/products, or purified blood extracted products or recombinant proteins. Blood-derived therapies conventionally used for management of affected infants with genetic/acquired deficiencies, bleeding problems (coagulation Factor reduced or missing) or thrombotic disorders (reduced or missing anticoagulant proteins) pose some additional risks...
March 15, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28343665/defining-the-association-between-operative-time-and-outcomes-in-children-s-surgery
#18
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/28341949/complications-and-outcomes-after-gynecomastia-surgery-analysis-of-204-pediatric-and-1583-adult-cases-from-a-national-multi-center-database
#19
Dmitry Zavlin, Kevin T Jubbal, Jeffrey D Friedman, Anthony Echo
BACKGROUND: Gynecomastia is a common disease that is prevalent across all age groups of boys and men. Although benign in nature, it can lead to psychological and social distress, prompting affected patients to seek medical attention. Management strategies include observation and drug therapy, yet surgical procedures remain the hallmark of treatment. The goal of this study was to analyze patient demographics, outcomes, and complication rates of gynecomastia surgery in a large multi-institutional cohort...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28328654/outcomes-for-children-receiving-noninvasive-ventilation-as-the-first-line-mode-of-mechanical-ventilation-at-intensive-care-admission-a-propensity-score-matched-cohort-study
#20
Jenny V Morris, Padmanabhan Ramnarayan, Roger C Parslow, Sarah J Fleming
OBJECTIVES: To compare outcomes of children receiving noninvasive ventilation with those receiving invasive ventilation as first-line mode of mechanical ventilation following unplanned intensive care admission. DESIGN: Propensity score-matched cohort study analyzing data prospectively collected by the Pediatric Intensive Care Audit Network over 8 years (2007-2014). SETTING: Thirty-one PICUs in the United Kingdom and Ireland; twenty-one of whom submitted Pediatric Critical Care Minimum Dataset data for the entire study period...
March 21, 2017: Critical Care Medicine
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