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Pediatric surgery quality

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https://www.readbyqxmd.com/read/29677085/surgical-antimicrobial-prophylaxis-among-pediatric-patients-in-south-africa-comparing-two-healthcare-settings
#1
Nicolene van der Sandt, Natalie Schellack, Lindi A Mabope, Mothahadini Pb Mawela, Danie Kruger, Brian Godman
BACKGROUND: Appropriate use of surgical antimicrobial prophylaxis (SAP) is a concern in view of its impact on morbidity, mortality and costs. Little is currently known about SAP in South Africa. OBJECTIVE: Assess compliance to SAP guidelines for pediatric patients undergoing surgery in one of four surgical sub-specialties among hospitals in South Africa. METHODS: Eight month retrospective chart review in both a teaching hospital and a private hospital between February and August 2015...
April 19, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29677063/the-anesthesia-perioperative-call-for-help-experience-at-a-quaternary-pediatric-medical-center-analysis-of-67-564-anesthesia-encounters
#2
Bistra G Vlassakova, Sean M Sinnott, Nissa Askins, Matthew X Callahan, Izabela C Leahy, David Zurakowski, Paul R Hickey, Joseph P Cravero
BACKGROUND: During the past several decades, anesthesia has become increasingly safe. Truly major adverse events are rare, and anesthesia quality researchers have instituted programs to evaluate "near miss" or less critical adverse events to evaluate the safety of anesthesia delivery. In this study, we aimed to evaluate calls for emergency help in our institution as a surrogate for pending critical events. We hypothesized that calls would be more common in patients with high American Society of Anesthesiologists (ASA) physical status, history of prematurity, and children with recent respiratory illness compared to those without these characteristics...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29677059/pediatric-perioperative-cardiac-arrest-death-in-the-off-hours-a-report-from-wake-up-safe-the-pediatric-quality-improvement-initiative
#3
Robert E Christensen, Angela C Lee, Marie S Gowen, Mallikarjuna R Rettiganti, Jayant K Deshpande, Jeffrey P Morray
BACKGROUND: Pediatric perioperative cardiac arrest (CA) is a rare but catastrophic event. This case-control study aims to analyze the causes, incidence, and outcomes of all pediatric CA reported to Wake Up Safe. Factors associated with CA and mortality after arrest are examined and possible strategies for improving outcomes are considered. METHODS: CA in children was identified from the Wake Up Safe Pediatric Anesthesia Quality Improvement Initiative, a multicenter registry of adverse events in pediatric anesthesia...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29671293/surgical-treatment-for-refractory-epilepsy
#4
Johannes Herta, Christian Dorfer
The goal of any epilepsy surgery is to improve patient ́s quality of life by achieving seizure freedom or by reducing the frequency of severely debilitating seizures. To achieve this goal, non-invasive and invasive diagnostic methods must precisely delineate the epileptogenic zone (EZ), which is defined as the area that needs to be resected to obtain seizure freedom. At the same time, the correct identification of eloquent brain areas is inevitable to avoid new neurological deficits from surgery. In recent years, the technical advances in diagnostics have enabled us to achieve these goals in an increasing number of cases...
April 18, 2018: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/29664759/characteristics-of-medical-professional-liability-claims-in-pediatric-orthopedics
#5
Jessica Burns, M Wade Shrader, Carla Boan, Mohan Belthur
OBJECTIVES: Medical malpractice is burdensome to the U.S. healthcare system. The following is an epidemiological analysis of the closed medical professional liability (MPL) claims in pediatric orthopedics using data maintained by the Physician Insurers Association of America. METHODS: The Physician Insurers Association of America registry of MPL claims from 1985 to 2013 for all specialties included 286,021 closed claims in the United States. All closed MPL claims for orthopedic surgery in patients younger than 18 years were retrospectively reviewed (N = 2,671)...
April 16, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29661575/outcomes-of-laparoscopic-resection-of-meckel-s-diverticulum-are-equivalent-to-open-laparotomy
#6
Brian Ezekian, Harold J Leraas, Brian R Englum, Brian F Gilmore, Christopher Reed, Tamara N Fitzgerald, Henry E Rice, Elisabeth T Tracy
PURPOSE: Meckel's diverticulum (MD) is a common congenital anomaly caused by failure of involution of the omphalomesenteric duct. Enthusiasm for minimally invasive surgery (MIS) in children has burgeoned as technologies have advanced, but the outcomes of laparoscopic resection in comparison to open laparotomy for MD remain poorly defined. We queried a large national database to compare current practice patterns and clinical outcomes between surgical approaches for MD in the pediatric population...
March 15, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29643628/pediatric-critical-incidents-reported-over-15-years-at-a-tertiary-care-teaching-hospital-of-a-developing-country
#7
Shemila Abbasi, Fauzia Anis Khan, Sobia Khan
Background and Aims: The role of critical incident (CI) reporting is well established in improving patient safety but only a limited number of available reports relate to pediatric incidents. Our aim was to analyze the reported CIs specific to pediatric patients in our database and to reevaluate the value of this program in addressing issues in pediatric anesthesia practice. Material and Methods: Incidents related to pediatric population from neonatal period till the age of 12 years were selected...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29619786/comparative-study-of-levobupivacaine-and-bupivacaine-for-bilateral-maxillary-nerve-block-during-pediatric-primary-cleft-palate-surgery-a-randomized-double-blind-controlled-study
#8
Mohamed F Mostafa, Ragaa Herdan, Mohamed Elshazly
BACKGROUND: Cleft lip and palate are common major congenital anomalies. Cleft palate (CP) repair causes pain and needs large doses of intravenous opioids. The risk of postoperative airway obstruction or respiratory depression is high, requiring continuous and vigilant monitoring. The primary outcome was to evaluate the efficacy of using different local anesthetics during bilateral maxillary nerve block (MNB) with general anesthesia on quality of recovery after primary CP repair. We hypothesized that levobupivacaine would be better than bupivacaine...
April 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29611453/trends-in-pediatric-otolaryngology-disparities-research
#9
Jad Jabbour, Karl W Doerfer, Thomas Robey, Michael J Cunningham
Objectives To describe trends in disparities research within pediatric otolaryngology as evidenced by major meeting presentations and to compare observed trends with those in the realm of patient safety and quality improvement (PSQI). Study Design Retrospective review of presentations at national otolaryngology meetings. Setting Online review of meeting programs. Subjects and Methods Meeting programs from the American Society of Pediatric Otolaryngology, Triological Society, American Academy of Otolaryngology-Head and Neck Surgery Foundation, and Society for Ear, Nose and Throat Advances in Children from 2003 to 2016 were manually searched for pediatric oral and poster presentations addressing disparities and socioeconomic determinants of health, as well as PSQI...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29605344/development-and-validation-of-a-quality-of-life-instrument-for-patients-with-laryngeal-cleft
#10
Alexandria L Irace, Ryan D Walker, Kosuke Kawai, Meaghan Maddock, Natasha D Dombrowski, Georgios Sideridis, Lynne Ferrari, Reza Rahbar
OBJECTIVE: To develop and validate a novel pediatric health-related quality of life (HR-QoL) instrument for patients with laryngeal cleft and their families. METHODS: We surveyed primary caregivers of patients that underwent endoscopic repair of Type I or II laryngeal cleft. The proposed HR-QoL instrument consists of 40 items representing four domains, assessing the patient's physical symptoms, the patient's and family's social functioning, and the family's emotions regarding the patient's illness pre- and post-operatively...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29602551/relationship-between-perioperative-blood-transfusion-and-surgical-site-infections-in-pediatric-general-and-thoracic-surgical-patients
#11
Jason Fawley, Thomas H Chelius, Marjorie J Arca
BACKGROUND: Recently, perioperative transfusions were demonstrated to be associated with higher rate of surgical site infections (SSIs) in neonates. We sought to examine whether a similar relationship exists between perioperative blood transfusions and SSI among non-neonatal pediatric general surgical patients. METHODS: We conducted an IRB-approved retrospective study reviewing non-neonatal patients (age greater than 28days and less than 18years) who underwent a general or thoracic surgical procedure in 2012, 2013, 2014, in the American College of Surgeons National Safety and Quality Improvement Project-Pediatric (ACS-NSQIP-P) Participant User Files...
March 4, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29602550/minimally-invasive-repair-of-pectus-excavatum-analysis-of-the-nsqip-database-and-the-use-of-thoracoscopy
#12
Oswald Tetteh, Daniel S Rhee, Emily Boss, Samuel M Alaish, Alejandro V Garcia
BACKGROUND: The minimally invasive repair of pectus excavatum (MIRPE) has been widely accepted and has become a viable alternative to the open Ravitch technique. MIRPE has evolved over time with some advocating that a safe repair can be accomplished without direct visualization utilizing thoracoscopy. The MIRPE with and without a thoracoscopic approach has not been previously analyzed from a nationwide database to determine differences in safety and short-term outcomes. METHODS: The American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) 2012-2015 database was used in identifying patients that had MIRPE using Current Procedural Terminology (CPT) codes and ICD-9CM/ICD-10CM postoperative diagnosis codes...
March 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29596095/dexamethasone-as-an-adjuvant-for-caudal-blockade-in-pediatric-surgical-patients-a-systematic-review-and-meta-analysis
#13
Matthew A Chong, Daniel J Szoke, Nicolas M Berbenetz, Cheng Lin
BACKGROUND: Caudal block is commonly used to provide postoperative analgesia after pediatric surgery in the lower abdomen. Typically administered as a single-shot technique, 1 limitation of this block is the short duration of analgesia. To overcome this, dexamethasone has been used as an adjuvant to prolong block duration. However, there are concerns about steroid-related morbidity and the optimal route of dexamethasone administration (eg, caudal or intravenous) is unknown. METHODS: We conducted a systematic review and random-effects meta-analysis of randomized controlled trials recruiting pediatric surgical patients receiving a caudal block for surgical anesthesia or postoperative analgesia...
March 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29594089/the-need-for-specialized-pediatric-cardiac-critical-care-training-program-in-limited-resource-settings
#14
REVIEW
Indah K Murni, Ndidiamaka L Musa
Congenital heart disease (CHD) is one of the major global health problems with the highest birth prevalence in low- and middle-income countries. In these populous countries, basic health services for the children with CHD, including surgery, are lacking. Even though surgery is performed, outcome after cardiac surgery is influenced by the quality of the postoperative management with a reported high morbidity and mortality. Henceforth, there is an urgent need for comprehensive interventions to provide high quality cardiac intensive care programs to improve the quality of pediatric cardiac surgery services in order to address high morbidity and mortality after cardiac surgery...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29588987/single-item-measure-for-assessing-quality-of-life-in-children-with-drug-resistant-epilepsy
#15
Lauryn Conway, Elysa Widjaja, Mary Lou Smith
Objective: The current study investigated the psychometric properties of a single-item quality of life (QOL) measure, the Global Quality of Life in Childhood Epilepsy question (G-QOLCE), in children with drug-resistant epilepsy. Method: Data came from the Impact of Pediatric Epilepsy Surgery on Health-Related Quality of Life Study (PESQOL), a multicenter prospective cohort study (n = 118) with observations collected at baseline and at 6 months of follow-up on children aged 4-18 years...
March 2018: Epilepsia Open
https://www.readbyqxmd.com/read/29581155/disorders-of-sex-development-timing-of-diagnosis-and-management-in-a-single-large-tertiary-center
#16
Ella Kohva, Päivi Miettinen, Seppo Taskinen, Matti Hero, Annika Tarkkanen, Taneli Raivio
BACKGROUND: We describe the phenotypic spectrum and timing of diagnosis and management in a large series of patients with disorders of sexual development (DSD) treated in a single pediatric tertiary center. METHODS: DSD patients who had visited our tertiary center during the survey period (between 2004 and 2014) were identified based on an ICD-10 inquiry, and their phenotypic and molecular genetic findings were recorded from patient charts. RESULTS: Among the 550 DSD patients, 53...
March 26, 2018: Endocrine Connections
https://www.readbyqxmd.com/read/29573766/-quality-of-life-of-children-with-otitis-media-and-impact-of-insertion-of-transtympanic-ventilation-tubes-in-a-portuguese-population
#17
Ana Rita Lameiras, Deodato Silva, Assunção O Neill, Pedro Escada
INTRODUCTION: Quality of life is an important measure for health-outcome evaluation. Although otitis media is one of the most common childhood diseases, its impact on Portuguese children's quality of life is unknown. The aim of this study is to determine the quality of life of Portuguese children with chronic otitis media with effusion and/or recurrent acute otitis media and the short-term impact of transtympanic ventilation tubes, using the Portuguese version of the OM-6 questionnaire, a valid, reliable and sensitive instrument to evaluate the health-related quality of life in children with otitis media...
January 31, 2018: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29572808/readmission-and-complications-within-30-days-after-intrathecal-baclofen-pump-placement
#18
Sandi K Lam, Rory R Mayer, Aditya Vedantam, Kristen A Staggers, Dominic A Harris, I-Wen Pan
AIM: To describe 30-day outcomes after intrathecal baclofen (ITB) pump placement in children and identify risk factors for readmission, reoperation, and perioperative complication using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. METHOD: Patients aged 0 to 18 years who underwent ITB pump placement (2012-2014) comprised the study cohort defined in the database. Multivariate regression analysis was performed using preoperative and perioperative data from the American College of Surgeons' NSQIP-P database...
March 23, 2018: Developmental Medicine and Child Neurology
https://www.readbyqxmd.com/read/29532454/impact-of-short-bowel-syndrome-on-quality-of-life-and-family-the-patient-s-perspective
#19
Federica Pederiva, Basem Khalil, Antonino Morabito, Sarah J Wood
BACKGROUND:  Short bowel syndrome (SBS) has an impact on children and their families not only physically, but also emotionally, mentally, and socially. This study aimed to evaluate quality of life and family impact in patients with SBS, using the Pediatric Quality of Life Inventory (PedsQL) measurement model. MATERIALS AND METHODS:  PedsQL questionnaires were administered to patients with SBS followed at the Pediatric Surgery of Royal Manchester Children's Hospital...
January 30, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29525534/the-evaluation-of-three-comorbidity-indices-in-predicting-postoperative-complications-and-readmissions-in-pediatric-urology
#20
Ruiyang Jiang, Steven Wolf, Muhammad H Alkazemi, Gina-Maria Pomann, J Todd Purves, John S Wiener, Jonathan C Routh
INTRODUCTION: The surgical comorbidity assessment is important for patient risk stratification, counseling, and research. In adults, risk assessment indices, such as the Charlson Co-morbidity Score (CCS) or Van Walraven Index (VWI), are well established. In pediatrics, however, risk assessment indices are scarce. Recently, a pediatric-specific risk assessment index, the Rhee index, was developed to discriminate mortality for pediatric general surgery patients. Currently, there is no validated risk assessment tool in pediatric urology...
February 26, 2018: Journal of Pediatric Urology
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