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Pediatric surgery quality

Sofia Geralemou, Tong J Gan
PURPOSE OF REVIEW: Postoperative and postdischarge nausea and vomiting have profound impact on the efficient delivery of quality healthcare. In addition to patient dissatisfaction, physical morbidities as well as unplanned hospital admissions may result. It is important to risk stratify and intervene on patients at risk. The aim of this review is to explore the benefits and shortcomings of the scoring systems commonly used today. RECENT FINDINGS: Two widely-used risk stratification systems identify and score patient-, anesthesia-, and surgery-related risk factors for postoperative/postdischarge nausea and vomiting in the adult population...
September 29, 2016: Current Opinion in Anaesthesiology
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
BACKGROUND: Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. OBJECTIVE: To describe the availability of faculty in medical schools in Tanzania. DESIGN: We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
2016: Global Health Action
Nima Azarakhsh, Sandra Grimes, Pranit N Chotai, Claudette Shephard, Eunice Y Huang
PURPOSE: Pediatric surgeons often care for children with ovarian tumors. Few studies report long-term outcomes for these patients. This study characterizes intermediate-term results for patients who underwent surgical resection of ovarian neoplasms as children. METHODS: Patients who underwent surgery for ovarian neoplasms at a children's hospital were identified. They were invited to participate in a telephone-based survey assessing post-surgical recurrence, dysmenorrhea, quality of life, and fertility...
October 13, 2016: Pediatric Surgery International
Joseph A Gil, Steven F DeFroda, Kunal Sindhu, Aristides I Cruz, Alan H Daniels
Osteogenesis imperfecta is caused by qualitative or quantitative defects in type I collagen. Although often considered a disease with primarily pediatric manifestations, more than 25% of lifetime fractures are reported to occur in adulthood. General care of adults with osteogenesis imperfecta involves measures to preserve bone density, regular monitoring of hearing and dentition, and maintenance of muscle strength through physical therapy. Surgical stabilization of fractures in these patients can be challenging because of low bone mineral density, preexisting skeletal deformities, or obstruction by instrumentation from previous surgeries...
October 13, 2016: Orthopedics
Mohamed M Abu Elyazed, Shaimaa F Mostafa, Mohammad A Abdullah, Gehan M Eid
BACKGROUND: Transversus abdominis plane block (TAP) is a compartmental block of the anterior abdominal wall. Surgical trauma produces multisystem reactions. Anesthetic techniques can modify the neuroendocrine surgical stress response. AIM: The aim of this study was to evaluate the effect of TAP block on the modification of the surgical neuroendocrine stress response as well as its analgesia effect in children undergoing open inguinal hernia repair. METHOD: Sixty children aged 3-10 years undergoing elective unilateral open inguinal hernia repair were randomized into group I (general anesthesia) or group II (received TAP block after induction of general anesthesia)...
October 12, 2016: Paediatric Anaesthesia
Gyanesh Sethi, Arunabha Chakravarti
OBJECTIVE: The present study aims to evaluate the role of Endoscopic Sinus Surgery (ESS) in refractory pediatric Chronic Rhinosinusitis (CRS) and to assess the change in quality of life after ESS. MATERIALS AND METHODS: This prospective interventional study included 35 children (aged between 6 and 12 years) of refractory CRS, not responding to 4 weeks of maximal medical therapy attending the pediatric ENT clinic of a tertiary referral centre. Study period was from November 2013 to March 2016...
November 2016: International Journal of Pediatric Otorhinolaryngology
Christina Eguizabal Love, Frank Webbe, Gunha Kim, Ki Hyeong Lee, Michael Westerveld, Christine M Salinas
OBJECTIVE: Children with epilepsy are vulnerable to executive dysfunction, but the relationship between executive functioning (EF) and quality of life (QOL) in children with epilepsy is not fully delineated. This exploratory study elucidated the relationship between ecological EF and QOL in pediatric intractable epilepsy. METHOD: Fifty-four consecutively referred pediatric epilepsy surgery candidates and their parents were administered IQ measures, the Behavior Rating Inventory of Executive Function (BRIEF), and the Quality of Life in Childhood Epilepsy (QOLCE) as part of a comprehensive neuropsychological evaluation...
October 8, 2016: Epilepsy & Behavior: E&B
Meena Nathan, Marshall L Jacobs, J William Gaynor, Jane W Newburger, Carolyn Dunbar Masterson, Linda M Lambert, Danielle Hollenbeck-Pringle, Felicia L Trachtenberg, Owen White, Brett R Anderson, Margaret C Bell, Phillip T Burch, Eric M Graham, Jonathan R Kaltman, Kirk R Kanter, Carlos M Mery, Christian Pizarro, Marcus S Schamberger, Michael D Taylor, Jeffrey P Jacobs, Sara K Pasquali
BACKGROUND: Data routinely captured in clinical registries may be leveraged to enhance efficiency of prospective research. The quality of registry data for this purpose has not been studied, however. We evaluated the completeness and accuracy of perioperative data within congenital heart centers' local surgical registries. METHODS: Within 12 Pediatric Heart Network (PHN) sites, we evaluated 31 perioperative variables (and their subcategories, totaling 113 unique fields) collected via sites' local clinical registries for submission to The Society of Thoracic Surgeons Database, compared with chart review by PHN research coordinators...
October 7, 2016: Annals of Thoracic Surgery
Alexander L Macdonald, Nick Sevdalis
BACKGROUND: Adult surgical patient safety literature is plentiful; however, there is a disproportionate paucity of published safety work in the children's surgical literature. We sought to systematically evaluate the nature and quality of patient safety evidence pertaining to pediatric surgical practice. METHODS: Systematic search of MEDLINE and EMBASE databases and gray literature identified 1399 articles. Data pertaining to demographics, methodology, interventions, and outcomes were extracted...
September 24, 2016: Journal of Pediatric Surgery
Hee Jung Yoo, Hyery Kim, Hyeon Jin Park, Dong Seok Kim, Young Shin Ra, Hee Young Shin
The neurocognitive function and quality of life of 58 Korean survivors of childhood medulloblastoma were assessed after surgery, cranial radiation and chemotherapy. All patients were evaluated with a battery of neurocognitive function tests and the Pediatric Functional Assessment of Cancer Therapy-Brain Tumor Survivors, which consists of self-report questionnaires on quality of life. The mean full-scale intelligence quotient (IQ), verbal IQ, and performance IQ scores were 90.2, 97.1, and 84.16, respectively...
November 2016: Journal of Korean Medical Science
Juan-Miguel Gil-Jaurena, Ramón Pérez-Caballero, Ana Pita-Fernández, María-Teresa González-López, Jairo Sánchez, Juan-Carlos De Agustín
BACKGROUND: Mid-line sternotomy is the commonest incision for cardiac surgery. Alternative approaches are becoming fashionable in many centres, amidst some reluctance because of learning curves and overall complexity. Our recent experience in starting a new program on minimally invasive pediatric cardiac surgery is presented. The rationale for a stepwise onset and the short-medium term results for a three-year span are displayed. METHODS: A three-step schedule is planned: First, an experienced surgeon (A) starts performing simple cases...
July 2016: Translational pediatrics
Justin P Wagner, Alexander D Schroeder, Juan C Espinoza, Jonathan R Hiatt, John D Mellinger, Robert A Cusick, Robert J Fitzgibbons, Giampiero Campanelli, Marta Cavalli, Sergio Roll, Rodrigo A Silva, Wolfgang Reinpold, Louis-Franck Télémaque, Brent D Matthews, Charles J Filipi, David C Chen
Importance: Sustainable, capacity-building educational collaborations are essential to address the global burden of surgical disease. Objective: To assess an international, competency-based training paradigm for hernia surgery in underserved countries. Design, Setting, and Participants: In this prospective, observational study performed from November 1, 2013, through October 31, 2015, at 16 hospitals in Brazil, Ecuador, Haiti, Paraguay, and the Dominican Republic, surgeons completed initial training programs in hernia repair, underwent interval proficiency assessments, and were appointed regional trainers...
October 5, 2016: JAMA Surgery
Faten Fedhila, Samar Rhayem, Habiba Hafsi, Wiem Douira, Raoudha Doghri, Monia Khemiri, Karima Mrad, Ibtissem Bellagha, Bechir Zouari, Sihem Barsaoui
Background Extracranial Germ cell tumors (GCT) are a rare and a heterogeneous group of pediatric cancers but highly curable. Aim We aimed to review management, outcome and prognostic factors that influence overall survival (OS) in a pediatric Tunisian oncologic unit. Methods We retrospectively evaluated between January 1998 and December 2012, 33 patients affected by extracranial germ cell tumors and treated according to TGM95 protocol established by the SFOPin a pediatric Tunisian oncologic unit. Results Patients had a mean age of 57 months (ranges: 1 day-13 years)...
April 2016: La Tunisie Médicale
Marketa Rejtar, Lee Ranstrom, Christina Allcox
Nurse practitioners (NPs) have been providing high-quality and safe patient care for a few decades, and evidence showing the extent of their impact is emerging. This article describes the implementation of a 24/7 NP patient care model on an inpatient pediatric general surgery service in a tertiary free-standing Children's Hospital in the Northeastern United States. The literature shows that there is limited evidence regarding NP models of care and their effect on patient outcomes. In response to policy changes leading to reduction of resident work hours and a more acute and complex inpatient pediatric general surgery patient population, our existing NP model evolved into a 24/7 NP Model in June 2011...
September 27, 2016: Journal of Pediatric Health Care
Natashia M Seemann, Sebastian K King, Abdul Elkadri, Thomas Walters, Joel Fish, Jacob C Langer
BACKGROUND/PURPOSE: Perianal Crohn's disease (PCD) can affect both quality of life and psychological wellbeing. A subset of pediatric patients with complex PCD require surgical intervention, although appropriate timing and treatment regimens remain unclear. This study aimed to describe a large pediatric cohort in a tertiary center to determine the range of surgical management in children with complex PCD. METHODS: A retrospective review of children requiring operative intervention for PCD over 13 years (2002-2014) was performed...
September 15, 2016: Journal of Pediatric Surgery
Julia Hamonet-Torny, Daniel Le Bellego, Elisabeth Jasper, Annie-Laure Suc, Laurent Fourcade
OBJECTIVE: The réseau enfance et handicap du grand Sud-Ouest (REHSO) as founded in November 2015 to promote pediatric PRM on this territory and to standardize the practices within the establishments participant. MATERIAL/PATIENTS AND METHODS: In May 2015, a study on the management of surgical projects in disabled children was realised by a questionnaire sent to the structures of pediatric PRM of the West. In June 2015, a working group composed by 17 surgeons, pediatrician and MPR practitioners discussed about their different practices and built a consensus on the steps to lead during a surgical project in disabled children...
September 2016: Annals of Physical and Rehabilitation Medicine
Jonathan B Koffel, Melissa L Rethlefsen
BACKGROUND: A high-quality search strategy is considered an essential component of systematic reviews but many do not contain reproducible search strategies. It is unclear if low reproducibility spans medical disciplines, is affected by librarian/search specialist involvement or has improved with increased awareness of reporting guidelines. OBJECTIVES: To examine the reporting of search strategies in systematic reviews published in Pediatrics, Surgery or Cardiology journals in 2012 and determine rates and predictors of including a reproducible search strategy...
2016: PloS One
Philip K Frykman, Andrew L Freedman, Timothy D Kane, Zhi Cheng, Mikael Petrosyan, Kenneth Catchpole
INTRODUCTION: We studied operating team acceptability of Video Telescopic Monitor (VITOM(®)) exoscope by exploring the ease of use of the device in two centers. We also assessed factors affecting surgeon musculoskeletal discomfort. METHODS: We focused on how the operating team interacted with the VITOM system with surrogate measures of usefulness, image quality, ease of use, workload, and setup time. Multivariable linear regression was used to model the relationships between team role, experience, and setup time...
September 26, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Matthew T Brown, Frederick A Boop
INTRODUCTION: Pediatric low-grade tumors are found in roughly 1-3 % of patients with childhood epilepsy; seizures associated with these tumors are often medically refractory and often present a significant morbidity, greater than the presence of the tumor itself. DISCUSSION: The unique morbidity of the seizures often requires an epilepsy surgical approach over a standard oncologic resection to achieve a reduction in morbidity for the child. Multiple quality-of-life studies have shown that unless a patient is seizure-free, they remain disabled throughout their life; the best way to achieve this in our patient population is with a multidisciplinary team approach with treatment goals focusing primarily on the epilepsy...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Eric C Cheon, Hannah L Palac, Kristine H Paik, John Hajduk, Gildasio S De Oliveira, Narasimhan Jagannathan, Santhanam Suresh
BACKGROUND: To date, the independent predictors and outcomes of unplanned postoperative intubation (UPI) in pediatric patients after noncardiac surgery are yet to be characterized. The authors aimed to identify the incidence and predictors of this event and evaluated the effect of this event on postoperative mortality. METHODS: Data of 87,920 patients from the American College of Surgeons National Surgical Quality Improvement Program Pediatric database were analyzed and assigned to derivation (n = 58,614; 66...
November 2016: Anesthesiology
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