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Pediatric surgery quality

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https://www.readbyqxmd.com/read/28628521/experiences-of-acute-pain-in-children-who-present-to-a-healthcare-facility-for-treatment-a-systematic-review-of-qualitative-evidence
#1
Nicole Pope, Mary Tallon, Ruth McConigley, Gavin Leslie, Sally Wilson
BACKGROUND: Pain is a universal and complex phenomenon that is personal, subjective and specific. Despite growing knowledge in pediatric pain, management of children's pain remains sub-optimal and is linked to negative behavioral and physiological consequences later in life. As there is no synthesis of these studies, it was timely to undertake a systematic review. OBJECTIVES: To identify, evaluate and synthesize the existing qualitative evidence on children's experiences of acute pain, including pain management, within a healthcare facility...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28617685/adult-congenital-heart-disease-magnitude-of-the-problem
#2
Akanksha N Thakkar, Ponraj Chinnadurai, C Huie Lin
PURPOSE OF REVIEW: To define the magnitude of problems faced by patients with adult congenital heart disease (ACHD) and to identify unmet needs for this population. RECENT FINDINGS: The ACHD population is estimated to include more than 1 million people in the United States and continues to grow at a steady rate. Owing to the decline in early mortality in this group, modern medicine is now faced by the long-term complications associated with congenital heart disease such as chronic heart failure, increased endocarditis risk, elevated burden of arrhythmias, pulmonary hypertension, valvular dysfunction, and pregnancy...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28610795/perceived-fatigue-following-pediatric-burns
#3
Moniek Akkerman, Leonora J Mouton, Froukje Dijkstra, Anuschka S Niemeijer, Marco van Brussel, Lucas H V van der Woude, Laurien M Disseldorp, Marianne K Nieuwenhuis
PURPOSE: Fatigue is a common consequence of numerous pediatric health conditions. In adult burn survivors, fatigue was found to be a major problem. The current cross-sectional study is aimed at determining the levels of perceived fatigue in pediatric burn survivors. METHODS: Perceived fatigue was assessed in 23 children and adolescents (15 boys and 8 girls, aged 6-18 years, with burns covering 10-46% of the total body surface area, 1-5 years post burn) using both child self- and parent proxy reports of the Pediatric Quality of Life Inventory Multidimensional Fatigue Scale...
June 10, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28601318/debriefing-the-forgotten-phase-of-the-surgical-safety-checklist
#4
Marisa A Bartz-Kurycki, Kathryn T Anderson, Jocelyn E Abraham, Kendall M Masada, Jiasen Wang, Akemi L Kawaguchi, Kevin P Lally, KuoJen Tsao
BACKGROUND: The debriefing phase of the surgical safety checklist (SSC) provides the operative team an opportunity to share pertinent intraoperative information and communicate postoperative plans. Prior quality improvement initiatives at our institution focused on the preincision phase of the SSC; however, the debriefing phase has not been evaluated. We aimed to assess adherence to the debrief checklist at our institution and identify areas for improvement. MATERIALS AND METHODS: An observational study was conducted from 2014 to 2016 with a convenience sample of pediatric surgery cases at an academic children's hospital over 8-wk periods annually to evaluate the debriefing checklist across 14 subspecialties...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28598945/long-term-outcomes-of-pediatric-cardiac-patients-supported-by-extracorporeal-membrane-oxygenation
#5
Matthew D Elias, Barbara-Jo Achuff, Richard F Ittenbach, Chitra Ravishankar, Thomas L Spray, Stephanie Fuller, Lisa M Montenegro, J William Gaynor, Matthew J O'Connor
OBJECTIVE: Extracorporeal membrane oxygenation is an important form of short-term mechanical support in children with cardiac disease, but information on long-term outcomes and quality of life is limited. The primary objective of this study was to determine the long-term outcomes of children previously supported by extracorporeal membrane oxygenation for cardiac etiologies. DESIGN: A retrospective analysis was performed on patients with cardiac disease managed with extracorporeal membrane oxygenation between January 1, 1995, and December 31, 2012, at the Children's Hospital of Philadelphia...
June 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28595843/analysis-of-risk-factors-associated-with-unplanned-reoperations-following-pediatric-plastic-surgery
#6
Kevin T Jubbal, Dmitry Zavlin, Edward P Buchanan, Larry H Hollier
BACKGROUND/PURPOSE: Unplanned reoperation (UR) is an outcome measure with multiple advantages that can be used as a standardized tool to assess an institution's quality and safety of medical care. This study aimed to identify parameters associated with an increased likelihood of UR following plastic surgery in patients less than 18 years of age by using a large validated national multicenter database. METHODS/DESCRIPTION: We performed a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Pediatric database between 2012 and 2014 to identify pediatric patients undergoing primary plastic surgery procedures...
May 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28595818/do-not-resuscitate-orders-and-high-risk-pediatric%C3%A2-surgery-professional-nuisance-or%C3%A2-medical%C3%A2-necessity
#7
Lauren M Baumann, Kibileri Williams, Fizan Abdullah, Richard J Hendrickson, Tolulope A Oyetunji
BACKGROUND: There is a paucity of data in the literature regarding end-of-life care and do-not-resuscitate (DNR) status of the pediatric surgical patient, although invasive procedures are frequently performed in very high risk and critically ill children. Despite significant efforts in adult medicine to enhance discussions around end-of-life care, little is known about similar endeavors in the pediatric population. METHODS: A retrospective review of the National Surgical Quality Improvement Program Pediatric database was performed...
May 11, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28593400/a-collaborative-intervention-to-improve-surgical-antibiotic-prophylaxis-in-children-results-from-a-prospective-multicenter-study
#8
Marta Ciofi Degli Atti, Stefania Spila Alegiani, Roberto Raschetti, Pasquale Arace, Angela Giusti, Raffaele Spiazzi, Massimiliano Raponi
PURPOSE: The use of surgical antibiotic prophylaxis (SAP) in children is poorly characterized. Our aim was to evaluate the effectiveness of a quality improvement (QI) intervention targeting SAP in children, by means of a multicenter prospective intervention study, with a before and after design. METHODS: We prospectively investigated elective surgical procedures performed in children <18 years, prior to the QI intervention, after the intervention and at 9-month follow-up...
June 7, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28583497/safety-of-endoscopic-sinus-surgery-in-children-with-cystic-fibrosis
#9
Dmitry Tumin, Don Hayes, Stephen E Kirkby, Joseph D Tobias, Christopher McKee
INTRODUCTION: Data on the safety of endoscopic sinus surgery (ESS) are limited in children with cystic fibrosis (CF). We used a multi-institutional surgical registry to examine ESS outcomes in children with CF. METHODS: The 2014-2015 American College of Surgeons' National Surgical Quality Improvement Program-Pediatric database was queried for patients age <18 years undergoing elective ESS. Prolonged hospital stay (>1 day), 30-day readmission, and 30-day unplanned reoperation were compared according to presence of CF diagnosis...
July 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28576670/validation-of-the-youth-acute-pain-functional-ability-questionnaire-yapfaq-in-children-and-adolescents-undergoing-inpatient-surgery
#10
Jennifer A Rabbitts, Rachel V Aaron, William T Zempsky, Tonya M Palermo
Half of children admitted after surgery experience intense pain in hospital, and many experience continued pain and delayed functional recovery at home. However, there is a gap in tools available to measure acute functional ability in pediatric postsurgical settings. We aimed to validate the Youth Acute Pain Functional Ability Questionnaire (YAPFAQ) in a large inpatient pediatric surgical population, evaluate its responsiveness to expected functional recovery, and develop a short form for broad clinical implementation...
May 30, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28576543/pycnodysostosis-at-otorhinolaryngology
#11
Tekin Baglam, Adem Binnetoglu, Muhammet Fatih Topuz, Nilay Baş Ikizoglu, Refika Ersu, Serap Turan, Murat Sarı
AIM: Pycnodysostosis is a rare autosomal, recessive, skeletal dysplasia caused by a mutation in the cathepsin k gene. Pycnodysostosis is characterized by short stature, characteristic facial appearance (delayed closure of fontanelles and cranial sutures, mandibular hypoplasia and angle disorder, blue sclera), and acroosteolysis of the distal phalanges. Our aim was to describe the otorhinolaryngologic findings, differential diagnoses, various treatment options, and followup in eight cases of pycnodysostosis...
April 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28574593/early-versus-delayed-appendicectomy-for-appendiceal-phlegmon-or-abscess
#12
REVIEW
Yao Cheng, Xianze Xiong, Jiong Lu, Sijia Wu, Rongxing Zhou, Nansheng Cheng
BACKGROUND: Appendiceal phlegmon and abscess account for 2% to 10% of acute appendicitis. People with appendiceal phlegmon or abscess usually need an appendicectomy to relieve their symptoms and avoid complications. The timing of appendicectomy for appendiceal phlegmon or abscess is controversial. OBJECTIVES: To assess the effects of early versus delayed appendicectomy for appendiceal phlegmon or abscess, in terms of overall morbidity and mortality. SEARCH METHODS: We searched the Cochrane Library (CENTRAL; 2016, Issue 7), MEDLINE Ovid (1950 to 23 August 2016), Embase Ovid (1974 to 23 August 2016), Science Citation Index Expanded (1900 to 23 August 2016), and the Chinese Biomedical Literature Database (CBM) (1978 to 23 August 2016)...
June 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28574389/-radical-reconstructive-toracoplasty-a-new-method-of-treatment-of-patients-with-choanoid-deformation-of-breast
#13
N Dvaladze
Objective - development of a new method of surgery correction of choanoid deformation of breast, leading to significant improvement of the treatment results of the patients with this pathotology. The new method is being developed based on the analysis of the own long experience of treatment of the patients with choanoid deformation of breast. In total, over than 70 patients have been surged, with the age ranging from 5 to 35. The surgeries have been implemented in Leningrad Pediatric Medical Institute clinic as well as clinics in Georgia...
April 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28571639/longitudinal-outcomes-of-patients%C3%A2-with%C3%A2-single-ventricle-after%C3%A2-the%C3%A2-fontan%C3%A2-procedure
#14
Andrew M Atz, Victor Zak, Lynn Mahony, Karen Uzark, Nicholas D'agincourt, David J Goldberg, Richard V Williams, Roger E Breitbart, Steven D Colan, Kristin M Burns, Renee Margossian, Heather T Henderson, Rosalind Korsin, Bradley S Marino, Kaitlyn Daniels, Brian W McCrindle
BACKGROUND: Multicenter longitudinal objective data for survival into adulthood of patients who have undergone Fontan procedures are lacking. OBJECTIVES: This study sought to describe transplant-free survival and explore relationships between laboratory measures of ventricular performance and functional status over time. METHODS: Exercise testing, echocardiography, B-type natriuretic peptide, functional health assessment, and medical history abstraction were repeated 9...
June 6, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28570465/shared-medical-appointments-for-adolescent-breast-reduction
#15
Tara L Braun, Matthew G Kaufman, Cristina Hernandez, Laura A Monson
Adolescents with macromastia face serious physical, emotional, and social burdens because of their large breast size. Studies have shown that reduction mammoplasty results in improvement in physical symptoms and quality of life for these patients. Shared medical appointments (SMAs), defined as individual patient-physician encounters that occur in a group setting, have been successfully applied to clinics for adult patients seeking breast reduction for this condition. We decided to apply the SMA model to our clinic for preoperative evaluation of adolescent patients with macromastia...
May 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28567798/management-for-intussusception-in-children
#16
REVIEW
Steven Gluckman, Jonathan Karpelowsky, Angela C Webster, Richard G McGee
BACKGROUND: Intussusception is a common abdominal emergency in children with significant morbidity. Prompt diagnosis and management reduces associated risks and the need for surgical intervention. Despite widespread agreement on the use of contrast enema as opposed to surgery for initial management in most cases, debate persists on the appropriate contrast medium, imaging modality, pharmacological adjuvant, and protocol for delayed repeat enema, and on the best approach for surgical management for intussusception in children...
June 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28558846/perioperative-antibiotics-in-pediatric-cardiac-surgery-protocol-for-a-systematic-review
#17
Vijay Anand, Angela Bates, Robin Featherstone, Srinivas Murthy
BACKGROUND: Post-operative infections in pediatric cardiac surgery are an ongoing clinical challenge, with rates between 1 and 20%. Perioperative antibiotics remain the standard for prevention of surgical-site infections, but the type of antibiotic and duration of administration remain poorly defined. Current levels of practice variation through informal surveys are very high. Rates of antibiotic-resistant organisms are increasing steadily around the world. METHODS/DESIGN: We will identify all controlled observational studies and randomized controlled trials examining prophylactic antibiotic use in pediatric cardiac surgery...
May 30, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28557237/disorders-of-sex-development-dsd-clinical-service-delivery-in-the-united-states
#18
Aimee M Rolston, Melissa Gardner, Kathleen van Leeuwen, Lauren Mohnach, Catherine Keegan, Emmanuèle Délot, Eric Vilain, David E Sandberg
Following the principles of care recommended in the 2006 Consensus Statement on Disorders of Sex Development (DSD), along with input from representatives of peer support and advocacy groups, this study surveyed DSD clinical management practices at healthcare facilities in the United States. DSD are congenital conditions in which development of chromosomal, gonadal, or anatomic sex is atypical. Facilities providing care for patients with DSD were targeted for participation. Specialty providers completed a survey with questions in six broad categories: Institution Information, Nomenclature and Care Guidelines, Interdisciplinary Services, Staff and Community Education, DSD Management, and Research...
May 30, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28544520/safety-and-perioperative-adverse-events-in-pediatric-endoscopic-sinus-surgery-an-acs-nsqip-p-analysis
#19
Christopher R Roxbury, Lilun Li, Daniel Rhee, Kris R Jatana, Rahul K Shah, Emily F Boss
INTRODUCTION: This study describes safety outcomes of pediatric endoscopic sinus surgery (ESS) to identify risk factors for 30-day postoperative adverse events using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database. METHODS: We performed a retrospective cohort study involving patients in the 2012-2015 NSQIP-P database who underwent ESS. Predictors included demographics, comorbidities and surgical acuity. Outcomes included 30-day complications, reoperations, and readmissions...
May 23, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28544343/levels-of-anxiety-in-parents-in-the-24-h-before-and-after-their-child-s-surgery-a-descriptive-study
#20
Laura Pomicino, Elena Maccacari, Sara Buchini
AIMS AND OBJECTIVES: To: a. investigate pre and post-operative anxiety levels in parents of surgical patients; b. identify factors that affect parental anxiety; c. analyze assistance provided and overall parental satisfaction in order to assess if and how this aspect can impact their anxiety level. BACKGROUND: Surgery as an event generates anxiety in children and their parents. Children who are anxious before surgery are likely to develop more postoperative psychological and physiological complications than those who are not...
May 25, 2017: Journal of Clinical Nursing
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