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Pediatric surgery quality

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https://www.readbyqxmd.com/read/29441407/disability-weights-for-pediatric-surgical-procedures-a-systematic-review-and-analysis
#1
REVIEW
Emily R Smith, Tessa Concepcion, Stephanie Lim, Sam Sadler, Dan Poenaru, Anthony T Saxton, Mark Shrime, Emmanuel Ameh, Henry E Rice
BACKGROUND: Metrics to measure the burden of surgical conditions, such as disability weights (DWs), are poorly defined, particularly for pediatric conditions. To summarize the literature on DWs of children's surgical conditions, we performed a systematic review of disability weights of pediatric surgical conditions in low- and middle-income countries (LMICs). METHOD: For this systematic review, we searched MEDLINE for pediatric surgery cost-effectiveness studies in LMICs, published between January 1, 1996, and April 1, 2017...
February 13, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29432946/postoperative-cerebral-infarction-risk-factors-and-postoperative-management-of-pediatric-moyamoya-disease-patients
#2
Shinsuke Muraoka, Yoshio Araki, Goro Kondo, Michihiro Kurimoto, Yoshiki Shiba, Kenji Uda, Shinji Ota, Sho Okamoto, Toshihiko Wakabayashi
OBJECT: Though revascularization surgery for moyamoya disease patients can effectively prevent ischemic events and thus improve the long-term clinical outcome, the incidence of postoperative ischemic complications affects patients' quality of life. This study aimed to clarify the risk factors associated with postoperative ischemic complications and to discuss the appropriate perioperative management. METHODS: Fifty-eight revascularization operations were performed in 37 children with moyamoya disease...
February 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29431909/dermatologic-surgery-in-children-an-update-on-indication-anesthesia-analgesia-and-potential-perioperative-complications
#3
REVIEW
Diana Crisan, Karin Scharffetter-Kochanek, Sabine Kastler, Maria Crisan, Avram Manea, Katja Wagner, Lars Alexander Schneider
BACKGROUND: Children undergoing dermatosurgical procedures require, unlike adults, particular attention; the administration of various analgesics, anesthetics or sedatives requires a thorough knowledge of drug pharmacokinetics and pharmacodynamics. Furthermore, there are concerns that drugs used for sedation/general anesthesia may result in anesthetic/analgesic complications in children undergoing surgery, with a risk of impaired mental development. OBJECTIVES: Based on our clinical experience and a literature review, we illustrate the most commonly used analgesic, anesthetic and sedative drugs in pediatric dermatosurgery, and identify risk factors and complications following dermatosurgical procedures...
February 12, 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/29429350/-steroid-21-hydroxylase-deficiency-the-most-frequent-cause-of-congenital-adrenal-hyperplasia
#4
Márton Doleschall, Dóra Török, Katalin Mészáros, Andrea Luczay, Zita Halász, Krisztina Németh, Nikolette Szücs, Róbert Kiss, Judit Tőke, János Sólyom, György Fekete, Attila Patócs, Péter Igaz, Miklós Tóth
Congenital adrenal hyperplasia is a group of genetic diseases due to the disablement of 7 genes; one of them is steroid 21-hydroxylase deficiency. The genes of congenital adrenal hyperplasia encode enzymes taking part in the steroidogenesis of adrenal gland. Steroid 21-hydroxylase deficiency is an autosomal recessive disorder caused by mutations of the steroid 21-hydroxylase gene. The mutations of steroid 21-hydroxylase gene cause 95% of the congenital adrenal hyperplasia cases. Although the non-classic steroid 21-hydroxylase deficiency with mild symptoms is seldom diagnosed, the classic steroid 21-hydroxylase deficiency may lead to life-threatening salt-wasting and adrenal crises due to the insufficient aldosterone and cortisol serum levels...
February 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29427773/tissue-engineered-vascular-grafts-in-children-with-congenital-heart-disease-intermediate-term-followup
#5
Tadahisa Sugiura, Goki Matsumura, Shinka Miyamoto, Hideki Miyachi, Christopher K Breuer, Toshiharu Shinoka
OBJECTIVE: Tissue engineering holds great promise for the advancement of cardiovascular surgery as well as other medical fields. Tissue-engineered vascular grafts have the ability to grow and remodel and could therefore make great advances for pediatric cardiovascular surgery. In 2001, we began a human clinical trial evaluating these grafts in patients with a univentricular physiology. Herein, we report the long-term results of patients who underwent implantation of tissue-engineered vascular grafts as extracardiac total cavopulmonary conduits...
February 7, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29426688/variation-in-adolescent-idiopathic-scoliosis-surgery-implications-for-improving-healthcare-value
#6
Jennifer K Workman, Jacob Wilkes, Angela P Presson, Yizhe Xu, John A Heflin, John T Smith
OBJECTIVES: To investigate the variation in care and cost of spinal fusion for adolescent idiopathic scoliosis (AIS), and to identify opportunities for improving healthcare value. STUDY DESIGN: Retrospective cohort study from the Pediatric Health Information Systems database, including children 11-18 years of age with AIS who underwent spinal fusion surgery between 2004 and 2015. Multivariable regression was used to evaluate the relationships between hospital cost, patient outcomes, and resource use...
February 6, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29420431/challenges-in-transition-of-care-for-patients-with-anorectal-malformations-a-systematic-review-and-recommendations-for-comprehensive-care
#7
Sarah B Cairo, Alessandra Gasior, Michael D Rollins, David H Rothstein
BACKGROUND: Anorectal malformations are one of the most common congenital intestinal anomalies affecting newborns. Despite advances in neonatal care and surgical techniques, many patients with a history of anorectal malformations are affected by long-term challenges involving bowel and bladder dysfunction, sexual dysfunction, and psychosocial issues. These outcomes or challenges are additionally exacerbated by the lack of a structured transition of care from the pediatric to the adult setting...
March 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29413742/current-evidence-regarding-the-diagnostic-methods-for-pediatric-lumbar-spondylolisthesis-a-report-from-the-scoliosis-research-society-evidence-based-medicine-committee
#8
Han Jo Kim, Charles H Crawford, Charles Ledonio, Shay Bess, A Noelle Larson, Marilyn Gates, Matthew Oetgen, James O Sanders, Douglas Burton
STUDY DESIGN: Structured literature review. OBJECTIVES: The Scoliosis Research Society (SRS) requested an assessment of the current state of peer-reviewed evidence regarding pediatric lumbar spondylolisthesis with the goal of identifying what is known and what gaps remain in further understanding the diagnostic methods for pediatric spondylolisthesis. SUMMARY OF BACKGROUND DATA: Spondylolisthesis in the lumbar spine is common among children and adolescents and no formal synthesis of the published literature regarding diagnostic methods has been previously performed...
March 2018: Spine Deformity
https://www.readbyqxmd.com/read/29411177/pseudarthrosis-in-adult-and-pediatric-spinal-deformity-surgery-a-systematic-review-of-the-literature-and-meta-analysis-of-incidence-characteristics-and-risk-factors
#9
REVIEW
Nathan E How, John T Street, Marcel F Dvorak, Charles G Fisher, Brian K Kwon, Scott Paquette, Justin S Smith, Christopher I Shaffrey, Tamir Ailon
We conducted a systematic review with meta-analysis and qualitative synthesis. This study aims to characterize pseudarthrosis after long-segment fusion in spinal deformity by identifying incidence rates by etiology, risk factors for its development, and common features. Pseudarthrosis can be a painful and debilitating complication of spinal fusion that may require reoperation. It is poorly characterized in the setting of spinal deformity. The MEDLINE, EMBASE, and Cochrane databases were searched for clinical research including spinal deformity patients treated with long-segment fusions reporting pseudarthrosis as a complication...
February 6, 2018: Neurosurgical Review
https://www.readbyqxmd.com/read/29397933/associations-between-unplanned-cardiac-reinterventions-and-outcomes-after-pediatric-cardiac-operations
#10
John M Costello, Michael C Mongé, Kevin D Hill, Sunghee Kim, Sara K Pasquali, Babatunde A Yerokun, Jeffrey P Jacobs, Carl L Backer, Mjaye L Mazwi, Marshall L Jacobs
BACKGROUND: After pediatric heart operations, we sought to determine the incidence of unplanned cardiac reinterventions during the same hospitalization, assess risk factors for these reinterventions, and explore associations between reinterventions and outcomes. We hypothesized that younger patients undergoing more complex operations would be at greater risk for unplanned cardiac reinterventions and that operative mortality and postoperative length of stay (PLOS) would be greater in patients who undergo reintervention than in those who do not...
February 1, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29396791/quality-and-readability-of-online-patient-information-regarding-sclerotherapy-for-venous-malformations
#11
Jonathan H Pass, Amani H Patel, Sam Stuart, Alex M Barnacle, Premal A Patel
BACKGROUND: Patients often use the internet as a source of information about their condition and treatments. However, this information is unregulated and varies in quality. OBJECTIVE: To evaluate the readability and quality of online information for pediatric and adult patients and caregivers regarding sclerotherapy for venous malformations. MATERIALS AND METHODS: "Venous malformation sclerotherapy" was entered into Google, and results were reviewed until 20 sites that satisfied predefined inclusion criteria were identified...
February 2, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29393875/professional-well-being-of-practicing-physicians-the-roles-of-autonomy-competence-and-relatedness
#12
Oksana Babenko
This study investigated the roles of basic psychological needs-autonomy, competence, and relatedness-in physicians' professional well-being, specifically satisfaction with professional life, work-related engagement, and exhaustion. Using an online survey, quantitative data were collected from 57 practicing physicians. Overall, 65% of the participants were female; 49% were family medicine (FM) physicians, with the rest of the participants practicing in various non-FM specialties (e.g., internal medicine, pediatrics, surgery); and 47% were in the early-career stage (≤10 years in practice)...
February 2, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29373439/psychological-factors-and-outcomes-in-the-surgical-treatment-of-pediatric-patients-with-median-arcuate-ligament-syndrome
#13
Colleen Stiles-Shields, Christopher L Skelly, Grace Zee Mak, Christopher Speaker, Hope Boyd, Setareh O'Brien, Tina Drossos
OBJECTIVE: Median Arcuate Ligament Syndrome (MALS) is a frequently overlooked cause of chronic abdominal pain (CAP), and results in many symptoms that mimic other gastrointestinal conditions that result in CAP. A small, but growing body of literature indicates that surgery improves quality of life (QOL) in patients with MALS. The purpose of the current study was to examine the psychological characteristics of pediatric patients with MALS to determine their prevalence and impact on surgical outcomes...
January 25, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29372853/a-standardized-protocol-to-reduce-pediatric-baclofen-pump-infections-a-quality-improvement-initiative
#14
Virendra R Desai, Jeffrey S Raskin, Arvind Mohan, JoWinsyl Montojo, Valentina Briceño, Daniel J Curry, Sandi Lam
OBJECTIVE Intrathecal baclofen pumps are generally placed in children for the treatment of spasticity and dystonia. Use of implants in this pediatric population with comorbidities is reported to have a high risk of complications and infections. With the aim of reducing baclofen pump-related infections, a quality improvement project was instituted at the authors' institution. METHODS A workflow paradigm unique to baclofen pump implantation aimed at decreasing implant-related infections was implemented. All baclofen pump operations performed at the authors' institution between August 2012 and June 2016 were reviewed...
January 26, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29370891/risk-factors-for-venous-thromboembolic-events-in-pediatric-surgical-patients-defining-indications-for-prophylaxis
#15
Sarah B Cairo, Timothy B Lautz, Beverly A Schaefer, Guan Yu, Hibbut-Ur-Rauf Naseem, David H Rothstein
BACKGROUND: Venous thromboembolism (VTE) in pediatric surgical patients is a rare event. The risk factors for VTE in pediatric general surgery patients undergoing abdominopelvic procedures are unknown. STUDY DESIGN: The American College of Surgeon's National Surgical Quality Improvement Program-Pediatric (NSQIP-P) database (2012-2015) was queried for patients with VTE after abdominopelvic general surgery procedures. Patient and operative variables were assessed to identify risk factors associated with VTE and develop a pediatric risk score...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29359366/ultrasound-guided-lumbar-plexus-block-in-children-and-adolescents-using-a-transverse-lumbar-paravertebral-sonogram-initial-experience
#16
Karen Boretsky, Maria A Hernandez, Elizabeth Eastburn, Cornelius Sullivan
BACKGROUND: The clinical reliability and reproducibility of ultrasound-guided lumbar plexus blocks is not established in pediatric populations. We present the results of a combined nerve stimulation ultrasound-guided lumbar plexus block using the vertebral body, transverse process, and psoas muscle as landmarks on a transverse lumbar paravertebral sonogram with mid-axillary transducer placement, "shamrock method," in children and adolescents. AIMS: Our primary objective was to determine the rate of achieving sensory changes in the lumbar plexus distribution...
January 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29352663/early-versus-delayed-closure-of-bladder-exstrophy-a-national-surgical-quality-improvement-program-pediatric-analysis
#17
J J Ahn, M Shnorhavorian, C Katz, A B Goldin, P A Merguerian
INTRODUCTION: Delayed closure of bladder exstrophy has become more popular; however, there is limited the evidence of its success. Existing literature focuses on intermediate and long-term outcomes, and short-term postoperative outcomes are limited by the small number of cases and varying follow-up methods. OBJECTIVE: The objectives of the current study were to: 1) compare 30-day complications after early and delayed closure of bladder exstrophy, and 2) evaluate practice patterns of bladder exstrophy closure...
December 15, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29351327/a-novel-risk-classification-system-for-30-day-mortality-in-children-undergoing-surgery
#18
Oguz Akbilgic, Max R Langham, Arianne I Walter, Tamekia L Jones, Eunice Y Huang, Robert L Davis
A simple, objective and accurate way of grouping children undergoing surgery into clinically relevant risk groups is needed. The purpose of this study, is to develop and validate a preoperative risk classification system for postsurgical 30-day mortality for children undergoing a wide variety of operations. The National Surgical Quality Improvement Project-Pediatric participant use file data for calendar years 2012-2014 was analyzed to determine preoperative variables most associated with death within 30 days of operation (D30)...
2018: PloS One
https://www.readbyqxmd.com/read/29337121/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-2018-update-on-outcomes-and-quality
#19
Jeffrey P Jacobs, John E Mayer, Sara K Pasquali, Kevin D Hill, David M Overman, James D St Louis, S Ram Kumar, Carl L Backer, Charles D Fraser, James S Tweddell, Marshall L Jacobs
The Society of Thoracic Surgeons Congenital Heart Surgery Database is a comprehensive clinical outcomes registry which captures almost all pediatric cardiac surgical operations in the United States. It is the platform for all activities of The Society of Thoracic Surgeons related to the analysis of outcomes and the improvement of quality in this subspecialty. This article summarizes current aggregate national outcomes in congenital and pediatric cardiac surgery and reviews related activities in the areas of quality measurement, performance improvement, and transparency...
January 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29324498/five-steps-to-successfully-implement-and-evaluate-propensity-score-matching-in-clinical-research-studies
#20
Steven J Staffa, David Zurakowski
In clinical research, the gold standard level of evidence is the randomized controlled trial (RCT). The availability of nonrandomized retrospective data is growing; however, a primary concern of analyzing such data is comparability of the treatment groups with respect to confounding variables. Propensity score matching (PSM) aims to equate treatment groups with respect to measured baseline covariates to achieve a comparison with reduced selection bias. It is a valuable statistical methodology that mimics the RCT, and it may create an "apples to apples" comparison while reducing bias due to confounding...
January 9, 2018: Anesthesia and Analgesia
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