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cirugia pediatrica

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Injury is still the number 1 killer of children ages 1 to 18 years in the United States ( Children who sustain injuries with resulting disabilities incur significant costs not only for their health care but also for productivity lost to the economy. The families of children who survive childhood injury with disability face years of emotional and financial hardship, along with a significant societal burden. The entire process of managing childhood injury is enormously complex and varies by region...
August 2016: Pediatrics
Victoria A Lane, Kristine M Nacion, Jennifer N Cooper, Marc A Levitt, Katherine J Deans, Peter C Minneci
BACKGROUND: Health related Quality of Life (HRQoL) is an important outcome in medical care. The aim of our study was to identify characteristics associated with lower HRQoL scores in children with anorectal malformation (ARM) and Hirschsprung disease (HD). METHODS: Patients younger than 18years, with HD or ARM, who were evaluated at our center from April 2014 to August 2015, were identified. The results of comprehensive questionnaires regarding diagnosis, symptoms, comorbidities and previous medical/surgical history, and validated tools to assess urinary status, stooling status and HRQoL were evaluated...
November 2016: Journal of Pediatric Surgery
J Zimmer, C Tomuschat, P Puri
INTRODUCTION: Several operative techniques have been developed for the treatment of Hirschsprung's disease (HD) in the past decades. Since one-stage transanal pull-through (TAPT) was first performed in 1998, multiple studies have shown favourable short-and midterm results compared to other techniques with shorter operation length, shorter hospital stay and lower complication rates. The aim of this meta-analysis was to determine the longterm results following TAPT for HD. METHODS: A systematic literature search for relevant articles was performed in four databases using the following terms "Hirschsprung/Hirschsprung's disease", "aganglionosis", "transanal", "pullthrough/pull-through", "longterm/long-term" "results", "follow-up" and "outcome"...
August 2016: Pediatric Surgery International
Brent Bauman, Daniel Stephens, Hannah Gershone, Connie Bongiorno, Erin Osterholm, Robert Acton, Donavon Hess, Daniel Saltzman, Bradley Segura
PURPOSE: Despite the numerous methods of closure for giant omphaloceles, uncertainty persists regarding the most effective option. Our purpose was to review the literature to clarify the current methods being used and to determine superiority of either staged surgical procedures or nonoperative delayed closure in order to recommend a standard of care for the management of the giant omphalocele. METHODS: Our initial database search resulted in 378 articles. After de-duplification and review, we requested 32 articles relevant to our topic that partially met our inclusion criteria...
October 2016: Journal of Pediatric Surgery
Joshua D Rouch, Jessica A Keeley, Andrew Scott, Roman Sydorak, Daniel DeUgarte, Steven L Lee
No abstract text is available yet for this article.
September 1, 2016: JAMA Surgery
Kitty G Snoek, Irma Capolupo, Francesco Morini, Joost van Rosmalen, Anne Greenough, Arno van Heijst, Irwin K M Reiss, Hanneke IJsselstijn, Dick Tibboel
OBJECTIVE: Accurate and validated predictors of outcome for infants with congenital diaphragmatic hernia are needed. Score for Neonatal Acute Physiology-II has been validated to predict mortality in newborns. We investigated whether Score for Neonatal Acute Physiology-II scores in congenital diaphragmatic hernia could predict mortality, need for extracorporeal membrane oxygenation (in patients born in a center with extracorporeal membrane oxygenation availability), and development of bronchopulmonary dysplasia (oxygen dependency beyond 28 d after birth) in survivors...
June 2016: Pediatric Critical Care Medicine
Mauricio A Escobar, Carolynn J Morris
BACKGROUND: The American College of Surgeons Committee on Trauma (ACS-COT) view over- and undertriage rates based on trauma team activation (TTA) criteria as surrogate markers for quality trauma patient care. Undertriage occurs when classifying patients as not needing a TTA when they do. Over-triage occurs when a TTA is unnecessarily activated. ACS-COT recommends undertriage <5% and overtriage 25-35%. We sought to improve the under-triage and over-triage rates at our Level II Pediatric Trauma Center by updating our outdated trauma team activation criteria in an evidence-based fashion to better identify severely injured children and improving adherance to following established trauma team activation criteria...
September 2016: Journal of Pediatric Surgery
Stefan Gfroerer, Henning Fiegel, Udo Rolle
OBJECTIVES: Ultrasound has developed as the method of choice for diagnosing intussusception. Ultrasound-guided enema reduction is the standard method for treating intussusception. This retrospective study evaluates the efficacy and safety of ultrasound in diagnosis and treatment of intussusception performed solely by pediatric surgeons. METHODS: Charts were studied of all patients who were treatedfor intussusception in our unit from 2013 to 2015. Primary outcome measure was the completeness of reduction, and secondary outcome measure was the rate of complications and elapsed time until surgical treatment...
July 2016: Pediatric Surgery International
Kelly E Clements, Marilyn Fisher, Kofi Quaye, Rebecca O'Donnell, Christine Whyte, Michael J Horgan
BACKGROUND: Surgical site infections (SSI) increase morbidity and mortality. In adult and pediatric populations, the incidence ranges from 1.5-12%. Studies in neonates have shown an association between preoperative stay in an intensive care unit and development of SSI. To date, there has only been a single study looking exclusively at SSI in the Neonatal Intensive Care Unit (NICU). Additionally, there has been a suggestion that prematurity may be a risk factor for SSI, but this has come from studies looking at all neonates less than 28days, rather than only neonates hospitalized in a NICU...
September 2016: Journal of Pediatric Surgery
Qiu-Ming He, Wei Zhong, Hong Zhang, Le Li, Zhe Wang, Yunpu Tan, Junjian Lv, Fen Liu, Jiakang Yu, Huimin Xia
BACKGROUND: To analyze the early outcome of thoracoscopic repair (TR) of neonatal congenital diaphragmatic hernia (CDH) with standardized indications. METHODS: Clinical data of 14 neonates with CDH who underwent TR from September 2013 to August 2014 were retrospectively analyzed. SELECTION CRITERIA: weight beyond 2.0 kg; liver in the abdomen; no intestinal obstruction; no severe cardiopulmonary anomalies; not required high-frequency oscillatory ventilation or extracorporeal membrane oxygenation...
May 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Lena E Gottesman, Michael T Del Vecchio, Stephen C Aronoff
BACKGROUND: The etiologies of conjugated hyperbilirubinemia in infancy are diverse. OBJECTIVE: Determine the prevalence rates of the specific etiologies of conjugated hyperbilirubinemia in infancy. DATA SOURCES: EMBASE and Pubmed were searched electronically and the bibliographies of selected studies were search manually. The search was conducted independently by two authors. STUDY SELECTION: (1) prospective or retrospective case series or cohort study with 10 or more subjects; (2) consecutive infants who presented with conjugated hyperbilirubinemia; (3) subjects underwent appropriate diagnostic work-up for conjugated hyperbilirubinemia; (4) no specific diagnoses were excluded in the studied cohort...
2015: BMC Pediatrics
Holly L Hedrick
Congenital diaphragmatic hernia (CDH) is a congenital anomaly that presents with a broad spectrum of severity that is dependent upon components of pulmonary hypoplasia and pulmonary hypertension. While advances in neonatal care have improved the overall survival of CDH in experienced centers, mortality and morbidity remain high in a subset of CDH infants with severe CDH. Prenatal predictors have been refined for the past two decades and are the subject of another review in this issue. So far, all randomized trials comparing prenatal intervention to standard postnatal therapy have shown no benefit to prenatal intervention...
February 2013: Seminars in Pediatric Surgery
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