Gun Violence in the COVID-19 Era: Using Multiple Databases to Describe the Experience in Buffalo, NY.

Objectives: In 2020, the public health crises of gun violence and novel coronavirus (COVID-19) collided and interventions to decrease COVID-19 transmission displaced millions of Americans from normal activity. We analyzed the effects of COVID-19 and its resultant shutdowns on gun violence in Buffalo, NY.

Methods: We queried the Gun Violence Archive (GVA) and the hospital databases from the 2 level 1 trauma centers which serve Buffalo firearm victims between March 15th and June 24th, 2020 ("COVID") and the same time period for years 2013 (hospital data)/2014 (GVA data) through 2019 ("pre-COVID") and 2021 through 2022 ("post-COVID").

General Surgery Resident Operative Experiences in Solid Organ Injury: An Examination of Case Logs.

Background: Non-operative management (NOM) of traumatic solid organ injury (SOI) has become commonplace. This paradigm shift, along with reduced resident work hours, has significantly impacted surgical residents' operative trauma experiences. We examined ongoing changes in residents' operative SOI experience since duty hour restriction implementation, and assessed whether missed operative experiences were gained elsewhere in the resident experience.

Secondary overtriage in a pediatric level one trauma center.

Background: Previous studies have explored under- and overtriage, and the means by which to optimize these rates. Few have examined secondary overtriage (SO), or the unnecessary transfer of minimally injured patients to higher level trauma centers. We sought to determine the incidence and impact of SO in our pediatric level one trauma center.

An Enhanced Recovery Protocol that Facilitates Same-day Discharge for Simple Laparoscopic Appendectomies.

Unlabelled: Acute appendicitis is the most common gastrointestinal condition requiring urgent operation in the pediatric population with laparoscopic appendectomy (LA) being the current surgical technique. We describe the implementation of a standardized protocol to reduce postoperative nausea and vomiting (PONV) and facilitate same-day discharge after LA.

Methods: A multidisciplinary team developed this protocol to facilitate same-day discharge after observing high rates of overnight stay due to PONV among simple appendectomies performed in 2011-2012.

Gangrenous appendicitis: No longer complicated.

Background: Appendicitis presents on a spectrum ranging from inflammation to gangrene to perforation. Studies suggest that gangrenous appendicitis has lower postoperative infection rates relative to perforated cases. We hypothesized that gangrenous appendicitis could be successfully treated as simple appendicitis, reducing length of stay (LOS) and antibiotic usage without increasing postoperative infections.

Ambulatory pediatric surgery.

Ambulatory pediatric surgery has become increasingly common in recent years, with greater numbers of procedures being performed on an outpatient basis. This practice has clear benefits for hospitals and healthcare providers, but patients and families also often prefer outpatient surgery for a variety of reasons. However, maximizing the potential opportunities requires critical attention to patient and procedure selection, as well as anesthetic choice.

Standardized ultrasound templates for diagnosing appendicitis reduce annual imaging costs.

Background: Ultrasound is preferred over computed tomography (CT) for diagnosing appendicitis in children to avoid undue radiation exposure. We previously reported our experience in instituting a standardized appendicitis ultrasound template, which decreased CT rates by 67.3%.

Effective methods to decrease surgical site infections in pediatric gastrointestinal surgery.

Background: Gastrointestinal (GI) surgeries represent a significant proportion of the surgical site infection (SSI) burden in pediatric patients, resulting in significant morbidity. Previous studies have shown that perioperative bundles reduce SSIs, but few have focused on pediatric GI operations. We hypothesized that a GI bundle would decrease SSI rates, length of stay (LOS), and hospital charges.

U.S. Pediatric Burn Patient 30-Day Readmissions.

The objectives of the study were to determine unscheduled 30-day readmission rates for pediatric burn patients and to identify readmission reasons. We used the 2013-2014 National Readmission Database to produce 30-day all-cause unscheduled readmission rates by patient and hospital characteristics. Readmission risk factors were evaluated with multivariable logistic regression.

The use of spinal angiography in the management of posterior mediastinal tumors: case series and review of the literature.

Introduction: Resection of inferiorly located posterior mediastinal tumors can be complicated by their proximity to the artery of Adamkiewicz (AKA). Although uncommon, intraoperative injury to the AKA may result in paraparesis or paralysis secondary to spinal cord ischemia. The use of preoperative spinal angiography may serve as a useful adjunct to the surgeon in guiding extent of resection of the tumor to avoid injury to this critical artery.

Congenital hepatic cyst with antenatal diagnosis: a case report and literature review.

Congenital hepatic cysts are rare lesions of infancy. While operative management and outcomes have been extensively studied in adult patients with hepatic cysts, data in pediatric patients are limited. We discuss our experience in an infant and review relevant literature regarding operative technique and surgical outcomes.