At Home and at Risk: A Study on Pediatric Unintentional Firearm Injuries in the USA.

Aim Of The Study: Firearm injury is the leading cause of death among pediatric patients in the United States. Unintentional firearm injury remains underexplored compared to intentional firearm injury. This study aims to characterize risk factors and demographics associated with pediatric unintentional firearm injury.

Prehospital Reverse Shock Index Times Glasgow Coma Scale as a Predictor for Trauma Intervention in Paediatric Trauma Patients.

Background: Previous studies have identified the reverse shock index x Glasgow Coma Scale (rSIG) as a tool for predicting the need for trauma intervention in pediatric patients. This study sought to investigate the utility of prehospital rSIG as a triage tool to predict the need for trauma-center level of care in a large pediatric cohort.

Methods: Data from the American College of Surgeons National Trauma Data Bank (NTDB) (2018-2020) were used.

Predictors of Conservative Management Failure in Pediatric Renal Trauma: National Trauma Database Insights.

Aim Of The Study: This study aimed to evaluate contemporary management strategies of pediatric renal trauma, focusing on the failure of conservative management and identifying its predictors.

Methods: The National Trauma Database (2018-2021) was queried for pediatric patients (≤18 years) with renal injury, identified via AIS codes aligned with the AAST kidney injury grading system. Urological surgical procedures were identified via ICD-10 Procedure Codes.

Identifying Novel Genetic Markers in Pediatric Rhabdomyosarcoma.

Background/purpose: Rhabdomyosarcoma risk stratification is traditionally determined by tumor histology and staging. Recent studies revealed the importance of molecular features in predicting prognosis. We investigated prognosis by age of onset and mutation incidence in rhabdomyosarcoma tumors.

"Signet Ring Sign" on Plain X-ray Indicates the Need for Surgical Intervention After Magnet Ingestion in Children.

The ingestion of magnets used in toys and household products is a common problem in children and can have potentially devastating health consequences. The attraction between multiple magnets across intestinal walls can lead to bowel obstruction, fistula formation, necrosis, and perforation of the involved segments. Multiple magnets attached to each other within the intestinal lumen can also pass spontaneously.

A Report of a Rare Case of BCOR (B-cell Line 6 Corepressor)-Altered Sarcoma of the Lung in a Child.

Ewing sarcoma is one of the small round blue cell tumors of childhood that typically affects bone. Recently, a subgroup of undifferentiated round-cell sarcomas has been genetically identified as BCOR (B-cell Line 6 Corepressor)-altered sarcomas (BAS). We present a case of a six-year-old male child who presented with a chief complaint of shortness of breath and tachypnea and was found to have a large mediastinal mass concerning sarcoma.

Opportunity for Reduction of Intensive Care Unit Resource Utilization in Pediatric Blunt Liver and Spleen Injuries: A National Trauma Data Bank Analysis.

Introduction: Guidelines for blunt liver and spleen injury (BLSI) by the Arizona-Texas-Oklahoma-Memphis-Arkansas Consortium (ATOMAC) emphasize hemodynamic stability over injury grade when considering non-operative management (NOM). In this study, we examined rates of intensive care unit (ICU) admission for children with isolated low-risk BLSI among US hospitals.

Methods: The National Trauma Data Bank (NTDB) was queried for patients ages 1-15 admitted between 2017 and 2019 with BLSI.

Pediatric Peripheral Vascular Trauma: Incidence and Outcomes.

Peripheral vascular trauma (PVT) is rare in children, with an incidence estimated below 1%. We studied pediatric PVT and risk factors for major amputation by accessing the 2019 National Trauma Data Bank (NTDB). Demographics, injury type and location, trauma center capability, injury severity score (ISS), length of stay (LOS), and major amputation rates were evaluated.

The Obesity Paradox in the Pediatric Trauma Patient.

Background: Obesity is a chronic disease that adversely impacts patient outcomes and increasingly affecting the pediatric population. According to the CDC, in 2020 the prevalence of obesity among children and adolescents was estimated to be as high as 19.7%.

Pediatric Blunt Splenic Trauma: Disparities in Management and Outcomes.

Introduction: While nonoperative management has become widely accepted, whether nonoperative management of blunt splenic trauma is standardized across pediatric trauma centers and different racial groups warrants further investigation. Using the National Trauma Database, the purpose of this study was to quantify the differences in the management of pediatric splenic trauma across different pediatric trauma centers, with respect to injury severity, race, ethnicity, and insurance.

Methods: Patients under 20 y of age with blunt splenic trauma reported to the 2018 and 2019 National Trauma Data Bank were identified.

Pediatric Melanoma: Geographic Trends in Incidence, Stage, and Mortality in the United States.

Introduction: Pediatric melanoma is the most commonly diagnosed skin cancer in children, with the annual incidence recently increasing by an average of 2% each year. Ultraviolet (UV) radiation from excessive sun exposure is an important carcinogenic risk factor, with penetration varying greatly throughout the country. Consequently, an individual's geographic location may play a role in how much exposure to high UV index rays they receive throughout their lifetime.

Nephron sparing surgery outcomes in Wilms' tumor: is it ready for primetime?

Purpose: Radical nephrectomy is the gold standard in Wilms tumor (WT) treatment and is combined with adjuvant treatment in early stage disease or performed after neo adjuvant therapy in advanced disease. With the development of novel adjuvant and neoadjuvant therapeutic strategies, there is increasing interest in organ preserving procedures in several adult malignancies. Potential long-term complications of living with a single kidney include hyperfiltration syndrome, hypertension, and fluid retention.

Pediatric cerebrovascular trauma: Incidence, management, and outcomes.

Background: Pediatric cerebrovascular trauma (CVT) is rare. There is an increasing use of endovascular management in vascular trauma. We studied the incidence, management, and outcomes of CVT in the pediatric population using the NTDB (National Trauma Data Bank).

Pediatric firearm injury trends in the United States: A national trauma data bank (NTDB) analysis.

Aim Of Study: Firearm injuries are the second leading cause of injury-related death in the USA in children less than 18. We compared overall and intent-specific firearm hospitalizations across age group and race to understand recent trends.

Methods: A retrospective cohort of 20,083 children from the national trauma data bank involved in incidences of firearm discharges from 2013 to 2017 was divided by race, discharge intent, gun type, and four age groups: infants (ages 0-2), toddlers (3-6), children (7-12), and adolescents (13-18).

A nationwide database analysis of demographics and outcomes related to Extracorporeal Membrane Oxygenation (ECMO) in congenital diaphragmatic hernia.

Purpose: The aim of the study was to understand the use of Extracorporeal Membrane Oxygenation (ECMO) in congenital diaphragmatic hernia (CDH) and its outcomes.

Methods: The 2016 Kid's Inpatient Database (KID) obtained from the national Healthcare Cost and Utilization Project (HCUP) was used to obtain CDH birth, demographic, and outcome data associated with ECMO use. Categorical variables were analyzed and odds ratios (OR) with 95% confidence intervals (CI) are reported for variables found to have significance (p < 0.

Regional variation in gastroschisis: a nationwide database review of demographics and outcomes.

Background: Gastroschisis is an index neonatal malformation with an increasing incidence from earlier decades. The aim of this study was to investigate regional variations in patient demographics, outcomes, and costs in gastroschisis.

Materials And Methods: The 2016 kid's inpatient database (KID) obtained from the Healthcare Cost and Utilization Project (HCUP) was used to obtain gastroschisis birth, demographic, and outcome data across four U.

Study of social disparities in pediatric laparoscopic appendectomy outcomes and cost.

Purpose: There is an increasing focus on racial and social disparities in health care. There have been several studies that have documented disparities in outcome between racial groups in the adult literature. Not much is known about disparities in outcomes after surgical procedures in children.

Pediatric Nonaccidental Trauma: Experience at a Level 1 Trauma Center.

Introduction: Pediatric nonaccidental trauma (NAT) is difficult to diagnose. Several isolated injuries in NAT could happen in the setting of accidental trauma (AT), and having a high index of suspicion is important to correctly identify abuse. NAT has a significant mortality rate if the sentinel event is not adequately diagnosed, and the infant is not separated from the perpetrator.

Central line associated blood stream infections in gastroschisis patients: A nationwide database analysis of risks, outcomes, and disparities.

Purpose: The aim of this study was to determine the risk of central line associated blood-stream infections (CLABSI) in neonatal gastroschisis patients, risk factors, outcomes, and financial implications.

Methods: The 2016 Healthcare Cost and Utilization Project (HCUP)'s kid's inpatient database (KID), a national database of pediatric inpatient admissions across the United States, was used to obtain a large sample of gastroschisis admissions. Incidence of CLABSI in the gastroschisis patient population was compared to the incidence of CLABSI in the database.

Trending Weight Loss Patterns in Obese and Super Obese Adolescents: Does Laparoscopic Sleeve Gastrectomy Provide Equivalent Outcomes in both Groups?

Background: Many factors, including preoperative weight, may determine final weight loss after bariatric surgery; however, their proportional contribution is unclear. To such end, we evaluated weight loss patterns among obese adolescents.

Methods: We evaluated 57 adolescents who underwent laparoscopic sleeve gastrectomy from 2011 to 2017.

Enhanced recovery after surgery (ERAS) protocols in neonates should focus on the respiratory tract.

Background/purpose: Enhanced recovery after surgery (ERAS) protocols have shown significant benefits in terms of patient outcomes and institutional cost savings in colorectal and bariatric surgery. This has not, however, been tried in the neonatal setting. One of the major barriers to developing ERAS protocols in the neonatal intensive care unit (NICU) is the often-prolonged intubation of neonates after surgery.

Characterizing Bariatric Surgery Utilization and Complication Rates in the Adolescent Population.

Introduction: Bariatric surgery is an increasingly common treatment of morbid obesity in the United States and has demonstrated effective weight loss and improvement of comorbidities. We used the National Surgical Quality Improvement Program (NSQIP) data to characterize bariatric surgery utilization and complication rates in the adolescent population.

Methods: Demographics, surgical procedures, comorbidities, and 30-day outcomes of 2625 adolescents ages 18-21 who underwent bariatric surgery were analyzed from NSQIP data-bank from 2005 to 2015.

Controversies in the management of neonatal testicular torsion: A meta-analysis.

Objective: This meta-analysis seeks to discern the optimal management strategy in neonatal testicular torsion (NTT).

Methods: Reviewed all English-language articles published between 2005 and 2015 in Medline/Pubmed that had a defined diagnosis of NTT within the first thirty days of life, and discussed specific surgical and nonsurgical management. Exclusion criteria were non-English literature, case reports, case studies, and failure to clearly describe the management of NTT.