Leveraging Quality Improvement Tools to Improve Administration of First-line Surgical Antibiotic Prophylaxis in Patients Labeled as Penicillin Allergic.

Introduction: A reported penicillin allergy reduces the likelihood that the patient will receive first-line surgical antibiotic prophylaxis (SAP), which can increase the risk of developing a surgical site infection (SSI). This project aimed to increase the use of first-line SAP agents in orthopedic and pediatric surgery patients with a reported penicillin allergy.

Methods: The Institute for Healthcare Improvement quality improvement methodology was followed.

Isolated aortic arch anomalies are associated with defect severity and outcome in patients with congenital diaphragmatic hernia.

Purpose: Congenital diaphragmatic hernia (CDH) patients often have suspected isolated aortic arch anomalies (IAAA) on imaging. The purpose of this work was to describe the incidence and outcomes of CDH + IAAA patients.

Methods: Cardiovascular data were collected for infants from the CDH Study Group born between 2007 and 2019.

Introduction of a novel ultrasound-guided extrathoracic sub-paraspinal block for control of perioperative pain in Nuss procedure patients.

Background: A safe and effective method of multilevel thoracic pain control remains an elusive goal in patients undergoing the Nuss procedure. The aim of our study was to develop a nonopioid centered approach using a novel regional technique as part of a quality improvement initiative.

Methods: The proposed ultrasound-guided technique positions multi-perforated soaker catheter deep to the paraspinal muscles from T2 to T11.

Initial experience with thoracoscopic esophageal atresia and tracheoesophageal fistula repair: lessons learned and technical considerations to achieve success.

The minimally invasive surgical (MIS) repair of esophageal atresia/tracheoesophageal fistula (EA/TEF) is challenging and requires advanced endoscopic skills. The purpose of this study was to provide insight in successfully introducing the MIS repair based on the initial cases performed by a single pediatric surgeon and review of the experience of others. A retrospective review of all MIS TEF repairs performed by a single surgeon was conducted.

Differentiating biliary atresia from other causes of cholestatic jaundice.

Diagnosis of biliary atresia (BA) in infants presenting with cholestatic jaundice (CJ) requires exploratory surgery with cholangiography. However, the lack of a standardized approach to preoperative evaluation of infants with CJ can lead to a high number of negative surgical explorations. We reviewed our experience with CJ and BA to determine preoperative variables that might reliably identify BA.

Thoracoscopic decortication for advanced pediatric empyema.

Background: Although tube thoracostomy with fibrinolytic agents and video-assisted thoracoscopic (VATS) decortication are relatively equivalent in the treatment of empyema with regard to time to patient defervescence and hospital discharge, the potential for greater benefit with VATS decortication in the setting of advanced empyema has not been explored fully. This paper describes our transition from a policy of drainage and antibiotics to primary operative management with VATS. We wanted to assess the safety and efficacy of primary operative management as a first-line treatment for advanced disease.

Line positions and line strengths for the 3<--0 electric quadrupole band of H2 1Sigmag +.

Several rotational lines in the S and Q branches [including the previously unobserved Q(2) and Q(3) lines] of the 3-0 electric quadrupole band of H2 have been detected by cavity ring-down spectroscopy. Line strengths were measured at densities between 2.7x10(18) and 7.

Tumor size and extent of disease at diagnosis predict the response to initial therapy for papillary thyroid carcinoma in children and adolescents.

Treatment of papillary thyroid carcinoma (PTC) in children and adolescents is controversial. We previously showed that large tumor size, multifocal disease, and extensive disease at diagnosis predict recurrence. We examined 47 patients with PTC to determine whether these features predict response to treatment.

Unique management of stage 4S neuroblastoma complicated by massive hepatomegaly: case report and review of the literature.

Stage 4S neuroblastoma is an unusual malignancy that has an excellent prognosis, except in young infants. A 2-month-old with 4S neuroblastoma complicated by massive hepatomegaly, managed by abdominal decompression surgery and a negative-pressure dressing system is presented. Diffuse alveolar hemorrhage also developed, which was treated with high-dose corticosteroids.