Variables associated with pediatric emergency department visits for uncontrolled pain in postoperative adenotonsillectomy patients.

Objective: Returns to the emergency department (ED) for pain or dehydration after adenotonsillectomy (T&A) are frequent. Attempts to associate the specific pain regimens with these visits have been unrevealing, suggesting a need to assess for other potential factors associated with readmission.

Methods: A review of a 2:1 cohort matched by age, gender and payer status compared post-T&A patients who did not return ED for pain or dehydration within 21 days to those who returned.

Pediatric emergency department visits for uncontrolled pain in postoperative adenotonsillectomy patients.

Objective: Identify demographic variables related to emergency department (ED) returns, and analgesic administration in the ED for postoperative pain after adenotonsillectomy (T&A).

Study Design: Pediatric Health Information System (PHIS) database analysis.

Methods: Forty-seven children's hospitals included in the PHIS database were queried for all ED visits within 30 days of surgery with a diagnosis of acute postoperative pain (n = 2459) from 2014 to 2015.

Measuring the impact of surgical intervention on pediatric pectus excavatum using white light scanning.

Background: Objective preoperative assessment of pectus excavatum (PE) deformity in patients is limited to preoperative measurement of severity using computed tomography (CT) or magnetic resonance imaging (MRI). Postoperative assessment is currently subjective as postoperative CT scans are not recommended in light of radiation exposure and high cost to families. White Light Scanning (WLS) is a novel 3D imaging modality that offers an alternative that is a quick, nonionizing, inexpensive, and safe strategy for measurement both pre- and postsurgery.

Procedural burden experienced by children with cancer during their terminal hospital admission.

Background: Children with chronic conditions, including cancer, have been shown to have high-intensity end-of-life care. We assessed the frequency and timing of invasive procedures that children with cancer undergo during their terminal hospital admission (THA).

Methods: The Pediatric Health Information System database was queried from 2011 to 2015 for patients ages 1-18 years with a "malignancy" flag who died in the hospital.

Research using clinical registries in children's surgical care.

Clinical registries provide a valuable opportunity to study specific diagnoses or conditions with a broader scope than possible using individual center-based series and with more clinical detail than typically available in administrative data sources. These registries amass structured data with uniform definitions, thus facilitating reliable adoption and consistent use across contributing sites. By compiling granular data from a multitude of geographically diverse sites, clinical registries allow investigation of rare outcomes, comparison of practice and cost variation, and benchmarking across institutions.

Measuring the impact of brace intervention on pediatric pectus carinatum using white light scanning.

Background: Evaluation of Pectus Carinatum (PC) deformity in patients undergoing bracing is limited to subjective assessment of the chest through physical exam and photography. White Light Scanning (WLS) is a novel 3D imaging modality and offers an objective alternative that is quick, inexpensive, and safe. We previously demonstrated the feasibility of using a WLS-derived proxy for Haller index, called the Hebal-Malas Index (HMI), in measuring the surgical correction of Pectus Excavatum.

Prevention of hypergranulation tissue after gastrostomy tube placement: A randomised controlled trial of hydrocolloid dressings.

Hypergranulation tissue formation is a common complication after gastrostomy tube (G-tube) placement, occurring in 44%-68% of children. Hydrocolloid dressings are often used in the treatment of hypergranulation tissue but have not been studied for the prevention of postoperative hypergranulation tissue. An institutional review board (IRB)-approved, prospective, randomised study was performed in paediatric patients who underwent G-tube placement at a single, large children's hospital from January 2011 to November 2016.

A novel technique to measure severity of pediatric pectus excavatum using white light scanning.

Background/purpose: Computed tomography (CT) derived Haller Index (HI) remains the standard for quantifying severity in patient with pectus excavatum (PE). Optical scanning described in literature reports optimistic results and new indices that correlate with HI. This study assessed the feasibility of a handheld White Light Scanner (WLS) to obtain 3D measurements and indices of PE deformity.

Using accelerometers to characterize recovery after surgery in children.

Background: Assessment of recovery after surgery in children remains highly subjective. However, advances in wearable technology present an opportunity for clinicians to have an objective assessment of postoperative recovery. The aims of this pilot study are to: (1) evaluate acceptability of accelerometer use in pediatric surgical patients, (2) use accelerometer data to characterize the recovery trajectory of physical activity, and (3) determine if postoperative adverse events are associated with a decrease in physical activity.

Pediatric arterial catheters: Complications and associated risk factors.

Background/purpose: Arterial catheter complications are a common problem in a pediatric critical care setting, but reported complication rates and risk factors associated with peripheral arterial catheter complications vary. We conducted a retrospective cohort study to identify risk factors in a pediatric patient population.

Methods: We performed a detailed abstraction of provider notes in the electronic medical records of inpatients ≤18years of age who underwent arterial line placement between January 1, 2008 and January 1, 2013 at a university-affiliated standalone pediatric hospital.

Preliminary Evaluation of a Novel Rigid Bronchoscopy Simulator.

Purpose: Emergent retrieval of airway foreign bodies (AFBs) in children remains a priority skill set for pediatric surgeons. In the setting of low procedural volume, simulation-based education with deliberate practice is essential to ensure trainees reach expected surgical competency. The purposes of this work were to (1) create a realistic rigid bronchoscopy for AFB retrieval simulation model and (2) to evaluate preliminary validity evidence of a novel simulator for the use of training and assessing pediatric surgical trainees' rigid bronchoscopy skills.

Automated data extraction: merging clinical care with real-time cohort-specific research and quality improvement data.

Background/purpose: Although prohibitively labor intensive, manual data extraction (MDE) is the prevailing method used to obtain clinical research and quality improvement (QI) data. Automated data extraction (ADE) offers a powerful alternative. The purposes of this study were to 1) assess the feasibility of ADE from provider-authored outpatient documentation, and 2) evaluate the effectiveness of ADE compared to MDE.

Pediatric Intussusception: Decreased Surgical Risk with Timely Transfer to a Children's Hospital.

Introduction: Intussusception is a potentially life-threatening condition, and a frequent cause of bowel obstruction during the first two years of life. We hypothesized that patients who were transferred from outside community hospitals, or OSH, without tertiary care capabilities for pediatric services to a large academic children's hospital with intussusception were more likely to require operative management for their intussusception than those who were directly admitted.

Methods: The electronic medical record was queried for patients presenting to Ann and Robert H.

Bipolar spectrum features in obese individuals.

Unlabelled: AIM : The relationships between obesity and bipolar spectrum disorders (BSD) are unclear. Thus, the aim of our study were to approximate the prevalence of soft bipolar features in patients seeking treatment for obesity.

Methods: We performed a nested case-control study (cases: 90 patients with the mean BMI=38.

A single center retrospective review of hair tourniquet syndrome and a proposed treatment algorithm.

Introduction: Hair tourniquet syndrome (HTS) is a rare disorder characterized by a hair becoming tightly wound around an appendage. There is little known about the epidemiology, optimal treatment, or indications for surgical intervention in HTS. We hypothesized that HTS could be readily diagnosed and treated in the pediatric emergency department and we sought out factors predictive of surgical intervention.