Publications by authors named "John W Difiore"

Article Synopsis
  • Intercostal nerve cryoablation (CRYO) during the Nuss procedure helps manage postoperative pain, but its effects on sensory recovery are not well-studied.
  • A study of 121 patients showed that most returned to normal chest wall sensation within a year, with 98.3% achieving this by 12 months.
  • Some experienced hypersensitivity (20.7%), but it was rarely painful, while permanent numbness was very uncommon.
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Article Synopsis
  • * A study looked at 40 patients who had the surgery and used a special pain management plan that included methods to reduce the need for strong painkillers.
  • * Most patients were able to go home the day after their surgery, experienced low pain levels, and didn't need as many opioids, showing that the new pain management strategy worked well.
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Thoracic outlet syndrome (TOS) is extremely rare in children. Only several pediatric cases have been reported, and all presented with neurologic symptoms. The authors report on a 6-year-old boy with an asymptomatic left subclavian artery aneurysm caused by compression of the subclavian artery by an anomalous first rib with poststenotic aneurysmal dilatation.

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A case of congenital bronchobiliary fistula is reported in conjunction with another congenital anomaly, right-sided congenital diaphragmatic hernia. The liver was herniated through the diaphragmatic defect into the right chest where a fistula tract was identified from the surface of the liver to the right mainstem bronchus. The patient was treated successfully.

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Thoracic outlet syndrome (TOS) is rare in childhood. In adults, TOS results in compression of the neurovascular bundle (branches of the brachial plexus and the subclavian artery), but more than 95% of cases present solely with neurologic compression. We present a case of TOS in a very young child and describe the rare finding of subclavian artery compression and post-stenotic aneurysm.

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