Fetal malrotation with midgut volvulus: Prenatal diagnosis and planning.

Introduction: Malrotation of the intestinal tract is a congenital malformation commonly found either incidentally or after affected individuals develop signs and symptoms of intestinal obstruction. Malrotation is prone to midgut volvulus that can cause intestinal obstruction and lead to ischemia and necrosis requiring emergent surgical intervention. Rare instances of midgut volvulus have been reported in the literature and carry a high mortality given the difficulty in establishing a diagnosis prior to development of signs of intestinal ischemia and necrosis.

Thoracoscopic Resection of Thoracic Inlet Neuroblastic Tumors in Young Children.

Thoracic inlet (TI) tumors are rare, and can be particularly challenging to resect due to proximity to mediastinal vessels and nerves. Traditional resection is typically performed through "trapdoor" or sternoclavicular incisions. The purpose of our study was to evaluate the feasibility and effectiveness of thoracoscopic resection of this group of tumors.

Variations in Nuss Procedure Operative Techniques and Complications: A Retrospective Review.

Introduction:  The Nuss procedure is the most common and preferred operative correction of pectus excavatum. Surgeon preference and patient factors can result in variations in Nuss procedure technique. We hypothesize that certain techniques are associated with increased risk of complications.

Metastable states in plateaus and multi-wave epidemic dynamics of Covid-19 spreading in Italy.

The control of Covid 19 epidemics by public health policy in Italy during the first and the second epidemic waves has been driven by using reproductive number R(t) to identify the supercritical (percolative), the subcritical (arrested), separated by the critical regime. Here we show that to quantify the Covid-19 spreading rate with containment measures there is a need of a 3D expanded parameter space phase diagram built by the combination of R(t) and doubling time T(t). In this space we identify the Covid-19 dynamics in Italy and its administrative Regions.

Intercostal cryoablation during Nuss procedure: A large volume single surgeon's experience and outcomes.

Background: Recent studies have shown intercostal cryoablation(IC) during the Nuss procedure decreases hospital length of stay(LOS) and opioid administration. However, few studies have also evaluated the risk of postoperative complications related to IC.

Methods: We performed a single center retrospective analysis of all patients who underwent Nuss procedure by one surgeon from 2/2016 to 2/2020, comparing intraoperative IC to other pain management modalities(non-IC).

Lung ultrasonography: A prognostic tool in non-ICU hospitalized patients with COVID-19 pneumonia.

Background: High diagnostic accuracy for pneumonia, absence of radiation exposure and repeatability are intrinsic features of lung ultrasonography making it an attractive tool in the assessment of patients with COVID-19 pneumonia. The aim of our prospective, observational study was to detect COVID-19-associated sonographic features and assess the potential value of LUS in predicting adverse events.

Methods: From March 12th to April 20th 2020 patients admitted to two medium-intensive wards with a discharge diagnosis of COVID-19 pneumonia were enrolled and underwent lung ultrasonography.

Preoperative resource utilization prior to minimally invasive repair of pectus excavatum.

Background: Preoperative testing to assess the physiologic impact of pectus excavatum is sometimes ordered to meet third-party payor preauthorization requirements. This study describes the utility of physiologic testing prior to minimally invasive repair of pectus excavatum (MIRPE).

Methods: We retrospectively reviewed patients that underwent MIRPE from 1/2012-7/2016 at two academic children's hospitals.

Quantifying the effect of resident education on outcomes in pediatric appendicitis.

Background/purpose: Surgical residents are involved in the care of patients in a climate where quality of care is an important outcome measure. The purpose of this study was to evaluate the effect of resident involvement on appendectomy outcomes.

Methods: We retrospectively reviewed appendectomies, ages 0-18, from January 2016 to December 2018.

Same Anesthesia Endoscopic Retrograde Cholangiopancreatography and Laparoscopic Cholecystectomy: The Pediatric ERCP Database Intiative Experience.

Background: Successful combined Laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) in the Same Session (LESS) has been reported in several studies in adult patients with choledocholithiasis.

Methods: This was a retrospective analysis of data collected prospectively in the Pediatric ERCP Database Initiative using REDCAP. Adverse events were recorded separately and were reviewed for this study.

Repetitive Imaging following Minimally Invasive Repair of Pectus Excavatum Is Unnecessary.

Introduction:  The objective of this study was to evaluate the necessity of repeat imaging after an initial chest radiograph (CXR) following minimally invasive repair of pectus excavatum (MIRPE).

Materials And Methods:  A retrospective review was performed on patients who underwent MIRPE from January 2012 to July 2016 at two academic children's hospitals. Data collected included demographics, severity of pectus defect (Haller index [HI]), utilization of CXRs, outpatient follow-up, and clinical outcomes.

Collaborations with Pediatric Hospitalists: National Surveys of Pediatric Surgeons and Orthopedic Surgeons.

To understand characteristics of pediatric hospitalist (PH) involvement in the care of children admitted to surgical services and explore surgeons' perspectives of PH effectiveness, we conducted a cross-sectional, web-based survey of pediatric surgical (PS) and pediatric orthopedic subspecialists (OS) from professional organizations. We used basic analyses to compare responses between the 2 surgical groups. The initial response rate was 48% (291/606) for PS and 59% (415/706) for OS.

Are Foley catheters needed after minimally invasive repair of pectus excavatum?

Background: High narcotic requirements after minimally invasive repair of pectus excavatum (MIRPE) can increase the risk of urinary retention. Placement of intraoperative Foley catheters to minimize this risk is variable. This study determines the rate of urinary retention in this population to guide future practice.

Postoperative Feeding Regimens After Laparoscopic Gastrostomy Placement.

Purpose: The objective of this study was to evaluate postoperative feeding regimens after laparoscopic gastrostomy placement and their effect on outcomes.

Methods: Children 18 years of age or younger, who underwent laparoscopic gastrostomy placement at a tertiary-care academic children's hospital between January 2014 and October 2016, were reviewed. Data collected included patient characteristics, postoperative feeding regimen, and clinical outcomes.

Twelve tips for creating an academic teaching portfolio.

An academic teaching portfolio is not only a requirement at many academic teaching institutions, but it is also important in a medical educator's growth and development through documentation, reflection, evaluation, and change. Creating an academic portfolio may appear daunting at first but with careful advanced preparation, organized evidence collection of your educational work, proof of scholarship, and thorough documentation of self-reflection and change, you can produce a successful product that accurately represents your educational beliefs, accomplishments, and growth throughout your career. This article provides medical educators with twelve steps for creating a successful academic teaching portfolio.

Comparison of two bacterial DNA extraction methods from non-polluted and polluted soils.

DNA extraction from soil samples is a critical step for molecular biology analyses. The present study compared the efficiency of two DNA isolation methods from non-polluted and polluted soils with or without the presence of a plant. Both applied methods used chemical and physical lyses, but method 1 had an additional physical disruption.

A peculiar case of diffuse hemangiomatosis of the left hepatic lobe in an asymptomatic adult patient: case report and literature review.

We report a rare case of diffuse hepatic hemangiomatosis (DHH) of the left hepatic lobe coexistent with giant hepatic hemangioma and without extra-hepatic involvement in an asymptomatic adult patient. Liver hemangiomas are the most common benign liver tumors. However, DHH without extra-hepatic involvement has rarely been reported in adults.

Endoscopic retrograde cholangiography for pediatric choledocholithiasis: Assessing the need for endoscopic intervention.

Aim: To assess pediatric patients for choledocholithiasis. We applied current adult guidelines to identify predictive factors in children.

Methods: A single-center retrospective analysis was performed at a tertiary children's hospital.

Spontaneous pneumomediastinum in the pediatric patient.

Background: Spontaneous pneumomediastinum (SPM) data in children are limited. We investigated the management of SPM at our institution.

Methods: We reviewed children with pneumomediastinum treated from January 2011 to October 2014.

Persistent cat scratch disease requiring surgical excision in a patient with MPGN.

We present the case of a 13-year-old immunosuppressed patient with unrelenting cat scratch disease despite 9 months of antibiotic therapy. The patient was being treated with mycophenolate and prednisone for membranoproliferative glomerulonephritis (type 1) diagnosed 13 months before the onset of cat scratch disease. Cat scratch disease was suspected due to epitrochlear lymphadenitis and an inoculation papule on the ipsilateral thumb, and the diagnosis was confirmed by the use of acute and convalescent titers positive for Bartonella henselae.

Analysis of submitted abstracts for the American Academy of Pediatrics, Section on Surgery, National Conference (AAP SoSU).

Purpose: In this study, we characterized the topics and type of research performed for abstracts submitted to the AAP SoSU national conferences from 2010-2013.

Methods: All abstracts submitted to the AAP SoSU Program Committee from 2010-2013 were analyzed. Abstracts were classified as basic science, clinical, domestic, international, as well as by disease processes, single, multicenter, retrospective, prospective, registry data, or other.

Management of the pediatric spontaneous pneumothorax: is primary surgery the treatment of choice?

Background: Surgery as the primary management strategy for pediatric primary spontaneous pneumothorax is controversial. This study aims to evaluate the outcomes and effectiveness of management approaches for pediatric spontaneous pneumothorax.

Methods: Outcomes of pediatric patients undergoing initial nonoperative treatment versus video-assisted thoracoscopic surgery with blebectomy and mechanical pleurodesis were compared via a retrospective review.

Complications related to the Nuss procedure: minimizing risk with operative technique.

Introduction: Pectus Excavatum (PEx) is the most frequent congenital chest wall deformity; surgical correction has a complication rate of 10%-50%. The purpose of this study was to evaluate outcomes in a recent cohort of pediatric patients from a single institution and investigate factors associated with complications.

Methods: A review of all patients with PEx treated with a Nuss procedure from 2003 to 2011 was performed.

Duodenum inversum: a report and review of the literature.

Duodenum inversum is a rare congenital malformation defined by a duodenum which travels superiorly and then posteriorly prior to crossing the midline above the pancreas. It is often confused with other, more common, anomalies of intestinal rotation. We present a case of duodenum inversum diagnosed incidentally in a one-month old infant with Trisomy 21 during evaluation for reflux disease.