Firearm Injuries in Young Children: Surgical Resource Utilization and Implications for Prevention.

Introduction: Pediatric firearm injury prevention research in younger age groups is limited. This study evaluated a large multicenter cohort of younger children with firearm injuries, focusing on injury patterns and surgical resource utilization.

Methods: Children ≤15 y old sustaining firearm injuries between 2016 and 2021 and treated at 10 pediatric trauma centers in Florida were included.

Surgical Urgency, Patient Comorbidities, and Socioeconomic Factors in Surgical Site Infections in Pediatric Surgery.

Background: The rise of value-based purchasing has led to decreased compensation for hospital-acquired conditions, including surgical site infections (SSI). This study aims to assess the risk factors for SSI in children and teenagers undergoing gastrointestinal surgery across US hospitals.

Methods: The 2018-2020 Nationwide Readmissions Database was queried for patients undergoing gastrointestinal surgery under the age of 18.

Venous Thromboembolism in Children and Teenagers Admitted for Trauma: A 5-Year Nationwide Perspective.

Venous thromboembolism (VTE) in pediatric trauma patients is under-investigated. The purpose of this study was to perform an evaluation of the risk factors for VTE after pediatric trauma, including readmissions across the United States. The Nationwide Readmissions Database for 2016-2020 was queried for all patients under the age of 18 years admitted for trauma.

Social determinants of health in pediatric trauma: Associations with injury mechanisms and outcomes in the context of the COVID-19 pandemic.

Background: Relationships between social determinants of health and pediatric trauma mechanisms and outcomes are unclear in context of COVID-19.

Methods: Children <16 years old injured between 2016 and 2021 from ten pediatric trauma centers in Florida were included. Patients were stratified by high vs.

Laparoscopic transperitoneal repair of pediatric diaphragm eventration using an endostapler device.

Background: Minimally invasive repairs of pediatric diaphragm eventration have been well described via a thoracoscopic approach, oftentimes requiring single-lung ventilation and tube thoracostomy, with the disadvantage of not being able to clearly visualize what lies beneath the diaphragm. We describe a novel pediatric diaphragm eventration repair using a laparoscopic transperitoneal approach and an endostapler device. We also describe our initial experience with this technique.

Hepatic artery thrombosis and liver malignancy in pediatric liver transplantation.

Background: Hepatic artery thrombosis (HAT) remains a significant cause of graft failure and mortality after pediatric liver transplantation. Conditions not associated with hepatic failure, such as liver tumors, may be more prone to thrombotic problems after transplant. We hypothesized that liver transplant for hepatic malignancies may be associated with increased rates of HAT in the posttransplant period.

Pediatric inguinal hernias, hydroceles, and undescended testicles.

Pediatric inguinal hernias are extremely common, and can usually be diagnosed by simple history taking and physical examination. Repair is elective, unless there is incarceration or strangulation. Hydroceles are also quite common, and in infancy many will resolve without operative intervention.

Postoperative Bowel Perforation due to Heterotopic Ossification (Myositis Ossificans Traumatica): A Case Report and Review of the Literature.

Heterotopic ossification (HO) is the ectopic development of normal bone within soft tissue that can occur after traumatic injury. It is uncommon and may be missed or misdiagnosed, which can lead to complications. We report the case of an 84-year-old male with a previous history of a laparotomy who underwent resection of an intra-abdominal tumor through a midline incision.

Identifying the futile pediatric liver re-transplant in the PELD era.

Survival following pediatric re-transplant is inferior to that following primary transplant. We analyzed UNOS data (1987-2007) to identify factors associated with poor outcomes following re-transplant in both the pre-PELD and PELD eras. There may be a combination of factors associated with a futile pediatric liver re-transplant.

Impact of obesity on children undergoing liver transplantation.

Controversies exist with respect to the mortality of patients undergoing liver transplantation at the extremes of the body mass index (BMI). For pediatric liver transplantation, weight is usually the only factor considered in survival analysis. A review of the United Network for Organ Sharing database (1987-2007) revealed 9701 pediatric patients (<18 years old) who underwent primary liver transplantation.

The biopsied donor liver: incorporating macrosteatosis into high-risk donor assessment.

To expand the donor liver pool, ways are sought to better define the limits of marginally transplantable organs. The Donor Risk Index (DRI) lists 7 donor characteristics, together with cold ischemia time and location of the donor, as risk factors for graft failure. We hypothesized that donor hepatic steatosis is an additional independent risk factor.

Steroid use after the Kasai procedure for biliary atresia.

Background: The aim of this study was to describe patients undergoing the Kasai procedure at children's hospitals, evaluate outcomes, and analyze the association of these outcomes with systemic steroid use.

Methods: Biliary atresia patients (International Classification of Diseases, Ninth Revision, code 751.61) who underwent Kasai procedures at freestanding children's hospitals in the Pediatric Health Information System database from 2003 to 2008 were identified.

Extracorporeal life support for adults with malignancy and respiratory or cardiac failure: The Extracorporeal Life Support experience.

Background: Adults with cancer may be considered for extracorporeal life support (ECLS) as a means of support if failing conventional therapy.

Methods: The Extracorporeal Life Support Organization Registry was queried for patients aged >or=21 years with diagnoses of malignancy or hematopoietic stem cell transplantation.

Results: Seventy-two adults met inclusion criteria: 47 with solid tumors, 21 with hematologic malignancies, and 4 with hematopoietic stem cell transplantation.

Outcomes in children after intestinal transplant.

Objective: The survival rates after pediatric intestinal transplant according to underlying disease are unknown. The objective of our study was to describe the population of pediatric patients receiving an intestinal transplant and to evaluate survival according to specific disease condition.

Patients: Pediatric patients (< or =21 years of age) with intestinal failure meeting criteria for intestinal transplant were included in the study.

Outcomes in children with intestinal failure following listing for intestinal transplant.

Purpose: The purpose of this study was to describe the population of pediatric patients waiting for intestinal transplant and to evaluate the risk of death or transplant by specific disease states.

Methods: We studied the United Network for Organ Sharing (UNOS) database (Jan 1,1991 to 5/16/08) for patients 21 years old or younger at first listing for intestinal transplant and examined their age, sex, weight, and diagnoses. Time to list removal was summarized with cumulative incidence curves.

Thoracoscopic repair of congenital diaphragmatic hernia in infancy.

Background: Minimally invasive surgical techniques, specifically the thoracoscopic approach, have been applied to congenital diaphragmatic hernia (CDH) with varying outcomes from selected centers. The aim of our study was to examine the rate of successful completion and compare outcomes between open and thoracoscopic approaches in CDH repair.

Methods: We performed a retrospective analysis of infants with CDH repair (From February 2004 to January 2008).

Outcomes in neonates with gastroschisis in U.S. children's hospitals.

Our objectives are to report patient characteristics, comorbidities, and outcomes for gastroschisis patients and analyze factors associated with mortality and sepsis. Using Pediatric Health Information System data, we examined neonates with both an International Classification of Diseases, 9th Revision diagnosis (756.79) and procedure (54.

Pre-transplant therapy for hepatocellular carcinoma is associated with a lower recurrence after liver transplantation.

Background: Hepatic transplantation has been advocated as an effective treatment for hepatocellular carcinoma (HCC). We seek to determine if pre-transplant therapies can reduce post-transplant recurrence.

Methods: We conducted a retrospective review of prospective data in patients undergoing transplantation for HCC 2001-2006.

Adverse events after radiofrequency ablation of unresectable liver tumors: a single-center experience.

Background: Radiofrequency ablation (RFA) is a relatively new modality to treat liver tumors that is being incorporated into practice despite the fact that its risk profile has not been well described.

Methods: A retrospective cohort study, using structured chart review, on patients with liver tumor(s) was conducted from August 1998 to November 2006. Univariate and multivariate exploratory analyses were used to evaluate factors associated with adverse events.

Synchronous Todani types I and III choledochal cysts in a 10-month-old-infant: type IVb.

A 10-month-old, previously healthy boy presented with one week of mild jaundice, light-colored stools and irritability. Abdominal sonography showed a large type I choledochal cyst and a separate, distinct cystic mass at the head of the pancreas. Magnetic resonance cholangiopancreatography was performed to evaluate the relationship of the two lesions.

Physiologic properties of small intestine submucosa.

Background: Porcine small intestine submucosa (SiS) has been introduced as a bioprosthesis in herniorrhaphy. This study evaluates in vivo properties of SiS that would affect clinical use.

Materials And Methods: Twelve pigs underwent implantation of SiS (perforated and nonperforated) on the peritoneal surface.

Cerebral activation of mitogen-activated protein kinases after circulatory arrest and low flow cardiopulmonary bypass.

Objectives: Mitogen-activated protein kinases (MAPK) are important intermediates in the signal transduction pathways involved in neuronal dysfunction following cerebral ischemia-reperfusion injury. One subfamily, extracellular regulated kinase 1/2, has been heavily implicated in the pathogenesis of post-ischemic neuronal damage. However, the contribution of extracellular regulated kinase 1/2 to neuronal damage following deep hypothermic circulatory arrest and low flow cardiopulmonary bypass is unknown.

Sleeve resection of a transcarinal bronchial carcinoid after laser debulking.

We report a case of a bronchial carcinoid tumor extending from the right upper lobe into the left mainstem bronchus in a 30-year-old woman. Diagnosis was established by preoperative bronchoscopy and biopsy. After extensive debulking with seven sessions of bronchoscopic neodymium:yttrium-aluminum-garnet laser therapy, the tumor was resected by right upper-lobe sleeve lobectomy.