Impact of Gift Giving During General Surgery Resident Match Interviewing Since Initiation of Virtual Interviews.

Objective: Following the transition to virtual interviews in 2021, interviewees began receiving gifts as a recruitment strategy in lieu of the preinterview dinner. This study characterizes quantity, type, and frequency of gift receipt in relation to program perception and ranking.

Design: An anonymous survey study was conducted.

Routine Assessment of Surgical Resident Wellness-Related Concerns During Biannual Review.

Background: Surgery residency confers stress burdens on trainees. To monitor and mitigate areas of concerns, our education team implemented a 6-item biannual survey querying potential stressors. We reviewed the initial 5-year experience to assess for trends and improve efforts in maintaining resident well-being.

Subcutaneous Endoscopic-Assisted Ligation of the Internal Ring for Inguinal Hernia Repair in Neonates Under Spinal Anesthesia.

While laparoscopy is now widely accepted for inguinal hernia repair in infants, it traditionally has required general anesthesia. We sought to evaluate the safety of laparoscopic inguinal hernia repair in infants under spinal anesthesia. We performed a retrospective cohort study of all inguinal hernia repairs at a single institution between December 2011 and June 2019 in patients younger than 6 months of age.

Return of the Banana Knife: An Alternative Instrument for Laparoscopic Pyloromyotomy.

When the disposable arthroscopic banana knife (Linvatec, Largo, FL) became unavailable, many pediatric surgeons adapted the use of spatula tip cautery for laparoscopic pyloromyotomy; however, reusable arthroscopic knives remain readily available and are well suited to the procedure. We compared laparoscopic pyloromyotomy with a reusable arthroscopic banana knife (Sklar, West Chester, PA; catalog no. 45-6050) to those using spatula tip cautery at a single institution between September 1, 2012, and December 31, 2019.

Boot Camp in a Box: Initial Experience with Pretraining Skills Preparation for New Interns.

Purpose: In order to increase selected skills at onset of training, we provided newly matched PGY-1 trainees with materials and instructions to practice these skills, as well as the opportunity to share video-recorded performance and receive feedback based on these videos.

Methods: Knot tying and suturing kits, instruments and supplies, and video instructions for task performance were sent to newly matched trainees to our program (n = 10), with instructions to practice 4 tasks (1- and 2-handed knot tying, interrupted and running suturing) until self-assessed comfort with each task was achieved or the 8-week time point before start of training was reached. Each trainee returned a video of each task, which was graded by blinded reviewers for time and errors using an itemized evaluation instrument (12 items for suturing and five items for knot-tying).

Clinical outcomes following identification of tip appendicitis on ultrasonography and CT scan.

Background/purpose: With recent improvements in imaging technology, subtler variations in the anatomy of the appendix can be appreciated. We hypothesized that radiographic findings of tip appendicitis may not correlate strongly with a pathologic diagnosis of appendicitis.

Methods: Our radiology database was searched for reports of a diagnosis of tip appendicitis between January 2013 and June 2017 for patients between the ages of 2 and 17.

Ureteric transection secondary to penetrating handlebar injury.

Ureteric trauma is rare, occurring in < 1% of all traumas. We present a unique case of a 13 year old female who sustained a penetrating abdominal injury from a bicycle handlebar. Upon initial examination there was herniation of bowel through the abdominal wound, so exploratory laparotomy was performed.

Laparoscopic Pediatric Inguinal Hernia Repair: A Pilot Study in a Novel Guinea Pig Animal Model.

Background: The purpose of this study was to compare different techniques for pediatric laparoscopic inguinal hernia repair. We hypothesize that the amount of dissection performed at the internal ring, with or without division of the peritoneum, will impact healing and thus long-term success of the repair.

Methods: Following the Institution's Animal Care and Use Committee approval (708024-4), 20 Hartley guinea pigs underwent laparoscopic repair of their natural open internal rings.

Operative vs Nonoperative Management of Pediatric Blunt Pancreatic Trauma: Evaluation of the National Trauma Data Bank.

Background: Traumatic pancreatic injury is associated with significant morbidity and mortality. We evaluated the differences in outcomes among children with blunt pancreatic injuries managed operatively and nonoperatively.

Study Design: The National Trauma Data Bank was evaluated from 2002 to 2011.

Evaluation of the treatment of pectus carinatum with compressive orthotic bracing using three dimensional body scans.

Purpose: The purpose of this study is to measure the effectiveness of compressive orthotic brace therapy for the treatment of pectus carinatum using an adjusted Haller Index (HI) measurement calculated from 3D body scan (BS) images.

Methods: Pediatric patients with pectus carinatum were treated with either compressive orthotic bracing or observation. An adjusted BS Haller index (HI) was calculated from serial 3D BS images obtained on all patients.

Guns and states: pediatric firearm injury.

Background: A recent report indicates that firearm-related injuries are responsible for 30% of pediatric trauma fatality. The literature is however limited in examining pediatric firearm injuries and variations in state gun control laws. Therefore, we sought to examine the association between pediatric firearm injuries and the Stand-Your-Ground (SYG) and Child Access Protection (CAP) laws.

Less is more: management of pediatric splenic injury.

Objective: To analyze national trends in the nonoperative management of pediatric splenic injury.

Design: Retrospective cohort analysis.

Patients: All children and adolescents 18 years or younger from 2 national databases who were hospitalized with pediatric splenic injury.

Surgical management of pediatric adhesive bowel obstruction.

Introduction: The objective of this study was to analyze a population-based database for recent trends in surgical management of pediatric adhesive bowel obstruction and compare open versus laparoscopic lysis of adhesions (LOA).

Subjects And Methods: Pediatric adhesive bowel obstruction cases were identified in the Kids' Inpatients Database from 1997, 2000, 2003, 2006, and 2009. Data analysis included patients' demographics, hospital variables, length of stay (LOS), and total hospital charges (THC).

Missed opportunities in the treatment of pediatric appendicitis.

Introduction: This study sought to evaluate the outcomes of in-hospital delay and determine associated co-morbidities in the treatment of pediatric acute appendicitis.

Methods: This was a retrospective analysis of the national inpatient sample from 2000 to 2008. Immediate treatment was defined as treatment in hospital day 0 or 1.

Is partial colectomy the operation of choice in pediatric Clostridium difficile colitis?

Purpose: This study examined the national trends in incidence and surgical management of pediatric Clostridium difficle colitis (CDC) hospitalizations.

Methods: This was a cross-sectional Nationwide Inpatient Sample (NIS) analysis of pediatric CDC from 2000 to 2008. Data analysis included patient demographics, procedures, length of stay (LOS), total hospital charges (THC), and in-hospital mortality.

Primary repair of facial dog bite injuries in children.

Objectives: The management of dog bite wounds is controversial, and current data on risk of infection are variable and inconsistent. Furthermore, the use of prophylactic or empiric antibiotics for the treatment of these wounds is debatable. We investigate the rate of wound infections and other complications after primary repair of pediatric facial dog bite injuries.

Geographic distribution of community-acquired methicillin-resistant Staphylococcus aureus soft tissue infections.

Purpose: The goal of this study is to look at the geographic growth patterns of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infections in our local region and to determine if specific geographic areas are at increased risk.

Methods: After Institution Review Board approval (132603-3), a retrospective chart review was conducted of 614 patients who underwent incision and drainage of an abscess by a single pediatric surgical practice from January 2004 to December 2008. In addition, previously published data from 195 patients who underwent incision and drainage of an abscess from January 2000 to December 2003 were reviewed.

Competition between selenomethionine and methionine absorption in the intestinal tract of green sturgeon (Acipenser medirostris).

l-Selenomethionine (SeMet) is a dominant form of selenium (Se) found in organisms at all levels of aquatic food chains and a key source of Se bioaccumulation and ecotoxicity. In mammals, intestinal absorption of SeMet is at least partly via the Na(+)-dependent neutral amino acid transporter. The mechanism of SeMet absorption and competitive effects of other dietary components on SeMet absorption in fish are unknown.

Endoscopic treatment with Deflux for refluxing duplex systems.

Purpose: The aim of this study was to review the experience of a single institution with the endoscopic Deflux (Q-Med Scandinavia, Uppsala, Sweden) procedure and assess its effectiveness in the treatment of refluxing duplex systems.

Materials And Methods: A retrospective review of all patients that underwent endoscopic Deflux treatment for vesicoureteral reflux (VUR) in duplex systems between June 2003 and July 2007 was performed. Data collection included: age, gender, side of refluxing ureter, preoperative radiologic grade of VUR on a voiding cystourethrogram (VCUG), presence of VUR on a radionuclide VCUG 3 months postprocedure, volume of Deflux injected, number of Deflux injections performed per patient, and number of patients that underwent reimplantation surgery.

Improving tactile sensation in minimally invasive pediatric surgery.

Purpose: The aim of this study was to investigate factors that impact tactile sensation during minimally invasive pediatric surgery.

Methods: Three different 3-mm Maryland laparoscopic instruments were tested with and without the resistance of a trocar (Ethicon 3-mm): Jarit (24-cm shaft, 113 g), Storz (30-cm shaft, 62 g), and an ultra-light prototype (24-cm shaft, 5 g). Experiments were conducted in a custom-designed laparoscopic simulator that directs instruments at fixed angles toward a central target.

Outcomes after a Ladd procedure for intestinal malrotation with heterotaxia.

Purpose: Intestinal rotation abnormalities and complex congenital heart disease associated with heterotaxia coexist. Despite the risk for midgut volvulus, performing a Ladd procedure for asymptomatic malrotation with heterotaxia remains to be controversial because the presumed risk for postoperative complications is thought to exceed the benefits of the operation. The purpose of this study was to review the incidence of complications after a Ladd procedure in asymptomatic patients with heterotaxia to guide recommendations for this patient population.

Basal cell carcinoma metastatic to cervical lymph nodes and lungs.

Metastatic basal cell carcinoma (MBCC) of the skin is rare in occurrence and may initially elude proper diagnosis and management. We describe a case of MBCC to cervical lymph nodes, originally evaluated and treated surgically as metastatic thyroid carcinoma. After definitive diagnosis of MBCC was made, chemotherapy and concomitant radiation treatment were initiated; however, despite these measures, the patient then developed MBCC to the lung.

Selenium absorption, distribution, and excretion in white sturgeon orally dosed with l-selenomethionine.

The usefulness of a newly developed, combined technique consisting of esophageal intubation, dorsal aortic cannulation, and urinary catheterization to deliver Se orally and to monitor Se uptake, accumulation, and excretion in white sturgeon (Acipenser transmontanus) was explored. Groups of five yearling sturgeon (1-2 kg) each were intubated with 0 (sham), 250, 500, or 1,000 microg Se/kg body weight in the form of L-selenomethionine, an ecologically relevant organic form of Se. Selenium concentrations in whole blood, plasma, and red blood cells did not change in the sham group but began to rise within 2 h postintubation in the other groups, and levels remained near maximum concentrations throughout the 48-h sampling period.

Bioaccumulation and chronic toxicity of dietary L-selenomethionine in juvenile white sturgeon (Acipenser transmontanus).

An 8-week growth trial was conducted to determine the sensitivity of white sturgeon (Acipenser transmontanus) to the toxicological effects of elevated dietary selenium (Se). Juvenile white sturgeon were fed diets supplemented with Se in the form of L-selenomethionine (SeMet), resulting in dietary concentrations of 0.4, 9.