Publications by authors named "Zachary Winthrop"

Importance: After the COVID-19 pandemic, there was a surge of pediatric respiratory syncytial virus (RSV) infections, but national data on hospitalization and intensive care unit use and advanced respiratory support modalities have not been reported.

Objective: To analyze demographics, respiratory support modes, and clinical outcomes of children with RSV infections at tertiary pediatric hospitals from 2017 to 2023.

Design, Setting, And Participants: This cross-sectional study evaluated children from 48 freestanding US children's hospitals registered in the Pediatric Health Information System (PHIS) database.

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Article Synopsis
  • Tracheobronchomalacia (TBM) leads to severe airway collapse and can cause serious health issues, especially in children, with this study focusing on those with severe primary TBM without underlying causes like esophageal atresia or vascular issues.
  • A cohort of 73 children underwent airway pexy surgery, and the study compared their symptoms and bronchoscopic findings before and after the procedure.
  • Results showed significant improvements in many symptoms, but about 29% of patients still had issues afterward, leading to further surgical interventions for symptom relief.
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Background: "Bridging" is a term used to describe the implementation of various treatment modalities to improve waitlist survival while a patient awaits lung transplantation. ECMO and PLAD are technologies used to bridge patients to lung transplantation. ECMO and PLAD are cardiopulmonary support systems that help move blood forward while using an artificial membrane to remove CO from and add O to the blood.

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Purpose: Clinical fellows, those training to become subspecialists in a program certified by the Accreditation Council for Graduate Medical Education, supervise residents on inpatient subspecialty rotations. Unlike for supervising residents or for faculty, there is a paucity of literature describing fellows' supervision of residents. The aim of this study was to understand residents' and fellows' perception of successful supervision of residents by fellows on inpatient subspecialty rotations to inform the development of curricula to support fellows as supervisors.

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Current literature suggests that distal tibia Salter-Harris Type III and IV fractures with > 2 mm of displacement should be treated surgically to minimize growth arrest. The objective of the current study is to determine, in Salter-Harris Type III and IV distal tibia fractures, if gap displacements < 2 mm post-surgery are associated with fracture union, if step-offs > 2 mm post-surgery are associated with osteoarthritis, and to determine how often growth disturbances are observed in surgically-treated patients. A retrospective case series review of fourteen patients with displaced distal tibia Salter-Harris Type III and IV fractures was performed.

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Extension type supracondylar humerus fractures in children commonly displace in two directions: posteromedial and posterolateral. The traditional maneuver to reduce posteromedial displaced fractures utilizes pronation of the forearm, while the maneuver for posterolateral displaced fractures utilizes supination. Traditional teaching suggests that the periosteum is an aid to reduction.

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Participation in boxing, mixed martial arts, and wrestling is extremely popular among children and adolescents. The objective of this study was to determine themes depicted in a select number of combat-related films. Twenty films were independently viewed and analyzed by 4 reviewers.

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A long arm cast with the elbow extended is a useful but often forgotten technique to manage some pediatric fractures. Specifically, proximal forearm fractures of both the radius and ulna, olecranon fractures, flexion-type supracondylar fractures and type II Monteggia fractures are well managed in this manner. Although some of these fractures are seen infrequently, timely diagnosis and treatment are essential to prevent complications.

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The surgical approach for open reduction and internal fixation of lateral condyle fractures in children is controversial. Some authors recommend the lateral approach to the elbow over the posterior approach because of theoretical concern for injury to the vascular supply of the distal humerus and potential avascular necrosis (AVN). The purpose of this retrospective case series study is to report the outcomes of open reduction and internal fixation of displaced lateral condyle fractures of the humerus by the posterior approach.

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Alagille syndrome is a rare multisystem disorder affecting the liver, heart, vertebrae, eyes, and face. Alagille syndrome shares multiple phenotypic variants of other congenital or chronic childhood illnesses such as DiGeorge syndrome, Down syndrome, spina bifida, type 1 diabetes mellitus, and cystic fibrosis. All of these chronic illnesses have well-established links to psychiatric conditions.

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Osteochondritis dissecans (OCD) of the knee is a disease of the subchondral bone with secondary injury to the overlying articular cartilage. OCD lesions are generally categorized as juvenile-growth plates open-or adult-growth plates closed. This maturity-based classification scheme has a prognostic value in that many juvenile OCD lesions will heal with conservative care while most symptomatic adult OCD lesions need surgical intervention.

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