Revisiting inhaled nitric oxide utilization in congenital diaphragmatic hernia: A national cohort study of major children's hospitals in the United States.

Purpose: For over a decade, there has been evidence suggesting a lack of efficacy of inhaled nitric oxide (iNO) in the treatment of pulmonary hypertension associated with congenital diaphragmatic hernia (CDH). Our study aimed to evaluate hospital-level data on contemporary iNO use in CDH infants.

Methods: The Pediatric Health Information System database was queried for neonates with CDH managed at 48 major children's hospitals in the United States (2016-2023).

Resource use in infants undergoing esophageal atresia repair at major children's hospitals.

Background: Esophageal atresia with or without tracheoesophageal fistula is a resource-intensive neonatal surgical condition; however, the magnitude of the institutional cost burden is not well understood. In this study, we used a national database to measure resource use associated with the initial management of esophageal atresia at major children's hospitals nationwide.

Methods: The Pediatric Health Information System database was queried for infants undergoing esophageal atresia repair at 1 of 47 children's hospitals in the United States between 2014 and 2021.

Prematurity Associated With Increased Complications and Reoperation After Pull-Through in Hirschsprung Disease.

Introduction: Hirschsprung disease (HD) is a congenital disorder of the enteric nervous system, requiring definitive surgical treatment through pull-through procedures. While prematurity generally increases postoperative risk, it remains unclear whether prematurity is associated with worse short-term surgical outcomes in HD patients. This study investigates the association between prematurity and postoperative complications and reoperation rates following pull-through procedures in HD.

Intestinal Dysmotility and the Risk of Volvulus Following Omega-Jejunostomy Tube Placement in Children.

Introduction: Gastric dysmotility complicates enteral feeding in children, often requiring distal feeding access. While nasoduodenal and gastrojejunostomy tubes are common, frequent dislodgements necessitate hospital visits for fluoroscopic-guided replacement, exposing children to radiation and potential anesthesia risks. The omega-jejunostomy (OJ) tube was developed as a simpler alternative to roux-en-Y feeding jejunostomy, allowing easy at-home tube changes after tract maturation.

Multidisciplinary tumor boards in pediatric surgical oncology: a systematic review of approaches in low- and middle-income countries.

Pediatric cancer outcomes have improved significantly in recent decades, importantly through multidisciplinary collaboration. Multidisciplinary Tumor Boards (MTBs) foster cross-specialty discussions, leading to refined treatment plans. However, their use in low- and middle-income countries (LMICs) remains underexplored.

Inequities in Pediatric Cancer: Unveiling the Impact of Social Determinants of Health on Survival.

Background: The implications of sociodemographic factors across a wide range of pediatric cancers remain unclear. This study aims to assess the impact of social determinants of health (SDOH) on the survival rates of children diagnosed with cancer.

Methods: This retrospective cohort study included children <18 years with cancer in the National Cancer Database (2004-2020).

COVID-19's causal impact on child abuse and socioeconomic status: a Bayesian time series study.

Background: The COVID-19 pandemic intensified psychosocial stressors, potentially contributing to increased rates of child abuse. This study aimed to compare trends in child abuse/traumatic brain injury (TBI) admissions and socioeconomic status before and after the pandemic.

Methods: A 7-year retrospective study was conducted at a Level-1 Pediatric Trauma Center.

How We Do It: Video-Based Assessment Conference for Intraoperative Decision Making in Pediatric Surgery.

Objective: To demonstrate our experience with establishing a video-based assessment conference (VBA) for rare and complex procedures in a pediatric surgery fellowship program.

Design: We share our experience in establishing a VBA conference in our Division of Pediatric Surgery from case selection, methods of operative video recording, equipment, and editing, and the structure of how cases are presented in conference.

Setting: Pediatric Surgery Fellowship at the Johns Hopkins Children's Center in Baltimore, MD.

Adults and Adolescents With Neuroblastoma: An Analysis of the National Cancer Database.

Background And Objectives: Neuroblastoma, the most common extracranial solid tumor in children, is rare in adults. This study compares patient characteristics, disease patterns, and treatments among adults, adolescents, and children with neuroblastoma.

Methods: We queried the National Cancer Database (2004-2019) for neuroblastoma cases.

Extracorporeal Membrane Oxygenation Use in Pediatric Trauma: A Report From the National Trauma Data Bank.

Introduction: Indications for extracorporeal membrane oxygenation (ECMO) in pediatric trauma continue to evolve. This study evaluates trends and practices in ECMO use for injured children and identifies factors associated with mortality using the National Trauma Data Bank (NTDB).

Methods: We conducted a retrospective review of children ≤18 years who underwent ECMO therapy following trauma, recorded in the NTDB from 2007 to 2018.

Impact of Hospital Volume on Survival for Pediatric Wilms Tumor.

Background: Treatment for children with Wilms tumor (WT) is multidisciplinary, often including surgery, chemotherapy, and sometimes radiation therapy. High-volume hospitals (HVH) have been associated with improved outcomes in cancer care. Our study evaluates the association of hospital volume and survival outcomes in pediatric WT management.

Statewide Variation in Practices and Charges for Primary Spontaneous Pneumothorax in Maryland, United States: A Retrospective Study.

Background: The optimal treatment for primary spontaneous pneumothorax (PSP) remains undefined. Furthermore, the overall utilization and costs of various treatment approaches are incompletely understood. We investigated hospital charges and resource utilization by management strategy across the state of Maryland in adult and pediatric patients with PSP.

Pediatric Firearm Reinjury: A Retrospective Statewide Risk Factor Analysis.

Introduction: Pediatric firearm injuries are a significant public health concern in the United States. This study examines risk factors for firearm reinjury in Maryland's pediatric population.

Methods: Pediatric patients (age 0-19 y) who presented to any hospital in Maryland with a firearm injury between October 1, 2015, and December 31, 2019, were identified in the Maryland Health Services Cost Review Commission database and were followed for repeat firearm injuries through March 31, 2020.

BNP and NT-proBNP as prognostic biomarkers for the prediction of adverse outcomes in HFpEF patients: A systematic review and meta-analysis.

Heart failure with preserved ejection fraction (HFpEF) presents a challenge in clinical practice due to its complexity and impact on morbidity and mortality. The aim of this systematic review and meta-analysis (SR/MA) was to evaluate the value of B-Type Natriuretic Peptide (BNP) and NT-proBNP in predicting overall adverse outcomes, cardiovascular events, and mortality, in patients with HFpEF. This SR/MA included observational studies and randomized controlled trials (RCTs) that reported the use of BNP and NT-proBNP as prognostic biomarkers for adverse outcomes in HFpEF patients.

Failure to Significantly Reduce Radiation Exposure in Children with Suspected Appendicitis in the United States.

Background: Ultrasound (US) or magnetic resonance imaging (MRI) is recommended over computed tomography (CT) as the initial imaging modality when considering a diagnosis of appendicitis in children. This reduces unnecessary radiation exposure and has excellent accuracy. We hypothesized a significant increase in US utilization and a reduction in CT utilization in hospitals across the United States.

Access to Laparoscopic Pediatric Surgery: Do Ethnic and Racial Disparities Exist?

Introduction: Disparate access to laparoscopic surgery may contribute to poorer health outcomes among racial and ethnic minorities, especially among children. We investigated whether racial and ethnic disparities in laparoscopic procedures existed among four common surgical operations in the pediatric population in the United States.

Methods: Using the American College of Surgeons National Surgical Quality Improvement Program-Pediatrics, we conducted a retrospective review of pediatric patients, aged less than 18 y old, undergoing appendectomy, fundoplication, cholecystectomy, and colectomy from 2012 to 2021.

A Scoping Review of Limited English Proficiency and Immigration in Pediatric Surgery.

Introduction: With increasing globalization and diversity, the intersection of immigration and language barriers can impact patient outcomes. This scope review aims to summarize current evidence on immigration and language barriers on pediatric surgical outcomes.

Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Evaluation of Limited English Proficiency in the Management and Outcomes of Appendicitis in Children.

Introduction: Appendectomies are one of the most common pediatric surgical procedures. Limited English proficiency (LEP) may lead to disparities in health outcomes between English-proficient and LEP patients. This study assesses the association between LEP and postoperative outcomes in pediatric appendectomy.

Interpersonal Violence-Related Trauma Among South African Children.

Introduction: Injuries account for a major portion of disability-adjusted life years in children globally, and low-and middle-income countries are disproportionally affected. While injuries due to motor vehicle collisions and self-harm have been well-characterized in pediatric populations in South Africa, injuries related to interpersonal violence (IPV) are less understood. Our study aims to characterize patterns of injury, management, and outcomes for pediatric patients presenting with IPV-related injuries in a South African trauma center.

Enhanced Recovery After Surgery 2.0: Optimizing Pain Management in Nuss Procedure: Cryoablation and Nerve Block Strategies for Reduced Opioid Use.

Introduction: Our study assesses the association between cryoablation, with and without nerve block supplementation, post-Nuss procedure pain, and opioid use in pectus excavatum (PE) patients.

Methods: We conducted a retrospective cohort study at a single center for PE patients who underwent the Nuss procedure from 2017 to 2022. Outcomes included postoperative opioid use (measured in oral morphine milligram equivalent per kilogram [OME/kg]), average pain score (scale 0-10), and length of stay (LOS).

Artiss fibrin sealant for the fixation of autografts in pediatric burn care.

Background: Traditional fixation of autografts in the treatment of burns involves the use of sutures and staples. A novel fibrin sealant, Artiss, has been introduced as an alternate method of fixation and has shown promising safety and efficacy results in the adult population. Our study assessed the effectiveness of fibrin sealant to secure autologous split thickness skin grafts (ASTSG) in the pediatric burn population.

Nutritional Profile, Disease Severity, and Quality of Life of Patients with Inflammatory Bowel Disease: A Case-Control Study.

Introduction: Diet is thought to play an important role in the clinical course and quality of life (QOL) of patients with inflammatory bowel disease (IBD). However, dietary habits of patients with IBD are still unknown. This case-control study aims to compare the dietary habits of patients with IBD to healthy controls and evaluate differences in disease severity and QOL.

Patient Characteristics, Treatment, and Survival in Pleuropulmonary Blastoma: An Analysis from the National Cancer Database.

Pleuropulmonary blastoma (PPB) is a rare childhood tumor originating from the lung or pleura, typically treated with surgery, chemotherapy (CTx), and/or radiation therapy (RTx). This study aimed to assess patient and tumor features, treatment methods, and survival rates in PPB. We retrospectively analyzed PPB patients under 18 from 2004 to 2019, using the National Cancer Database (NCDB).

Ethnic disparities in pediatric appendicitis: the impact of hispanic ethnicity on presentation, complications, and postoperative outcomes.

Purpose: Our study investigates ethnic disparities in pediatric appendicitis, focusing on the impact of Hispanic ethnicity on presentation, complications, and postoperative outcomes.

Methods: We conducted a retrospective analysis of pediatric patients undergoing appendectomy for acute appendicitis from 2015 to 2020 using the National Surgical Quality Improvement Program-Pediatric database. We compared 30-day postoperative complications, postoperative length of stay, and postoperative interventions between Hispanic and non-Hispanic White patients.

Cryoablation Reduces Opioid Consumption and Length of Stay After Pulmonary Metastasectomy.

Introduction: Intraoperative cryoablation of intercostal thoracic nerves is gaining popularity as a technique that decreases postoperative pain in thoracic surgery. Our study evaluates the efficacy and safety of cryoablation in pain management of pediatric cancer patients undergoing thoracotomy.

Methods: We reviewed cancer patients undergoing thoracotomies for pulmonary metastasis resection at our children's hospital from 2017 to 2023.