Journal of pediatric surgery
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The objective was to investigate the relationship of high gun ownership and gun death rate on children and determine predictors influencing the incidence and outcome of pediatric firearm injuries in a major pediatric level 1 trauma center. ⋯ The overwhelming majority of children were injured after a gun went off unintentionally, whereas most African American children were shot violently. We identified certain seasonal and geographic clusters. These data can be used to target gun injury prevention programs.
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Review
Traumatic pseudoaneurysms of the liver and spleen in children: is routine screening warranted?
Although blunt injury to the spleen and liver can lead to pseudoaneurysm formation, current surgical guidelines do not recommend follow-up imaging. Controversy exists regarding the clinical implications of these traumatic pseudoaneurysms as well as their management. ⋯ Pseudoaneurysm development after blunt abdominal trauma is associated with high-grade splenic and liver injuries. Routine screening of this group of patients before discharge from hospital may be warranted because of the potential risk of life-threatening hemorrhage.
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Comparative Study
Outcome of peripherally inserted central venous catheters in surgical and medical neonates.
Peripherally inserted central venous catheters (PICCs) are commonly used for neonatal vascular access. The aim of this study was to look at PICC line complication rates and possible predictors of PICC infection in a neonatal intensive care unit. ⋯ Our PICC infection rate was 17 per 1000 catheter-days. The length of catheter stay was the only predictor of PICC infection.
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The trust crisis in health care demands action by health care professionals. Trust is based on quality, candor, and accountability. The pediatric surgeon, as the expert in the field, should be in control of quality management. ⋯ To assess these targets, performance indicators have been developed by the Association of Pediatric Surgeons in The Netherlands for 7 neonatal conditions. Variation can be distinguished as special-cause and common-cause variation using the control chart method of Walter Shewhart. The various activities in this field that have been developed and are ongoing in The Netherlands are presented.
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Open transumbilical pyloromyotomy (UMBP) and laparoscopic pyloromyotomy (LAP) have been compared on different outcomes, but postoperative pain as a primary end point had never been assessed. The aim of this study was to compare the use of analgesia in UMBP and LAP patients. ⋯ Our study suggests that UMBP infants might experience more postoperative pain in the ward, without any impact on various outcomes. A prospective study with a larger sample size should be undertaken to verify these findings.