Base deficit (BD) and lactic acid (LA) are accepted markers of hypoperfusion predictors outcome in the trauma patient we aim to assess value these triage elderly with “normal” vital signs. Patients older than age 65 who presented between 1997 2004 but did not have isolated head injuries were included. Three groups established: normal, occult (OH), shock. Outcome measures included mortality, hospital length stay, intensive care unit discharge disposition. One hundred six patients analysis had...

IMPORTANCEThe present study is the largest on use and effect of intracranial pressure (ICP) monitoring in pediatric trauma patients.OBJECTIVE To determine ICP survival patients with severe head injuries using National Trauma Data Bank. DESIGN, SETTING, AND PARTICIPANTSThe Bank was queried (version 6.2, 2001-2006) for information younger than 17 years admitted to an intensive care unit blunt traumatic brain injury (TBI), Injury Severity Score (ISS) greater 9, Glasgow Coma Scale (GCS) score...

<h3>Hypothesis</h3>The outcomes of and parental satisfaction with same-day discharge in children undergoing laparoscopic appendectomy warrant making it the usual customary pathway.<h3>Design</h3>Prospective cohort study.<h3>Setting</h3>Tertiary care children's hospital.<h3>Patients</h3>Between July 1, 2010, March 30, 2011, a total 207 were considered for after acute or interval appendectomy. The all-in-one single-incision single-instrument technique was used 95.7%...

Appendicitis continues to be one of the most common surgical conditions in pediatric population. We set out determine demographic and practice variations among children admitted with appendicitis highlight racial/ethnic healthcare access role relation rate complicated using 2012 Kids' Inpatient Database (KID). Methodology. A retrospective cross-sectional database study was performed KID. All (age 1 months 20 years) were identified ICD-9 diagnosis codes. Children a compared all other...

Severely head-injured patients require significant resources across the continuum of care. The objective this study is to analyze impact level trauma center designation on outcome severely patient. National Trauma Data Bank between 2001 and 2006 (NTDB 6.2) was queried for all with isolated traumatic head injury Glasgow Coma Score (GCS) less than 9. Comparisons Level I II centers were made reviewing hospital length stay (LOS), intensive care unit LOS, ventilator days, major complication rate...

Epstein Barr Virus (EBV) is a ubiquitous herpes virus that persists lifelong in normal humans by colonizing memory B cells. Infection during childhood usually asymptomatic. Isolated gallbladder wall thickening or hydrops have been reported patients with EBV infectious mononucleosis. However, acute acalculous cholecystitis an atypical clinical presentation of primary infection. We present teenager associated Acute accounts for 2-15% all cases cholecystitis. Few the course

Blood transfusion therapy (BTT) is widely used in trauma patients. However, the adverse effects of BTT pediatric patients with traumatic brain injury (TBI) were poorly studied. The objective this study to evaluate effect on mortality children severe TBI.In retrospective cohort analysis, we analyzed 2012 and 2016 Kids' Inpatient Databases a weighted sample obtain national outcome estimates. We included aged 1 month 21 years TBI who mechanically ventilated, considered TBI; then compared...

Thyroid hormone (T3) is a critical regulator of intestinal epithelial development and homeostasis, but its mechanism action within the gut not well understood. We have examined molecular mechanisms underlying T3 activation enterocyte differentiation marker alkaline phosphatase (IAP) gene. RT-PCR Western blotting showed that thyroid receptors TRα1 TRβ1 were expressed in human colorectal adenocarcinoma Caco-2 cells. Northern detected expression two IAP transcripts, which increased...

We have examined the role that caudal-related homeobox transcription factors Cdx1 and Cdx2 play in activating enterocyte differentiation marker gene intestinal alkaline phosphatase (IAP). Human colon cancer Caco-2 cells were transiently transfected with and/or Cdx2, semiquantitative RT-PCR was used to study effects on IAP mRNA expression. Transfections a variety of IAP-luciferase reporter constructs identify Cdx response element located within human promoter. Protein-DNA interactions by...

Modifications to conventional laparoscopic cholecystectomy are aimed decrease abdominal pain and improve cosmetic results. Single-port robotic is a safe feasible approach that has been reported in adults, though reports limited children. This study aims report our experience with single-port children, evaluate the safety, feasibility, outcomes of this approach.After was available at institution, we prospectively followed patients who underwent from March 2013 May 2015 children's...

There are a variety of different products available for laparoscopic ventral hernia repairs (LVHR), which vary widely in their costs. few clinical studies commenting on cost efficacy LVHR. The objective this study is to investigate the cost, safety, and using intraperitoneal nonheavyweight polypropylene (PP) mesh LVHR.Between years 2002 2006, LVHR was performed 141 consecutive patients (84 male, 57 female) PP. Using 3-trocar technique, PP underlayed by 3 5 cm beyond edges defect fixed...

Purpose . To compare narcotic versus nonnarcotic outpatient oral pain management after pediatric laparoscopic appendectomy. Methods In a prospective study from July 1, 2010, to March 30, 2011, children undergoing appendectomy on rapid discharge protocol were treated with either or postoperative analgesia. Two surgeons in four-person faculty group employed the regimen, while other two used narcotics. Days of medication use, time needed for return normal activity, and satisfaction rate control...

Spontaneous perforation of choledochal cyst is a rare presentation. Complicated cysts are routinely managed by staged open surgical procedures for excision and reconstruction [1, 2]. Complex laparoscopic surgery in infants an evolving field but no reports have been published describing minimal invasive approach to the management spontaneous cyst. We report case perforated 12 week old, female which was single stage resection with biliary reconstruction. She presented fever bilious vomiting 4...

Background: Median arcuate ligament (MAL) syndrome is a rare cause of chronic abdominal pain in adults and children. Release the MAL has traditionally been performed open or laparoscopically. There have not any published cases to our knowledge robotic-assisted release pediatric patients. Patients Methods: Two adolescent patients, aged 12 15 years, at institution underwent release. The procedure involved dissecting muscle fibers overlying scar tissue. stayed inpatient postoperatively...

Purpose: There is no one standard procedure encompassing the needs and differences of entire pediatric population for inguinal hernia repair (IHR). Several techniques can be used, including open repair, laparoscopic, robotic-assisted laparoscopic repair. This a report single hospital's experience performing IHRs in an adolescent population. Methods: Robotic performed by surgery department were prospectively captured reviewed. The operation was modified robotic transabdominal preperitoneal...

We present the case of a 54-year-old woman who underwent right adrenalectomy for palliation Cushing's symptoms. She had recently been diagnosed with lung adenocarcinoma. Pathologic findings revealed 5 cm adrenal adenoma metastatic adenocarcinoma deposit. The occurrence tumor-to-tumor metastasis is rare, and finding within functional exceptionally so. Previously reported incidences this in patients cancer range from 0.14% to 0.63%. review literature regarding unusual finding.

We report a case of granular cell tumor colliding with intramucosal adenocarcinoma the esophagus. A 58-year-old white was found to have 5 mm nodule in distal esophagus detected by upper gastrointestinal endoscopy performed as part workup long standing reflux. Endoscopic biopsies revealed arising setting Barrett's The infiltrated also present at nodular site. mucosal resection using Duette band ligation and hot snare electrocautery performed. Margins were negative for both tumors, endoscopic...