Cholelithiasis and cholecystitis in children and adolescents: Does this increasing diagnosis require a common guideline for pediatricians and pediatric surgeons?

Abstract Background In contrast to adults, for whom guidelines on the cholelithiasis treatment exist, there is no consistent treatment of pediatric patients with cholelithiasis throughout national and international departments, most probably due to the lack of evidence-based studies. Methods We evaluated the German management of pediatric cholelithiasis in a dual approach. Firstly, a retrospective, inter-divisional study was established, comparing diagnostics and therapy of patients of the pediatric surgery department with the management of patients aged < 25 years of the visceral surgery department in our institution over the past ten years. Secondarily, a nation-wide online survey was implemented through the German Society of Pediatric Surgery. Results Management of pediatric patients with cholelithiasis was primarily performed by pediatricians in the retrospective analysis (p < 0.001). Pediatric complicated cholelithiasis was not managed acutely in the majority of cases with a median time between diagnosis and surgery of 22 days (range 4 days–8 months vs. 3 days in visceral surgery subgroup (range 0 days–10 months), p = 0.003). However, the outcome remained comparable. The hospital’s own results triggered a nation-wide survey with a response rate of 38%. Primary pediatric medical management of patients was confirmed by 36 respondents (71%). In case of acute cholecystitis, 22% of participants perform a cholecystectomy within 24 h after diagnosis. Open questions revealed that complicated cholelithiasis is managed individually. Conclusions The management of pediatric cholelithiasis differs between various hospitals and between pediatricians and pediatric surgeons. Evidence-based large-scale population studies as well as a common guideline may represent very important tools for treating this increasing diagnosis.

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Malformaciones urológicas en niños, en el Servicio de Cirugía Pediátrica del Hospital José Carrasco Arteaga. Enero 2014 – Diciembre 2018

Revista Médica del Hospital José Carrasco Arteaga ◽

10.14410/2020.12.2.ao.15 ◽

2020 ◽

Vol 12 (2) ◽

pp. 106-111

Author(s):

Juan Sebastián Ordoñez Peña ◽

Priscila Estefanía Orellana Proaño ◽

Fernando Córdova Neira

Keyword(s):

Urinary Tract ◽

Pediatric Surgery ◽

Pediatric Patients ◽

Renal Dysplasia ◽

Cross Sectional Study ◽

Cross Sectional ◽

Urinary Tract Abnormalities ◽

Genetic Abnormalities ◽

Tract Infections ◽

Surgery Department

BACKGROUND: Congenital urinary tract abnormalities are diverse, and can affect different structures of this system. The importance of early diagnosis is avoiding kidney damage in the children. The aim of this study was to identify the frequency of urinary tract abnormalities in pediatric patients, in Hospital José Carrasco Arteaga Pediatric Surgery Department, from January 2014 to December 2018. METHODS: Descriptive cross-sectional study. The universe were 230 pediatric patients with confirmed diagnosis of congenital urinary tract abnormalities, from Hospital José Carrasco Arteaga Pediatric Surgery Department, from January 2014 to December 2018. Incomplete medical charts were excluded (n=47 children). 183 children were part of the this study. . La malformación más frecuente fue la hidronefrosis transitoria 70%, seguida de reflujo Vesico-Ureteral (RVU) 16.39% (n=30), estenosis pieloureteral 5.46% (n=10), megauréter 6.55% (n=12) y displasia renal 1.63% (n=3). RESULTS: The frequency of urological abnormalities was 2.73% (n = 183), predominately infants with 56%, and 57% male. 26.78% presented with symptoms related to urinary tract infection. Ultrasound was performed in 95% of the children, urethrocistography in 55% and renal scintigraphy in 31%. Prenatal findings were found in 34.97%. The most frequent abnormality was transient hydronephrosis (70%), followed up by vesico-ureteral reflux (VUR) 16.39% (n = 30), pyeloureteral stenosis 5.46% (n = 10), megaureter 6.55% (n = 12) and renal dysplasia 1.63% (n = 3). CONCLUSION: Urological malformations are common between genetic abnormalities, most of them are asymptomatic; locally due to the low rate of prenatal diagnosis, they are diagnosed in between 24 months of age. Transient hydronephrosis is the most frequent abnormality. Urinary tract infections are commonly the starting line in this groups of patients; when malformations are suspected, ultrasound is always suitable.

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Bella Italia: Specialized Pediatric Surgical Care in Italy

European Journal of Pediatric Surgery ◽

10.1055/s-0037-1607027 ◽

2017 ◽

Vol 27 (05) ◽

pp. 422-428 ◽

Cited By ~ 2

Author(s):

Piergiorgio Gamba ◽

Mario Lima ◽

Alessandro Inserra ◽

Ascanio Martino ◽

Girolamo Mattioli ◽

...

Keyword(s):

Pediatric Surgery ◽

Large Scale ◽

Pediatric Patients ◽

Surgical Care ◽

Multicenter Studies ◽

Effective Care ◽

European Reference Networks ◽

History Of ◽

The Rich ◽

The 19Th Century

AbstractItalian pediatric surgery has a long history, rich in events, places, and personalities that make it unique. Our first pediatric surgical unit dates back to the first half of the 19th century and its number has grown exponentially during the following decades, with a maximum flowering in the years after the second world war.The rich history of pediatric surgery has not prevented it from facing important problems, such as the demographic crisis, underemployment of surgeons, and care of pediatric patients by adult specialists.The attempt to find solutions to these problems has led to a great deal of efforts not only by pediatric surgeons, but also by the Italian government and institutions, with the implementation of ministerial plans that favor the specificity and growth of our discipline through thematic and territorial networks, through more effective training and specialization plans, the cooperation between the Directors of Pediatric Surgical Units for a better coordination of care, the participation in European networks, such as the recently created ERNs (European Reference Networks).Many Italian pediatric surgeons are active in International Societies, as members or coordinators, in the design and management of multicenter studies and surveys and even in the creation of new international networks.The Italian response to the demand for specialization and centralization involves knowledge sharing, large-scale cooperation, transversal between specialists and vertical with governmental authorities for a better and more effective care of pediatric patients.

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A Clinical Study and Management of Inguino-scrotal Swellings In Children

Journal of Medical Research and Innovation ◽

10.15419/jmri.125 ◽

2018 ◽

Vol 2 (S1) ◽

pp. e000125

Author(s):

Khyati Vaja ◽

Mukesh Suvera

Keyword(s):

Inguinal Hernia ◽

Pediatric Surgery ◽

Pediatric Patients ◽

Undescended Testis ◽

Length Of Hospital Stay ◽

Indirect Inguinal Hernia ◽

Short Term ◽

One Year ◽

Groin Hernias ◽

Inguinal Hernia In Children

Aims and Objectives: To know the most common surgical problems in pediatric patients presented with inguino-scrotal swellings and management done routinely. Methodology: This study was carried out in the department of general surgery, Sharadaben hospital and pediatric surgery of VS hospital, Ahmedabad. The cases were studied for a period of about one year (January, 2017 to Dec, 2017) and all children below 12 years of age, presenting to us with inguinoscrotal swellings were included in this study. The information was analysed in terms of age, diagnosis, procedure carried out and outcome. Results: Amongst the 150 children under the age of 12 years, 143 patients were males and 7 were females. Among these 150, 52 cases were of hydrocoele, 70 cases of hernia (of which 63 were males and 7 were females), 25 cases of undescended testis and 3 cases of epididymo orchitis were documented. All cases underwent simple herniotomy for hernia and hydrocoele, orchidopexy for undescended testis. The length of hospital stay ranged from 2-4 days with mean of 2.46 days. 11 children in the study were documented to have short term complications, all of which were recognised in the hospital and managed with good results. Conclusion: Hernia and Hydrocoele in children are often congenital and diagnosed clinically (history and examination). Indirect inguinal hernia are more common than other groin hernias. Open herniotomy is the operation of choice for inguinal hernia in children.

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Older and Wiser? The Need to Reexamine the Impact of Health Professionals Age and Experience on Competency-Based Practices

SAGE Open Nursing ◽

10.1177/23779608211029067 ◽

2021 ◽

Vol 7 ◽

pp. 237796082110290

Author(s):

Jing Xu ◽

Kristen Hicks-Roof ◽

Chloe E. Bailey ◽

Hanadi Y. Hamadi

Keyword(s):

Health Professionals ◽

Online Survey ◽

Evidence Based Practice ◽

Core Competencies ◽

Healthcare Services ◽

Interdisciplinary Teams ◽

Evidence Based ◽

Health Providers ◽

Cross Sectional ◽

The Impact

Introduction Delivery of healthcare services makes up a complex system and it requires providers to be competent and to be able to integrate each of the institute of medicine’s (IOM) 5 core competencies into practice. However, healthcare providers are challenged with the task to be able to understand and apply the IOM core competencies into practice. Objective The purpose of the study was to examine the factors that influence health professional’s likelihood of accomplishing the IOM core competencies. Methods A cross-sectional study design was used to administer a validated online survey to health providers. This survey was distributed to physicians, nursing professionals, specialists, and allied healthcare professionals. The final sample included 3,940 participants who completed the survey. Results The study findings show that younger health professionals more consistently practice daily competencies than their older counterparts, especially in the use of evidence-based practice, informatics, and working in interdisciplinary teams. Less experienced health professionals more consistently applied quality improvement methods but less consistently used evidence-based practice compared to their more experienced counterparts. Conclusion There is a need to understand how health professionals’ age and experience impact their engagement with IOM’s core competencies. This study highlights the need for educational resources on the competencies to be tailored to health providers’ age and experience.

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Management of multiple brain metastases: a patterns of care survey within the German Society for Radiation Oncology

Journal of Neuro-Oncology ◽

10.1007/s11060-021-03714-w ◽

2021 ◽

Author(s):

Johannes Kraft ◽

Michael Mayinger ◽

Jonas Willmann ◽

Michelle Brown ◽

Stephanie Tanadini-Lang ◽

...

Keyword(s):

Brain Metastases ◽

Radiation Oncology ◽

Online Survey ◽

Whole Brain Radiotherapy ◽

German Society ◽

Patterns Of Care ◽

Prognostic Scores ◽

Mutational Status ◽

Hippocampal Avoidance ◽

Current Guidelines

Abstract Purpose The treatment of brain metastases (BM) has changed considerably in recent years and in particular, the management of multiple BM is currently undergoing a paradigm shift and treatment may differ from current guidelines. This survey was designed to analyze the patterns of care in the management of multiple BM. Methods An online survey consisting of 36 questions was distributed to the members of the German Society for Radiation Oncology (DEGRO). Results In total, 193 physicians out of 111 institutions within the German Society for Radiation oncology responded to the survey. Prognostic scores for decision making were not used regularly. Whole brain radiotherapy approaches (WBRT) are the preferred treatment option for patients with multiple BM, although stereotactic radiotherapy treatments are chosen by one third depending on prognostic scores and overall number of BM. Routine hippocampal avoidance (HA) in WBRT is only used by a minority. In multiple BM of driver-mutated non-small cell lung cancer origin up to 30% favor sole TKI therapy as upfront treatment and would defer upfront radiotherapy. Conclusion In multiple BM WBRT without hippocampal avoidance is still the preferred treatment modality of choice regardless of GPA and mutational status, while SRT is only used in patients with good prognosis. Evidence for both, SRS and hippocampal avoidance radiotherapy, is growing albeit the debate over the appropriate treatment in multiple BM is yet not fully clarified. Further prospective assessment of BM management—ideally as randomized trials—is required to align evolving concepts with the proper evidence and to update current guidelines.

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Well-Being of Healthcare Workers and the General Public during the COVID-19 Pandemic in Vietnam: An Online Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094737 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4737

Author(s):

Tuyen Dinh Hoang ◽

Robert Colebunders ◽

Joseph Nelson Siewe Fodjo ◽

Nhan Phuc Thanh Nguyen ◽

Trung Dinh Tran ◽

...

Keyword(s):

Healthcare Workers ◽

Large Scale ◽

Online Survey ◽

Preventive Measures ◽

Vaccine Coverage ◽

Health Sector ◽

Well Being ◽

Multivariate Logistic Regression Model ◽

The Mean ◽

Restrictive Measures

The COVID-19 pandemic and associated restrictive measures implemented may considerably affect people’s lives. This study aimed to assess the well-being of Vietnamese people after COVID-19 lockdown measures were lifted and life gradually returned to normal. An online survey was organized from 21 to 25 April 2020 among Vietnamese residents aged 18 and over. The survey was launched by the Hue University of Medicine and Pharmacy. The WHO-5 Well-Being Index (scored 0–25) was used to score participants’ well-being. A multivariate logistic regression model was used to determine the predictors of well-being. A total of 1922 responses were analyzed (mean age: 31 years; 30.5% male; 88.2% health professionals or students in the health sector). The mean well-being score was 17.35 ± 4.97. Determinants of a high well-being score (≥13) included older age, eating healthy food, practicing physical exercise, working from home, and adhering to the COVID-19 preventive measures. Female participants, persons worried about their relatives’ health, and smokers were more likely to have a low well-being score. In conclusion, after the lockdown measures were lifted, the Vietnamese have people continued to follow COVID-19 preventive measures, and most of them scored high on the well-being scale. Waiting to achieve large-scale COVID-19 vaccine coverage, promoting preventive COVID-19 measures remains important, together with strategies to guarantee the well-being of the Vietnamese people.

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Public perception and acceptance of negative emission technologies – framing effects in Switzerland

Climatic Change ◽

10.1007/s10584-021-03150-9 ◽

2021 ◽

Vol 167 (3-4) ◽

Author(s):

Ariane Wenger ◽

Michael Stauffacher ◽

Irina Dallo

Keyword(s):

Moral Hazard ◽

Public Perception ◽

Large Scale ◽

Online Survey ◽

The Public ◽

Net Zero ◽

Negative Emission ◽

Public Opinion Perception ◽

Negative Emission Technologies ◽

Technological Fix

AbstractLimiting global warming to 1.5 °C requires negative emission technologies (NETs), which remove carbon dioxide from the atmosphere and permanently store it to offset unavoidable emissions. Successful large-scale deployment of NETs depends not only on technical, biophysical, ecological, and economic factors, but also on public perception and acceptance. However, previous studies on this topic have been scarce. In 2019, Switzerland adopted a net zero greenhouse gas emissions by 2050 target, which will require the use of NETs. To examine the current Swiss public perception and acceptance of five different NETs, we conducted an online survey with Swiss citizens (N = 693). By using a between-subjects design, we investigated differences in public opinion, perception, and acceptance across three of the most used frames in the scientific literature — technological fix, moral hazard, and climate emergency. Results showed that the public perception and acceptance of NETs does not differ between the frames. The technological fix frame best reflected participants’ opinion, whereas participants perceived the moral hazard frame the least credible and the climate emergency frame the most unclear. Moreover, our findings confirm the public’s unfamiliarity with NETs. We found no strong opposition, as participants indicated a moderate acceptance and a neutral evaluation of all five NETs, with afforestation standing out as the most accepted and positively evaluated NET. We conclude that, in the future, the public debate on NETs should be intensified, and the public perception should be monitored regularly to inform the development of NETs.

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Would You Share This Video? Factors Influencing Willingness to Share Online Health Misinformation. (Preprint)

10.2196/preprints.30323 ◽

2021 ◽

Author(s):

Alla Keselman ◽

Catherine Arnott Smith ◽

Gondy Leroy ◽

David R. Kaufman

Keyword(s):

Immune System ◽

Information Sharing ◽

Information Literacy ◽

Online Survey ◽

Science Literacy ◽

Survey Methodology ◽

Interpersonal Trust ◽

The United States ◽

Evidence Based ◽

Information Competencies

BACKGROUND The rapidly evolving digital environment of the social media era increases the reach of both quality health information and misinformation. Platforms such as YouTube enable easy sharing of attractive, if not always evidence-based, videos with large personal networks as well as the general public. While much research has focused on characterizing health misinformation online, it has not sufficiently focused on describing and measuring individuals’ information competencies that build resilience. OBJECTIVE This study 1) assesses individuals’ willingness to share a non-evidence-based YouTube video about strengthening the immune system, 2) describes types of evidence that individuals view as supportive of the claim by the video, and 3) relates information-sharing behavior to several information competencies: information literacy, science literacy, knowledge of the immune system, interpersonal trust, and trust in health authority. METHODS The study employs an online survey methodology with 150 individuals across the United States. Participants were asked to watch a YouTube excerpt from a morning TV show featuring a wellness pharmacy representative promoting an immunity-boosting dietary supplement produced by his company; answer questions about the video and say whether they would share it with a cousin who was frequently sick; and complete instruments pertaining to the information competencies outlined in the objectives. RESULTS Most participants (105 out of 150) said that they would share the video with their cousin. Their confidence in the supplement would be further boosted by a friend’s recommendations, positive reviews on a crowdsourcing website, and statements of uncited effectiveness studies on the producer’s website. While all information literacy competencies analyzed in this study had a statistically significant relationship with the outcome, each was also highly correlated with each other. Information literacy and interpersonal trust independently predicted the largest amount of variance in the intent to share the video (17% and 16%). Interpersonal trust was negatively related to the willingness to share the video. Science literacy explained 7% of the variance. CONCLUSIONS People are vulnerable to online misinformation and are likely to propagate it online. Information literacy and science literacy are associated with lesser vulnerability to misinformation and lesser propensity to spread it. Of the two, information literacy holds the greater promise as an intervention target. Understanding the role of different kinds of trust on information sharing merits further research.

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