Faculty Opinions recommendation of Influence of surgical procedures and general anesthesia on child development before primary school entry among matched sibling pairs.

2018 ◽  
Author(s):  
Roderic Eckenhoff
Keyword(s):  
Child Development ◽  
Primary School ◽  
General Anesthesia ◽  
Surgical Procedures ◽  
School Entry ◽  
Sibling Pairs ◽  
Matched Sibling

scholarly journals Influence of Surgical Procedures and General Anesthesia on Child Development Before Primary School Entry Among Matched Sibling Pairs

2019 ◽  
Vol 173 (1) ◽  
pp. 29 ◽  
Author(s):  
James D. O’Leary ◽  
Magdalena Janus ◽  
Eric Duku ◽  
Duminda N. Wijeysundera ◽  
Teresa To ◽  
...  
Keyword(s):  
Child Development ◽  
Primary School ◽  
General Anesthesia ◽  
Surgical Procedures ◽  
School Entry ◽  
Sibling Pairs ◽  
Matched Sibling

A Population-based Study Evaluating the Association between Surgery in Early Life and Child Development at Primary School Entry

2016 ◽  
Vol 125 (2) ◽  
pp. 272-279 ◽  
Author(s):  
James D. O’Leary ◽  
Magdalena Janus ◽  
Eric Duku ◽  
Duminda N. Wijeysundera ◽  
Teresa To ◽  
...  
Keyword(s):  
Child Development ◽  
Adverse Effects ◽  
Primary School ◽  
Early Life ◽  
Odds Ratio ◽  
Population Based ◽  
School Entry ◽  
Administrative Databases ◽  
Increased Risk ◽  
Early Developmental

Abstract Background It is unclear whether exposure to surgery in early life has long-term adverse effects on child development. The authors aimed to investigate whether surgery in early childhood is associated with adverse effects on child development measured at primary school entry. Methods The authors conducted a population-based cohort study in Ontario, Canada, by linking provincial health administrative databases to children’s developmental outcomes measured by the Early Development Instrument (EDI). From a cohort of 188,557 children, 28,366 children who underwent surgery before EDI completion (age 5 to 6 yr) were matched to 55,910 unexposed children. The primary outcome was early developmental vulnerability, defined as any domain of the EDI in the lowest tenth percentile of the population. Subgroup analyses were performed based on age at first surgery (less than 2 and greater than or equal to 2 yr) and frequency of surgery. Results Early developmental vulnerability was increased in the exposed group (7,259/28,366; 25.6%) compared with the unexposed group (13,957/55,910; 25.0%), adjusted odds ratio, 1.05; 95% CI, 1.01 to 1.08. Children aged greater than or equal to 2 yr at the time of first surgery had increased odds of early developmental vulnerability compared with unexposed children (odds ratio, 1.05; 95% CI, 1.01 to 1.10), but children aged less than 2 yr at the time of first exposure were not at increased risk (odds ratio, 1.04; 95% CI, 0.98 to 1.10). There was no increase in odds of early developmental vulnerability with increasing frequency of exposure. Conclusions Children who undergo surgery before primary school age are at increased risk of early developmental vulnerability, but the magnitude of the difference between exposed and unexposed children is small.

General anesthesia and hepatic circulation

1987 ◽  
Vol 65 (8) ◽  
pp. 1762-1779 ◽  
Author(s):  
Simon Gelman
Keyword(s):  
Blood Flow ◽  
General Anesthesia ◽  
Surgical Procedures ◽  
Hepatic Blood Flow ◽  
Portal Blood Flow ◽  
Arterial Blood Flow ◽  
Hepatic Circulation ◽  
Arterial Blood ◽  
Total Hepatic Blood Flow ◽  
Circulatory Disturbances

This article describes hepatic circulatory disturbances associated with anesthesia and surgical intervention. The material is presented in three parts: part 1 describes the effects of general anesthetics on the hepatic circulation; part 2 deals with different factors related to surgical procedures and anesthesia; and part 3 analyzes the role of hepatic circulatory disturbances and hepatic oxygen deprivation in anesthesia-induced hepatotoxicity. The analysis of available data suggests that general anesthesia affects the splanchnic and hepatic circulation in various directions and to different degrees. The majority of anesthetics decreases portal blood flow in association with a decrease in cardiac output. However, hepatic arterial blood flow can be preserved, decreased, or increased. The increase in hepatic arterial blood flow, when it occurs, is usually not enough to compensate for a decrease in portal blood flow and therefore total hepatic blood flow is usually decreased during anesthesia. This decrease in total hepatic blood flow-has certain pharmacokinetic implications, namely a decrease in clearance of endogenous and exogenous substances with a high hepatic extraction ratio. On the other hand, a reduction in the hepatic oxygen supply might play a certain role in liver dysfunction occurring perioperatively. Surgical procedures–preparations combined with anesthesia have a very complex effect on the splanchnic and hepatic circulation. Within this complex, the surgical procedure–preparation plays the main role in developing circulatory disturbances, while anesthesia plays only a modifying role. Hepatic oxygen deprivation may play an important role in anesthesia-induced hepatotoxicity in different experimental models.

scholarly journals Impact of child development at primary school entry on adolescent health—protocol for a participatory systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Michelle Black ◽  
Amy Barnes ◽  
Mark Strong ◽  
David Taylor-Robinson
Keyword(s):  
Systematic Review ◽  
Child Development ◽  
Health Outcomes ◽  
Primary School ◽  
Adolescent Health ◽  
Health Inequalities ◽  
Starting School ◽  
Children's Development ◽  
The Relationship ◽  
Children’S Development

Abstract Background Reducing child health inequalities is a global health priority and evidence suggests that optimal development of knowledge, skills and attributes in early childhood could reduce health risks across the life course. Despite a strong policy rhetoric on giving children the ‘best start in life’, socioeconomic inequalities in children’s development when they start school persist. So too do inequalities in child and adolescent health. These in turn influence health inequalities in adulthood. Understanding how developmental processes affect health in the context of socioeconomic factors as children age could inform a holistic policy approach to health and development from childhood through to adolescence. However, the relationship between child development and early adolescent health consequences is poorly understood. Therefore the aim of this review is to summarise evidence on the associations between child development at primary school starting age (3–7 years) and subsequent health in adolescence (8–15 years) and the factors that mediate or moderate this relationship. Method A participatory systematic review method will be used. The search strategy will include; searches of electronic databases (MEDLINE, PsycINFO, ASSIA and ERIC) from November 1990 onwards, grey literature, reference searches and discussions with stakeholders. Articles will be screened using inclusion and exclusion criteria at title and abstract level, and at full article level. Observational, intervention and review studies reporting a measure of child development at the age of starting school and health outcomes in early adolescence, from a member country of the Organisation for Economic Co-operation and Development, will be included. The primary outcome will be health and wellbeing outcomes (such as weight, mental health, socio-emotional behaviour, dietary habits). Secondary outcomes will include educational outcomes. Studies will be assessed for quality using appropriate tools. A conceptual model, produced with stakeholders at the outset of the study, will act as a framework for extracting and analysing evidence. The model will be refined through analysis of the included literature. Narrative synthesis will be used to generate findings and produce a diagram of the relationship between child development and adolescent health. Discussion The review will elucidate how children’s development at the age of starting school is related to subsequent health outcomes in contexts of socioeconomic inequality. This will inform ways to intervene to improve health and reduce health inequality in adolescents. The findings will generate knowledge of cross-sector relevance for health and education and promote inter-sectoral coherence in addressing health inequalities throughout childhood. Protocol Registration This systematic review protocol has been registered with PROSPERO CRD42020210011.

Access, Sorting, and Achievement: The Short-Run Effects of Free Primary Education in Kenya

2012 ◽  
Vol 4 (4) ◽  
pp. 226-253 ◽  
Author(s):  
Adrienne M Lucas ◽  
Isaac M Mbiti
Keyword(s):  
Primary School ◽  
Primary Education ◽  
Education Program ◽  
Private School ◽  
Test Scores ◽  
School Entry ◽  
Exit Examination ◽  
Free Primary Education ◽  
Short Run ◽  
The Impact

We examine the impact of the Kenyan Free Primary Education program on student participation, sorting, and achievement on the primary school exit examination. Exploiting variation in pre-program dropout rates between districts, we find that the program increased the number of students who completed primary school, spurred private school entry, and increased access for students from disadvantaged backgrounds. We argue that the program was welfare enhancing as it promoted educational access without substantially reducing the test scores of students who would have been in school in the absence of the program. (JEL H52, I21, I28, O15)

scholarly journals Persistent ventricular dysrhythmia follow in general anesthesia for tonsillectomy

2021 ◽  
pp. 131-134
Keyword(s):  
Ventricular Tachycardia ◽  
General Anesthesia ◽  
Medical Therapy ◽  
Surgical Procedures ◽  
Cardiovascular Complications ◽  
Premature Ventricular Complex ◽  
Ventricular Dysrhythmia ◽  
Usual Treatment ◽  
Benign Course

Arrhythmia is one of the most common cardiovascular complications during anesthesia. Its occurrence has been reported in 70% of patients undergoing general anesthesia for various surgical procedures. Premature ventricular complex usually follows a benign course and shows a good response to medical therapy. In this study, a case was reported that did not respond to the usual treatment of ventricular tachycardia and frequent premature ventricular complex.

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