Quick Literature Updates Episode 8

Hello, pediatric surgery family. I'm M Tombash, a research fellow from Cincinnati Children's Hospital Medical Center. And along with Stake Kurin, we are sharing knowledge to improve child health around the globe. Today, our team is going to deliver the articles that you should know about. We have four papers today. First few of them are from Journal of Pediatric Surgery. And the last one is from Pediatric Critical Care Medicine. We don't have much time, so let's start. Our first paper titled, Inter-hospital Variability in Localization Techniques for Small Pulmonary Nodules in Children, a Pediatric Surgical Oncology Research Collaborative Study by Morgan et al. And this paper is summarized by Ellen Enscisco. She's a research fellow at Cincinnati Children's Hospital. This is a study from the Pediatric Surgical Oncology Research Collaborative or Psork. They wanted to see how different institutions are localizing small pulmonary nodules and kids and if they have different outcomes based on the methods. They did a review at 15 hospitals and found that the different institutions are using a number of different methods, including wires, methylene blue dye, indocyanine green, micro coils, and technitium 99 and different combinations of those different methods. They found that there was no significant difference in the success of localization between all of the different techniques. The only significant differences were in which institution performed each technique, and in IR, OR, and anesthesia times. Great. Moving to the next one. Our second paper is Same-Day Discharge Following Nuss Repair, a Comparison by Reddick et al. This one is summarized by Rod Gerardo. He spent two years as a research fellow at Cincinnati Children's Hospital, and he's currently a general surgery resident at Wright State University. In this single institution prospective study, the researchers looked at around 40 pediatric patients who received a Nuss bar repair for their pectus excavatum. All of the patients received a perioperative ERAS pain protocol. So what did they find? 92% of the patients were discharged on post-operative day one. On top of that, there was a reduction in the total number of morphine equivalent doses that the patients received without any difference in their pain scores at the time of discharge. This is awesome Rod. Now, our third paper of today, transamniotic stem cell therapy for intrauterine growth restriction, a comparison between placental and amniotic fluid donor mesenmal stem cells by witlock at all. This paper is summarized by Cecilia Giano. She is also a research fellow at Cincinnati Children's Hospital as well. This is a pre-clinical study made by Boston Children's Hospital and Harvard Medical School. Aim was to see if mesenmal stem cell or MSC based transamniotic stem cell therapy can reduce the inflammation of the fetal brain in intrauterine growth restriction. So for this, they create an intrauterine growth restriction, and they divided the patients into four groups. One remained untreated. The second one received only saline. The third one received transamniotic stem cell therapy. And the fourth one received the same mesenmal stem cells, but with a primer. The overall survival was 75%. The gross brain waith was significantly lower in patients with no treatment or just saline, and it was significantly higher in those patients that were treated with MSC. The trusset prime group revealed significantly lowered levels of TNF alpha and interleukin beta in their brain. So it seems that prime trusset reverse some of the central nervous system effects of intrauterine growth. And here we are. Our last paper of today is from Pediatric Critical Care Medicine. Optimal Timing of tracheostomy in injured Adolescents by Butler at all. And this paper is summarized by Britney Levy. She's a research fellow at Cincinnati Children's Hospital as well. So the real question here is when should we provide a tracheostomy for adolescent trauma victims following their traumatic injury. So how exactly do we figure that out? Well, the authors looked at the National Trauma Data Bank, where they could find over 40,000 adolescent trauma victims who were intubated for more than 24 hours and survived until discharge. So what did they find? Well, first they broke it up into kids that had a TBI or a non TBI, and they looked at both three and seven days for a tracheostomy. So at three days, there was really no difference in overall hospital length of stay, but in kids that didn't have a TBI, they had a decreased ICU length of stay if they had a tracheostomy before three days by about 16 days less than ICU. That's a lot. Similar trends were seen for all children, regardless of TBI or non-TBI status, for if they received a tracheostomy before 7 days of intubation. Check the link in the description below to read each paper. We hope you liked this episode. Please follow us on social media, give us a rating, and subscribe to our YouTube channel. And don't forget to download our Stake Cure app on App Store or Play Store for more content. Thank you for listening. Cincinnati Children's Hospital and Stake Kurin are sharing knowledge to improve child health around the globe.