2024 Update Course - Over and Under the Radar in Literature Updates - Jose Campos & Shawn St. Peter
With Dr. Jose Campos (Nano) & Dr. Sean Saint Peter
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What the experts said
Journal Hive screens 1200 articles each month with 30 volunteers
JAMA 2024 study on inguinal hernia repair involved 338 preterm infants randomized to early repair before NICU discharge or late repair after NICU discharge
Late inguinal hernia repair reduced serious adverse events to 18% compared to 28% in early repair group
Late repair group experienced 3-day reduction in length of stay
The difference in serious adverse events was mostly apnea requiring intervention
Inguinal hernia recurrence rate in late repair group was 4%
The hernia timing study was designed in the open surgery era starting from 2011 conversation
Within 2 years of study start, practice had shifted completely to laparoscopy
The difference in outcomes was driven by respiratory complications regardless of open vs laparoscopic approach
FAST ultrasound has high false positive and false negative rates in children based on adult-derived algorithms
PECARN study enrolled 27,541 children under 18 years with blunt abdominal or minor head trauma across 6 US pediatric centers
PECARN prediction rules demonstrated 100% sensitivity and 100% negative predictive value for intraabdominal injuries requiring intervention and clinically important traumatic brain injuries
Implementing PECARN rules could avoid up to 25% of abdominal CT scans and 15% of brain CT scans
PECARN rules have different criteria for children under 2 years versus above 2 years for head trauma
With no symptoms and no physical findings, chances of 3D imaging changing management are slim
Normal ultrasound and normal labs place patient in very low risk category where intraoperative cholangiogram may not be needed
Pediatric cholelithiasis is becoming increasingly common due to rising obesity rates in children and adolescents
Unobstructed common bile duct stones can be found in up to 30% of pediatric cholelithiasis patients during surgery
Machine learning study for choledocholithiasis included 1,597 pediatric cholecystectomy patients across 10 institutions between 2016-2019
Machine learning model for choledocholithiasis achieved AUC of 0.95 and negative predictive value of 98%
Multidisciplinary algorithm reduced unnecessary oophorectomy rate from 16% to 8%