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Surgery

The First Opioid-Prescribing Guidelines for Children Who Require Surgery
 The First Opioid-Prescribing Guidelines for Children Who Require Surgery 1024 573 Lauren Dembeck
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Providers should recognize the risks of opioids, maximize nonopioid regimens, and educate families appropriately. The first opioid-prescribing guidelines to address the unique needs of children who require surgery have been published by an expert panel in JAMA Surgery. The new guidelines aim to help health care professionals caring for children and adolescents in the perioperative…

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A New Kind of Rectal Diversion in Classic Bladder Exstrophy
 A New Kind of Rectal Diversion in Classic Bladder Exstrophy 1024 754 Jeb Phillips
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  This article appeared in the Spring/Summer 2021 print issue. Download the full issue.   Medical illustrations by Mandy Root-Thompson for Nationwide Children’s Hospital Source: V. Rama Jayanthi, chief of Urology at Nationwide Children’s Hospital To learn more about the procedure and it’s applications, read A Surprising Approach to Classic Bladder Exstrophy.

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A Quick and Reliable Method to Determine The Time to Full Weight Bearing in Patients Undergoing Intramedullary Limb Lengthening
 A Quick and Reliable Method to Determine The Time to Full Weight Bearing in Patients Undergoing Intramedullary Limb Lengthening 1024 575 Lauren Dembeck
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A new method to objectively measure bone healing may help the patient with an intramedullary lengthening nail make strides to full weight bearing status. Intramedullary limb lengthening is indicated for the treatment of limb length discrepancy and short stature. Traditionally, the procedure was done using external fixators, which must remain on the patient’s limb for…

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How Do Parents and Surgeons Evaluate Treatment Options for Uncomplicated Appendicitis?
 How Do Parents and Surgeons Evaluate Treatment Options for Uncomplicated Appendicitis? 1024 575 Natalie Wilson
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Parent and provider at child's hospital bed

The most recent in a series of publications on management of uncomplicated appendicitis showed patients and families cited the same concerns when electing either surgery or nonoperative treatment. Antibiotics alone have been shown to successfully treat uncomplicated appendicitis in children. But patients, families and surgeons may differently evaluate risks and benefits of this treatment option.…

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Race Is a Risk Factor for Postoperative Death in Apparently Healthy Children in United States
 Race Is a Risk Factor for Postoperative Death in Apparently Healthy Children in United States 1024 683 Abbie Roth
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African American children were nearly 3.5 times more likely to die within 30 days after surgery, compared to white peers. In a new study, published in Pediatrics, researchers have shown that being African American was strongly associated with a higher risk of postoperative complications and mortality among apparently healthy children. In fact, compared to their white peers,…

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Determining Ureteropelvic Junction Obstruction Surgical Success Using Biomarkers
 Determining Ureteropelvic Junction Obstruction Surgical Success Using Biomarkers 1024 575 Katie Brind'Amour, PhD, MS, CHES
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Biomarkers initially found to differ among patients with ureteropelvic junction obstruction and healthy controls may also objectively gauge post-surgical resolution of obstruction. A follow-up study of a trial that initially identified four biomarkers that differ between healthy controls and pediatric patients about to undergo surgery for ureteropelvic junction obstruction (UPJO) has confirmed that two of…

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American Academy of Pediatrics Releases First Policy Statement on Organ Transplants for Children with Intellectual, Developmental Disabilities
 American Academy of Pediatrics Releases First Policy Statement on Organ Transplants for Children with Intellectual, Developmental Disabilities 1024 575 Katelyn Hanzel
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Today, the American Academy of Pediatrics (AAP) has released its first policy statement addressing children with intellectual and developmental disabilities as organ transplantation recipients. The policy statement, published online today in Pediatrics, recommends that transplant teams consider both the cognitive and adaptive skills of a patient when determining if a transplant could be of benefit, and recognize that…

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Open Reduction May Improve Acetabular Remodeling in Developmental Dysplasia of the Hip
 Open Reduction May Improve Acetabular Remodeling in Developmental Dysplasia of the Hip 1024 575 Lauren Dembeck
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Study of children who had reductions for developmental hip dysplasia at age 2 years or younger highlights differences in outcomes for open and closed reductions. In children under 2 years of age with developmental dysplasia of the hip, open reduction with capsulorrhaphy appears to improve acetabular remodeling more than closed reduction, according to a study…

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Transforming Medical Science Through Research Affinity Groups
 Transforming Medical Science Through Research Affinity Groups 150 150 Katie Brind'Amour, PhD, MS, CHES
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Purposeful synergy drives the most meaningful medical science. Nephrology physician-scientists require tissue samples, urologists desire tests to know which patients truly require surgery, and basic scientists must find ways to meaningfully assess new animal models to yield clinically valuable data. If each of these professionals had a defined network of colleagues from the other disciplines…

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Keeping Options Open in Complex Pediatric Nephrolithiasis
 Keeping Options Open in Complex Pediatric Nephrolithiasis 1024 575 Lauren Dembeck
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Urologists in the Pediatric Urology Midwest Alliance recently looked at how endoscopic assisted robotic pyelolithotomy could reduce the number of procedures for children with ureteropelvic junction obstruction. The Pediatric Urology Midwest Alliance (PUMA) recently published a new report demonstrating that endoscopic assisted robotic pyelolithotomy (EARP) is an acceptable treatment option for complex cases of pediatric…

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Dentists Heeded FDA Warning on Codeine
 Dentists Heeded FDA Warning on Codeine 1024 683 Mary Bates, PhD
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open bottle of pills

An FDA black box warning directed at ENT doctors performing tonsil and adenoid surgeries also affected prescribing patterns by dentists. Codeine, an opioid analgesic, was popular in pediatrics because it was thought to be a safe alternative to morphine. However, in recent years, the drug has been found to have variability in therapeutic doses, with…

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When Should Preoperative Neuromonitoring for Adolescent Idiopathic Scoliosis Be Used?
 When Should Preoperative Neuromonitoring for Adolescent Idiopathic Scoliosis Be Used? 150 150 Abbie Roth
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Study leads researchers to recommend against routine use of preoperative SSEP/TMS testing in cases of AIS requiring corrective surgery. Adolescent idiopathic scoliosis (AIS) is a coronal curvature of the spine that affects 1 to 3% of adolescents. Of these, a very small percentage – at most 0.5% – progress to the point of needing surgical…

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Linking Structure and Function in Children With 22q11.2 Deletion Syndrome
 Linking Structure and Function in Children With 22q11.2 Deletion Syndrome 1024 575 Kevin Mayhood
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Children with 22q11.2 deletion syndrome commonly have velopharyngeal dysfunction (VPD), affecting speech and swallowing. A recent series of studies finds that anatomy of their soft palate and associated bony structures and muscles differ from children who don’t have the syndrome. The findings suggest that these differences may be associated with speech, hearing and middle ear…

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Type of Anorectal Malformation at Birth is Predictive of Fecal Continence
 Type of Anorectal Malformation at Birth is Predictive of Fecal Continence 150 150 Kevin Mayhood
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Study also finds fecal continence rates for children born with ARMs are lower than previously reported. Recently published research shows the rate of fecal continence among 4-year-olds who underwent surgery for an anorectal malformation (ARM) as infants averages 40%, and the type of malformation — which reflects severity — is predictive of the outcome. Though…

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Predicting Urinary Continence For a Child With Anorectal Malformation
 Predicting Urinary Continence For a Child With Anorectal Malformation 150 150 Kevin Mayhood
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Researchers suggest objective, measurable factors can be used to provide families with reasonable expectations In a child born with an anorectal malformation (ARM), anatomical features including a low-complexity ARM, high sacral ratio and a normal spine each independently predicts the child has a higher chance of urinary continence, research at Nationwide Children’s Hospital shows. “When…

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Multicenter Data Reveals Distal Hypospadias Repair Overall Success Rate
 Multicenter Data Reveals Distal Hypospadias Repair Overall Success Rate 150 150 Katie Brind'Amour, PhD, MS, CHES
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Despite its use as an indicator of a department’s surgical skill, the reoperation rate for distal hypospadias repair has long been based on publications covering data from single-center studies — until now. Among its indicators for urologic surgery quality, U.S. News & World Report examines the complication rate for children undergoing distal hypospadias repair (relocation of the…

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Meet Oluyinka Olutoye, MD, PhD
 Meet Oluyinka Olutoye, MD, PhD 1024 575 Abbie Roth
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In August 2019, Nationwide Children’s welcomed Oluyinka Olutoye, MD, PhD, as surgeon-in-chief. In a Q&A, the internationally renowned fetal surgeon shares his thoughts about the past, present and future of fetal surgery and the challenges and opportunities facing pediatric surgeons today.   Q: What brought you to Nationwide Children’s Hospital? I was initially attracted to…

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Saving Constipation Treatment Costs With a Bowel Management Program
 Saving Constipation Treatment Costs With a Bowel Management Program 1024 575 Jeb Phillips
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Simple illustrated diagram of the GI track with organs colorized and body outline and background in blue

A protocolized approach significantly reduced ED visits and hospital admissions for children with chronic constipation – and became a driver for surgical referrals. If hospitals are willing to foot the bill for staffing and start-up costs, a structured bowel management program for children with chronic severe constipation likely saves both individual and institutional health care…

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Reducing Radiation Exposure and Imaging Costs for Children With Appendicitis
 Reducing Radiation Exposure and Imaging Costs for Children With Appendicitis 1024 575 Rachael Hardison
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Black and white photo of boy sitting up on hospital bed

Appendicitis is one of the most common indications for abdominal surgery in children. Accurate, efficient diagnosis is critical for initiating timely treatment. Current imaging options for diagnosing appendicitis include ultrasound and computed tomography (CT). CT scans, while readily available and highly sensitive, require radiation exposure that can increase the risk of malignancy over the child’s…

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Can Spinal Replace General Anesthesia in Pediatric Urology Patients?
 Can Spinal Replace General Anesthesia in Pediatric Urology Patients? 150 150 Jeb Phillips
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Spinal anesthesia offers a viable low-risk alternative to general anesthesia for a wide range of pediatric procedures, particularly for urology patients. As research continues to illuminate the possibility of neurotoxic effects from general anesthesia in pediatric patients, surgeons and anesthesiologists at Nationwide Children’s Hospital have already sought out an alternative among children 2 years of…

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When Should Kids With Severe Functional Constipation Have Surgery?
 When Should Kids With Severe Functional Constipation Have Surgery? 150 150 Jeb Phillips
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A protocol developed by pediatric surgeons and gastroenterologists allows patients to receive specific surgical interventions that will be most beneficial – and allows many patients originally referred for surgery to avoid it altogether. Children with severe functional constipation are most often referred for surgery after failure of medical management. But there’s a problem with this…

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Simulating Surgery With High-Performance Computing
 Simulating Surgery With High-Performance Computing 1024 575 Abbie Roth
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By applying high-performance computing to the field of otolaryngology, a team of researchers is developing a simulation environment for teaching surgical techniques related to the temporal bone. The purpose of training — whether a fire drill or practicing a surgical technique — is to create successes and avoid failures. “The impact of training is safety…

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Remote Control Treatment
 Remote Control Treatment 1024 575 Jeb Phillips
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Magnetic growing rods help patients who have early-onset scoliosis avoid repeated surgeries. A common surgical treatment for young children with severe early-onset scoliosis is the implantation of growing rods or expandable titanium ribs. The devices are lengthened as the child grows, helping to straighten the spine. Lengthening involves surgery under general anesthesia every six months. Magnetic Expansion Control (MAGEC)…

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Using Antibiotics Alone for Children with Uncomplicated Appendicitis
 Using Antibiotics Alone for Children with Uncomplicated Appendicitis 150 150 Gina Bericchia
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One year follow-up of patients treated only with antibiotics found that 76 percent avoided surgery. Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery when chosen by the family, finds a recent study led by researchers at Nationwide Children’s Hospital. Three out of four children with uncomplicated appendicitis…

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InSight: Restoring Normal Habits
 InSight: Restoring Normal Habits 471 285 Tiasha Letostak, PhD
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SACRAL NERVE STIMULATION (SNS) is a new treatment that helps control urinary incontinence and fecal soiling. For some children, the nerves that control urination and bowel movements do not work correctly. The SNS unit consists of a small, safe battery and wire under the skin and sends signals to the sacral nerve. The signals help restore…

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