Liver transplant after donation from controlled circulatory death versus brain death: A UNOS database analysis and publication bias adjusted meta-analysis.

BACKGROUND: Donation after circulatory death (DCD) is an increasingly utilized alternative to donation after brain death (DBD) to expand the liver donor pool. We compared the outcomes of liver transplant (LT) after DCD versus DBD. METHODS: A PRISMA-compliant systematic literature review was performed using the PubMed, Cochrane Library, and Embase databases (end-of-search-date: July 2, 2020). US outcomes were analyzed using the UNOS database (February, 2002-September, 2020). Pooled hazard ratios (HR) for patient and graft survival were obtained through random effect meta-analyses and adjusted for publication bias. RESULTS: Thirteen studies reporting on 1426 DCD and 5385 DBD LT recipients were included. 5620 DCD and 87561 DBD LT recipients were analyzed from the UNOS database. Meta-analysis showed increased risk of patient mortality for DCD (HR = 1.36; 95%CI, 1.09-1.70; P = .01; I2  = 53.6%). When adjusted for publication bias, meta-analysis showed no difference in patient survival between DCD and DBD (HR = 1.15; 95%CI, .91-1.45; P = .25; I2  = 61.5%). Meta-analysis showed increased risk of graft loss for DCD (HR = 1.50; 95%CI, 1.20-1.88; P < .001; I2  = 67.8%). When adjusted for publication bias, meta-analysis showed a reduction in effect size (HR = 1.36; 95%CI, 1.06-1.74; P = .02; I2  = 73.5%). CONCLUSION: When adjusted for publication bias, no difference was identified between DCD and DBD regarding patient survival, while DCD was associated with an increased risk of graft loss.

Giant cell tumor of the patellar tendon sheath in childhood: case report.

The aim of this study was to report a rare case of a giant cell tumor of the patellar tendon sheath. This indicates the diagnostic procedures and treatment options for giant cell tumors of the patellar tendon. This study reported a case of a 13-year-old male patient with a giant cell tumor of the tendon sheath. In our case, open arthrotomy was performed with complete surgical excision of the lesion. Histopathological examination revealed a giant cell tumor. At the last follow-up, 2 years after surgery, no complications were reported. The giant cell tumor of the patellar tendon sheath is an uncommon benign tumor. It mimics common knee symptoms. A differential diagnosis is definitely a challenge. Available operation approaches have demonstrated similar results, which lead to symptom relief and a low recurrence rate.

Hospitalization in neonatal intensive care unit: parental anxiety and satisfaction.

Introduction: the birth of an infant constitutes a challenge for all parents. Stress is intense when an infant is born prematurely or experiences health problems and enters the Neonatal Intensive Care Unit (NICU). Moreover, mothers with premature babies in the NICU would feel frustrated if they are hospitalized in the maternity clinic away from their children. The purpose of this study is to assess the stress experienced by the parents of newborns hospitalized in NICU and its correlation with their level of satisfaction from the services provided during the hospitalization. Methods: the sample consisted of 102 parents whose children were hospitalized in NICU. Parental Satisfaction questionnaires of NICU and the Picker´s institute were used. Statistical analysis was performed using χ2 (chi square) and Pearson´s correlation test (bivariate). STROBE checklist was applied. Results: out of the 102 parents, 66% were mothers and 33% were fathers. Parents expressed their satisfaction at a rate of 87.8% (±13.9%). In addition, there was strong evidence that the degree of parental satisfaction was significantly related to the age of the mother (p<0.05). The sudden noises from the alarms of the monitoring instruments were strongly correlated with the degree of parents´ satisfaction from the services provided by the NICU (p<0.05). Parents feel less stressful when their child is being monitored (p<0.05). Conclusion: the results of this study could help the staff of NICU clinics to improve parents´ satisfaction about health services. Proper and adequate communication between parents and health professionals in NICU increases parental satisfaction.

Robot-Assisted Minimally Invasive Esophagectomy versus Open Esophagectomy for Esophageal Cancer: A Systematic Review and Meta-Analysis.

Robot-assisted minimally invasive esophagectomy (RAMIE) was introduced as a further development of the conventional minimally invasive esophagectomy, aiming to further improve the high morbidity and mortality associated with open esophagectomy. We aimed to compare the outcomes between RAMIE and open esophagectomy, which remains a popular approach for resectable esophageal cancer. Ten studies meeting our inclusion criteria were identified, including five retrospective cohort, four prospective cohort, and one randomized controlled trial. RAMIE was associated with significantly lower rates of overall pulmonary complications (odds ratio (OR): 0.38, 95% confidence interval (CI): [0.26, 0.56]), pneumonia (OR: 0.39, 95% CI: [0.26, 0.57]), atrial fibrillation (OR: 0.53, 95% CI: [0.29, 0.98]), and wound infections (OR: 0.20, 95% CI: [0.07, 0.57]) and resulted in less blood loss (weighted mean difference (WMD): -187.08 mL, 95% CI: [-283.81, -90.35]) and shorter hospital stays (WMD: -9.22 days, 95% CI: [-14.39, -4.06]) but longer operative times (WMD: 69.45 min, 95% CI: [34.39, 104.42]). No other statistically significant difference was observed regarding surgical and short-term oncological outcomes. Similar findings were observed when comparing totally robotic procedures only to OE. RAMIE is a safe and feasible procedure, resulting in decreased cardiopulmonary morbidity, wound infections, blood loss, and shorter hospital stays compared to open esophagectomy.

Video-assisted thoracoscopic versus open sleeve lobectomy for non-small cell lung cancer: A systematic review and meta-analysis from six comparative studies.

BACKGROUND: Lung sleeve resection is indicated for centrally located lung tumors, especially for patients who cannot tolerate pneumonectomy. With video-assisted thoracoscopic surgery (VATS) being increasingly implemented for a wide variety of thoracic pathologies, this study aims to compare the intraoperative, postoperative, and long-term outcomes of VATS and open bronchial sleeve lobectomy for non-small cell lung cancer (NSCLC). METHODS: The MEDLINE (via PubMed), Cochrane Library, and Scopus databases were searched. Original clinical studies, comparing VATS and open sleeve lobectomy for NSCLC were included. Evidence was synthesized as odds ratios for categorical and weighted mean difference (WMD) for continuous variables. RESULTS: Our analysis included six studies with non-overlapping populations reporting on 655 patients undergoing bronchial sleeve lobectomy for NSCLC (229 VATS and 426 open). VATS sleeve lobectomy was associated with significantly longer operative time ((WMD): 45.85 min, 95% confidence interval (CI): 12.06 to 79.65, p = 0.01) but less intraoperative blood loss ((WMD): -34.57 mL, 95%CI: -58.35 to -10.78, p < 0.001). No significant difference was found between VATS and open bronchial sleeve lobectomy in margin-negative resection rate, number of lymph nodes resected, postoperative outcomes (drainage duration, length of hospital stay, 30-day mortality), postoperative complications (pneumonia, bronchopleural fistula/empyema, prolonged air leakage, chylothorax, pulmonary embolism, and arrhythmia), and long-term outcomes (overall survival, recurrence-free survival). CONCLUSIONS: The limitation of our study arises mainly due to the heterogeneity of the included studies. Nevertheless, VATS bronchial sleeve lung resection constitutes a feasible and safe alternative to the open sleeve lung resection surgery for the management of centrally located lung tumors.

Reduction in Pediatric Surgery's Emergency Department Visits During COVID-19 Pandemic in a Tertiary University General Hospital in Greece.

Background From January 2020, coronavirus has caused more than three million deaths. Lockdown has been enforced in many countries worldwide, affecting the emergency department visits of many surgical specialties. Methods The purpose of this study was to present the difference in trends in pediatric emergency department visits from March 1 to May 30, 2020, compared to the same 3-month period in 2019 in a tertiary university hospital in Greece, which was one of the referral centers for COVID-19 patients. Results A 42.5% reduction in emergency department visits was observed. In 2020, only 196 patients visited the pediatric surgery emergency department, versus 341 patients in 2019 (p<0.05). The reasons for visiting the emergency department did not change in most categories. Even though visits to the emergency department were reduced, the rates of the distance of the patient's residency from the hospital remained roughly the same. Hospital admission rates remained roughly the same. Conclusion Even though there was a huge decrease in numbers, the reasons for visiting the ED remained roughly the same. The only exception was indoor accidents, which increased in 2020.

Hypertrophic pyloric stenosis case series in twins and first cousins: genes, feeding patterns or both? (a case report).

We present two cases of dizygotic male twins and two cases of male first cousins with infantile hypertrophic pyloric stenosis (IHPS). All patients were treated with open pyloromyotomy. No complications were reported. The patients had the same risk factors for IHPS. First, all patients were first-born white males. Second, the twins were preterm (35 weeks). Third, the twins and the first cousins were exclusively bottle feeding. Thus, a combination of genetic and environmental factors may have contributed to the appearance of IHPS.

Serious Rodent Bites to an 8-Month-Old Infant Due to Child Neglect.

Animal bites are among the top causes of preventable traumatic injuries. We describe the case of an 8-month-old female infant who was brought to the emergency department by her grandfather with serious rodent bites on her eyes, nose, right cheek, upper right extremity, and other smaller bites all over her body. This case is another proof of child neglect, or a possible infanticide attempt, as the motives of leaving the child in a hut without proper care, are not cleared up to this date. Rodent bites could be associated with Streptobacillus moniliformis infection and rat-bite fever. If the bites are left untreated for hours, the infant may suffer from hypovolemic shock due to bleeding, a possible fatal situation. The emergency surgical treatment of wounds is of vital importance.

The Effectiveness of Single-Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy/One Anastomosis Duodenal Switch (SADI-S/OADS): an Updated Systematic Review.

Single-anastomosis duodenoileal bypass with sleeve gastrectomy/one anastomosis duodenal switch (SADI-S/OADS) was developed as a bariatric operation with reduced overall morbidity and lasting weight loss results. We performed a systematic review of the literature, including 14 studies reporting on weight loss, comorbidity resolution, postoperative complications, and nutritional deficiencies following SADI-S. Twelve months after SADI-S, the mean total body weight lost ranged from 21.5 to 41.2%, with no weight regain being observed after 24 months. The comorbidity resolution rate was 72.6% for diabetes, 77.2% for dyslipidemia, and 59.0% for hypertension cases. The need for reoperation was the most common postoperative complication. While several patients developed nutrient deficiencies, SADI-S seems to be an overall safe and effective bariatric operation.

Influence of education and residence on the parental search for pediatric surgical information on the internet.

BACKGROUND: The internet is a valuable tool for access to health-related information. There is limited literature regarding its use by parents of children with surgical conditions. AIM: To investigate internet usage by parents seeking information about the surgical conditions of their offspring in relation to epidemiological factors such as family residential area and parental educational level and to subsequently review the literature regarding this topic. METHODS: An anonymous questionnaire about internet usage was completed by eligible parents of children who were admitted to our clinic for minor surgical procedures during a six-month period. RESULTS: Our results demonstrated that the internet has been mostly used by mothers for children's health information. Google was the most commonly used search engine, while pediatricians were the first parental choice for 'live' information. Only one-quarter of the parents informed their doctor about the information found online. Nine of ten parents had a positive opinion of an official website managed by the doctors of our clinic. Our results mostly agreed with the international literature. CONCLUSION: In conclusion, the establishment of official websites (designed and managed by specialists) that parents can access to receive appropriate health information is mandatory in the internet era.

Corneal Graft Success Rates in HSV Keratitis: A Systematic Review.

Herpes Simplex Virus (HSV) has worldwide prevalence. The primary objective of this systematic review was to compare penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK) regarding the efficacy and complications of the treatment of corneal scarring caused by herpes simplex keratitis. Out of the 469 articles identified during the combined search of the literature based on the PubMed and Cochrane libraries, 10 retrospective and 2 prospective studies published from January 2010 to December 2019 were included. The study outcomes indicated that both surgical approaches resulted in a comparable improvement of visual acuity (VA). However, DALK demonstrated fewer complications in the majority of studies. Higher graft survival rates were associated with higher acyclovir (ACV) doses (above 800 mg/day), topical steroid and antibiotic drops. In conclusion, in terms of postoperative VA, both PK and DALK demonstrate comparable efficacy. However, DALK, which is applied in less severe HSK cases, is associated with fewer complications and better graft survival rates. High dosages of ACV, topical steroids and antibiotics contribute significantly to improved postoperative outcomes.