Palmcollier7830

Shock index-pediatric age-adjusted (SIPA) is a proven tool to predict outcomes in blunt pediatric trauma. We hypothesized that an elevated SIPA in either the pre-hospital or in the emergency department (ED) would identify children with blunt liver or spleen injury (BLSI) needing a blood transfusion and those at risk for failure of non-operative management (NOM).

Pediatric patients (1-18 years) in the ACS pediatric-TQIP database (2014-2016) with a BLSI were included. Patients were stratified by the need for a blood transfusion and/or abdominal operation.

A total of 3561 patients had BLSI, of which 4% received a blood transfusion, and 4% underwent an abdominal operation. Patients who received blood had higher ISS scores (27.0 vs. 5.0, p < 0.001) and mortality (22% vs. 0.4%, p < 0.001). Those who failed NOM had higher ISS scores (17.0 vs. 5.0, p < 0.001) and mortality (7.9% vs. 0.9%, p < 0.001). On multivariable regression, an elevated SIPA score in either pre-hospital or ED was significantly associated with blood transfusion (odds ratio (OR) 8.2, 95% confidence intervals (CI) 5.8-11.5, p < 0.001) and failure of NOM (OR 2.3, CI 1.5-3.4, p < 0.001).

Hemodynamic instability, represented by an elevated pre-hospital or ED SIPA, accurately identifies children with BLSI who may need blood products or an operative intervention.

Retrospective Comparative Study.

Level III.

Level III.

The use of transanal proctectomy may have particular advantages for pediatric patients with small pelvic working space. We report short-term outcomes of transanal completion proctectomy (taCP) during surgery for inflammatory bowel disease.

All patients (age≤19) underwent taCP from January 1, 2018 to December 31, 2019. Prior total abdominal colectomy (TAC) was performed using a single-incision technique. selleck products At operation, patients underwent single-incision laparoscopy with taCP. Patient demographics, pre and perioperative details, and postoperative complications were abstracted.

Seven patients (n=6) with a median age of 18 years [Range 13-19] were included in this initial series. All patients had a prior TAC with end-ileostomy with taCP occurring a median of 6 [Range 3-89] months after TAC. Six of 7 had a diagnosis of ulcerative colitis (UC) while 1 patient had Crohn's colitis. For patients with UC, taCP was part of an ileal pouch-anal anastomosis with the majority (n=4) proceeding as a modified-two stage anP for applications in pediatric inflammatory bowel disease.

Case series.

IV.

IV.

Six minute walk test (6MWT), Spirometry and chest expansion are used regularly to investigate the status of functional capacity and pulmonary function pre and post operatively. We assessed whether Functional capacity Ten meter walk test (10mWT), Nine stair climbing test (9SCT), pulmonary function [Spirometry parameters (FVC, FEV1, FEV1/FVC ratio and PEFR)] and chest expansion have correlation in children undergoing open abdominal surgery.

Total 18 children aged 5-17 years old undergoing open abdominal surgery participated in the study. The study follows secondary analysis from randomized clinical trial. 6MWT, Spirometry parameters (FVC, FEV1, FEV1/FVC ratio and PEFR), 10mWT, 9SCT, and Chest expansion measures were taken before [Preoperative day (Pre-OP)] and after open abdominal surgery [postoperative day one (POD1) and postoperative day five (POD5)].

Bivariate analysis showed no correlation (r

<0.25; p>0.05) between Functional capacity and pulmonary function preoperatively, on POD1, and on POD5. 9SCT (Functional capacity) showed moderate to good correlation (r

= 0.742; p<0.05) with pulmonary function at the Pre-OP. Chest expansion parameters also showed moderate to good correlation (r

=0.50-0.75; p<0.05) with the pulmonary function on Pre-OP, POD1, and POD5.

There is moderate correlation exists between pulmonary function and chest expansion, but poor correlation of functional capacity with pulmonary function and chest expansion. Hence, all the outcome measures (6MWT, 10Mwt, 9SCT, Spirometry, and Chest expansion) are having individual importance.

There is moderate correlation exists between pulmonary function and chest expansion, but poor correlation of functional capacity with pulmonary function and chest expansion. Hence, all the outcome measures (6MWT, 10Mwt, 9SCT, Spirometry, and Chest expansion) are having individual importance.

Following high influenza activity in 2017, the state of Queensland, Australia, funded a quadrivalent inactivated influenza vaccination program for children aged 6months to <5years in 2018. We calculated influenza vaccine effectiveness (VE) among children eligible for this program.

A matched case-control study was conducted. Cases were identified using Queensland 2018 influenza notification data among children age-eligible for funded vaccination. Controls were drawn from Australian Immunisation Register records of Queensland resident children age-eligible for funded influenza vaccine. Up to 10 controls per case were matched for location and birthdate. First dose vaccination was valid if received≥14days prior to specimen collection; a second dose was valid if received≥28days after first dose receipt. VE was calculated for vaccine doses and adherence to national recommendations for two doses in the first season (schedule completeness) and adjusted (VE

) for sex and First Nations status.

There were 1,125 cases and 10,645 matched controls analysed. Overall VE

against laboratory-confirmed influenza was 51% (95% confidence interval (CI) 41-60). VE

was 60% (95% CI 46-70) for children who received two doses in 2018, and 60% (95% CI 48-69) for children vaccinated appropriately according to schedule completeness. VE increased with age.

Moderate vaccine effectiveness was observed for children eligible for the funded program in Queensland in 2018, adding to the sparse evidence for influenza vaccine use in Australian children. Adhering to the national first season two dose schedule for influenza vaccine receipt in children ensures maximum protection.

Moderate vaccine effectiveness was observed for children eligible for the funded program in Queensland in 2018, adding to the sparse evidence for influenza vaccine use in Australian children. Adhering to the national first season two dose schedule for influenza vaccine receipt in children ensures maximum protection.