1 00:00:00,000 --> 00:00:11,360 Hello, pediatric surgery family. 2 00:00:11,360 --> 00:00:17,000 I'm Emgody, a research fellow from Cincinnati Children's Hospital Medical Center. 3 00:00:17,000 --> 00:00:26,080 And today, our team is going to deliver the articles that you should know about. 4 00:00:26,080 --> 00:00:27,360 We have three papers today. 5 00:00:27,360 --> 00:00:31,620 Two of them are from the Journal of Pediatric Surgery, and the one in the middle is from 6 00:00:31,620 --> 00:00:33,520 Pediatric Critical Care Medicine. 7 00:00:33,520 --> 00:00:41,240 We don't have much time, so let's start. 8 00:00:41,240 --> 00:00:47,420 Our first paper titled, Nowell Index to Estimate the Cephalocardial Extent of the Excavation 9 00:00:47,420 --> 00:00:50,120 in Pechtus Excavatum. 10 00:00:50,120 --> 00:00:54,360 The Titanic Index by Belio Monzon et al. 11 00:00:54,360 --> 00:00:57,040 This paper is summarized by Ellen Insisko. 12 00:00:57,040 --> 00:01:01,400 She was a research fellow at Cincinnati Children's, and as of July, she is back to being a general 13 00:01:01,400 --> 00:01:06,680 surgery resident at Mayo Clinic. 14 00:01:06,680 --> 00:01:12,800 In this article, the authors introduce a new index for patients with Pechtus Excavatum. 15 00:01:12,800 --> 00:01:17,280 The indices that are currently primarily used are the Haller Index and the Correction Index, 16 00:01:17,280 --> 00:01:20,180 and they tell us about the severity of the deformity. 17 00:01:20,180 --> 00:01:24,920 This new index, or the Titanic Index as they're calling it, takes into account the extent 18 00:01:24,920 --> 00:01:25,920 of the deformity. 19 00:01:25,920 --> 00:01:31,000 Here's the calculation for how to calculate it, but essentially it's the percentage of 20 00:01:31,000 --> 00:01:35,560 the sternum that lies behind the anterior costal line as seen on CT scans. 21 00:01:35,560 --> 00:01:40,360 So the authors did a retrospective review of patients at their institution in Argentina 22 00:01:40,360 --> 00:01:45,680 who had undergone minimally invasive repair of Pechtus Excavatum and calculated all these 23 00:01:45,680 --> 00:01:46,680 indices. 24 00:01:46,680 --> 00:01:51,640 They found a weak correlation between the Titanic Index and the other indices, but also 25 00:01:51,640 --> 00:01:56,120 they found the Titanic Index might be more helpful for helping determine how many bars 26 00:01:56,120 --> 00:01:58,400 a patient's going to need for repair. 27 00:01:58,400 --> 00:02:03,400 The threshold they established here was 66.5%, meaning that patients with a higher Titanic 28 00:02:03,400 --> 00:02:08,480 Index than that probably needed more than two bars. 29 00:02:08,480 --> 00:02:11,360 Awesome. 30 00:02:11,360 --> 00:02:17,220 Our second paper is Early Peritoneal Dialysis and Postoperative Outcomes in Infants After 31 00:02:17,220 --> 00:02:19,120 Pediatric Cardiac Surgery. 32 00:02:19,120 --> 00:02:23,480 A Systematic Review and Meta Analysis by Namatiyam et al. 33 00:02:23,480 --> 00:02:25,640 And this paper is summarized by Alex Halpern. 34 00:02:25,640 --> 00:02:30,360 He is one of our contributors here at Staker and MD and a general surgery resident at George 35 00:02:30,360 --> 00:02:33,080 Washington University. 36 00:02:33,080 --> 00:02:38,240 They ended up including five studies in their meta-analysis. 37 00:02:38,240 --> 00:02:39,840 And what did they find? 38 00:02:39,840 --> 00:02:44,440 They found that early initiation of peritoneal dialysis was associated with a decreased post-op 39 00:02:44,440 --> 00:02:45,440 mortality. 40 00:02:45,440 --> 00:02:50,960 They also found that early initiation of peritoneal dialysis shortened duration of mechanical 41 00:02:50,960 --> 00:02:54,240 ventilation and shortened length of stay in the ICU. 42 00:02:54,240 --> 00:02:59,120 So it seems that early initiation of peritoneal dialysis may benefit infants after pediatric 43 00:02:59,120 --> 00:03:03,640 cardiac surgery. 44 00:03:03,640 --> 00:03:06,320 Now moving to the last paper of the day. 45 00:03:06,320 --> 00:03:11,080 Pediatric Button Bettering Ingestion, a single-center experience and risk score to predict severe 46 00:03:11,080 --> 00:03:13,420 outcomes by Skilles et al. 47 00:03:13,420 --> 00:03:15,800 This one is summarized by Cecilia Gihana. 48 00:03:15,800 --> 00:03:18,840 She is a research fellow at Cincinnati Children's. 49 00:03:18,840 --> 00:03:27,400 This is a retrospective study done in Boston Children's Hospital from 2008 to 2021. 50 00:03:27,400 --> 00:03:32,920 And their aim was to propose a risk score to predict severe outcomes in patients with 51 00:03:32,920 --> 00:03:35,080 a button bettering intestine. 52 00:03:35,080 --> 00:03:36,680 And what did they find? 53 00:03:36,680 --> 00:03:40,120 They analyzed 143 patients. 54 00:03:40,120 --> 00:03:43,360 Of them, 24 had severe outcomes. 55 00:03:43,360 --> 00:03:47,280 And they found three independent predictors for severe outcomes. 56 00:03:47,280 --> 00:03:51,280 The first was the location of the button battery in the esophagus. 57 00:03:51,280 --> 00:03:55,520 Second, a button battery larger than 2 centimeters. 58 00:03:55,520 --> 00:04:01,640 And third, having symptoms at presentation. 59 00:04:01,640 --> 00:04:03,160 Thank you for listening. 60 00:04:03,160 --> 00:04:05,920 Please check the link in the description below to read each paper. 61 00:04:05,920 --> 00:04:08,360 We hope you liked this episode. 62 00:04:08,360 --> 00:04:12,760 Please follow Staker and MD on social media, give us a rating and subscribe to YouTube 63 00:04:12,760 --> 00:04:13,900 Channel. 64 00:04:13,900 --> 00:04:18,120 And don't forget to download the Staker and app on the App Store or Play Store for tons 65 00:04:18,120 --> 00:04:43,320 of content.