World Journal of Pediatric Surgery最新文献

{"title":"Congenital diaphragmatic hernia survival in an English regional ECMO center.","authors":"Elizabeth O'Connor,&nbsp;Ryo Tamura,&nbsp;Therese Hannon,&nbsp;Sundeep Harigopal,&nbsp;Bruce Jaffray","doi":"10.1136/wjps-2022-000506","DOIUrl":"https://doi.org/10.1136/wjps-2022-000506","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital diaphragmatic hernia (CDH) remains a cause of neonatal death. Our aims are to describe contemporary rates of survival and the variables associated with this outcome, contrasting these with our study of two decades earlier and recent reports.</p><p><strong>Materials and methods: </strong>A retrospective review of all infants diagnosed in a regional center between January 2000 and December 2020 was performed. The outcome of interest was survival. Possible explanatory variables included side of defect, use of complex ventilatory or hemodynamic strategies (inhaled nitric oxide (iNO), high-frequency oscillatory ventilation (HFOV), extracorporeal membrane oxygenation (ECMO), and Prostin), presence of antenatal diagnosis, associated anomalies, birth weight, and gestation. Temporal changes were studied by measuring outcomes in each of four consecutive 63-month periods.</p><p><strong>Results: </strong>A total of 225 cases were diagnosed. Survival was 60% (134 of 225). Postnatal survival was 68% (134 of 198 liveborn), and postrepair survival was 84% (134 of 159 who survived to repair). Diagnosis was made antenatally in 66% of cases. Variables associated with mortality were the need for complex ventilatory strategies (iNO, HFOV, Prostin, and ECMO), antenatal diagnosis, right-sided defects, use of patch repair, associated anomalies, birth weight, and gestation. Survival has improved from our report of a prior decade and did not vary during the study period. Postnatal survival has improved despite fewer terminations. On multivariate analysis, the need for complex ventilation was the strongest predictor of death (OR=50, 95% CI 13 to 224, p<0.0001), and associated anomalies ceased to be predictive.</p><p><strong>Conclusions: </strong>Survival has improved from our earlier report, despite reduced numbers of terminations. This may be related to increased use of complex ventilatory strategies.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000506"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ed/1b/wjps-2022-000506.PMC10152044.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9415020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the potential transcriptional regulatory network in Hirschsprung disease by integrated analysis of microarray datasets.","authors":"Wenyao Xu,&nbsp;Hui Yu,&nbsp;Dian Chen,&nbsp;Weikang Pan,&nbsp;Weili Yang,&nbsp;Jing Miao,&nbsp;Wanying Jia,&nbsp;Baijun Zheng,&nbsp;Yong Liu,&nbsp;Xinlin Chen,&nbsp;Ya Gao,&nbsp;Donghao Tian","doi":"10.1136/wjps-2022-000547","DOIUrl":"https://doi.org/10.1136/wjps-2022-000547","url":null,"abstract":"<p><strong>Objective: </strong>Hirschsprung disease (HSCR) is one of the common neurocristopathies in children, which is associated with at least 20 genes and involves a complex regulatory mechanism. Transcriptional regulatory network (TRN) has been commonly reported in regulating gene expression and enteric nervous system development but remains to be investigated in HSCR. This study aimed to identify the potential TRN implicated in the pathogenesis and diagnosis of HSCR.</p><p><strong>Methods: </strong>Based on three microarray datasets from the Gene Expression Omnibus database, the multiMiR package was used to investigate the microRNA (miRNA)-target interactions, followed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Then, we collected transcription factors (TFs) from the TransmiR database to construct the TF-miRNA-mRNA regulatory network and used cytoHubba to identify the key modules. Finally, the receiver operating characteristic (ROC) curve was determined and the integrated diagnostic models were established based on machine learning by the support vector machine method.</p><p><strong>Results: </strong>We identified 58 hub differentially expressed microRNAs (DEMis) and 16 differentially expressed mRNAs (DEMs). The robust target genes of DEMis and DEMs mainly enriched in several GO/KEGG terms, including neurogenesis, cell-substrate adhesion, PI3K-Akt, Ras/mitogen-activated protein kinase and Rho/ROCK signaling. Moreover, 2 TFs (<i>TP53</i> and <i>TWIST1</i>), 4 miRNAs (<i>has-miR-107</i>, <i>has-miR-10b-5p</i>, <i>has-miR-659-3p</i>, and <i>has-miR-371a-5p</i>), and 4 mRNAs (<i>PIM3</i>, <i>CHUK</i>, <i>F2RL1</i>, and <i>CA1</i>) were identified to construct the TF-miRNA-mRNA regulatory network. ROC analysis revealed a strong diagnostic value of the key TRN regulons (all area under the curve values were more than 0.8).</p><p><strong>Conclusion: </strong>This study suggests a potential role of the TF-miRNA-mRNA network that can help enrich the connotation of HSCR pathogenesis and diagnosis and provide new horizons for treatment.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000547"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10111925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the regional distribution of the pediatric surgery workforce and surgical load in Brazil.","authors":"Joaquim Bustorff-Silva,&nbsp;Marcio Lopes Miranda,&nbsp;Amanda Rosendo,&nbsp;Ayla Gerk,&nbsp;Antonio Gonçalves Oliveira-Filho","doi":"10.1136/wjps-2022-000522","DOIUrl":"https://doi.org/10.1136/wjps-2022-000522","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study is to examine the regional distribution of the pediatric surgery workforce and the expected local demand for pediatric surgical procedures in Brazil.</p><p><strong>Methods: </strong>We collected data on the pediatric surgical workforce, surgical volume, Gross Domestic Product per capita, and mortality for gastrointestinal tract malformations (MGITM) across the different regions of Brazil for 2019.</p><p><strong>Results: </strong>Data from the Federal Medical Council reported 1515 pediatric surgery registries in Brazil, corresponding to 1414 pediatric surgeons (some pediatric surgeons are registered in more than one state), or 2.4 pediatric surgeons per 100 000 children 14 years of age and younger. There were 828 men and 586 women. The mean age was 51.5±12.8 years, and the mean time from graduation was 3.4±5.7 years. There is a higher concentration of pediatric surgeons in the wealthier Central-West, South, and Southeast regions. Individual surgical volume ranged from 88 to 245 operations/year (average 146 operations/year) depending on the region. Of these, only nine (6.1%) were high-complexity (including neonatal) operations. MGITM tended to be higher in the poorer North and Northeast regions than in other regions of Brazil.</p><p><strong>Conclusions: </strong>Our findings suggest significant disparities in the surgical workforce and workload across Brazil related to socioeconomic status. Regions with an increased surgical workforce were associated with lower MGITM. The average number of complex operations performed annually by each pediatric surgeon was considerably low. Strategic investment and well-defined health policies are imperative to enhance the quality of surgical care in the different regions of Brazil.</p><p><strong>Level of evidence: </strong>Retrospective review; level IV.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000522"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/dd/wjps-2022-000522.PMC10193071.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9858901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of perioperative respiratory adverse events among children with upper respiratory tract infection undergoing pediatric ambulatory ilioinguinal surgery: a prospective observational research.","authors":"Anouar Jarraya,&nbsp;Manel Kammoun,&nbsp;Saloua Ammar,&nbsp;Wiem Feki,&nbsp;Kamel Kolsi","doi":"10.1136/wjps-2022-000524","DOIUrl":"https://doi.org/10.1136/wjps-2022-000524","url":null,"abstract":"<p><strong>Objectives: </strong>Anesthesia for children with an upper respiratory tract infection (URI) has an increased risk of perioperative respiratory adverse events (PRAEs) that may be predicted according to the COLDS score. The aims of this study were to evaluate the validity of the COLDS score in children undergoing ilioinguinal ambulatory surgery with mild to moderate URI and to investigate new predictors of PRAEs.</p><p><strong>Methods: </strong>This was a prospective observational study including children aged 1-5 years with mild to moderate symptoms of URI who were proposed for ambulatory ilioinguinal surgery. The anesthesia protocol was standardized. Patients were divided into two groups according to the incidence of PRAEs. Multivariate logistic regression was performed to assess predictors for PRAEs.</p><p><strong>Results: </strong>In this observational study, 216 children were included. The incidence of PRAEs was 21%. Predictors of PRAEs were respiratory comorbidities (adjusted OR (aOR)=6.3, 95% CI 1.19 to 33.2; p=0.003), patients postponed before 15 days (aOR=4.3, 95% CI 0.83 to 22.4; p=0.029), passive smoking (aOR=5.31, 95% CI 2.07 to 13.6; p=0.001), and COLDS score of >10 (aOR=3.7, 95% CI 0.2 to 53.4; p=0.036).</p><p><strong>Conclusions: </strong>Even in ambulatory surgery, the COLDS score was effective in predicting the risks of PRAEs. Passive smoking and previous comorbidities were the main predictors of PRAEs in our population. It seems that children with severe URI should be postponed to receive surgery for more than 15 days.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000524"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/d4/wjps-2022-000524.PMC10032407.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9561095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey on surgical treatment of neonatal necrotizing enterocolitis in China 2022.","authors":"Jiafang Gao,&nbsp;Dengming Lai,&nbsp;Jinfa Tou","doi":"10.1136/wjps-2023-000588","DOIUrl":"https://doi.org/10.1136/wjps-2023-000588","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to identify the state of surgical treatment of neonatal necrotizing enterocolitis (NEC) in China.</p><p><strong>Methods: </strong>A total of 246 delegates (88.0% senior surgeons) completed a survey sent by the Neonatal Surgery Group of the Pediatric Surgery Branch of the Chinese Medical Association in 2022. Five centers were eliminated due to lack of experience.</p><p><strong>Results: </strong>Generally, 38.2% of surgeons work in centers where more than 20 cases of surgical NEC are treated per year. A total of 81.3% of surgeons reported the use of ultrasonography; the most used biomarkers were white blood cell count (95.9%), C-reactive protein (93.8%), and procalcitonin (76.3%). Most surgeons (80.9%) used a combination of two (67.2%) antibiotics or single (29.5%) antibiotic for a treatment period of 7-14 days, and most used antibiotics were carbapenems (73.9%), penicillin and cephalosporins (56.0%). Patients are issued the fasting order for 5-7 days by nearly half surgeons (49.8%) for conservative treatment. 70.1% of surgeons deemed that the most difficult decision was to evaluate the optimal timing of surgery. Most surgeons (76.3%) performed diagnostic aspiration of peritoneal fluid. Laparoscopy was performed for the diagnosis and/or treatment of NEC by 40.2% of surgeons. A total of 53.5% of surgeons reported being able to identify localized intestinal necrosis preoperatively. Surgeons relied the most on pneumoperitoneum (94.2%) and failure of conservative treatment (88.8%) to evaluate the surgical indications. At laparotomy, surgical treatments vary according to NEC severity. Infants are fasted for 5-7 days by 55.2% of surgeons postoperatively. Most surgeons (91.7%) followed up with patients with NEC after discharge for up to 5 years (53.8%).</p><p><strong>Conclusions: </strong>The most difficult aspect of surgical NEC is evaluating the timing of surgery, and surgeons in the children's specialized hospitals are experienced. The treatment of NEC totalis is controversial, and the indications for laparoscopy need to be further clarified. More multicenter prospective studies are needed to develop surgical guidelines in the future.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 4","pages":"e000588"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10414103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10350999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does time to theater matter in simple gastroschisis?","authors":"Kathryn O'Shea,&nbsp;Rachel Harwood,&nbsp;Sean O'Donnell,&nbsp;Colin Baillie","doi":"10.1136/wjps-2023-000575","DOIUrl":"https://doi.org/10.1136/wjps-2023-000575","url":null,"abstract":"<p><strong>Objective: </strong>A recent publication has suggested that expedited time to theater in gastroschisis results in higher rates of primary closure and decreases the length of stay (LOS). This study primarily aims to assess the impact of time to first management of neonates with gastroschisis on the LOS.</p><p><strong>Methods: </strong>Neonates admitted between August 2013 and August 2020 with gastroschisis were included. Data were collected retrospectively, and neonates with complex gastroschisis were excluded. Variables including gestation, birth weight, time of first management, primary/delayed closure and use of patch were evaluated as possible confounding variables. The outcome measures were time to full feeds, time on parenteral nutrition (PN) and LOS. Univariate and multivariate linear regression analyses were performed. P<0.05 was regarded as significant.</p><p><strong>Results: </strong>Eighty-six neonates were identified, and 16 were then excluded (eight patients with complex gastroschisis, eight patients with time to first management not documented). The median LOS for those who underwent primary closure was 21 days (interquartile range (IQR) =16-29) and for those who underwent silo placement and delayed closure was 59 days (IQR=44-130). The mean time to first management was 473 min (standard deviation (SD) =146 min), with only 20% of these infants being operated on at less than 6 hours of age. Univariate and multivariate analyses demonstrated no relationship between time to first management and LOS (r²=0.00, p=0.82) but did demonstrate a consistent positive association between time to first feed and LOS and delayed closure, resulting in a longer time to full feeds and a longer time on PN.</p><p><strong>Conclusions: </strong>The time to first management was not associated with a change in LOS in these data. Further prospective evaluation of the impact of reducing the time to first feed on the LOS is recommended.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 4","pages":"e000575"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/8a/wjps-2023-000575.PMC10476109.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10540765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role and significance of SIRT1 in regulating the LPS-activated pyroptosis pathway in children with congenital hydronephrosis.","authors":"Zhan Wang,&nbsp;Gu Weizhong,&nbsp;Juan Zhou,&nbsp;Daxing Tang","doi":"10.1136/wjps-2023-000602","DOIUrl":"https://doi.org/10.1136/wjps-2023-000602","url":null,"abstract":"<p><strong>Objective: </strong>To explore the characteristics and mechanism of sirtuin 1 (SIRT1) in lipopolysaccharide (LPS)-activated pyroptosis in the renal tissue of children with congenital hydronephrosis (CHn).</p><p><strong>Methods: </strong>We detected the expression characteristics and clinical significance of SIRT1 and pyroptosis pathway proteins in CHn renal tissues by immunohistochemistry. The degree of renal fibrosis was detected by Masson staining. The human renal tubular epithelial cell line (HK-2) was cultured in vitro and treated with LPS (1 µg/mL), the SIRT1-specific agonist SRT1720 (2.5 µmol/L) and small interfering RNA (siRNA)-SIRT1 for 48 hours. After 48 hours, Cell Counting Kit-8 was used to detect the changes in cell proliferation ability, and ELISA was used to detect the changes in the expression of interleukin (IL)-1β and IL-18 in the cell supernatant. Real-time PCR (quantitative RT-PCR) and western blot analysis were used to detect the expression of SIRT1, caspase-1, caspase-4, NOD-like receptor thermal protein domain associated protein 3(NLRP3), and cleaved gasdermin D (GSDMD) in each group.</p><p><strong>Results: </strong>Serum inflammatory cytokines were significantly elevated in 13 children with CHn with urinary tract infection, mainly caused by Gram-negative bacteria. Severe renal fibrosis occurred in children with CHn. Compared with the control group, the expression of SIRT1 in CHn kidney tissues was decreased, and the expression of caspase-4 and GSDMD was increased. LPS inhibited the expression of SIRT1 in HK-2 cells, promoted the expression of caspase-1, caspase-4, NLRP3, cleaved GSDMD, promoted the expression of IL-1β and IL-18 in the supernatant, and promoted pyroptosis in HK-2 cells. SRT1720 can inhibit LPS-activated pyroptosis by promoting SIRT1 expression, while siRNA-SIRT1 can further aggravate LPS-activated pyroptosis after inhibiting SIRT1 expression.</p><p><strong>Conclusions: </strong>LPS can promote the inflammatory response in children with CHn by activating non-canonical pyroptosis and inhibiting SIRT1 expression. Promoting SIRT1 expression can inhibit pyroptosis of renal tubular epithelial cells, reduce the release of IL-18 and IL-1β, and alleviate the progression of renal fibrosis in children with CHn.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 4","pages":"e000602"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10391807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9987605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare case of superior vesical fissure with hypospadias: variants of classic bladder exstrophy.","authors":"Sudhir Singh,&nbsp;Jiledar Rawat,&nbsp;Nitin Pant","doi":"10.1136/wjps-2022-000552","DOIUrl":"https://doi.org/10.1136/wjps-2022-000552","url":null,"abstract":"© Author(s) (or their employer(s)) 2023. Reuse permitted under CC BYNC. No commercial reuse. See rights and permissions. Published by BMJ. Rare variants of bladder exstrophy are pseudoexstrophy, covered exstrophy, duplicate exstrophy, superior vesical fissure, visceral sequestration, and omphalocele, exstrophy of the cloaca, imperforate anus, and spinal defects syndrome. They comprise 10% of all cases of the exstrophy–epispadias complex. Here, we managed a 1yearold male child who presented with a 2.5 cm diameter mucosal opening in the hypogastric region, draining urine through it. The child also had distal penile hypospadias with a stenotic meatus through which he passed urine. The prepuce was hooded, and there was no chordee. On inserting a smallcaliber feeding tube through the stenotic meatus, it is visible through the hypogastric region defect. A lowlying umbilicus was present (figure 1A,B). Widening of the symphysis pubis both clinically and on an Xray was present. There was a divergence of the rectus abdominis muscle. Both testes were in the scrotum. He was continent of urine. Blood investigations were normal, including serum creatinine, and ultrasonography of the bilateral kidney and ureter was normal. The anatomy of the bladder was studied preoperatively via contrast study, although the bladder was open and not holding the contrast, so proper VCUG (voiding cystourethrogram) was not possible to perform at that time (figure 2). At 1 year of age, the child was planned for surgical correction. A circumferential bladder fissure incision with a lower abdominal midline incision was made; the upper part of the bladder was mobilized extraperitoneal. The bladder was repaired in two layers, and then the rectus muscle was approximated in the midline. Meatotomy was performed because of the stenotic meatus (figure 1C,D). The patient tolerated closure well. The child developed a right inguinal hernia at followup. The second surgery was performed at 2 years of age. Snodgrass repair for hypospadias along with right inguinal hernia was performed. The child was doing Figure 1 Clinical and operative pictures of the case of superior vesical fissure with hypospadias. (A) Lowset umbilicus and hypospadias meatus. (B) Hypospadias meatus. (C) Picture showing hypospadias meatus, meatotomy performed. (D) Intraoperative view showing repair of abdominal wall after repair of the bladder. Figure 2 Cystogram (radiograph of the bladder with contrast, not properly visualized as not holding the contrast). R, right.","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 2","pages":"e000552"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e6/0a/wjps-2022-000552.PMC10193042.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9504739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A deep learning-based method for pediatric congenital heart disease detection with seven standard views in echocardiography.","authors":"Xusheng Jiang,&nbsp;Jin Yu,&nbsp;Jingjing Ye,&nbsp;Weijie Jia,&nbsp;Weize Xu,&nbsp;Qiang Shu","doi":"10.1136/wjps-2023-000580","DOIUrl":"https://doi.org/10.1136/wjps-2023-000580","url":null,"abstract":"<p><strong>Background: </strong>With the aggregation of clinical data and the evolution of computational resources, artificial intelligence-based methods have become possible to facilitate clinical diagnosis. For congenital heart disease (CHD) detection, recent deep learning-based methods tend to achieve classification with few views or even a single view. Due to the complexity of CHD, the input images for the deep learning model should cover as many anatomical structures of the heart as possible to enhance the accuracy and robustness of the algorithm. In this paper, we first propose a deep learning method based on seven views for CHD classification and then validate it with clinical data, the results of which show the competitiveness of our approach.</p><p><strong>Methods: </strong>A total of 1411 children admitted to the Children's Hospital of Zhejiang University School of Medicine were selected, and their echocardiographic videos were obtained. Then, seven standard views were selected from each video, which were used as the input to the deep learning model to obtain the final result after training, validation and testing.</p><p><strong>Results: </strong>In the test set, when a reasonable type of image was input, the area under the curve (AUC) value could reach 0.91, and the accuracy could reach 92.3%. During the experiment, shear transformation was used as interference to test the infection resistance of our method. As long as appropriate data were input, the above experimental results would not fluctuate obviously even if artificial interference was applied.</p><p><strong>Conclusions: </strong>These results indicate that the deep learning model based on the seven standard echocardiographic views can effectively detect CHD in children, and this approach has considerable value in practical application.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000580"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/41/wjps-2023-000580.PMC10255206.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9620243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns, procedures, and indications for pediatric surgery in a Tanzanian Refugee Camp: a 20-year experience.","authors":"Sarah Rapaport,&nbsp;Zachary Obinna Enumah,&nbsp;Hilary Ngude,&nbsp;Daniel S Rhee,&nbsp;Mohamed Abbas,&nbsp;Amber Lekey,&nbsp;Peter J Winch,&nbsp;Joseph V Sakran,&nbsp;Kent A Stevens","doi":"10.1136/wjps-2022-000528","DOIUrl":"https://doi.org/10.1136/wjps-2022-000528","url":null,"abstract":"<p><strong>Background: </strong>There are 103 million displaced people worldwide, 41% of whom are children. Data on the provision of surgery in humanitarian settings are limited. Even scarcer is literature on pediatric surgery performed in humanitarian settings, particularly protracted humanitarian settings.</p><p><strong>Methods: </strong>We reviewed patterns, procedures, and indications for pediatric surgery among children in Nyarugusu Refugee Camp using a 20-year retrospective dataset.</p><p><strong>Results: </strong>A total of 1221 pediatric surgical procedures were performed over the study period. Teenagers between the ages of 12 and 17 years were the most common age group undergoing surgery (n=991; 81%). A quarter of the procedures were performed on local Tanzanian children seeking care in the camp (n=301; 25%). The most common procedures performed were cesarean sections (n=858; 70%), herniorrhaphies (n=197; 16%), and exploratory laparotomies (n=55; 5%). Refugees were more likely to undergo exploratory laparotomy (n=47; 5%) than Tanzanian children (n=7; 2%; p=0.032). The most common indications for exploratory laparotomy were acute abdomen (n=24; 44%), intestinal obstruction (n=10; 18%), and peritonitis (n=9; 16%).</p><p><strong>Conclusions: </strong>There is a significant volume of basic pediatric general surgery performed in the Nyarugusu Camp. Services are used by both refugees and local Tanzanians. We hope this research will inspire further advocacy and research on pediatric surgical services in humanitarian settings worldwide and illuminate the need for including pediatric refugee surgery within the growing global surgery movement.</p>","PeriodicalId":23823,"journal":{"name":"World Journal of Pediatric Surgery","volume":"6 3","pages":"e000528"},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f8/ff/wjps-2022-000528.PMC10314687.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10104559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}