Articles: retrospective-studies.
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Paediatric anaesthesia · Mar 2025
Retrospective Cohort Study of Perioperative Complications in Symptomatic and Asymptomatic Children Testing SARS-CoV-2-Positive Within 21 Days Before Surgery.
COVID-19 increases anesthetic risk in children, but understanding of complication differences by symptom presence and severity is limited. We hypothesized that symptomatic COVID-19+ children, especially with lower respiratory symptoms, would have higher perioperative complications than asymptomatic patients and that complications would be higher in all patients diagnosed < 6 days before anesthesia. ⋯ The presence of symptoms, particularly of the lower respiratory tract, should be strongly considered in the shared decision-making process between providers and families when discussing the potential delay of procedures in the setting of COVID-19.
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Surveillance studies offer sparse knowledge of predictors of future growth in sporadic vestibular schwannomas (VS).Our aim was identification of these risk factors. We propose a scoring system to estimate the risk of growth in sporadic vestibular schwannoma. ⋯ Our retrospective study revealed that younger age, cystic morphology, cisternal extent, larger volume, and growth during 1st year were strong predictors of future growth. Moreover, we propose a scoring system that accurately estimates the risks of future tumor growth.
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Pain is common during pregnancy yet there are few contemporary studies of opioid utilisation in pregnancy. We aimed to describe prescription analgesic opioid use during pregnancy across four regions: Oceania [New South Wales (Australia), New Zealand], North America [Ontario (Canada), United States (US)], Northern Europe [Denmark, Finland, Iceland, Norway, Sweden, United Kingdom (UK)], and East Asia (Hong Kong, South Korea, Taiwan). ⋯ In this large multinational study, we observed wide global variation in prevalence of analgesic opioid use in pregnancy, yet patterns of use by sociodemographic- and pregnancy characteristics were relatively consistent. Analgesic opioid use remained stable or downward trending over time in most, but not all, countries.
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Periacetabular osteotomy (PAO) is an established treatment for symptomatic developmental hip dysplasia. Epidural analgesia is traditionally used for perioperative pain management but may have negative secondary effects, including distal motor and sensory deficits, and hypotension which delays rehabilitation and prolongs discharge. One alternative is Erector Spinae Plane Block (ESPB), an ultrasound-guided injection or catheter insertion remote to the spinal canal. Despite high success with minimal complications, ESPB use during PAO has not been studied. This study's purpose was to retrospectively evaluate the efficacy and side effect profile of ESPB compared to epidural analgesia for PAO pain control. ⋯ ESPB provides an effective method of pain control for PAO patients. Compared to lumbar epidurals, patients required less systemic opioids and reported fewer side effects, particularly numbness, symptomatic hypotension, and weakness. ESPB is an attractive option in multimodal pain protocol for PAO.
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The treatment of acute uncomplicated diverticulitis (UD) with antibiotics remains common despite substantial evidence supporting the non-inferiority of nonantibiotic outpatient management. In the past 15 years, there have been two landmark randomized-controlled clinical trials, follow-up studies, and numerous retrospective studies that have supported the non-inferiority of nonantibiotic management of UD. Multiple medical societies including the American Gastroenterological Association and the American College of Physicians recommend using antibiotics selectively rather than routinely in UD. We aim to raise physician awareness of the latest guideline recommendations through our article, potentially improving antibiotic stewardship and reducing related healthcare costs.