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CPVT (catecholaminergic Polymorphic Ventricular Tachycardia)

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Guidelines require no events for six months, a functional device, and medication compliance before allowing return to sports — John, Cardiac Sympathectomy: Update Course 2017 · 18:50

Cardiac Sympathectomy: Update Course 2017
At the 5th Annual Stay Current Pediatric Surgery Update Course in 2017, Drs John Clark and Sophia Abdulhai discuss cardiac sympathectomy for ventricular arrhythmia. They review technique including amount of stellate ganglion to resect, bene
video28:38 · Sep 2018
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Top Ten Things to Remember from the 2017 Stay Current Annual Update Course...
This podcast recording highlights the things to remember from the recent Stay Current Annual Pediatric Surgery Update Course 2017 (also available in video format), with top ten topics including: gastric stimulation, cardiac sympathectomy, d
podcast25:04 · Sep 2018
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Top Ten Things to Remember: Update Course 2017
This video highlights the things to remember from the recent Stay Current Annual Pediatric Surgery Update Course 2017, with the top ten topics including: gastric stimulation, cardiac sympathectomy, diaphragmatic pacing, abdominal wall recon
video25:04 · Sep 2018
Watch →
Top Ten Things to Remember: Update Course 2017
This video highlights the things to remember from the recent Stay Current Annual Pediatric Surgery Update Course 2017, with the top ten topics including: gastric stimulation, cardiac sympathectomy, diaphragmatic pacing, abdominal wall recon
podcast25:04 · Jan 2021
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Top Ten Things to Remember from the 2017 Stay Current Annual Update Course...
Gastric stimulation for pediatric gastroparesis can be tested temporarily via endoscopic placement before permanent laparoscopic or open implantation
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position0:00
Reynaldo Garcia from Akron Children's Hospital presented gastric stimulation results showing significant symptom improvement in patients with persistent nausea and vomiting unresponsive to medical therapy
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position0:00
Cardiac sympathectomy for CPVT (catecholaminergic polymorphic ventricular tachycardia) and hypertrophic cardiomyopathy involves high thoracoscopic approach to the lower stellate ganglion to prevent fatal arrhythmias
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position0:00
Sophia Abdulhai and John Clark presented cardiac sympathectomy technique using clips and scissors for partial stellate ganglion resection, avoiding electrocautery to prevent Horner's syndrome
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position0:00
Sympathectomy provides 100% compliance for arrhythmia management as patients cannot skip the intervention once performed
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position0:00
Ray Anders from University Hospitals of Cleveland demonstrated diaphragm pacing for spinal cord injury, transverse myelitis, acute flaccid myelitis, and brain stem tumors, with youngest implant at one year of age
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
Diaphragm pacing requires intact phrenic nerve and motor neurons; diaphragm contraction with neurostimulation must be confirmed before implantation
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
Dave Carpata from Cleveland Clinic stated biologic mesh is not appropriate for bridging gaps in ventral hernia repair, only for temporary solution or reinforcement
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
The best mesh for ventral hernia repair is macroporous monofilament lightweight polypropylene synthetic mesh such as Marlex, which performs well in contaminated fields in retromuscular space
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
Retrorectus repair with mesh is superior to laparoscopic underlay for ventral hernia repair
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
Posterior component separation has less wound morbidity than anterior component separation while providing space for wide mesh overlap and minimal fixation
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
David Lanning from Virginia Commonwealth presented gastroesophageal disconnection (esophageal division with Roux-en-Y jejunal interposition) for severe reflux after failed Nissen fundoplication
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
Gastroesophageal disconnection may be appropriate as primary repair for high-risk patients predicted to fail fundoplication
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
Laparoscopic gastroesophageal disconnection can take 6 to 8 hours
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
Patients who took full feeds by mouth preoperatively can continue oral feeding after gastroesophageal disconnection
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position3:00
Chris Druck published a five-variable prediction rule identifying low-risk population for intra-abdominal injury after blunt trauma to guide CT scan decisions
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
Patients with only abdominal pain after trauma have approximately 5% risk of abdominal injury and nearly 0% chance of requiring intervention
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
Patients with abnormal physical exam findings such as handlebar injury have approximately 15% chance of abdominal injury
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
The low-risk group (55% of trauma population) has less than 5% risk of any injury and less than 0.3% risk of injury requiring acute intervention
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
Patients without abdominal wall trauma, tenderness or distention, with normal chest X-ray, no abdominal pain complaints, normal AST, and normal pancreatic enzymes probably do not need CT scan and can be sent home
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
The ATOMAC prospective multi-institutional solid organ injury protocol de-emphasizes injury grade in favor of clinical predictive factors
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
Patients with solid organ injury who do not respond to 20 cc/kg crystalloid bolus should receive 10-20 cc/kg blood bolus rather than second crystalloid bolus
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
Patients requiring 40 cc/kg blood (4 units) or with hemoglobin less than 7 after blood transfusion should go to the operating room as this indicates non-operative management failure
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
Stable solid organ injury patients can be admitted to the floor with vitals every 2-4 hours and hemoglobin at 6 hours, and discharged the next day if they never required blood transfusion
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
Sean Saint Peter's group demonstrated stable solid organ injury patients can be discharged much more quickly than traditional prolonged admissions based on injury grade
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position7:00
Mike Rubin from Akron Children's Hospital recommends chest CT for suspected airway foreign bodies in unclear cases, with nearly 100% sensitivity for detecting radiolucent and radiopaque foreign bodies
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position13:00
CT scan for suspected airway foreign body eliminates unnecessary bronchoscopies in children with respiratory virus symptoms
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position13:00
Oral contrast is unnecessary for suspected bowel obstruction CT scans as intraluminal fluid serves as adequate contrast
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position13:00
Eliminating oral contrast speeds up CT acquisition time and prevents nausea and vomiting in bowel obstruction patients
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position13:00
Unsuccessful intussusception reduction should be reattempted if there is movement to the ileocecal valve, with second attempts mostly successful
Host summaryTodd Ponsky summarizing a resource — not the host's own clinical position13:00
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