Digestive System Diseases Commons^™

Pain Management In Perforated Appendicitis: Transitioning To A Minimal Narcotic Strategy, Seth Saylors, Meredith Elman, Pablo Aguayo, Rebecca M. Rentea, Richard J. Hendrickson, David Juang, Charles L. Snyder, Jason D. Fraser, Tolulope A. Oyetunji Md Mph, Shawn D. St Peter, Nelimar Cruz-Centeno, Charles Marchese

Research Days

Introduction: Patient controlled analgesia (PCA) was previously standard for postoperative pain control in children with perforated appendicitis at our institution. We previously reported the equivocal outcome of intravenous (IV) acetaminophen as a pain control adjunct used to transition from PCA to oral narcotics. We have since transitioned to a PCA-free, multi-modal pain control regimen postoperatively in perforated appendicitis. Through observational study, we aim to describe the impact of our new pain control regimen on postoperative narcotic use.

Methods: Children– June 2020 at a single freestanding children’s hospital were reviewed. Details of their hospitalization, including demographic, operative, anesthesia, pain management, and …

Sigirr Variants Identified In Nec Infants Exaggerate Toll-Like Receptor Mediated Inflammation, Jennie Godwin

Research Days

Background: A key event underlying uncontrolled inflammation in necrotizing enterocolitis (NEC) is pathologic activation of Toll-like receptors (TLR). TLR4 recognizes lipopolysaccharide (LPS), from Gramnegative bacteria, and TLR2 peptidoglycans (PAM3Csyk4, PAM), from Gram-positive bacteria. TLR4 and TLR2 signaling events induce an inflammatory cascade through NF-kB, a cytokine inducing transcription factor. Single-immunoglobulin interleukin-1-related receptor (SIGIRR) is a major negative regulator of TLR-mediated NF-kB activation. Previous work from our lab suggests that loss of function in SIGIRR may predispose to NEC. Our lab has identified four variants in NEC patients predicted to alter function of SIGIRR. We hypothesized that identified SIGIRR variants will …

Reconsidering Perioperative Antibiotic Use In Elective Laparoscopic Cholecystectomy, Kayla B. Briggs

Research Days

Background: As rates of antimicrobial resistance increase, the use of prophylactic perioperative antibiotics (PPA) has been questioned in cases with a low risk of surgical site infection (SSI). In laparoscopic cholecystectomy performed for biliary dyskinesia, hyperkinetic gallbladder, and gallbladder polyps, the use of PPA varies with no widely accepted practice pattern.

Objectives/Goal: We examined institutional PPA usage and SSI rates for elective laparoscopic cholecystectomy to determine if PPAs are indicated.

Methods/Design: Following IRB approval, children/2010 and 8/2020 for symptomatic cholelithiasis, biliary dyskinesia, hyperkinetic gallbladder, and/or gallbladder polyps were included. Several surgeons changed practice to selective PPA use in 2016, decreasing …

The Role Of Fractionated Exhaled Nitric Oxide (Feno) In Eosinophilic Esophagitis And The Relationship With Downstream Eosinophils, Panamdeep Kaur

Research Days

Background: Eosinophilic Esophagitis (EoE) is a chronic immune mediated disease of the esophagus characterized by symptoms of esophageal dysfunction and eosinophilic-predominant inflammation of the esophagus. It can lead to feeding difficulties, failure to thrive, and esophageal stricturing. Currently, the gold standard for diagnosis and assessing response to therapy is upper endoscopy and histopathological analysis of biopsies. A noninvasive, cost-effective, and low risk alternative that can aid in the management of EoE is not currently available. Previous studies assessing correlation of fractionated exhaled nitric oxide (FeNO) with degree of esophageal eosinophilic inflammation were low powered but noted a trend for association. …

Setting A Threshold For Discharge Antibiotics In Children With Perforated Appendicitis: A Study Update, Kayla B. Briggs

Research Days

Background: To address concerns of antibiotic overutilization, normal white blood cell count (WBC) for age was previous l criteria for discontinuing antibiotics at discharge in perforated appendicitis. Retrospective review suggested a decrease in threshold for additional antibiotic administration to a discharge WBC(IAA).

Objectives/Goal: The purpose of our study is to determine if lowering the threshold for additional antibiotic administration decreased the rate of IAA after laparoscopic appendectomy for perforated appendicitis in children who were not discharged with additional antibiotics.

Methods/Design: Following IRB approval, prospective data was retrospectively reviewed. Children with perforated appendicitis identified during laparoscopic appendectomy at our institution between …

Similac Special Care And Elecare Cause Neonatal Gut Injury In Mice, Karishma Rao, Heather L. Menden, Wei Yu, Inamul Haque, Susana Chavez-Bueno, Alain C. Cuna, Shahid Umar, Venkatesh Sampath

Research Days

No abstract provided.

Methotrexate Polyglutamates As Biomarkers Of Treatment Response In Ibd Vs. Jia, Ryan Morrow

Research Days

No abstract provided.

Pediatric Ppi Use And Fractures, Nathan R. Fleishman Md, Thomas M. Attard, Troy E. Richardson

Research Days

No abstract provided.

Effect Of Crohn’S Disease On Villous Length And Cyp3a4 Expression In The Pediatric Small Intestine, Brian D. Chapron

Research Days

No abstract provided.