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Article ; Online: Gestational gigantomastia.

Gerall, Claire D / Jatoi, Ismail

2018 Volume 165, Issue 2, Page(s) 485

MeSH term(s)	Adult ; Breast/abnormalities ; Breast/diagnostic imaging ; Breast/pathology ; Breast/surgery ; Female ; Humans ; Hypertrophy/diagnostic imaging ; Hypertrophy/pathology ; Hypertrophy/surgery ; Magnetic Resonance Imaging ; Mammaplasty ; Pregnancy ; Pregnancy Complications/diagnostic imaging ; Pregnancy Complications/pathology ; Pregnancy Complications/surgery
Language	English
Publishing date	2018-10-30
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	202467-6
ISSN	1532-7361 ; 0039-6060
ISSN (online)	1532-7361
ISSN	0039-6060
DOI	10.1016/j.surg.2018.09.019
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Article ; Online: Assessment of the Nutritional Status and Quality of Life in Chronic Kidney Disease and Kidney Transplant Patients: A Comparative Analysis.

Pawlaczyk, Weronika / Rogowski, Lukasz / Kowalska, Joanna / Stefańska, Małgorzata / Gołębiowski, Tomasz / Mazanowska, Oktawia / Gerall, Claire / Krajewska, Magdalena / Kusztal, Mariusz / Dziubek, Wioletta

Nutrients

2022 Volume 14, Issue 22

Abstract: Background: Chronic kidney disease (CKD) can significantly influence a patient's nutritional status, leading to malnutrition. Malnutrition is associated with an increase in morbidity and hospital admissions, as well as a decrease in functional status. ... ...

Abstract	Background: Chronic kidney disease (CKD) can significantly influence a patient's nutritional status, leading to malnutrition. Malnutrition is associated with an increase in morbidity and hospital admissions, as well as a decrease in functional status. All these factors impact emotional, physical, and psychosocial health, leading to a lower quality of life (QOL). The aim of the study was to assess the nutritional status and QOL in patients with CKD compared to patients after kidney transplantation and determine what factors influence nutritional status and QOL in this patient population. Methods: The study included 167 patients: 39 pre-dialysis patients-group 1; 65 dialysis patients-group 2; 63 kidney transplant patients-group 3. Patients completed the Kidney Disease Quality of Life questionnaire (KDQoL) and the Mini Nutritional Assessment questionnaire (MNA). Results: A comparative analysis of the QOL of patients in the three study groups showed no statistically significant differences in the overall KDQoL scores. Factors that affected quality of life included the designated group, determined by disease status, MNA score, patient age, and WHR. Nearly 1/3 of patients from groups 2 and 3 were at risk of malnutrition. Conclusions: A systematic assessment of nutritional status and monitoring of QOL should be integrated into the standard management guidelines for CKD patients.
MeSH term(s)	Humans ; Quality of Life/psychology ; Nutritional Status ; Kidney Transplantation ; Renal Insufficiency, Chronic/therapy ; Renal Insufficiency, Chronic/psychology ; Malnutrition/diagnosis ; Malnutrition/etiology
Language	English
Publishing date	2022-11-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu14224814
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Article ; Online: Prenatal ultrasound-and MRI-based imaging predictors of respiratory symptoms at birth for congenital lung malformations.

Gerall, Claire / Chumdermpadestuk, Ritah / Jacobs, Shimon / Weijia, Fan / Maddocks, Alexis / Ayyala, Rama / Miller, Russell / Simpson, Lynn / Rothenberg, Steven / Duron, Vincent

Journal of pediatric surgery

2022 Volume 58, Issue 3, Page(s) 420–426

Abstract: Background: Congenital lung malformations (CLM) are rare developmental anomalies of the fetal lung with a minority of patients exhibiting symptoms around the time of birth. Although ultrasound remains the gold standard, fetal MRI has recently been ... ...

Abstract	Background: Congenital lung malformations (CLM) are rare developmental anomalies of the fetal lung with a minority of patients exhibiting symptoms around the time of birth. Although ultrasound remains the gold standard, fetal MRI has recently been incorporated as an adjunct imaging modality in the workup and prenatal counseling of patients with CLM as it is thought to more accurately delineate lesion boundaries and diagnose lesion type. We evaluate what prenatal variables correlate with postnatal respiratory symptoms. Methods: We performed a retrospective review of patients with prenatal diagnosis of CLM treated at our institution between 2006-2020. Fetal ultrasound and magnetic resonance imaging (MRI) parameters including maximal congenital pulmonary airway malformation volume ratio (CVR), absolute cyst volume, and observed to expected normal fetal lung volume (O/E NFLV) were correlated with outcomes including postnatal respiratory symptoms, need for supplementary oxygen or mechanical ventilation, delay in tolerating full feeds, resection in the neonatal period. Results: Our study included 111 patients, all of whom underwent fetal ultrasound with 64 patients additionally undergoing fetal MRI. Postnatal respiratory symptoms were noted in 22.5% of patients, 19.8% required supplemental oxygen, 2.7% mechanical ventilation and two patients requiring urgent resection. Ultrasound parameters including absolute cyst volume and maximal CVR correlated with need for mechanical ventilation (p=0.034 and p=0.024, respectively) and for urgent resection (p=0.018 and p=0.023, respectively) and had a marginal association with postnatal respiratory symptoms (p=0.050 and p=0.052). Absolute cyst volume became associated with postnatal respiratory symptoms (p=0.017) after multivariable analysis controlling for maternal steroid administration and gestational age. O/E NFLV did not correlate with perinatal outcomes. Conclusion: We have found that ultrasound-based measurements correlate with postnatal respiratory symptoms, while MRI derived O/E NFLV does not. Further studies are needed to elucidate the role of MRI in the prenatal workup of congenital lung malformations. Type of study: Study of Diagnostic Test. Level of evidence: Level I.
MeSH term(s)	Pregnancy ; Infant, Newborn ; Female ; Humans ; Lung/abnormalities ; Lung Diseases/congenital ; Respiratory System Abnormalities/diagnostic imaging ; Respiratory System Abnormalities/surgery ; Ultrasonography, Prenatal/methods ; Magnetic Resonance Imaging/methods ; Retrospective Studies
Language	English
Publishing date	2022-09-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2022.08.026
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Article ; Online: Microcystic Adnexal Carcinoma: A Rare, Commonly Misdiagnosed Malignancy.

Gerall, Claire D / Sippel, Michael R / Yracheta, Jaclyn L / Hogan, Fawn S

Military medicine

2019 Volume 184, Issue 11-12, Page(s) 948–950

Abstract: Microcystic adnexal carcinoma (MAC) is a rare, malignant cutaneous neoplasm that often presents as an inconspicuous, benign appearing lesion. Patients most commonly are asymptomatic and present for improved cosmesis, however perineural invasion may ... ...

Abstract	Microcystic adnexal carcinoma (MAC) is a rare, malignant cutaneous neoplasm that often presents as an inconspicuous, benign appearing lesion. Patients most commonly are asymptomatic and present for improved cosmesis, however perineural invasion may result in local numbness, paresthesia or pruritus. Although distant metastasis is rare, MAC has an increased propensity for local invasion, often resulting in significant morbidity as late presentation and misdiagnosis are common. A high index of suspicion is imperative, and deep tissue biopsy with defining histologic characteristics is required for diagnosis. Mohs micrographic surgery is currently the standard of care, providing the highest possibility for long-term cure. We present a case report of a 43-year-old male Air Force U-2 pilot with a benign presentation and initial clinical misdiagnoses of MAC, who underwent Mohs micrographic surgery followed by cervicofacial flap reconstruction of a 5.5 × 3.5 cm defect. We also identify increased radiation exposure of U-2 pilots as a potential risk factor for the early development of MAC, emphasizing the importance of exploring patient risk factors while having a high index of suspicion to aid in early diagnosis.
MeSH term(s)	Adult ; Diagnostic Errors/adverse effects ; Humans ; Male ; Military Personnel ; Mohs Surgery/methods ; Neoplasms, Adnexal and Skin Appendage/diagnosis ; Neoplasms, Adnexal and Skin Appendage/pathology ; Neoplasms, Adnexal and Skin Appendage/surgery ; Pilots ; Skin Neoplasms/diagnosis ; Skin Neoplasms/pathology ; Skin Neoplasms/surgery ; Surgical Flaps/pathology ; Surgical Flaps/surgery
Language	English
Publishing date	2019-06-07
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	391061-1
ISSN	1930-613X ; 0026-4075
ISSN (online)	1930-613X
ISSN	0026-4075
DOI	10.1093/milmed/usz123
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Article ; Online: Emergency department thoracotomy in children: A Pediatric Trauma Society, Western Trauma Association, and Eastern Association for the Surgery of Trauma systematic review and practice management guideline.

Selesner, Leigh / Yorkgitis, Brian / Martin, Matthew / Ng, Grace / Mukherjee, Kaushik / Ignacio, Romeo / Freeman, Jennifer / Wong, Lye-Yeng / Durbin, Samantha / Crandall, Marie / Longshore, Shannon W / Gerall, Claire / Flynn-O'Brien, Katherine T / Jafri, Mubeen

The journal of trauma and acute care surgery

2023 Volume 95, Issue 3, Page(s) 432–441

Abstract: Background: The role of emergency department resuscitative thoracotomy (EDT) in traumatically injured children has not been elucidated. We aimed to perform a systematic review and create evidence-based guidelines to answer the following PICO (population, ...

Abstract	Background: The role of emergency department resuscitative thoracotomy (EDT) in traumatically injured children has not been elucidated. We aimed to perform a systematic review and create evidence-based guidelines to answer the following PICO (population, intervention, comparator, and outcome) question: should pediatric patients who present to the emergency department pulseless (with or without signs of life [SOL]) after traumatic injuries (penetrating thoracic, penetrating abdominopelvic, or blunt) undergo EDT (vs. no EDT) to improve survival and neurologically intact survival? Methods: Using Grading of Recommendations Assessment, Development and Evaluation methodology, a group of 12 pediatric trauma experts from the Pediatric Trauma Society, Western Trauma Association, and Eastern Association for the Surgery of Trauma assembled to perform a systematic review. A consensus conference was conducted, a database was queried, abstracts and manuscripts were reviewed, data extraction was performed, and evidence quality was determined. Evidence tables were generated, and the committee voted on guideline recommendations. Results: Three hundred three articles were identified. Eleven studies met the inclusion criteria and were used for guideline creation, providing 319 pediatric patients who underwent EDT. No data were available on patients who did not undergo EDT. For each PICO, the quality of evidence was very low based on the serious risk of bias and serious or very serious imprecision. Conclusion: Based on low-quality data, we make the following recommendations. We conditionally recommend EDT when a child presents pulseless with SOL to the emergency department following penetrating thoracic injury, penetrating abdominopelvic injury and after blunt injury if emergency adjuncts point to a thoracic source. We conditionally recommend against EDT when a pediatric patient presents pulseless without SOL after penetrating thoracic and penetrating abdominopelvic injury. We strongly recommend against EDT in the patient without SOL after blunt injury.
MeSH term(s)	Child ; Humans ; Consensus ; Emergency Service, Hospital ; Thoracotomy ; Wounds, Nonpenetrating/surgery ; Wounds, Penetrating/surgery ; Systematic Reviews as Topic ; Practice Guidelines as Topic
Language	English
Publishing date	2023-03-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000003879
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Article ; Online: Allocation of resources and development of guidelines for extracorporeal membrane oxygenation (ECMO): Experience from a pediatric center in the epicenter of the COVID-19 pandemic.

Gerall, Claire / Cheung, Eva W / Klein-Cloud, Rafael / Kreines, Erica / Brewer, Michael / Middlesworth, William

Journal of pediatric surgery

2020 Volume 55, Issue 12, Page(s) 2548–2554

Abstract: The rapid spread of coronavirus disease 2019 (COVID-19) has exceeded the standard capacity of many hospital systems and led to an unprecedented scarcity of resources, including the already limited resource of extracorporeal membrane oxygenation (ECMO). ... ...

Abstract	The rapid spread of coronavirus disease 2019 (COVID-19) has exceeded the standard capacity of many hospital systems and led to an unprecedented scarcity of resources, including the already limited resource of extracorporeal membrane oxygenation (ECMO). With the large amount of critically ill patients and the highly contagious nature of the virus, significant consideration of ECMO candidacy is crucial for both appropriate allocation of resources as well as ensuring protection of health care personnel. As a leading pediatric ECMO program in the epicenter of the pandemic, we established new protocols and guidelines in order to continue caring for our pediatric patients while accepting adult patients to lessen the burden of our hospital system which was above capacity. This article describes our changes in consultation, cannulation, and daily care of COVID-19 positive patients requiring ECMO as well as discusses strategies for ensuring safety of our ECMO healthcare personnel and optimal allocation of resources. LEVEL OF EVIDENCE: Level V.
MeSH term(s)	Adult ; COVID-19/therapy ; Child ; Extracorporeal Membrane Oxygenation/economics ; Extracorporeal Membrane Oxygenation/standards ; Health Care Rationing/economics ; Health Care Rationing/organization & administration ; Humans ; Practice Guidelines as Topic ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-08-26
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2020.08.015
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Article ; Online: Primary gastrojejunostomy tube placement using laparoscopy with endoscopic assistance: A novel technique.

Gerall, Claire / Mencin, Ali-Andre / DeFazio, Jennifer / Griggs, Cornelia / Kabagambe, Sandra / Duron, Vincent

Journal of pediatric surgery

2020 Volume 56, Issue 2, Page(s) 412–416

Abstract: Background: Gastrojejunostomy (GJ) tubes are commonly used to provide postpyloric enteral nutrition in pediatric patients who cannot tolerate gastric feeds. Most techniques depend on a preexisting gastrostomy tube (GT) site to convert to a ... ...

Abstract	Background: Gastrojejunostomy (GJ) tubes are commonly used to provide postpyloric enteral nutrition in pediatric patients who cannot tolerate gastric feeds. Most techniques depend on a preexisting gastrostomy tube (GT) site to convert to a gastrojejunostomy. Several minimally invasive techniques have been described; however, their risk profile varies widely. Description of the operative technique: We present a technique for primary laparoscopic GJ tube placement that minimizes the risk of hollow viscus injury and the use of fluoroscopy through endoscopic assistance. Results: Eleven GJ tubes were placed using this technique in patients ranging from 5 months to 17 years of age and weighing 6.3 to 46.0 kg. Endoscopy through the gastrostomy site allowed direct visualization of wire and tube placement. There were no intraoperative or postoperative complications within 30 days of operation. Use of fluoroscopy was limited with minimal total radiation exposure. Conclusion: The described technique of laparoscopic primary gastrojejunostomy tube placement with endoscopic assistance was associated with a low complication rate and minimal use of fluoroscopy. Level of evidence: IV.
MeSH term(s)	Child ; Enteral Nutrition ; Gastric Bypass ; Gastrostomy ; Humans ; Intubation, Gastrointestinal ; Laparoscopy
Language	English
Publishing date	2020-11-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/j.jpedsurg.2020.10.012
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Article ; Online: Multisystem Inflammatory Syndrome in Children Mimicking Surgical Pathologies: What Surgeons Need to Know about MIS-C.

Gerall, Claire D / Duron, Vincent P / Griggs, Cornelia L / Kabagambe, Sandra K / Maddocks, Alexis B / DeFazio, Jennifer R

Annals of surgery

2020 Volume 273, Issue 4, Page(s) e146–e148

MeSH term(s)	Appendicitis/diagnosis ; COVID-19/epidemiology ; COVID-19/surgery ; Child ; Comorbidity ; Female ; Humans ; Magnetic Resonance Imaging/methods ; SARS-CoV-2 ; Surgical Procedures, Operative/methods ; Systemic Inflammatory Response Syndrome/epidemiology ; Systemic Inflammatory Response Syndrome/surgery
Language	English
Publishing date	2020-10-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000004368
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Article ; Online: Allocation of resources and development of guidelines for extracorporeal membrane oxygenation (ECMO)

Gerall, Claire / Cheung, Eva W. / Klein-Cloud, Rafael / Kreines, Erica / Brewer, Michael / Middlesworth, William

Journal of Pediatric Surgery ; ISSN 0022-3468

Experience from a pediatric center in the epicenter of the COVID-19 pandemic

2020

Keywords	Pediatrics, Perinatology, and Child Health ; Surgery ; General Medicine ; covid19
Language	English
Publisher	Elsevier BV
Publishing country	us
Document type	Article ; Online
DOI	10.1016/j.jpedsurg.2020.08.015
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Allocation of resources and development of guidelines for extracorporeal membrane oxygenation (ECMO): Experience from a pediatric center in the epicenter of the COVID-19 pandemic

Gerall, Claire / Cheung, Eva W / Klein-Cloud, Rafael / Kreines, Erica / Brewer, Michael / Middlesworth, William

J. pediatr. surg

Abstract	The rapid spread of coronavirus disease 2019 (COVID-19) has exceeded the standard capacity of many hospital systems and led to an unprecedented scarcity of resources, including the already limited resource of extracorporeal membrane oxygenation (ECMO). With the large amount of critically ill patients and the highly contagious nature of the virus, significant consideration of ECMO candidacy is crucial for both appropriate allocation of resources as well as ensuring protection of health care personnel. As a leading pediatric ECMO program in the epicenter of the pandemic, we established new protocols and guidelines in order to continue caring for our pediatric patients while accepting adult patients to lessen the burden of our hospital system which was above capacity. This article describes our changes in consultation, cannulation, and daily care of COVID-19 positive patients requiring ECMO as well as discusses strategies for ensuring safety of our ECMO healthcare personnel and optimal allocation of resources. LEVEL OF EVIDENCE: Level V.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #733734
Database	COVID19

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