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  1. Article ; Online: Optimizing Triage Practice in Pediatric Trauma: Lessons From Under-triage and Over-triage Rates and Risk Factors.

    Ngo, Lisa C / Carroll, Hayley M / Massimilian, Stephanie Salgueiro / Garapaty, Nikitha / Palladino, Kelsey / Samuels, Shenae K / Lao, Oliver B / Parreco, Joshua P / Levene, Tamar

    The American surgeon

    2024  , Page(s) 31348241241693

    Abstract: Background: Triage accuracy is essential for delivering effective trauma care, especially in the pediatric population where unique challenges exist. The purpose of this study was to investigate risk factors contributing to under-triage and over-triage ... ...

    Abstract Background: Triage accuracy is essential for delivering effective trauma care, especially in the pediatric population where unique challenges exist. The purpose of this study was to investigate risk factors contributing to under-triage and over-triage in an urban pediatric trauma center.
    Methods: This retrospective cohort study included all trauma activations at an urban level 1 trauma center between January 1, 2021, and July 31, 2023 (patients <18 years old.) Patients who were under- or over-triaged were identified based on the level of trauma activation and injury severity score.
    Results: There were 1094 trauma activations included in this study. The rate of under-triage was 3.8% (n = 42) and over-triage was 13.6% (n = 149). Infants aged 0-1 years had the highest rate of under-triage (10.9%, n = 19,
    Discussion: This study reveals the complexity of trauma triage in the pediatric population. We identified key predictive factors, such as age, comorbidities, and mechanism of injury, that can be used to refine triage practices and improve the care of pediatric trauma patients.
    Language English
    Publishing date 2024-03-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    DOI 10.1177/00031348241241693
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Social determinants of health in pediatric trauma: Associations with injury mechanisms and outcomes in the context of the COVID-19 pandemic.

    Avila, Azalia / Lao, Oliver B / Neville, Holly L / Yorkgitis, Brian K / Chang, Henry L / Thatch, Keith / Plumley, Donald / Larson, Shawn D / Fitzwater, John W / Markley, Michele / Pedroso, Felipe / Fischer, Anne / Armstrong, Lindsey B / Petroze, Robin T / Snyder, Christopher W

    American journal of surgery

    2023  Volume 228, Page(s) 107–112

    Abstract: Background: Relationships between social determinants of health and pediatric trauma mechanisms and outcomes are unclear in context of COVID-19.: Methods: Children <16 years old injured between 2016 and 2021 from ten pediatric trauma centers in ... ...

    Abstract Background: Relationships between social determinants of health and pediatric trauma mechanisms and outcomes are unclear in context of COVID-19.
    Methods: Children <16 years old injured between 2016 and 2021 from ten pediatric trauma centers in Florida were included. Patients were stratified by high vs. low Social Vulnerability Index (SVI). Injury mechanisms studied were child abuse, ATV/golf carts, and firearms. Mechanism incidence trends and mortality were evaluated by interrupted time series and multivariable logistic regression.
    Results: Of 19,319 children, 68% and 32% had high and low SVI, respectively. Child abuse increased across SVI strata and did not change with COVID. ATV/golf cart injuries increased after COVID among children with low SVI. Firearm injuries increased after COVID among children with high SVI. Mortality was predicted by injury mechanism, but was not independently associated with SVI, race, or COVID.
    Conclusion: Social vulnerability influences pediatric trauma mechanisms and COVID effects. Child abuse and firearm injuries should be targeted for prevention.
    MeSH term(s) Child ; Humans ; Adolescent ; Firearms ; Pandemics ; Social Determinants of Health ; Wounds, Gunshot/epidemiology ; COVID-19/epidemiology ; Retrospective Studies
    Language English
    Publishing date 2023-08-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/j.amjsurg.2023.08.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Laparoscopic transperitoneal repair of pediatric diaphragm eventration using an endostapler device.

    Lao, Victoria Valinluck / Lao, Oliver B / Abdessalam, Shahab F

    Journal of laparoendoscopic & advanced surgical techniques. Part A

    2013  Volume 23, Issue 9, Page(s) 808–813

    Abstract: Background: Minimally invasive repairs of pediatric diaphragm eventration have been well described via a thoracoscopic approach, oftentimes requiring single-lung ventilation and tube thoracostomy, with the disadvantage of not being able to clearly ... ...

    Abstract Background: Minimally invasive repairs of pediatric diaphragm eventration have been well described via a thoracoscopic approach, oftentimes requiring single-lung ventilation and tube thoracostomy, with the disadvantage of not being able to clearly visualize what lies beneath the diaphragm. We describe a novel pediatric diaphragm eventration repair using a laparoscopic transperitoneal approach and an endostapler device. We also describe our initial experience with this technique.
    Patients and methods: Four pediatric diaphragmatic eventration patients underwent laparoscopic transperitoneal repair using an endostapler device. Repairs were performed in both male and female patients with right-sided eventrations. We approach the repair in a transperitoneal fashion using inverting sutures at the apex of the diaphragm to create tension toward the pelvis. Subsequently, an endostapler is used to remove the redundant portion of diaphragm, leaving a repaired, taut diaphragm.
    Results: The median age at operation was 10.5 months. The median operative time was 70 minutes. There was no mortality, surgical complications, or recurrence at a median follow-up of 17 months.
    Conclusions: This laparoscopic approach allows for clear visualization of the intraabdominal organs and, at least in our early experience, a very simple, straightforward operation. Additionally, with the use of the endostapler, the redundant, often weakened diaphragm is removed, leaving the native, healthy diaphragm behind, resulting in a reliable and reproducible repair. This repair should be considered as a feasible alternative approach to the more traditional open and thoracoscopic repairs.
    MeSH term(s) Child ; Diaphragm/surgery ; Diaphragmatic Eventration/surgery ; Female ; Humans ; Infant ; Laparoscopy/methods ; Male ; Minimally Invasive Surgical Procedures ; Operative Time ; Peritoneum/surgery ; Surgical Stapling/instrumentation ; Surgical Stapling/methods
    Language English
    Publishing date 2013-08-12
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 1381909-4
    ISSN 1557-9034 ; 1092-6429
    ISSN (online) 1557-9034
    ISSN 1092-6429
    DOI 10.1089/lap.2013.0113
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Postoperative Bowel Perforation due to Heterotopic Ossification (Myositis Ossificans Traumatica): A Case Report and Review of the Literature.

    Lao, Victoria Valinluck / Lao, Oliver B / Figueredo, Edgar

    Case reports in gastrointestinal medicine

    2011  Volume 2011, Page(s) 908514

    Abstract: Heterotopic ossification (HO) is the ectopic development of normal bone within soft tissue that can occur after traumatic injury. It is uncommon and may be missed or misdiagnosed, which can lead to complications. We report the case of an 84-year-old male ...

    Abstract Heterotopic ossification (HO) is the ectopic development of normal bone within soft tissue that can occur after traumatic injury. It is uncommon and may be missed or misdiagnosed, which can lead to complications. We report the case of an 84-year-old male with a previous history of a laparotomy who underwent resection of an intra-abdominal tumor through a midline incision. On postoperative day six, the patient was taken to the operating room, as succus was draining from the incision. Upon re-exploration, sharp bone-like material was found in the wound directly adjacent to an enterotomy. Pathology confirmed mature lamellar bone and the diagnosis of HO. This is the first report of postoperative intestinal perforation secondary to HO in a midline wound. We report this case to encourage accurate reporting of HO and its morbidity and complications for the benefit of appropriate surgical planning and epidemiologic tracking of outcomes.
    Language English
    Publishing date 2011-07-10
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2627636-7
    ISSN 2090-6536 ; 2090-6528
    ISSN (online) 2090-6536
    ISSN 2090-6528
    DOI 10.1155/2011/908514
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Postoperative Bowel Perforation due to Heterotopic Ossification (Myositis Ossificans Traumatica)

    Edgar Figueredo / Oliver B. Lao / Victoria Valinluck Lao

    Case Reports in Gastrointestinal Medicine, Vol

    A Case Report and Review of the Literature

    2011  Volume 2011

    Keywords Diseases of the digestive system. Gastroenterology ; RC799-869 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R ; DOAJ:Gastroenterology ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Language English
    Publishing date 2011-01-01T00:00:00Z
    Publisher Hindawi Publishing Corporation
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Widespread employment of conserved C. elegans homeobox genes in neuronal identity specification.

    Reilly, Molly B / Tekieli, Tessa / Cros, Cyril / Aguilar, G Robert / Lao, James / Toker, Itai Antoine / Vidal, Berta / Leyva-Díaz, Eduardo / Bhattacharya, Abhishek / Cook, Steven J / Smith, Jayson J / Kovacevic, Ismar / Gulez, Burcu / Fernandez, Robert W / Bradford, Elisabeth F / Ramadan, Yasmin H / Kratsios, Paschalis / Bao, Zhirong / Hobert, Oliver

    PLoS genetics

    2022  Volume 18, Issue 9, Page(s) e1010372

    Abstract: Homeobox genes are prominent regulators of neuronal identity, but the extent to which their function has been probed in animal nervous systems remains limited. In the nematode Caenorhabditis elegans, each individual neuron class is defined by the ... ...

    Abstract Homeobox genes are prominent regulators of neuronal identity, but the extent to which their function has been probed in animal nervous systems remains limited. In the nematode Caenorhabditis elegans, each individual neuron class is defined by the expression of unique combinations of homeobox genes, prompting the question of whether each neuron class indeed requires a homeobox gene for its proper identity specification. We present here progress in addressing this question by extending previous mutant analysis of homeobox gene family members and describing multiple examples of homeobox gene function in different parts of the C. elegans nervous system. To probe homeobox function, we make use of a number of reporter gene tools, including a novel multicolor reporter transgene, NeuroPAL, which permits simultaneous monitoring of the execution of multiple differentiation programs throughout the entire nervous system. Using these tools, we add to the previous characterization of homeobox gene function by identifying neuronal differentiation defects for 14 homeobox genes in 24 distinct neuron classes that are mostly unrelated by location, function and lineage history. 12 of these 24 neuron classes had no homeobox gene function ascribed to them before, while in the other 12 neuron classes, we extend the combinatorial code of transcription factors required for specifying terminal differentiation programs. Furthermore, we demonstrate that in a particular lineage, homeotic identity transformations occur upon loss of a homeobox gene and we show that these transformations are the result of changes in homeobox codes. Combining the present with past analyses, 113 of the 118 neuron classes of C. elegans are now known to require a homeobox gene for proper execution of terminal differentiation programs. Such broad deployment indicates that homeobox function in neuronal identity specification may be an ancestral feature of animal nervous systems.
    MeSH term(s) Animals ; Caenorhabditis elegans/genetics ; Caenorhabditis elegans/metabolism ; Caenorhabditis elegans Proteins/metabolism ; Cell Differentiation/genetics ; DNA-Binding Proteins/genetics ; Employment ; Gene Expression Regulation, Developmental ; Genes, Homeobox/genetics ; Neurons/metabolism ; Transcription Factors/genetics ; Transcription Factors/metabolism
    Chemical Substances Caenorhabditis elegans Proteins ; DNA-Binding Proteins ; Transcription Factors
    Language English
    Publishing date 2022-09-30
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2186725-2
    ISSN 1553-7404 ; 1553-7390
    ISSN (online) 1553-7404
    ISSN 1553-7390
    DOI 10.1371/journal.pgen.1010372
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Pediatric inguinal hernias, hydroceles, and undescended testicles.

    Lao, Oliver B / Fitzgibbons, Robert J / Cusick, Robert A

    The Surgical clinics of North America

    2012  Volume 92, Issue 3, Page(s) 487–504, vii

    Abstract: Pediatric inguinal hernias are extremely common, and can usually be diagnosed by simple history taking and physical examination. Repair is elective, unless there is incarceration or strangulation. Hydroceles are also quite common, and in infancy many ... ...

    Abstract Pediatric inguinal hernias are extremely common, and can usually be diagnosed by simple history taking and physical examination. Repair is elective, unless there is incarceration or strangulation. Hydroceles are also quite common, and in infancy many will resolve without operative intervention. Undescended testicles harbor an increased risk of infertility and malignancy, and require orchiopexy in early childhood.
    MeSH term(s) Adolescent ; Cryptorchidism/diagnosis ; Cryptorchidism/surgery ; Hernia, Inguinal/diagnosis ; Hernia, Inguinal/embryology ; Hernia, Inguinal/epidemiology ; Hernia, Inguinal/surgery ; Herniorrhaphy ; Humans ; Infant ; Infant, Newborn ; Laparoscopy ; Male ; Orchiopexy ; Testicular Hydrocele/diagnosis ; Testicular Hydrocele/surgery
    Language English
    Publishing date 2012-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 215713-5
    ISSN 1558-3171 ; 0039-6109
    ISSN (online) 1558-3171
    ISSN 0039-6109
    DOI 10.1016/j.suc.2012.03.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Pre-transplant therapy for hepatocellular carcinoma is associated with a lower recurrence after liver transplantation.

    Lao, Oliver B / Weissman, Jennifer / Perkins, James D

    Clinical transplantation

    2009  Volume 23, Issue 6, Page(s) 874–881

    Abstract: ... nine factors [body mass index, Asian race, hepatitis B, prior HCC therapy, alpha-fetoprotein (AFP ...

    Abstract Background: Hepatic transplantation has been advocated as an effective treatment for hepatocellular carcinoma (HCC). We seek to determine if pre-transplant therapies can reduce post-transplant recurrence.
    Methods: We conducted a retrospective review of prospective data in patients undergoing transplantation for HCC 2001-2006. Patients were followed for recurrence every six months with abdominal computerized tomography or magnetic resonance imaging. Logistic regression analyzed recipient factors such as prior treatment for HCC, donor, operative, and tumor factors in comparing patients developing HCC recurrence with those without recurrence.
    Results: During the study period, we performed 124 hepatic transplants for HCC [age: 55 +/- 7.6 yr; 104 (85%) male, 81 (66%) white, and 32 (26%) Asian]. Recurrence was found in nine at a mean of 2.6 yr follow-up. Thirty-three patients (27%) had pre-transplant treatment (radiofrequency ablation, transarterial chemoembolization or percutaneous ethanol injection). Univariable logistic regression identified nine factors [body mass index, Asian race, hepatitis B, prior HCC therapy, alpha-fetoprotein (AFP), model for end-stage liver disease (MELD) score, bilirubin, and international normalized ratio] predictive of HCC recurrence at a level of p < 0.1. Multiple logistic regression analysis of six of the nine selected factors demonstrated AFP level >1000, calculated pre-transplant MELD score <14, and the lack of any pre-transplant treatment were significantly associated with recurrence of HCC. No patient with prior HCC therapy had recurrence.
    Conclusions: In patients with HCC awaiting hepatic transplantation, there is a reduced rate of recurrence of HCC if tumors are pre-treated with liver-directed therapy. By treating HCC tumors with any type of treatment prior to transplant, we can significantly reduce the odds of HCC recurrence after transplant.
    MeSH term(s) Carcinoma, Hepatocellular/diagnosis ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/therapy ; Catheter Ablation/methods ; Chemoembolization, Therapeutic/methods ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms/diagnosis ; Liver Neoplasms/epidemiology ; Liver Neoplasms/therapy ; Liver Transplantation ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local/diagnosis ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Recurrence, Local/prevention & control ; Preoperative Care/methods ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome ; United States/epidemiology
    Language English
    Publishing date 2009-11
    Publishing country Denmark
    Document type Comparative Study ; Journal Article
    ZDB-ID 639001-8
    ISSN 1399-0012 ; 0902-0063
    ISSN (online) 1399-0012
    ISSN 0902-0063
    DOI 10.1111/j.1399-0012.2009.00993.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Extracorporeal life support for adults with malignancy and respiratory or cardiac failure: The Extracorporeal Life Support experience.

    Gow, Kenneth W / Lao, Oliver B / Leong, Traci / Fortenberry, James D

    American journal of surgery

    2010  Volume 199, Issue 5, Page(s) 669–675

    Abstract: Background: Adults with cancer may be considered for extracorporeal life support (ECLS) as a means of support if failing conventional therapy.: Methods: The Extracorporeal Life Support Organization Registry was queried for patients aged >or=21 years ... ...

    Abstract Background: Adults with cancer may be considered for extracorporeal life support (ECLS) as a means of support if failing conventional therapy.
    Methods: The Extracorporeal Life Support Organization Registry was queried for patients aged >or=21 years with diagnoses of malignancy or hematopoietic stem cell transplantation.
    Results: Seventy-two adults met inclusion criteria: 47 with solid tumors, 21 with hematologic malignancies, and 4 with hematopoietic stem cell transplantation. Patients required ECLS primarily for pulmonary support (n = 54). The median duration of ECLS was 4.1 days. Overall, 44 patients (61%) died on ECLS, 23 (32%) survived to hospital discharge, and 5 (7%) survived ECLS but died before discharge. Risk factors for death include pulmonary support as reason for ECLS, impaired lung function before ECLS, and development of infection.
    Conclusions: Adults with cancer can be offered ECLS with a small but real expectation for survival. Impaired pulmonary status and the development of infections are associated with death.
    MeSH term(s) Adult ; Aged ; Extracorporeal Membrane Oxygenation/methods ; Female ; Heart Failure/etiology ; Heart Failure/mortality ; Heart Failure/therapy ; Hematologic Neoplasms/complications ; Hematologic Neoplasms/diagnosis ; Hematologic Neoplasms/therapy ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Life Support Care/methods ; Male ; Middle Aged ; Neoplasms/complications ; Neoplasms/diagnosis ; Neoplasms/therapy ; Prognosis ; Registries ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/mortality ; Respiratory Insufficiency/therapy ; Risk Assessment ; Survival Analysis ; Treatment Outcome
    Language English
    Publishing date 2010-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/j.amjsurg.2010.01.018
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Adverse events after radiofrequency ablation of unresectable liver tumors: a single-center experience.

    Lao, Oliver B / Farjah, Farhood / Flum, David R / Yeung, Raymond S

    American journal of surgery

    2009  Volume 198, Issue 1, Page(s) 76–82

    Abstract: Background: Radiofrequency ablation (RFA) is a relatively new modality to treat liver tumors that is being incorporated into practice despite the fact that its risk profile has not been well described.: Methods: A retrospective cohort study, using ... ...

    Abstract Background: Radiofrequency ablation (RFA) is a relatively new modality to treat liver tumors that is being incorporated into practice despite the fact that its risk profile has not been well described.
    Methods: A retrospective cohort study, using structured chart review, on patients with liver tumor(s) was conducted from August 1998 to November 2006. Univariate and multivariate exploratory analyses were used to evaluate factors associated with adverse events.
    Results: RFA procedures were performed on 196 patients (58% primary tumors, 24% colorectal metastases, and 18% other metastases). Twenty-three patients (12%) experienced serious adverse events. Multivariate analysis showed advanced age (>or=55 y), underlying liver disease, large tumor size (>4 cm), and concomitant procedure were associated with an increased risk of adverse events (P = .01, P < .01, P = .01, and P = .01, respectively). There were no in-hospital deaths.
    Conclusions: RFA was associated with acceptable morbidity and mortality. Factors associated with adverse events should be considered when counseling patients regarding RFA procedures.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Female ; Follow-Up Studies ; Humans ; Incidence ; Laparoscopy ; Laparotomy ; Liver Neoplasms/pathology ; Liver Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Complications/epidemiology ; Retrospective Studies ; Risk Factors ; Survival Rate/trends ; Washington/epidemiology ; Young Adult
    Language English
    Publishing date 2009-07
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/j.amjsurg.2008.09.025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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