2022
Association Between Antibiotic Redosing Before Incision and Risk of Incisional Site Infection in Children With Appendicitis
Cramm S, Chandler N, Graham D, Kunisaki S, Russell R, Blakely M, Lipskar A, Allukian M, Aronowitz D, Campbell B, Collins D, Commander S, Cowles R, DeFazio J, Esparaz J, Feng C, Griggs C, Guyer R, Hanna D, Kahan A, Keane O, Lamoshi A, Lopez C, Pace E, Regan M, Santore M, Scholz S, Tracy E, Williams S, Zhang L, Rangel S. Association Between Antibiotic Redosing Before Incision and Risk of Incisional Site Infection in Children With Appendicitis. Annals Of Surgery 2022, 278: e863-e869. PMID: 36317528, DOI: 10.1097/sla.0000000000005747.Peer-Reviewed Original ResearchConceptsIncisional surgical site infectionHour of incisionPediatric National Surgical Quality Improvement ProgramNational Surgical Quality Improvement ProgramSurgical Quality Improvement ProgramSite infectionQuality Improvement ProgramAntibiotic redosingIncisional surgical site infection rateMulticenter retrospective cohort studyDisease severityDiagnosis of appendicitisSurgical site infectionRetrospective cohort studyRedosing of antibioticsOperative report dataMultivariate logistic regressionHospital-level clusteringIncreased disease severityAntibiotic regimensInitial doseAntibiotic administrationPatient demographicsAntibiotic utilizationChart reviewAssociation of Gangrenous, Suppurative, and Exudative Findings With Outcomes and Resource Utilization in Children With Nonperforated Appendicitis
Cramm SL, Lipskar AM, Graham DA, Kunisaki SM, Griggs CL, Allukian M, Russell RT, Chandler NM, Santore MT, Aronowitz DI, Blakely ML, Campbell B, Collins DT, Commander SJ, Cowles RA, DeFazio JR, Echols JC, Esparaz JR, Feng C, Guyer RA, Hanna DN, He K, Kahan AM, Keane OA, Lamoshi A, Lopez CM, McLean SE, Pace E, Regan MD, Scholz S, Tracy ET, Williams SA, Zhang L, Rangel SJ, Chang A, Fitzgerald M, Middlesworth W, Finck C, Hackam D, Engwall-Gill A, Gerall C, Orlas C, Hwang R, Dantes G. Association of Gangrenous, Suppurative, and Exudative Findings With Outcomes and Resource Utilization in Children With Nonperforated Appendicitis. JAMA Surgery 2022, 157: 685-692. PMID: 35648410, PMCID: PMC9161124, DOI: 10.1001/jamasurg.2022.1928.Peer-Reviewed Original ResearchConceptsSurgical site infectionSite infectionExudative findingsPostoperative lengthOperative reportsNonperforated appendicitisNational Surgical Quality Improvement ProgramMultivariable mixed-effects regressionPostoperative surgical site infectionSurgical Quality Improvement ProgramPediatric National Surgical Quality Improvement ProgramMean postoperative lengthOrgan space infectionMulticenter cohort studyMedical record reviewCohort of childrenQuality Improvement ProgramPostoperative antibioticsCohort studyInpatient managementPatient characteristicsSecondary outcomesSpace infectionPrimary outcomeHospital revisitsComparing Serum Matrix Metalloproteinase-7 in Parenteral Nutrition-Associated Liver Disease and Biliary Atresia
Salvi PS, Fawaz R, Cowles RA. Comparing Serum Matrix Metalloproteinase-7 in Parenteral Nutrition-Associated Liver Disease and Biliary Atresia. The Journal Of Pediatrics 2022, 249: 97-100. PMID: 35714967, DOI: 10.1016/j.jpeds.2022.06.014.Peer-Reviewed Original ResearchConceptsBiliary atresiaLiver diseaseParenteral nutrition-associated liver diseaseParenteral Nutrition–Associated Liver DiseaseMetalloproteinase-7Matrix metalloproteinase 7 levelsSerum matrix metalloproteinase-7Cross-sectional studyMatrix metalloproteinase-7Parenteral nutritionInvasive testingAtresiaInfantsDiseaseJaundiceIndex Admission Cholecystectomy and Recurrence of Pediatric Gallstone Pancreatitis: Multicenter Cohort Analysis.
Muñoz Abraham AS, Osei H, Bajinting A, Cowles RA, Greenspon J, Hosfield BD, Keller MS, Landman MP, Owens H, Shaughnessy MP, St Peter SD, Sujka J, Vogel AM, Villalona GA. Index Admission Cholecystectomy and Recurrence of Pediatric Gallstone Pancreatitis: Multicenter Cohort Analysis. Journal Of The American College Of Surgeons 2022, 234: 352-358. PMID: 35213498, DOI: 10.1097/xcs.0000000000000062.Peer-Reviewed Original ResearchConceptsGallstone pancreatitisEarly cholecystectomyIndex admissionRecurrent pancreatitisRecurrence rateMean body mass indexIndex admission cholecystectomyMean age 13.5Multicenter cohort analysisTiming of cholecystectomyBody mass indexBiliary complicationsInterval cholecystectomyIndex dischargeCholecystectomy ratesGroup patientsMost patientsLaboratory characteristicsMild pancreatitisPediatric patientsRetrospective reviewMass indexCholecystectomyCohort analysisPancreatitis
2021
Butyrate and the Intestinal Epithelium: Modulation of Proliferation and Inflammation in Homeostasis and Disease
Salvi PS, Cowles RA. Butyrate and the Intestinal Epithelium: Modulation of Proliferation and Inflammation in Homeostasis and Disease. Cells 2021, 10: 1775. PMID: 34359944, PMCID: PMC8304699, DOI: 10.3390/cells10071775.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAnti-proliferative effectsIntestinal stem cellsTolerogenic dendritic cellsAnti-inflammatory cytokinesEpithelial cellsInflammatory bowel diseaseMicrobial metabolite butyrateStem cellsApparent protective effectButyrate-producing bacteriaCellular fuelRole of butyrateCrypt base stem cellsModulation of proliferationButyrate paradoxMalabsorptive statesBowel diseaseDendritic cellsEpithelial inflammationColonic neoplasiaIntestinal microbiomeProtective effectIntestinal neoplasiaIntestinal lumenEpithelial proliferationPoint-of-Care Ultrasound to Evaluate the Acute Abdomen
Malik R, Leviter J, Gross I, Saluja S, Cowles RA, Riera A. Point-of-Care Ultrasound to Evaluate the Acute Abdomen. Pediatric Emergency Care 2021, 38: e1022-e1024. PMID: 34116554, DOI: 10.1097/pec.0000000000002460.Peer-Reviewed Case Reports and Technical NotesSerotonin as a Mitogen in the Gastrointestinal Tract: Revisiting a Familiar Molecule in a New Role
Shah PA, Park CJ, Shaughnessy MP, Cowles RA. Serotonin as a Mitogen in the Gastrointestinal Tract: Revisiting a Familiar Molecule in a New Role. Cellular And Molecular Gastroenterology And Hepatology 2021, 12: 1093-1104. PMID: 34022423, PMCID: PMC8350061, DOI: 10.1016/j.jcmgh.2021.05.008.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsEnteric nervous systemSerotonin receptorsGI tractPotentiation of serotoninInflammatory bowel diseaseVascular smooth muscleIntestinal epithelial proliferationIntestinal crypt cellsBody's serotoninMalabsorptive conditionsIntestinal injuryEnteric neuronsIntestinal motilityBowel diseaseIntestinal inflammationEnterochromaffin cellsGI diseaseSerotonergic neuronsMuscarinic receptorsCholinergic signalingSerotonin synthesisGastrointestinal systemGastrointestinal tractIntestinal mucosaSmooth muscleTrends in fundoplication volume for pediatric gastroesophageal reflux disease
Maassel NL, Shaughnessy MP, Solomon DG, Cowles RA. Trends in fundoplication volume for pediatric gastroesophageal reflux disease. Journal Of Pediatric Surgery 2021, 56: 1495-1499. PMID: 33745746, DOI: 10.1016/j.jpedsurg.2021.02.045.Peer-Reviewed Original ResearchConceptsGastro-esophageal reflux diseasePediatric Health Information SystemPediatric surgery fellowsReflux diseaseSurgical volumeCase volumeSevere gastro-esophageal reflux diseasePediatric gastroesophageal reflux diseaseICD-9/ICDTotal operative volumeGastroesophageal reflux diseaseGraduate Medical Education caseFellow case logsPatient characteristicsPatient demographicsPediatric surgeonsOperative volumePediatric surgical trainingSecondary analysisHealth information systemsAbstractTextCase logsFundoplicationNational dataRecent dataLaparoscopy is increasingly used for pediatric inguinal hernia repair
Shaughnessy MP, Maassel NL, Yung N, Solomon DG, Cowles RA. Laparoscopy is increasingly used for pediatric inguinal hernia repair. Journal Of Pediatric Surgery 2021, 56: 2016-2021. PMID: 33549307, DOI: 10.1016/j.jpedsurg.2021.01.032.Peer-Reviewed Original ResearchConceptsLaparoscopic inguinal hernia repairInguinal hernia repairHernia repairLaparoscopic repairCHA HospitalProcedure typePediatric Health Information SystemPediatric inguinal hernia repairStudy periodDefinitive prospective studiesLong-term outcomesTotal hospital costsUse of laparoscopyTen-year study periodIHR groupLaparoscopic groupYounger patientsProspective studyHospital costsOperative approachSurgeon preferencePediatric surgeonsHealth information systemsAbstractTextLaparoscopyReducing Underdiagnosis of Hirschsprung-Associated Enterocolitis: A Novel Scoring System
Lewit RA, Veras LV, Cowles RA, Fowler K, King S, Lapidus-Krol E, Langer JC, Park CJ, Youssef F, Vavilov S, Gosain A. Reducing Underdiagnosis of Hirschsprung-Associated Enterocolitis: A Novel Scoring System. Journal Of Surgical Research 2021, 261: 253-260. PMID: 33460971, PMCID: PMC8166452, DOI: 10.1016/j.jss.2020.12.030.Peer-Reviewed Original ResearchConceptsHirschsprung-associated enterocolitisNew scoring systemSensitivity/specificityScoring systemHirschsprung's diseaseMultivariate analysisPercent of patientsReceipt of treatmentStepwise multivariate analysisProspective data collectionNovel scoring systemHAEC episodesRectal irrigationBowel restSignificant underdiagnosisRadiographic findingsPatient cohortColonic diseaseMore episodesUnivariate analysisHigh riskDiagnostic cutoffHead comparisonClinical settingLogistic regression
2020
Outcomes following adoption of a standardized protocol for abscess drain management in pediatric appendicitis
Eysenbach LM, Caty MG, Christison-Lagay ER, Cowles RA, Dillon B, Goodman TR, Ozgediz DE, Stitelman DH, Solomon DG. Outcomes following adoption of a standardized protocol for abscess drain management in pediatric appendicitis. Journal Of Pediatric Surgery 2020, 56: 43-46. PMID: 33143877, DOI: 10.1016/j.jpedsurg.2020.09.050.Peer-Reviewed Original ResearchConceptsPediatric appendicitisClinical outcomesStandardized protocolImaging studiesTertiary care children's hospitalEvidence-based clinical pathwayAlternative imaging studyIR proceduresManagement of abscessesRetrospective chart reviewCases of appendicitisPercutaneous abscess drainageInterventional radiologic proceduresDiagnostic imaging studiesComplicated appendicitisBaseline demographicsChart reviewClinical factorsAbscess drainageClinical presentationDrain outputChildren's HospitalDrain daysClinical pathwayAnesthetic administrationNational Survey of Pediatric Intestinal Rehabilitation Programs in the United States
Park CJ, Shaughnessy MP, Zhang L, Armenia SJ, Caty MG, Cowles RA. National Survey of Pediatric Intestinal Rehabilitation Programs in the United States. Journal Of Parenteral And Enteral Nutrition 2020, 45: 1249-1258. PMID: 32797633, DOI: 10.1002/jpen.1997.Peer-Reviewed Original ResearchConceptsPediatric intestinal rehabilitation programIntestinal rehabilitation programPIR programRehabilitation programChildren's Hospital AssociationHospital AssociationQualtrics online survey softwareIntestinal failureReferral centerPrimary carePatient outcomesImproved outcomesNutrition servicesResponse rateOnline survey softwareSurgeryMajority of programsGastroenterologyNursingFurther studiesNational surveySocial work supportSurvey softwareDedicated timeOutcomes
2019
Guidelines for the management of postoperative soiling in children with Hirschsprung disease
Saadai P, Trappey AF, Goldstein AM, Cowles RA, De La Torre L, Durham MM, Huang EY, Levitt MA, Rialon K, Rollins M, Rothstein DH, Langer JC. Guidelines for the management of postoperative soiling in children with Hirschsprung disease. Pediatric Surgery International 2019, 35: 829-834. PMID: 31201486, DOI: 10.1007/s00383-019-04497-y.Peer-Reviewed Original ResearchConceptsHirschsprung's diseasePostoperative soilingMethods of diagnosisObstructive symptomsSphincter controlOptimize outcomesRational approachTreatment approachesExpert consensusMost childrenDiseaseChildrenSymptomsAbnormalitiesDiagnosisCauseCommon problemStepwise algorithmLiterature reviewGuidelinesSurgeryGroup discussionsManagementSoilingStoolingOrally Dosed Citalopram Stimulates Small Intestinal Mucosal Growth
Zhang L, Greig CJ, Cowles RA. Orally Dosed Citalopram Stimulates Small Intestinal Mucosal Growth. Journal Of Surgical Research 2019, 236: 326-331. PMID: 30694773, DOI: 10.1016/j.jss.2018.11.033.Peer-Reviewed Original ResearchConceptsMucosal surface areaSelective serotonin reuptake inhibitorsSerotonin reuptake inhibitorsIntestinal mucosal growthVillus heightVillus widthD citalopramReuptake inhibitorsMucosal growthCrypt depthCrypt widthSmall intestinal mucosal growthShort bowel syndromeT-testSerious intestinal disordersStudent's t-testOral agentsBowel syndromeOral therapyEnteral administrationC57BL/6 miceIleal segmentIntestinal disordersDay 21Day 7
2018
Retracing our STEPs: Four decades of progress in intestinal lengthening procedures for short bowel syndrome
Greig CJ, Oh PS, Gross ER, Cowles RA. Retracing our STEPs: Four decades of progress in intestinal lengthening procedures for short bowel syndrome. The American Journal Of Surgery 2018, 217: 772-782. PMID: 30514435, DOI: 10.1016/j.amjsurg.2018.11.025.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsShort bowel syndromeBowel syndromeReversed intestinal segmentInnovative new treatmentsBowel dilationIntestinal rehabilitationIntestinal failureBowel lengthSurgical managementBacterial overgrowthIntestinal adaptationColonic transpositionPatient outcomesSurgical techniqueLengthening surgeryIntestinal segmentsArtificial valvesNew treatmentsSyndromeCare paradigmPoor motilityBirthOutcomesTransit timeLong termSurgical modifications of the Kasai hepatoportoenterostomy minimize invasiveness without compromising short- and medium-term outcomes
Park CJ, Armenia SJ, Keung CH, Compton JT, Cowles RA. Surgical modifications of the Kasai hepatoportoenterostomy minimize invasiveness without compromising short- and medium-term outcomes. Journal Of Pediatric Surgery 2018, 54: 537-542. PMID: 30041859, DOI: 10.1016/j.jpedsurg.2018.06.028.Peer-Reviewed Original ResearchConceptsKasai hepatoportoenterostomyBiliary atresiaLiver transplantLiver transplant proceduresNative liver survivalEffective surgical therapyMedium-term outcomesYears of ageLiver survivalLiver dysfunctionOverall survivalSurgical therapyLiver failureBile stasisMedian timeProgressive fibrosisBile drainageTransplant proceduresMean ageBiliary treeSingle institutionPatient outcomesPortal plateSurgical modificationsAbdominal cavity
2001
Images in vascular medicine
Cowles R, Cardneau J, Taheri P. Images in vascular medicine. Vascular Medicine 2001, 6: 189-190. PMID: 11789974, DOI: 10.1177/1358836x0100600310.Peer-Reviewed Case Reports and Technical NotesDoctor-patient communication in surgery: attitudes and expectations of general surgery patients about the involvement and education of surgical residents1 1No competing interests declared.
Cowles R, Moyer C, Sonnad S, Simeone D, Knol J, Eckhauser F, Mulholland M, Colletti L. Doctor-patient communication in surgery: attitudes and expectations of general surgery patients about the involvement and education of surgical residents1 1No competing interests declared. Journal Of The American College Of Surgeons 2001, 193: 73-80. PMID: 11442257, DOI: 10.1016/s1072-7515(01)00936-x.Peer-Reviewed Original ResearchConceptsSurgical resident educationPatients' perceptionsGastrointestinal surgery serviceGeneral surgery patientsMajority of patientsAttitudes of patientsInpatient hospital stayResident educationAcademic medical centerDoctor-patient communicationHospital staySurgery patientsSurgery serviceTeaching hospitalMedical CenterSurgical servicesPatients' answersSurgical settingPatientsInstitution residentsCareSurgical residentsPatient orientationExtra attentionImpact of residentsSurgical Management of Peptic Ulcer Disease in the Helicobacter Era—Management of Bleeding Peptic Ulcer
Cowles R, Mulholland M. Surgical Management of Peptic Ulcer Disease in the Helicobacter Era—Management of Bleeding Peptic Ulcer. Surgical Laparoscopy Endoscopy & Percutaneous Techniques 2001, 11: 2-8. PMID: 11269550, DOI: 10.1097/00129689-200102000-00002.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsPeptic ulcer diseaseUlcer diseaseEndoscopic therapySevere underlying medical conditionsNonsteroidal anti-inflammatory drugsBleeding Peptic UlcerUpper gastrointestinal bleedingPeptic ulcer bleedingUnderlying medical conditionsH. pylori infectionAnti-inflammatory drugsExcellent success ratesGastrointestinal bleedingUlcer bleedingUpper endoscopyDuodenal ulcerSurgical managementPeptic ulcerPylori infectionMedical conditionsH. pyloriPatientsHelicobacter pyloriSignificant causeBleeding
2000
Efficacy of the laparoscopic approach for anterior lumbar spinal fusion
Cowles R, Taheri P, Sweeney J, Graziano G. Efficacy of the laparoscopic approach for anterior lumbar spinal fusion. Surgery 2000, 128: 589-596. PMID: 11015092, DOI: 10.1067/msy.2000.108055.Peer-Reviewed Original ResearchConceptsAnterior lumbar spinal fusionLumbar spinal fusionLess blood lossLaparoscopic proceduresSpinal fusionBlood lossOpen procedureShorter operating room timeShorter postoperative ileusCharts of patientsImmediate postoperative outcomesImmediate postoperative resultsOperating room timePostoperative ileusPostoperative coursePostoperative outcomesLaparoscopic approachOperative timePostoperative resultsPatientsRoom timeLearning curveIleusLaparoscopic