2024
The impact of undergoing elective pediatric lung resection during respiratory syncytial virus peak season on patient outcomes: A nationwide retrospective analysis
Salvi P, Canner J, Coons B, Cowles R, Engwall‐Gill A, Kunisaki S, Penikis A, Schneider E, Sferra S, Solomon D. The impact of undergoing elective pediatric lung resection during respiratory syncytial virus peak season on patient outcomes: A nationwide retrospective analysis. Pediatric Pulmonology 2024, 59: 1346-1353. PMID: 38353176, DOI: 10.1002/ppul.26914.Peer-Reviewed Original ResearchRespiratory syncytial virus seasonCongenital lung malformationsRespiratory syncytial virusPediatric Health Information SystemPostoperative mechanical ventilationLung resectionHospital billing chargesLung surgeryViral seasonMechanical ventilationAssociated with adverse surgical outcomesCLM patientsRSV incidencePediatric Health Information System dataCenters for Disease Control dataRetrospective observational cohort studyElective lung resectionPediatric lung resectionsPediatric thoracic surgeryElective lung surgeryTime of surgeryAdverse surgical outcomesObservational cohort studyIncreased utilization of healthcare resourcesUtilization of healthcare resources
2023
Antibiotic-induced microbial depletion enhances murine small intestinal epithelial growth in a serotonin-dependent manner
Salvi P, Shaughnessy M, Sumigray K, Cowles R. Antibiotic-induced microbial depletion enhances murine small intestinal epithelial growth in a serotonin-dependent manner. AJP Gastrointestinal And Liver Physiology 2023, 325: g80-g91. PMID: 37158470, DOI: 10.1152/ajpgi.00113.2022.Peer-Reviewed Original ResearchConceptsSerotonin activitySERT protein expressionSerotonin potentiationEpithelial proliferationSerotonin transporterEndogenous serotoninVillus heightMicrobial depletionIntestinal epithelial growthProtein expressionEpithelial growthSerotonin-dependent mechanismIntestinal villus heightSmall intestine resultsIntestinal surface areaSmall intestinal villiSmall intestinal cryptsIntestinal pathologyPara-chlorophenylalanineISC numbersSerotonin synthesisIntestinal homeostasisEpithelial expressionMouse modelAnimal models
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 reviewShort Bowel Syndrome and Intestinal Lengthening Procedures
Salvi P, Cowles R. Short Bowel Syndrome and Intestinal Lengthening Procedures. 2022, 345-356. DOI: 10.1007/978-3-030-96542-6_31.ChaptersIntestinal lengthening proceduresParenteral nutritionLengthening proceduresIntestinal transplantSurgical interventionMultidisciplinary intestinal rehabilitation programParenteral nutrition failureIntestinal rehabilitation programShort bowel syndromeSmall bowel resectionSignificant physiologic consequencesCompensatory-adaptive changesBowel functionBowel resectionBowel syndromeIntestinal transitIntestinal adaptationIntestinal lossSpecialized epithelial cellsMucosal growthRehabilitation programPhysiologic consequencesDistal ileumPatientsFat absorptionPreoperative Transfusion and Surgical Outcomes for Children with Sickle Cell Disease.
Salvi PS, Solomon DG, Cowles RA. Preoperative Transfusion and Surgical Outcomes for Children with Sickle Cell Disease. Journal Of The American College Of Surgeons 2022, 235: 530-538. PMID: 35972175, DOI: 10.1097/XCS.0000000000000267.Peer-Reviewed Original ResearchVariability in pediatric appendectomy: The association between disposable supply cost and procedure duration.
Salvi PS, Cowles RA, Oh PS, Solomon DG. Variability in pediatric appendectomy: The association between disposable supply cost and procedure duration. Surgery 2022, 172: 729-733. PMID: 35581029, DOI: 10.1016/j.surg.2022.04.006.Peer-Reviewed Original ResearchAssociation 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 testingAtresiaInfantsDiseaseJaundiceJejunoileal mucosal growth in mice with a limited microbiome
Shaughnessy MP, Park CJ, Salvi PS, Cowles RA. Jejunoileal mucosal growth in mice with a limited microbiome. PLOS ONE 2022, 17: e0266251. PMID: 35349599, PMCID: PMC8963542, DOI: 10.1371/journal.pone.0266251.Peer-Reviewed Original ResearchConceptsIntestinal mucosal growthMucosal surface areaSmall intestinal mucosal growthCrypt proliferation indexCONV miceGF miceMucosal growthVillus heightEnteral antibioticsCrypt depthCell proportionSmall intestinal villus heightGerm-free miceBroad-spectrum antibioticsConventional floraIntestinal villus heightGerm-free conditionsEnteral administrationMucosal homeostasisGnotobiotic miceProliferation indexEnterocyte proliferationMiceTaller villiGF conditionsIndex 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
Cholecystectomy Is Superior to Medical Management for Biliary Pain in Pediatric Patients.
Shah PA, Saluja S, Cowles RA. Cholecystectomy Is Superior to Medical Management for Biliary Pain in Pediatric Patients. Journal Of Gastrointestinal Surgery : Official Journal Of The Society For Surgery Of The Alimentary Tract 2021, 25: 2435-2436. PMID: 34255291, DOI: 10.1007/s11605-021-05083-1.Commentaries, Editorials and LettersButyrate 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 NotesDuodenal Duplication Cyst.
Shah PA, Saluja S, Cowles RA. Duodenal Duplication Cyst. Journal Of Gastrointestinal Surgery : Official Journal Of The Society For Surgery Of The Alimentary Tract 2021, 25: 1635-1637. PMID: 33443687, DOI: 10.1007/s11605-020-04890-2.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 administrationExisting Scoring Systems for Hirschsprung-Associated Enterocolitis Result in Underdiagnosis and Overtreatment
Lewit R, Veras L, Cowles R, King S, Lapidus-Krol E, Langer J, Park C, Youssef F, Vavilov S, Gosain A. Existing Scoring Systems for Hirschsprung-Associated Enterocolitis Result in Underdiagnosis and Overtreatment. Journal Of The American College Of Surgeons 2020, 231: s196. DOI: 10.1016/j.jamcollsurg.2020.07.559.Peer-Reviewed Original Research