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Biomedical subjects

Grant G Miller

Publications and source records attributed to Grant G Miller.

7 recordsLinked to original sources
PubMed2004

Waiting for an operation: parents' perspectives.

OBJECTIVE: To determine parents' attitudes toward and acceptance of waiting times for their child's operation. DESIGN: Waiting times were measured by a cross-sectional method. A descriptive survey was conducted of families with a child waiting for a non-urgent operation. SETTING: A university teaching hospital. SUBJECTS: Parents of children (age < 20 yr) waiting for non-urgent pediatric general-surgery operations. MAIN OUTCOME MEASURES: Parents' concerns and attitudes about waiting for their child's operation, how it was affecting the child and family, how urgent they felt the need for surgery was, and what they thought was a reasonable maximum waiting period. RESULTS: Of 89 patients waiting for non-urgent pediatric general-surgery operations at the time of the survey, 61% had been waiting > 6 months and 30% > 12 months. Of the 57 families (64%) who returned completed surveys, 94% reported the wait to be emotionally stressful for the family; 81.5% expected their child's quality of life would improve after the operation. As for length of wait, 83% felt that > 3 months was unacceptable, and 98% > 6 months. CONCLUSIONS: Parents of children waiting for pediatric general surgery operations thought that the need for the operation was significantly more urgent then their classification of elective. They felt that waiting periods should not exceed 3 months. Long waiting periods are stressful for both family and child. Parental perceptions are important when considering strategies for wait-list management.

Attitude to Health↗
PubMed2003

Zygomycotic infection of the neonatal upper extremity.

Zygomycosis is a rare fungal infection that may present as a necrotizing soft tissue infection in the neonate. This report illustrates the typical presentation of a premature, infant with a rapidly progressive soft tissue necrotizing infection of his upper extremity at an intravenous site. Early diagnosis with tissue biopsy confirmed the diagnosis of Zygomycosis. Successful treatment required systemic amphotercin B and aggressive debridement requiring through-the-elbow amputation for survival.

Amputation, Surgical↗
PubMed2003

Parenteral nutrition-associated cholestasis in neonates: the role of aluminum.

Parenteral nutrition (PN) is an essential component in the care of premature and ill infants. The incidence of parenteral nutrition-associated cholestasis (PNAC) ranges from 7.4 to 84%. One substance in PN solutions that has been implicated in PNAC is aluminum. Aluminum loading in animals and humans causes hepatic accumulation and damage. The degree of aluminum contamination of PN solutions has decreased over time, but contamination still significantly exceeds levels that are safe for human neonates. Further study into the relationship between aluminum contamination in neonatal PN solutions and the development of PNAC is necessary.

Aluminum↗
PubMed2003

Routine pathological evaluation of tissue from inguinal hernias in children is unnecessary.

INTRODUCTION: Because unexpected disease is rare in a child's inguinal hernia sac we decided to investigate the cost of routine pathological evaluation of inguinal hernial sacs in children and the incidence of clinically significant pathological findings. METHODS: We searched the health records at the University Hospital, Saskatoon, for patients under 20 years of age who had inguinal hernia repair between 1988 and 1997. For records noting pathology findings of duct-like structures, the operative reports and histology slides were reviewed. Specimens were immunostained for muscle-specific actin. The cost of pathological evaluation was estimated using a provincial physician-billing schedule. RESULTS: During the study period, there were 488 inguinal hernia repairs in 371 patients under 20 years of age. Of these, 456 (93.4%) specimens were evaluated microscopically. There were 4 (0.88%) cases with unexpected findings diagnosed as epididymis at a cost of Can dollar 6988/case. CONCLUSION: The routine histologic evaluation of inguinal hernia sacs in children is an unnecessary expense and should be reserved for select cases at the discretion of the surgeon.

Child, Preschool↗
PubMed2002

Telehealth provides effective pediatric surgery care to remote locations.

PURPOSE: The aim of this study was to document the experience and patient satisfaction with providing pediatric surgery consultations and follow-up appointments to remote locations via audiovisual telecommunications technology. METHODS: From January 2000 to April 2001, 16 consecutive pediatric general surgery clinics were reviewed for the type of patient (new or review), the diagnosis, the adequacy and accuracy of the evaluation, and the ability to formulate a plan. In the first year, first-time users were requested to complete a satisfaction survey of 15 questions. Responses to 13 questions were recorded on a 4-point Likert scale, and 2 questions required a "yes" or "no" response. RESULTS: One hundred eighteen appointments were scheduled. Twenty patients did not show up or cancelled. There were 45 new patient consultations. Thirty-three patients were scheduled for surgery, of which, 21 are completed, and 12 are pending. There were no errors in diagnosis or changes in planned procedures. There were 42 patients seen in 53 follow-up sessions. Thirty-six surveys of a possible 53 were available for analysis. The mean rating of overall treatment experience at Telehealth was 3.47 (95% confidence interval 0.17). One hundred percent responded they would use Telehealth again and would recommend it to another person. CONCLUSION: Telehealth is an effective and acceptable way to provide pediatric general surgery clinics to remote locations.

Adult↗