The Canadian Pediatric Surgery Network (CAPSNet): Lessons Learned from a National Registry Devoted to the Study of Congenital Diaphragmatic Hernia and Gastroschisis

Butler, Alison; Puligandla, Pramod S.; Skarsgard, Erik D.

doi:10.1055/s-0035-1569477

Cited by 9 publications

(4 citation statements)

References 40 publications

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“…This was observed both in the general rate reported by the CCASS ( Public Health Agency of Canada and Health Canada, 2013 ) and in the age-adjusted and age-unadjusted data reported by ( Bassil et al, 2016 ). This result is consistent both with the uniform findings of all seven studies which have examined this question ( Torfs et al, 1994 ; Werler et al, 2003 ; Forrester and Merz, 2007 ; Draper et al, 2008 ; van Gelder et al, 2009a ; David et al, 2014 ; Skarsgard et al, 2015 ) including several prior reports from the Canadian Surgical Surveillance Group on this subject ( Alshehri et al, 2013 ; Butler et al, 2015 ; Skarsgard et al, 2015 ; Bassil et al, 2016 ; Puligandla et al, 2017 ) presumably reporting on cases which overlap in part with some of the subjects reported herein by CCASS ( Moore et al, 2013 ). This uniformity of the literature in this subject is indeed noteworthy.…”

Section: Discussionsupporting

confidence: 87%

Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis

Reece

Hulse

2020

Journal of Addiction Medicine

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Objectives: Cannabis is a known teratogen. Data availability addressing both major congenital anomalies and cannabis use allowed us to explore their geospatial relationships. Methods: Data for the years 1998 to 2009 from Canada Health and Statistics Canada was analyzed in R. Maps have been drawn and odds ratios, principal component analysis, correlation matrices, least squares regression and geospatial regression analyses have been conducted using the R packages base, dplyr, epiR, psych, ggplot2, colorplaner and the spml and spreml functions from package splm. Results: Mapping showed cannabis use was more common in the northern Territories of Canada in the Second National Survey of Cannabis Use 2018. Total congenital anomalies, all cardiovascular defects, orofacial clefts, Downs syndrome and gastroschisis were all found to be more common in these same regions and rose as a function of cannabis exposure. When Canada was dichotomized into high and low cannabis use zones by Provinces v Territories the Territories had a higher rate of total congenital anomalies 450.026 v 390.413 (O.R. = 1.16 95%C.I. 1.08-1.25, P = 0.000058; attributable fraction in exposed 13.25%, 95%C.I. 7.04–19.04%). In geospatial analysis in a spreml spatial error model cannabis was significant both alone as a main effect ( P < 2.0 × 10 −16 ) and in all its first and second order interactions with both tobacco and opioids from P < 2.0 × 10 −16 . Conclusion: These results show that the northern Territories of Canada share a higher rate of cannabis use together with elevated rates of total congenital anomalies, all cardiovascular defects, Down's syndrome and gastroschisis. This is the second report of a significant association between cannabis use and both total defects and all cardiovascular anomalies and the fourth published report of a link with Downs syndrome and thereby direct major genotoxicity. The correlative relationships described in this paper are confounded by many features of social disadvantage in Canada's northern territories. However, in the context of a similar broad spectrum of defects described both in animals and in epidemiological reports from Hawaii, Colorado, USA and Australia they are cause for particular concern and indicate further research.

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Section: Discussionsupporting

confidence: 87%

Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis

Reece

Hulse

2020

Journal of Addiction Medicine

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“…The logical step would be to design national and international registries that may be instrumental in centralizing and collecting data to give an overall picture of the disease, which could be the basis for guidelines formation and subsequent prospective studies and randomized trials, and provide quality indicators that may be used to determine hospitals' performance and best practice variations. The importance of pediatric collaborative networks for the progress in clinical care of patients with rare disorders has been already pointed out (17)(18)(19)(20). Accordingly, the European Union is currently making an effort to develop reference networks (ERN) of expert institutions for the treatment of rare disorders, among whom ERNICA will focus specifically on congenital gastro-intestinal disorders, including EA/TEF 1 .…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Workup of Neonates With Esophageal Atresia: Results From the EUPSA Esophageal Atresia Registry

et al. 2020

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Aim: Controversies exist on the optimal diagnostic workup for neonates with esophageal atresia (EA) with/without tracheoesophageal fistula (TEF). Aim of this study was to describe the current diagnostic policies in EA/TEF patients enrolled in an International multicenter registry. Methods: All patients consecutively registered from July 2014 to December 2017 in the EUPSA Esophageal Atresia Registry (EUPSA-EAR) were included in the study. Data related to diagnostic investigations among Centers forming the EUPSA-EAR were analyzed. Main Results: During the study period, 374 consecutive patients were recorded by 23 Centers. The majority of patients underwent chest X-rays, echocardiography, abdominal ultrasound, and abdominal X-rays. Preoperative bronchoscopy and esophageal gap measurement were performed in one third of the patients. Conclusions: Present data from a large cohort of patients from the EUPSA-EAR show both inter-institutional and intra-institutional variability in diagnostic workup of patients with EA/TEF. Efforts should be made to develop guidelines on the diagnostic workup for EA/TEF patients.

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“…Quality of pediatric surgery in Germany: Although Quality Reports of the Hospitals are required from all hospitals in Germany, the reports provide data on the quantity of care rather than the quality of care. Registries that cover a special aspect of pediatric surgery and the whole country have been established, for example, in Canada, 18 United Kingdom, 19 and France. 20 These registries are lacking in Germany, except for oncology.…”

Section: Centralization and Full Coverage Of Pediatric Surgery In Germentioning

confidence: 99%

Decentralized Rather than Centralized Pediatric Surgery Care in Germany

Schmedding

Rolle

2017

Eur J Pediatr Surg

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Introduction Pediatric surgery has emerged from general surgery to take better care of the needs of surgically ill children. The development of pediatric surgery in Germany started in the early 19th century and is still ongoing. This study was performed to investigate how pediatric surgery is organized in Germany. Materials and Methods Data were obtained from the following sources: German Society, Information System of the Federal Health Monitoring, German Medical Association, Joined Federal Committee, Federal Bureau of Statistics, and Perinatal Centers. Results Pediatric surgery in Germany was started in the beginning of the 19th century. In 1962, there were approximately 20 units. The number increased to 98 in 2005 and to 129 in 2017. Presently, there are 769 pediatric surgeons registered in Germany. The current growth of pediatric surgery is attributed to a political decision of implementing centers for the care of preterm babies who need pediatric surgeons. Most work performed by pediatric surgeons in Germany can be categorized as low-risk, high-volume surgery. Currently, there is a trend of spontaneous centralization for some high-risk, low-volume pediatric surgical procedures. Conclusion Pediatric surgery in Germany shows a development toward a nearly complete coverage of the country, thus providing increasing number of children with specialist care. Rare diseases, such as in oncology or newborn surgery, are generally not centralized and rarely performed by small units. New approaches for better quality measurements may lead to centralization even without political action in the future.

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The Canadian Pediatric Surgery Network (CAPSNet): Lessons Learned from a National Registry Devoted to the Study of Congenital Diaphragmatic Hernia and Gastroschisis

Cited by 9 publications

References 40 publications

Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis

Canadian Cannabis Consumption and Patterns of Congenital Anomalies: An Ecological Geospatial Analysis

Diagnostic Workup of Neonates With Esophageal Atresia: Results From the EUPSA Esophageal Atresia Registry

Decentralized Rather than Centralized Pediatric Surgery Care in Germany

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