Management and outcomes for long-segment Hirschsprung disease: A systematic review from the APSA Outcomes and Evidence Based Practice Committee

OBJECTIVE

Long-Segment Hirschsprung Disease (LSHD) differs clinically from short-segment disease. This review article critically appraises current literature on the definition, management, outcomes, and novel therapies for patients with LSHD.

METHODS

Four questions regarding the definition, management, and outcomes of patients with LSHD were generated. English-language articles published between 1990 and 2018 were compiled by searching PubMed, Scopus, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar. A qualitative synthesis was performed.

RESULTS

66 manuscripts were included in this systematic review. Standardized nomenclature and preoperative evaluation for LSHD are recommended. Insufficient evidence exists to recommend a single method for the surgical repair of LSHD. Patients with LSHD may have increased long-term gastrointestinal symptoms, including Hirschsprung-associated enterocolitis (HAEC), but have a quality of life similar to matched controls. There are few surgical technical innovations focused on this disorder.

CONCLUSIONS

A standardized definition of LSHD is recommended that emphasizes the precise anatomic location of aganglionosis. Prospective studies comparing operative options and long-term outcomes are needed. Translational approaches, such as stem cell therapy, may be promising in the future for the treatment of long-segment Hirschsprung disease.

Mind like Water: Flexibly Adapting to Serve Patrons in the Era of COVID-19

The ability to be flexible and adapt quickly to changing circumstances is a crucial skill for librarians to develop in a world increasingly characterized by rapid change. It can take a crisis to learn how effective librarians have become in developing the needed adaptive behaviors, including a willingness to change workstyles, experiment with new technologies and readily move on from failed experiments. In this paper, librarians from the Preston Medical Library at the University of Tennessee Graduate School of Medicine, prompted by the crisis of COVID-19, present their response. Beginning with a description of how services were provided prior to the pandemic, librarians detail their response in several key areas and show how they implemented new approaches to teaching, collaboration, and mutual support, working together to handle patron issues and pursue scholarly activities.

The Impact of Library Resources and Services on the Scholarly Activity of Medical Faculty and Residents

Librarians at an academic medical center library gathered data to determine if library services and resources impacted scholarly activity. A survey was developed and sent out to faculty and residents asking how they used the library during scholarly activity. Sixty-five faculty members and residents responded to the survey. The majority of respondents involved with scholarly activity use the library's services and resources. PubMed is the most frequently used database. The positive results show the library impacts the scholarly activity of medical faculty and residents.