Key factors in the establishment of pediatric surgery: Who did it and how?

This review details essential factors in the establishment of the specialty of Pediatric Surgery in the United States as well as the individuals involved to the time of Board certification, which was the final step in the specialty. Foremost in the effort was D. H.

Academic Partnerships in Global Surgery: An Overview American Surgical Association Working Group on Academic Global Surgery.

: Most surgeons from high-income countries who work in global surgery will do so through partnerships between their institutions and institutions in low- and middle-income countries (LMICs). In this article, the American Surgical Association Working Group for Global Surgery lays out recommendations for criteria that contribute to equitable, sustainable, and effective partnerships. These include ethically engaging with the LMIC partner institution by putting its interests first and by proactively seeking to be aware of cultural issues.

A model for humanitarian outreach in today's world.

The traditional model for humanitarian work for surgeons has been a few long-term people and a larger number of volunteers on short-term missions to needy places for one or two weeks with limited opportunity for follow-up. While a great deal of good has resulted from these efforts, in the long term not much has changed. Recent studies like the U.

Effect of a Clinical Practice Guideline for Pediatric Complicated Appendicitis.

Importance: Complicated appendicitis is a common condition in children that causes substantial morbidity. Significant variation in practice exists within and between centers. We observed highly variable practices within our hospital and hypothesized that a clinical practice guideline (CPG) would standardize care and be associated with improved patient outcomes.

Genetic and chromosomal alterations in Kenyan Wilms Tumor.

Wilms tumor (WT) is the most common childhood kidney cancer worldwide and poses a cancer health disparity to black children of sub-Saharan African ancestry. Although overall survival from WT at 5 years exceeds 90% in developed countries, this pediatric cancer is alarmingly lethal in sub-Saharan Africa and specifically in Kenya (36% survival at 2 years). Although multiple barriers to adequate WT therapy contribute to this dismal outcome, we hypothesized that a uniquely aggressive and treatment-resistant biology compromises survival further.

Risk factors for abandonment of Wilms tumor therapy in Kenya.

Background: Survival from Wilms tumor (WT) in sub-Saharan Africa remains dismal as a result of on-therapy mortality and treatment abandonment. Review of patients diagnosed from 2008 to 2011 in our Kenyan Wilms Tumor Registry showed a loss to follow up (LTFU) rate approaching 50%. The purpose of this study was to trace those LTFU, estimate the survival rate, and identify risk factors for treatment abandonment.

Race disparities in peptide profiles of North American and Kenyan Wilms tumor specimens.

Background: Wilms tumor (WT) is the most common childhood kidney cancer worldwide and arises in children of black African ancestry with greater frequency and severity than other race groups. A biologic basis for this pediatric cancer disparity has not been previously determined. We hypothesized that unique molecular fingerprints might underlie the variable incidence and distinct disease characteristics of WT observed between race groups.

Changing relationship of pediatric surgical workforce to patient demographics.

Background: Physician workforce studies indicate that more specialists contribute to higher average costs. The closely monitored pediatric surgery specialty may reflect what is occurring in other specialties.

Methods: This report reviews the number of complex operations performed on infants and children in 1970, with <225 trained US pediatric surgeons, and in 2010, when there were 1,130.

Wilms tumor survival in Kenya.

Purpose: Survival from Wilms Tumor (WT) exceeds 90% at 5 years in developed nations, whereas at last report, 2-year event-free survival (EFS) in Kenya reached only 35%. To clarify factors linked to these poor outcomes in Kenya, we established a comprehensive web-based WT registry, comprised of patients from the four primary hospitals treating childhood cancers.

Materials And Methods: WT patients diagnosed between January 2008 and January 2012 were identified.

Computational studies on the mechanism of the gold(I)-catalysed rearrangement of cyclopropenes.

Density functional theory calculations have been employed to investigate the mechanism of gold(I)-catalysed rearrangements of cyclopropenes. Product formation is controlled by the initial ring-opening step which results in the formation of a gold-stabilised carbocation/gold carbene intermediate. With 3-phenylcyclopropene-3-methylcarboxylate, the preferred intermediate allows cyclisation via nucleophilic attack of the carbonyl group and hence butenolide formation.

Defining hepatoblastoma responsiveness to induction therapy as measured by tumor volume and serum alpha-fetoprotein kinetics.

Purpose: Hepatoblastoma is commonly unresectable at presentation, necessitating induction chemotherapy before definitive resection. To refine the paradigm for timing of resection, we questioned whether a plateau in hepatoblastoma responsiveness to neoadjuvant therapy could be detected by calculating tumor volume (TV) and serum alpha-fetoprotein (sAFP) kinetics.

Methods: To calculate TV and sAFP as measures of treatment responsiveness over time, infants having initially unresectable epithelial-type hepatoblastomas were identified at a single institution (1996-2008).

Liver transplantation for childhood hepatic malignancy: a review of the United Network for Organ Sharing (UNOS) database.

Background: Orthotopic liver transplantation (OLT) is the only treatment option for unresectable hepatoblastoma (HB) and hepatocellular carcinoma (HCC) in children. Aggregated outcomes of OLT for these hepatic malignancies have not been evaluated in the United Network for Organ Sharing national database.

Purpose: The purpose of this study was to evaluate graft and patient survival in pediatric OLT recipients with HB and HCC.