Journal of pediatric surgery
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This article is based on the Hugh Greenwood Lecture delivered at the 2016 Congress of the British Association of Paediatric Surgeons. It presents the view of the global surgery movement from the bottom of the surgical food chain and proposes what HICs (high-income countries) can do for global surgery in a coordinated fashion. From the LMIC (low- and middle-income countries) surgeon perspective, global surgery is transitioning from the charity-based surgery model to codevelopment with multiple stakeholders. ⋯ Surgeons may not play a pivotal role in the solutions. The future of the surgical workforce, innovation, workarounds, unmet burden of disease, and health metrics are discussed and multidisciplinary solutions proposed for the entire chain of surgical healthcare delivery in LMIC. A new breed of "essential surgeons", technology solutions for intellectual and physical isolation, competency-based credentialing, industry-driven innovation, task sharing over task shifting, prioritizing delivery based on surgical burden, and a rota-based overseas model of help are proposed as solutions for the issues facing global surgery.
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Skiing and snowboarding are popular winter recreational activities that are commonly associated with orthopedic type injuries. Unbeknownst to most parents, however, are the significant but poorly described risks for head, cervical spine and solid organ injuries. Although helmet use is not mandated for skiers and snowboarders outside of resort sponsored activities, we hypothesized that helmet use is associated with a lower risk of severe head injury, shorter ICU stay and shorter hospital length of stay. ⋯ III.
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Malnutrition is common among congenital diaphragmatic hernia (CDH) survivors and may result from elevated respiratory effort. We evaluated body mass index (BMI), measured resting energy expenditure (mREE) and pulmonary function test (PFT) results in children and adolescents with CDH to determine if there is a correlation. ⋯ II.
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No consensus exists on management of children with a negative trauma CT following blunt abdominal trauma (BAT). Asymptomatic children are frequently "admitted for observation" following negative CT owing to concerns about missing an intraabdominal injury (IAI) without evidence for this practice. We aimed to investigate the feasibility of discharge following a negative CT scan in children sustaining blunt abdominal trauma. ⋯ This is a level II evidence study. In itself it is a retrospective study, with the literature review including one large, high-quality prospective cohort study, and further prospective cohort studies of ordinary quality.
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Multicenter Study Clinical Trial
Oesophageal atresia with no distal tracheoesophageal fistula: Management and outcomes from a population-based cohort.