Journal of pediatric surgery
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The goal of this study was to determine the compliance of pediatric surgery fellowships with Accreditation Council for Graduate Medical Education (ACGME) duty hour restrictions while confronting a reduced resident workforce. ⋯ A minority of fellows comply with ACGME guidelines. Vigilance of duty hour tracking correlates to better compliance. A shift of patient care to fellows is perceived. Use of support personnel did not significantly aid compliance.
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Clinical Trial
Cerebral oxygenation in major pediatric trauma: its relevance to trauma severity and outcome.
Trauma is the commonest cause of death in the pediatric population, which is prone to diffuse primary brain injury aggravated by secondary insults (eg, hypoxia, hypotension). Standard monitoring involves intracranial pressure (ICP) and cerebral perfusion pressure, which do not reflect true cerebral oxygenation (oxygen delivery [Do(2)]). We explore the merits of a brain tissue oxygen-directed critical care guide. ⋯ Pbto(2) monitoring allows for early recognition of low-Do(2) situations, enabling appropriate therapeutic intervention.
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Conjoined pygopagus twins are very rare. They represent about 17% of all conjoined twins and commonly share the gluteal region, terminal spine, and lower gastrointestinal, urological, and reproductive tracts. Meticulous preoperative investigations and planning as well as a multispecialty team approach contribute to the success of surgical separation. We report a case of successful surgical separation of pygopagus conjoined twins.
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The purpose of this study was to describe the laparoscopic approach to incarcerated inguinal hernia in children. ⋯ Laparoscopy allowed for simultaneous reduction under direct visual control, inspection of the incarcerated organ, and definitive repair of the hernia. Technically, it appears easier than the conventional approach because of the internal inguinal ring being widened by intraabdominal carbon dioxide insufflation. The hospital stay is shorter.
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Pediatric surgery is a well-established specialty in many developed countries, but little is known about the status of the specialty in most developing countries. ⋯ There is a need for more pediatric surgeons in Nigeria. More trainees need to be mentored and encouraged to take up the specialty. Collaboration with centers in developed countries and other parts of Africa and improved funding are necessary to improve the profile of the specialty.