The Surgical clinics of North America
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Surg. Clin. North Am. · Aug 2012
ReviewGraduate medical education in trauma/critical care and acute care surgery: defining goals for a new workforce.
The increasing need for skilled emergency surgical providers, coupled with decreasing experience in emergency surgery among trainees, has led to significant shortages in the availability of such surgeons. In response to this crisis, surgical leaders have developed a comprehensive curriculum and a set of professional standards to guide the training of a new specialist: the acute care surgeon. This article reviews the development and goals for Fellowship training of this new specialty.
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Surg. Clin. North Am. · Jun 2012
ReviewPediatric malignancies: neuroblastoma, Wilm's tumor, hepatoblastoma, rhabdomyosarcoma, and sacroccygeal teratoma.
Common pediatric malignancies are reviewed: neuroblastoma, Wilms tumor, hepatoblastoma, rhabdomyosarcoma, and sacrococcygeal teratoma. Elements of presentation, diagnosis, staging, treatment, and longterm prognosis are discussed, with particular attention to surgical management.
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Surg. Clin. North Am. · Jun 2012
ReviewPyloric stenosis in pediatric surgery: an evidence-based review.
Pyloric stenosis is a common pediatric surgical problem that requires a combination of both medical and surgical attention. This article reviews the classical elements necessary to care for the patient in a safe and effective manner. ⋯ Perioperative management of the patient is discussed and the currently used techniques are reviewed. Current recommendations include the routine use of ultrasonography for diagnosis, attention to the preoperative correction of electrolytes, and the use of minimally invasive techniques for treatment.
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Surg. Clin. North Am. · Jun 2012
ReviewPediatric inguinal hernias, hydroceles, and undescended testicles.
Pediatric inguinal hernias are extremely common, and can usually be diagnosed by simple history taking and physical examination. Repair is elective, unless there is incarceration or strangulation. Hydroceles are also quite common, and in infancy many will resolve without operative intervention. Undescended testicles harbor an increased risk of infertility and malignancy, and require orchiopexy in early childhood.
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Surgeons performing painful, invasive procedures in pediatric patients must be cognizant of both the potential short- and long-term detrimental effects of inadequate analgesia. This article reviews the available tools, sedation procedures, the management of intraoperative, postoperative, and postprocedural pain, and the issues surrounding neonatal addiction.