Current Landscape of Children's Surgery in Africa: A Multicenter Analysis of 16,000 Cases.

Background: Although prior studies have estimated the burden of pediatric surgical disease in low- and middle-income countries (LMICs) through statistical modeling and hospital- or household-based surveys, few large-scale descriptions of procedures and outcomes have been published. We aimed to describe the epidemiology and outcomes of children's surgical care at multiple centers across Africa.

Methods: Perioperative clinical data were collected prospectively from 2018 to 2023 at 17 hospitals in 11 African countries using a preexisting tool.

The potential of kidney transplantation to reduce mortality from chronic kidney disease: a global, cross-sectional, modelling study.

Background: Globally, the burden of chronic kidney disease and ensuing need for kidney replacement therapy (KRT)-dialysis or kidney transplantation-are increasing. Despite the mortality benefit of transplantation over dialysis, dialysis services are expanding more rapidly than access to transplantation. We aimed to cross-sectionally assess the association between country-level KRT rates and chronic kidney disease mortality to facilitate evidence-based prioritisation of KRT modalities.

Ugandan physician attitudes towards a potential, local trauma fellowship program.

Introduction: In low-income countries, clinicians trained through a context-specific trauma surgery fellowship program (TFP) can help reduce injury-related mortality to levels closer to those observed in higher-resource settings. Successful implementation, however, hinges on buy-in from local clinicians. We assessed clinician support for a potential TFP in Uganda, considering perceived need, curricular recommendations, barriers, and motivating factors.

Malakoplakia among kidney transplant recipients: case series and literature review.

We report two cases of malakoplakia after kidney transplant, a rare granulomatous condition that occurs primarily in immunocompromised patients and his thought to occur due to incomplete clearance of phagocytized bacterial residue by macrophages. Both patients were at heightened immunological risk due to being highly sensitized or prior episodes of rejection, both experienced infections in the first 4 months after transplant, and both presented with granulomatous masses that were biopsied and confirmed to be malakoplakia. Both were treated with suppressive antibiotics and required urinary drainage of the transplant kidney, resulting in improvements in the size of the mass on imaging.

Ugandan Physician Attitudes towards a Potential, Local Trauma Fellowship Program.

Background: In low-income countries, clinicians trained through a context-specific trauma surgery fellowship program (TFP) can help reduce injury-related mortality to levels closer to those observed in higher-resource settings. Successful implementation, however, hinges on buy-in from local clinicians. We therefore assessed clinician support for a potential TFP in Uganda, considering perceived need, curricular recommendations, barriers, and motivating factors.

Don't Ask Us to Stop Cycling: A Surgical Perspective.

In this surgical perspective, we argue that counseling avoidance of bicycle commuting is not the right approach to cycling injury prevention or to overall urban health. Instead, we propose surgeons should take a more holistic approach that includes mitigating individual risk factors as well as creating an equitable environment of safety.

Inadequate Lymph Node Yield: An Inadequate Indication for Adjuvant Chemotherapy in Stage II Colon Cancer.

Background: Optimal therapy for stage II colon cancer remains unclear, and national guidelines recommend "consideration" of adjuvant chemotherapy (ACT) in the presence of high-risk features, including inadequate lymph node yield (LNY, <12 nodes). This study aims to determine whether the survival benefit of ACT in stage II disease varies based on the adequacy of LNY.

Methods: We used the National Cancer Database (NCDB) to identify adults who underwent resection for a single primary T3 or T4 colon cancer between 2006 and 2018.

Gaps and priorities in innovation for children's surgery.

Lack of access to pediatric medical devices and innovative technology contributes to global disparities in children's surgical care. There are currently many barriers that prevent access to these technologies in low- and middle-income countries (LMICs). Technologies that were designed for the needs of high-income countries (HICs) may not fit the resources available in LMICs.

Exploring the complexity and spectrum of racial/ethnic disparities in colon cancer management.

Background: Colorectal cancer is a leading cause of morbidity and mortality across U.S. racial/ethnic groups.

Health care utilization in young adults with childhood physical disabilities: a nationally representative prospective cohort study.

Background: Young people with physical disabilities face barriers to accessing health care; however, few studies have followed adolescents with physical disabilities longitudinally through the transition of care into adulthood. The objective of this study was to investigate differences in health care utilization between adolescents with physical disabilities and those without during the transition period from adolescent to adult care.

Methods: We utilized the National Longitudinal Study of Adolescent to Adult Health, a prospective cohort study following adolescents ages 11-18 at baseline (1994-1995) through adulthood.

Postoperative Surveillance in Older Adults With T1N0M0 Low-risk Papillary Thyroid Cancer.

Background: The frequency and cost of postoperative surveillance for older adults (>65 y) with T1N0M0 low-risk papillary thyroid cancer (PTC) have not been well studied.

Methods: Using the SEER-Medicare (2006-2013) database, frequency and cost of surveillance concordant with American Thyroid Association (ATA) guidelines (defined as an office visit, ≥1 thyroglobulin measurement, and ultrasound 6- to 24-month postoperatively) were analyzed for the overall cohort of single-surgery T1N0M0 low-risk PTC, stratified by lobectomy versus total thyroidectomy.

Results: Majority of 2097 patients in the study were white (86.

Severe Hypocalcemia After Thyroidectomy: An Analysis of 7366 Patients.

Objective: The aim of the study was to determine severe hypocalcemia rate following thyroidectomy and factors associated with its occurrence.

Background: Hypocalcemia is the most common complication after thyroidectomy. Severe post-thyroidectomy hypocalcemia can be life-threatening; data on this specific complication are scarce.

Extent of surgery for low-risk thyroid cancer in the elderly: Equipoise in survival but not in short-term outcomes.

Background: Total thyroidectomy is more common than lobectomy for low-risk papillary thyroid cancer, despite equipoise in survival. Because postoperative morbidity increases with age, we aimed to investigate how the extent of thyroidectomy affects short-term outcomes among older patients.

Methods: Using the Surveillance, Epidemiology, and End Results-Medicare database, we identified patients aged ≥66 years who were treated between 1996 and 2011 for papillary thyroid cancer with tumors ≤2 cm in diameter.

Low-Risk Thyroid Cancer in Elderly: Total Thyroidectomy/RAI Predominates but Lacks Survival Advantage.

Background: Papillary thyroid cancer (PTC) is the fastest increasing cancer in the United States; incidence increases with age. It generally has a favorable prognosis but may behave more aggressively in older patients. This study aims to describe national treatment patterns for low-risk PTC in older adults.

Prediction of primary breast cancer size and T-stage using micro-computed tomography in lumpectomy specimens.

Background: Histopathology is the only accepted method to measure and stage the breast tumor size. However, there is a need to find another method to measure and stage the tumor size when the pathological assessment is not available. Micro-computed tomography.

Pulmonary Microvascular Blood Flow in Mild Chronic Obstructive Pulmonary Disease and Emphysema. The MESA COPD Study.

Rationale: Smoking-related microvascular loss causes end-organ damage in the kidneys, heart, and brain. Basic research suggests a similar process in the lungs, but no large studies have assessed pulmonary microvascular blood flow (PMBF) in early chronic lung disease.

Objectives: To investigate whether PMBF is reduced in mild as well as more severe chronic obstructive pulmonary disease (COPD) and emphysema.