• Hancock Lawrence posted an update 4 hours, 13 minutes ago

    Given the formidable health burdens associated with children’s exposure to community-based violence (CBV) and trafficking and exploitation (TE), continued investments in determining their epidemiology constitute an important focus for Canada.

    The objective of the present study is to provide a narrative summary and policy perspective concerning the quantitative studies reporting on the risk and protective factors and prevalence of children’s (<18 years) exposure to CBV and TE in Canada.

    To identify literature, we searched eight electronic databases. English and French citations from database inception to December 2018 were included; this was supplemented with citation chaining for peer-reviewed publications and grey literature up to December 2019. Evidence is synthesized via a narrative summary.

    There are few studies that have investigated children’s exposure to TE and CBV in Canada. Self-reported exposure to these forms of violence varies according to the type investigated, with estimates ranging from 2 % – to – 23 % and 5 % – to – 53 % for TE and CBV, respectively. Literature focused on risk and protective factors for these forms of victimization are also limited.

    Canada has the infrastructure in place to make significant gains in their data collection and monitoring of children’s exposure to TE and CBV via five national-level studies. To help realize the goal of ending all forms of violence against children by 2030, incorporation of reliable measures of these forms of exposure in new and ongoing national-level data collection systems is urgently needed.

    Canada has the infrastructure in place to make significant gains in their data collection and monitoring of children’s exposure to TE and CBV via five national-level studies. To help realize the goal of ending all forms of violence against children by 2030, incorporation of reliable measures of these forms of exposure in new and ongoing national-level data collection systems is urgently needed.

    Prevention and management of violence against children requires a multidisciplinary approach. Countries and regions tackle this problem according to their understanding and capacity, and therefore these teams work differently in different countries and regions.

    Current study is a bird’s eye view looking at the response to violence against children through exploring multidisciplinary approaches and challenges in child protection in high, upper-middle, and lower-middle-income countries.

    Participants for this study were selected through purposive sampling from eleven countries, one key informant from each country (N = 11).

    Current study is qualitative in nature and phenomenological design was used. Key informants were approached through email, and semi-structured online interviews were conducted. Thematic analysis was used to analyze the data and several themes emerged.

    Capacity building systems are established in upper-middle and high-income countries, whereas lower-income countries are struggling witibility of each country to protect children as per their commitment to SDGs. Although the functioning of multidisciplinary teams seems better in high and upper-middle countries, the low-middle income countries are trying to combat violence against children according to their priorities, some are doing better than others.Male-to-female reassignment surgery or vaginoplasty includes those surgical procedures that aim to recreate a functional and cosmetically acceptable female perineum with minimal scarring. The technique of choice at our center is penile inversion vaginoplasty with or without scrotal skin grafts. We present 4 cases diagnosed with rectoneovaginal fistulas treated at our center with favorable evolution. The first patient was diagnosed in the late postoperative period during dilation. She underwent 2 failed vaginal repair attempts. Finally, a temporary colostomy and a rectal flap were performed. The second patient was diagnosed 2 weeks after the initial surgery due to aggressive dilation and was treated with a temporary colostomy and secondary wound closure. The third patient was diagnosed on the fifth post-operative day after removal of the vaginal packing. Dietary restriction was indicated, and a rectal flap was performed. A fourth patient was diagnosed within the late postoperative period; she was submitted to surgical exploration and a rectal wall flap was created. Rolipram price Rectoneovaginal fistulas after sex reassignment surgery has an incidence of about 2-17% and they are the most common type of fistula after this procedure. In most cases, it is secondary to rectal injury during the initial surgery. The management of these fistulas ranges from primary closure, diverting colostomies, conservative management, or the performance of flaps. A multidisciplinary team approach is recommended for the diagnosis and treatment of this complication.Diagnosis and treatment of renal cell carcinoma with venous tumor thrombosis remains a challenge today, requiring multidisciplinary teams, mainly in tumor thrombus levels III-IV. Our objective is to present the various diagnostic techniques used and its controversies. A review of the most relevant related articles between January 2000 and August 2020 has been carried out in PubMed, EMBASE and Scielo. Continuous technological development has allowed progress in its detection, in the approximation of the histological subtype, and in the determination of tumor thrombus level. Regardless of the imaging technique used for its diagnosis (CT, MRI, TEE, ultrasound with contrast), the time elapsed until treatment is vitally important to reduce the risk of complications, some of them fatal, such as pulmonary thromboembolism.

    Finding and preserving normal parathyroid glands or localizing and removing diseased parathyroid glands are crucial steps to successful thyroid and parathyroid operations. Using near-infrared fluorescence detection to identify parathyroid glands during thyroid and parathyroid operations has lately gained widespread recognition, with 2 Food and Drug Administration-cleared devices currently in the market. We aim to update the endocrine surgery community on how near-infrared fluorescence detection can be most optimally used for rapid intraoperative parathyroid gland identification or preservation.

    A literature review was performed using the key terms “parathyroid,” “near infrared,” and “fluorescence” in relevant search engines. Based on the reviewed literature and expert surgeons’ opinions, recommendations were formulated for applying near-infrared fluorescence detection to identify or preserve parathyroid glands during cervical endocrine surgery.

    The scope of near-infrared fluorescence detection can be broadly categorized into (1) using near-infrared auto-fluorescence to identify or locate both healthy and diseased parathyroid glands, and (2) using contrast-enhanced near-infrared fluorescence to evaluate parathyroid gland perfusion.