In an urban safety-net hospital, disparities in communications regarding medications between hospital staff and patients were found based on housing status.Mortality due to cardiovascular disease in pregnancy is a growing problem in developed countries, being nowadays the leading cause of maternal death. Within this group, the most common cause of death are congenital or acquired heart diseases, representing a challenge in the management of these patients, since the pregnancy-related physiological alterations can impair their basal condition and treatment. We present the case of a 34-year-old patient, without any relevant pathological antecedents, who developed a second-degree atrioventricular block, Mobitz type I, following the administration of methylergometrine during cesarean section due to failure to progress in labour. We emphasize the importance of considering the side effects of commonly used drugs in pregnant patients, despite rare possibility of some adverse reactions.
  The purpose of this study was to assess variability in age at Kasai portoenterostomy (KP) in infants with biliary atresia (BA) across children's hospitals in the United States.
 
  A multi-institutional retrospective study was performed examining infants with BA undergoing KP within 6 months of birth from 2016-2019, utilizing the Pediatric Health Information System (PHIS). Multivariable negative binomial mixed effects regression was performed for age at KP, and inter-hospital variability was examined.
 
  Across 46 hospitals, 470 infants with BA underwent KP at a median age of 57 days (IQR 42-72), with 212 (45.1%) undergoing KP at ≥60 days of age.  https://www.selleckchem.com/products/loxo-292.html  There was significant inter-hospital variability in age at KP ranging from 38 days (95% CI 31d, 47d) to 76 days (95% CI 63d, 91d) (p<0.0001). Factors associated with later KP were black or African-American race, urgent/emergent admission, and treatment at a hospital in the Pacific-West region. Predictors of earlier KP included later year, history of neonatal comorbidity, and admission to an intensive care service (all p<0.05).
 
  There is significant variability in the age at KP in infants with BA across children's hospitals in the United States.
 
  Retrospective study.
 
  III.
 III.
  A retrospective chart review of liver histologies in Kasai biliary atresia BA patients operated 1/2017- 7/2019 at our institution was conducted to identify histologic prognostic factors for biliary outcome.
 
  Patients with wedge liver biopsies and portal plate biopsies (n=85) were categorized into unfavorable and favorable outcome, based on a 3-month serum total bilirubin level of <34μM or mortality. Hepatocellular histologies, presence of ductal plate malformation (DPM) and of large bile duct of ≥ 150μm diameter size at the portal plate were evaluated.
 
  Total Bilirubin levels> 34μM correlates with worse 1-year survival. Age at surgery, histologic fibrosis or inflammation does not predict outcome. Potential adverse predictors are severe hepatocellular swelling, severe cholestasis, presence of DPM (n=24), and portal plate bile duct size < 150µm (n=28). In multivariate analyses adjusting for age at Kasai and postop cholangitis, bile duct size and severe hepatocellular swelling remain independent histologic prognosticators (OR 3.25, p=0.039 and OR 3.26, p=0.006 respectively), but not DPM.
 
  Advanced histologic findings of portal plate bile duct size of <150µm and severe hepatocellular damage predict poor post-Kasai jaundice clearance and short-term survival outcome, irrespective of Kasai timing.
 
  Level III.
 Level III.
  The Accreditation Council for Graduate Medical Education (ACGME) regulates the general surgery residency curriculum. Case volume remains a priority as recent concerns surrounding a lack of proficiency for certain surgical cases have circulated. We hypothesize that there is a significant decrease in pediatric surgery case numbers during general surgery residency despite residents meeting the minimum case requirements.
 
  We reviewed publicly available ACGME case reports for general surgery residency from 1999 to 2018. Cases are classified as Surgeon Chief or Surgeon Junior. Analyzed data included case classifications, number of residents, and number of residency programs. Simple linear regression analysis was performed.
 
  We identified a significant decrease in total number of logged pediatric surgery cases over the past 20 years (p<0.001). Nearly 60% of cases were logged under a single category - inguinal/umbilical hernia. From the past five years, pyloric stenosis was the only other category with an average of greater than two cases logged (range 2.1-2.8).
 
  We identified a significant decrease in total pediatric surgery case numbers during general surgery residency from 1999 to 2018. Though meeting set requirements, overall case variety was limited. With minimal number of cases required by the ACGME, graduating general surgery residents may lack proficiency in simple pediatric surgery cases.
 We identified a significant decrease in total pediatric surgery case numbers during general surgery residency from 1999 to 2018. Though meeting set requirements, overall case variety was limited. With minimal number of cases required by the ACGME, graduating general surgery residents may lack proficiency in simple pediatric surgery cases.
  The recognition of child physical abuse can be challenging and often requires a multidisciplinary assessment. Deep learning models, based on clinical characteristics, laboratory studies, and imaging findings, were developed to facilitate unbiased identification of children who may have been abused.
 
  Level 1 pediatric trauma center registry data from 1/1/2010-1/31/2020 were queried for abused children and matched participants with non-abusive trauma. Observations were de-identified and divided into training and validation sets. Model 1 used patient demographics (age, gender, and insurance type) and clinical characteristics (vital signs, shock index pediatric age-adjusted, Glasgow Coma Score, lactate, base deficit, and international normalized ratio). Model 2 used the same features as Model 1, but with the text of the radiology reports of head computed tomography, brain MRIs, and skeletal surveys. Google's latest BERT Natural Language Processing (NLP) model, which was pre-trained on a large corpus, was used for fine-tuning Model 2.