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Topic Review
Pediatric Surgery Simulation-Based Training
Pediatric surgery is the diagnostic, operative, and postoperative surgical care of children with congenital and acquired anomalies and diseases. The early history of the specialty followed the classic “see one, do one, teach one” philosophy of training but has since evolved to modern methods including simulation-based training (SBT). Current trainees in pediatric surgery face numerous challenges, such as the decreasing incidence of congenital disease and reduced work hours. 
  • 148
  • 11 Jan 2024
Topic Review
Pediatric Oncology Palliative Care Programs in Central America
Palliative care offers children who have life-limiting and life-threatening oncologic illnesses and their families improved quality of life. In some instances, impeccable symptom control can lead to improved survival. Cultural and financial barriers to palliative care in oncology patients occur in all countries, and those located in Central America are no exception. In this article, we summarize how the programs participating in the Asociación de Hemato-Oncólogos Pediatras de Centro America (AHOPCA) have developed dedicated oncology palliative care programs. The experience in Guatemala, El Salvador, Costa Rica, Panama, Dominican Republic and Haiti is detailed, with a focus on history, the barriers that have impeded progress, and achievements. Future directions, which, of course, may be impacted by the COVID-19 pandemic, are described as well.
  • 407
  • 02 Dec 2021
Topic Review
Pediatric Medical Devices
Children represent the future, and ensuring their physical, socio-emotional, language, and cognitive development is integral to health technology development. The development of a child from term or preterm neonate to a fully mature individual relies on complex physiological, anatomical, developmental, and social changes. Understanding the inter- and intra-population differences within the pediatric subpopulations is necessary to address the existing challenges and break down some of the long-recognized barriers. There is thus a clear need for research infrastructure and networks with the depth of expertise to support pediatric device development through collaboration across the life sciences sector. 
  • 463
  • 10 Jan 2022
Topic Review
Pedestrian Violations
Pedestrians are a vulnerable group of road users. Worldwide, the number of pedestrian deaths annually in road traffic accidents is about 270,000, which exceeds 22% of all traffic mortalities. This rate reveals its critical role in traffic safety research. Of these, pedestrian accidents mainly occur at signalized intersections when pedestrians illegally pass-through crosswalks, which are highly dangerous due to the high risk of pedestrian–vehicle interactions. Illegal crossings mainly include pedestrians crossing at red lights or outside of marked crosswalks, and the former usually causes severe harm. This risky behavior may raise traffic safety issues between pedestrians and driving vehicles. As such, it is necessary to analyze pedestrian red-light violations at signalized intersections and to reduce the risk of pedestrian crossing violations.
  • 1.1K
  • 14 Nov 2022
Topic Review
PD-L1 in Pancreatic Ductal Adenocarcinoma
Pancreatic ductal adenocarcinoma (PDAC) is one of the deadliest cancers, with a five-year survival rate of approximately 5–10%. The immune checkpoint blockade represented by PD-1/PD-L1 inhibitors has been effective in a variety of solid tumors. 
  • 438
  • 06 Dec 2022
Topic Review
PCN in Malignancy-Associated Ureteric Obstruction
Malignant ureteric obstruction occurs in a variety of cancers and has been typically associated with a poor prognosis. Percutaneous nephrostomy (PCN) can potentially help increase patient longevity by establishing urinary drainage and treating renal failure. PCN is to put a small tube through a kidney to drain urine.
  • 562
  • 29 Jun 2021
Topic Review
PBUTs Therapeutics in AKI and CKD
Uremic toxins are defined as harmful metabolites that accumulate in the human body of patients whose renal function declines, especially chronic kidney disease (CKD) patients. Growing evidence demonstrates the deteriorating effect of uremic toxins on CKD progression and CKD-related complications, and removing uremic toxins in CKD has become the conventional treatment in the clinic.
  • 617
  • 19 Apr 2022
Topic Review
Patient-Worker-Management of Vasovagal Syncope at Work
Syncope is a complex clinical manifestation that presents considerable diagnostic difficulties and, consequently, numerous critical issues regarding fitness for work, especially for high-risk tasks. It is impossible to quantify the exact impact of syncope on work and public safety since it is highly improbable to identify loss of consciousness as the fundamental cause of work or driving-related accidents, especially fatal injuries. Working at high-risk jobs such as public transport operators, in high elevations, or with exposure to moving parts, construction equipment, fireworks, or explosives demand attention and total awareness.
  • 373
  • 28 Apr 2023
Topic Review
Patient-Centered Care for Depression Patients
People have specific and unique individual and contextual characteristics, so healthcare should increasingly opt for person-centered care models. Care planning focused on people with depression and/or anxiety disorder must be individualized, dynamic, flexible, and participatory. It must respond to the specific needs of the person, contemplating the identification of problems, the establishment of individual objectives, shared decision making, information and education, systematic feedback, and case management, and it should meet the patient’s preferences and satisfaction with care and involve the family and therapeutic management in care.
  • 1.3K
  • 18 Aug 2021
Topic Review
Patient Protection and Affordable Care Act
The Patient Protection and Affordable Care Act, also known as the Affordable Care Act (ACA) or colloquially as Obamacare, is a United States federal statute enacted by the 111th United States Congress and signed into law by President Barack Obama on March 23, 2010. Together with the Health Care and Education Reconciliation Act of 2010 amendment, it represents the U.S. healthcare system's most significant regulatory overhaul and expansion of coverage since the passage of Medicare and Medicaid in 1965. PPACA's major provisions came into force in 2014. By 2016, the uninsured share of the population had roughly halved, with estimates ranging from 20 to 24 million additional people covered. The law also enacted a host of delivery system reforms intended to constrain healthcare costs and improve quality. After the law went into effect, increases in overall healthcare spending slowed, including premiums for employer-based insurance plans. The increased coverage was due, roughly equally, to an expansion of Medicaid eligibility and to changes to individual insurance markets. Both received new spending, funded through a combination of new taxes and cuts to Medicare provider rates and Medicare Advantage. Several Congressional Budget Office reports said that overall these provisions reduced the budget deficit, that repealing PPACA would increase the deficit, and that the law reduced income inequality by taxing primarily the top 1% to fund roughly $600 in benefits on average to families in the bottom 40% of the income distribution. The act largely retained the existing structure of Medicare, Medicaid and the employer market, but individual markets were radically overhauled. Insurers were made to accept all applicants without charging based on pre-existing conditions or demographic status (except age). To combat the resultant adverse selection, the act mandated that individuals buy insurance (or pay a fine/tax) and that insurers cover a list of "essential health benefits". Before and after enactment PPACA faced strong political opposition, calls for repeal and legal challenges. In National Federation of Independent Business v. Sebelius, the Supreme Court ruled that states could choose not to participate in PPACA's Medicaid expansion, although it upheld the law as a whole. The federal health exchange, HealthCare.gov, faced major technical problems at the beginning of its rollout in 2013. Polls initially found that a plurality of Americans opposed the act, although its individual provisions were generally more popular and the law gained majority support by 2017.
  • 1.7K
  • 05 Nov 2022
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