"CF asthma": what is it and what do we do about it?

The diagnosis of "CF asthma" is problematic and it is difficult to determine which patients have a combination of CF and asthma and which have asthma like symptoms caused by inflammation of the CF lung. This may not matter, however; the relevance lies in the possible approaches to treatment.     

Bias and discrimination in surgery: Where are we and what can we do about it?

Bias is an inclination or preconceived outlook that favors toward or against an idea, person, or group. It manifests in implicit and explicit ways throughout all aspects and institutions of society. These cognitive shortcuts are often based on stereotypes and can lead to prejudice and discrimination in medicine as they mediate interactions with patients, between providers, and at the institutional level. It is important to understand the drivers and consequences of bias in order to overcome barriers to representation, equity, and inclusion. This paper provides definitions of bias; discusses its manifestations across academic medicine at the institutional and individual levels; and concludes by examining techniques to reduce bias and measure progress. Equity for patients, families, and members of the broader surgical community cannot be achieved without reducing bias and discrimination. We call for action to increase intentional efforts that reduce the influences of bias in healthcare, research, and education, particularly in the field of pediatric surgery.     

Breast cancer and HIV: what do we know?

The present acquired human immunodeficiency syndrome-defining neoplasms are Kaposi's sarcoma, non-Hodgkins lymphoma, and cervical cancer. However, other malignancies have recently been associated with human immunodeficiency virus (HIV) infection. Is there also a link between breast cancer and HIV infection? Breast cancer seems to be more aggressive in the setting of immunocompromise by HIV infection, as demonstrated by the clinical course of two patients recently treated at this institution and review of the available literature. As the acquired human immunodeficiency syndrome epidemic affects increasing numbers of women and survival improves, surgeons will be frequently called on to diagnose and treat breast cancer in the HIV+ patient.     

Hip abductor deficiency: What can you do about it?

Abductor deficiency after THA can result from a number of causes resulting in considerable functional impairment and hip instability. Treatment of instability may require use of a constrained component. However, constrained implants can fail mechanically and do not address the gait impairment caused by abductor weakness. Surgical reattachment of the abductors or reconstruction using an allograft tendon may be beneficial, but results of these procedures have not been predictable. Whiteside described combined transposition of the tensor and anterior gluteus maximus muscles for abductor deficiency after THA. This restores an autogenous soft tissue connection between the pelvis and lateral hip, which can provide modest improvement in abductor function.     

Current topics in pancreato-biliary endotherapy: what can we do?

Introduction  

Endotherapy is progressing steadily, especially for various pancreato-biliary diseases. This article introduced new procedures and devices, and revealed improvement of treatment outcomes.