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A generation of learners is growing up in one of the most polarized eras in modern US history, where demands for credible connections and pluralistic policies are countered with divisive rhetoric. The urgent need for honest dialog emanates from the public square, mass media, news, popular culture, schools, and universities. As controversial events touch our lives in deeply personal ways, educators must explore strategies for discussion in classrooms around matters of social justice. In this article, I highlight the competition between the narrative and the counter-narrative that form our social justice worldviews, and the implications of this conflict for students. I explore the subjectivity of beliefs about injustice and our resulting inability to dialog effectively about it. I examine the rationale for our long-standing teaching of false narratives and argue for supporting and supplementing school curriculum with corrected historical, social, and cultural truths. Four interrelated principles are covered: (a) the competing narratives of racial inequality, (b) the current divisive socio-political climate, (c) student advocacy and knowledge of social justice topics, and (d) the complexity of engagement on controversial issues. [ABSTRACT FROM AUTHOR]

Background: Some technical aspects of laparoscopic spleen surgery still are debated, although efforts have been made to standardize them. The position of the patient, the approach to the spleen, vessel identification and division, and spleen extraction can vary from center to center.Methods: This retrospective muticentric study led by the Società Italiana di Videochirurgia Infantile (SIVI) examined indications, surgical details, and complications of laparoscopic spleen surgery in the pediatric population during a 5-year period.Results: The study period from January 1999 to December 2003 (5 years) involved nine centers and included 85 patients with a mean age of 10 years (range, 2-17 years). Hypersplenism or severe hemolysis in cases of hematologic disorders represented the most important indications. More than 90% of the patients underwent total laparoscopic splenectomy. Specific technical details from each center were collected. Intraoperative complications occurred in 19% of the patients (hemorrhage in 8% and technical problems in 14%), and 6% of the patients required conversion to the open approach. No deaths occurred, and no reoperations were required. Postoperative complications were experienced by 2% of the patients.Conclusion: Laparoscopic spleen surgery is safe, reliable, and effective in the pediatric population. On the basis of the results, some technical details for laparoscopic spleen surgery can be suggested. The patient is preferably kept supine or lateral, approaching the spleen anteriorly. Moreover, the ilar vessels should be identified selectively and individually, with initial artery division performed to achieve spleen shrinking. Any hemostatic device proved to be effective in experienced hands. Once freed, the spleen is preferably extracted via a suprapubic cosmetic transverse incision (faster, easier, and safer), although a bag can be used. Finally, the size of the spleen does not represent a contraindication for a trained and experienced surgeon. Nevertheless, this parameter must be considered when laparoscopic spleen surgery is planned. [ABSTRACT FROM AUTHOR]

To perform a laparoscopic appendectomy, three trocars are usually needed. In order to reduce abdominal wall trauma, we have adopted an umbilical one-puncture laparoscopic-assisted appendectomy (UOPLAA). We did a retrospective study of UOPLAA performed during last 2 years on 200 children aged from 5 to 18 years (median, 9 years). The patients were selected after clinical examination. No child with advanced generalized peritonitis or an abscess with a palpable mass was a candidate for this technique. UOPLAA was successful in 184 patients (92%). In 16 cases (8%), an additional trocar was required to manage perforated or retrocecal appendicitis. The mean operative time was 15 min, and the mean hospital stay was 2 days. There were no intraoperative complications. There were 10 (5%) postoperative complications (three parietal and seven intraabdominal). Four patients (2%) needed reoperation under general anesthesia. The UOPLAA is our preference in cases of acute nonperforated appendicitis because it is simple and fast, with good cosmetic results; but in 8% of our cases, an intraoperative difficulty (retrocecal location, abnormal adhesive band, peritonitis, etc.) arose that required the introduction of additional devices to ensure the safety of the laparoscopic procedure. [ABSTRACT FROM AUTHOR]

The authors report a case of double accessory tongue in a female neonate. The embryology of this extremely rare congenital anomaly, along with the diagnostic approach followed and the surgical intervention undertaken, are discussed. The surgical procedure was radical and led to good functional and esthetic results. [ABSTRACT FROM AUTHOR]