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There are existing healthcare disparities in pediatric surgery today. Identity and racial incongruity between patients and providers contribute to systemic healthcare inequities and negatively impacts health outcomes of minoritized populations. Understanding the current demographics of the American Pediatric Surgical Association and therefore the cognitive diversity represented will help inform how best to strategically build the organization to optimize disparity solutions and improve patient care.1558 APSA members were sent an anonymous electronic survey. Comparative data was collected from the US Census Bureau and the Association of American Medical Colleges. Results were analyzed using standard statistical tests.Of 423 respondents (response rate 27%), the race and ethnicity composition were 68% non Hispanic White, 12% Asian American and Pacific Islander, 6% Hispanic, 5% multiracial, and 4% Black/African American. Respondents were 35% women, 63% men, and 1% transgender, androgyne, or uncertain. Distribution of sexual identity was 97% heterosexual and 3% LGBTQIA. Religious identity was 50% Christian, 22% Agnostic/Atheist, 11% Jewish, 3% Hindu, and 2% Muslim. 32% of respondents were first-generation Americans. Twenty-four different primary languages were spoken, and 46% of respondents were conversational in a second language. These findings differ in meaningful ways from the overall American population and from the population of matriculants in American medical schools.There are substantial differences in the racial, gender, and sexual identity composition of APSA members compared with the overall population in the United States. To achieve excellence in patient care and innovate solutions to existing disparities, representation, particularly in leadership is essential.Survey; original research.Level IV.

Congenital tumors of the umbilical cord are rare, and teratomas of the umbilical cord are exceedingly rare. Umbilical cord masses are often detected on routine prenatal ultrasound; however, umbilical teratomas are difficult to diagnose by imaging studies alone, and often require histopathologic examination for definitive diagnosis. Given the polymorphic presentation of umbilical cord teratomas and associated congenital anomalies, amniocentesis for genetic screening and fetal karyotyping should be offered. Here we report a case of a prenatally suspected umbilical cord angiomyxoma in an otherwise normal fetus who was found to be a mature teratoma on surgical pathology.

Background Emergency Medical Services (EMS) system in Armenia follows the Franco-German model in which physician - nurse dyads staff ambulances. This study aims to evaluate the knowledge and attitudes of EMS nurses regarding pediatric rapid assessment and resuscitation. Methods This is a cross-sectional, anonymous, self-administered survey study of a convenience sample of 200 out-of-hospital emergency nurses in June and July 2015. Results Response rate was 87.5%. Half of respondents failed to achieve the pre-defined passing score of 70% on the 10-question knowledge test (sample mean 6.32 ± 1.85 SD). Test score was positively correlated with pediatric training, current pediatric continuing medical education (CME), years with EMS and female gender. Questions regarding recognition of shock and initiation of neonatal and pediatric cardiopulmonary resuscitation were most frequently missed. Nurses were least confident in their ability to care for neonates and infants. 79.4% indicated that they would benefit from further pediatric training, and 86.1% indicated that knowledge from the Anglo-American model of emergency medicine could improve pediatric emergency care (PEC) in Armenia. Conclusions There is a need for additional PEC training and continuing education for EMS nurses in Yerevan, Armenia. Training EMS nurses would improve first responder awareness of pediatric acute management and resuscitation and enhance the quality of emergency care of children.

The use of methimazole for the treatment of hyperthyroidism in the first trimester of pregnancy has been linked to several congenital malformations. Most commonly reported is choanal atresia; however, other anomalies have been described including aplasia cutis, esophageal atresia, omphalomesenteric duct remnant, and omphalocele. A definitive phenotype of methimazole embryopathy has not been described. We report a case of a newborn with prenatal methimazole exposure who was found to have an H type tracheoesophageal (TE) fistula, vitelline fistula, ruptured omphalocele, as well as multiple duplication cysts of the stomach and small intestine.