Nationwide questionnaire survey on pediatric pancreatic tumors in Japan

BACKGROUND Pediatric pancreatic tumors are rare and account for<0.1%of all childhood cancers.The primary treatment for pancreatic tumors is surgical resection.However,because of the lack of knowledge regarding pediatric pancreatic tumors,no comprehensive treatment plans for pediatric pancreatic tumors have been developed.AIM To compared the clinical features,treatment methods,and prognosis of pediatric pancreatic tumors in Japan with those in other countries.METHODS Questionnaires were sent to 213 pediatric surgical units in Japan.Pancreatic tumors that were not surgically treated were excluded from the survey.The primary survey investigated the number of patients aged 0-18 years who underwent pancreatic tumor surgery and the type of tumors managed during the 22-year study period(from January 1,2000 to December 31,2021)by post card.The secondary survey assessed the clinical images,treatment methods,and tumor outcomes via email.RESULTS The primary survey enrolled 228 patients.In the secondary survey,213 patients were eventually enrolled.The most common type of pancreatic tumor was solid pseudopapillary neoplasm(SPN)[n=164(77.0%)],followed by pancreatoblastoma[n=16(7.5%)],pancreatic endocrine tumor[n=14(6.6%)],non-epithelial tumor[n=9(4.2%)],pancreatic tumor[n=7(3.3%)],and metastatic pancreatic tumor[n=3(1.4%)].Overall,123(57.7%)patients underwent distal pancreatectomy,of whom 49 underwent laparoscopic surgery.Forty-four(20.7%)patients underwent enucleation,of whom eight underwent laparoscopic surgery.Thirty-two(15.0%)patients underwent pancreaticoduodenectomy,of whom one underwent laparoscopic surgery.All patients with SPN,including those with distant metastases and recurrent disease,survived.CONCLUSION SPN was more common in Japan than in other countries.Regardless of the histological type,resection is the most effective treatment for pediatric pancreatic tumors.

Managing liver transplantation during the COVID-19 pandemic:A survey among transplant centers in the Southeast United States

BACKGROUND The coronavirus disease-2019(COVID-19)pandemic has had a profound worldwide impact.Indeed,it has led to a vast decrease in organ transplantation,including liver transplants(LT).There is little data regarding adjustments made by LT centers as a response to the COVID-19 pandemic.AIM To assess the experience of LT centers in the United States during the pandemic.METHODS We performed an observational survey study from May 11,2020 to June 5,2020.We sent out a 13 question survey to 15 LT centers across the southeastern United States.RESULTS Eleven LT centers responded to the survey.We found that(11/11)100%of transplant centers made adjustments because of the COVID-19 pandemic.At least 50%of transplant centers had at least one transplant recipient infected with COVID-19.To adjust,greater than 50%of centers performed fewer LT,100%of patients were tested for COVID-19,and most centers implemented a virtual platform.CONCLUSION The COVID-19 pandemic greatly affected liver transplantation in the southeastern United States.It was evident that a concerted effort was made by LT centers to protect their patients and employees from COVID-19 but also to continue the lifesaving procedure of LT in this sick patient population.Further studies are needed to assess how LT centers around the world managed the pandemic in order to learn strategies to continue life-saving procedures in this patient population.

Case Study: Finding Better Solutions for Municipal Solid Waste Management in a Semi Local Authority in Sri Lanka

This case study investigates better and sustainable waste management for a given area in Sri Lanka. A questionnaire and field surveys were performed in a small local authority adjacent to Colombo, the capital city. Composting for organic waste and incineration for non-compostable waste were found to be important treatment methods for solid-waste management. The reduction of solid waste is a critical process for sustainable management. Currently, people in the area do not have much interest in waste recycling to decrease the cost of solid-waste management. It was therefore concluded that raising people’s awareness would play an important role in the reduction of solid waste. A suitable waste-management plan needs to be made for each community and area. The situation and conditions of every area is different, therefore each community needs to make an effort to find its own better and sustainable solid-waste management process.