The State of Pediatric Research in Hawai'i: A Comparative Bibliometric Analysis.

The current state of pediatric research in Hawai'i was analyzed using bibliometric methods. The Web of Science bibliometric database was used to retrieve 989 Hawai'i records, which were compared with 264 064 records from the United States (US). Hawai'i was compared to the country as a whole in terms of total output of research, article types, top journals, co-authorship, and subject areas. The research was also analyzed in 2 time periods, 1980-1999 and 2000-2019. It was found that the total Hawai'i pediatric research output has not kept pace with the US output. However, it was found that Hawai'i had a greater share of Asia-Pacific co-authorship. Subspecialty areas of study also differed between Hawai'i and the US, and have changed over time from a predominance of infectious diseases and immunology research to a focus on emergency medicine and orthopedics. Neonatology research has increased locally as it has nationally. Hawai'i authors tend to publish a greater percentage of full-length original research articles in the top pediatric journals compared to US authors as a whole. The set of institutions publishing pediatric research in Hawai'i has diversified over time. This analysis of the pediatric research in Hawai'i can be used by researchers, funders, and policy makers to direct future research efforts to improve the health of children in Hawai'i.

Achilles tendon rupture and tendinopathy: management of complications.

Ailments of the Achilles tendon are on the increase and present in athletic and sedentary patients. The management of tendinopathy and rupture is not codified; Achilles tendon rupture and tendinopathy can be managed conservatively or surgically. Tackling the complications that arise from the management of these conditions provides a formidable challenge to the surgeon. Rupture, rerupture, disordered scarring with potential keloid formation, nerve damage (especially the sural nerve), poor healing, infection, bleeding and hematoma formation, wound dehiscence, deep vein thrombosis (DVT), and loss of function have been reported. This article gives an up-to-date account on our personal views of managing complications following Achilles tendon rupture, tendinopathy, and delayed rupture.