International journal of surgery
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Mortality and morbidity in trauma remain a major problem in developing countries. Organized emergency response systems for transfer of trauma patients to hospitals are absent and the consequent delays could cause significant complications. ⋯ Transfer and delay in admission to a tertiary care center does not affect in-hospital mortality of trauma patients in a setting with no emergency response system. This may be due to self selection of patients who survive long enough to reach the hospital.
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The aim of this study was to assess the role of adding gabapentin (Neurontin) to the prescription of patients with opiate resistant pain as a result of critical limb ischaemia (CLI). ⋯ The study has demonstrated that gabapentin is a useful adjuvant in the management of CLI and leads to significant reductions in pain scores and improves night pain for most patients.
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The effect of vasopressors on the healing of gastrointestinal anastomoses is still controversial. The purpose of our study was to research the relationship between dose of dopamine, which is used generally as a vasopressor in shock status, and anastomotic leak in colonic surgery. ⋯ Although vasopressors appeared to increase the risk of anastomotic leakage as a result of splanchnic vasoconstriction, deterioration of microcirculation, and local hypoxia, we found that BPA were increased with high doses of vasopressor. We speculated that the use of vasopressors without shock might increase blood supply to the anastomotic line by increasing cardiac output.
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To compare the traditional anatomic landmark technique with the ultrasound-guided method for central venous catheterization. ⋯ The ultrasound-guided method is faster, more efficient, and less morbid procedure compared with the classical anatomic landmark technique. Therefore, it should be preferred over the classical landmark method, especially in high-risk patients for the development of complications.
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To evaluate the risk-adjusted perioperative outcome of colorectal cancer surgery, applying the Colorectal Physiological and Operative Severity Score for the enumeration of Mortality and morbidity (CR-POSSUM). ⋯ Perioperative outcome of colorectal surgery in Trinidad and Tobago is comparable to the developed countries as evaluated by the CR-POSSUM. Patients presenting for emergency surgery and those with advanced stages of cancer had higher perioperative mortality.