World journal of surgery
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World journal of surgery · Jan 2011
Evaluation of trauma and critical care training courses on the knowledge and confidence of participants in Kenya and Zambia.
Trained health-care personnel are essential for improved outcomes for injured and critically ill patients. The highest injury-related mortality is seen in sub-Saharan Africa, where there is a paucity of skilled personnel. Therefore, the College of Surgeons of East, Central, and Southern Africa (COSECSA) along with Emory University provided an acute trauma care (ATC) and fundamental critical care support course (FCCS). This study evaluates the impact of American-derived courses on the knowledge and confidence of participants from resource-limited countries. ⋯ Participants from resource-limited countries benefit from ATC/FCCS courses as demonstrated by increased knowledge and confidence across all topics presented. However, the strongest increase in confidence was in performing life-saving procedures. Therefore, future courses should emphasize essential procedures, reduce didactics, and link knowledge acquisition to skill-based teaching.
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World journal of surgery · Jan 2011
Multicenter StudyOutcomes from prehospital cardiac arrest in blunt trauma patients.
There are few strategies for treating patients who have suffered cardiopulmonary arrest due to blunt trauma (BT-CPA). The aim of this population-based case series observational study was to clarify the outcome of BT-CPA patients treated with a standardized strategy that included an emergency department thoracotomy (EDT) under an emergency medical service (EMS) system with a rapid transportation system. ⋯ In BT-CPA patients, a 20-min resuscitation effort and termination of the effort are thought to be relevant. The initial rhythm is not a prognostic indicator. We believe that the decision on whether to undertake aggressive resuscitation efforts should be made on a case-by-case basis.
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World journal of surgery · Jan 2011
Comparative StudyComparison of early and late complications after various bariatric procedures: incidence and treatment during 15 years at a single institution.
Bariatric procedures are effective in the life-long treatment of clinically severe obesity, but they are technically demanding and have known complications. The present study presents mortality and morbidity with different procedures from the prospective 15-year bariatric database of the University Hospital of Patras in Greece. ⋯ Bariatric procedures, even in specialized centers, may have serious complications because of their technical complexity in a high-risk population. Almost all can be managed successfully.
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World journal of surgery · Jan 2011
Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.
Injuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city. ⋯ Patterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted.
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World journal of surgery · Jan 2011
Management of penetrating abdominal trauma in the conflict environment: the role of computed tomography scanning.
Computed tomography (CT) scanning is a vital imaging technique in selecting patients for nonoperative management of civilian penetrating abdominal trauma. This has reduced the rate of nontherapeutic laparotomies and associated complications. Battlefield abdominal injuries conventionally mandate laparotomy, and with the advent of field deployable CT scanners it is unclear whether some ballistic injuries can be managed conservatively. ⋯ Computed tomography scanning can be used in stable patients who have sustained penetrating battlefield abdominal injury to exclude peritoneal breach and identify solid abdominal organ injury that can be safely managed nonoperatively.