World journal of surgery
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World journal of surgery · Nov 2007
Epidemiology and contemporary patterns of trauma deaths: changing place, similar pace, older face.
The epidemiology of trauma deaths in Europe is less than well investigated. Thus, our goal was to study the contemporary patterns of trauma deaths within a defined population with an exceptionally high trauma autopsy rate. ⋯ While pre-hospital and early deaths still predominate, an increasing proportion succumb after arrival in hospital. Focus on injury prevention is imperative, particularly for brain injuries. Although hemorrhage and multiorgan failure deaths have decreased, they do still occur. Redirected attention and focus on the geriatric trauma population is mandated.
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World journal of surgery · Oct 2007
Accuracy of the surgeons' clinical prediction of perioperative complications using a visual analog scale.
The ability to predict who will develop perioperative complications remains difficult because the etiology of adverse events is multifactorial. This study examines the preoperative and postoperative ability of the surgeon to predict complications and assesses the significance of a change in prediction. ⋯ Clinical assessment of risk by the surgeon using a VAS score independently improves the prediction of perioperative complications. Including the unique contribution of the surgeon's clinical assessment should be considered in models designed to predict the risk of surgery.
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World journal of surgery · Sep 2007
Multidisciplinary crisis simulations: the way forward for training surgical teams.
High-reliability organizations have stressed the importance of non-technical skills for safety and of regularly providing such training to their teams. Recently safety skills training has been applied in the practice of medicine. In this study, we developed and piloted a module using multidisciplinary crisis scenarios in a simulated operating theatre to train entire surgical teams. ⋯ Multidisciplinary simulation-based team training is feasible and well received by surgical teams. Non-technical skills can be assessed alongside technical skills, and differences in performance indicate where there is a need for further training. Future work should focus on developing team performance measures for training and on the development and evaluation of systematic training for technical and non-technical skills to enhance team performance and safety in surgery.
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World journal of surgery · Sep 2007
VEGF-C expression in squamous cell carcinoma and adenocarcinoma of the esophagus.
Vascular endothelial growth factor C (VEGF-C) is the only factor known to cause lymphangiogenesis. In esophageal cancer the histologic tumor type and lymph node metastasis are independent predictors of recurrence and poor outcome. To evaluate the rule of VEGF-C expression in esophageal cancer, we investigated 113 specimens, 59 squamous cell and 54 adenocarcinomas of the esophagus. ⋯ The present study indicates that VEGF-C may play a role in tumor progression via lymphangiogenesis in squamous cell carcinoma of the esophagus. This seems not to be true for the adenocarcinoma of the esophagus. These data could help with the understanding of the different onset and characteristics of lymph node metastasis in squamous cell carcinoma and adenocarcinoma of the esophagus.
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World journal of surgery · Sep 2007
Classifying post-herniorrhaphy pain syndromes following elective inguinal hernia repair.
Chronic post-herniorrhaphy pain is diverse in origin. The aim of our study was to classify post-herniorrhaphy pain syndromes following elective inguinal hernia repair. ⋯ Chronic pain following elective hernia repair is common and diverse in etiology but may allow for a classification contributing to the development of tailored treatment regimens.