Canadian journal of surgery. Journal canadien de chirurgie
-
Accidents and their sequelae are the main cause of death in Germany among people under 40 years of age. The cost in disability payments and lost work averages $40 000 per injury. The author describes the German system for trauma rescue. ⋯ A study comparing the efficiency of the helicopter and ambulance systems showed that as the severity of the injuries increases, the death rate is greater in the group rescued by ambulance. Of 22 accidents involving rescue helicopters, 7 (32%) resulted in at least one death. Between 1973 and 1983, 16 doctors, pilots or attendants were killed.
-
From 1978 to 1983, 111 patients with symptomatic internal hemorrhoids were treated as outpatients by a modification of the Barron ligation technique. Each ligated hemorrhoid was injected with a sclerosant. Follow-up, available for 94 of the patients, ranged from 2 to 60 months (mean 18 months). ⋯ Nine patients had minor complications, which included pain lasting 24 to 72 hours in seven, bleeding in one and syncope in one. The addition of sclerotherapy to traditional band ligation for the management of internal hemorrhoids has the advantages of exciting a greater inflammatory reaction between the mucosa and submucosa and preventing premature slipping of the band. The authors conclude that this method of therapy is effective for symptomatic hemorrhoids and that surgical hemorrhoidectomy is seldom indicated.