Journal of the Royal College of Surgeons of Edinburgh
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An ancient Egyptian mummy from the collections of the National Museums of Scotland was examined using computerised tomography (CT) scanning as part of the NMS mummy project. A facial reconstruction was produced from the CT scans for comparison with a painted 'portrait' which covers the face of the wrappings. ⋯ The facial features were reconstructed onto a plaster model of the skull from known tissue depths using terracotta clay. The resultant face was compared with the portrait and an extremely close match obtained, suggesting this was an individual portrait painted around the time of death.
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J R Coll Surg Edinb · Feb 2000
Clinical TrialWould measurement of C-reactive protein reduce the rate of negative exploration for acute appendicitis?
Appendicectomy for suspected acute appendicitis is a common procedure. The rate of normal appendices unnecessarily removed remains high (15-30%) despite several techniques and investigations used to improve the diagnostic accuracy. Many studies investigated the role of raised C-reactive protein in improving the diagnosis of acute appendicitis, but with conflicting results. This study emphasies the impact of a normal (rather than raised) serum C-reactive protein in reducing the rate of negative explorations. ⋯ A normal pre-operative serum CRP measurement in patients with suspected acute appendicitis is most likely associated with a normal appendix. Deferring surgery in this group of patients would probably reduce the rate of unnecessary appendicectomies.
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J R Coll Surg Edinb · Oct 1999
The role of the intensive care unit in the management of the critically ill surgical patient.
Surgical patients make up 60-70% of the work load of intensive care units in the UK. There is a recognised short fall in the resource allocation for high dependency units (HDUs) and intensive care units (ICUs) in this country, despite repeated national audits urging that this resource be increased. British ICUs admit patients later and with higher severity of illness scores than elsewhere and this leads to higher ICU mortality. ⋯ Early admission to ICU, with potential improvement in outcomes, could also be achieved using multi-disciplinary medical emergency teams. These teams would be alerted by ward staff in response to set specific conditions and physiological criteria. These proposals are still under trial but may offer benefit by reducing mortality in critically ill surgical patients.
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J R Coll Surg Edinb · Jun 1999
Do patients with acute abdominal pain wait unduly long for analgesia?
A prospective audit of 100 emergency admissions was carried out to determine local surgical practice for analgesia administration in patients with acute abdominal pain. The main outcome measure investigated was waiting time for analgesia and how this was influenced by (i) severity of pain, (ii) clinical diagnosis, (iii) clinical setting. The data were correlated with the results of a questionnaire on timing of analgesia. ⋯ In conclusion, a substantial cohort of patients with acute abdominal pain (43%) wait too long for analgesia. Delays are due to omission of analgesia in A&E, and reluctance of junior staff to administer analgesia for fear of masking physical signs. Clinical guidelines for pain medication in acute surgical emergencies are warranted.
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J R Coll Surg Edinb · Jun 1999
Completion of the journey of care: Scottish Audit of Surgical Mortality (SASM).
The ideal must be to audit all deaths as part of routine surgical and anaesthetic practice. We have examined the level of compliance of surgeons and anaesthetists participating in the Scottish Audit of Surgical Mortality (SASM) for the audit's first three years. The audit has achieved more than 92% compliance, unchanged over a three year period. As a consequence it can be regarded as a truly routine part of surgical and anaesthetic practice within Scotland.