Antibiotic Use and Antimicrobial Resistance of Surgical Patients with Peritonitis at a Tertiary Referral Hospital in Rwanda.

Background: There is growing recognition of the worsening problem of antibiotic resistance and the need for antibiotic stewardship in low-resource settings. The aim of this study was to describe antibiotic use and antimicrobial resistance in patients undergoing surgery for peritonitis at a Rwandan referral hospital.

Patients And Methods: All surgical patients with peritonitis at a Rwandan referral hospital were enrolled.

Conscious status is associated with the likelihood of trauma centre care and mortality in patients with moderate-to-severe traumatic brain injury.

Objective: To assess the relationship between The International Classification of Diseases, Ninth Revision, Clinical Modification-derived conscious status and mortality rates in trauma centres (TC) vs. non-trauma centres (NTC).

Methods: Patients in the 2006-2011 Nationwide Emergency Department Sample meeting, The Centers for Disease Control and Prevention criteria for traumatic brain injury (TBI), with head/neck Abbreviated Injury Scale (AIS) scores ≥3 were included.

Critical Care Management of Peritonitis in a Low-Resource Setting.

Background: Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda.

Validation of the Surgical Apgar Score After Laparotomy at a Tertiary Referral Hospital in Rwanda.

Background: The surgical Apgar score (SAS) has demonstrated utility in predicting postoperative outcomes in a variety of surgical disciplines. However, there has not been a study validating the utility of the SAS in surgical patients in low-income countries. We conducted a prospective, observational study of patients undergoing laparotomy at a tertiary referral hospital in Rwanda and determined the ability of SAS to predict inpatient major complications and mortality.

Peritonitis in Rwanda: Epidemiology and risk factors for morbidity and mortality.

Background: Few studies discuss causes and outcomes of peritonitis in low-income settings. This study describes epidemiology of patients with peritonitis at a Rwandan referral hospital. Identification of risk factors associated with mortality and unplanned reoperation could improve management of peritonitis.

Conscious status predicts mortality among patients with isolated traumatic brain injury in administrative data.

Background: Outcome studies in trauma using administrative data traditionally employ anatomy-based definitions of injury severity; however, physiologic factors, including consciousness, may correlate with outcomes. We examined whether accounting for conscious status in administrative data improved mortality prediction among patients with moderate to severe TBI.

Methods: Patients meeting Centers for Disease Control and Prevention (CDC) guidelines for TBI in the 2006 to 2011 Nationwide Emergency Department Sample were identified.

Tackling causes and costs of ED presentation for American football injuries: a population-level study.

Background: American tackle football is the most popular high-energy impact sport in the United States, with approximately 9 million participants competing annually. Previous epidemiologic studies of football-related injuries have generally focused on specific geographic areas or pediatric age groups. Our study sought to examine patient characteristics and outcomes, including hospital charges, among athletes presenting for emergency department (ED) treatment of football-related injury across all age groups in a large nationally representative data set.

United States trends in thrombolysis for older adults with acute ischemic stroke.

Objective: Thrombolysis for ischemic stroke has been increasing in the United States. We sought to investigate recent trends in thrombolysis use in older adults.

Methods: A retrospective, observational analysis of hospitalization data from the Nationwide Inpatient Sample (NIS) in 2005-2010 was performed.

The use of an essay examination in evaluating medical students during the surgical clerkship.

Background: Third-year medical students are graded according to subjective performance evaluations and standardized tests written by the National Board of Medical Examiners (NBME). Many "poor" standardized test takers believe the heavily weighted NBME does not evaluate their true fund of knowledge and would prefer a more open-ended forum to display their individualized learning experiences. Our study examined the use of an essay examination as part of the surgical clerkship evaluation.