29 results match your criteria: "Government Gousia Hospital[Affiliation]"

Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper.

World J Emerg Surg

October 2024

Department of General and Emergency Surgery, Anesthesia and Intensive Care Unit, Maurizio Bufalini Hospital, Cesena, Italy.

Article Synopsis
  • * A thorough literature review led to the selection of 287 studies, which informed the development of 39 key statements addressing surgical indications, timing, and techniques for SSRF.
  • * The consensus document serves to clarify best practices in managing rib fractures, helping clinicians make informed decisions about the surgical treatment process.
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Article Synopsis
  • The trauma mortality rate is higher in elderly patients due to age-related physiological changes and frailty, necessitating specialized management guidelines to improve outcomes and minimize unnecessary procedures.
  • Expert surgeons reviewed literature and developed evidence-based recommendations for geriatric trauma care, focusing on frailty assessment, early activation of trauma protocols, and multimodal pain management.
  • Key practices include administering antibiotics selectively for certain traumatic injuries, ensuring timely venous thromboembolism prevention, and involving palliative care teams to address end-of-life discussions with a holistic approach.
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Article Synopsis
  • Diaphragmatic hernia (DH) can be life-threatening and its management raises ongoing debates.
  • A CT scan is the best way to diagnose complicated DH, and timely surgical intervention is crucial for successful treatment.
  • Laparoscopic repair is preferred for stable patients, while open surgery and Damage Control Surgery are necessary for unstable patients.
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Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking.

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Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines.

World J Emerg Surg

July 2023

General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, AB, Canada.

Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control.

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The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study.

World J Emerg Surg

April 2023

Department of General Surgery, Level I Trauma Center, Bufalini Hospital, Cesena, eCampus University, CREAS, Ser.In.Ar. Bologna University, Cesena, Italy.

Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The "timing in acute care surgery" (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies.

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Acute mesenteric ischemia (AMI) is a group of diseases characterized by an interruption of the blood supply to varying portions of the intestine, leading to ischemia and secondary inflammatory changes. If untreated, this process may progress to life-threatening intestinal necrosis. The incidence is low, estimated at 0.

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Background: In 2017, the World Society of Emergency Surgery published its guidelines for the management of adult and pediatric patients with splenic trauma. Several issues regarding the follow-up of patients with splenic injuries treated with NOM remained unsolved.

Methods: Using a modified Delphi method, we sought to explore ongoing areas of controversy in the NOM of splenic trauma and reach a consensus among a group of 48 international experts from five continents (Africa, Europe, Asia, Oceania, America) concerning optimal follow-up strategies in patients with splenic injuries treated with NOM.

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Background: Patients presenting with acute abdominal pain that occurs after months or years following bariatric surgery may present for assessment and management in the local emergency units. Due to the large variety of surgical bariatric techniques, emergency surgeons have to be aware of the main functional outcomes and long-term surgical complications following the most performed bariatric surgical procedures. The purpose of these evidence-based guidelines is to present a consensus position from members of the WSES in collaboration with IFSO bariatric experienced surgeons, on the management of acute abdomen after bariatric surgery focusing on long-term complications in patients who have undergone laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass.

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Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.

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Background: Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic.

Methods: The survey was composed of 29 items.

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Background: Despite the call to enhance accuracy and value of operation records few international recommended minimal standards for operative notes documentation have been described. This study undertook a systematic review of existing operative reporting systems for laparoscopic cholecystectomy (LC) to fashion a comprehensive, synoptic operative reporting template for the future.

Methods: A search for all relevant articles was conducted using PubMed version of Medline, Scopus and Web of Science databases in June 2021, for publications from January 1st 2011 to October 25th 2021, using the keywords: laparoscopic cholecystectomy AND operation notes OR operative notes OR proforma OR documentation OR report OR narrative OR audio-visual OR synoptic OR digital.

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Article Synopsis
  • Acute left colonic diverticulitis (ALCD) in the elderly differs from younger patients in terms of clinical presentation, higher mortality rates during hospitalization and after surgery, and increased risk from geriatric comorbidities.
  • Despite these risks, elderly patients have a lower chance of recurrent episodes and less likelihood of needing urgent surgery if recurrence occurs.
  • A recent workshop in Italy involving various medical organizations sought to develop age-specific guidelines for diagnosing and treating ALCD in older adults, concluding with expert-approved recommendations on diagnosis, management, surgical techniques, and antibiotic treatment.
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Anorectal emergencies: WSES-AAST guidelines.

World J Emerg Surg

September 2021

General, Emergency and Trauma Surgery Dept., Bufalini Hospital, Cesena, Italy.

Anorectal emergencies comprise a wide variety of diseases that share common symptoms, i.e., anorectal pain or bleeding and might require immediate management.

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Immunocompromised patients are a heterogeneous and diffuse category frequently presenting to the emergency department with acute surgical diseases. Diagnosis and treatment in immunocompromised patients are often complex and must be multidisciplinary. Misdiagnosis of an acute surgical disease may be followed by increased morbidity and mortality.

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Background: Despite the current therapeutic options for the treatment of inflammatory bowel disease, surgery is still frequently required in the emergency setting, although the number of cases performed seems to have decreased in recent years. The World Society of Emergency Surgery decided to debate in a consensus conference of experts, the main pertinent issues around the management of inflammatory bowel disease in the emergent situation, with the need to provide focused guidelines for acute care and emergency surgeons.

Method: A group of experienced surgeons and gastroenterologists were nominated to develop the topics assigned and answer the questions addressed by the Steering Committee of the project.

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Introduction: Dexamethasone is commonly administered in intracranial tumors to reduce the cerebral edema. Its administration may be associated with hyperglycemia. The primary objective of this study was to study the magnitude of rise in blood sugar levels following the administration of a single 10 mg dose of dexamethasone.

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Background: Surgical site infections (SSI) represent a considerable burden for healthcare systems. They are largely preventable and multiple interventions have been proposed over past years in an attempt to prevent SSI. We aim to provide a position paper on Operative Room (OR) prevention of SSI in patients presenting with intra-abdominal infection to be considered a future addendum to the well-known World Society of Emergency Surgery (WSES) Guidelines on the management of intra-abdominal infections.

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Background: Proper positioning of the head and neck is important for an optimal laryngeal visualization. Traditionally, sniffing position (SP) is recommended to provide a superior glottic visualization, during direct laryngoscopy, enhancing the ease of intubation. Various studies in the last decade of this belief have challenged the need for sniffing position during intubation.

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Blood transfusion practices in neuroanaesthesia.

Indian J Anaesth

September 2014

Department of Anaesthesiology, Sheri Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.

Neuroanaesthesia practice is associated with risk of significant blood loss resulting in anaemia in the intraoperative and postoperative period. The transfusion triggers in a neurologically injured brain are not clearly defined. Both a low haematocrit and a high haematocrit have not shown any improvement in the outcome.

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Background & Objectives: The "Shri Amarnath Ji Yatra" is an annual congregation in which the devotees trek a difficult route of around 40 km to reach to a cave at a height of approximately 14,000 feet at Pahalgam in the State of Jammu & Kashmir, India. These trekkers are subjected to stress and strain of the long mountainous route and difficult security scenario as a result of which they are prone to develop some surgical disorders. We ascertained the profile of non-traumatic surgical conditions met in these people at the various medical aid centres and the base hospital Pahalgam so that a policy could be framed to prevent these conditions.

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