Panamerican journal of trauma, critical care & emergency surgery最新文献

{"title":"COVID-19 Pandemic Acute-care Surgery Practice Survey Results from the Panamerican Trauma Society International Trauma Tele-Grand Rounds","authors":"N. Namias, E. Ginzburg, G. Pust, A. Marttos, G. Ruiz, R. Rattan, P. Byers, C. Olvera, D. Yeh, S. Satahoo","doi":"10.5005/jp-journals-10030-1283","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1283","url":null,"abstract":"Objective: As of June 9, 2020, the coronavirus disease 2019 (COVID-19) pandemic has affected more than 7 million people worldwide, causing more than 400,000 deaths. Acute-care surgery approaches in times of the COVID-19 pandemic were discussed during the Panamerican Trauma Society International Trauma Tele-Grand Rounds meeting in April 27, 2020. The purpose of this study is to identity practice patterns among surgeons treating acute surgical diseases during the pandemic. Materials and methods: COVID-19 epidemiology, prevalence in surgical patients, and treatment options of patients with acute surgical diseases in the presence of SARS-CoV-2-positive status were discussed. An electronic audience response system was used to assess opinions and practice patterns of the participating surgeons. Deidentified data collection was performed, stored, and subsequently analyzed using Excel software 2018. Results: The conference was attended by 91 participants from 20 countries. Forty-six surgeons participated in the survey, with 36% practising at a hospital with >80 active COVID-19 inpatients. Forty-eight percent of the participating surgeons had provided surgical care for SARS-CoV2-positive (CoV+) patients. At the time of provider–patient interaction, 58% of surgeons were not aware of the CoV+ status. Surgeons reported changing practice patterns during the pandemic. They would treat CoV+ patients with acute cholecystitis with antibiotics only (64%), IR drain (12%), laparoscopic-(5%), open cholecystectomy (12%), and no opinion (7%). For acute appendicitis, 57% of surgeons favor antibiotics only vs open-(29%), laparoscopic appendicectomy (10%), and no opinion (4%). Gas/smoke-filtering systems for laparoscopy were available only to 14% of respondents. SARS-CoV-2 screening protocols utilize one RNA real-time polymerase chain reaction (RT-PCR) (29%), two RNA-RT-PCR 72 hours apart (7%), and IgG/IgM plus RNA RT-PCR (17%); 17% have no screening capacities. Conclusion: Standard acute-care surgery practice patterns changed favoring nonoperative treatment. Testing protocols vary among healthcare systems. Further studies are needed to understand the impact of the COVID-19 pandemic on outcomes in acute-care surgery patients.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"14 1","pages":"158-161"},"PeriodicalIF":0.0,"publicationDate":"2020-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88849591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Care Surgery in the Times of COVID-19 Pandemic: Our Experience at a Large Safety Net Hospital","authors":"N. Namias, G. Pust, A. Marttos, G. Ruiz, S. Modi, Bhuwan Giri, Rodrigo Olvera","doi":"10.5005/jp-journals-10030-1284","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1284","url":null,"abstract":"Ab s t r Ac t Background: There is limited experience in managing confirmed or suspected coronavirus disease 2019 (COVID-19) patients who present for emergency general surgery. Differing presentations, diagnostic uncertainty, and lack of guidelines present challenges to surgeons taking care of these patients. Materials and methods: We present a retrospective case series of five patients (age: 20s–50s) with acute surgical emergencies, highly suspected or positive for COVID-19, providing an overview of diagnosis, management, and outcomes. Results: The first two cases were patients with acute cholecystitis and perforated duodenal ulcer with high suspicion for COVID-19 but negative reverse transcription polymerase chain reaction (RT-PCR) results. The third case was a COVID-19 confirmed patient with acute appendicitis managed nonoperatively. The last two cases were COVID-19 positive patients with lower extremity abscess and intussusception. Conclusion: Clinical decisions were made based on the urgency of each case while simultaneously navigating their COVID-19 infection status. Recognizing asymptomatic carriers, maintaining effective communication between different teams, and planning perioperative care were important aspects in achieving favorable outcomes.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"14 1","pages":"142-146"},"PeriodicalIF":0.0,"publicationDate":"2020-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77763341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of S-100B as a Potential Tool for Neuromonitoring and Prediction of Neuroworsening in Acute Phase of Traumatic Brain Injury","authors":"Alexander Rodríguez, Eliana Cervera, G. Macchia, Xilene Mendoza, Walter Martínez, Osmar Perez, Homero Sanjuán, P. Villalba","doi":"10.5005/jp-journals-10030-1288","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1288","url":null,"abstract":"Aim: In this review, we summarize the evidence on the use of S-100B in traumatic brain injury (TBI) of all severities, its clinical significance, and its prognostic value in the different posttrauma phases. Background: Most of the published studies report the serum determination of S-100B in the context of mild TBI as a predictor of positive CT scan, which represents a valuable tool when establishing a criterion to indicate the performance of the CT and decide the medical discharge. Likewise, we have reported several studies that correlate S-100B with the clinical evolution of the patient with severe TBI, showing an excellent indicator of intracranial hypertension. However, there are few studies that report on the impact of S-100B as a predictor of neuroworsening in the acute phase in moderate TBI. Review results: Traumatic brain injury comprises a heterogeneous group of traumatic injuries that can evolve progressively. Almost 90% of head injuries that reach the hospital are mild head injuries or mild TBI, which is defined by a score of more than 12 on the Glasgow Coma Scale (GCS). Of this, a few can be accompanied by a hemorrhagic lesion that can be detected by further imaging techniques. Still, utilizing these techniques in every single patient that comes to the ER does not only take a toll on the finances of the hospital but, more importantly, also exposes the patients to unnecessary radiation. There are still difficulties to correlate the findings on imaging with secondary injury, and to predict the clinical evolution in the acute phase and in the long-term. Serum S-100B levels have shown high sensibility and negative predictive value (NPV) for intracranial complications after mild head injury. Most of the published studies report that measurement in serum of S-100B in the context of mild TBI, as a predictor of CT findings, represents a valuable tool when establishing a criterion for indication of CT and to decide medical discharge. However, there are few studies that report the impact of S-100B as a predictor of neuroworsening in the acute phase of moderate TBI, which is defined by a score between 9 and 12 on the GCS. Conclusion: Serum S-100B is a useful marker of brain damage in TBI. Its usefulness has been studied mainly as a support to evaluate the need to perform a CT scan in mild TBI, and to monitor patients with moderate-to-severe TBI, in order to predict the outcome and validate the response to treatment. This review highlights S-100B as a versatile marker whose clinical utility depends on the severity of the head trauma. In this way, S-100B would be a potential predictor of neuroworsening in the acute phase in moderate TBI. Clinical significance: Despite its valuable utility as a predictor of positive CT in mild TBI, and as a tool for neuromonitoring in established severe TBI, the greater utility of S-100B could be as a predictor of neuroworsening in the acute phase in the moderate TBI.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"10 1 1","pages":"105-113"},"PeriodicalIF":0.0,"publicationDate":"2020-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83752634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations for the Emergency and Perioperative Management of Patients with COVID-19","authors":"Galvan Talamantes Yazmin, Vega Felipe, Mercedes N Lopez-Hernandez, Alvarez Reséndiz G Esteban","doi":"10.5005/jp-journals-10030-1280","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1280","url":null,"abstract":"The COVID-19 pandemic is a threat to global health, which is multiplying rapidly due to its high degree of contagiousness; some of these patients will require surgical services and anesthesia care for endotracheal intubation. Protecting staff members and preventing cross transmission of infection during airway approaches and surgical procedures for patients with known or suspected COVID-19 infection is paramount, preserving the capacity of health systems. Careful planning, consensual clinical decision-making, and rigorous personal protective equipment (PPE) will be required; avoid performing nonessential or urgent surgical procedures that generate greater viral exposure. The medical teams during the perioperative period will face unexpected inconveniences therefore, and due to the continuous management, that is evolving, this article aims to discuss the essential PPE, describe the modifications in the management of the airway, and cite the particular precautions consequent to the surgical act.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"36 1","pages":"133-141"},"PeriodicalIF":0.0,"publicationDate":"2020-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76145637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cycle of Freezing and Thawing as a Modified Method for Activating Platelets in Platelet-rich Plasma to Use in Regenerative Medicine","authors":"A. Ünlü, Soner Yılmaz, İ. Eker, R. Çetinkaya, A. Pekel, R. Sagkan, Zerrin Ertaş, O. Gürsel, H. U. Musabak, Ertuğrul Yazici, Sebahattin Yılmaz, C. Acikel, İ. Y. Avcı, F. Avcu, E. Kurekci, P. Petrone","doi":"10.5005/jp-journals-10030-1285","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1285","url":null,"abstract":"A Cycle of Freezing and Thawing as a Modified Method for Activating Platelets in Platelet-rich Plasma to Use in Regenerative Medicine İbrahim Eker1, Soner Yilmaz2, Rıza A Çetinkaya3, Aytekin Ünlü4, Aysel Pekel5, Rahşan I Sağkan6, Zerrin Ertaş7, Orhan Gürsel8, Hacı U Muşabak9, Ertuğrul Yazici10, Sebahattin Yilmaz11, Cengizhan Açikel12, İsmail Y Avci13, Ferit Avcu14, Emin Kürekçi15, Patrizio Petrone16","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"9 1","pages":"101-104"},"PeriodicalIF":0.0,"publicationDate":"2020-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77511028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Perceptions of Safety of Surgical Practice at a Tertiary Academic Trauma Hospital in Havana, Cuba","authors":"M. Moya, E. M. Serrano, G. Molina, Geoffrey A Anderson, S. Singer, William R. Berry, A. Haynes, M. Fabra","doi":"10.5005/jp-journals-10030-1289","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1289","url":null,"abstract":"Ab s t r Ac t Aim: The aim of this study was to demonstrate the feasibility of measuring the perceptions of safety of surgical practice in a tertiary hospital in Havana, Cuba. Materials and methods: A validated survey used to measure the perceptions of safety of surgical practice among operating room (OR) personnel was translated into Spanish. The survey was administered to all OR personnel who worked at the General Calixto García Hospital between June 15, 2015, and October 30, 2017. The survey consisted of two demographic questions and 16 items that respondents could answer using a seven-point Likert scale. Responses were dichotomized and evaluated between surgeons and trainees and between participants with ≤5 years and ≥6 years of experience. Results: There were 200 respondents (response rate of 46.5%, 200/430), which included 55 (27%) surgeons, 116 (58%) trainees, 10 (5%) anesthesiologists, and 19 (9.5%) nurses. The majority of respondents reported having ≤5 years of experience (71.4%, n = 142). Surgeons and participants with ≥6 years of experience more often had a significantly more favorable perception of surgical safety than trainees and participants with ≤5 years of experience, respectively. Conclusion: The perceptions of safety of surgical practice were successfully measured at a tertiary hospital in Havana, Cuba. The perception of surgical safety differed according to professional role and years of experience. Clinical significance: Making surgery safer includes fostering a favorable culture of surgical safety in the OR so that all personnel feel empowered to speak up and act on behalf of patient’s safety.","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"56 1","pages":"114-119"},"PeriodicalIF":0.0,"publicationDate":"2020-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84752830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma and Acute-care Surgeons’ Perception of Personal Safety during the COVID-19 Pandemic","authors":"S. Rizoli, A. Marttos, M. Azfar, Marcelo A. F. Ribeiro, T. Campos, S. Saverio, C. Y. Benítez","doi":"10.5005/jp-journals-10030-1282","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1282","url":null,"abstract":"The World Health Organization recognized in March 2020 the existence of a pandemic of the new coronavirus that appeared in China in late 2019, which was named coronavirus disease 2019 (COVID-19). In this context, a survey was conducted with 125 trauma and emergency surgeons from across the world regarding the availability of personal protective equipment (PPE) and the role of the surgeon in the pandemic, using an electronic survey. The study findings suggest that many surgeons work under inadequate conditions, particularly in South America, without the necessary supplies and equipment such as N95 masks and facial shields when contacting potentially contaminated patients. The findings indicate an increased risk of contamination by healthcare workers, which may result in losses of working professionals. Immediate measures must be taken to guarantee access to safety equipment throughout the globe, since all patients with emergency surgical conditions must be managed as potentially carrying the COVID-19 virus..","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"62 1","pages":"155-157"},"PeriodicalIF":0.0,"publicationDate":"2020-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88878690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Institutional Merit Award Fundacion Valle de Lili, Cali, Colombia","authors":"M. Granados","doi":"10.5005/jp-journals-10030-1270","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1270","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"550 1","pages":"3-6"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77590404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Data Gap”: Desafío Para Las Estrategias de Mejora de la Calidad en Trauma","authors":"Ezequiel Monteverde, Laura Bosque, Betina Lartigue, Jorge Neira, Joaquín Baliña, Santiago Donikian, Marilina Santero","doi":"10.5005/jp-journals-10030-1260","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1260","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"131 1","pages":"67-73"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79347269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Memoriam José Félix Patiño Restrepo","authors":"L. Torregrosa, Hernando Abaúnza, O. Borráez, M. Sánchez","doi":"10.5005/jp-journals-10030-1269","DOIUrl":"https://doi.org/10.5005/jp-journals-10030-1269","url":null,"abstract":"","PeriodicalId":74395,"journal":{"name":"Panamerican journal of trauma, critical care & emergency surgery","volume":"121 1","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78172298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}