6 research outputs found
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Corrections to: The Trauma Golden Hour
The affiliation of co-editors Nicholas Namias and Antonio Marttos was incorrectly updated in the book front matter and this is corrected as follows
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The Trauma Golden Hour A Practical Guide
The Golden Hour is a well-established concept in emergency medicine, related to the critical period of one hour after an injury, accident or trauma. This term implies that the mortality rates increase substantially if efficient care is not provided within 60 minutes after the trauma. This book is intended as a practical manual in Trauma Care within the context of the golden hour, addressing all trauma types and all body parts. Readers will find essential decision-making algorithms and protocols with commentary for traumas, along with easily accessible information on how to treat patients in a very practical and handy fashion. Furthermore, the content is presented in a didactic way suitable for a wide audience, from medical students who want to learn about the basics of trauma care to experienced surgeons seeking a comprehensive guide to trauma-related interventions. The book combines contributions from experts at two renowned Trauma Centers, the Hospital do Trabalhador at Curitiba, Brazil, and the Ryder Trauma Center in Miami, USA. Therefore, considering the different local environments and resources, the book provides distinct perspectives for several injuries, presenting the state of the art in Trauma Care. The diversity of perspectives in this book contributes to a global health care approach suitable for trauma-related events from developed countries to remote areas. The Trauma Golden Hour - A Practical Guide celebrates the Centennial Anniversary of the Federal University of Parana (Brazil), the 25th Anniversary of the Ryder Trauma Center (USA) and the 20th Anniversary of the Hospital do Trabalhador (Brazil)
Damage Control Surgery
Damage control surgery (DCS) is an abbreviated laparotomy for patients who have life-threating bleeding, injuries, and septic sources. The procedure consists of hemorrhage control, by procedures like hemostasis, packing, clamping, and ligation; limits contamination by simple resections, primary suturation, closed absorbent systems, and external drainage; and leads to temporary abdominal closure as quickly as possible. The non-life-threatening injuries are delayed to a reoperation. The main purpose of the damage control surgery is to prevent complications of the lethal triad: coagulopathy, acidosis, and hypothermia
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Liver resections for metastasis: surgical outcomes of a single center academic institution
Background Hepatic metastasis are frequent and liver resection may be an option for some cases, despite the high complexity of the procedure and the possibility of postoperative complications. Methods This retrospective comparative descriptive study aims to evaluate a series of 86 consecutive liver resections (LRs) performed for the treatment of metastatic liver tumors, comparing the results between patients undergoing major and minor LR. All patients submitted to LR from October 2010 to July 2015 at the Erasto Gaertner Hospital in Curitiba-PR were included. Quantitative numerical variables were analyzed with the Student t-test. The nonparametric Mann-Whitney U test was used for numerical variables of non-normal distribution. Categorical variables were analyzed with the Chi-square test with Fisher's correction. The data were analyzed with the SPSS 23.0 and STATA 15 programs, being p < 0.05 considered statistically significant. Results Eighty-six LR were performed, 56 cases by colorectal metastasis. The major LR corresponded to 68 cases, with 13.2% of Clavien-Dindo III-V complications and 2.9% of reoperation rate. Eighteen minor LR were performed and one patient had a postoperative complication requiring reoperation. Conclusion Preoperative elevation of transaminases and jaundice negatively influence surgical outcomes in patients undergoing LR. Tumors greater than 3 cm presented worse postoperative survival. Major LR did not significantly increase the surgical morbidity rate. Institutional Review Board registration 1.122.319/201
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Alternative Biomarkers to Predict Tumor Biology in Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) is the most frequent primary malignant liver tumor, with more than 800,000 new cases diagnosed each year and with high mortality, ranking fourth in the world in cancer deaths. The worst prognosis is related to the late diagnosis, in which the tumor is at an advanced stage and curative treatments are not efficient in terms of increasing overall survival. Currently, screening and monitoring tests based on current guidelines have limited accuracy, which points to the need for the development of new biomarkers that improve HCC detection as well as its early diagnosis. This review will discuss the five phases of development of a biomarker, from its discovery to its application in clinical practice, and indicate the main biomarkers per development phase. Potential emerging technologies such as "Radiomics", "Proteomics" and "Metabolomics" will also be discussed, which should serve as tools for the elucidation of tumor heterogeneity, as well as provide data for future studies on HCC biomarkers