Day 2 :
Keynote Forum
Akram Fayed
University of Alexandria, Egypt
Keynote: Trauma to the Gravid Uterus
Time : 10:30-11:10
Biography:
Akram M Fayed has completed his training in Egypt and USA and earned his Doctorate degree in Critical Care Medicine as well as the ABIM in 2005. Since then, he contributed by giving talks and presenting research activities in many national and international conferences. He is the Founder and Member of the Egyptian Society of Critical Care and Emergency. He is also a Member of SCCM, ESICM and others. He has a number of publications in CCM in elite journals. He is currently an Associate Professor of Critical Care Medicine, Faculty of Medicine, University of Alexandria, Egypt.
Abstract:
Trauma to the gravid uterus is the most common non obstetrical cause of death in pregnant women. It is important to suspect pregnancy in any female in the childbearing age presenting with trauma. Specific anatomical and physiological changes develop during the varying stages of pregnancy to the mother and the uterus make the likelihood of injury during pregnancy high. A number of mechanisms are involved in the blunt trauma of the gravid uterus incluing road traffic accidents, falls and domestic violence. Causes of death identified following trauma of the gravid uterus include: hypovolemic shock, head and neck injuries and respiratory failure. Important steps in management include: resuscitation and stabilization of the mother which takes a priority of the fetus. When vital signs cannot be stabilized, an emergency cesarean section could save the fetus. Prevention of gravid uterus trauma include public awareness of the magnitude of the problem, counseling regarding safety during driving and encouraging prompt reporting of domestic violence to the authority.
Keynote Forum
Claudia M.Elsig
Calda Clinic, Switzerland
Keynote: The devastating effects of domestic violence
Time : 11:30-12:10
Biography:
Claudia Elsig has more than 20 years of experience in the area of psychiatric and psychotherapeutic medicine. She studied at the medical faculty of the Zurich University and after this completed an extensive and deepened training in various evidence-based psychotherapeutic methods. She specialised on psycho-traumatology. Out of a deep interest for the effects of psychological and physical traumas like post-traumatic stress disorder, depression, eating disorders, the whish in her grew to help those people individually, holistic and sustaining. On the way to a multi-specialist, she looked for the best mentors in Europe for behavioural therapy, hypnosis and EMDR. She passed through training in genetics and genetic consultation with the focus on addiction, depression and anxiety disorders and discovered the fascination of epigenetics. For years, she managed the special consultation for clinical hypnosis at a private clinic in Zurich. During the past years as a Medical Director and Manager of the Psychiatry Department in an international practice she deepened her knowledge on multiple types of addiction and their effects.rnIn 2004, she founded the Calda AG and developed an individual integrative treatment concept for psychological diseases. Currently, she is the manager of the Calda Clinic for in-patient clients at Lake Zurich and an outpatient, psychiatric-psychotherapeutic practice in Zollikon. Furthermore, she is a demanded referee and trainer.
Abstract:
Domestic violence covers a broad spectrum of physical and psychological abuse. In this presentation, the referee focuses on psychological violence in relationships and families, as psychological and sexual abuse usually are the dominating topics at trauma congresses. Psychological violence unfortunately still does not receive adequate attention; the publicity work is rather modest. Often it takes many years until those affected realise the vortex of verbal manipulation they were drawn into. Humiliations, insults and accusations paired with control, lies and threats aim to destroy the integrity and identity of the victim. The perpetrator creates psychological and materialistic dependencies. It can take just as long to liberate oneself from the entanglement of the violence spiral. Manifold symptoms can be the effects: chronic traumatising, depression, fears, addiction. The focus of this presentation is on therapeutic possibilities for those affected. However, the various types of narcissist personality disorders are presented shortly. Furthermore, the social-cultural dimension is included, the helplessness of authorities, courts, lawyers in case of divorce or separation. In this way, the attrition can continue on a legal level for a long time. It is therefore not sufficient to make this phenomenon known only amongst therapists and counselling centres. On a socio-political level still many changes have to take place in order to ensure sufficient protection for those affected and their children.
- Elderly TraumaTrauma-Mass Casualties IncidentEvolution in Emergency Medicine PracticesTrauma-An International Perspective
Chair
Andreas Engelbrecht
University of Pretoria, South Africa
Session Introduction
Willy Aasebo
Akershus University Hospital, Norway
Title: Can Death in Police Cells be Prevented ?
Time : 12:10-12:40
Biography:
Willy Aasebo is a Specialist in Internal Medicine and Nephrology and Leader of section of Nephrology (Medical Department), Akershus University Hospital, Norway. He has published a few scientific articles about alcohol intoxication, deaths in police cells and some nephrological topics including transplantation.
Abstract:
Unexpected deaths in police cells are always tragic for the next of kin and custodial officers, but may also cause several problems both in a local society as well as in a larger community/country. Thus minimizing the number of deaths in police custody is desirable in many countries for obvious reasons. One of the aims of my research has been to find and compare death rates in police cells from as many countries as possible. However, as only a few reports have been published in medical literature, I searched for such reports in other databases using google, and even google translate. I found, only few reports on death rates from 15-16 different countries and the death rates varied between 0.14 deaths to 4-5 (and even higher) deaths per million inhabitants per year. The methodological difficulties in obtaining these death rates and the methodological differences between the reports as well as cultural and organizational differences between countries make it very difficult to compare death rates between countries. In 2002, a project was initiated in Norway aiming at reducing deaths in police cells. During the 90’s, a mean of 4 persons died each year. 81% of the deaths happened in persons arrested for drunkenness. In 1/3 of all deaths alcohol intoxication was the only cause of death. The project then recommended that a doctor should examine all persons before they were being placed in a cell if they were considered unable to take care of themselves. The intention was that dead drunk persons should not be placed in police cells, but, preferably, in a health facility unit. In 2013, we again investigated all deaths in Norwegian police cells during the previous 10 years period and compared with numbers from the first period (the 90’s). In the second period a mean of 1.1 deaths occurred each year in the police cells. The total death rate was reduced from 0.83 deaths per million inhabitants per year in the first period to 0.20 in the second period. Deaths caused by alcohol intoxication, including cerebral traumas in drunken persons, had almost been eliminated (one death in the second period). The most common cause of deaths in Norwegian police cells in period two was mixed intoxications (6 deaths during the second period) and suicides (3 deaths).
Biography:
David Fuchs, BARN, is a Trauma Co-ordinator of Ziv Medical Center. He has worked in Trauma Care and Emergency Medicine for over 20 years. He is a Senior Nurse in the Emergency Department and responsible for Acute Trauma Care, the Trauma Room, training in Trauma and Trauma research.
Abstract:
Since February 2013, Syrian citzens injured in the civil war have been treated in Israel. The closest hospital to the Israel-Syria border, Ziv Medical Center, has treated over 600 patients. Patients arrived initally with war related injuries, but, as word spread of the care they received, patients also came for the treatment of chronic medical conditions. As civil war continues, reports indicate a collapse of health services in many parts of Syria. The care provided in Israel has been life-saving for men, women and children; and yet, they are accepting care from people they have regarded for generations to be their enemy. Crossing the border into Israel may be regarded in Syria as an illegal or punishable act. The identity of the patients is, therefore, carefully protected. Crucial to their reception, orientation and reassurance as soon as they arrive in the hospital, is the communication, in Arabic, between the social worker and the patients. As such the social worker is a crucial member of the team. Initially, some of the patients arrived unaware that they had been transported to Israel. They were afraid, reluctant to eat the food and weary of the staff. Patients, however, were extremely grateful for the high level care that they received, and staff at the hospital were at pains to welcome them and put them at their ease. Children arrived with relatives or sometimes alone. The hospital organised radios and access to computers and books and received donations of clothing and games.
Wisam Matanis
Ziv Medical Center, Israel
Title: Teaching acute trauma management to medical students
Time : 14:00-14:30
Biography:
Wisam Matanis is a surgical resident in Ziv Medical Center. He gained his basic Medical degree from the Technion- Israel Institute of Technology in Haifa, Israel. In addition to training in operative surgery, he has an active interest in undergraduate teaching and research.
Abstract:
Medical students may believe that Acute Trauma Management is the last thing they need to learn but in conflict and disaster zones, medical students play an important role in the trauma team. Rather than simply taking blood, fetching equipment and assisting in the transportation of patients, students need to understand trauma as a disease and the principles and practice of Acute Trauma Care. As part of their surgical rotation, medical students at Ziv Medical Center spend time in the trauma room learning, how monitoring and ventilation equipment works, how to connect these correctly, how to administer oxygen, work the suction, intubate, obtain venous access, apply limb splints and pelvic binders and to lead their own student teams (in turns) in trauma management for one hour drills twice weekly. These drills complement tutorials they have in trauma care (including molecular mechanisms) as part of their surgical teaching. At the end of the rotation, they have an examination in the trauma room (assessed drills which they take turns to lead) as well as a written and oral examination in trauma care and surgery. Some of the students work as paramedics, some as physician assistants, and on qualification in two years time, of course, as doctors. This training is vital to them, builds their confidence, enables them to participate fully in the resuscitation of trauma and critically ill septic patients or patients with massive gastrointestinal or obstetric haemorrhage. Students understand exactly what decisions are taken by seniors in the trauma room and why.
Raphael Fedidat
Ziv Medical Center, Israel
Title: Surgical complications database: Surgical databases designed by surgeons for surgeons
Time : 14:50-15:20
Biography:
Raphael Fedidat is a surgical resident in Ziv Medical Center. He gained his basic Medical degree in the Technion-Israel Institute of Technology in Haifa, Israel. He researched, designed and developed this technology himself.
Abstract:
The recording of morbidity and mortality amongst surgical in-patients in the departments of surgery is universal. Yet, the collection of accurate data for review, discussion and research is frequently retrospective and may even be at the last minute in preparation for departmental morbidity and mortality meetings. The surgical team at Ziv Medical Center has designed a database for the real time recording of complications which utilises the Clavien-Dindo classification and grading system. This enables surgical outcome to be compared with national and international data and for data to be easily retrieved. The database was designed and constructed from first principles by a surgical resident, charged with the responsibility for recording patient data in preparation for weekly departmental morbidity and mortality meetings. It is easy to use, all on one page, has a series of short drop down menus, and is comprehensive in terms of co-morbidity, procedure and complication. Its simplicity has been its success and complications may be recorded in a matter of seconds during or just after ward rounds. Data may be analysed within the database as well as exported in to Excel. Further applications for the database are being planned as a means for recording data used for research in all aspects of departmental surgical practice (rather than complications only) such as trauma, cancer resections and procedures for benign disease. The program also has great potential in the daily evaluation of critically ill patients.
Noman Shahzad
Aga Khan University Hospital, Pakistan
Title: Quality of life after damage control laparotomy for trauma
Time : 15:20-15:50
Biography:
Dr Noman Shahzad is General Surgery Resident at The Aga Khan University Hospital (AKUH) Pakistan. AKUH is JCIA accredited hospital with state of the art trauma facility and intensive care unit. He has recently completed his licensure requirement to practice general surgery in Pakistan - Fellowship of College of Physicians and Surgeons of Pakistan. He is also Member of Royal College of Surgeons of England. He has keen interest in trauma surgery and critical care management and has published in this field.
Abstract:
Introduction: Though short term survival advantage of damage control laparotomy in management of critically ill trauma patients is established, there is little known about the long term quality of life of these patients. Facial closure rate after damage control laparotomy is reported to be 20-70 percent. Abdominal wall reconstruction in those who failed to achieve facial closure is challenging and can potentially affect quality of life of these patients. Methodology: We conducted retrospective matched cohort study. Adult patients who underwent damage control laparotomy from Jan 2007 till Dec 2013 were identified through medical record. Patients who had concomitant disabling brain injury or limb injuries requiring amputation were excluded. Age, gender and presentation time matched non exposure group of patients who underwent laparotomy for trauma but no damage control were identified for each damage control laparotomy patient. Quality of life assessment was done via telephonic interview at least one year after the operation, using Urdu version of EuroQol Group Quality of Life (QOL) questionnaire EQ5D after permission. Wilcoxon signed rank test was used to compare QOL scores and McNemar test was used to compare individual parameters of QOL questionnaire. Study was approved by institutional ethical review committee. Results: Out of 32 patients who underwent damage control laparotomy during study period, 20 fulfilled the selection criteria for which 20 matched non damage control group patients were selected. Median age of patients (IQ Range) was 33 (26-40) years. Facial closure rate in damage control laparotomy group was 40% (8/20). One third of those who did not achieve facial closure (4/12) underwent abdominal wall reconstruction. Self-reported QOL score of damage control laparotomy patients was significantly worse than non-damage control group (p = 0.032). There was no statistically significant difference in two groups regarding individual QOL measures. Significantly more patients in damage control group were requiring use of abdominal binder, and more patients in damage control group had to either change their job or had limitations in continuing previous job. Our study was not adequately powered to detect factors responsible for worse QOL in damage control group. Conclusion: Quality of life of damage control patients is worse than their age and gender matched patients who underwent trauma laparotomy but not damage control. Adequately powered studies need to be conducted to explore factors responsible for this finding for potential improvement.
Hassan Ravari
Mashhad University of Medical Sciences, Iran
Title: Causes and outcome of elderly trauma in our general trauma center
Time : 15:50-16:20
Biography:
Hassan Ravari has completed his General Surgery from Shiraz University of Medical Sciences and Vascular Surgery from Tehran University of Medical Sciences. He is the Director of Vascular and Endovascular Surgery Research Center. He has published more than 28 papers in PubMed central.
Abstract:
Treatment of the elderly trauma patients in special centers can result in better treatment of potentially fatal injuries and satisfactory conditions at the time of discharge. The mortality rate in elderly trauma patients was reported 15-19%, which is twice as much as trauma patients with younger ages and 80% of spared trauma patients require long-term or permanent care. From September 2013 to August 2015, of 47425 patients who referred to Mashhad general trauma center 19527 patients were admitted according to the cause of trauma and ISS. During the study, 825 injury and trauma patients over 65 years were admitted, 166 of whom expired, which was 24.1% of all expired cases of all ages. There was a significant difference between elderly and other ages for causes of accident, strike of foreign body and quarrel but the difference was not significant for fall, bite, gunshot wound and self- striking. In our study, 2 major causes of trauma in the elderly were accident 52.7% and fall 33.2% . Although, a small proportion of injury and trauma patients as in this study in which 3.4% of those referred and 4.2% of the admitted patients consisted of the elderly, but a great proportion of trauma mortality in this group, which was 24.1%. This can be largely attributed to inattention to the elderly during driving and crossing streets, which are potential dangers for the well- being of the elderly. In conclusion, to decrease the mortality rate of this age group, extensive association of general surgeons, neurosurgeons, internist and orthopedist are required. Hospitalization of these patients in special units with skilled nurses can diminish the mortality rate. So, multidisciplinary special triage protocols, managements and discharge planning are needed.
Biography:
Akram M Fayed has completed his training in Egypt and USA and earned his Doctorate degree in Critical Care Medicine as well as the ABIM in 2005. Since then, he contributed by giving talks and presenting research activities in many national and international conferences. He is the Founder and Member of the Egyptian Society of Critical Care and Emergency. He is also a Member of SCCM, ESICM and others. He has a number of publications in CCM in elite journals. He is currently an Associate Professor of Critical Care Medicine, Faculty of Medicine, University of Alexandria, Egypt.
Abstract:
Trauma to the gravid uterus is the most common non obstetrical cause of death in pregnant women. It is important to suspect pregnancy in any female in the childbearing age presenting with trauma. Specific anatomical and physiological changes develop during the varying stages of pregnancy to the mother and the uterus make the likelihood of injury during pregnancy high. A number of mechanisms are involved in the blunt trauma of the gravid uterus incluing road traffic accidents, falls and domestic violence. Causes of death identified following trauma of the gravid uterus include: hypovolemic shock, head and neck injuries and respiratory failure. Important steps in management include: resuscitation and stabilization of the mother which takes a priority of the fetus. When vital signs cannot be stabilized, an emergency cesarean section could save the fetus. Prevention of gravid uterus trauma include public awareness of the magnitude of the problem, counseling regarding safety during driving and encouraging prompt reporting of domestic violence to the authority
Biography:
My name is Mai Badreldin Abdelaziz Helal. I am an assistant lecturer of Oral Biology, Faculty of Dentistry, Tanta University, Egypt. In 2009, I got my Bachelor of Dental Medicine and Surgery, Faculty of Dentistry, Tanta University, Egypt with general grade Excellent, Honor. In 2015, I got my Master of Science in Oral Biology with general grade excellent, Faculty of Dentistry, Tanta University Egypt. The title of my Master thesis is "The putative role of epithelial rest of Malassez in alleviation of traumatic occlusion effect on denervated rat periodontium". As a biologist, my main field of research focuses on periodontal homeostasis. Largely, the dynamic role of epithelial rest of Malassez to sustain, repair and regenerate para-dental tissues, under different physiological conditions. Also, I am interested on isolation, characterization of dental epithelial stem cell, hopefully, to help in mediating dental tissue repair and/or regeneration.
Abstract:
Traumatic occlusion provides a trauma that distresses the whole tooth and its supporting tissues. Epithelial cell rests of Malassez (ERM) are odontogenic epithelial cells located throughout life within the periodontal ligament (PDL) matrix. Recent studies suggested that ERM may have their role not only in maintaining the normal width of the periodontium but also has a significant manner in periodontal regeneration and homeostasis. Aim of Study: The aim of the present study was to investigate the role of ERM in alleviating the deteriorating effect of traumatic occlusion on normal and denervated rat periodontium. Material and methods: Sixty, 7 month old male rats were used in this study. They were randomly and equally divided into five groups. Control, sham, denervated, traumatic occlusion and traumatic-denervation groups. In the latter group, the right inferior alveolar nerve (IAN) was exposed and transected before getting inside the mandibular canal through a 2.5 cm skin incision made along the posterior border of the mandible. Then, after one week recovery, the occlusal surface of the right maxillary first molar was unilaterally raised 1-2 mm with our innovative 7/8 nickel chrome stainless steel crown with free distal surface. Three rats, from each group, were euthanized at 1, 3, 6, and 9 weeks. Half of their right mandibular first molars specimens were dissected, processed for light microscope (LM) and the other half were processed for transmission electron microscope (TEM) using routine and pop-off techniques. Results: Histological observations after one and three weeks, revealed disorganization of PDL fibers of the mandibular first molars of all rats in the denervated and/or traumatic occlusion groups in contrast to those of the control and sham groups, which disclosed normal structured PDL with few clusters of ERM cells throughout the study periods. Remarkably, traumatic occlusion group depicted rise in ERM clusters that disclosed secretory apparatus by EM whereas denervation and traumatic-denervation groups illustrated reduction in size of ERM clusters and cells which revealed apoptotic and karyolitic cells with rarified cytoplasm. On the other hand, after six weeks both traumatic occlusion and traumatic-denervation groups illustrated reorganization of PDL in association with increase in ERM clusters whereas, denervation group revealed further decline in ERM cells numbers and features together with PDL hyalinization and signs of dentoalveolar ankylosis. Interestingly, healing signs were observed after nine weeks in all experimental groups that was marked by the existence of secretory ERM cells. Conclusions: ERM is not a vestigial functionless remnant but it is an active dynamic groups of cells that portray the condition of the periodontium. There are resting ERM in quiescent PDL, apoptotic ERM in traumatized and or denervated ERM and secretory ERM in recovering periodontium.
Fusun Terzioglu
Hacettepe University Hospitals Turkey
Title: High fidelity simulation educational model about trauma patients
Biography:
Füsun Terzioğlu is graduated in first place from Hacettepe University School of Nursing in 1989. She won the İhsan Dogramacı Superior Merit Award and Student Science Incentive Award. She earned her pilot’s license from Republic of Turkey Ministry of Transport. She studied about counseling on assisted reproductive techniques at Liverpool Women’s Hospital Reproductive Medicine Unit in United Kingdom on the British Council Research Scholarship. She earned a certificate in management and leadership in nursing. She is an active member of Thematic Network leadership work group. She studied as a research scholar at Kent State University College of Nursing in 2006. In 2007, she worked on a project named “Development of Leadership Skills in Nursing Doctoral Students†at University of Michigan Faculty of Nursing on an international research scholarship which was supported by International Network for Doctoral Education in Nursing (INDEN) and Sigma Theta Tau and provided to only three people around the world every year. She worked as a Co-Head of Nursing Department, Erasmus Department Coordinator, Head of Strategic Planning Group and board member of Hacettepe University Women’s Research and Implementation Center (HUWRICH). Her interest subjects are simulation education, sexuality and reproductive health and management and leadership in nursing. She is member of national and international nurse’s organizations such as INDEN and Sigma Theta Tau. She has been working as a Director of Nursing Services at Hacettepe University Hospitals since 2012 and was Founding Dean of Faculty of Nursing between 2012- 2013.
Abstract:
Background: Recently, an innovative teaching strategy, scenario-based full-scale high-fidelity simulation in nursing education is gaining more attention to improve nursing students’ clinical skills and competencies. Although previous researches showed that simulation-based teaching contributed to nursing students’ learning outcomes, satisfaction, and self-confidence, there is no study related to using high-fidelity simulation in nursing education and its effects on students’ learning outcomes in Turkey. Aim: A quasi experimental design was used determine the effects of high-fidelity simulation experience on students’ learning outcomes, self-confidence, and satisfaction. Methods: The sample consisted of 40 volunteer undergraduate nursing students who studied at one university in Turkey and took part in a high-fidelity simulation session related to the care of trauma patients. Students were randomly allocated to either a control or an experimental group. Students from the experimental group, as well as following their normal curriculum, were exposed to scenario-based full-scale simulation training. Subsequently, both experimental and control groups were re-tested and completed a Trauma Case Questionnaire; experimental group students also completed a Student Satisfaction Questionnaire and a Patient Intervention Self-Confidence/Competency Scale. The data was collected between January 2012 and May 2012. Results: There were no statistical differences between experimental and control group learning outcome scores (p>0.05). After the simulation session, the mean score of the experimental group students’ satisfaction was 114±5.09 (out of 135) and confidence/competency score was 76,35 ±5.69 (out of 90). There was a statistically significant strong positive correlation between students’ satisfaction score and confidence/competence scores (r=0.974, p< 0.000). Students also reported that high-fidelity simulation was an effective method to improve their clinical skills and competencies. Conclusion: This study indicated that students’ satisfaction and confidence/competency were high after participating in high-fidelity simulation sessions. According to the study results, it is recommended to use high-fidelity simulation in nursing education as an innovative teaching strategy to develop students’ clinical competencies and confidence.
Wei Gu
Third Military Medical University China
Title: Common SNP in pre-miR-608 decreases mature miR expression and predisposes to sepsis in severe trauma patients
Biography:
Wei Gu has completed her PhD at the age of 28 years from the Third Military Medical University. She is now an asoociated professor of State Key Laboratory of Trauma, Burns and Combined Injury, Research Institute of Surgery of the Third Military Medical University, China. Her research is focuse on the genetic mechanisms and early diagnosis of complicaitons after severe trauma, especially sepsis and MODS. She has published more than 32 papers in reputed journals.
Abstract:
Recent evidence indicates that small noncoding RNA molecules known as miRNAs can function as important negative gene regulators and are implicated in the pathogenesis of various diseases. We conducted a 2-stage study to examine the impact of 9 selected SNPs with potential functional significance on the susceptibility to sepsis of 1268 trauma patients in China. Among the 9 selected SNPs with potential functional significance,only 1 (miR-608 rs4919510) was found to be strongly associated with a higher risk of developing spsis and multiple organ dysfunction in all 3 independent study cohorts. An even stronger association was observed for the rs4919510 polymorphism when combining these 3 study cohorts together. In addition, the rs4919510 polymorphism showed a significant correlation with a higher production of proinflammatory cytokines and a lower production of antiinflammatory cytokines. In vitro experiments further indicated that the G→C variant of this polymorphism could significantly increase the expression of mature miR-608. Furthermore, we illustrated that miR-608 downregulated ELA2 mRNA and protein by directly binding exon of ELANE in monocytes based on expression genechip and several in vitro experiments. Our data showed that miR-608 and its target, ELA2, maybe potential biomarkers or targets of sepsis in severe trauma patients.
Nguyen Huu Tu
Hanoi Medical University Vietnam
Title: Jugular bulb oxygen saturation changes during surgery for severe head injured patients
Biography:
Nguyen Huu Tu graduated from Hanoi Medical University (1984-1990). He obtained PhD (2000-2003) and became an Associate Professor of Hanoi Medical University in 2007 and Professor in 2014. He held Academic Positions of increasing importance: Vice President of Hanoi Medical University (2009-present), Primary Trauma Care Instructor and Local Coordinator (2004-present); Chairman, Anesthesia and Critical Care, Hanoi Medical University (2009-present). He has following hospital appointments: Anesthesist-Intensivist, Viet Duc University Hospital (1994-2008); Attaché Associé, Hotel Dieu Hospital, Lyon, France (1994-1995); Henri-Mondor University Hospital, France (1997-1998); Chef de clinique, Chercheur, Centre Nationale de Recherche Scientifique de Paris (CNRS), University Paris XII, Henri-Mondor University Hospital, France (2001-2002); Visiting Anesthetist, North-West Tasmania Hospital and Adelaide Royal Hospital, Australia (2006); Anesthetist-intensivist in Chief, Hanoi Medical University Hospital (2008-present). His major clinical and research interests are in trauma anesthesia and resuscitation, regional anesthesia, postoperative pain management, airway complications during anesthesia and pharmacology of neuromuscular relaxants. He is the author and co-author of 109 scientific publications published in the local and international journals including Anesthesiology, Anesthesia & Analgesia journals.
Abstract:
Objectives: To evaluate changes of Jugular bulb oxygen saturation (SjvO2) during surgery for severe head injured patients. Methods: A prospective study was conducted with 50 severe head injured patients undergoing craniotomy surgery. Preoperative SjvO2 in jugular bulb was measured after anesthesia induction by a catheter connecting to CeVOX monitor. SjvO2 was observed continuously during sugery and recorded at different phrases: before surgery (T1), after craniotomy (T2), after durotomy (T3), after removing hematoma (T4) and in 30 minutes after sugery (T5). Main Results: SjvO2 was in the normal range in 52% of patients, reduced in 32% and increased in 16% of patients. SjvO2 increased significantly during sugery, especially after craniotomy and durotomy compared to preoperative phrase (69.1±13.2% and 70.3±13.1% vs. 61.8±15.6%, p<0.05). SjvO2 did not change significantly in the patients with preoperative SjvO2>75% (85.1±4.9% and 85.3±5.6% vs. 84.4±4.0%, p>0.05). Conclusion: SjvO2 increased significantly after craniotomy and durotomy in severe head ịnjured patients with low or normal preoperative SjvO2 values.
Keva Bethell
Allen Institute of Research & Training Bahamas
Title: Using a supportive community group process to cope with the trauma of social fragmentation and promote re-socialization in the Bahamas
Biography:
Keva Bethell is an avid researcher who grew up in Nassau, Bahamas. In 2008, she earned her Bachelor of Science degree in Biology (with a minor in Biochemistry) from Oral Roberts University in Tulsa, Oklahoma. In 2012, she earned her Master’s in Public Health from the University of Oklahoma, where she was inducted into the Xi chapter of Delta Omega Society, the public health honorary society. Her duties included abstracting Medical Examiner reports and entering data related to violent deaths into the National Violent Death Reporting System. She started working along with Dr. David Allen, in two months she collaborated with the Central Detective Unit to abstract all suicide cases that occurred in a 14 year period. Her report is now a published paper in the Global Journal of Human Social Sciences and her thematic analysis in the Emergency Medicine Open Access Journal. For the last two years, she has been the Director of Research for ‘The Family: People Helping People’ project, a community based free offering program group therapy in inner city communities. During her tenor, she has abstracted over 700 reports. She aspires to pursue a PhD in Epidemiology, she is a young lady of faith, and enjoys spending time with her family.
Abstract:
The Family: People Helping People project is a supportive group process modality involving the sharing of personal stories, self examination, reflection and transformation using psychotherapeutic principles. The group process was developed to confront the prevailing social fragmentation in the Bahamas associated with or caused by the continuing effects of the country-wide crack cocaine epidemic of the 1980s and the fall-out due to the recent international financial downturn. Facing community disintegration, high youth unemployment and burgeoning rates of violent crime and murder, many persons have been severely traumatized. This paper reviews the major themes presented in 776 group process sessions indicating the pervasive nature of the negativity of the shame process expressed in the high incidence of anger, violence, grief, relationship issues and abuse. This innovative project has been proven to enhance the re-socialization of many participants in the program.