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The anesthesia ex utero intrapartum treatment (EXIT) procedure is a specialized surgical procedure used to deliver babies who have airway compression due to cystic adenomatoid malformation, bronchopulmonary sequestration, cervical teratomas, or other congenital conditions. EXIT is erroneously known as a routine cesarean section (CS), but is rather an extension of CS with discernible differences. The procedure creates an opening in the anesthetized abdomen of the mother and uterus. Once EXIT is complete, the remainder of the CS proceeds. EXIT is much more complex than a routine CS, as it requires coordination between the mother and a multidisciplinary team of surgical and neonatal personnel. This review highlights current anesthetic concepts during the EXIT procedure.
Non-communicable diseases (NCDs), account for a growing number of deaths worldwide. The English-speaking Caribbean has the highest per capita burden of NCDs in the region of the Americas . This paper presents an overview of availability and accessibility based on clinic hours and physician fulltime equivalents (FTE) on the island of Trinidad devoted to diabetes and wound care. The project integrates a Geographic Information System (GIS) with epidemiologic and bio-statistical data to provide a necessary spatial analysis not otherwise possible. It examines the island’s ability to effectively deliver treatment to residents with diabetes by providing a geographic perspective to data published on the internet by the Trinidad-Tobago Ministry of Health and the Central Statistical Office. Results indicate a significant regional variability in both numbers of physicians and office hours devoted to diabetes treatment.