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Search Results: 1 - 10 of 321 matches for " TC Hardcastle "
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The ethical and medico-legal issues of trauma care
TC Hardcastle
South African Journal of Bioethics and Law , 2010,
Abstract: Ethical issues confront trauma clinicians on a daily basis. This article highlights the similarities of trauma ethical dilemmas to those faced by other emergency care providers and takes the reader through the inpatient aspects of trauma care.
Direct admission versus inter-hospital transfer to a level I trauma unit improves survival An audit of the new Inkosi Albert Luthuli Central Hospital trauma unit
S Cheddie, DJJ Muckart, TC Hardcastle, DD Hollander, H Cassimjee, S Moodley
South African Medical Journal , 2011,
Abstract: Objective. To audit the performance of a new level I trauma unit and trauma intensive care unit. Methods. Data on patients admitted to the level I trauma unit and trauma intensive care unit at Inkosi Albert Luthuli Central Hospital, Durban, from March 2007 to December 2008 were retrieved from the hospital informatics system and an independent database in the trauma unit. Results. Four hundred and seven patients were admitted; 71% of admissions were inter-hospital transfers (IHT) and 29% direct from scene (DIR). The median age was 27 years (range 1 - 83), and 71% were male. Blunt injury accounted for 66.3% of admissions and penetrating trauma for 33.7%. Of the former, motor vehicle-related injury accounted for 87.4%, with 81% of paediatric admissions due to pedestrian-related injuries. The median injury severity score (ISS) for the entire cohort was 22 (survivors 18, deaths 29; p<0.001). Patients in the DIR group had a significantly higher mean ISS compared with the IHT group (DIR 25, IHT 20; p<0.02). The overall mortality rate was 26.3%. There were 37 deaths (31.1%) in the DIR group and 70 (24.3%) in the IHT group (p=0.19). In patients surviving more than 12 hours the overall mortality rate was 21.1% (DIR 13.7%, IHT 23.5%; p=0.042). Conclusions. Trauma is a major cause of premature death in the young. Despite a significantly higher median ISS in direct admissions, there was no difference in mortality. Of those surviving more than 12 hours, patients admitted directly had a significant decrease in mortality. Dedicated trauma units improve outcome in the critically injured.
Traumatic abdominal wall hernia - four cases and a review of the literature
TC Hardcastle, DF Du Toit, C Malherbe, GN Coetzee, M Hoogerboord, BK Warren, CC Modin
South African Journal of Surgery , 2005,
Abstract: Objective: To review blunt traumatic abdominal wall hernias (TAWHs) in our institution. Method: Retrospective review of blunt abdominal trauma cases over a 6-month period. Results: Four patients with TAWH were identified. The mean age was 36 years. Three had been involved in vehicular collisions, and 1 had been assaulted with a large stone. All were diagnosed on presentation, 3 by computed tomography scan and 1 clinically. Two were repaired as emergencies, and 1 was repaired after 4 months. The 4th patient refused surgery. Conclusion: This uncommon injury requires a high index of suspicion and a low threshold for intervention. CT scan offers the best imaging potential. South African Journal of Surgery Vol. 93(2) 2005: 41-43
The use of infant feeding tube as a combined nephrostomy and stent in Anderson-Hynes Pyeloplasty
TC Oguike
Nigerian Journal of Clinical Practice , 2007,
Abstract: No s. Nigerian Journal of Clinical Practice Vol.10(2) 2007: pp.166-168
Route optimization for solid waste collection: Onitsha (Nigeria) case study
TC Ogwueleke
Journal of Applied Sciences and Environmental Management , 2009,
Abstract: Routing of solid waste collection vehicles in developing countries poses a challenging task. New decision procedure for solid waste collection problem was introduced in this study. The problem objective was to minimize the overall cost, which was essentially based on the distance travelled by vehicle. The study proposed heuristic method to generate feasible solution to an extended Capacitated Arc Routing Problem (CARP) on undirected network, inspired by the refuse collection problems in Nigeria. The heuristic procedure consists of route first, cluster second method. The computational experience with the heuristic in Onitsha was presented. The technique was compared with the existing schedule with respect to cost, time and distance travelled. The adoption of the proposed heuristic in Onitsha resulted in reduction of the number of existing vehicles, a 22.86% saving in refuse collection cost and 16.31% reduction in vehicle distance travelled per day. The result revealed a good performance of the proposed heuristic method, which would be useful in vehicle scheduling
Aktuelles: Proinsulin als Marker für Betazell-Stress: Beeinflussbarkeit durch Insulintherapie?
Wascher TC
Journal für Klinische Endokrinologie und Stoffwechsel , 2011,
Abstract:
Therapie der Adipositas - konservativ oder chirurgisch?
Wascher TC
Journal für Gastroenterologische und Hepatologische Erkrankungen , 2008,
Abstract: Adipositas ist ein zunehmend an Bedeutung gewinnendes Problem in allen Industriestaaten. In der medizinischen Behandlung der Adipositas kommen sowohl konservative als auch chirurgisch-invasive Therapiestrategien zum Einsatz. DieserArtikel versucht beide Therapiestrategien in den Kontext einer integrierten Adipositasversorgung zu stellen.
Sympathikusaktivierung - Bedeutung für den Diabetiker
Wascher TC
Journal für Hypertonie , 2004,
Abstract: Sympathetic activation or, more adequate, autonomic imbalance has been found associated with cardiovascular and total mortality in the general population. It is frequently observed in hypertensive patients. The present mini-review summarizes the evidence that patients with the metabolic syndrome or type-2 diabetes in particular exhibit sympathetic imbalance also in the absence of manifest hypertension. These findings not only suggest that autonomic imbalance is a further feature of the metabolic syndrome but also emphasize the possible benefits of targeted treatment in this cardiovascular high-risk population.
Kurzinformation: Koronares Risiko bei Typ-II-Diabetes - Online Evaluation
Wascher TC
Journal für Kardiologie , 2003,
Abstract:
Postprandiale Hyperglyk mie und koronare Herzkrankheit: Welche therapeutischen Konsequenzen sollen wir aus den klinischen Studien ziehen?
Wascher TC
Journal für Kardiologie , 2004,
Abstract: Zus tzlich zu den klassischen kardiovaskul ren Risikofaktoren wurde für die postprandiale Hyperglyk mie gezeigt, da sie auch bei nichtdiabetischen Personen die Atherogenese und damit kardiovaskul re Morbidit t und Mortalit t f rdert. Die wenn auch limitierte Evidenz aus klinischen Interventionsstudien ist in einer Linie mit basiswissenschaftlichen, klinisch-experimentellen und epidemiologischen Studien und zeigt, da tats chlich das kardiovaskul re Risiko, insbesondere offenbar das für Myokardinfarkte, durch spezifische Senkung der postprandialen Hyper-glyk mie reduziert werden kann. Damit stellt die postprandiale Hyperglyk mie ein weiteres Ziel der kardiovaskul ren Therapie und Pr vention dar.
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