189 research outputs found
The Emberá, tourism and indigenous archaeology: "rediscovering" the past in Eastern Panama
No full textIn this article we discuss the interest of the Emberá (an Amerindian indigenous group) in collecting knowledge about material remains of the past-such as colonial and pre-colonial ceramic fragments - that are easily found in Eastern Panama. We situate this interest of the Emberá (and their desire to learn more about the past) within the context of indigenous tourism, which has inspired the articulation of new narratives about Emberá history and identity. In addition, the accidental discovery by the Emberá of ceramic fragments from past periods has instigated and facilitated archaeological investigation, a process that resulted in a reciprocal exchange of knowledge between the Emberá and the academic investigators. Such a reciprocal relationship, we argue, can contribute towards the decolonisation of archaeology, create synergies between anthropology and archaeology, and enhance indigenous representation in tourism
Polycystic Horseshoe Kidney: A Rare Coexistence as a Challenge for the Surgeons. Case Report [Policistinis pasagos inkstas: retas derinys ir iššūkis chirurgams. Atvejo analizė]
No full textAutosomal dominant polycystic kidney disease (ADPKD) with concomitant horseshoe kidney is an extremely rare entity. In this case, we report a 45-year-old male patient with ADPKD and a horseshoe kidney who demonstrated hypertension, urological complications, and discomfort symptoms such as pain, breathing difficulties, and abdominal meteorism. After preoperative assessment and planning, the patient underwent nephrectomy. Bilateral nephrectomy without dividing the isthmus was performed successfully. The isthmus, which had complicated vasculature and was full of cysts, remained intact, avoiding severe bleeding and in-fection. The postoperative course was uneventful. Keeping the isthmus intact in such cases is a challenge for the surgeon. The rarity of polycystic horseshoe kidney in combination with the altered abdominal anatomy requires the proper preoperative strategy in order to avoid intraoperative complications. © 2022 Dionysios Prevezanos, Nikolaos Garmpis, Dimitrios Dimitroulis, Anna Garmpi, Vasiliki E. Georgakopoulou, Christos Damaskos
All that Glitters is not Cholecystitis. A Rare Presentation of Acute Pericarditis Mimicking Cholecystitis and Review of the Literature [Ne viskas, kas blizga, yra ūminis cholecistitas. Retas ūminio perikardito, imituojančio cholecistitą, atvejis ir literatūros apžvalga]
No full textAcute pericarditis is the most common inflammatory disorder of the pericardium, responsible for approximately 5% of visits to the emergency departments, concerning chest pain without myocardial infarction. We report a case of a 41-year-old man who presented to our hospital, complaining about retrosternal and epigastrium pain. The transthoracic echocardiogram showed pericardial effusion while the electrocardiogram and laboratory findings revealed acute pericarditis. An abdominal ultrasound revealed gallbladder edema. The pericardial effusion was treated with pericardial catheter insertion, diuretics, and nonsteroidal anti-in-flammatory drugs. This case shows that acute pericarditis can be clinically presented with many ways, one of them being gallbladder edema. Furthermore, in this case-based review we present all cases of simultaneous appearance of pericarditis and acalculous cholecystitis or gallbladder edema. © 2022 Anna Garmpi, Christos Damaskos, Nikolaos Garmpis, Vasiliki E. Georgakopoulou, Vaios Vasileios Kaminiotis, Evangelos Diamantis, Alexandros Patsouras, Athanasios Syllaios, Dimitrios Dimitroulis
Correction: Minimally invasive surgery in emergency surgery: a WSES survey (World Journal of Emergency Surgery, (2022), 17, 1, (18), 10.1186/s13017-022-00419-x)
No full textFollowing the publication of the original article [1], in html tagging the author name “Dimitris Damaskos” under WSES MIS working group was incorrectly written as “Dimitris Damascos”.The original article has been corrected
Association of metabolic syndrome criteria with polymorphisms related to lipids metobolisms blood pressure and vascular
No full textINTRODUCTION: Metabolic syndrome (MetS) is a cluster of specific relatedclinical disorders whose presence increases the risk of cardiovascular disease. Variousgenetic polymorphisms are implicated in its pathophysiology. This study aims toevaluate the relationship between patients with MetS and healthy subjects, as far asthe allelic frequency of Cholesterol Ester Transfer Protein (CETP) TaqIB and I405V,ATP Binding Cassette Transporter A1 (ABCA1) R219K and Angiotensinogen (AGT)M235T polymorphisms are concerned.MATERIALS AND METHODS: We determined the allelic frequency of CETPTaqIB and I405V, ABCA1 R219K and AGT M235T in 180 MetS patients and 165healthy subjects. For the whole study population values for Total Cholesterol,Triglycerides, High Density Lipoprotein Cholesterol and Low Density LipoproteinCholesterol were collected. Relationships between the two study groups werecalculated.RESULTS: Allele R in ABCA1 R219K polymorphism strongly tends to appear more frequently (p=0.087) in healthy subjects compared to MetS patients. As far as allother studied alleles are concerned, no significant differences between the two studygroups were observed. Also, statistically significant higher levels of Total Cholesteroland Low Density Lipoprotein Cholesterol (p<0.01) were measured in MetS patients.CONCLUSION: Compared to MetS patients, healthy subjects have a strongtendency to carry the R allele of ABCA1 R219K polymorphism, a case that may berelated to more favorable lipid levels in Caucasian populations
Perceptions and practices surrounding the perioperative management of frail emergency surgery patients: a WSES-endorsed cross-sectional qualitative survey
No full textBACKGROUND: Frailty is associated with poor post-operative outcomes in emergency surgical patients. Shared multidisciplinary models have been developed to provide a holistic, reactive model of care to improve outcomes for older people living with frailty. We aimed to describe current perioperative practices, and surgeons’ awareness and perception of perioperative frailty management, and barriers to its implementation. METHODS: A qualitative cross-sectional survey was sent via the World Society of Emergency Surgery e-letter to their members. Responses were analysed using descriptive statistics and reported by themes: risk scoring systems, frailty awareness and assessment and barriers to implementation. RESULT: Of 168/1000 respondents, 38% were aware of the terms “Perioperative medicine for older people undergoing surgery” (POPS) and Comprehensive Geriatric Assessment (CGA). 66.6% of respondents assessed perioperative risk, with 45.2% using the American Society of Anaesthesiologists Physical Status Classification System (ASA-PS). 77.8% of respondents mostly agreed or agreed with the statement that they routinely conducted medical comorbidity management, and pain and falls risk assessment during emergency surgical admissions. Although 98.2% of respondents agreed that frailty was important, only 2.4% performed CGA and 1.2% used a specific frailty screening tool. Clinical frailty score was the most commonly used tool by those who did. Screening was usually conducted by surgical trainees. Key barriers included a lack of knowledge about frailty assessment, a lack of clarity on who should be responsible for frailty screening, and a lack of trained staff. CONCLUSIONS: Our study highlights the ubiquitous lack of awareness regarding frailty assessment and the POPS model of care. More training and clear guidelines on frailty scoring, alongside support by multidisciplinary teams, may reduce the burden on surgical trainees, potentially improving rates of appropriate frailty assessment and management of the frailty syndrome in emergency surgical patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13017-022-00471-7
Diagnosis of acute appendicitis based on clinical scores: is it a myth or reality?
No full textBackground and aim of the work In April 2020, the World Society
of Emergency Surgery (WSES) published the first update to the
Jerusalem Guidelines on the diagnosis and treatment of acute
appendicitis. In this review we have reported a summary of the
contemporary evidence from the literature that led to the
guidelines statements on the diagnostic strategies for
appendicitis. Methods A systematic literature search was
performed for studies published on the use of the most common
clinical scores and imaging for the diagnosis of appendicitis.
Results Alvarado, AIR and AAS scores are sufficiently sensitive
(up to 99\%) to exclude appendicitis, accurately identifying
low-risk patients and decreasing the need for imaging and the
negative appendectomy rates in such patients. Conversely, for
young patients deemed to be at high-risk of appendicitis
according to the scores, because of the high prevalence of the
disease in this group of patients (~90\%), a negative imaging
scan cannot rule out appendicitis. The sensitivity and
specificity of CT is reported at 0.91-0.94 and 0.90-0.95. The
corresponding results for US are 0.78-0.88 and 0.81-0.94,
respectively. Conclusions In young patients, a high-probability
score for appendicitis may be used to select patients in which
imaging is not needed. When the surgeon deems diagnostic imaging
is still needed to confirm appendicitis despite the patient has
been scored at high-risk, a conditional CT scan strategy is
advised, with CT scan performed only after a negative or
equivocal ultrasound scan
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