PubMed · 14348403
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C B LILLIBRIDGE. 1965. EMERGENCY-STAT.. https://pubmed.ncbi.nlm.nih.gov/14348403/
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In our institute, different procedures have been developed to measure the radioactivity content of drinking water both in normal and in emergency situations, such as those arising from accidental and terrorist events. A single radiometric technique, namely low level liquid scintillation counting (LSC), has been used. In emergency situations a gross activity screening is carried out without any sample treatment by a single and quick liquid scintillation counting. Alpha and beta activities can be measured in more than one hundred samples per day with sensitivities of a few Bq/L. Higher sensitivity gross alpha and beta, uranium and radium measurements can be performed on water samples after specific sample treatments. The sequential method proposed is designed in such a way that the same water sample can be used in all the stages, with slight modifications. This sequential procedure was applied in a survey of the Lombardia district. At first tap waters of the 13 largest towns were examined, then a more detailed monitoring was carried out in the surroundings of Milano and Lodi towns. The high sensitivity method for the determination of uranium isotopes was used to check the presence of depleted uranium in Lake Garda. Reduced equipment requirements and relative readiness of radiochemical procedures make LSC an attractive technique which can also be applied by laboratories lacking specific radiochemistry facilities and experience.
BACKGROUND: The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) is a scoring system that is used widely to predict 30-day mortality and morbidity rates. The Portsmouth predictor modification (P-POSSUM) was developed to overcome the overprediction of mortality by POSSUM, especially in low-risk patients. In this prospective study, the validity of POSSUM and P-POSSUM was tested in patients undergoing emergency laparotomy in a referral hospital of a developing country. METHODS: Some 120 patients who underwent emergency laparotomy in a single unit were studied. Predicted morbidity and mortality rates were calculated by POSSUM and P-POSSUM equations using both linear regression and the exponential methods of analysis. These were compared with actual outcomes. RESULTS: When the linear method of analysis was used POSSUM overpredicted morbidity, and there was a significant difference between the observed and predicted values (observed to expected (O : E) ratio 0.68). The prediction was more accurate when the exponential method was used (O : E ratio 0.91). POSSUM also significantly overpredicted mortality when analysed by the linear method (O : E ratio 0.39), but the prediction improved when exponential analysis was used (O : E ratio 0.62). Applying linear and exponential analyses for P-POSSUM, the O : E ratios for mortality were 0.66 and 0.88 respectively. CONCLUSION: If analysed correctly POSSUM is a good predictor of morbidity and mortality in patients undergoing emergency laparotomy. P-POSSUM predicts mortality equally well. Both equations may be used for risk-adjusted surgical audit of patients undergoing emergency laparotomy.
The aim of this pilot feasibility study was to investigate the efficacy and safety of hysteroscopy in the diagnosis and treatment of acute severe uterine bleeding. Forty-one women (mean age, 54 years) who underwent emergency hysteroscopy were assessed. In 40 women, a benign organic cause was found. In one postmenopausal patient, endometrial carcinoma was detected in endometrial chips and was managed with hysterectomy. None of the women with benign lesions required further surgery within the first postoperative year. One underwent hysterectomy at 18 months for new-onset fibromyomas. Hysteroscopy was found to be an effective tool for treating heavy uterine bleeding. It also prevented future episodes of severe bleeding in more than half the patients during 20 months of follow-up.