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PubMedDate not supplied

Team Echo: observations and lessons learned in the recovery phase of the 2004 Asian tsunami.

The 26 December 2004 Tsunami resulted in a death toll of >270,000 persons, making it the most lethal tsunami in recorded history. This article presents performance data observations and the lessons learned by a civilian team dispatched by the Australian government to "provide clinical and surgical functions and to make public health assessments". The team, prepared and equipped for deployment four days after the event, arrived at its destination 13 days after the Tsunami. Aspiration pneumonia, tetanus, and extensive soft tissue wounds of the lower extremities were the prominent injuries encountered. Surgical techniques had to be adapted to work in the austere environment. The lessons learned included: (1) the importance of team member selection; (2) strategies for self-sufficiency; (3) personnel readiness and health considerations; (4) face-to-face handover; (5) coordination and liaison; (6) the characteristics of injuries; (7) the importance of protocols for patient discharge and hospital staffing; and (8) requirements for interpreter services. Whereas disaster medical relief teams will be required in the future, the composition and equipment needs will differ according to the nature of the disaster. National teams should be on standby for international response.

Australia↗
PubMed1991

Bone marrow transplantation for leukemia after conditioning with busulfan and cyclophosphamide. Bone marrow morphology in the early recovery phase.

The bone marrow morphology of fifty patients with leukemia was analyzed before and two weeks after allogeneic bone marrow transplantation and compared to that of ten normal, healthy control subjects. Conditioning of the marrow graft recipients had been carried out with a combination of 16 mg/kg of Busulfan and 120 mg/kg of cyclophosphamide. The bone marrow at two weeks after transplant showed characteristic features that were unique for this clinical setting. Regenerative precursor cells with a distinct morphology commonly formed clusters or islands. Although mixed, multilinear islands were seen; the majority of islands were unilinear with a homogeneous cell content. These hematopoietic colonies were in direct proximity to degenerated cells of presumed host origin. No damage to the microenvironment was seen, the most characteristic finding being large, uniform, unilocular fat cells in close proximity to regenerative precursor cells. These morphologic changes are indicative of a complete and persistent marrow engraftment.

Adolescent↗
PubMed1990

[Myocardial ischemia induced by exercise. Analysis of the recovery phase. Behavior of the rate-pressure normalization product in patients with fixed ischemic threshold and patients with variable ischemic threshold].

Traditionally, in patients with exercise-induced myocardial ischemia we analyze the stress-test by studying the behaviour of double product at ischemia. We recognize the presence of a functional component in the reduction of coronary-flow reserve if the double product at ischemia (DPI) varies in 3 stress-tests i.e. more than 20% or more than 3200 mmHg b m'-1. Any analysis that relies exclusively on double product at ischemia is, of necessity, limited to the beginning of the ischemic phenomenon. To better understand the development of the whole event, we also considered the double product calculated when the ischemic electrocardiographic signal regressed (double product of normalization: DPN). More specifically, we set out to determine whether or not double product at ischemia behaviour in patients with variable ischemic threshold (i.e. double product at ischemia variation greater than 3200 mmHg b m'-1) differs from that of patients with fixed ischemic threshold (i.e. double product at ischemia variation less than b m'-1). We performed four multistage bicycle ergometer tests, without drugs, on 19 patients with chronic exertional anginal and exercise-induced ST depression. Patients were tested at the same time of day, within a 10 day period. In the second, third and fourth stress test double product at ischemia was calculated. On the basis of double product at ischemia values in three stress-tests, we distinguished two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗