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• Drake, Frederick Thurston; Quiroga, Elina; Kariuki, Hazel W; Shisanya, Kizito A; Hotchkiss, Matthew P; Monroe-Wise, Aliza; Drake, John K; Mburu, Joseph; Farquhar, Carey; Flum, David R 2014-05-01 A 34-y-old man presented to Naivasha District Hospital (NDH) in Naivasha Town, Kenya, with near-complete below-knee amputation and hemorrhage after a hippopotamus attack. Residents from the University of Washington (UW), Departments of Surgery, Anesthesia, and Medicine, were rotating at NDH with the Clinical Education Partnership Initiative, a joint venture of UW and University of Nairobi. These providers met the patient in the operating theater. The leg was mangled with severely traumatized soft tissues and tibia-fibula fractures. The visiting UW Surgery resident (R3) and an NDH medical officer (second-year house officer) performed emergency below-knee completion amputation--the first time either had performed this operation.

The three major vessel groups were identified and ligated. Sufficient gastrocnemius and soleus were preserved for future stump construction. The wound was washed out, packed with betadine-soaked gauze, and wrapped in an elasticized bandage.

Broad-spectrum antibiotics were initiated. Unfortunately, the patient suffered infection and was revised above the knee. After a prolonged course, the patient recovered well and was discharged home. Vmware Fusion 7.1.2 Keygen.

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NDH house officers and UW trainees collaborated successfully in an emergency and conducted the postoperative care of a patient with a serious and challenging injury. Their experience highlights the importance of preparedness, command of surgical basics, humility, learning from mistakes, the expertise of others, a digitally connected surgical community, and the role of surgery in global health. These lessons will be increasingly pertinent as surgical training programs create opportunities for their residents to work in developing countries; many of these lessons are equally applicable to surgical practice in the developed world. Copyright © 2014 Elsevier Inc. All rights reserved. • 1984-05-15 operation carried out as a surprise attack on German airfields on a 1200 kilometer-wide front from Smolensk to the Sea of Azov. This operation was to combine.damaged.

EAF gun camera films show the attack at Ras Nasrani and explosions on the taxiways. They also show two Mirage fighters becoming airborne • 2016-04-08 During the night of 13-14 November, the city of Paris was exposed, within a few hours, to three bomb explosions, four shooting scenes, and one 3-hour hostage-taking of several hundred people causing at least 130 deaths and more than 250 injured victims. Most unstable patients were transferred to the six trauma centers of the Paris area, all members of the TRAUMABASE Group. A rapid adaptation of the organization of trauma patients' admittance was required in all centers to face the particular needs of the situation.

Everything went relatively well in all centers, with overall hospital mortality below 2%. Nevertheless, most physicians nowadays agree that anticipation, teaching, and training are crucial to appropriately face such events. All of us have learned many additional issues from this experience. Following a meeting of the TRAUMABASE Group, the most relevant issues are detailed in the following. • Bragazzi, Nicola Luigi; Del Puente, Giovanni 2012-01-01 This clinical case report shows how important it is for a psychiatrist to have a knowledge of the cultural and religious context of the patient, in order to understand fully his or her complaints. Culture and religion, in fact, are not neutral, but convey symbols, meanings, and myths that should be properly explored to shed light on the patient's inner world. Mindcrack Server on this page. Autodesk Land Desktop 2006 64 Bit Free Download there.