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http://www.webmedcentral.com/images/Header_Logo.giftext/html2012-02-01T19:51:29+01:00http://www.webmedcentral.com/Dr. Francesco LaurettaThe Analgesic Effect of the Hyperbaric Oxygen Therapy
http://www.webmedcentral.com/article_view/2954
Aim: This observational study is a comparison between standard medications for acute soft tissue injuries versus the same treatments with the addition of hyperbaric treatment cycles, in order to evaluate whether hyperbaric oxygen therapy reduces analgesic consumption during 9 days of treatment. Method: Eighty patients were retrospectively assigned to either the traditional care group comprising several medications (Group “base”) or the alternative treatment group, comprising several medications as well as 14 cycles of hyperbaric oxygen therapy (Group “hyp”). Pain scores, painful restricted movement and analgesic consumption were evaluated in the same manner. Results: We observed a clear analgesic effect and a significant reduction in the assumption of Paracetamol ( p< 0.01) in group “hyp”. The analgesic effect of such hyperbaric treatment increased significantly during the entire observational period of 9 days.Conclusions: Although the best way to investigate a possible relationship between hyperbaric oxygen exposition and reduction of pain would be a perspective randomized clinical trial, in our retrospective analysis, the hyperbaric oxygen therapy seems to reduce both pain and Paracetamol consumption.In our opinion vasoconstriction caused by such hyperbaric treatment, reducing post-traumatic edema of tissues and determining low releasing of acute inflammatory agents such as lactates and H+, could supply analgesic effect on acute pain. This clinical intuition, if confirmed by perspective randomized studies, could lead to new multimodal modalities for management of acute pain in case of traumatic injuries during disasters. So, if a hyperbaric oxygen chamber is available, not only you should use it for healing but also for pain management. Thus, our intent is only to stimulate further clinical investigation.text/html2012-04-06T14:08:08+01:00http://www.webmedcentral.com/Dr. Michelangelo BortolinDisaster Medicine: Perspective
http://www.webmedcentral.com/article_view/3219
Disaster medicine, as recent events emphasize, is a specialty of growing importance in the field of medicine. The risk of disasters continues to increase due to multiple factors. These factors include global trends such as population growth, urbanization and the globalization of industry. Furthermore, there is an ever-increasing expectation among modern populations for an assurance of safety that also extends to emergency situations, as many citizens look to the state for what has been described as the “responsibility to protect”.
The need to share scientific knowledge related to disasters is crucial and the arguments posed include a wide range of subjects: (e.g. triage, surge capacity, ethics, preparedness and training, and standard of care). Moreover, in comparison to those challenges faced by other specialties, the empirical study of disaster medicine holds a unique set of barriers. Researchers often face significant challenges involving the most fundamental of scientific endeavors. Among these challenges are lack of accurate documentation during events, logistical difficulties in data collection, a broad lack of standardization for comparability and analysis of like events; and seeking to avoid bias or confounding factors. It is also difficult to develop large datasets for low probability, yet high impact events. Thus, in many instances, academic reports rely heavily on anecdote, lacking statistical evidence by which to guide decision-making. But, this doesn’t mean that it is not important for us to strive harder to share ideas among experts in order to improve scientific methodology and ultimately affect health outcomes.
It is therefore, important to promote an evidence-based specialty of medicine that will better serve to define the clinical practice, connect the scientific community, and encourage scrupulous debate around the modern practice of disaster medicine. text/html2013-07-13T04:56:20+01:00http://www.webmedcentral.com/Dr. Jeewan S PrakashGeneral Perspectives on Preparedness vis-a-vis Disaster Management & Capacity Development
http://www.webmedcentral.com/article_view/4332
Abstract: Increasing frequency and world-wide occurrences of natural and man-made disasters and mass casualty incidents are responsible for the heavy toll on lives, physical and mental trauma, as well as infrastructure/development and financial losses. Our record of disaster management falls woefully short in many ways and in multiple aspects. In developing nations there is a growing need to identify causes for delay and deficiencies in providing disaster relief, to assess preparedness status, and to define individual requirements of responders and service providers for an enhanced and effective capacity development in order to better cope with future disasters.
Introduction: American College of Surgeons, Committee on Trauma 1990 [ ACS COT ]1 states that a disaster may be a sudden event with a variable mixture of four factors : injury to human beings, destruction of property, overwhelming of local response resources and disruption of organized societal mechanisms. This is similar to the definition offered by WHO in 199518
Disasters may be natural or man-made and may occur anywhere and at any time. Statistics show a nearly exponential rise in number of people affected. For each disaster listed in officially recognized disaster database there are some 20 other smaller emergencies with destructive impact on local communities that are unacknowledged and go unnoticed16 text/html2013-07-15T04:37:58+01:00http://www.webmedcentral.com/Dr. Jeewan S PrakashDisaster Mitigation & Capacity Development: Need for Specialized Preparedness [following December 26, 2004 Indian Ocean Tsunamis]
http://www.webmedcentral.com/article_view/4336
On December 26, 2004 the double disaster of Asia Pacific undersea earthquake and the consequent tsunamis caused 223,000+ human deaths, multiple injuries and psychological trauma to hundreds of thousands, and destruction and damage worth more than 10 billion dollars in 12 countries including India. In south India a Tsunami Medical Relief Camp provided services to over 22,000 victims from January 07 to July end 2005. Substantial literature and guidelines are available on preparedness in general and on capacity building in relation to disaster management. One of the lessons learned was that in India there was a need to define, explore, document and discuss the requirements of individual medical, nursing, paramedical and allied specialities in order to bridge the existing lacunae in policies, preparedness and execution at local/national/international levels.