Zentralblatt für Chirurgie
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In developing countries, war-like injury involving civilians, including children, is still a relevant and massive health problem and the human and economic costs of the injuries are tremendous. ⋯ There is a considerable risk not only for adolescents but even for children under conditions similar to those of civil war. However, the challenge is to provide an appropriate treatment in spite of the potential severity of injuries. This requires an adequate logistic management, surgical expertise as well as equipment and even the collaboration with surgical centres from supporting countries.
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From 2004 to 2005, a survey concerning the structure and organisation of postoperative acute pain therapy (APT) was conducted in 1358 hospitals from 7 EU states. ⋯ Further initiatives to improve postoperative acute pain therapy are urgently needed in all nations under evaluation. National measures in Germany have to take into account the specific problems identified in this large survey and should focus on the interests and needs of German surgeons.
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An interdisciplinary ethics consultation (EC) on the intensive care unit (ICU) can be requested by the clinical team as a result of a subjective assessment of the patient's situation. The aim of this study was to objectify the initiation of EC by means of the SOFA score and to examine its impact on the clinical course. ⋯ In critically ill patients, the interdisciplinary EC provides a meaningful tool for decision making between maximisation and reduction of treatment - facilitating improved end-of-life care and dignified dying. The indication for EC at the bedside should be supported by the SOFA score.