The potential use of ozone as antifungal and antiaflatoxigenic agent in nuts and its effect on nutritional quality / O potencial uso do ozônio como agente antifúngico e antiaflatoxigênico em castanhas e seu efeito na qualidade nutricional

Ozone gas is considered as a safe antimicrobial agent in food industries. Here, we evaluated the antifungal and antiaflatoxigenic activities of ozone against fungal contamination in nuts. The most predominant fungal genera in nuts were Aspergillus, Penicillium, Fusarium, and Rhizopus. Ozone (4 ppm) significantly reduced the fungal sporulation of A. flavus and their aflatoxin production. Interestingly, ozone treatment of nuts reduced the total fungal count and increased aflatoxins degradation by approximately 95% and 85%, respectively. Ozone displayed high efficiency to increase the permeability of cell membrane and injury of cell wall of fungi. Increasing the exposure time of ozone in nuts up to 180 minutes showed to reduce the total lipid, carbohydrates, and protein by around 41.2%, 42.7% and 38.4% respectively, in pistachio, almond and peanuts. In conclusion, ozonation is a suitable decontaminating approach for reducing the microbial load in nuts, when used with suitable exposure time.

O gás ozônio é considerado um agente antimicrobiano seguro em indústrias alimentícias. Aqui, avaliamos as atividades antifúngicas e antiaflatoxigênicas do ozônio contra a contaminação fúngica em nozes. Os gêneros fúngicos mais predominantes em nozes foram Aspergillus, Penicillium, Fusarium e Rhizopus. O ozônio (4 ppm) reduziu significativamente a esporulação fúngica de A. flavus e sua produção de aflatoxinas. Curiosamente, o tratamento de nozes com ozônio reduziu a contagem total de fungos e aumentou a degradação de aflatoxinas em aproximadamente 95% e 85%, respectivamente. O ozônio apresentou alta eficiência para aumentar a permeabilidade da membrana celular e a lesão da parede celular dos fungos. O aumento do tempo de exposição do ozônio em nozes em até 180 minutos levou à redução do total de lipídios, carboidratos e proteínas em 41,2%, 42,7% e 38,4%, respectivamente, em pistache, amêndoa e amendoim. Em conclusão, a ozonização é uma abordagem de descontaminação adequada para reduzir a carga microbiana em nozes, quando usada com tempo de exposição adequado.

Prediction of short-term results after laparoscopic right hemicolectomy. Is sarcopenia superior to other methods?

Background: Complication treatment in colorectal cancer can be carried out quickly with the prediction and early diagnosis. However, there is no apparent predictive factor for this. Objective: We aimed to determine the factors that predict early mortality and morbidity in patients who underwent laparoscopic right hemicolectomy and their superiority over each other. Method: Demographic data, age-adjusted Charlson Comorbidity Index, American Society of Anesthesiologists Score, body mass index, modified-Glasgow Prognostic Score (mGPS), stage of disease, and sarcopenia were evaluated in patients who underwent right hemicolectomy between 2010-2022. Their superiority in predicting short-term outcomes was compared. Results: 78 patients were included in the study. The complication rate was higher in sarcopenic patients (p = 0.002). A high mGPS score was associated with increased mortality risk (p = 0.012). Other methods were not found to be related to short-term results. Conclusion: Sarcopenia is useful for the prediction of complications, and the mortality rate can be estimated by the mGPS score. These are superior to the other short-term results prediction methods. However, randomized controlled studies are needed.

Antecedentes: El tratamiento de complicaciones en el cáncer colorrectal puede llevarse a cabo rápidamente mediante la predicción y el diagnóstico temprano. Sin embargo, no existe un factor predictivo claro para esto. Objetivo: Determinar los factores que predicen la mortalidad y la morbilidad precoces en pacientes sometidos a hemicolectomía derecha laparoscópica y su superioridad entre ellos. Método: Se evaluaron datos demográficos, el índice de comorbilidad de Charlson ajustado por edad, el puntaje de la American Society of Anesthesiologists, el índice de masa corporal, el puntaje de pronóstico de Glasgow modificado (mGPS), el estadio de la enfermedad y la sarcopenia en pacientes que se sometieron a hemicolectomía derecha entre 2010 y 2022. Se comparó su superioridad en la predicción de resultados a corto plazo. Resultados: Se incluyeron en el estudio 78 pacientes. La tasa de complicaciones fue mayor en los pacientes sarcopénicos (p = 0.002). Una puntuación mGPS alta se asoció con un mayor riesgo de mortalidad (p = 0.012). No se encontró que otros métodos estuvieran relacionados con los resultados a corto plazo. Conclusiones: La sarcopenia es útil para la predicción de complicaciones y la tasa de mortalidad puede estimarse mediante la puntuación mGPS. Estos son superiores a los otros métodos de predicción de resultados a corto plazo. Sin embargo, se necesitan estudios controlados aleatorizados.

The potential use of ozone as antifungal and antiaflatoxigenic agent in nuts and its effect on nutritional quality.

Ozone gas is considered as a safe antimicrobial agent in food industries. Here, we evaluated the antifungal and antiaflatoxigenic activities of ozone against fungal contamination in nuts. The most predominant fungal genera in nuts were Aspergillus, Penicillium, Fusarium, and Rhizopus. Ozone (4 ppm) significantly reduced the fungal sporulation of A. flavus and their aflatoxin production. Interestingly, ozone treatment of nuts reduced the total fungal count and increased aflatoxins degradation by approximately 95% and 85%, respectively. Ozone displayed high efficiency to increase the permeability of cell membrane and injury of cell wall of fungi. Increasing the exposure time of ozone in nuts up to 180 minutes showed to reduce the total lipid, carbohydrates, and protein by around 41.2%, 42.7% and 38.4% respectively, in pistachio, almond and peanuts. In conclusion, ozonation is a suitable decontaminating approach for reducing the microbial load in nuts, when used with suitable exposure time.

Are there differences in oxidative stress and inflammatory processes between the autogenous and reactive subtypes of obsessive-compulsive disorder? A controlled cross-sectional study

Objective: To date, no study has investigated whether autogenous and reactive obsessive-compulsive disorder (OCD) types are different entities in terms of oxidative stress and inflammatory processes. The aim of this study is to compare them in terms of these features. Methods: The study was conducted in subjects with reactive OCD (n=19), autogenous OCD (n=14), and a control group (n=17). All participants were non-smokers. Sociodemographic data were collected and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Obsessive Beliefs Questionnaire (OBQ), and Overvalued Ideas Scale (OVIS) were administered. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), paraoxonase (PON1), total oxidant status (TOS), and total antioxidant status (TAS) were measured. Results: There were no significant differences in TAS, TOS, or oxidative stress index (OSI) between the OCD and control groups. PON1 and hs-CRP levels were higher in the OCD group, whereas IL-6 and IL-10 levels were lower. Comparison across the three groups revealed no differences in TAS, TOS, OSI, or PON1 levels; however, hs-CRP was significantly higher while IL-6 and IL-10 were significantly lower in the reactive group compared to controls. Conclusion: Our results show that, although inflammatory processes may play a role in OCD, the autogenous and reactive subtypes do not differ from each other in these respects. The classification of OCD into autogenous and reactive subtypes should be reevaluated.

Influence of foliar application of glycinebetaine on Tagetes erecta L yield cultivated under salinity conditions.

Tagetes genus of Composite family consider one of the most favorite floriculture plants. Therefore, of particular interest examine the salt tolerance of this bedding and coloring agent plant. In this research, was report the role of glycinebetaine (GB) in attenuating the adverse impacts of salt stress in African marigold plant, along with their anti-oxidative capacities and biochemical attributes. The salt stressed African marigold (100 and 150 mM NaCl) was treated with GB at 200 mM, beside untreated control plants. According to the obtained results, the growth characters were negatively in salt stressed plants but a mitigate impact of GB were observed in this respect. Obviously, the morphological as well as some physiological characters were reduced with salinity treatments while GB treatment reverses these effects. Overall, the alleviate impact of GB on the negative impact of salt stress was enhanced through improving total phenolic and antioxidant enzyme activity. Further, it is concluded that GB concentration induces the activities of antioxidative enzymes which scavenged ROS increased under saline conditions.

Are there differences in oxidative stress and inflammatory processes between the autogenous and reactive subtypes of obsessive-compulsive disorder? A controlled cross-sectional study.

OBJECTIVE: To date, no study has investigated whether autogenous and reactive obsessive-compulsive disorder (OCD) types are different entities in terms of oxidative stress and inflammatory processes. The aim of this study is to compare them in terms of these features. METHODS: The study was conducted in subjects with reactive OCD (n=19), autogenous OCD (n=14), and a control group (n=17). All participants were non-smokers. Sociodemographic data were collected and the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Obsessive Beliefs Questionnaire (OBQ), and Overvalued Ideas Scale (OVIS) were administered. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), paraoxonase (PON1), total oxidant status (TOS), and total antioxidant status (TAS) were measured. RESULTS: There were no significant differences in TAS, TOS, or oxidative stress index (OSI) between the OCD and control groups. PON1 and hs-CRP levels were higher in the OCD group, whereas IL-6 and IL-10 levels were lower. Comparison across the three groups revealed no differences in TAS, TOS, OSI, or PON1 levels; however, hs-CRP was significantly higher while IL-6 and IL-10 were significantly lower in the reactive group compared to controls. CONCLUSION: Our results show that, although inflammatory processes may play a role in OCD, the autogenous and reactive subtypes do not differ from each other in these respects. The classification of OCD into autogenous and reactive subtypes should be reevaluated.

Influence of foliar application of glycinebetaine on Tagetes erecta L yield cultivated under salinity conditions

Abstract Tagetes genus of Composite family consider one of the most favorite floriculture plants. Therefore, of particular interest examine the salt tolerance of this bedding and coloring agent plant. In this research, was report the role of glycinebetaine (GB) in attenuating the adverse impacts of salt stress in African marigold plant, along with their anti-oxidative capacities and biochemical attributes. The salt stressed African marigold (100 and 150 mM NaCl) was treated with GB at 200 mM, beside untreated control plants. According to the obtained results, the growth characters were negatively in salt stressed plants but a mitigate impact of GB were observed in this respect. Obviously, the morphological as well as some physiological characters were reduced with salinity treatments while GB treatment reverses these effects. Overall, the alleviate impact of GB on the negative impact of salt stress was enhanced through improving total phenolic and antioxidant enzyme activity. Further, it is concluded that GB concentration induces the activities of antioxidative enzymes which scavenged ROS increased under saline conditions.

Resumo O Tagetes, da família Composite, é um dos gêneros mais apreciados de plantas de floricultura. Portanto, é de particular interesse examinar a tolerância ao sal desta planta de substrato e corante. Nesta pesquisa, foi relatado o papel da glicinebetaína (GB) na atenuação dos impactos adversos do estresse salino na calêndula africana, juntamente com suas capacidades antioxidantes e atributos bioquímicos. A calêndula africana estressada com sal (NaCl 100 e 150 mM) foi tratada com GB a 200 mM, ao lado de plantas de controle não tratadas. De acordo com os resultados obtidos, os caracteres de crescimento foram negativos em plantas estressadas por sal, mas um impacto mitigado de GB foi observado neste aspecto. Obviamente, os caracteres morfológicos e fisiológicos foram reduzidos com os tratamentos de salinidade, enquanto o tratamento com GB reverteu esses efeitos. No geral, o impacto de alívio do GB no impacto negativo do estresse salino foi aprimorado através da melhoria da atividade das enzimas fenólicas e antioxidantes totais. Além disso, conclui-se que a concentração de GB induz as atividades de enzimas antioxidantes que sequestraram ROS aumentadas em condições salinas.

Influence of foliar application of glycinebetaine on Tagetes erecta L yield cultivated under salinity conditions / Influência da aplicação foliar de glicinebetaína na produtividade de Tagetes erecta L cultivada em condições de salinidade

Tagetes genus of Composite family consider one of the most favorite floriculture plants. Therefore, of particular interest examine the salt tolerance of this bedding and coloring agent plant. In this research, was report the role of glycinebetaine (GB) in attenuating the adverse impacts of salt stress in African marigold plant, along with their anti-oxidative capacities and biochemical attributes. The salt stressed African marigold (100 and 150 mM NaCl) was treated with GB at 200 mM, beside untreated control plants. According to the obtained results, the growth characters were negatively in salt stressed plants but a mitigate impact of GB were observed in this respect. Obviously, the morphological as well as some physiological characters were reduced with salinity treatments while GB treatment reverses these effects. Overall, the alleviate impact of GB on the negative impact of salt stress was enhanced through improving total phenolic and antioxidant enzyme activity. Further, it is concluded that GB concentration induces the activities of antioxidative enzymes which scavenged ROS increased under saline conditions.

O Tagetes, da família Composite, é um dos gêneros mais apreciados de plantas de floricultura. Portanto, é de particular interesse examinar a tolerância ao sal desta planta de substrato e corante. Nesta pesquisa, foi relatado o papel da glicinebetaína (GB) na atenuação dos impactos adversos do estresse salino na calêndula africana, juntamente com suas capacidades antioxidantes e atributos bioquímicos. A calêndula africana estressada com sal (NaCl 100 e 150 mM) foi tratada com GB a 200 mM, ao lado de plantas de controle não tratadas. De acordo com os resultados obtidos, os caracteres de crescimento foram negativos em plantas estressadas por sal, mas um impacto mitigado de GB foi observado neste aspecto. Obviamente, os caracteres morfológicos e fisiológicos foram reduzidos com os tratamentos de salinidade, enquanto o tratamento com GB reverteu esses efeitos. No geral, o impacto de alívio do GB no impacto negativo do estresse salino foi aprimorado através da melhoria da atividade das enzimas fenólicas e antioxidantes totais. Além disso, conclui-se que a concentração de GB induz as atividades de enzimas antioxidantes que sequestraram ROS aumentadas em condições salinas.

Salvage radiotherapy in patients affected by oligorecurrent pelvic nodal prostate cancer.

PURPOSE: Metastasis-directed therapy (MDT) is an investigational treatment option in patients with oligorecurrent prostate cancer (PCa). The aim of this retrospective study is to report oncologic outcome and toxicity of elective nodal radiotherapy (ENRT) in PCa patients affected by pelvic nodal oligorecurrence. METHODS: 41 consecutive patients were treated with salvage radiotherapy. At biochemical recurrence after primary treatment, oligorecurrent disease was detected by positron emission tomography (PET) in 94% of the patients. Image-guided intensity modulated radiation therapy (IMRT) was delivered using tomotherapy. 83% of the patients received androgen deprivation therapy (ADT) in combination with ENRT. Survival analysis was performed with Kaplan-Meier method, log-rank test was used to analyze associations between survival end-points and clinical parameters. Multivariate analysis was performed using Cox proportional hazards regression models. Toxicity was registered according to Common Terminology Criteria for Adverse Events (CTCAE) v4.0. RESULTS: The median at follow-up was 33.6 months. At 3 years, overall survival (OS), cancer-specific survival (CSS), and biochemical progression-free survival (b-PFS) were 89%, 92%, and 53%, respectively. At univariate analysis, all survival end-points were correlated with the number of positive pelvic lymph nodes at oligorecurrence (≤ 3 vs > 3). Biochemical-PFS was correlated with PSA (p = 0.034) and PSA doubling time (p = 0.004) at oligorecurrence. At multivariate analysis, no independent variable was statistically significant. No patient experienced grade ≥ 2 late toxicity after radiotherapy. CONCLUSIONS: The number of metastatic lymph nodes and PSA doubling time seems to be important prognostic factors in the pelvic oligorecurrent setting. Salvage radiotherapy combined with short-course ADT might be a valid treatment strategy.

Chronic non-communicable disease risk factor survey 2010 among University of the West Indies staff at Cave Hill, Barbados.

OBJECTIVE: To determine the prevalence of risk factors for chronic non-communicable diseases (CNCDs) among staff of The University of the West Indies (UWI), Cave Hill campus, in Barbados. METHODS: A self-administered questionnaire comprising validated questions from the WHO STEPS NCD Risk Factor Survey, the Jamaica Healthy Lifestyle (JHL) Survey and the Behaviour Risk Factor (BRF) Survey, was conducted during the Staff Health Day in May 2010, and at four locations on campus during July 2010. Standardized measurements of weight, height and blood pressure were taken. Data were analysed using EXCEL and STATA and results were compared to the Barbados 2007 STEPS NCD survey. RESULTS: The target population was all staff at the Cave Hill campus of UWI. The coverage rate was 25.2% (269/1068); 63.8% of males and 75% of females were either overweight or obese. Ninety-seven per cent ate less than the recommended 5 fruits and vegetables per day. Low levels of physical activity were reported in 51.9% of males and 62.2% of females. Thirty-two per cent of males and 13% of females were binge drinkers. All participants had at least one of the risk factors (current daily smoker < 5 fruits and vegetables/day, physical inactivity, overweight/obese and raised blood pressure) whilst 48% of males and 57.2% of females demonstrated three or more risk factors. These results are similar to those found in the Barbados STEPS NCD risk factor survey of 2007. CONCLUSION: The results confirm a similar high prevalence of NCD risk factors among Cave Hill UWI staff as among the Barbadian population. The study reveals opportunities to inform policy on strategies to positively impact the risk factors.

Chronic non-communicable disease Risk Factor Survey 2010 among University of the West Indies staff at Cave Hill, Barbados / Encuesta de 2010 Sobre Factores de Riesgo de las enfermedades no comunicables entre el personal de la Universidad de West Indies, en el Campus de Cave Hill, Barbados

OBJECTIVE: To determine the prevalence of risk factors for chronic non-communicable diseases (CNCDs) among staff of The University of the West Indies (UWI), Cave Hill campus, in Barbados. METHODS: A self-administered questionnaire comprising validated questions from the WHO STEPS NCD Risk Factor Survey, the Jamaica Healthy Lifestyle (JHL) Survey and the Behaviour Risk Factor (BRF) Survey, was conducted during the Staff Health Day in May 2010, and at four locations on campus during July 2010. Standardized measurements of weight, height and blood pressure were taken. Data were analysed using EXCEL and STATA and results were compared to the Barbados 2007 STEPS NCD survey. RESULTS: The target population was all staff at the Cave Hill campus of UWI. The coverage rate was 25.2% (269/1068); 63.8% of males and 75% of females were either overweight or obese. Ninety-seven per cent ate less than the recommended 5 fruits and vegetables per day. Low levels of physical activity were reported in 51.9% of males and 62.2% of females. Thirty-two per cent of males and 13% of females were binge drinkers. All participants had at least one of the risk factors (current daily smoker, < 5 fruits and vegetables/day, physical inactivity, overweight/obese and raised blood pressure) whilst 48% of males and 57.2% of females demonstrated three or more risk factors. These results are similar to those found in the Barbados STEPS NCD risk factor survey of 2007. CONCLUSION: The results confirm a similar high prevalence of NCD risk factors among Cave Hill UWI staff as among the Barbadian population. The study reveals opportunities to inform policy on strategies to positively impact the risk factors.

OBJETIVO: Determinar la prevalencia de los factores de riesgo de ENCs entre el personal de la Universidad de West Indies (UWI), en el campus de Cave Hill, Barbados. MÉTODOS: El Día de la Salud del Personal en mayo de 2010, y en cuatro localidades del campus durante julio de 2010, se aplicó un cuestionario auto-administrado formado por varias preguntas validadas de las encuestas conocidas como WHO STEPS NCD Risk Factor Survey, JHL Survey y BRF Survey. Se hicieron mediciones estandarizadas del peso, la altura, y la presión arterial. Los datos fueron analizados usando EXCEL y STATA, y los resultados fueron comparados como los de la encuesta de Barbados 2007 STEPS NCD. RESULTADOS: La población objeto del estudio estuvo formada por todo el personal en el campus de Cave Hill de la Universidad de West Indies (UWI). La tasa de cobertura fue 25.2% (269/1068); el 63.8% de los varones y el 75% de hembras tenían sobrepeso o eran obesos. Noventa y siete por ciento consumía menos de las 5 frutas y vegetales recomendados por día. Se reportaron bajos niveles de actividad física en 51.9% de los varones y 62.2% de las hembras. Treinta y dos por ciento de los varones y 13% de las hembras eran bebedores consumados. Todos los participantes tenían al menos uno de los factores de riesgo (fumador consuetudinario, < 5 frutas y vegetales/día, inactividad física, sobrepeso/obeso, y alta presión arterial) en tanto que el 48% de los varones y el 57.2% de las hembras mostraron tres o más factores de riesgo. Estos resultados son similares a los hallados en la encuesta Barbados STEPS NCD Risk Factor Survey del 2007. CONCLUSIÓN: Los resultados confirman una alta prevalencia de factores de riesgo de ENC entre el personal de Cave Hill de UWI similar a la existente entre la población barbadense en general. El estudio revela oportunidades de informar las políticas sobre estrategias de modo que puedan lograr un impacto positivo sobre los factores de riesgo.

Effect of basic prehospital trauma life support program on cognitive and trauma management skills.

We tested the effectiveness of a basic prehospital trauma life support (PHTLS) program by assessing cognitive performance and trauma management skills among prehospital trauma personnel. Fourteen subjects who completed a standard PHTLS course (group I) were compared to a matched group not completing a PHTLS program (group II). Cognitive performance was assessed on 50-item multiple choice examinations, and trauma skills management was assessed with four simulated trauma patients. Pre-PHTLS multiple choice questionnaire scores were similar (45.8 +/- 9.4% vs. 48.8 +/- 8.9% for groups I and II, respectively), but the post-PHTLS scores were higher in group I (80.4 +/- 5.9%) than in group II (52.6 +/- 4.9%). Pre-PHTLS simulated trauma patient performance scores (standardized to a maximum total of 20 for each station) were similar at all four stations for both groups, ranging from 7.9 to 10.4. The post-PHTLS scores were statistically significantly higher at all four stations for group I (range 16.0-19.0) compared to those for group II (range 8.0-11.1). The overall mean pre-PHTLS score for all four stations was 8.3 +/- 2.1 for group I and 8.8 +/- 2.0 (NS) for group II; the group I post-PHTLS mean score for the four stations was 17.1 +/- 2.7 (p < 0.05) compared to 9.1 +/- 2.3 for group II. Pre-PHTLS Adherence to Priority scores on a scale of 1 to 7 were similar (1.1 +/- 0.9 for group I and 1.2 +/- 1.0 for group II). Post-PHTLS group I Priority scores increased to 5.9 +/- 1.1. Group II (1.1 +/- 1.0) did not improve their post-PHTLS scores. The pre-PHTLS Organized Approach scores in the simulated trauma patients on a scale of 1 to 5 were 2.1 +/- 1.0 for group I and 1.9 +/- 1.2 for group II (NS) compared to 4.2 +/- 0.9 (p < 0.05) in group I and 2.0 +/- 0.8 in group II after PHTLS. This study demonstrates improved cognitive and trauma management skills performance among prehospital paramedical personnel who complete the basic PHTLS program.

Impact of the prehospital trauma life support programme in Trinidad and Tobago.

The impact of the Prehospital Trauma Life Support (PHTLS) programme, introduced in Trinidad and Tobago in 1992, was assessed by questionnaires completed by 26 medical personnel (MP); 71 ambulance personnel (AP); and 50 non ambulance paramedical personnel (NAP). Of the 23 MP, 45 AP and 38 NAP who were aware of the programme, 19 (82.6%) MP, 40 (88.9%) AP and 25 (65.8%) NAP were able to differentiate personnel that had taken the PHTLS programme based on their performance. 32 (71.1%) of the AP were PHTLS trained. 24 (53.3%) and 4 (9%) of the AP identified poor equipment and poor supervision, respectively, as reasons for difficulty in applying PHTLS principles. Improvements observed among those completing the PHTLS programme were: improved resuscitation techniques by 20 (86.9%) MP, 38 (84.4%) AP and 27 (71.1%) NAP; better vital signs recording by 8 (34.8%) MP, 27 (60%) AP and 8 (21.1%) NAP; improved immobilization by 23 (100%) MP, 40 (88.9%) AP and 33 (86.8%) NAP; better haemorrhage control by 22 (95.6%) MP, 40 (88.9%) AP and 24 (63.2%) NAP; appropriate splinting of fractures by 23 (100%) MP, 40 (88.9%) AP and 32 (84.2%) NAP; and increased utilization of oxygen by 15 (65.2%) MP, 31 (68.9%) AP and 21 (55.3%) NAP. 32 (71.1%) AP with PHTLS training indicated improvement in their ability to resuscitate and transport trauma victims, with 42 (93.3%) reporting improvement in overall prehospital care. Medical, paramedical and ambulance personnel all perceive a significant positive impact of PHTLS training on prehospital trauma care. Although improvements in supervision, documentation and equipment are still required, improved trauma resuscitative techniques after PHTLS training should improve trauma patient outcome in Trinidad and Tobago.

Impact of the prehospital trauma life support programme in Trinidad and Tobago

The impact of the Prehospital Trauma Life Support (PHTLS) programme, introduced in Trinidad and Tobago in 1992, was assessed by questionnaires completed by 26 medical personnel (MP); 71 ambulance personnel (AP); and 50 non ambulance paramedical personnel (NAP). Of the 23 MP, 45 AP and 38 NAP who were aware of the programme, 19 (82.6 percent) MP, 40(88.9 percent) AP and 25 (65.8 percent) NAP were able to differentiate personnel that had taken the PHTLS programme based on their performance. 32 (71.1 percent) of the AP were PHTLS trained. 24 (53.3 percent) and 4 (9 percent) of the AP identified poor equipment and poor supervision, respectively, as reasons for difficulty in applying PHTLS principles. Improvements observed among those completing the PHTLS programme were: improved resuscitation techniques by 20 (86.9 percent) MP, 38 (84.4 percent) AP and 27 (71.1 percent) NAP; better vital signs recording by 8 (34.8 percent) MP, 27 (60 percent) AP and 8 (21.1 percent) NAP; improved immobilization by 23 (100 percent) MP, 40 (88.9 percent) AP and 33 (86.8 percent) NAP: better haemorrhage control by 22 (95.6 percent) MP, 40 (88.9 percent) AP and 24 (63.2 percent) NAP; appropriate splinting of fractures by 23 (100 percent) MP, 40 (88.9 percent) AP and 32 (84.2 percent) NAP: and increased utilization of oxygen by 15 (65.2 percent) MP, 31 (68.9 percent) AP and 21 (55.3 percent) NAP. 32 (71.1 percent) AP with PHTLS training indicated improvement in their ability to resuscitate and transport trauma victims, with 42 (93.3 percent) reporting improvement in overall prehospital care. Medical, paramedical and ambulance personnel all perceive a significant positive impact of PHTLS training on prehospital trauma care. Although improvements in supervision, documentation and equipment are still required, improved trauma resuscitative techniques after PHTLS training should improve trauma patient outcome in Trinidad and Tobago. (AU)

Impact of the prehospital trauma life support programme in Trinidad and Tobago

The impact of the Prehospital Trauma Life Support (PHTLS) programme, introduced in Trinidad and Tobago in 1992, was assessed by questionnaires completed by 26 medical personnel (MP); 71 ambulance personnel (AP); and 50 non ambulance paramedical personnel (NAP). Of the 23 MP, 45 AP and 38 NAP who were aware of the programme, 19 (82.6) MP, 40 (88.9) AP and 25 (65.8) NAP were able to differentiate personnel that had taken the PHTLS programme based on their performance. 32 (71.1) of the AP were PHTLS trained. 24 (53.3) and 4 (9) of the AP identified poor equipment and poor supervision, respectively, as reasons for difficulty in applying PHTLS principles. Improvements observed among those completing the PHTLS programme were: improved resuscitation techniques by 20 (86.9) MP, 38 (84.4) AP and 27 (71.1) NAP; better vital signs recording by 8 (34.8) MP, 27 (60) AP and 8 (21.1) NAP; improved immobilization by 23 (100) MP, 40 (88.9) AP and 33 (86.8) NAP; better haemorrhage control by 22 (95.6) MP, 40 (88.9) AP and 24 (63.2) NAP; appropriate splinting of fractures by 23 (100) MP, 40 (88.9) AP and 32 (84.2) NAP; and increased utilization of oxygen by 15 (65.2) MP, 31 (68.9) AP and 21 (55.3) NAP. 32 (71.1) AP with PHTLS training indicated improvement in their ability to resuscitate and transport trauma victims, with 42 (93.3) reporting improvement in overall prehospital care. Medical, paramedical and ambulance personnel all perceive a significant positive impact of PHTLS training on prehospital trauma care. Although improvements in supervision, documentation and equipment are still required, improved trauma resuscitative techniques after PHTLS training should improve trauma patient outcome in Trinidad and Tobago.