RESUMO
The American College of Surgeons Committee on Trauma's Advanced Trauma Life Support Course is currently taught in 50 countries. The 8th edition has been revised following broad input by the International ATLS subcommittee. Graded levels of evidence were used to evaluate and approve changes to the course content. New materials related to principles of disaster management have been added. ATLS is a common language teaching one safe way of initial trauma assessment and management.
Assuntos
Currículo/normas , Educação Médica Continuada , Cuidados para Prolongar a Vida/normas , Traumatologia/educação , Ferimentos e Lesões/terapia , Competência Clínica , Currículo/tendências , Medicina de Emergência/educação , Tratamento de Emergência/normas , Tratamento de Emergência/tendências , Feminino , Previsões , Humanos , Cuidados para Prolongar a Vida/tendências , Masculino , Ressuscitação/educação , Sensibilidade e Especificidade , Traumatologia/tendências , Estados UnidosRESUMO
Diversion colitis is an iatrogenic disorder related to surgical diversion of the faecal stream from the colorectal mucosa, first described by Morson in 1972. Inflammation of the defunctioned mucosa seems to be related to deprivation of luminal nutrients, in particular short chain fatty acids. Histologic abnormalities include damage of the epithelium and reparative changes with crypt distortion and branching, a mixed acute and chronic inflammatory infiltrate with crypt abscesses and lymphoid hyperplasia, Paneth cell metaplasia and thickening of the muscularis mucosae. We report a case of diversion colitis in a 51-year-old female with Crohn's disease with multiple submucosal microcarcinoids in the rectal stump 17 years after diversion and discuss the hypothesis that hyperplastic and neoplastic lesions of neuroendocrine cells can result from proliferative response to chronic inflammation and repair, as well as epithelial neoplasms.
