Objective-To determine the rate of preventable trauma deaths in an African hospital; identify the potential effect of improvements in trauma care over the past decade; and identify deficiencies in care that still need to be addressed.Methods-A multidisciplinary panel assessed pre-hospital, hospital, and postmortem data on 89 consecutive in-hospital trauma deaths over 5-months in 2017 at the Komfo Anokye Teaching Hospital. The panel judged the preventability of each death. For definitely and potentially preventable deaths, the panel identified deficiencies in care.Results-Thirteen percent (13%) of trauma deaths were definitely preventable, 47% potentially preventable, and 39% non-preventable. In comparison to a panel review in 2007, there was no change in total preventable deaths, but there had been a modest decrease in definitely preventable deaths (25% in 2007 to 13% in 2017, p=0.07) There was a notable change in the pattern of deficiency (p=0.001) with decreases in pre-hospital delay (19% of all trauma deaths in 2007 to 3% Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1

The median prescription dose was 12Gy (IQR 0.5). At a median follow-up of 3.1 years (IQR 4.5), tumor stability and regression were 38.9% and 54.3%, respectively. The 5-and 10-year progression-free rate was 90.9% and 86.7%. Early tumor enlargement occurred in 10.9% of cases. The probability of serviceable hearing preservation at 5-and 10years was 56.8% and 45.2%, respectively. The probability of improvement or preservation of facial nerve function was 95.7% at 5 and 10-years. Adverse radiation effects were noted in 19.9%, 6 of them where managed with surgical resection of the VS. New-onset hydrocephalus occurred in 4.0%.CONCLUSIONS: Single-session SRS in selected Koos IV VS can be an alternative to surgery in a selected group of patients 45 years old. Longterm follow-up is warranted.

Lipoma arborescens is a benign intra-articular tumor characterized by joint effusions, pain and reduced range of motion. It is rare in adults and children. We present a case of Lipoma arborescens in a 16 year old male. The work up involved plain radiographs, MRI, incisional biopsy and laboratory analysis.