Delayed hemorrhage following surgical hemorrhoidectomy is a well-recognized complication. Emergency treatment may include suture ligation, anal packing, or other means of tamponade. At the Lehigh Valley Hospital, 27 patients were seen with the complication of delayed hemorrhage over an eight-year period from 1983 to 1990, for an incidence of 0.8 percent. Twenty-five patients (93 percent) underwent surgery primarily for hemorrhoidal disease; one patient had hemorrhoids removed in addition to a sphincterotomy for anal tissue, and the remaining patient had hemorrhoidectomy with fistulotomy. The mean interval from the operation to hemorrhage was six days. Treatment modalities included bedside anal packing in 20 patients (74 percent), observation alone in five patients (18 percent), and suture ligation in the operating room in two patients. Anal packing was successful in controlling postoperative hemorrhage in 20/20 patients, but late complications requiring reoperation developed in 15 percent.
The research described in this article tested the perception-response times for experienced police officers to transition from a firearm to a TASER and from a TASER to a firearm. The theoretical models and police training on use of force have largely ignored the temporal space between force modalities. Escalating through force modalities has by default been treated as equivalent, in task and timing, to deescalating through force modalities. This study employed a randomized controlled experiment using a police firearms training simulator and 139 active law enforcement officers. The average perception-response time for transition from a TASER to a firearm was 2.49 seconds for experienced police officers in response to an anticipated visual stimulus in a laboratory setting. The average perception-response time for transition from a firearm to a TASER was 4.7 seconds for experienced police officers in a response to an anticipated visual stimulus in a laboratory setting. 70% of the officers that participated in the study had never participated in department training that required them to transition between a firearm and a TASER. The findings demonstrate that moving from TASER to firearm and from firearm to TASER are not equivalent tasks. In the case of firearms and TASERs, it is significantly faster to move up the force continuum—from TASER to firearm—than it is to move down the force continuum. This research has implications for police training, tactics, policy, research, and post hoc investigations involving the use or potential use of force.
Once gastrointestinal function has returned after bowel surgery, a dairy-basecl liquid diet appears to be associated with an increased incidence of diarrhea when compared with a soft-solid diet. This retrospective study explores the hypothesis that these observations are causally related. Wc have modeled potential clinical and cost savings benefits, which might be derived from a change in clinical practice using a clear liquid and then soft-solid diet and avoiding the use of a dairy-based liquid diet. A chart review of 257 patients who had undergone bowel surgery over a 15-month period contained 64 patients with conditions predisposing to postoperative diarrhea. These patients were excluded leaving a study population of 193 patients. A model was developed to estimate dollar cost savings based on differences between groups of patients' length of stay (LOS). Of the 193 patients studied, the majority received an early postoperative dairy-based nutritional regimen (60%), whereas the remainder (40%) progressed directly from clear fluids to a soft-solid diet. The incidence of diarrhea was substantially different between these two groups (32% us 5'10, p < .001).Patients with diarrhea had a median length of stay of 10 days (range 5 to 34), and the figure for those without diarrhea was 7 (rangc 2 to 28) days (p < .001). The median costs for patients with and without diarrhea were $10,337 and $6,751, respectively (p < .001). In patients with a dairybased nutritional regimen who developed diarrhea, a change to the soft-solid diet led to diarrhea frequency reduction
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.