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The CCI is more strongly correlated with postoperative hospital stay than is the conventional CDC. The CUSUM-CCI model can be used for the continuous monitoring of surgical quality.

Prompt live-saving interventions, such as cardiopulmonary resuscitation (CPR), intravenous cannulation (IVC), and endotracheal intubation (ETI), are important for severely injured victims of chemical, biological, radiological, and nuclear (CBRN) disasters. Interventions sometime have to be performed by emergency medical service (EMS) personnel with personal protective equipment (PPE) worn in warm zones. We designed a randomized crossover simulation aimed to compare the performance of life-saving interventions in repetitive simulation of single-rescuer resuscitation wearing level-C PPE in the warm zone of a CBRN disaster. The success rate and completion time of IVC and ETI according to the presence of PPE were compared. The quality of 4-minute single-rescuer CPR was measured and compared as well. We found that the performance level of life-saving interventions performed in a simulated setting of disaster decreased when performed by EMS personnel wearing level-C PPE. Further efforts of optimizing current PPE for EMS personnel based on this study are needed.

Gastric cancer surgery in elderly patients aged ≥80 years achieves reasonable long-term survival despite the increased risk of severe complications.

BackgroundPalmar hyperhidrosis is a common disorder of excessive sweating. A number of studies have demonstrated the effectiveness of iontophoresis in the treatment of palmar hyperhidrosis. However, controlled clinical studies on iontophoresis for palmar hyperhidrosis have been limited.ObjectiveTo determine the efficacy and safety of iontophoresis in the treatment of palmar hyperhidrosis with a randomized, sham-controlled, single-blind, and parallel-designed study.MethodsTwenty nine patients with significant palmar hyperhidrosis were enrolled in this study. They received active iontophoresis treatment (group A) or sham treatment (group B). Iontophoresis was performed 20 minutes each time, five times per week, for 2 weeks. Its efficacy was assessed with starch-iodine test, mean sweat secretion rate, and hyperhidrosis disease severity scale.ResultsTwenty-seven of the 29 patients completed the 2-week treatment. After completion of 10 times of treatment, results of the starch-iodine test showed clinical improvement in 92.9% of patients in group A and 38.5% of patients in group B (p=0.001). The mean sweat secretion rate was reduced by 91.8% of patients in group A and by 39.1% of patients in group B (p<0.001). Improvement in quality of life was reported by 78.6% of patients in group A and by 30.8% of patients in group B (p=0.028). In group A, one case of localized adverse event was noted, although no adverse event was encountered in group B.ConclusionTap water iontophoresis could be used as an effective and safe treatment modality for palmar hyperhidrosis.

Intravenous lidocaine injection is as effective as intraperitoneal instillation for reducing pain and fentanyl consumption. The major benefit of intravenous injection is that this is an easily and universally applicable procedure compared to that of intraperitoneal instillation. Lidocaine intravenous administration is a better alternative for reducing the pain of patients who are undergoing laparoscopic surgery.

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