ABSTRACT
BACKGROUND: Resuscitative thoracotomy is a heroic procedure that may offer the only survival hope for trauma patients in extremis. However, this operation has been the subject of much debate and its use, feasibility, outcomes, and cost are being continuously re-evaluated. METHODS: This is a review of the most current (after 2000) literature on resuscitative thoracotomy, based on computer database searches for studies on resuscitative thoracotomy, emergency department thoracotomy, and emergency thoracotomy. Studies were selected for inclusion in this review based on their relevance and contribution to our understanding of resuscitative thoracotomy. RESULTS: A total of 37 studies were included, and the following resuscitative thoracotomy-related topics were critically discussed: indications, biochemical profile, long-term outcome, organ donation, pre-hospital use, military use, international aspects, intra-aortic balloon occlusion, suspended animation, and cost and occupational exposure. CONCLUSIONS: This review demonstrates that the indications for resuscitative thoracotomy become clearer and that new information is available regarding its use in the pre-hospital urban environment and military settings. Furthermore, it points to new strategies to supplement resuscitative thoracotomy including intra-aortic balloon occlusion and suspended animation. Finally, it sheds light on the long-term outcomes, organ donation, and cost and occupational exposure following resuscitative thoracotomy.
ABSTRACT
AIM: The study was conducted to investigate the differences in clinical-pathological, ethnic, and demographic presentations and the expression of mismatch repair proteins in a cohort of young-onset (50 years) with colorectal cancer. MATERIALS AND METHODS: Clinical, demographic, and histopathological data of patients with colorectal cancer were collected retrospectively from medical records and pathology reports. RESULTS: Ninety patients, 50 years of age or younger with a mean age of 42 years were compared with a group of 190 patients above 50 years of 50 (see Table 1). Sixty percent of the young-onset patients were females, compared to 40% in the older age group (P = 0.02). Twenty-one percent of the young-onset patients were Arabs as compared to 2% of older-onset patients (P = 0.001). Younger patients displayed a higher percentage of mucinous cancers and a higher percentage of diagnosis at an advanced stage of disease; 40% of young-onset versus 31% of older-onset patients presented Duke's stages C and D (P = 0.02). CONCLUSIONS: Younger age of onset colorectal cancer in our cohort of Israeli patients is associated with higher percentage of Arab patients, mucinous cancers, female gender, and advanced stage at diagnosis.
