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Article ; Online: Survivor's remorse.

Douglas, Anthony / Rogers, Selwyn

The journal of trauma and acute care surgery

2023 Volume 96, Issue 2, Page(s) e10–e12

Abstract: Abstract: In urban, large metropolitan trauma centers, we are accustomed to seeing the most gruesome morbidity and mortality in medicine. By far, the most devastating morbidity and mortality to observe are those inflicted on one human being to another. ... ...

Abstract	Abstract: In urban, large metropolitan trauma centers, we are accustomed to seeing the most gruesome morbidity and mortality in medicine. By far, the most devastating morbidity and mortality to observe are those inflicted on one human being to another. Gun violence is pervasive in this industrialized country, and it impacts us all. Staff, residents, and faculty in trauma centers bear the brunt of this trauma, second only to the families and communities that suffer the loss of loved ones. This burden is especially heavy for health care workers who share the same ethnic background of those who are disproportionately affected by interpersonal gun violence. Survivors of gun violence exist on a spectrum of chronic illness that ranges in physical and mental morbidity and social disruption in loss of wages and capabilities. This disease not only infects those wounded or killed but also transmits through communities and generations. Urban violence exists because of historic and systematic racism. It continues to persist because racism creates inequities in the quality of education, housing, and investment in urban environments, exacerbated by residential segregation. For two providers, a trainee and a faculty member of African descent, conscious of the determinants that create gun violence, it is overwhelming. We, as health care providers, must tell our stories and the stories of those whose voices are not empowered. We can hope that, by sharing these experiences, we stimulate action and change by raising the moral consciousness of those unaware of the tragedies we witness every day.
MeSH term(s)	Humans ; Gun Violence ; Survivors/psychology ; Guilt
Language	English
Publishing date	2023-11-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2651070-4
ISSN	2163-0763 ; 2163-0755
ISSN (online)	2163-0763
ISSN	2163-0755
DOI	10.1097/TA.0000000000004175
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Article: Stimulus Driven Functional Transformations in the Early Olfactory System.

Martelli, Carlotta / Storace, Douglas Anthony

Frontiers in cellular neuroscience

2021 Volume 15, Page(s) 684742

Abstract: Olfactory stimuli are encountered across a wide range of odor concentrations in natural environments. Defining the neural computations that support concentration invariant odor perception, odor discrimination, and odor-background segmentation across a ... ...

Abstract	Olfactory stimuli are encountered across a wide range of odor concentrations in natural environments. Defining the neural computations that support concentration invariant odor perception, odor discrimination, and odor-background segmentation across a wide range of stimulus intensities remains an open question in the field. In principle, adaptation could allow the olfactory system to adjust sensory representations to the current stimulus conditions, a well-known process in other sensory systems. However, surprisingly little is known about how adaptation changes olfactory representations and affects perception. Here we review the current understanding of how adaptation impacts processing in the first two stages of the vertebrate olfactory system, olfactory receptor neurons (ORNs), and mitral/tufted cells.
Language	English
Publishing date	2021-08-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2452963-1
ISSN	1662-5102
ISSN	1662-5102
DOI	10.3389/fncel.2021.684742
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Article ; Online: Black Medical Student Considerations in the Era of Virtual Interviews.

Douglas, Anthony / Hendrix, Justin

Annals of surgery

2021 Volume 274, Issue 2, Page(s) 232–233

MeSH term(s)	Black or African American ; COVID-19/epidemiology ; Education, Medical, Graduate ; Educational Status ; Humans ; Internship and Residency ; Interviews as Topic/methods ; Pandemics ; Personnel Selection/methods ; SARS-CoV-2 ; United States
Language	English
Publishing date	2021-05-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000004946
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Article ; Online: Pack the chest: Damage control strategy for management in thoracic trauma.

Douglas, Anthony D / Puzio, Thaddeus J / Murphy, Patrick B / Kinnaman, Gabriel B / Meagher, Ashley D

Injury

2024 Volume 55, Issue 5, Page(s) 111490

Abstract: Background: Damage control surgery aims to control hemorrhage and contamination in the operating room (OR) with definitive management of injuries delayed until normal physiology is restored in the intensive care unit (ICU). There are limited studies ... ...

Abstract	Background: Damage control surgery aims to control hemorrhage and contamination in the operating room (OR) with definitive management of injuries delayed until normal physiology is restored in the intensive care unit (ICU). There are limited studies evaluating the use of damage control thoracotomy (DCT) in trauma, and the best method of temporary closure is unclear. Methods: A retrospective review of trauma patients at two level I trauma centers who underwent a thoracotomy operation was performed. Subjects who underwent a thoracotomy after 24 h, age less than 16, expired in the trauma bay, or in the OR prior to ICU admission were excluded. One-way ANOVA and Kruskal-Wallis test were used to compare continuous and categorical variables between DCT and definitive thoracotomy (DT) patients. Results: 207 trauma patients underwent thoracotomy, 76 met our inclusion criteria. DCT was performed in 30 patients (39%), 46 (61 %) underwent DT operation. Techniques for temporizing the chest varied from skin closure with suture (8), adhesive dressing (5), towel clamps (2), or negative pressure devices (12). Compared to definitive closure, DCT had more derangements in HR, pH, (110 vs. 95, p = 0.04; 7.05 vs 7.24, p < 0.001), and injury severity score (41 vs 25, p < 0.001), and required more blood transfusions (40 vs 6, p < 0.001). Eleven (36.7 %) DCT patients survived to discharge compared to 38 patients (95.0 %) in the DT group. DCT showed significantly higher differences in cardiac arrest and unplanned returns to the OR rates. No differences were observed in ventilator days, or ICU length of stay. Conclusions: DCT is a viable option for management of patients in extremis following thoracic trauma. DCT was associated with higher mortality rates, likely due to differences in injury and physiologic derangement. Despite this, DCT was associated with similar rates of complications, ICU stay, and ventilator days.
MeSH term(s)	Humans ; Thoracic Injuries/surgery ; Thoracotomy/methods ; Hospitalization ; Injury Severity Score ; Retrospective Studies ; Bandages
Language	English
Publishing date	2024-03-08
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2024.111490
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Article ; Online: A Game of Adaptability: Reflecting on the Highlights and Challenges of Applying for Surgical Residency During the COVID-19 Pandemic.

Kubi, Boateng / Keiler, James / Douglas, Anthony

Annals of surgery

2021 Volume 274, Issue 5, Page(s) e381–e382

Abstract: Virtual recruitment of candidates applying into General Surgery residency during the COVID-19 pandemic presented a number of benefits and challenges. Notable benefits for candidates included financial and resource cost savings, the ability to conduct ... ...

Abstract	Virtual recruitment of candidates applying into General Surgery residency during the COVID-19 pandemic presented a number of benefits and challenges. Notable benefits for candidates included financial and resource cost savings, the ability to conduct multiple interviews within short time frame, and the ability to meet more faculty members on virtual interview day. Challenges included technological difficulties, difficulty assessing culture and authenticity of in-program relationships, zoom fatigue, and inability to form relationships with co-applicants. After assessing our experiences with these benefits and challenges, the authors recommend that future recruitment cycles maintain virtual interview days with optional, nonevaluative open house days for revisit and second look opportunities.
MeSH term(s)	COVID-19/epidemiology ; Education, Medical, Graduate/methods ; Faculty/organization & administration ; General Surgery/education ; Humans ; Internship and Residency/organization & administration ; Pandemics
Language	English
Publishing date	2021-06-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	340-2
ISSN	1528-1140 ; 0003-4932
ISSN (online)	1528-1140
ISSN	0003-4932
DOI	10.1097/SLA.0000000000004983
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Article ; Online: Caring for Incarcerated Patients: Can it Ever be Equal?

Douglas, Anthony D / Zaidi, Mohammad Y / Maatman, Thomas K / Choi, Jennifer N / Meagher, Ashley D

Journal of surgical education

2021 Volume 78, Issue 6, Page(s) e154–e160

Abstract: Background: Incarcerated patients represent one of the most vulnerable populations in the United States healthcare system. Studying disparities in care they receive, however, has been difficult due to a history of abuse at the hands of medical ... ...

Abstract	Background: Incarcerated patients represent one of the most vulnerable populations in the United States healthcare system. Studying disparities in care they receive, however, has been difficult due to a history of abuse at the hands of medical researchers rendering this population excluded from most current medical research. Due to incarceration, these patients are frequently maintained in shackles and under constant guard when receiving healthcare. There is a paucity of literature on the influence these measures exert on healthcare workers and the care they provide. Our study aimed to measure surgical trainee's perception of health inequities and disparities in incarcerated individuals undergoing surgical care. Methods: An anonymous cross-sectional survey was administered at our single institution to all general surgery trainees assessing perceptions in delivering care to incarcerated patients within our hospital system. The survey consisted of 10 items, nine of which were yes or no responses, and 1 open-ended text question. Survey results were averaged, and percentages were reported. Results: Of all current general surgery residents (n = 60), 40 (66%) completed the survey. Almost all respondents (n = 39, 97.5%) have cared for a patient that was incarcerated or in police custody. Most respondents (n = 25, 62.5%) have operated on an incarcerated patient with an armed guard present in the operating room. Similarly, most respondents (n = 26, 65%) have cared for a patient intubated and sedated that was shackled to a bed. The majority of respondents (n = 30, 75%) recalled incidents where a trauma patient was actively questioned by law enforcement during the primary/secondary survey during initial trauma evaluation. At the time of hospital discharge, a quarter (n = 10, 25%) of respondents reported being unable to prescribe all of the medications that a non-imprisoned patient would receive with the same condition. In addition, 18 (45%) respondents felt they were unable to arrange outpatient follow-up with physical or occupational therapy and/or the patient's primary/consulting physician due to patient's incarcerated status. Strikingly, half of respondents (n = 19, 47.5%) believed that the incarcerated patient received substandard care, and the majority of respondents (n = 28, 72%) agreed that the holding areas for incarcerated patients in the emergency room provide substandard patient care. Conclusions: The current status of caring for incarcerated patients within our system represents an urgent and needed area for quality improvement. Surgical trainees report difficulty caring for these patients, and they perceive these individuals receive substandard care. Though our cross-sectional study did not assess the origin of this disparity, the challenges trainees face in caring for incarcerated patients, from assessment to diagnosis and treatment, as well as in follow-up signals an area requiring further research and study.
MeSH term(s)	Cross-Sectional Studies ; Emergency Service, Hospital ; Humans ; Physicians ; Prisoners ; Surveys and Questionnaires ; United States
Language	English
Publishing date	2021-07-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2277538-9
ISSN	1878-7452 ; 1931-7204
ISSN (online)	1878-7452
ISSN	1931-7204
DOI	10.1016/j.jsurg.2021.06.009
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Article ; Online: Damage Control Thoracotomy: A Systematic Review of Techniques and Outcomes.

Douglas, Anthony / Puzio, Thaddeus / Murphy, Patrick / Menard, Laura / Meagher, Ashley D

Injury

2020 Volume 52, Issue 5, Page(s) 1123–1127

Abstract: Background: Damage control surgery is the practice of delaying definitive management of traumatic injuries by controlling hemorrhage in the operating room and restoring normal physiology in the intensive care unit prior to definitive therapy. Presently, ...

Abstract	Background: Damage control surgery is the practice of delaying definitive management of traumatic injuries by controlling hemorrhage in the operating room and restoring normal physiology in the intensive care unit prior to definitive therapy. Presently, damage control or "abbreviated" laparotomy is used extensively for abdominal trauma in an unstable patient. The application of a damage control approach in thoracic trauma is less established and there is a paucity of literature supporting or refuting this practice. We aimed to systematically review the current data on damage control thoracotomy (DCT), to identify gaps in the literature and techniques in temporary closure. Methods: An electronic literature search of Pubmed, MEDLINE, and the Cochrane Database of Collected Reviews from 1972-2018 was performed using the keywords "thoracic," "damage control," and "thoracotomy." Studies were included if they reported the use of DCT following thoracic trauma and included survival as an outcome. Results: Of 723 studies, seven met inclusion criteria for a total of a 130 DCT operations. Gauze packing with temporary closure of the skin with suture was the most frequently reported form of closure. The overall survival rate for the seven studies was 67%. Survival rates ranged from 42-77%. Average injury severity score was 30, and 64% of injuries were penetrating in nature. The most common complications included infections (57%; pneumonia, empyema, wound infection, bacteremia), respiratory failure (21%), ARDS (8%), and renal failure (18%). Conclusion: DCT may be associated with improved survival in the critically injured patient population. Delaying definitive operation by temporarily closing the thorax in order to allow time to restore normal physiology may be considered as a strategy in the unstable thoracic trauma patient population. The impact an open chest has on respiratory physiology remains inconclusive as well as best mechanisms of temporary closure. Multi-center studies are required to elucidate these important questions.
MeSH term(s)	Abdominal Injuries/surgery ; Humans ; Injury Severity Score ; Laparotomy ; Retrospective Studies ; Thoracic Injuries/surgery ; Thoracotomy
Language	English
Publishing date	2020-12-30
Publishing country	Netherlands
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2020.12.020
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Book ; Online: Partnership Working

Douglas, Anthony

2008

Abstract: ... Partnership working is recognised as the most effective way of improving social care and the government's aim is to provide a seamless service of care. In this comprehensive discussion of partnership working, Anthony Douglas - chief executive of ... ...

Abstract	Partnership working is recognised as the most effective way of improving social care and the government's aim is to provide a seamless service of care. In this comprehensive discussion of partnership working, Anthony Douglas - chief executive of CAFCASS and a former director of social services - looks at the reality of partnership working.
Language	English
Size	Online-Ressource (249 p)
Publisher	Taylor and Francis
Publishing place	Hoboken
Document type	Book ; Online
Note	Description based upon print version of record
ISBN	9780415311656 ; 0415311659
Database	Library catalogue of the German National Library of Science and Technology (TIB), Hannover

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Book ; Online: Partnership Working

Douglas, Anthony

(Social Work Skills)

2002

Abstract: Partnership working is recognised as the most effective way of improving social care and the government's aim is to provide a seamless service of care. In this comprehensive discussion of partnership working, Anthony Douglas - chief executive of CAFCASS ... ...

Series title	Social Work Skills
Abstract	Partnership working is recognised as the most effective way of improving social care and the government's aim is to provide a seamless service of care. In this comprehensive discussion of partnership working, Anthony Douglas - chief executive of CAFCASS and a former director of social services - looks at the reality of partnership working
Language	English
Size	Online-Ressource (249 p.)
Publisher	Taylor & Francis
Publishing place	Hoboken
Document type	Book ; Online
Note	Description based upon print version of record
ISBN	9780415311656 ; 0415311659
Database	Library catalogue of the German National Library of Science and Technology (TIB), Hannover

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Article ; Online: Churg-Strauss syndrome in a patient previously diagnosed with multiple sclerosis.

Sarkar, Pamela / Ibitoye, Richard Tolulope / Promnitz, Douglas Anthony

BMJ case reports

2011 Volume 2011

Abstract: A lady in her 70s with a background of multiple sclerosis (MS) and late-onset asthma was admitted with a 2-week history of cough and shortness of breath, progressive right-sided weakness and functional decline. Investigation revealed eosinophilia, ... ...

Abstract	A lady in her 70s with a background of multiple sclerosis (MS) and late-onset asthma was admitted with a 2-week history of cough and shortness of breath, progressive right-sided weakness and functional decline. Investigation revealed eosinophilia, elevated myeloperoxidase antineutrophil cytoplasmic antibody, CT sinuses showed long-standing inflammatory changes consistent with sinonasal polyposis and MRI head showed lesions consistent with vasculitis. She then developed left-sided weakness and increased wheeze. Review of her case notes demonstrated that, the eosinophilia was long-standing, her asthma was severe and steroid-dependent, and her neurologic syndrome was atypical for MS. Intravenous methylprednisolone then cyclophosphamide were administered. She demonstrated remarkable improvement, becoming more alert, with improvement in left-sided weakness. A diagnosis of Churg-Strauss syndrome was established. She was discharged to a nursing home with outpatient rheumatology follow-up. The diagnosis of MS was revisited.
MeSH term(s)	Aged ; Anti-Inflammatory Agents/therapeutic use ; Churg-Strauss Syndrome/diagnosis ; Churg-Strauss Syndrome/drug therapy ; Cyclophosphamide/therapeutic use ; Diagnosis, Differential ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Methylprednisolone/therapeutic use ; Multiple Sclerosis/diagnosis
Chemical Substances	Anti-Inflammatory Agents ; Immunosuppressive Agents ; Cyclophosphamide (8N3DW7272P) ; Methylprednisolone (X4W7ZR7023)
Language	English
Publishing date	2011-09-28
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr.06.2011.4300
Database	MEDical Literature Analysis and Retrieval System OnLINE

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