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Abstract

B a c k g r o u n d: Assessment of the neurocontrol of the external anal sphincter has long been restricted to investigating patients by invasive tools. Less invasive techniques have been regarded less uitable for diagnosis. O b j e c t iv e: The aim was to develop a surface electromyography-based algorithm to facilitate fecal incontinence diagnosis, and to assess its sensitivity and specificity. D e s i g n: Data analysis from a single center prospective study. P a t i e n t s: All patients from colorectal surgery office were considered. They underwent a structured interview, a general physical and proctologic examination. Patients with diagnosed fecal incontinence (Fecal Incontinence Severity Index >10) were included into the study group. The control group consisted of healthy volunteers that scored 5 or less and had negative history and physical exam. Both groups underwent the same tests (rectoscopy, anorectal manometry, transanal ultrasonography, multichannel surface electromyography and assessment of anal reflexes). M e t h o d s: EMG results were analyzed to find parameters that would facilitate fecal incontinence diagnosis. O u t c o m e m e a s u r e s: Sensitivity and specificity of surface electromyography, to diagnose fecal incontinence, were assessed. R e s u l t s: A total of 49 patients were included in the study group (mean age ± SD 58.9 ± 13.8). The control group (n = 49) gender matched the study group (mean age ± SD 45.4 ± 15.1). The constructed classification tree, based on surface electromyography results, correctly classified 97% of cases. The sensitivity and specificity of this classification tree, to diagnose FI, was 96% and 98% respectively. L i m i t a t i o n s: The age of women in the control group differs significantly from mean age of other groups. C o n c l u s i o n s: Surface electromyography is an good tool to facilitate diagnosing of fecal incontinence.
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Abstract

Introduction: Trauma is one of the leading causes of death in the European Union. The European Trauma Course (ETC) is a training course that focuses on administering aid to trauma patients in a Hospital’s Emergency Department by creating an effective and well-organized trauma team. The purpose of the study is to analyze how the ETC training is evaluated by its participants and whether it is tailored to local needs. Materials and Methodology: The study includes eight courses conducted between 2010 and 2015, involving 109 medical professionals. Participants were given questionnaires where they could evaluate the various aspects of the course and comment on each of them, using a four-level scale. Finally, 78 surveys were qualified for the study. Results: The exercises were very highly rated (average 3.79 points), mainly for their interesting scenarios and station preparation. Equally well-evaluated was the short and concise method of instruction. The lowest ranked aspect was the course fee (2.41 points). There were oft en negative comments about the use of English during the training (lectures and manuals). Discussion: The opinions of Polish students were similar to those of ETC participants in other European countries. There are many interesting advantages of workshop scenarios, while the downside is the time constraint. Nevertheless, the ETC has been very successful. High ratings and positive feedback affirm the high demand for such courses in Poland.
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