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111-963: René Primevère Lesson (20 March 1794 – 28 April 1849) was a French surgeon , naturalist , ornithologist , and herpetologist . Lesson was born at Rochefort , and entered the Naval Medical School in Rochefort at the age of sixteen. He served in the French Navy during the Napoleonic Wars ; in 1811, he was third surgeon on the frigate Saale , and in 1813, was second surgeon on the Regulus . In 1816, Lesson changed his classification to pharmacist . He served on Duperrey 's round-the-world voyage of La Coquille (1822–1825), of which he collected natural history specimens with his fellow surgeon Prosper Garnot and officer Dumont d'Urville . During his visits to

222-474: A radiosurgical procedure (e.g. irradiation of a tumor). Surgical procedures are commonly categorized by urgency, type of procedure, body system involved, the degree of invasiveness, and special instrumentation. Inpatient surgery is performed in a hospital, and the person undergoing surgery stays at least one night in the hospital after the surgery. Outpatient surgery occurs in a hospital outpatient department or freestanding ambulatory surgery center, and

333-525: A surgical procedure or surgical operation , or simply "surgery" or "operation". In this context, the verb "operate" means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments , surgical facility or surgical nurse . Most surgical procedures are performed by a pair of operators: a surgeon who is the main operator performing the surgery, and a surgical assistant who provides in-procedure manual assistance during surgery. Modern surgical operations typically require

444-412: A surgical team that typically consists of the surgeon, the surgical assistant, an anaesthetist (often also complemented by an anaesthetic nurse ), a scrub nurse (who handles sterile equipment), a circulating nurse and a surgical technologist , while procedures that mandate cardiopulmonary bypass will also have a perfusionist . All surgical procedures are considered invasive and often require

555-555: A "mistake" originating with a 19th-century dictionary of the New Zealand language published by the Rev. William Williams , at the time Archdeacon of Waiapu . "Many years ago a statement appeared which at once attracted attention and awakened curiosity. It was to the effect that the Maoris, the aboriginal inhabitants of New Zealand, used as the basis of their numeral system the number 11; and that

666-486: A $ 12.3 trillion loss in economic productivity by the year 2030. This was especially true in the poorest countries, which account for over one-third of the population but only 3.5% of all surgeries that occur worldwide. It emphasized the need to significantly improve the capacity for Bellwether procedures – laparotomy , caesarean section , open fracture care – which are considered a minimum level of care that first-level hospitals should be able to provide in order to capture

777-489: A Component of Universal Health Coverage . The Lancet Commission for Global Surgery outlined the need for access to "available, affordable, timely and safe" surgical and anesthesia care; dimensions paralleled in ICESCR General Comment No. 14, which similarly outlines need for available, accessible, affordable and timely healthcare. Surgical treatments date back to the prehistoric era. The oldest for which there

888-605: A component of universal health coverage." This not only mandated the WHO to prioritize strengthening the surgical and anesthesia care globally, but also led to governments of the member states recognizing the urgent need for increasing capacity in surgery and anesthesia. Additionally, the third edition of Disease Control Priorities (DCP3), published in 2015 by the World Bank , declared surgery as essential and featured an entire volume dedicated to building surgical capacity. Data from WHO and

999-463: A decimal channel. Any numerical system with a base greater than ten requires one or more new digits; "in an undenary system (base eleven) there should be a character for ten." To allow entry on typewriters, letters such as ⟨ A ⟩ (as in hexadecimal ), ⟨ T ⟩ (the initial of "ten"), or ⟨ X ⟩ (the Roman numeral 10) are used for the number 10 in base 11. It

1110-461: A division of human races based on simple color terms: White for Caucasians, Dusky for South Asians, Orange for Austronesians, Yellow for East Asians, Red for Indigenous Americans, and Black for Africans. This model achieved moderate use among ethnologists. René Primevère Lesson is sometimes confused with his brother, Pierre Adolphe Lesson (1805-1888), who participated on the Astrolabe expedition (as

1221-650: A footnote to mark an error: Von Chamisso's text, as translated by Lesson: "...de l'E. de la mer du Sud ... c'est là qu'on trouve premierement le système arithmétique fondé sur un échelle de vingt, comme dans la Nouvelle-Zélande (2)..." [...east of the South Sea ... is where we first find the arithmetic system based on a scale of twenty, as in New Zealand (2)...] Lesson's footnote on von Chamisso's text: "(2) Erreur. Le système arithmétique des Zélandais est undécimal, et les Anglais sont les premiers qui ont propagé cette fausse idée. (L.)" [(2) Error. The Zealander arithmetic system

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1332-450: A less irritating emollient, made of egg yolk , rose oil and turpentine . He also described more efficient techniques for the effective ligation of the blood vessels during an amputation . Undecimal For about a century, the idea that Māori counted by elevens was best known from its mention in the writing of the American mathematician Levi Leonard Conant . He identified it as

1443-1041: A member of the committee, was credited with influencing the committee to select decimal. The debate over which one to use seems to have been lively, if not contentious, as at one point, Lagrange suggested adopting 11 as the base number, on the grounds indivisibility was actually advantageous; because 11 was a prime number, no fraction with it as its denominator would be reducible: Delambre wrote: "Il était peu frappé de l'objection que l'on tirait contre ce système du petit nombre des diviseurs de sa base. Il regrettait presque qu'elle ne fut pas un nombre premier, tel que 11, qui nécessairement eût donné un même dénominateur à toutes les fractions. On regardera, si l'on veut, cette idée comme une de ces exagérations qui échappent aux meilleurs esprits dans le feu de la dispute; mais il n'employait ce nombre 11 que pour écarter le nombre 12, que des novateurs plus intrépides auraient voulu substituer à celui de 10, qui fait partout la base de la numération." As translated: "He [Lagrange] almost regretted [the base]

1554-520: A military physician". The researchers were impressed by the complexity of the brain surgical operation. In 1991 at the Polystylon fort in Greece, researchers discovered the head of a Byzantine warrior of the 14th century. Analysis of the lower jaw revealed that a surgery has been performed, when the warrior was alive, to the jaw which had been badly fractured and it tied back together until it healed. During

1665-513: A period of postoperative care (sometimes intensive care ) for the patient to recover from the iatrogenic trauma inflicted by the procedure. The duration of surgery can span from several minutes to tens of hours depending on the specialty , the nature of the condition, the target body parts involved and the circumstance of each procedure, but most surgeries are designed to be one-off interventions that are typically not intended as an ongoing or repeated type of treatment. In British colloquialism,

1776-498: A peripheral IV line is placed, and pre-operative medications (antibiotics, sedatives, etc.) are given. When the patient enters the operating room and is appropriately anesthetized, the team will then position the patient in an appropriate surgical position . If hair is present at the surgical site, it is clipped (instead of shaving). The skin surface within the operating field is cleansed and prepared by applying an antiseptic (typically chlorhexidine gluconate in alcohol, as this

1887-414: A person shows signs of infection and not as a preventative. A systematic review published by Cochrane (organisation) in 2016, though, concluded that topical antibiotics applied over certain types of surgical wounds reduce the risk of surgical site infections, when compared to no treatment or use of antiseptics . The review also did not find conclusive evidence to suggest that topical antibiotics increased

1998-403: A physical exam which did not indicate a chest x-ray. Routine x-ray examination is more likely to result in problems like misdiagnosis, overtreatment, or other negative outcomes than it is to result in a benefit to the person. Likewise, other tests including complete blood count , prothrombin time , partial thromboplastin time , basic metabolic panel , and urinalysis should not be done unless

2109-544: A prehistoric individual from the Indus River valley show evidence of teeth having been drilled. Sushruta Samhita is one of the oldest known surgical texts and its period is usually placed in the first millennium BCE. It describes in detail the examination, diagnosis, treatment, and prognosis of numerous ailments, as well as procedures for various forms of cosmetic surgery, plastic surgery and rhinoplasty . In 1982 archaeologists were able to find significant evidence when

2220-440: A recent study done with lumbar decompressions, the patient's length of stay was decreased by 1–3 days. The use of topical antibiotics on surgical wounds to reduce infection rates has been questioned. Antibiotic ointments are likely to irritate the skin, slow healing, and could increase risk of developing contact dermatitis and antibiotic resistance . It has also been suggested that topical antibiotics should only be used when

2331-464: A reçues de M. de Blosseville, ... [en Nouvelle-Zélande], on a trouvé en usage un système de numération undécimal " [Mr. Nell de Bréauté writes that, according to the communications he has received from M. de Blosseville, ... [in New Zealand], a system of undecimal numbering was found in use]. Lesson was also likely to have authored an undated, anonymous essay found among and published with the papers of

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2442-466: A risk factor for adverse post-surgical outcomes. It has been linked to many disorders such as obesity hypoventilation syndrome, atelectasis and pulmonary embolism, adverse cardiovascular effects, and wound healing complications. If removable skin closures are used, they are removed after 7 to 10 days post-operatively, or after healing of the incision is well under way. It is not uncommon for surgical drains to be required to remove blood or fluid from

2553-477: A scrub cap, a sterile surgical gown, sterile latex or non-latex polymer gloves and a surgical mask), and they must scrub hands and arms with an approved disinfectant agent before each procedure. Prior to surgery, the person is given a medical examination , receives certain pre-operative tests, and their physical status is rated according to the ASA physical status classification system . If these results are satisfactory,

2664-636: A specialty of medicine, rather than an accessory field. Basic surgical principles for asepsis etc., are known as Halsteads principles . There were some important advances to the art of surgery during this period. The professor of anatomy at the University of Padua , Andreas Vesalius , was a pivotal figure in the Renaissance transition from classical medicine and anatomy based on the works of Galen , to an empirical approach of 'hands-on' dissection. In his anatomic treaties De humani corporis fabrica , he exposed

2775-470: A weekend, and also, decrease number and level of experience over a weekend. Postoperative pain affects an estimated 80% of people who underwent surgery. While pain is expected after surgery, there is growing evidence that pain may be inadequately treated in many people in the acute period immediately after surgery. It has been reported that incidence of inadequately controlled pain after surgery ranged from 25.1% to 78.4% across all surgical disciplines. There

2886-417: Is administered to prevent pain from the trauma of cutting, tissue manipulation, application of thermal energy, and suturing. Depending on the type of operation, anesthesia may be provided locally, regionally , or as general anesthesia . Spinal anesthesia may be used when the surgical site is too large or deep for a local block, but general anesthesia may not be desirable. With local and spinal anesthesia,

2997-402: Is also possible to use the digit ↊ ("dek"), the so-called Pitman numeral for 10 proposed in 1947 by Isaac Pitman as one of the two transdecimal symbols needed to represent base 12 ( duodecimal ). The 10-digit numbers in the system of International Standard Book Numbers (ISBN) used undecimal as a check digit . A check digit is the final digit of an ISBN that is related mathematically to all

3108-647: Is among the controversial topics related to surgery in children. Doctors perform surgery with the consent of the person undergoing surgery. Some people are able to give better informed consent than others. Populations such as incarcerated persons , people living with dementia , the mentally incompetent, persons subject to coercion, and other people who are not able to make decisions with the same authority as others, have special needs when making decisions about their personal healthcare, including surgery. Global surgery has been defined as 'the multidisciplinary enterprise of providing improved and equitable surgical care to

3219-449: Is applied to the area of the person's body that will be operated on. Sterile drapes are placed around the operative site. Surgical masks are worn by the surgical team to avoid germs on droplets of liquid from their mouths and noses from contaminating the operative site. Work to correct the problem in body then proceeds. This work may involve: Blood or blood expanders may be administered to compensate for blood lost during surgery. Once

3330-444: Is being done to find a solution.As such, surgical care globally has been described as the 'neglected stepchild of global health,' a term coined by Paul Farmer to highlight the urgent need for further work in this area. Furthermore, Jim Young Kim , the former President of the World Bank , proclaimed in 2014 that "surgery is an indivisible, indispensable part of health care and of progress towards universal health coverage." In 2015,

3441-481: Is credited with the performance of the first thyroidectomy . Al-Zahrawi pioneered techniques of neurosurgery and neurological diagnosis, treating head injuries , skull fractures , spinal injuries , hydrocephalus , subdural effusions and headache . The first clinical description of an operative procedure for hydrocephalus was given by Al-Zahrawi, who clearly describes the evacuation of superficial intracranial fluid in hydrocephalic children. In Europe ,

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3552-744: Is evidence is trepanation , in which a hole is drilled or scraped into the skull , thus exposing the dura mater in order to treat health problems related to intracranial pressure. Prehistoric surgical techniques are seen in Ancient Egypt , where a mandible dated to approximately 2650 BC shows two perforations just below the root of the first molar , indicating the draining of an abscessed tooth . Surgical texts from ancient Egypt date back about 3500 years ago. Surgical operations were performed by priests, specialized in medical treatments similar to today, and used sutures to close wounds. Infections were treated with honey. 9,000-year-old skeletal remains of

3663-551: Is increasingly recognized as an integral aspect of healthcare and therefore is evolving into a normative derivation of human right to health . The ICESCR Article 12.1 and 12.2 define the human right to health as "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health" In the August 2000, the UN Committee on Economic, Social and Cultural Rights (CESCR) interpreted this to mean "right to

3774-500: Is insufficient evidence to determine if giving opioid pain medication pre-emptively (before surgery) reduces postoperative pain the amount of medication needed after surgery. Postoperative recovery has been defined as an energy‐requiring process to decrease physical symptoms, reach a level of emotional well‐being, regain functions, and re‐establish activities. Moreover, it has been identified that patients who have undergone surgery are often not fully recovered on discharge. In 2011, of

3885-410: Is larger than 1 ⁄ 3 , which in turn is larger than 1 ⁄ 4 ). However, comparisons become more difficult when both numerators and denominators are mixed: 3 ⁄ 4 is larger than 5 ⁄ 7 , which in turn is larger than 2 ⁄ 3 , though this cannot be determined by simple inspection of the denominators in the way possible if the numerator is 1. He noted the difficulty

3996-456: Is made to access the surgical site. Blood vessels may be clamped or cauterized to prevent bleeding, and retractors may be used to expose the site or keep the incision open. The approach to the surgical site may involve several layers of incision and dissection, as in abdominal surgery, where the incision must traverse skin, subcutaneous tissue, three layers of muscle and then the peritoneum. In certain cases, bone may be cut to further access

4107-401: Is that the physician might discover some unknown medical condition which would complicate the surgery, and that upon discovering this with the chest x-ray, the physician would adapt the surgery practice accordingly. However, medical specialty professional organizations recommend against routine pre-operative chest x-rays for people who have an unremarkable medical history and presented with

4218-503: Is the custom of the New Zealanders to count things by pairs. The natives of Tonga count the bananas and fish likewise by pairs and by twenties ( Tecow , English score)." Lesson's use of the term "undécimal" in 1825 was possibly a printer's error that conjoined the intended phrase "un décimal," which would have correctly identified New Zealand numeration as decimal. Lesson knew Polynesian numbers were decimal and highly similar throughout

4329-580: Is the same Mr. Kendall who has communicated to us the Vocabulary in Nicolas's voyage. The language has now been opened to us, and we correct our opinion." And, "It is very far from easy to find out the arithmetical system of a people. It is at New Zealand, as at Tonga, the decimal system. What may, perhaps, have deceived Mr. Kendall, at the beginning, in his first attempt in Nicholas's voyage, and which we followed,

4440-424: Is twice as effective as povidone-iodine at reducing the risk of infection). Sterile drapes are then used to cover the borders of the operating field . Depending on the type of procedure, the cephalad drapes are secured to a pair of poles near the head of the bed to form an "ether screen", which separate the anesthetist / anesthesiologist 's working area (unsterile) from the surgical site (sterile). Anesthesia

4551-548: Is undecimal, and the English are the first to propagate this false idea. (L).] Von Chamisso had mentioned his error himself in 1821, tracing the source of his confusion and its clarification to Thomas Kendall , the English missionary to New Zealand who provided the material on the Māori language that was the basis for a grammar published in 1820 by the English linguist Samuel Lee . In the same 1821 publication, von Chamisso also identified

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4662-501: Is undecimal, and the English are the first to propagate this misconception. (L).]" The term "undécimal" was possibly a printer's error that conjoined the phrase "un decimal," which would have correctly identified the New Zealand number system as decimal. Undecimal was interpreted to mean "counting by elevens," as a parallel construction to the term "duodecimal" for twelve-based counting. The mention of "the English" likely referred to Samuel Lee and Thomas Kendall , as their 1820 grammar of

4773-586: The Bantu and Semi-Bantu languages. He too noted suggestive similarities between the Pañgwa term for eleven and terms for ten in related languages: "Occasionally there are special terms for 'eleven'. So far as my information goes they are the following: Ki-dzigꞷ 36 (in this language, the Pangwa of North-east Nyasaland, counting actually goes by elevens. Ki-dzigꞷ-kavili = 'twenty-two', Ki-dzigꞷ-kadatu = 'thirty-three'). Yet

4884-523: The Coquille had been renamed) in 1826–29, under the command of Jules Dumont d'Urville . listed in the order they were described (only species still recognized are listed) On his return from his voyage on the Coquille in 1825, Lesson published a French translation of "Du Grand Océan, de ses îles et de ses côtes" written by the German botanist Adelbert von Chamisso . In the article, von Chamisso had claimed that

4995-512: The Islamic Golden Age , largely based upon Paul of Aegina 's Pragmateia , the writings of Albucasis (Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi), an Andalusian-Arab physician and scientist who practiced in the Zahra suburb of Córdoba , were influential. Al-Zahrawi specialized in curing disease by cauterization . He invented several surgical instruments for purposes such as inspection of

5106-700: The Moluccas and New Guinea , Lesson became the first naturalist to see birds of paradise in the wild. On returning to Paris , he spent seven years preparing the section on vertebrates for the official account of the expedition: " Voyage autour du monde entrepris par ordre du Gouvernement sur la corvette La Coquille " (published from 1826 to 1839). During this time period, he also produced " Manuel d'Ornithologie " (1828), " Traité d'Ornithologie " (1831), " Centurie Zoologique " (1830–1832) and " Illustrations de Zoologie " (1832–35). Lesson also published several monographs on hummingbirds and one book on birds of paradise: In

5217-464: The 1822–1825 circumnavigational voyage of the Coquille , a French corvette commanded by Louis Isidore Duperrey and seconded by Jules Dumont d'Urville . On his return to France in 1825, Lesson published his French translation of an article written by the German botanist Adelbert von Chamisso . At von Chamisso's claim that the New Zealand number system was based on twenty ( vigesimal ), Lesson inserted

5328-403: The 2000 comment to include timely access to "basic preventative, curative services… for appropriate treatment of injury and disability .". Obstetric care shares close ties with reproductive rights , which includes access to reproductive health. Surgeons and public health advocates, such as Kelly McQueen , have described surgery as "Integral to the right to health ". This is reflected in

5439-418: The 38.6 million hospital stays in U.S. hospitals, 29% included at least one operating room procedure. These stays accounted for 48% of the total $ 387 billion in hospital costs. The overall number of procedures remained stable from 2001 to 2011. In 2011, over 15 million operating room procedures were performed in U.S. hospitals. Data from 2003 to 2011 showed that U.S. hospital costs were highest for

5550-573: The Italian geographer Adriano Balbi , who detailed a letter he received from Lesson in 1826, and the Hungarian astronomer Franz Xaver von Zach , who briefly mentioned the alleged discovery as part of a letter from Blosseville he had received through a third party. De Blosseville also mentioned it to the Scottish author George Lillie Craik , who reported this letter in his 1830 book The New Zealanders . Lesson

5661-716: The Lancet Commission on Global Surgery (LCoGS) published the landmark report titled "Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development", describing the large, pre-existing burden of surgical diseases in low- and middle-income countries (LMICs) and future directions for increasing universal access to safe surgery by the year 2030. The Commission highlighted that about 5 billion people lack access to safe and affordable surgical and anesthesia care and 143 million additional procedures were needed every year to prevent further morbidity and mortality from treatable surgical conditions as well as

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5772-620: The Māori number system as decimal, noting the source of the confusion was the Polynesian practice of counting things by pairs, where each pair was counted as a single unit, so that ten units were numerically equivalent to twenty: "We have before us a Grammar and Vocabulary of the Language of New Zealand, published by the Church Missionary Society. London, 1820. 8vo. The author of this grammar

5883-430: The New Zealand language had been von Chamisso's source. Regardless of whether his 1825 use of "undécimal" originated as a printer's error or not, over the next several years, Lesson and his friend and shipmate Jules de Blosseville would deliberately embellish and attempt to establish as fact the idea that New Zealand had a base 11 number system . The idea was published in 1826 by the Italian geographer Adriano Balbi as

5994-537: The Paliokastro on Thasos ten skeletal remains, four women and six men, who were buried between the fourth and seventh centuries A.D. Their bones illuminated their physical activities, traumas, and even a complex form of brain surgery. According to the researchers: "The very serious trauma cases sustained by both males and females had been treated surgically or orthopedically by a very experienced physician/surgeon with great training in trauma care. We believe it to have been

6105-625: The Prussian linguist Wilhelm von Humboldt in 1839. The essay contains the most extensive detail of the known sources, mentioning Thomas Kendall by name and listing several North Island locations where the alleged informants were supposedly from, matters that would have been known to Lesson from his work and 1824 visit to that island. Lessonia is a genus of large kelp native to the southern Pacific Ocean and named in René Lesson's honour, in 1825. Then Lessoniopsis (a brown algae) Reinke in 1903

6216-644: The World Bank indicate that scaling up infrastructure to enable access to surgical care in regions where it is currently limited or is non-existent is a low-cost measure relative to the significant morbidity and mortality caused by lack of surgical treatment. In fact, a systematic review found that the cost-effectiveness ratio – dollars spent per DALYs averted – for surgical interventions is on par or exceeds those of major public health interventions such as oral rehydration therapy , breastfeeding promotion , and even HIV/AIDS antiretroviral therapy . This finding challenged

6327-493: The alleged local informants were supposedly from. The idea that Māori counted by elevens highlights an ingenious and pragmatic form of counting once practiced throughout Polynesia. This method of counting set aside every tenth item to mark ten of the counted items; the items set aside were subsequently counted in the same way, with every tenth item now marking a hundred (second round), thousand (third round), ten thousand items (fourth round), and so on. The counting method worked

6438-550: The ancient land, called 'Alahana Pirivena' situated in Polonnaruwa, with ruins, was excavated. In that place ruins of an ancient hospital emerged. The hospital building was 147.5 feet in width and 109.2 feet in length. The instruments which were used for complex surgeries were there among the things discovered from the place, including forceps, scissors, probes, lancets, and scalpels. The instruments discovered may be dated to 11th century AD. In ancient Greece , temples dedicated to

6549-434: The anesthesia, he/she is either transferred to a surgical ward elsewhere in the hospital or discharged home. During the post-operative period, the person's general function is assessed, the outcome of the procedure is assessed, and the surgical site is checked for signs of infection. There are several risk factors associated with postoperative complications, such as immune deficiency and obesity. Obesity has long been considered

6660-424: The committee reported they had considered using duodecimal (base 12) as the basis for weights, lengths/distances, and money because of its greater divisibility, relative to decimal (base 10). However, they ultimately rejected the initiative, deciding a common scale based on spoken numbers would simplify calculations and conversions and make the new system easier to implement. Mathematician Joseph-Louis Lagrange ,

6771-1072: The common misconception that surgical care is financially prohibitive endeavor not worth pursuing in LMICs. A key policy framework that arose from this renewed global commitment towards surgical care worldwide is the National Surgical Obstetric and Anesthesia Plan (NSOAP). NSOAP focuses on policy-to-action capacity building for surgical care with tangible steps as follows: (1) analysis of baseline indicators, (2) partnership with local champions, (3) broad stakeholder engagement, (4) consensus building and synthesis of ideas, (5) language refinement, (6) costing, (7) dissemination, and (8) implementation. This approach has been widely adopted and has served as guiding principles between international collaborators and local institutions and governments. Successful implementations have allowed for sustainability in terms of longterm monitoring, quality improvement, and continued political and financial support. Access to surgical care

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6882-437: The contents of a letter he received from Lesson, a missive that added an elevens-based numerical vocabulary (including terms meaning eleven squared and cubed) and details of its purported collection from New Zealand informants. It was again mentioned in 1826 by the Hungarian astronomer Franz Xaver von Zach , who reported it thirdhand as a letter written by Blosseville: "M. Nell de Bréanté écrit que, d'après les communications qu'il

6993-566: The counting method was used with pairs, nine pairs were counted (18) and the last pair (2) was set aside for the next round. Less is known about the idea the Pañgwa people of Tanzania counted by elevens. It was mentioned in 1920 by the British anthropologist Northcote W. Thomas : "Another abnormal numeral system is that of the Pangwa, north-east of Lake Nyassa, who use a base of eleven." And, "If we could be certain that ki dzigo originally bore

7104-414: The demand grew for surgeons to formally study for many years before practicing; universities such as Montpellier , Padua and Bologna were particularly renowned. In the 12th century, Rogerius Salernitanus composed his Chirurgia , laying the foundation for modern Western surgical manuals. Barber-surgeons generally had a bad reputation that was not to improve until the development of academic surgery as

7215-454: The digits 0 through 9 or an X (for ten), being equal to the tenth digit of the ISBN. As of 1 January 2007 , thirteen-digit ISBNs are the standard. The International ISBN Agency provides an online calculator that will convert ten-digit ISBNs into thirteen digits. In the novel Contact by Carl Sagan , a message left by an unknown advanced intelligence lies hidden inside the number pi ;

7326-485: The enjoyment of a variety of facilities, goods, services, and conditions necessary for the realization of the highest attainable health". Surgical care can be thereby viewed as a positive right – an entitlement to protective healthcare. Woven through the International Human and Health Rights literature is the right to be free from surgical disease. The 1966 ICESCR Article 12.2a described the need for "provision for

7437-539: The establishment of the WHO Global Initiative for Emergency and Essential Surgical Care in 2005, the 2013 formation of the Lancet Commission for Global Surgery, the 2015 World Bank Publication of Volume 1 of its Disease Control Priorities Project "Essential Surgery", and the 2015 World Health Assembly 68.15 passing of the Resolution for Strengthening Emergency and Essential Surgical Care and Anesthesia as

7548-454: The field of herpetology he described many new species of amphibians and reptiles. On 3 February 1827, he married the artist and scientific illustrator Clémence Dumont de Sainte-Croix . Dumont de Sainte-Croix along with her sister Zoë Dumont de Sainte-Croix illustrated plates in Lesson's publications. From 1831, he served as a professor of pharmacy, and following a series of promotions, became

7659-477: The greatest surgeons of the ancient world and performed many audacious operations – including brain and eye surgery – that were not tried again for almost two millennia. Hippocrates stated in the oath ( c.  400 BCE ) that general physicians must never practice surgery and that surgical procedures are to be conducted by specialists Researchers from the Adelphi University discovered in

7770-461: The healer-god Asclepius , known as Asclepieia ( Greek : Ασκληπιεία , sing. Asclepieion Ασκληπιείον ), functioned as centers of medical advice, prognosis, and healing. In the Asclepieion of Epidaurus , some of the surgical cures listed, such as the opening of an abdominal abscess or the removal of traumatic foreign material, are realistic enough to have taken place. The Greek Galen was one of

7881-594: The hospital, and are three times as likely to be discharged to a skilled nursing facility instead of to their own homes. People who are frail and elderly (score of 4 or 5) have even worse outcomes, with the risk of being discharged to a nursing home rising to twenty times the rate for non-frail elderly people. Surgery on children requires considerations that are not common in adult surgery. Children and adolescents are still developing physically and mentally making it difficult for them to make informed decisions and give consent for surgical treatments. Bariatric surgery in youth

7992-409: The indicated problem, minimize the risk of complications, optimize the time needed for recovery, and limit the surgical stress response. The intraoperative phase begins when the surgery subject is received in the surgical area (such as the operating theater or surgical department ), and lasts until the subject is transferred to a recovery area (such as a post-anesthesia care unit ). An incision

8103-427: The interior of the urethra and for removing foreign bodies from the throat, the ear, and other body organs. He was also the first to illustrate the various cannulae and to treat warts with an iron tube and caustic metal as a boring instrument. He describes what is thought to be the first attempt at reduction mammaplasty for the management of gynaecomastia and the first mastectomy to treat breast cancer . He

8214-490: The interior of the body; for example, cutting the skull for brain surgery or cutting the sternum for thoracic (chest) surgery to open up the rib cage . Whilst in surgery aseptic technique is used to prevent infection or further spreading of the disease. The surgeons' and assistants' hands, wrists and forearms are washed thoroughly for at least 4 minutes to prevent germs getting into the operative field, then sterile gloves are placed onto their hands. An antiseptic solution

8325-497: The many anatomical errors in Galen and advocated that all surgeons should train by engaging in practical dissections themselves. The second figure of importance in this era was Ambroise Paré (sometimes spelled "Ambrose" ), a French army surgeon from the 1530s until his death in 1590. The practice for cauterizing gunshot wounds on the battlefield had been to use boiling oil; an extremely dangerous and painful procedure. Paré began to employ

8436-518: The meaning of eleven, not ten, in Pangwa, it would be tempting to correlate the dzi or či with the same word in Walegga-Lendu, where it means twelve, and thus bring into a relation, albeit of the flimsiest and most remote kind, all three areas in which abnormal systems are in use." The claim was repeated by the British explorer and colonial administrator Harry H. Johnston in Vol. II of his 1922 study of

8547-623: The most basic emergency surgical care. In terms of the financial impact on the patients, the lack of adequate surgical and anesthesia care has resulted in 33 million individuals every year facing catastrophic health expenditure – the out-of-pocket healthcare cost exceeding 40% of a given household's income. In alignment with the LCoGS call for action, the World Health Assembly adopted the resolution WHA68.15 in 2015 that stated, "Strengthening emergency and essential surgical care and anesthesia as

8658-559: The most part, abandoned this method, and, leaving out ngahuru , reckon tekau or tahi tekau as 10, rua tekau as 20, &c. *This seems to be on the principle of putting aside one to every ten as a tally. A parallel to this obtains among the English, as in the case of the baker's dozen." In 2020, an earlier, Continental origin of the idea the Māori counted by elevens was traced to the published writings of two 19th-century scientific explorers, René Primevère Lesson and Jules de Blosseville . They had visited New Zealand in 1824 as part of

8769-508: The need for extended care. Assessment of older people before elective surgery can accurately predict the person's recovery trajectories. One frailty scale uses five items: unintentional weight loss, muscle weakness , exhaustion, low physical activity, and slowed walking speed. A healthy person scores 0; a very frail person scores 5. Compared to non-frail elderly people, people with intermediate frailty scores (2 or 3) are twice as likely to have post-surgical complications, spend 50% more time in

8880-586: The number system of New Zealand was based on twenty: "…de l'E. de la mer du Sud … c'est là qu'on trouve premierement le système arithmétique fondé sur un échelle de vingt, comme dans la Nouvelle-Zélande (2)..." […east of the South Sea … is where we first find the arithmetic system based on a scale of twenty, as in New Zealand (2)...]. Lesson inserted the footnote (2) to mark this claim as an error: "(2) Erreur. Le système arithmétique des Zélandais est undécimal, et les Anglais sont les premiers qui ont propagé cette fausse idée. (L.)" [(2) Error. The Zealander arithmetic system

8991-429: The number that is the base of the system, like the number 10 in our decimal system, has divisors or not; perhaps there would even be, in some respects, an advantage if this number did not have divisors, like the number 11, which would happen in the undecimal system, because one would be less inclined to use the fractions 1 ⁄ 2 , 1 ⁄ 3 , etc." In recounting the story, Ralph H. Beard (in 1947, president of

9102-456: The number-words and counting procedure were supposedly elicited from local informants. In an interesting twist, it also changed the mistaken classification needing correction from vigesimal to decimal. The 1839 essay published with von Humboldt's papers named Thomas Kendall , the English missionary whose confusion over the effects of pair-counting on Māori numbers had caused von Chamisso to misidentify them as vigesimal . It also listed places

9213-563: The numbers six and higher borrowed from Swahili . In June 1789, mere weeks before the French Revolution began with the storming of the Bastille , the Academy of Sciences established a committee ( la Commission des Poids et Mesures ) to standardize systems of weights and measures, a popular reform that was an early step toward creating the international metric system . On 27 October 1790,

9324-415: The other digits it contains that is used to verify their accuracy. It represents the answer to a mathematical calculation, in this case, one that multiplies the ten digits of the ISBN by the integers ten (leftmost digit) through two (second-to-last rightmost digit, the last being the check digit itself) and then sums them. The calculation should yield a multiple of eleven, with its final digit, represented by

9435-410: The person requiring surgery signs a consent form and is given a surgical clearance. If the procedure is expected to result in significant blood loss, an autologous blood donation may be made some weeks prior to surgery. If the surgery involves the digestive system , the person requiring surgery may be instructed to perform a bowel prep by drinking a solution of polyethylene glycol the night before

9546-585: The person who had surgery is discharged the same working day. Office-based surgery occurs in a physician's office, and the person is discharged the same day. At a hospital , modern surgery is often performed in an operating theater using surgical instruments , an operating table , and other equipment. Among United States hospitalizations for non-maternal and non-neonatal conditions in 2012, more than one-fourth of stays and half of hospital costs involved stays that included operating room (OR) procedures. The environment and procedures used in surgery are governed by

9657-413: The principles of aseptic technique : the strict separation of "sterile" (free of microorganisms) things from "unsterile" or "contaminated" things. All surgical instruments must be sterilized , and an instrument must be replaced or re-sterilized if it becomes contaminated (i.e. handled in an unsterile manner, or allowed to touch an unsterile surface). Operating room staff must wear sterile attire ( scrubs ,

9768-422: The procedure is complete, sutures or staples are used to close the incision. Once the incision is closed, the anesthetic agents are stopped or reversed, and the person is taken off ventilation and extubated (if general anesthesia was administered). After completion of surgery, the person is transferred to the post anesthesia care unit and closely monitored. When the person is judged to have recovered from

9879-444: The procedure. People preparing for surgery are also instructed to abstain from food or drink (an NPO order after midnight on the night before the procedure), to minimize the effect of stomach contents on pre-operative medications and reduce the risk of aspiration if the person vomits during or after the procedure. Some medical systems have a practice of routinely performing chest x-rays before surgery. The premise behind this practice

9990-413: The published public lectures at the École Normale , Lagrange observed that fractions with varying denominators (e.g., 1 ⁄ 2 , 1 ⁄ 3 , 1 ⁄ 4 , 1 ⁄ 5 , 1 ⁄ 7 ), though simple in themselves, were inconvenient, as their different denominators made them difficult to compare. That is, fractions aren't difficult to compare if the numerator is 1 (e.g., 1 ⁄ 2

10101-430: The recovery period. A recent post-operative care philosophy has been early ambulation. Ambulation is getting the patient moving around. This can be as simple as sitting up or even walking around. The goal is to get the patient moving as early as possible. It has been found to shorten the patient's length of stay. Length of stay is the amount of time a patient spends in the hospital after surgery before they are discharged. In

10212-457: The reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child" which was subsequently interpreted to mean "requiring measures to improve… emergency obstetric services". Article 12.2d of the ICESCR stipulates the need for "the creation of conditions which would assure to all medical service and medical attention in the event of sickness", and is interpreted in

10323-675: The region, as he had learned a lot about Pacific number systems during his 2.5 years on the Coquille , collecting numerical vocabularies and ultimately publishing or commenting on more than a dozen of them. He was also familiar with the work of Thomas Kendall and Samuel Lee through his translation of von Chamisso's work. These circumstances suggest Lesson was unlikely to have misunderstood New Zealand counting as proceeding by elevens. Lesson and his shipmate and friend, Blosseville, sent accounts of their alleged discovery of elevens-based counting in New Zealand to their contemporaries. At least two of these correspondents published these reports, including

10434-447: The results of these tests can help evaluate surgical risk. A surgical team may include a surgeon, anesthetist, a circulating nurse, and a "scrub tech", or surgical technician, as well as other assistants who provide equipment and supplies as required. While informed consent discussions may be performed in a clinic or acute care setting, the pre-operative holding area is where documentation is reviewed and where family members can also meet

10545-523: The risk of local skin reactions or antibiotic resistance. Through a retrospective analysis of national administrative data, the association between mortality and day of elective surgical procedure suggests a higher risk in procedures carried out later in the working week and on weekends. The odds of death were 44% and 82% higher respectively when comparing procedures on a Friday to a weekend procedure. This "weekday effect" has been postulated to be from several factors including poorer availability of services on

10656-539: The root -dzigꞷ is obviously the same as the -tsigꞷ , which stands for 'ten' in No. 38. It may also be related to the -digi ('ten') of 148, -tuku or -dugu of the Ababua and Congo tongues, -dikꞷ of 130, -liku of 175 ('eight'), and the Tiag of 249." In Johnston's classification of the Bantu and Semi-Bantu languages, Today, Pañgwa is understood to have decimal numbers, with

10767-512: The same regardless of whether the base unit was a single item, pair, or group of four — base counting units used throughout the region — and it was the basis for the unique binary counting found in Mangareva , where counting could also proceed by groups of eight. The method of counting also solves another mystery: why the Hawaiian word for twenty , iwakalua , means "nine and two." When

10878-443: The so-called "noninvasive surgery" ought to be more appropriately called minimally invasive procedures , which usually refers to a procedure that utilizes natural orifices (e.g. most urological procedures) or does not penetrate the structure being excised (e.g. endoscopic polyp excision , rubber band ligation , laser eye surgery ), are percutaneous (e.g. arthroscopy , catheter ablation , angioplasty and valvuloplasty ), or to

10989-512: The surgical service line; the surgical service line costs were $ 17,600 in 2003 and projected to be $ 22,500 in 2013. For hospital stays in 2012 in the United States, private insurance had the highest percentage of surgical expenditure. in 2012, mean hospital costs in the United States were highest for surgical stays. Older adults have widely varying physical health. Frail elderly people are at significant risk of post-surgical complications and

11100-439: The surgical site is anesthetized, but the person can remain conscious or minimally sedated. In contrast, general anesthesia may render the person unconscious and paralyzed during surgery. The person is typically intubated to protect their airway and placed on a mechanical ventilator , and anesthesia is produced by a combination of injected and inhaled agents. The choice of surgical method and anesthetic technique aims to solve

11211-423: The surgical team. Nurses in the preoperative holding area confirm orders and answer additional questions of the family members of the patient prior to surgery. In the pre-operative holding area, the person preparing for surgery changes out of their street clothes and are asked to confirm the details of his or her surgery as previously discussed during the process of informed consent. A set of vital signs are recorded,

11322-601: The surgical wound during recovery. Mostly these drains stay in until the volume tapers off, then they are removed. These drains can become clogged, leading to abscess . Postoperative therapy may include adjuvant treatment such as chemotherapy , radiation therapy , or administration of medication such as anti-rejection medication for transplants. For postoperative nausea and vomiting (PONV), solutions like saline, water, controlled breathing placebo and aromatherapy can be used in addition to medication. Other follow-up studies or rehabilitation may be prescribed during and after

11433-452: The system was quite extensively developed, having simple words for 121 and 1331, i.e. for the square and cube of 11." As published by Williams in the first two editions of the dictionary series, this statement read: "The Native mode of counting is by elevens, till they arrive at the tenth eleven, which is their hundred; then onwards to the tenth hundred, which is their thousand:* but those Natives who hold intercourse with Europeans have, for

11544-713: The term "surgery" can also refer to the facility where surgery is performed, or simply the office / clinic of a physician , dentist or veterinarian . As a general rule, a procedure is considered surgical when it involves cutting of a person's tissues or closure of a previously sustained wound. Other procedures that do not necessarily fall under this rubric, such as angioplasty or endoscopy , may be considered surgery if they involve "common" surgical procedure or settings, such as use of antiseptic measures and sterile fields, sedation / anesthesia , proactive hemostasis , typical surgical instruments , suturing or stapling . All forms of surgery are considered invasive procedures;

11655-490: The then-named Duodecimal Society of America) noted that base 11 numbers have the disadvantage that for prime numbers higher than 11, "we are unable to tell, without actually testing them, not only whether or not they are prime, but, surprisingly, whether or not they are odd or even." Undecimal (often referred to as unodecimal in this context) is useful in computer science and technology for understanding complement (subtracting by negative addition) and performing digit checks on

11766-550: The top-ranking naval pharmacist at Rochefort (1835). His experience as a ship's surgeon resulted in his two-volume " Manuel d'histoire naturelle medicale, et de pharmacographie " (1833), intended as a handbook for naval surgeons. He became a corresponding member of the Académie de Médecine in 1828, later becoming a correspondent of the Académie des Sciences (1833). He received the Légion d'honneur in 1847. In 1847, Lesson presented

11877-647: The world's population, with its core belief as the issues of need, access and quality". Halfdan T. Mahler , the 3rd Director-General of the World Health Organization (WHO) , first brought attention to the disparities in surgery and surgical care in 1980 when he stated in his address to the World Congress of the International College of Surgeons, "'the vast majority of the world's population has no access whatsoever to skilled surgical care and little

11988-408: Was also likely the author of an undated essay, written by a Frenchman but otherwise anonymous, found among and published with the papers of the Prussian linguist Wilhelm von Humboldt in 1839. The story expanded in its retelling: The 1826 letter published by Balbi added an alleged numerical vocabulary with terms for eleven squared ( Karaou ) and eleven cubed ( Kamano ), as well as an account of how

12099-534: Was also named. Surgery Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery such as gastric bypass ), to reconstruct or improve aesthetics and appearance ( cosmetic surgery ), or to remove unwanted tissues ( body fat , glands , scars or skin tags ) or foreign bodies . The act of performing surgery may be called

12210-404: Was not a prime number, such as 11, which necessarily would give all fractions the same denominator. This idea will be regarded, if you will, as one of those exaggerations that escape the best minds in the heat of argument; but he only used the number 11 to rule out the number 12, which the more intrepid innovators wanted to substitute for 10, which is the basis of numeration everywhere." In 1795, in

12321-608: Was resolved if all the fractions had the same denominator: Lagrange wrote: "On voit aussi par-là, qu'il est indifférent que le nombre qui suit la base du système, comme le nombre 10 dans notre système décimal, ait des diviseurs ou non; peut-être même y aurait-il, à quelques égards, de l'avantage à ce que ce nombre n'eût point de diviseurs, comme le nombre 11, ce qui aurait lieu dans le système undécimal, parce qu'on en serait moins porté à employer les fractions 1 ⁄ 2 , 1 ⁄ 3 , etc." As translated: "We also see by this [argument about divisibility], it does not matter whether

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