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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1316_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Acknowledgements
- •Foreword
- •Contents
- •Preface
- •Recognition of the Sick Patient
- •Shock and Organ Perfusion
- •Outcomes of Resuscitation
- •Investigations
- •Fluid and Electrolyte Replacement
- •Haematological Therapy
- •Coagulopathy
- •Antibiotics
- •Emergency Laparoscopic Surgery
- •Approach to Traumatic Abdominal Pain
- •Ancillary Investigations in the ED
- •Indications for Referral
- •References
- •Risk Factors for Surgery
- •Postoperative Care
- •Intensive Care/High Dependency
- •Sepsis Syndromes
- •Acute respiratory distress syndrome(ARDS)
- •Blood transfusion and blood component therapy
- •Postoperative Oliguria
- •Renal Replacement Therapy (RRT)
- •Abdominal compartment syndrome (ACS)
- •Nutrition
- •Pros and cons of TPN
- •Introduction
- •Initial Management
- •Rockall score
- •Glasgow–Blatchford score
- •Medical Therapy
- •Endoscopic Therapy
- •Timing of endoscopy
- •Epinephrine injection
- •Thermal therapy
- •Argon plasma coagulation
- •Endoscopic clipping
- •Failure of endoscopic therapy
- •References
- •Introduction
- •Management of Variceal Bleeding
- •Medical Management and Resuscitation
- •Endoscopic Management
- •Variceal band ligation
- •Cyanoacrylate glue
- •Endoscopic sclerotherapy
- •Subsequent endoscopy
- •Portosystemic shunts: TIPS and surgery
- •References
- •Introduction
- •Management Options
- •Catheter Angiography
- •CT Angiography
- •Embolic Agents
- •Complications of Angiography
- •Indirect Bleeding
- •References
- •I. Indications
- •II. Preoperative Preparation
- •B. Over-Sewing a Bleeding Ulcer
- •Pyloroplasty/gastroenterostomy
- •Truncal vagotomy
- •Ensure safe duodenal stump closure
- •Dealing with problems related to the posterior duodenal ulcer penetratinginto the pancreas
- •Mobilisation of distal stomach
- •Billroth II gastroenteral anastomosis
- •Surgical Techniques for BleedingGastric Ulcer
- •F. Local Excision of Gastric Ulcer
- •Key Points in Billroth I Gastrectomyfor Bleeding Gastric Ulcer
- •Incisional wound closure
- •Postoperative care
- •References
- •Indications
- •Preoperative Preparation
- •Operative Treatment
- •A. Benign Duodenal Ulcer Perforation
- •B. Benign Gastric Ulcer Perforations
- •References
- •2. Preoperative Preparation
- •3. Surgery
- •Open Appendectomy
- •Introduction
- •General Complications
- •Thromboembolism
- •Atelectasis
- •Nausea and Vomiting
- •Wound Complications
- •Acute Abdominal Complications
- •1. Bleeding
- •2. Leaks
- •Treatment options for GJ leak
- •Managing sleeve leak
- •3. Stenosis and Stricture
- •4. Gastric Band Slippage and IntestinalObstruction
- •5. Other Complications
- •Gastric banding
- •Gastric bypass
- •Nutritional problems
- •1. Indications
- •Operative Strategy of Acute Appendicitis
- •Laparoscopic Appendectomy
- •4. Postoperative care
- •Special Situations
- •Introduction
- •Management of Acute Sigmoid Colonic Diverticulitis
- •A. Preoperative Management
- •B. Indications for Surgery
- •C. Options of Surgical Procedure
- •Two-stage approach
- •Single-stage approach
- •Role of laparoscopic surgery in acute perforative sigmoid colonic diverticulitis
- •E. Position of Patient for Surgery
- •Intra-Operative Surgical Techniques
- •A. Incision and Laparotomy
- •Tips and tricks to help locate the ‘difficult’ left ureter
- •Common sites of left ureteric injury during anterior resection
- •D. Splenic Flexure Take Down
- •Tips and tricks to tackle difficultsplenic flexure
- •E. Vascular Control
- •Ligation of the inferior mesenteric artery (IMA)
- •How to identify the IMA?
- •On-table colonic lavage
- •When is it not safe to anastomose?
- •J. Completion of Surgery
- •K. Postoperation Care
- •References
- •Introduction
- •I. Preoperative Management
- •II. Management Options
- •III. Endoscopic Colonic Stenting
- •Indications
- •IV. Defunctioning Stoma
- •Indications
- •Postoperative Considerations
- •References
- •Definition
- •Risk Factors for DifficultLaparoscopic Cholecystectomyin Acute Cholecystitis
- •Preoperative preparation
- •Surgical Treatment
- •Laparoscopic approach
- •References
- •Pre- ERCP Preparation
- •ERCP for Choledocholithiasis
- •ERCP in Bile Duct Injuries
- •Difficult Biliary Cannulation
- •Post- ERCP Care
- •References
- •A) Acute Cholangitis
- •C) Bile Duct Injuries During Surgery
- •D) Pancreatic Trauma
- •E) ERCP Perforation
- •I. Introduction
- •IV. Postoperative Management
- •Special situations
- •Final Note
- •Introduction
- •Disadvantages of Radiological Drainage
- •Radiological Evaluation of the Abscess
- •1) Diagnosis of Abscess
- •2) Identify a Potential Cause for an Abscess
- •3) Determine Drainability of an Abscess
- •4) Identifying the Complications from an Abscess
- •5) Aid Drainage Planning
- •Role of RadiologicalIntervention
- •Contraindications
- •Technique
- •Imaging Guidance
- •Insertion of the Drain
- •Drainage Catheter
- •Site Specific Comments on Radiological Drainage of Intra-Abdominal Abscess
- •Liver Abscess
- •Subphrenic and Lesser Sac Abscess
- •Percutaneous Cholecystostomy
- •Pancreatic Collection/Abscess
- •Pelvic Abscess
- •Enteric Abscess
- •Others
- •Conclusion
- •References
- •I. Ectopic Pregnancy
- •Operative procedures
- •II. Ruptured Tubo-Ovarian Abscess
- •Preoperative
- •Operative procedures
- •Postoperative
- •III. Haemorrhage or LeakingOvarian Cyst and Adnexal Torsion
- •A. Adnexal torsion
- •Preoperative — Benign Ovarian Cyst
- •Laparoscopic intervention
- •2. Laparoscopic ovarian oophorectomy
- •3. Open Cystectomy
- •Introduction
- •Repair of Bladder Injuries
- •Boari Flap
- •Other Manoeuvres
- •Post-Operative Care
- •Conclusion
- •II. Perioperative Care
- •IV. Mycotic Aneurysms
- •VI. Post-Surgery Follow-up
- •I. Introduction and Indications
- •II. Preoperative Management
- •III. OT Preparation
- •IV. Operative Procedure
- •Damage Control Mode
- •Splenic Injuries
- •Bowel Injuries
- •Kidney Injuries
- •Pancreatic Injuries
- •Liver Injuries
- •VI. Postoperative Care
- •V. Wound Closure
- •Introduction
- •Preoperative Planning
- •Choice of Surgical Technique
- •Operative Procedure
- •1. Component Separation Technique
- •3. Bilateral Skin Flap Advancement
- •5. Use of Alloplastic Materials
- •Postoperative Management
- •References
- •Laparotomy
- •Laparoscopy
- •Interventional Radiology
- •Air Enema
- •Neonatal Intestinal Obstruction
- •Duodenal Atresia
- •Duodenoduodenostomy
- •Malrotation with Volvulus
- •Intestinal Atresia
- •Hirschsprung’s Disease (HD)
- •Anorectal Malformations
- •Inguinal Hernia in Children
- •References
- •Introduction
- •Benefits of Laparoscopy in Emergency
- •Indications of Emergency Laparoscopy
- •Instrumentation
- •Instruments for Removal of Specimen
- •Instruments for Port Closure
- •Patient Position and O.T. Setup
- •Suggested Reading
- •Index
- •Uploaded by [StormRG]
- •Contents


Renegade:
Adjective
‘Having rejected tradition: Unconventional.’
Merriam-Webster Dictionary

Acquiescence to tyranny is the death of the spirit
You may be 38 years old, as I happen to be. And one day,
some great opportunity stands before you and calls you to
stand up for some great principle, some great issue, some
great cause. And you refuse to do it because you are afraid
… You refuse to do it because you want to live longer …
You’re afraid that you will lose your job, or you are afraid
that you will be criticised or that you will lose your
popularity, or you’re afraid that somebody will stab you, or
shoot at you or bomb your house; so you refuse to take the
stand.
Well, you may go on and live until you are 90, but you’re just
as dead at 38 as you would be at 90. And the cessation of
breathing in your life is but the belated announcement of an
earlier death of the spirit.
Martin Luther King

How the few control the many and always have – the many do
whatever they’re told
‘Forward, the Light Brigade!’
Was there a man dismayed?
Not though the soldier knew
Someone had blundered.
Theirs not to make reply,
Theirs not to reason why,
Theirs but to do and die.
Into the valley of Death
Rode the six hundred.
Cannon to right of them,
Cannon to le of them,
Cannon in front of them
Volleyed and thundered;
Stormed at with shot and shell,
Boldly they rode and well,
Into the jaws of Death,
Into the mouth of hell
Rode the six hundred
Alfred Lord Tennyson (1809-1892)

The mist is liing slowly
I can see the way ahead
And I’ve le behind the empty streets
That once inspired my life
And the strength of the emotion
Is like thunder in the air
’Cos the promise that we made each other
Haunts me to the end
The secret of your beauty
And the mystery of your soul
I’ve been searching for in everyone I meet
And the times I’ve been mistaken
It’s impossible to say
And the grass is growing
Underneath our feet
The words that I remember
From my childhood still are true
That there’s none so blind
As those who will not see
And to those who lack the courage
And say it’s dangerous to try
Well they just don’t know
That love eternal will not be denied
I know you’re out there somewhere
Somewhere, somewhere
I know you’re out there somewhere

Somewhere you can hear my voice
I know I’ll find you somehow
Somehow, somehow
I know I’ll find you somehow
And somehow I’ll return again to you
The Moody Blues

Are you a gutless wonder - or a Renegade Mind?
Monuments put from pen to paper,
Turns me into a gutless wonder,
And if you tolerate this,
Then your children will be next.
Gravity keeps my head down,
Or is it maybe shame ...
Manic Street Preachers
Rise like lions aer slumber
In unvanquishable number.
Shake your chains to earth like dew
Which in sleep have fallen on you.
Ye are many – they are few.
Percy Shelley

CHAPTER 1
CHAPTER 2
CHAPTER 3
CHAPTER 4
CHAPTER 5
CHAPTER 6
CHAPTER 7
CHAPTER 8
CHAPTER 9
CHAPTER 10
CHAPTER 11
CHAPTER 12
Postscript
APPENDIX
BIBLIOGRAPHY
INDEX
Contents
‘I’m thinking’ – Oh, but are you?
Renegade perception
The Pushbacker sting
‘Covid’: The calculated catastrophe
There is no ‘virus’
Sequence of deceit
War on your mind
‘Reframing’ insanity
We must have it? So what is it?
Human 2.0
Who controls the Cult?
Escaping Wetiko
Cowan-Kaufman-Morell Statement on Virus Isolation

F
CHAPTER ONE
I’m thinking’ – Oh, but
are
you?
Think for yourself and let others enjoy the privilege of doing so too
Voltaire
rench-born philosopher, mathematician and scientist René
Descartes became famous for his statement in Latin in the 17th
century which translates into English as: ‘I think, therefore I am.’
On the face of it that is true. Thought reflects perception and
perception leads to both behaviour and self-identity. In that sense
‘we’ are what we think. But who or what is doing the thinking and is
thinking the only route to perception? Clearly, as we shall see, ‘we’
are not always the source of ‘our’ perception, indeed with regard to
humanity as a whole this is rarely the case; and thinking is far from
the only means of perception. Thought is the village idiot compared
with other expressions of consciousness that we all have the
potential to access and tap into. This has to be true when we are
those other expressions of consciousness which are infinite in nature.
We have forgoen this, or, more to the point, been manipulated to
forget.
These are not just the esoteric musings of the navel. The whole
foundation of human control and oppression is control of
perception. Once perception is hijacked then so is behaviour which
is dictated by perception. Collective perception becomes collective
behaviour and collective behaviour is what we call human society.
Perception is all and those behind human control know that which is

why perception is the target 24/7 of the psychopathic manipulators
that I call the Global Cult. They know that if they dictate perception
they will dictate behaviour and collectively dictate the nature of
human society. They are further aware that perception is formed
from information received and if they control the circulation of
information they will to a vast extent direct human behaviour.
Censorship of information and opinion has become globally Nazilike in recent years and never more blatantly than since the illusory
‘virus pandemic’ was triggered out of China in 2019 and across the
world in 2020. Why have billions submied to house arrest and
accepted fascistic societies in a way they would have never believed
possible? Those controlling the information spewing from
government, mainstream media and Silicon Valley (all controlled by
the same Global Cult networks) told them they were in danger from
a ‘deadly virus’ and only by submiing to house arrest and
conceding their most basic of freedoms could they and their families
be protected. This monumental and provable lie became the
perception of the billions and therefore the behaviour of the billions. In
those few words you have the whole structure and modus operandi
of human control. Fear is a perception – False Emotion Appearing
R
eal – and fear is the currency of control. In short … get them by the
balls (or give them the impression that you have) and their hearts
and minds will follow. Nothing grips the dangly bits and freezes the
rear-end more comprehensively than fear.
World number 1
There are two ‘worlds’ in what appears to be one ‘world’ and the
prime difference between them is knowledge. First we have the mass
of human society in which the population is maintained in coldlycalculated ignorance through control of information and the
‘education’ (indoctrination) system. That’s all you really need to
control to enslave billions in a perceptual delusion in which what are
perceived to be their thoughts and opinions are ever-repeated
mantras that the system has been downloading all their lives
through ‘education’, media, science, medicine, politics and academia
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