Study on the Outcome of Damage Control Surgery

Study on the Outcome of Damage Control Surgery A RETROSPECTIVE STUDY ON THE OUTCOME OF DAMAGE CONTROL SURGERY IN SPMC FROM YEAR 2005 TO 2010. A RETROSPECTIVE STUDY Submitted by: Chris George C. Pales, MD Co-Author: Benedict Edward P. Valdez, MD INTRODUCTION: WHAT IS THE TOPIC ALL ABOUT? The traditional approach to combat injury care is surgical exploration with definitive repair of all injuries. This approach is successful when there is limited number of injuries. These are usually performed in patients with unstable conditions such as profound hemorrhagic shock which known to affect the over-all survival of the patient. Prolonged operative times and persistent bleeding lead to the lethal triad of coagulopathy, acidosis, and hypothermia, resulting in a mortality of about 90%. The Three stages of damage control are as follows: Control of hemorrhage and contamination. Also known as bail-out surgery is the first stage. It is a life-saving procedures and is rapidly performed by the surgeon. The main goal this time is to control blood loss and minimizing contamination. It includes control of hemorrhage from bleeding major vessels and solid organs through packing of abdomen, deviation from intestinal anastomosis and temporary closure of abdomen. Resuscitation: Once control of hemorrhage is achieved, patient is now transferred to ICU for correction of any derangement. Rewarming of the patient to avoid hypothermia, correction of blood loss, hydration and stabilization of BP, and avoiding coagulopathy. Reoperation. One patient has been stabilized, especially within 24-48 hours, definite procedure will be done at operating room. WHAT IS ALREADY KNOWN ABOUT THE TOPIC? Damage control surgery is relatively new technique, about 20 years old. It is well recognized that trauma patients especially those with profound shock has a higher chance to die secondary to intra-operative metabolic failure than from the trauma itself. The analogy of damage control surgery is to stop all haemorrhage and gastrointestinal spillage as quickly as possible while patient is having unstable vital signs at the operating room. It is coined from a U.S. Navy technique which is â€Å"the capacity of a ship to absorb damage and maintain mission integrity.† Speed of decision and surgery in severely injured trauma patients is the key to avoid death to patient. The well recognized consequence of hypovolemic, hypothermic patient is what we call the â€Å"lethal triad.† It comprises the vicious cycle of hypothermia, acidosis, and coagulopathy. It is a viscous cycle that is very lethal if not recognized and controlled immediately. Patient who is stable with acceptable laboratory results, good ventilator response, non-hypothermic, are then returned to the operating for the â€Å"definitive operation.† (figure 1). Bowel anastomoses and colostomy maturation, definitive vascular repair, removal of hemostatic packing, and closure of abdominal fascia where is done. Figure 1. The documented mortality for the damage control approximately 50% with a documented morbidity of approximately 40% as summarized in the following table. WHAT IS NOT YET KNOWN ABOUT THE TOPIC? With the advent of modern technology and numerous studies, what is the outcome of patients undergoing Damage control surgery in SPMC from January 1, 2005 to December 31, 2010. WHAT IS THE SIGNIFICANCE OF THE STUDY? This study will give us data on the effectiveness of Damage Control Surgery done at SPMC from January 1, 2005 – December 31, 2010. It will give the surgeons the data of factors that determine the outcome of damage control surgery, thus giving ways of improving healthcare management to patients. WHAT WILL THIS STUDY DO? General Objective: The study aims to determine the outcome of damage control surgery done in SPMC from January 1, 2005 to December 31, 2010 Specific Objective: To describe the demographic and clinical profile of patients who underwent damage control surgery To determine the number of patients who underwent definitive surgical procedure after damage control surgery 3. To determine the mortality rate of patients who underwent undergoing damage control surgery in SPMC from January 1, 2005 to December 2010. 4. To determine the factors that affects the outcome of patients undergoing damage control surgery in SPMC from January 1, 2005 to December 2010 in terms of nature of injury, time of operation from injury and pre-operative vital signs. Patient’s Demographic Profile Describe the trauma patients according to the following variables: Sociodemographic characteristics Age Sex Clinical characteristics: Pre-operative vital signs Associated Injuries GCS score Organs Involved Co-morbidities Determine the interventions and clinical outcome of patients Duration of Operation Operations performed Mortality rate Re-operation performed Disposition Figure 1. Conceptual Framework METHODOLOGY General Design The study employed is a retrospective, descriptive study design. Chart review of all patients who underwent damage control surgery during January 1, 2005 to 2010 will be done by the author with the permission of the medical records section and the hospital research committee. Setting The study will be will be conducted at Southern Philippines Medical Center, a tertiary hospital in Davao City in June 2013. PARTICIPANTS: INCLUSION CRITERIA: This study will include all patients admitted and underwent Damage control surgery at Southern Philippines Medical center in 2005-2010. Damage control surgery includes resection of major injuries to the gastrointestinal tract without re-anastomosis; control of hemorrhage through peri-hepatic packing and temporary closure of abdomen and use of an alternate closure of a cervical incision, thoracotomy, laparotomy, or site of exploration of an extremity. EXLCLUSION CRITERIA: None SAMPLING PROCEDURES: The study subjects (target population) of this research are the patients admitted and underwent Damage control surgery at Southern Philippines Medical Center in 2005-2010. Randomization: None DATA GATHERING Dependent Variable: Number of Damage Control Surgery from 2005-2010 Main outcome measures and other dependent variables: Number of patients who expired and number of patients survived. Independent Variables Age and Sex Nature of injury Time of intervention from time of injury Pre-Operative vital signs Glasgow coma scale Organs involved Duration of Operation Availability of Blood Interventions: None Data Handling and Analysis: All data will be computed as to the mortality rate by computing the number of patients who expired to the total number of patients who underwent Damage control surgery. Furthermore, determination of mortality will be computed by computing the ratio of mortality as of Age and Sex, Nature of injury, Time of operation from injury and Pre-op vital signs, Duration of Operation, Availability of blood, Organs involved. ETHICAL CONSIDERATIONS Ethics Review The proponent of the study will secure an approval from the Cluster Ethics Research Committee of The Southern Philippines Medical Center prior to doing the research. A similar approval is also secured from the Department of Surgery of the same institution with the approval of a consultant in-charge. Privacy No phone calls or home visits as follow up to participants. Confidentiality The researchers will not disclose the identities of the patients at any time. The data obtained during the study will be under the Department of Surgery of Southern Philippines Medical Center and will be kept in confidentiality. Extent of Use of Study Data The data collected by the researcher will only be used to answer the objectives of stated in the protocol. Data will be available to others as a finished paper. Authorship and Contributorship The main proponent of the study is the main author and researcher of the study. Consultant guidance and support will be provided Dr. Benedict Valdez, head of Section of Trauma, Department of Surgery, SPMC. He is the co-author who will aide in the study design. A professional statistician will help in the study write-up and data analysis. The author and co-author gives consent to use the data collected for further research. Conflicts of Interest The main proponent and the co-authors declare no conflict of interest. Publication The research will be submitted for national and international publication groups and may be chosen for publication. In all portions in the paper, the author and co-authors will be duly acknowledged. Funding The main proponent of the study is using personal funds to conduct the study. Funding of the braces will depend on the patients and their guardians . REFERRENCES Schwartz book of Surgery 8th Edition by F. Charles Brunicardi Trauma, Fifth Edition by David Feliciano, MD A logical approach to trauma – Damage control surgery Shibajyoti Ghosh, Gargi Banerjee, Susma Banerjee, D. K. Chakrabarti Department of Surgery, R. G. Kar Medical college, West Bengal, India. Townsend: Sabiston Textbook of Surgery, 17th ed., Copyright  © 2004 Elsevier Combat Damage Control Resuscitation: Today and Tomorrow ;Colonel Lorne H. Blackbourne, MDUS Army Institute of Surgical Research, 3400 Rawley E. Chambers Ave. Fort Sam Houston, TX 78234USA Damage Control: Beyond the Limits of the Abdominal Cavity. A Review Maeyane S. Moeng, MB, BCh, FCS(SA),1 Jerome A. Loveland, MB, BCh, FCS(SA),2 and Kenneth D. Boffard, BSc(Hons), MB, BCh, FRCS, FRCS(Edin), FRCPS(Glas), FCS(SA), FACS, FCS(SA) Feasibility of Damage Control Surgery in the Management of Military Combat Casualties Ben Eiseman, MD, Ernest Moore, MD, Daniel Meldrum, MD, Christopher Raeburn MD DUMMY TABLES TABLE 1: Demographics and Clinical Characteristics. TABLE 2: OUTCOME TABLE 3: BUDGET TABLE 4: TIMETABLE CURRICULUM VITAE Name: Chris George C. Pales Address: Unit 303, Palmetto Place, Maa road, Davao City Telephoneà ¢Ã¢â€š ¬Ã‚ ¨Cell: 09238060856 Phoneà ¢Ã¢â€š ¬Ã‚ ¨Email: [emailprotected]/[emailprotected] Personal Informationà ¢Ã¢â€š ¬Ã‚ ¨ Date of Birth: April 9, 1983 à ¢Ã¢â€š ¬Ã‚ ¨Place of Birth: Koronadal City, South Cotabato à ¢Ã¢â€š ¬Ã‚ ¨Citizenship: Filipino à ¢Ã¢â€š ¬Ã‚ ¨Status: Married à ¢Ã¢â€š ¬Ã‚ ¨Gender: Male Education: Elementary: Kipalbig Elementary School, Kipalbig, Tampakan, South Cotabato (SY 1990-1996) High School: Notre Dame of Marbel University, Koronadal, South Cotabato (SY 1996-2000) Colllege: West Visayas State University, Iloilo City (SY 2000-2004) Medicine: West Visayas State University, Iloilo City (SY 2004-2008) DATA COLLECTION SHEET A RETROSPECTIVE STUDY ON THE OUTCOME OF DAMAGE CONTROL SURGERY IN SPMC FROM YEAR 2005 TO 2010. A RETROSPECTIVE STUDY Chris George C. Pales, MD/Benedict Edward P. Valdez, MD Hospital #: Age: Sex: NATURE OF INJURY Stab wound______ Gunshot wound______ Blunt Trauma______ Penetrating Injuries______ VITAL SIGNS ON ADMISSION BP: HR: RR: TEMP: GCS score: TIME OF ARRIVAL SINCE INJURY _______ Minutes _______ Hours _______ Days DURATION OF OPERATION: UNITS OF BLOOD TRANSFUSED: INTRA-OP VITAL SIGNS: BP: CR: ORGANS INVOLVED: RE-OPERATION DONE FOR DEFINITIVE PROCEDURE? ____Yes ____No NUMBER OF HOSPITAL STAY: DISPOSITION: ______DISCHARGED IMPROVED ______DIED CAUSE OF DEATH:

Final Exam: Corporations Essay

Question 1: Buttercup Corporation issued 250 shares of $11 par value common stock for $4,125. Prepare Buttercup’ journal entry. Question 2: Wilco Corporation has the following account balances at December 31, 2012. Common stock, $5 par value $511,670 Treasury stock 95,260 Retained earnings 2,400,840 Paid-in capital in excess of par 1,320,150 Prepare Wilco’s December 31, 2012, stockholders’ equity section Question 3: Woolford Inc. declared a cash dividend of $1.38 per share on its 2.22 million outstanding shares. The dividend was declared on August 1, payable on September 9 to all stockholders of record on August 15. Prepare the journal entries necessary on those three dates. Question 4: The outstanding capital stock of Pennington Corporation consists of 3,100 shares of $109 par value, 6% preferred, and 5,700 shares of $52 par value common. Assuming that the company has retained earnings of $83,000, all of which is to be paid out in dividends, and that preferred dividends were not paid during the 2 years preceding the current year, state how much each class of stock should receive under each of the following conditions. Question 5: Martinez Company’s ledger shows the following balances on December 31, 2012. 5% Preferred stock-$10 par value, outstanding 22,480 shares $224,800 Common stock-$100 par value, outstanding 33,720 shares 3,372,000 Retained earnings 708,120 Assuming that the directors decide to declare total dividends in the amount of $298,984, determine how much each class of stock should receive under each of the conditions stated below. One year’s dividends are in arrears on the preferred stock. Question 6: On January 1, 2012, Barwood Corporation granted 5,040 options to executives. Each option entitles the holder to purchase one share of Barwood’s $5 par value common stock at $50 per share at any time during the next 5 years. The market price of the stock is $72 per share on the date of grant. The fair value of the options at the grant date is $154,000. The period of benefit is 2 years. Prepare Barwood’s  journal entries for January 1, 2012, and December 31, 2012 and 2013. Question 7: Rockland Corporation earned net income of $340,800 in 2012 and had 100,000 shares of common stock outstanding throughout the year. Also outstanding all year was $908,800 of 10% bonds, which are convertible into 18,176 shares of common. Rockland’s tax rate is 40 percent. Compute Rockland’s 2012 diluted earnings per share. Question 8: DiCenta Corporation reported net income of $250,000 in 2012 and had 50,000 shares of common stock outstanding throughout the year. Also outstanding all year were 5,410 shares of cumulative preferred stock, each convertible into 2 shares of common. The preferred stock pays an annual dividend of $5 per share. DiCenta’ tax rate is 40%. Compute DiCenta’ 2012 diluted earnings per share. Question 9: Ferraro, Inc. established a stock appreciation rights (SAR) program on January 1, 2012, which entitles executives to receive cash at the date of exercise for the difference between the market price of the stock and the pre-established price of $24 on 5,050 SARs. The required service period is 2 years. The fair value of the SAR’s are determined to be $6 on December 31, 2012, and $13 on December 31, 2013. Question 10: Hillsborough Co. has an available-for-sale investment in the bonds of Schuyler with a carrying (and fair) value of $88,020. Hillsborough determined that due to poor economic prospects for Schuyler, the bonds have decreased in value to $57,020. It is determined that this loss in value is other-than temporary. Prepare the journal entry, if any, to record the reduction in value. Question 11: Capriati Corporation made the following cash purchases of securities during 2012, which is the first year in which Arantxa invested in securities. 1. On January 15, purchased 11,700 shares of Gonzalez Company’s common stock at $43.55 per share plus commission $2,574. 2. On April 1, purchased 6,500 shares of Belmont Co.’s common stock at $67.60 per share plus commission $4,381. 3. On September 10, purchased 9,100 shares of Thep Co.’s preferred stock at $34.45 per share plus commission $6,383. On May 20, 2012, Capriati sold 3,900 shares of Gonzalez Company’s common stock at a market price of $45.50 per share less brokerage commissions, taxes, and fees of $3,705. The year-end fair values per share were: Gonzalez $39.00, Belmont $71.50, and Thep $36.40. In addition, the chief accountant of Capriati told you that Capriati Corporation plans to hold these securities for the long term but may sell them in order to earn profits from appreciation in pri ces. Question 12: (Journal Entries for Fair Value and Equity Methods) Presented below are two independent situations. Prepare all necessary journal entries in 2012 for each situation. Situation 1 Hatcher Cosmetics acquired 10% of the 207,400 shares of common stock of Ramirez Fashion at a total cost of $15 per share on March 18, 2012. On June 30, Ramirez declared and paid a $80,200 cash dividend. On December 31, Ramirez reported net income of $123,500 for the year. At December 31, the market price of Ramirez Fashion was $18 per share. The securities are classified as available-for-sale. Situation 2 Holmes, Inc. obtained significant influence over Nadal Corporation by buying 25% of Nadal’s 30,800 outstanding shares of common stock at a total cost of $9 per share on January 1, 2012. On June 15, Nadal declared and paid a cash dividend of $43,800. On December 31, Nadal reported a net income of $90,500 for the year. Question 13: (Equity Method) Gator Co. invested $1,380,000 in Demo Co. for 25% of its outstanding stock. Demo Co. pays out 40% of net income in dividends each year. Use the information in the following T-account for the investment in Demo to answer the following questions. Question 14: (Fair Value and Equity Method Compared). Gregory Inc. acquired 20% of the outstanding common stock of Handerson Inc. on December 31, 2012. The purchase price was $1,320,000 for 50,000 shares. Handerson Inc. declared and paid an $0.87 per share cash dividend on June 30 and on December 31, 2013. Handerson reported net income of $741,000 for 2013. The fair value of Handerson’s stock was $32 per share at December 31, 2013. Question 15: (Call Option). On January 2, 2012, Jones Company purchases a call option for $450 on Merchant common stock. The call option gives Jones the option to buy 1,000 shares of Merchant at a strike price of $50 per share. The market price of a Merchant share is $50 on January 2, 2012 (the intrinsic value is therefore $0). On March 31, 2012, the market price for Merchant stock is $60 per share, and the time value of the option is $200. Question 16: In 2012, Amirante Corporation had pretax financial income of $207,000 and taxable income of $166,400. The difference is due to the use of different  depreciation methods for tax and accounting purposes. The effective tax rate is 40%. Compute the amount to be reported as income taxes payable at December 31, 2012. Question 17: At December 31, 2012, Fell Corporation had a deferred tax liability of $732,802, resulting from future taxable amounts of $2,155,300 and an enacted tax rate of 34%. In May 2013, a new income tax act is signed into law that raises the tax rate to 42% for 2013 and future years. Prepare the journal entry for Fell to adjust the deferred tax liability. Question 18: AMR Corporation (parent company of American Airlines) reported the following for 2009 (in millions). Service cost $405 Interest cost on P.B.O 736 Return on plan assets 825 Amortization of service cost 29 Amortization of loss 66 Compute AMR Corporation’s 2009 pension expense (in millions). Question 19: For Warren Corporation, year-end plan assets were $2,094,700. At the beginning of the year, plan assets were $1,762,400. During the year, contributions to the pension fund were $120,000, and benefits paid were $200,000. Compute Warren’s actual return on plan assets. Question 20: For 2010, Campbell Soup Company had pension expense of $48 million and contributed $296 million to the pension fund. Prepare Campbell Soup Company’s journal entry to record pension expense and funding. Question 21: Lahey Corp. has three defined-benefit pension plans as follows. Pension Assets (at Fair Value) Projected Benefit Obligation Plan X $637,500 $504,000 Plan Y 902,200 739,900 Plan Z 584,600 713,200 How will Lahey report these multiple plans in its financial statements? Question 22: For 2012, Sampsell Inc. computed its annual postretirement expense as $278,680. Sampsell’s contribution to the plan during 2012 was $185,750. Prepare Sampsell’s 2012 entry to record postretirement expense. Question 23: Wertz Corporation decided at the beginning of 2012 to change  from the completed-contract method to the percentage-of-completion method for financial reporting purposes. The company will continue to use completed-contract method for tax purposes. For years prior to 2012, pre-tax income under the two methods was as follows: percentage-of-completion $143,000, and completed-contract $65,800. The tax rate is 32%. Prepare Wertz’s 2012 journal entry to record the change in accounting principle. Question 24: In 2012, Bailey Corporation discovered that equipment purchased on January 1, 2010, for $50,000 was expensed at that time. The equipment should have been depreciated over 5 years, with no salvage value. The effective tax rate is 29%. Prepare Hiatt’s 2012 journal entry to correct the error. Question 25: At January 1, 2012, Beilder Company reported retained earnings of $2,027,300. In 2012, Beilder discovered that 2011 depreciation expense was understated by $442,300. In 2012, net income was $931,270 and dividends declared were $204,310. The tax rate is 38%. Complete the 2012 retained earnings statement for Beilder Company. Question 26: Simmons Corporation owns stock of Armstrong, Inc. Prior to 2012, the investment was accounted for using the equity method. In early 2012, Simmons sold part of its investment in Armstrong, and began using the fair value method. In 2012, Armstrong earned net income of $81,100 and paid dividends of $90,400. Prepare Simmons’s entries related to Armstrong’s net income and dividends, assuming Simmons now owns 11% of Armstrong’s stock. Question 27: Manno Corporation has the following information available concerning its postretirement benefit plan for 2012. Service cost $53,750 Interest cost 58,360 Actual return on plan assets 40,190 Compute Manno’s 2012 postretirement expense Question 28: Ravonette Corporation issued 310 shares of $13 par value common stock and 130 shares of $47 par value preferred stock for a lump sum of $17,500. The common stock has a market price of $22 per share, and the preferred stock has a market price of $98 per share. Prepare the journal entry to record the issuance Question 29: Garfield Company purchased, as a held-to-maturity investment, $82,400 of the 9%, 8-year bonds of Chester Corporation for $73,919, which provides an 11% return. Prepare Garfield’s journal entries for (a) the purchase of the investment and (b) the receipt  of annual interest and discount amortization. Assume effective interest amortization is used. Question 30: Clydesdale Corporation has a cumulative temporary difference related to depreciation of $606,600 at December 31, 2012. This difference will reverse as follows: 2013, $43,100; 2014, $264,300; and 2015, $299,200. Enacted tax rates are 34% for 2013 and 2014, and 40% for 2015. Compute the amount Clydesdale should report as a deferred tax liability at December 31, 2012

Green Sea Urchin Fact Sheet

With its sharp-looking spines, the green sea urchin may look frightful, but to us, it is mostly harmless. Sea urchins arent poisonous, although you might get poked by a spine if youre not careful. In fact, green sea urchins can even be eaten. Here you can learn some facts about this common marine invertebrate. Sea Urchin Identification Green sea urchins can grow to about 3 across, and 1.5 high. They are covered in thin, short spines. The sea urchins mouth (called Aristotles lantern) is located on its underside, and its anus is on its top side, in a spot that is not covered with spines. Despite their immobile appearance, sea urchins can move relatively quickly, like a sea star, using their long, thin water-filled tube feet and suction. Where to Find Sea Urchins If youre tide pooling, you might find sea urchins underneath rocks. Look closely - sea urchins may camouflage themselves by attaching algae, rocks, and detritus to their spines. Classification Kingdom: AnimaliaPhylum: EchinodermataClass: Echinoidea Order: CamarodontaFamily: StrongylocentrotidaeGenus: StronglyocentrotusSpecies: droebachiensis Feeding Sea urchins feed on algae, scraping it off of rocks with their mouth, which is made up of 5 teeth collectively called Aristotles lantern. In addition to his work and writings on philosophy, Aristotle wrote about science, and sea urchins - he described the sea urchins teeth by saying they resembled a lantern made of horn that had 5 sides. Thus the urchins teeth came to be known as Aristotles lantern. Habitat and Distribution Green sea urchins are found in tide pools, kelp beds, and on rocky ocean bottoms, to areas as deep as 3,800 feet. Reproduction Green sea urchins have separate sexes, although it is difficult to tell males and females apart. They reproduce by releasing gametes (sperm and eggs) into the water, where fertilization takes place. A larva forms and lives in the plankton for up to several months before it settles on the sea floor and eventually turns into an adult form. Conservation and Human Uses Sea urchin roe (eggs), called uni in Japan, are considered a delicacy. Maine fishermen became huge suppliers of green sea urchins in the 1980s and 1990s, when the ability to fly urchins overnight to Japan opened an international market for urchins, creating a Green Gold Rush, in which millions of pounds of urchins were harvested for their roe. Overharvesting amid a lack of regulation caused the urchin population to bust. Regulations now prevent overharvesting of urchins, but populations have been slow to recover. The lack of grazing urchins has caused kelp and algae beds to flourish, which in turn has increased crab populations. Crabs love to eat baby urchins, which has contributed to the lack of recovery of urchin populations. Sources Clark, Jeff. 2008. After the Gold Rush (Online) Downeast Magazine. Accessed Online June 14, 2011.Coulombe, Deborah A. 1984. The Seaside Naturalist. Simon Schuster.Daigle, Cheryl and Tim Dow. 2000. Sea Urchins: Movers and Shakers of the Subtidal Community (Online). The Quoddy Tides. Accessed June 14, 2011.Ganong, Rachel. 2009. Return of the Urchin?(Online). Times Record. Accessed June 14, 2011 - no longer online as of 5/1/12.Kiley Mack, Sharon. 2009. Maine Sea Urchins Making a Slow Recovery (Online) Bangor Daily News. Accessed June 14, 2011.Maine Department of Marine Resources. Green Sea Urchins (Strongylocentrotus drobachiensis) in Maine - Fishery, Monitoring, and Research Information. (Online) Maine DMR. Accessed June 14, 2011.Martinez, Andrew J. 2003. Marine Life of the North Atlantic. Aqua Quest Publications, Inc.: New York.Meinkoth, N.A. 1981. National Audubon Society Field Guide to North American Seashore Creatures. Alfred A. Knopf, New York.

A World Lit Only by Fire Reading Guide Essay - 3337 Words

Regine Jackson AP European History A World Lit Only by Fire Reading Guide Part One: The Medieval Mind 1. I know both the Middle Ages and Renaissance took place in Europe. The Middle Ages were terrible times marked by plagues, primitive agricultural machinery, war and lack of proper sanitation. The Renaissance occurred later in Europe, and that was marked by the rebirth of interest in art and intellectual capability. Art usually intertwined religion. 2. Manchester supported using the term â€Å" Dark Ages† to describe the historical period between 400 BCE and 1000 BCE due to the lack of intellectual life, â€Å"incessant war†, where multiple groups, including the Goths and Huns took part in the massacre and pillaging of villages. 3. The many†¦show more content†¦Part Two: The Shattering 18. This passage suggests that the way history is perceived is based on the effect it has on current events rather than the possibilities of its long term effects. 19. Magellans discovery of the Philippines was significant because it proved the world was round. He provided a â€Å"linchpin† for the Renaissance by giving others the means of challenging medieval assumptions. 20. European â€Å"life became very cheap† in the late 1400s and early 1500s because: bubonic plague syphilis pneumonia Spanish Inquisition 21. The unchristian acts of the five popes during Magellans lifetime included: Innocent VIII (1484-1492) -forged papal bills Julius II (1561-1564) – watched the murders of Christians for amusement Sixtus IV (1471-1485) -anointed family members as cardinals; conspired murder Alexander VI (1492- 1503) – buying off leading candidates Leo X (1513-1521) -appointed members of family into church; illegitimate children 22. 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