European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes
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Microcirculation and tissue oxygenation play key roles in many diseases and have been studied in various settings. Comparison and interpretation of measurements at the capillary level, however, is difficult when different techniques are employed and when data on systemic parameters are missing. ⋯ Changes of systemic parameters have significant effects on peripheral tissue oxygenation but may not always be detected at the capillary level. MAP, blood gases and haematocrit must be analysed to correctly interpret microcirculatory parameters.
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Comparative Study Clinical Trial
Estimation of the mortality risk of surgical intensive care patients based on routine laboratory parameters.
In established risk score models the collection and documentation of clinical data is time-consuming, causes labor-related costs, and is dependent on the examiner. ⋯ A general admission risk score for surgical intensive care patients solely based on quality controlled low-cost routine laboratory parameters is feasible.
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Comparative Study
External jugular Groshong catheter is associated with fewer complications than a subclavian Argyle catheter.
To demonstrate the efficacy and safety of insertion of a Groshong catheter via the external jugular vein (EJV) for central vein access. ⋯ Insertion of a Groshong catheter via the EJV is more acceptable for central venous access than insertion of a conventional subclavian venous catheter.
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Leptin is involved in the sepsis syndrome. A possible relationship exists between low leptin levels and peritonitis severity and a poorer prognosis. ⋯ A serum leptin below the threshold of 10 ng/ml is an adverse prognostic marker in patients with moderate to severe secondary peritonitis. The results of the regression analysis suggest that the mechanisms involved are opposing, in that leptin associated with IL-6 has a proinflammatory effect and, through IL-10 and CRP production, restrains the inflammatory response.
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To determine the influence of computed tomography (CT) scans on diagnosis and management of patients with suspected appendicitis. ⋯ CT scan utilization increased the appendectomy rate only in patients with a low clinical suspicion for appendicitis. Preoperative CT scans did not decrease the negative appendectomy rate.