World journal of surgery
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World journal of surgery · Feb 2013
Outcomes of conservative treatment of 134 cases of umbilical pilonidal sinus.
There are different opinions about the treatment of umbilical pilonidal sinus. The aim of the present study was to evaluate the outcome of conservative treatment of this disease. ⋯ Conservative treatment should be regarded as the first choice and the main method of treatment in the management of umbilical pilonidal sinus. Improper extraction of hair is the main cause of failure of conservative treatment. Recurrence can be prevented by giving the patients instructions on preventive measures.
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World journal of surgery · Feb 2013
Excessive decrease in serum magnesium after total thyroidectomy for Graves' disease is related to development of permanent hypocalcemia.
Transient postoperative hypocalcemia is one of the most common complications after thyroidectomy. Permanent hypocalcemia, however, is rare, but usually requires life-long treatment and follow-up. The risk of permanent hypocalcemia has been shown to be significantly higher in patients with Graves' disease. In the present study we evaluated short-term and long-term changes in serum calcium, phosphate, magnesium, and parathyroid hormone (PTH) levels in order to characterize subjects at risk of postoperative hypoparathyroidism. ⋯ Serum calcium prior to operation, serum PTH, and degree of decrease in magnesium levels in serum 48 h after operation may predict development of permanent hypocalcemia. Magnesium plays an important role in calcium homeostasis via stimulation of PTH secretion and modulation of PTH receptor sensitivity. Both mechanisms may have played a role for the findings reported in this article.
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World journal of surgery · Feb 2013
Effect of obesity and decompressive laparotomy on mortality in acute pancreatitis requiring intensive care unit admission.
Controversy still exists on the effect that obesity has on the morbidity and mortality in severe acute pancreatitis (SAP). The primary purpose of this study was to compare the mortality rate of obese versus nonobese patients admitted to the ICU for SAP. Secondary goals were to assess the potential risk factors for abdominal compartment syndrome (ACS) and to investigate the performance of validated scoring systems to predict ACS and in-hospital mortality. ⋯ Patients' age was the most significant factor associated with mortality in patients affected by SAP. Higher APACHE II and Glasgow-Imrie scores were associated with the development of ACS, but their discrimination performance was unsatisfactory.