World journal of surgery
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World journal of surgery · Nov 2009
ReviewBilateral neck exploration in primary hyperparathyroidism--when is it selected and how is it performed?
Although most patients with primary hyperparathyroidism (PHPT) are ideal candidates for minimally invasive parathyroidectomy, some will have more than one enlarged gland and require bilateral neck exploration to achieve biochemical cure. We evaluated the clinical evidence for when to choose bilateral neck exploration for patients with PHPT. ⋯ No level I or II evidence reliably identifies preoperative clinical risk factors for determining which patients should have routine bilateral neck exploration for multi-gland disease or for intraoperative decision making to convert to bilateral neck exploration. Imaging studies are positive in most patients (level II). No randomized studies exist to determine when a bilateral neck exploration is indicated based on clinical risk factors or imaging studies that may suggest multi-gland disease.
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World journal of surgery · Nov 2009
Discrepancy between the extent of pancreatic necrosis and multiple organ failure score in severe acute pancreatitis.
Whether pancreatic necrosis is a prerequisite for the development of multiorgan failure (MOF) in severe acute pancreatitis (AP) is not clear and has implications for the rational design of translational therapies. This study was designed to investigate the magnitude of any association between MOF and radiologically evident pancreatic or extrapancreatic complications of AP. ⋯ The discrepancy between the presence of necrosis and the occurrence of MOF favors association but not cause in AP. A complex, systems-based, pleiotropic inflammatory network with a common root, in which the extent of pancreatic necrosis influences the severity of MOF in certain individuals and MOF exacerbates the development of pancreatic necrosis in others, seems more likely.
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World journal of surgery · Nov 2009
Helicopter evacuation of trauma victims in Los Angeles: does it improve survival?
The purpose of this study was to investigate the relationship between the method of transport after injury and survival among trauma patients admitted to a Level 1 trauma facility in Los Angeles, California. ⋯ In a metropolitan Los Angeles trauma system, EMS helicopter transportation of injured patients does not appear to improve overall adjusted survival after injury. There is however a potential benefit for severely injured subgroups of patients due to the shorter prehospital times.
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Fraud is an important issue that affects research of both scientific and clinical fields because of its potential to adversely affect patient care. Fraud can take many forms, each with varying prevalence and implications. ⋯ The increasing importance of editorial responsibility is highlighted and discussed. Finally, we suggest solutions for how to effectively regulate and eradicate this practise.
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Recent international cancer prevention guidelines recommend weight loss, where appropriate, for the purpose of cancer risk reduction. However, limited research associates voluntary weight loss to subsequent cancer incidence because of the difficulty of achieving long-term weight loss maintenance among large participant groups. ⋯ Reduced cancer mortality and incidence as well as reduced cancer-related physician visits after bariatric surgery are presented. Study limitations and future research questions related to cancer and bariatric surgery are briefly discussed.