Surgery today
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In Japan, the National Clinical Database (NCD) was founded in April 2010 as the parent body of the database system linked to the board certification system. Registration began in 2011, and to date, more than 3,300 facilities have enrolled and more than one million cases are expected to enroll each year. Given the broad impact of this database initiative, considering the social implications of their activities is important. ⋯ The NCD project is realistic in terms of effort and cost, and its activities are conducted lawfully and ethically with due consideration of its effects on society. Continuous evaluation on the whole system is essential. Such evaluation provides the validity of the framework of healthcare standards as well as ensures the reliability of collected data to guarantee the scientific quality in clinical databases.
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This study examined the feasibility of using the serum intestinal fatty acid binding protein (I-FABP) level for the early diagnosis of acute mesenteric ischemia, and investigated whether it contributes to the clinical decision-making process. ⋯ The I-FABP level is a more reliable parameter for diagnosing acute mesenteric ischemia compared to leukocytosis and D-dimer elevation.
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To evaluate the routine postoperative fluid management in relation to the British Consensus Guidelines on Intravenous Fluid Therapy for Adult Surgical Patients 2008 by the assessment of the fluid overload and electrolyte disorders in patients who were postoperatively treated according to an 'enhanced recovery after surgery' (ERAS) protocol. ⋯ Postoperative registration of fluid charts is difficult, which results in incomplete charts. This has resulted in more attention being paid to recording the fluid balance at our institution. Concerning electrolyte disorders, we recommend prophylactic potassium administration. However, there is no reason to replace standard 0.9 % NaCl/glucose 5 % by Ringer's lactate, as the British guidelines advice.
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To review the surgical techniques and mid-term results of mitral valve repair in children with moderate or severe mitral regurgitation (MR). ⋯ Pediatric patients with moderate or severe MR require early surgical treatment. The early and mid-term results of mitral valve repair in pediatric patients were satisfactory.