American journal of surgery
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This analysis examines gastrointestinal recovery in patients who underwent bowel resection (BR) in 3 recent trials. ⋯ This analysis provides valuable clinical insight into gastrointestinal recovery after BR in a large homogenous patient population receiving multimodal care.
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Comparative Study
A comparative study of secretory immunoglobulin A and immunoglobulin G in host defense in an in vitro pneumonia model.
An exaggerated inflammatory response to infections including nosocomial pneumonia may be detrimental to the host and contribute to morbidity and mortality. Both secretory immunoglobulin A (SIgA) and IgG contribute to the immune defense of respiratory surfaces. However, their relative ability to protect against invasive infections and the resultant host inflammatory response are unknown and were the basis for this study. ⋯ SIgA may function to protect against microbial invasion of respiratory surfaces and protect against tissue injury from an exaggerated inflammatory response.
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In July 2003, the American Council for Graduate Medical Education (ACGME) required residency programs to significantly restrict resident work hours. The effect of these regulations on trauma services has not yet been investigated. The purpose of this study was to evaluate the effect of the ACGME regulations on the care of injured patients and resident education. ⋯ The ACGME-mandated work-hour restrictions have had a dramatic effect on resident and staff surgeons involved in the care of injured patients. Appropriate methods of responding to these challenges must be developed to improve trauma care and enhance resident education.
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Right or left side of placement for subclavian vein catheterization for placement of long-term central catheters and size of the catheters has not been analyzed completely. ⋯ This study supports placing the smallest catheter necessary via the left subclavian vein.