American journal of surgery
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Factors affecting the severity of spontaneous retroperitoneal hemorrhage in anticoagulated patients.
Clinical manifestations of spontaneous retroperitoneal hemorrhage (SRH) range from a small decrease in hemoglobin to hypotension requiring transfer to the intensive care unit (ICU). Our goal was to identify which anticoagulated patients are at increased risk for SRH and its complications. ⋯ Patients on combined anticoagulant-antiplatelet therapy are more likely to require ICU admission and longer ICU stay. Close observation is warranted in these patients for early detection of SRH.
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For patients with borderline resectable pancreatic cancer, preoperative chemoradiation and standalone chemotherapy may allow for R0 resection and improved survival. ⋯ Preoperative chemoradiation and chemotherapy allow a select group of patients with borderline resectable pancreatic cancer to undergo an R0 or R1 resection with acceptable morbidity and mortality. Tumor response may be associated with survival.
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The American Board of Surgery Maintenance of Certification program requires more effort on the part of individual diplomates, but the principle is to create a better way of documenting the approach to maintenance of certification. The Maintenance of Certification program was designed to document that American Board of Surgery diplomates are maintaining the necessary competencies to provide quality care.
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Comparative Study
Hyperbilirubinemia: a risk factor for infection in the surgical intensive care unit.
Hyperbilirubinemia in intensive care unit (ICU) patients is common. We hypothesized that hyperbilirubinemia in the surgical ICU predisposes patients to infection. ⋯ There is an increased susceptibility to infection among jaundiced surgical ICU (SICU) patients that persists even when sepsis-related hyperbilirubinemia patients are excluded.