American journal of surgery
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Review Meta Analysis
Stapler vs suture closure of pancreatic remnant after distal pancreatectomy: a meta-analysis.
Suture closure and stapler closure of the pancreatic remnant after distal pancreatectomy are the techniques used most often. The ideal choice remains a matter of debate. ⋯ No significant differences occur between suture and stapler closure with respect to the pancreatic fistula or intra-abdominal abscess after distal pancreatectomy, though there is a trend favoring stapler closure.
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Comparative Study
Protection against head injuries should not be optional: a case for mandatory installation of side-curtain air bags.
More than 9,000 vehicle occupants die each year in side-impact vehicle collisions, primarily from head injuries. The authors hypothesized that side-curtain air bags significantly improve head and neck safety in side-impact crash testing. ⋯ Side-curtain air bags significantly improve vehicle occupant safety in side-impact crash tests. Installation of these air bags should be federally mandated in all passenger vehicles.
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Comparative Study
Improved detection does not fully explain the rising incidence of well-differentiated thyroid cancer: a population-based analysis.
The increasing incidence of thyroid cancer may be an artifact of increased diagnostic scrutiny, permitting detection of smaller, subclinical thyroid cancers. Our objective was to examine trends in the incidence of well-differentiated thyroid cancers with large size and adverse pathological features. ⋯ While the model of improving screening does explain increased diagnoses of small thyroid cancers, significant rises in the incidence of large cancers, and cancers with clinically significant pathological adverse features, are harder to explain. Alternative hypotheses, including a true increase in cancer incidence, would seem to merit exploration.
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Emphysematous cholecystitis is an uncommon variant of acute cholecystitis, and a communication between biliary ducts and gastrointestinal tract should be evaluated. Making the diagnosis often is straightforward on plain abdominal radiography. Prompt diagnosis of emphysematous cholecystitis is critical, and the standard treatment is emergent cholecystectomy. In severely ill patients, percutaneous cholecystostomy with broad-spectrum antibiotics may be an alternative choice for treatment.
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Randomized Controlled Trial Multicenter Study Comparative Study
Multicenter prospective randomized trial comparing modified Limberg flap transposition and Karydakis flap reconstruction in patients with sacrococcygeal pilonidal disease.
There is still no consensus as to the optimal treatment for sacrococcygeal pilonidal disease (SPD). Many recommend off-midline closure, if any excisional procedure is to be selected. ⋯ The MLF technique and the Karydakis procedure appear to generate comparable outcomes. With laterally situated orifices, however, the applicability of the Karydakis method may be limited.