American journal of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
Ertapenem or ticarcillin/clavulanate for the treatment of intra-abdominal infections or acute pelvic infections in pediatric patients.
Ertapenem, a group I carbapenem antibiotic, has been shown to be safe and effective in treating adults with complicated intra-abdominal (cIAI) or acute pelvic infection (API). This study evaluated ertapenem for treating these infections in children. ⋯ This study suggests that ertapenem is generally safe and efficacious for treating cIAI or API in pediatric patients.
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The impact of high-fidelity simulators as an adjunct for endovascular training of general surgery residents has not yet been defined. The purpose of this study was to evaluate general surgery resident perspectives on the value of a simulator-based endovascular training program by using various measurement tools. ⋯ Based on subjective and objective measures, general surgery residents found valuable and benefited in knowledge base from a focused simulator-based endovascular training program. Integrating endovascular simulation into general surgery resident training and its influence on resident interest in vascular specialization as a career choice holds future potential.
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The antidiabetic effect of bariatric surgery has been interpreted as a conceivable result of surgically induced weight loss and decreased caloric intake. However, glycemic control often occurs within days, before significant weight loss has been reached. The aim of our work was to investigate the hormones that control glycemic status in diabetes mellitus after a duodenal-jejunal exclusion in an animal model of nonobese type 2 diabetes. ⋯ Gastrojejunal bypass in a nonobese diabetic model improves glycemic control with a significant decrease in leptin levels, without changes in enteroinsular axis (GLP-1, GIP, glucagons, and insulin levels).
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Controlled Clinical Trial
Administration of cancer chemotherapeutic drugs through the enhanced peripheral veins by creating a radiocephalic fistula.
Administration of chemotherapy through peripheral veins is a morbid procedure. The alternatives include implantable venous ports with associated cost and complication of buried foreign body. ⋯ Ten patients were offered this new technique after prior informed consent and were followed prospectively for 1 year. Venous accessibility was excellent in the experimental arm with no incident of erythema, thrombophlebitis, or skin necrosis. No significant alteration was found in cardiac parameters at 1, 6, and 12 months post AVF surgery. The procedure proved economical and affordable for a majority of our patients.
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Perioperative treatment with beta-blockade is a widely advocated practice. We assessed the preoperative, intraoperative, and postoperative control of heart rate (HR) in patients who received beta-blockade as recommended during preoperative medicine clearance. ⋯ Beta-blockade is achieved sufficiently in the preoperative and intraoperative settings. However, attention to postoperative HR may be warranted to maintain the benefits of beta-blockade.