American journal of surgery
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Although most breast abscesses can be treated with the current first-line treatment of antibiotics by needle aspiration, the therapeutic duration is lengthy and recurrences often occur. Therefore, we aimed to investigate the clinical efficacy of the Mammotome biopsy system (Johnson & Johnson Corp., New Brunswick, NJ) in a cohort of patients with breast abscesses. ⋯ The Mammotome biopsy system, an effective treatment strategy that is minimally invasive and less damaging, in combination with appropriate antibiotic therapy can be used safely as the first-line approach to breast abscess management.
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Although longevity is becoming frequent, there are no scores to assess nonagenarians undergoing emergency surgery. The aim of this prospective observational study was to determine 30-day mortality and the individual performance of the Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (POSSUM) and other scores in predicting their risk for death. ⋯ In a population with as high a risk as nonagenarians, the age-modified POSSUM proved accurate to audit surgery and assess mortality risk.
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Comparative Study Clinical Trial
A comparison of thoracic CT and abdominal CT for the identification of thoracic blunt trauma.
In light of current trends to limit radiation exposure and costs, as well as increased traffic safety, computed tomography (CT) may have decreasing value for evaluating patients with blunt trauma. The authors examined the utility of chest x-ray and abdominal CT for identifying clinically significant thoracic blunt trauma. ⋯ Clinically significant injuries can be identified with abdominal CT and chest x-ray, safely allowing reductions in radiation exposure, hospital stays, and costs by limiting the use of thoracic CT.
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A minimum of 12 lymph nodes has been endorsed as a quality measure to confirm node-negative colon cancer, but its relevance to early-stage rectal cancer is unclear. ⋯ Five-year overall survival improved as the number of sampled nodes increased. A thorough lymphadenectomy should routinely be performed to optimize staging and to improve survival of patients with early-stage rectal cancer.
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Hormone replacement therapy increases the number and quality of grafts recovered from brain-dead organ donors. Arginine vasopressin (AVP) has also been shown to have beneficial effects. The aim of this study was to determine the effect of AVP on recovery rates. ⋯ The use of AVP with hormone replacement therapy is independently associated with an increased rate of organ recovery. This strategy should be universally adopted in the management of donors progressing to neurologic death.