The American surgeon
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Analysis of blood by polymerase chain reaction (PCR) is a more rapid and sensitive method to detect bacteremia than blood culture. The PCR was performed on blood obtained from patients during blood culture draws and on blood from normal volunteers. Eighty-seven patients provided 125 blood samples for blood culture comparison with PCR. ⋯ Only three of the 78 specimens with negative PCR had positive blood cultures. The PCR was negative in all but one of the 50 volunteers. PCR is more sensitive than blood culture, and it can quickly rule out bacteremia.
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This is a report of a 10-year experience (1989-1998) with 300 consecutive patients found to have an injury to a named abdominal vessel at the time of an exploratory laparotomy for trauma. An abdominal gunshot wound was the mechanism of injury in 78 per cent of patients, and injury to more than one named abdominal vessel was present in 42 per cent. The abdominal aorta, inferior vena cava, and external iliac artery and vein were the most commonly injured vessels. ⋯ Despite significantly increased Injury Severity Scores for patients treated from 1993 through 1998 as compared with those treated from 1989 through 1992 survival rates for patients with injuries to the abdominal aorta and inferior vena cava were unchanged. Survival rates for injuries to the external iliac artery and vein increased significantly. The local changes in management should be considered for prospective studies in other urban trauma centers.
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The American surgeon · Jun 2001
Historical ArticleThe history of the Gold Medal Papers of the Southeastern Surgical Congress: 1960-2000.
Since 1960 at its annual meeting the Southeastern Surgical Congress has selected a varying number of "Gold Medal Papers" to be presented. Customarily a prize is awarded for the first place among the Gold Medal Papers and in some instances a second and third place. ⋯ With the assistance of the Executive Secretary of the Southeastern Surgical Congress a list of the Gold Medal presenters insofar as can be ascertained from the Council minutes is presented. It is unfortunate that all of the names of the Gold Medal Paper presenters have not been preserved.
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Our objective was to evaluate a new technique for the bedside placement of nasoenteral feeding tubes into the duodenum using an external hand-held magnet to maneuver the tube from the stomach to the distal duodenum. We conducted a prospective case series of 20 consecutive patients requiring nasoenteral tube feeding in the intensive care units of a university-affiliated hospital. Twenty patients were entered into the study after the attending physician requested assistance in tube placement. ⋯ There were no complications related to the procedure. Using a novel magnetically guided nasoenteral feeding tube transpyloric tube placement was achieved in 95 per cent of cases with an average procedure time of 9.6 minutes. This new and inexpensive bedside technique will allow prompt and safe initiation of enteral nutrition.