The American surgeon
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Traumatic cardiac or pulmonary arrest is often associated with a dismal outcome and is considered by many to be an example of medical futility and inappropriate use of resources. This study aimed to identify the predictors of survival in patients experiencing traumatic cardiac arrest. We retrospectively reviewed all trauma patients undergoing cardiopulmonary resuscitation on arrival to the Emergency Department (ED) at an American College of Surgeons-designated Level I trauma center over 4 years. ⋯ The presence of sinus rhythm and nondilated reactive pupils was highly significant in predicting ED and hospital survival (P = 0.001). No patient with agonal rhythm or ventricular fibrillation/tachycardia survived, and 14 of the 15 hospital survivors had reactive pupils on arrival to the ED. We conclude that sinus rhythm and pupil size and reactivity are important physiologic variables that predict potential survival and may be used to guide continuation of resuscitative efforts in patients with traumatic cardiac arrest.
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The American surgeon · Feb 2003
Case ReportsLiposarcoma of the spermatic cord masquerading as an incarcerated inguinal hernia.
We present a rare case of liposarcoma of the spermatic cord. There are only 61 reports in the literature. The presenting complaint is usually a painless bulge in the inguinal or scrotal region. ⋯ The treatment for a spermatic cord liposarcoma is radical orchiectomy with high ligation of the cord. Radiation therapy is recommended in addition to surgery in situations with evidence of tumor with propensity for more aggressive behavior (i.e., high-grade tumor, lymphatic invasion, inadequate margin, or recurrence). The current literature, diagnosis, and management of malignant tumors of the spermatic cord are reviewed.