The American surgeon
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In recent years, trauma care delivery has come under close scrutiny from within and outside the medical profession. With the development and designation of trauma centers, two problems have become evident. First is a reliable, simple means of triaging patients to the appropriate facility. ⋯ From July 1, 1985 through June 30, 1986, 495 patients were admitted to the trauma service at the Medical College of Georgia. All patients were given a trauma score on arrival to the emergency department. The trauma score can be used as a quality assurance tool by any physician or hospital providing trauma services as will be demonstrated by analyzing our data.
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The American surgeon · Mar 1988
Intra-aortic balloon cardiac assist: complication rates for the surgical and percutaneous insertion techniques.
A retrospective study was performed to evaluate complications with the two most common intra-aortic balloon pump (IABP) insertion techniques. During a nine year period, 202 patients (51 women, 151 men) underwent IABP cardiac assist utilizing the arteriotomy surgical (103 balloons) and percutaneous (99 balloons) insertion techniques. Complications, including asymptomatic loss of pedal pulse, vascular-symptomatic, infection, or balloon rupture occurred in 22.8 per cent of patients. ⋯ The number of patients requiring surgical intervention or removal was not significantly different between the surgical and percutaneous methods (9 versus 18%, P = .06). While the method of IABP insertion did not significantly alter hospital mortality, a significantly greater complication rate was observed with percutaneous insertion (P = .007). This was particularly relevant to complications occurring at the time of removal of IABP.
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The American surgeon · Jan 1988
Comparative StudySurface oximetry. A new method to evaluate intestinal perfusion.
Accepted methods to evaluate intestinal vascularity intraoperatively include standard clinical criteria (SCC), doppler ultrasound (DUS), and intravenous fluorescein (FLF). A combination of methods is often used to overcome disadvantages of individual techniques. ⋯ POX uses a commercially available instrument to assess tissue oxygenation and arterial flow, and is rapid, reproducible, and noninvasive. POX appears to be a superior technique when compared to SCC and DUS.
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Hypothermia is a frequent complication of severe hemorrhagic shock and can complicate the treatment of trauma patients. The authors have investigated the effect of external warming on a treated model of hemorrhagic shock in rats. Their data show that externally heating the animal during the shock period decreases the animal's ability to withstand shock and increases intrashock and postshock mortality when compared to nonheated controls. The authors have also shown that nonheated animals that can retain body heat by passive retention can withstand increased shock time and have an increased postshock survival.
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The American surgeon · Nov 1987
The diagnostic value of laparoscopy in women with chronic pelvic pain.
Laparoscopy was performed in 130 patients with chronic pelvic pain. Laparoscopy confirmed the preoperative diagnosis of pelvic inflammatory disease (PID) in 41 of 63 women with preoperative diagnosis of chronic PID (65%), whereas in 8 (13%), no pathologic findings were revealed. ⋯ Of the total group, laparoscopy prevented laparotomy in 20 cases. These results are in accord with those of previous studies and emphasize the importance of laparoscopy in the management of women with chronic pelvic pain.