Journal of the American College of Surgeons
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Developments in the specialty of general surgery have never been more important, nor have the opportunities for general surgeons been more exciting, than at the present. Technologic advances and the expansion of basic knowledge of surgical diseases have contributed to this renaissance of the field. ⋯ Education of the student preparing for a nonsurgical career in the fundamental concepts underlying surgical therapy must be kept at the forefront of an undergraduate surgical curriculum. Integration and coordination of graduate surgical education in all of the general surgery-based specialties is an important obligation for the future, as knowledge expands in each specialty and the need for more specialty-specific education becomes apparent.
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Editorial Comment
Cardiopulmonary resuscitation in the intensive care unit.
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Continuous arteriovenous hemofiltration does not improve survival in a canine model of septic shock.
We examined whether or not continuous arteriovenous hemofiltration (CAVH), in the absence of renal failure, would improve either hemodynamic abnormalities or survival in a canine model of septic shock. ⋯ The results of this study suggest that CAVH would be unlikely to provide benefit to patients with gram-negative septic shock, in the absence of renal failure.
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We have previously shown high morbidity and mortality rates in patients with acquired immunodeficiency syndrome (AIDS) who require emergency abdominal operations. In a larger series of patients, we have investigated the reasons for these findings and have hypothesized that they are primarily the result of starvation and decreased resistance to infection. ⋯ Patients who meet the criteria for the diagnosis of AIDS have increased morbidity and mortality rates after emergency abdominal operations. This, however, should not exclude these patients from operation when it is indicated because many will survive and benefit from the operative procedure. Attention to nutritional support and the early diagnosis and treatment of associated infectious complications may result in decreased morbidity and mortality rates subsequent to the emergency abdominal operations.