Annals of surgery
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To determine the sensitivity of emergency department ultrasonography (US) in the diagnosis of occult cardiac injuries. ⋯ The sensitivity of US to detect hemopericardium in stable patients was only 86.7%. The 2 main factors that limit the screening are the presence of a hemothorax and air in the pericardial sac. A new regimen for screening of occult injuries to make allowance for this is proposed.
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To assess the proportion of outpatient surgery currently delivered in ambulatory surgery centers (ASCs) unconnected to nearby hospitals. ⋯ Most ASCs are strongly connected to their local health system. Thus, efforts to constrain spending should target population-based rates of surgery, not unconnected ASCs.
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To assess the long-term survival and quality of life in total pancreatectomies and to identify risk factors for perioperative morbidity and mortality. ⋯ Standard total pancreatectomy, if needed, is associated with good long-term outcome in pancreatic cancer. Marked surgical morbidity and impaired survival associated with vascular resections reflect the invasiveness of extended total pancreatectomies and the underlying advanced malignant disease.