Annals of surgery
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To assess long-term survival and prognostic factors in a large series of patients with bile duct cancer. ⋯ R0 resection remains the best chance for long-term survival, and lymph node status is the most important prognostic factor following R0 resection.
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Almost 50% of traumatic brain-injured (TBI) patients are alcohol intoxicated. The Glasgow Coma Scale (GCS) is frequently used to direct diagnostic and therapeutic decisions in these patients. It is commonly assumed that alcohol intoxication reduces GCS, thus limiting its utility in intoxicated patients. The purpose of this study was to test the hypothesis that the presence of blood alcohol has a clinically significant impact on GCS in TBI patients. ⋯ Alcohol use does not result in a clinically significant reduction in GCS in trauma patients. Attributing low GCS to alcohol intoxication in TBI patients may delay necessary diagnostic and therapeutic interventions.
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Review the evidence regarding methods to prevent wrong site operations and present a framework that healthcare organizations can use to evaluate whether they have reduced the probability of wrong site, wrong procedure, and wrong patient operations. ⋯ There is limited evidence of behavioral interventions to reduce wrong site, patient, and surgical procedures. We have outlined a framework of measures that healthcare organizations can use to start evaluating whether they have reduced adverse events in operations.
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Multicenter Study
The association between fluid administration and outcome following major burn: a multicenter study.
To determine patient and injury variables that influence fluid requirements following burn injury and examine the association between fluid volume received and outcome. ⋯ TBSA, age, weight, and intubation status on admission were significant predictors of fluid received. Patients who received larger volumes of resuscitation fluid were at higher risk for injury complications and death.
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Randomized Controlled Trial
Preoperative hepatic and regional arterial chemotherapy in the prevention of liver metastasis after colorectal cancer surgery.
To investigate whether preoperative hepatic and regional arterial chemotherapy is able to prevent liver metastasis and improve overall survival in patients receiving curative colorectal cancer resection. ⋯ Preoperative hepatic and regional arterial chemotherapy, in combination with surgical resection, could be able to reduce and delay the occurrence of liver metastasis and therefore improve survival rate in patients with stage III colorectal cancer.