Annals of surgery
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Comparative Study
Enteral nutrition prevents remote organ injury and death after a gut ischemic insult.
To determine whether parenteral feeding (IV-TPN) influences the local and systemic response to an intestinal insult. ⋯ Enteral feeding reduced the death rate and organ permeability after 15 minutes of ischemia. However, prolonged ischemia (30 minutes) eliminated any benefits of intragastric TPN on survival.
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To determine the success of a clinical pathway for outpatient laparoscopic cholecystectomy (LC) in an academic health center, and to assess the impact of pathway implementation on same-day discharge rates, safety, patient satisfaction, and resource utilization. ⋯ Implementation of a clinical pathway for outpatient LC was successful, safe, and satisfying for patients. Converting LC to an outpatient procedure resulted in a significant reduction in medical resource use, including a decreased length of stay and total cost of care.
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To screen a library of small chemicals for compounds that activate the DPC4 signal transduction pathway in a human pancreatic cancer cell line. ⋯ These results confirm the feasibility of a specific high-throughput reporter system to screen a large compound library in human cells efficiently. The screening identified several compounds capable of augmenting DPC4-specific luciferase reporter activity, and a specific mechanism for one compound was identified. The discovery of such agents will aid our understanding of complex tumor-suppressive signaling pathways and may identify other potential therapeutic targets within this critical signaling pathway. In addition, random drug screening provides an unbiased method for identifying drugs or lead compounds for potential therapeutic use.
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Randomized Controlled Trial Clinical Trial
Double-blind placebo-controlled trial of fluconazole to prevent candidal infections in critically ill surgical patients.
To evaluate the prophylactic use of enteral fluconazole to prevent invasive candidal infections in critically ill surgical patients. ⋯ Enteral fluconazole safely and effectively decreased the incidence of fungal infections in high-risk, critically ill surgical patients.
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To explore the hypothesis that oxandrolone may reverse muscle catabolism in cachectic, critically ill pediatric burn patients. ⋯ In burn victims, oxandrolone improves muscle protein metabolism through enhanced protein synthesis efficiency. These findings suggest the efficacy of oxandrolone in impeding muscle protein catabolism in cachectic, critically injured children.