Annals of surgery
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Comparative Study
Health-related quality of life after different types of solid organ transplantation.
To describe functional health and health-related quality of life (QOL) before and after transplantation; to compare and contrast outcomes among liver, heart, lung, and kidney transplant patients, and compare these outcomes with selected norms; and to explore whether physiologic performance, demographics, and other clinical variables are predictors of posttransplantation overall subjective QOL. ⋯ Different types of transplant patients have a different health-related QOL before transplantation. Performance improved after transplantation for all four types of transplants, but the trajectories were not the same. Subjective QOL measured by the SF-36 and the PAIS also improved after transplantation. Path analysis shows the important predictors of health-related QOL. These data provide clearly defined and widely useful QOL outcome benchmarks for different types of solid organ transplants.
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To determine which patient factors affect the degree of catabolism after severe burn. ⋯ Heavier, more muscular subjects, and subjects whose definitive surgical treatment is delayed are at the greatest risk for excess catabolism after burn. Sepsis and excessive hypermetabolism are also associated with protein catabolism.
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To build a predictive tool for assessing both favorable outcome and morbidity in a large series of unruptured aneurysms. ⋯ It is possible to predict outcome in patients with unruptured middle cerebral artery aneurysm by calculating FAI. The postoperative morbidity increases with an FAI within a range of 3 to 4.
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Randomized Controlled Trial Clinical Trial
Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial.
To evaluate the endpoints of complications (specifically pancreatic fistula and total complications) and death in patients undergoing pancreaticoduodenectomy. ⋯ These data demonstrate that the prophylactic use of perioperative octreotide does not reduce the incidence of pancreatic fistula or total complications after pancreaticoduodenectomy. Prophylactic octreotide use in this setting should be eliminated, at a considerable cost savings.
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To examine the impact of laparoscopic nephrectomy and recipient education on the proportion of kidney recipients who could identify a potential live donor, and on the live donor (LD) transplantation rate. ⋯ The availability of LDN and an LD family education program has doubled the live donor transplantation rate, and outcomes remain excellent.