Arch Surg Chicago
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of spinal vs general anesthesia via laryngeal mask airway in inguinal hernia repair.
The use of laryngeal mask airway and propofol in inguinal hernia repair results in shorter operative and recovery room times. ⋯ We found no differences between short-acting spinal anesthesia and general anesthesia via laryngeal mask airway with intravenous propofol in efficiency or in early or late outcomes after elective inguinal hernia repair. Surgeon and patient preferences appear to be the most important reasons for selecting an anesthetic technique for individual patients undergoing inguinal hernia repair.
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The success of an educational program in July 1999 that lowered the catheter-related bloodstream infection (CRBSI) rate in our intensive care unit (ICU) 3-fold is correlated with compliance with "best-practice" behaviors. ⋯ Although a previous educational program decreased the CRBSI rate, this was associated with only modest compliance with best practice principles when bedside audits were performed 18 months later. A behavioral intervention improved all identified deficiencies, leading to a nonsignificant decrease in CRBSIs.
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Comparative Study
Hospital teaching status and outcomes of complex surgical procedures in the United States.
Complex operations performed in teaching hospitals have similar outcomes as those performed in nonteaching hospitals. ⋯ Teaching hospitals have lower operative mortality rates for complex surgical procedures. However, the lower mortality rates at teaching hospitals can be explained by higher procedural volume.
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Randomized Controlled Trial Comparative Study Clinical Trial
The advantage of total thyroidectomy to avoid reoperation for incidental thyroid cancer in multinodular goiter.
To investigate the impact of total thyroidectomy on the rate of completion thyroidectomy for incidentally found thyroid cancer in euthyroid multinodular goiter. ⋯ We recommend total or near-total thyroidectomy in multinodular goiter to eliminate the necessity for early completion thyroidectomy in case of a final diagnosis of thyroid cancer.