Arch Surg Chicago
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To reassess the use of emergency thoracotomy in resuscitating victims of abdominal or thoracic trauma. ⋯ Emergency thoracotomy is a useful therapeutic modality for victims of penetrating trauma who have vital signs on admission to the hospital, and it should be considered in blunt trauma patients who present with any evidence of life. This modality is largely ineffective, however, in resuscitating victims of penetrating and blunt trauma who present to the hospital without vital signs.
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More than 160,000 women will develop breast cancer in the United States during the next year. Traditionally, their definitive surgery has been performed on an inpatient basis, with postoperative hospital stays ranging from 1 to 7 days. ⋯ Most operations for carcinoma of the breast can be performed on an outpatient basis, without increasing the risk of complications.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A multicenter trial for resuscitation of injured patients with 7.5% sodium chloride. The effect of added dextran 70. The Multicenter Group for the Study of Hypertonic Saline in Trauma Patients.
To evaluate the use of 250 mL of a 7.5% sodium chloride solution, both with and without added dextran 70, for the prehospital resuscitation of hypotensive trauma patients. ⋯ Prehospital infusion of 250 mL of 7.5% sodium chloride is associated with an increase in blood pressure and an increase in survival to hospital discharge compared with survival predicted by the MTOS norms. Patients with low baseline Glasgow Coma Scale scores seem to benefit the most from 7.5% sodium chloride resuscitation. Hypertonic saline solution without added dextran 70 is as effective as the more expensive solutions that contain dextran 70.
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Comparative Study
The role of duplex ultrasound arterial imaging in patients with penetrating extremity trauma.
To investigate the role of color-flow duplex ultrasound vascular imaging in screening patients for potential arterial injuries following penetrating trauma of the extremities. ⋯ Color-flow duplex imaging reliably detects occult arterial injuries and may also have a role in following up minor injuries treated without surgery.
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Comparative Study
Accuracy of ultrasound in the diagnosis of acute appendicitis compared with the surgeon's clinical impression.
To compare the accuracy of the surgeon's clinical diagnosis of acute appendicitis with that of an ultrasonographic examination of the abdomen. ⋯ The overall accuracy of ultrasonography in the diagnosis of appendicitis was statistically superior to that of the surgeon's clinical impression (P < .0001). However, 24% of the patients with normal ultrasound findings were ultimately found to have appendicitis at operation, emphasizing the point that ultrasonography cannot be relied on to the exclusion of the surgeon's careful and repeated evaluation.