Arch Surg Chicago
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Multicenter Study Comparative Study
Risk factors for hepatic morbidity following nonoperative management: multicenter study.
Early risk factors for hepatic-related morbidity in patients undergoing initial nonoperative management of complex blunt hepatic injuries can be accurately identified. ⋯ Nonoperative management of high-grade liver injuries is associated with significant morbidity and correlates with grade of liver injury. Screening patients with transfusion requirements and high-grade injuries may result in earlier diagnosis and treatment of hepatic-related complications.
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Comparative Study
Whole body imaging in blunt multisystem trauma patients without obvious signs of injury: results of a prospective study.
The use of liberal whole body imaging (pan scan) in patients based on mechanism is warranted, even in evaluable patients with no obvious signs of chest or abdominal injury. ⋯ The use of pan scan based on mechanism in awake, evaluable patients is warranted. Clinically significant abnormalities are not uncommon, resulting in a change in treatment in nearly 19% of patients.
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Multicenter Study Comparative Study
Result of a national audit of bariatric surgery performed at academic centers: a 2004 University HealthSystem Consortium Benchmarking Project.
Bariatric surgery performed at US academic centers is safe and associated with low mortality. ⋯ Within the context of the 2004 University HealthSystem Consortium Bariatric Surgery Benchmarking Project, the risk for death within 30 days after bariatric surgery at academic centers is less than 1%. In addition, the practice of bariatric surgery at these centers has shifted from open surgery to predominately laparoscopic surgery. These quality-controlled outcome data can be used as a benchmark for the practice of bariatric surgery at most US hospitals.
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Good preoperative glycemic control (hemoglobin A(1c) [HbA(1c)] levels <7%) is associated with decreased postoperative infections. ⋯ Good preoperative glycemic control (HbA(1c) levels <7%) is associated with a decrease in infectious complications across a variety of surgical procedures.
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We investigated the frequency and reasons for conversion from cervical block anesthesia to general anesthesia (GA) in patients undergoing minimally invasive parathyroidectomy for primary hyperparathyroidism. ⋯ The vast majority of minimally invasive parathyroidectomies can be performed using cervical block anesthesia. However, conversion to GA is appropriate when unexpected intraoperative findings are encountered or for patient comfort.