Arch Surg Chicago
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Despite improvements in diagnostic and surgical techniques, operative mortality associated with liver resection is still greater than 2% in most of the recent studies. ⋯ Liver resection can be performed without mortality provided that it is carried out in a high-volume medical center by well-trained hepatobiliary surgeons paying meticulous attention to the balance between the liver functional reserve and the volume of liver to be removed.
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The changes reported with pulse oximetry after the injection of isosulfan blue for sentinel lymph node identification in patients with breast cancer are consistent and predictable. ⋯ Although the changes in pulse oximeter readings can be substantial, their course appears to be predictable, and therefore in most otherwise healthy patients with normal pulmonary function, invasive monitoring is not necessary.
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The use of albumin in the early resuscitation formula after major burn has been forbidden because of its damaging effect on the gut barrier function. We hypothesize that inhibition of the inducible isoform of nitric oxide synthase to stabilize endothelial permeability and to retain albumin in the vascular space will ameliorate the major trauma-induced gut barrier dysfunction. ⋯ Early albumin resuscitation aggravated the burn-induced gut damage. Albumin administration and inhibition of the inducible isoform of nitric oxide synthase in combination decreased burn-induced gut barrier dysfunction and reversed the damaging effect of albumin on gut barrier function and decreased BT.
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To review the physiological changes in fluid and electrolytes that occur in aging. ⋯ There are age-related alterations in the homeostatic mechanisms used to maintain electrolyte and water balance. Health care providers must familiarize themselves with these alterations to guide treatment of this growing population.
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The level of cervical spinal cord injury (CSCI) can be used to predict the need for a cardiovascular intervention. ⋯ There was no significant difference in the frequency of neurogenic shock by injury level. Patients with a high CSCI (C1-C5) had a significantly greater requirement for a cardiovascular intervention compared with patients with lower injuries (C6-C7).