Arch Surg Chicago
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Necrotizing soft tissue infection masquerading as cutaneous abcess following illicit drug injection.
To assess factors that might predict serious necrotizing soft tissue infections following illicit drug injection. ⋯ Parenteral injections of illicit drugs can produce infections that present with signs of simple cutaneous abscess and yet unpredictably become extensive necrotizing soft tissue infections. Treatment requires a high index of suspicion along with an inquisitive operative approach to avoid missing these potentially serious infections.
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The need for cardiopulmonary bypass in the treatment of penetrating heart injuries is debated. ⋯ Cardiopulmonary bypass was ineffective in salvaging patients with cardiogenic shock but was essential in some patients with complex multiple-chamber cardiac injuries that could not be exposed and repaired by other means.
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Randomized Controlled Trial Clinical Trial
Prophylactic iron supplementation after Roux-en-Y gastric bypass: a prospective, double-blind, randomized study.
To determine whether prophylactic oral iron supplements (320 mg twice daily) would protect women from iron deficiency and anemia after Roux-en-Y gastric bypass. ⋯ Prophylactic oral iron supplements successfully prevented iron deficiency in menstruating women after Roux-en-Y gastric bypass but did not consistently protect these women from developing anemia. On the basis of these results we now routinely recommend prophylactic iron supplements to menstruating women who have Roux-en-Y gastric bypass.
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To demonstrate the helical computed tomographic (CT) features of small polypoid lesions of the gallbladder and to establish a clinical strategy based on CT findings for the treatment of such lesions. ⋯ Computed tomography can differentiate neoplastic and nonneoplastic small polypoid lesions of the gallbladder and reliably identify the presence of neoplastic lesions that should be resected.
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Video-assisted thoracic surgery (VATS) appears to be replacing open thoracotomy for the treatment of posttraumatic thoracic complications. ⋯ Video-assisted thoracic surgery was a safe and effective operative strategy for the treatment of posttraumatic empyema. Therefore, because VATS has been shown in nontrauma patients to reduce morbidity and because it provides better cosmesis, we believe that it should be the initial operative approach to trauma patients with suspected posttraumatic empyema.