Arch Surg Chicago
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Clinical Trial
Utility of routine chest radiographs in the surgical intensive care unit. A prospective study.
To correlate patient condition and reasons for obtaining chest radiographs (CXRs) with the utility of CXRs in critical illness and to determine the potential impact of stricter criteria for obtaining a CXR in a surgical intensive care unit (ICU). ⋯ Chest radiographs should only be obtained on surgical ICU patients for specific indications. Routine CXRs for ICU patients are justified only for patients with indwelling Swan-Ganz catheters.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Interleukin-1 blockade attenuates mediator release and dysregulation of the hemostatic mechanism during human sepsis.
To define the influence of interleukin-1 activity on coagulation and fibrinolytic system activation and the release of proinflammatory mediators in the early human response to severe infection. ⋯ The results confirm that activation of the coagulation and fibrinolytic systems and release of soluble inflammatory mediators are consistently observed in patients with severe sepsis syndrome. Interleukin-1 activity contributes to activation of these processes as documented by the reduction in surrogate activation markers during recombinant human interleukin-1 receptor antagonist treatment.
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To identify the criteria deficiencies found during peer consultation of hospitals and the relationship to subsequent verification. ⋯ American College of Surgeons consultation assists hospitals to identify their trauma center capability and appears to improve their ability to pass subsequent trauma center verification. Most criteria deficiencies are correctable. Lack of commitment by the surgeons or hospital is difficult to correct. There is an inverse relationship between the number of deficiencies and subsequent verification.
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To evaluate the incidence and severity of grease and oil burns in children and to discuss prevention. ⋯ Grease burns often result in long-lasting, disfiguring, and debilitating injuries. Home deep fryers are frequently involved in these injuries. Careful use of these appliances is mandatory. Increased public awareness is vital to this effort.
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To determine the complication rate and risk factors associated with tube thoracostomy (TT) in the trauma patient. ⋯ Tube thoracostomy is associated with significant morbidity. The striking difference in the complication rate between surgeons and other physicians who perform this procedure suggests that additional training may be indicated.