Arch Surg Chicago
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Comparative Study
Evaluation of a new hemostatic agent in experimental splenic laceration.
To compare the effectiveness of several hemostatic agents and to evaluate a new hemostatic agent (ReClot) in controlling splenic hemorrhage. ⋯ The hemostatic agent ReClot had a significant advantage over other hemostatic agents for the time required to achieve control of splenic bleeding. Aggressive fluid resuscitation did not limit the ability of ReClot to produce hemostasis.
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To evaluate anatomic, physiologic, and mechanism-of-injury prehospital triage criteria as well as the subjective criterion of provider "gut feeling." ⋯ A limited set of high-yield prehospital criteria are acceptable indicators of MTV. Isolated low- and intermediate-yield criteria may not be useful for initiating trauma center triage or full activation of hospital trauma teams.
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In recent years, many trauma centers have been closing or scaling down their operations because of financial losses and lack of commitment by the relevant authorities. ⋯ Commitment of financial and human resources for the establishment of a dedicated trauma program is a sound investment in terms of improved survival and fewer permanent disabilities in critically injured patients.
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Comparative Study
Comparison of APACHE II and III scoring systems for mortality prediction in critical surgical illness.
To determine whether the Acute Physiology and Chronic Health Evaluation III (APACHE III), an updated version of APACHE II that contains a larger number of postoperative patients in the normative database, offers better prediction in critical surgical illness. ⋯ In institutions or groups of patients where APACHE II underestimates mortality, APACHE III may be corrective. However, the differences are subtle and may be difficult to detect in smaller studies.
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Comparative Study
Postoperative course after inguinal herniorrhaphy. A case-controlled comparison of patients receiving workers' compensation vs patients with commercial insurance.
To confirm our observation that patients with work-related hernias, when compared with self-employed patients, had longer recovery times and prolonged pain after hernia repairs, we reviewed our recent experience in a series of patients undergoing inguinal hernia repairs. ⋯ We believe our results confirm the observation that type of insurance coverage influences post-operative recovery time after inguinal herniorrhaphy. Other studies measuring a patient's outcome after surgical procedures such as herniorrhaphy should include type of insurance coverage as a factor that might affect early return to work. Using multivariate analysis, the only variable independently affecting the duration of pain after hernia repair was the type of insurance coverage (P < .005).