The Journal of surgical research
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The relationship between elastolytic matrix metalloproteinases (MMPs) (such as MMP-2, MMP-9) and thoracic aortic dissection (TAD) has been described, but little is known regarding the role of collagenolytic MMPs in thoracic aortic dissection. The aim of this study was to determine the role of MMP-8 in acute thoracic aortic dissection. ⋯ The acute phase of TAD is characterized by a prominent increase of MMP-8 plasma level, which may play a key role in the occurrence of TAD. MMP-8 could be involved in the acute inflammatory reaction and may be a useful marker for the diagnosis of acute TAD.
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Randomized Controlled Trial Comparative Study
Predictors of surgical site infection in laparoscopic and open ventral incisional herniorrhaphy.
Surgical site infection (SSI) after ventral incisional hernia repair (VIH) can result in serious consequences. We sought to identify patient, procedure, and/or hernia characteristics that are associated with SSI in VIH. ⋯ Open surgical technique and the medical center rather than patient co-morbidities or hernia characteristics are associated with the formation of postoperative SSI in VIH.
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The aim of this study is to evaluate the prognostic significance of preoperative and postoperative serum carcinoembryonic antigen (CEA) levels in patients with stage I non-small-cell lung cancer. ⋯ Age (≥65 years) and preoperative and postoperative serum CEA levels are independent prognostic factors in patients with stage I lung cancer. Patients with a persistently high serum CEA level after surgery had worst survival, and may be good candidates for adjuvant chemotherapy.
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Laparotomy is commonly performed as an emergency operation. It is often performed on elderly patients with high risks of mortality and morbidity. Currently, there is no accurate scoring system to predict mortality and morbidity, preoperatively, in these circumstances. This study was conducted to develop a scoring system that can accurately predict the risk of in-hospital mortality and complications for these patients in the emergency department prior to surgery. ⋯ Mortality and morbidity after emergency laparotomy are closely related to the presence or absence of acute physiologic impairment and the presence or absence of chronic organ system failure. The Simple Prognostic Index (SPI) is a simple scoring system for prediction of mortality and morbidity prior to emergency laparotomy.
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Evidence-based medicine has gained wide acceptance in practice of medicine since the 1990s. The objective of our study was to demonstrate the effect of evidence-based critical care practices on ICU and hospital length of stay in mechanically ventilated trauma patients. ⋯ The application of evidence-based critical care practices decreases length of ICU and hospital stay, but not mortality, in critically ill, mechanically ventilated trauma patients. Our trauma volume, including critically ill patients, increased during the study periods.