The European journal of surgery = Acta chirurgica
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison between sterile saline and tap water for the cleaning of acute traumatic soft tissue wounds.
To find out if there were any differences in infection rates if acute traumatic soft tissue wounds were cleaned with tap water instead of sterile saline. ⋯ Sterile saline should be replaced by tap water for the cleaning of acute traumatic superficial soft tissue wounds.
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A 49-year-old woman with a 2-month history of mild dysphagia and three episodes of haematemesis was found at endoscopy and barium swallow to have an epiphrenic oesophageal diverticulum containing an ulcerating crypt, but no ectopic gastric epithelium. Diverticulectomy and lower oesophageal myotomy gave a good result.
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Because perioperative blood transfusions have been shown to have an impaired effect on survival in patients with colorectal cancer, we examined retrospectively the records of 882 patients who had undergone curative operations: 170 patients had distant metastases at the time of operation. Of the 499 patients with colonic cancer 332 (67%) had received perioperative blood transfusions. The corresponding figure for the 213 patients with rectal cancer was 190 (89%). ⋯ This difference disappeared when the influence of age was eliminated. The estimated risk ratio of recurrence and death was 1.23 with the 95% confidence interval (0.99, 1.53) when taking Dukes' grade, current age and localization into account. Blood transfusion should be avoided if possible until adequate prospective studies have been carried out.
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To audit all stab wounds of the pericardium and heart treated by a policy of immediate exploration over a period of 17 years, and identify any factors predictive of outcome. ⋯ Some unrecordable factors--for example, the skill of the team on duty--may have had a considerable influence on outcome.