ANZ journal of surgery
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ANZ journal of surgery · Mar 2013
Five-year results of surgical colorectal cancer treatment in rural Australia.
The incidence of colorectal cancer in Australia is among the highest worldwide. We investigate whether similar treatment results for colorectal cancer can be achieved in rural surgery as reported from metropolitan centres. ⋯ Assessment of overall and cancer-specific survival of all patients undergoing surgery for colorectal cancer over a 5-year time period in a rural South Australian centre shows that good long-term results can be achieved with low perioperative mortality. These findings compare well with the results of other groups.
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Bisphosphonates decrease the risk of typical low trauma fractures, and are commonly prescribed for this indication. The link between atypical fractures and bisphosphonate use is well established; however, who is susceptible to atypical fracture remains unclear. A number of large population-based studies have disregarded the atypical fracture risk as they have found the absolute risk to be low. ⋯ The burden of bisphosphonate-associated atypical fractures is significant. The aetiology of these fractures is unclear, and to date, no studies have demonstrated the significance of the injury for the patient. Prescription of bisphosphonate therapy for osteoporosis should be accompanied by ongoing surveillance and warning of the possibility of atypical and minimal trauma fractures.
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ANZ journal of surgery · Jan 2013
The value of biochemical markers in predicting a perforation in acute appendicitis.
Acute appendicitis is the most common surgical diagnosis of abdominal pain. Perforated appendicitis can result in increased morbidity and mortality. Identifying a perforation early can reduce the impact on the patient. Bilirubin, C-reactive protein (CRP) and white cell count (WCC) have been shown to indicate perforation in appendicitis. This study aimed to identify whether these biochemical markers can be used to identify if patients are suitable for either a conservative or surgical approach. ⋯ Bilirubin and CRP are markers of perforation in appendicitis, but are not accurate enough to be diagnostic. In a patient with high clinical suspicion of acute appendicitis, a raised CRP and bilirubin suggests that a patient is not suitable for conservative treatment.
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ANZ journal of surgery · Jan 2013
Growing trend in older patients with severe injuries: mortality and mechanisms of injury between 1991 and 2010 at an inner city major trauma centre.
Elderly patients with major trauma are an increasingly important public health concern. The objective of the study was to describe the long term trend in patients aged 65 years and older with major trauma. ⋯ There has been a disproportionate increase in the proportion of major trauma due to older patients at this institution over the past twenty years. If this trend continues, it is likely to have significant impacts on future hospital and rehabilitation resources.
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ANZ journal of surgery · Jan 2013
Effect of the elderly and increasing injury severity on acute hospital resource utilization in a cohort of inner city trauma patients.
This study aimed to determine the relative effect of elderly patients and increasing injury severity on acute hospital costs and inpatient length of stay. ⋯ Both injury severity and elderly patients have a significant impact on acute hospital costs across the spectrum of major and minor trauma.