Abstract:
:Infections that involve the attention of the surgeon include those that require operations for cure as well as those that complicate emergency and elective surgical procedures. Mechanical correction is of paramount importance in the eradication of such infections with antibiotics serving an adjuvant role, primarily to clear lymphatics and prevent bacteremia and seeding of distant sites. Review of the current hospital antibiotic susceptibility profile is important to determine likely sensitivity to expected pathogens. Infection of the urinary tract remains the most common nosocomial infection, but in surgical patients the severe infections are pneumonia, fasciitis, and peritonitis. Often caused by the gram-negative Enterobacteriaceae, empiric broad spectrum antibiotic therapy is initiated after cultures are obtained. Bacterial infection of the respiratory tract is often difficult to diagnose in severely ill patients because the underlying fever, leukocytosis, and chest X-ray changes are often nonspecific. Reliance on sputum gram stain and culture is important to guide antibiotic therapy. Empiric treatment of peritonitis requires knowledge of the normal enteric flora and the likely pathogenic organisms. The most lethal agent against obligate anaerobic organisms is atmospheric oxygen, yet antibiotic coverage against these organisms appears wise, particularly when debridement or resection will be delayed or not performed. Staphylococcus aureus is still the most commonly cultured organism from our Surgical Intensive Care Unit and Burn Unit and S. aureus is often responsible for central line and burn wound infection. For patients in septic shock, we favor administration of a broad-spectrum penicillin or cephalosporin combined with an aminoglycoside, with subsequent narrowing of the antibiotic spectrum based on culture results. Antibiotic efficacy, toxicity, efficiency, and cost all must be weighed in the decision-making process.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Cheadle WGdoi
10.1016/s0002-9610(06)80057-7subject
Has Abstractpub_date
1992-10-01 00:00:00pages
44S-47Sissue
4A Suppleissn
0002-9610issn
1879-1883pii
S0002-9610(06)80057-7journal_volume
164pub_type
杂志文章abstract::The success of gastric restriction procedures for morbid obesity depends on a persistently small gastric pouch and stoma, an intact staple line, and, of equal importance, dietary compliance. Evaluation of patients with either excessive or inadequate weight loss should be directed at determining both the technical adeq...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90200-3
更新日期:1983-03-01 00:00:00
abstract::Thirty patients with carcinoid tumors of the ileum over a recent 10-year period have been analyzed. Seventeen patients were symptomatic and 13 others were found to have tumors incidentally at autopsy or celiotomy. Patients with symptoms almost invariably had metastatic disease, yet preoperative diagnosis was rarely ac...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90272-6
更新日期:1983-07-01 00:00:00
abstract::Ostomy closure following the Hartmann procedure is perceived to be associated with higher morbidity and mortality rates than is ostomy closure following divided colostomy, loop colostomy, and divided ileostomy-colostomy so that ostomy closure after Hartmann procedure may be denied to certain patients. To test that per...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90125-w
更新日期:1991-12-01 00:00:00
abstract::This study is a retrospective review of 18 patients treated from 1964 to 1990 with inguinal lymph node metastases from rectal adenocarcinoma. Statistical analyses were performed to determine the effects of sex, disease-free interval, extent of inguinal lymph node metastases, and the presence of extranodal disease upon...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80204-1
更新日期:1994-09-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to determine if there are clinical features that raise suspicion for parathyroid hyperplasia. MATERIALS & METHODS:We retrospectively reviewed patients with primary hyperparathyroidism who underwent parathyroidectomy from 1991 to 2017, analyzing demographics, calcium and PTH, ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.10.051
更新日期:2018-03-01 00:00:00
abstract::The human papillomavirus (HPV) has been shown to be associated with neoplasms of the human colon using immunohistochemistry and in situ hybridization. We now report our use of the polymerase chain reaction and Southern blotting to investigate that same association. We selected 38 carcinomas, 21 adenomas, and 24 normal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80690-7
更新日期:1993-12-01 00:00:00
abstract::We performed a large single-center prospective randomized controlled study to assess the role of peritoneal drainage in simple elective cholecystectomy. In 248 patients, drains were omitted; 122 patients had closed suction drains and 124 had Penrose drains. There were no deaths, and no patient required reoperation or ...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:10.1016/s0002-9610(05)80271-5
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:Hemoperfusion with PMX-F (polymyxin B covalently immobilized on fibers) has been reported to be safe and effective for patients with septic shock. However, the molecular mechanism of this usefulness is not yet clear. The purpose of this study was to evaluate whether the expression of CD14, human leukocyte an...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.12.067
更新日期:2004-08-01 00:00:00
abstract:BACKGROUND:Hypocalcemia caused by transient or definitive hypoparathyroidism is the most frequent complication after thyroidectomy. We aimed to compare the impact of incidental parathyroidectomy and serum vitamin D(3) level on postoperative hypocalcemia after total thyroidectomy (TT) or near total thyroidectomy (NTT). ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.01.032
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:Administrative data can be used to identify cases of postoperative respiratory failure (PRF). We aimed to determine if recent changes to the Agency for Healthcare Research and Quality Patient Safety Indicator 11 (PSI 11) and adoption of clinical documentation improvement programs have improved the validity o...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2019.11.019
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Intraoperative blood loss has been shown to be an important factor correlating with morbidity and mortality in liver surgery. A 5-cm long instrument with variably deployable metal electrodes using in-line radiofrequency ablation (ILRFA) energy was used for hepatic transection in an attempt to reduce bleeding...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.04.011
更新日期:2005-07-01 00:00:00
abstract::Among 400 patients with adenocarcinoma of the distal large bowel, anterior resection resulted in more anastomotic leaks, postoperative urinary retention and diarrhea when used for lesions of the mid-rectum than when used for lesions of the proximal rectum or sigmoid colon. However, the operative mortality, long-term m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90235-4
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:Studies of gender disparity in surgical training have yielded conflicting results. We hypothesize that there is no influence of gender on resident self-evaluation Milestone (SEM) scores and those assigned by the Clinical Competency Committee (CCC). METHODS:42 residents (25 male & 17 female) and faculty comp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.12.020
更新日期:2020-12-13 00:00:00
abstract::Studies using a refined substrate, n-acetyl-L-phenylalanyl-L-diiodotyrosine [n-APDT], demonstrate that bile salts inhibit pepsin activity in vitro by a noncompetitive effect on the enzyme. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90262-7
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:The appropriate management of gallstones in patients undergoing renal transplantation is controversial. Screening for gallstones and subsequent prophylactic cholecystectomy has been recommended by some authors for kidney transplant candidates. Our program does not practice routine pretransplant screening for...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00009-9
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:It is unknown whether surgical residents who learn minimal-access surgery skills in an unstructured environment (ie, at home), will develop a technical skill set that rivals that of those trained in the more traditional, structured learning environment. METHODS:Seven surgery residents were provided structur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.08.028
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:To analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers. METHODS:600 consecutive patients were studied. RESULTS:Mortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.10.005
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Mucinous Cystic Neoplasms are mucin producing cysts of the pancreas with malignant potential. The existing literature on treatment outcomes is limited to relatively small surgical series. METHODS:We reviewed the National Cancer Database assessing the outcomes of patients with mucinous cystic neoplasms betwe...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.006
更新日期:2020-12-01 00:00:00
abstract:INTRODUCTION:Medical students applying for general surgery residencies often require a letter of recommendation (LOR) from the Surgical Chair. However, LORs may reveal gender and ethnic bias. This study examines the presence of implicit bias in general surgery resident selection by evaluating chair LORs. METHODS:A ret...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.08.010
更新日期:2020-08-15 00:00:00
abstract:BACKGROUND:The aim of this study is to establish a relationship between critical ischemia of the lower limb and kidney dysfunction. MATERIALS AND METHODS:At rest, urine samples were collected from three groups: group A, 16 patients with critical ischemia; group B, 22 patients with stable intermittent claudication; and...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01406-x
更新日期:2003-04-01 00:00:00
abstract::The cause of severe and persistent neuralgia after hernia surgery is due to sensory nerve crushing. An operative technique has been described that prevents inadvertent crushing or division of the sensory nerves to the groin. With persistent postoperative pain, the offending nerve is usually difficult to identify. A pr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80044-8
更新日期:1988-06-01 00:00:00
abstract::Paraplegia or paraparesis after operations on the thoracic and abdominal aorta is a devastating event, both for the patient and the surgeon. While its incidence varies from under 1% with operations at the top and bottom of the aorta, its occurrence in the midportion of the aorta, just above the diaphragm, even in the ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(98)00133-0
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Identifying factors associated with resident autonomy may help improve training efficiency. This study evaluates resident and procedural factors associated with level of guidance needed in the operating room. METHODS:Intraoperative performance and yearly performance on Fundamentals of Laparoscopic Surgery (...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.03.019
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Vacuum Assisted Closure (VAC; Kinetic Concepts, Inc., San Antonio, TX) has been used to successfully treat a variety of complex wounds. This technique was investigated for use in managing Fournier's gangrene following initial debridement. METHODS:Ten patients with Fournier's gangrene were treated in this st...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.04.018
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Based on current evidence, the benefit of intraoperative nerve monitoring (IONM) in thyroid surgery is equivocal. METHODS:All patients who underwent planned thyroid surgery in the 2016-2018 ACS NSQIP procedure-targeted thyroidectomy dataset were included. Multivariable regression analyses were performed to ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.10.013
更新日期:2020-10-16 00:00:00
abstract:BACKGROUND:This study examined the clinical value of intraoperative peritoneal lavage for cytological examination in patients with gastric cancer. Peritoneal dissemination is the most frequent mode of recurrence for this tumor. METHODS:A retrospective of lavage findings, other factors, and outcome was performed in 1,2...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00162-2
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine the utility of breast-imaging studies in identifying cancer and high-risk lesions among patients with spontaneous, single-duct, nipple discharge (SSND). METHODS:The medical records of 168 cases with SSND treated with duct excision between June 1998 and May 2004 wer...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.06.032
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects. METHODS:We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications. RESULTS:Postoperative w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.11.019
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The influence of blood transfusions in the risk of postoperative infection remains controversial. We examined the association between autologous (AB) and homologous (HB) blood transfusions with postoperative infection in elective surgery. METHODS:The medical records of 991 Medicare patients aged > or =65 ye...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00242-1
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Teletrauma programs allow rural patients access to advanced trauma and emergency medical services that are often limited to urban areas. METHODS:A retrospective analysis of 59 teleconsults between 5 rural hospitals and a level I trauma center was performed. The objectives of this study were to report the in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.08.011
更新日期:2009-12-01 00:00:00