Abstract：
BACKGROUND:The bispectral index (BIS) is a processed electroencephalographic value (awake = 100, isoelectric = 0). The relationship of BIS and brain death (BD) is assessed. METHODS:BIS was evaluated in GCS 3 head-injured patients with BD (no brain function including apnea) or near BD (no apnea or negative ancillary test [cerebral perfusion and electroencephalogram]). RESULTS:In 27 patients, there were 37 BD evaluations (apnea assessment or ancillary test). BD was confirmed in 62% (n = 23). However, 38% (n = 14) showed near BD. BD BIS is 3 + or - 5 and near BD BIS is 36 + or - 31 (P = .002). In the 23 BD patients, BIS was <20 for 7 hours + or - 6 hours before a BD evaluation was performed. Of 14 near BD evaluations, 9 (64%) had BIS > or = 20. BIS <20 for predicting BD had a sensitivity of 100% (23/23), a positive predictive value of 84% (23/28), and a negative predictive value of 100% (9/9). CONCLUSIONS:Distinguishing brain death and near brain death in severely comatose trauma patients is complex. By indicating the likelihood of brain death, BIS is an adjunct for efficient evaluation.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Dunham CM,Katradis DA,Williams MDdoi
10.1016/j.amjsurg.2009.05.032subject
Has Abstractpub_date
2009-12-01 00:00:00pages
846-51issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(09)00565-0journal_volume
198pub_type
杂志文章abstract：:The effects of ischemia on the electrical and contractile activites of the small bowel were studied in dogs. Ischemia due to arterial occlusion abolished the contractile activity and made the regular rhythm of the pacesetter potential (PP) irregular. Revascularization within 3 hours restored the contractile activity a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90237-4
更新日期：1978-08-01 00:00:00
abstract：BACKGROUND:Pancreatic cancer is the 4th leading cause of cancer death in the United States. A screening protocol is needed to catch early-stage, resectable disease. This study suggests a protocol for high-risk individuals and assesses the cost in the context of the Affordable Care Act. METHODS:Medicare and national av...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.11.017
更新日期：2015-09-01 00:00:00
abstract：:Increased strength of healing incisions infected with E coli was demonstrated in this experiment. Efforts to measure respiratory gas tensions and pH in these incisions were unsuccessful. Therefore, these moieties were measured in normal and infected wound fluid contained in implanted wire cylinders. The wound fluid fr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90292-0
更新日期：1976-07-01 00:00:00
abstract：BACKGROUND:Despite impressive results with the Lap-Band in Europe and Australia, the early Food and Drug Administration A trial in the United States showed fairly poor results. This prospective study attempts to determine if the Lap-Band can produce effective weight loss in morbidly obese Americans. METHODS:Five hundr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.08.059
更新日期：2004-12-01 00:00:00
abstract：BACKGROUND:Loss of function of the tumor suppressor gene TP53 contributes to the development of several tumors. PATIENTS AND METHODS:We screened DNA samples from 47 patients with upper respiratory system squamous cell carcinomas for the presence of TP53 mutations. Exons 4 to 8 of the TP53 gene were amplified by the po...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80337-7
更新日期：1995-11-01 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：:The lower extremity complications of 100 consecutive patients who required the placement of an intra-aortic balloon pump (IABP) during a 3-year period were studied. Indications for the IABP included hypotension during cardiac catheterization (33%) or coronary angioplasty (13%), hemodynamic instability after open heart...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81192-4
更新日期：1992-11-01 00:00:00
abstract：:The presentation, surgical management, and clinical outcome in 153 patients with biliary pancreatitis has been reviewed. Only 37 percent of our patients demonstrated any of Ranson's 11 prognostic signs of severe pancreatitis, and only 3 percent had 3 or more signs. Fourteen patients underwent emergency operation withi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90028-0
更新日期：1986-01-01 00:00:00
abstract：:Cases of symptomatic Meckel's diverticulum treated surgically on an emergency basis during the last decade are reviewed. A series of 18 patients were divided into two groups depending on the presence or absence of ectopic tissue in the diverticulum. Group 1 consisted of five patients (28 percent) without ectopic tissu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(86)90576-3
更新日期：1986-05-01 00:00:00
abstract：BACKGROUND:Strategies for splenic preservation for trauma patients have gained acceptance; however, meaningful outcome evaluations have not been performed. To better understand the consequences of managing patients with splenic injuries, the short-term outcomes of different types of management strategies were examined....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.07.037
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND:Performance feedback or debriefing in surgery is increasingly recognized as an essential means to optimize learning in the operating room (OR). However, there is a lack of evidence regarding the current practice and barriers to debriefing in the OR. METHODS:Phase 1 consisted of semistructured interviews wit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.01.007
更新日期：2013-04-01 00:00:00
abstract：INTRODUCTION:While women represent approximately half of all medical students, only 38% of general surgery residents are women. The objective of this study is to explore how access to mentors and organizational support affects career choices. METHODS:In June of 2016, a survey was sent to medical students at a single i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.07.005
更新日期：2017-10-01 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：:There is a steady increase in the number of patients with chronic renal insufficiency undergoing long-term hemodialysis, and an increasing number of these patients have exhausted veins due to multiple vascular access and salvage procedures. These patients may be candidates for an alternative vascular access procedure,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90110-4
更新日期：1994-06-01 00:00:00
abstract：:Cytologic examination of peritoneal washings was performed in 40 patients with pancreatic ductal adenocarcinoma (35 head, 5 body) whose tumors had been selected as potentially resectable by computed tomographic (CT) findings. Saline (100 mL) was instilled and aspirated at laparoscopy in 27 patients and at laparotomy i...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90356-i
更新日期：1991-01-01 00:00:00
abstract：:The survival of 103 patients operated on for advanced carcinoma of the stomach other than the cardia was assessed. The median duration of survival for patients subjected to palliative partial gastrectomy, total gastrectomy, gastrojejunostomy, and biopsy only was 24, 22, 11, and 10 weeks, respectively. All of these pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90051-4
更新日期：1982-06-01 00:00:00
abstract：BACKGROUND:The teaching of surgical skills is based mostly on the traditional "see one, do one, teach one" resident-to-resident method. Surgical skills laboratories provide a new environment for teaching skills but their effectiveness has not been adequately tested. Cognitive task analysis is an innovative method to te...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2002.12.005
更新日期：2004-01-01 00:00:00
abstract：:Chronic anal fissure is the main cause of anal pain and is very common. Many treatment modalities have been tried-none is ideal. Recently, topical nitric oxide releasing agents and botulin toxin injections have been used, trying to replace surgery. No long-term experience is available. Personal experience with 2,108 o...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00307-x
更新日期：2000-03-01 00:00:00
abstract：BACKGROUND:The clinical pulmonary infection score (CPIS) and bronchoalveolar lavage (BAL) are 2 tools that have been validated to diagnose pneumonia in critically ill patients. However, the role of the CPIS in diagnosing trauma-associated pneumonia (TAP) remains in question. METHODS:This prospective observational stud...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.10.010
更新日期：2011-07-01 00:00:00
abstract：BACKGROUND:The multimodality addition of preoperative gabapentin, acetaminophen, and celecoxib (GAC) and postoperative TENS has been recommended to diminish narcotics. We predict that GAC-TENS implementation will reduce recovery room time, improve pain control, reduce narcotic refills, and demonstrate usefulness of TEN...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.01.070
更新日期：2018-05-01 00:00:00
abstract：PURPOSE:This study aimed to determine one-year outcomes and the impact of various factors on the need for readmission and reoperation following abdominoperineal resection (APR). METHOD:A multivariate logistic regression analysis was conducted to determine predictors of readmission and/or reoperation within one year of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.08.021
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:Establishment of an instant, reproducible, and reliable rat model of a refined 3-cuff technique for performing orthotopic intestinal transplantation is reported, and the surgical skills required to perform modified surgical procedure are discussed. METHODS:A retrospective analysis was used to study 270 rat ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.07.057
更新日期：2009-07-01 00:00:00
abstract：PURPOSE:The Integrated Procedural Performance Instrument (IPPI) consists of clinical scenarios in which bench-top models are positioned to simulated patients. Trainees are required to perform technical skills while engaging with the patient. The purpose of this study was to determine whether an IPPI format examination ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.08.011
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:The morbidity and mortality conference (M&M) is a key component of the performance improvement process. The audience response system (ARS) has been shown to improve audience participation and promote more truthful responses in various settings. We implemented the ARS in our trauma M&M and evaluated the respo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.05.015
更新日期：2009-06-01 00:00:00
abstract：:Yao and Bergan [8] have shown that an ankle systolic index of more than 0.25 is associated with a high rate of success from lumbar sympathectomy. This association has been borne out in our small series. We have also suggested that diseases that obviously compromise collateral circulation might be a relative contraindi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90316-6
更新日期：1977-12-01 00:00:00
abstract：OBJECTIVE:To demonstrate chest roentgenograms after central venous line changes over a guidewire delay the use of the central lines and increases charges with no change of morbidity or the rate of complication. METHODS:Retrospective study using the Surgical Intensive Care database followed by a nonrandomized, prospect...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00142-1
更新日期：1998-09-01 00:00:00
abstract：BACKGROUND:Fibroadenomas commonly found by palpation and routine mammography account for approximately 20% of open surgical breast biopsies. Alternatives to open surgery include tumor removal using an automated coring device and tumor ablation using heating or cooling elements. We report our initial experience with cry...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01010-3
更新日期：2002-11-01 00:00:00
abstract：:Consistent weight reduction by gastroplasty requires precise construction of an appropriately sized stoma that will not dilate. The technique described constructs such a stoma around a 32 French Hurst dilator with an external ring of Silastic tubing over polypropylene suture. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90206-3
更新日期：1981-03-01 00:00:00
abstract：BACKGROUND:There is little evidence supporting or refuting clamping trials, a period of clamping thoracostomy tubes prior to removal. We sought to evaluate whether clamping trials reduce the need for subsequent pleural drainage procedures. METHODS:We conducted a retrospective cohort study of trauma patients who underw...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.01.007
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:Trastuzumab has been found to have potent antiproliferative effects in human epidermal growth factor receptor 2 (HER-2)-overexpressing human breast tumors. Inhibition of vascular endothelial growth factor receptor (VEGFR), a protein often overexpressed in breast carcinoma, has been shown to induce apoptosis....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.10.009
更新日期：2009-03-01 00:00:00
