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 study included all trauma patients who were ventilated for longer than 48 hours from September 2008 to September 2009. The CPIS and quantitative culture results from the BAL were collected and used to define pneumonia. RESULTS:A total of 162 patients were identified. In all, 58 (35.8%) and 104 (64.2%) had a CPIS greater than 5 and a CPIS of 5 or less, respectively. There were 95 (58.6%) patients who had a BAL completed regardless of CPIS. There were 65 patients who met the bacteriologic definition of pneumonia (≥10(4) colonies/mL), for an overall TAP incidence of 40.1%. CONCLUSIONS:The CPIS is unreliable as a clinical tool to predict a positive BAL at 10(4) or 10(5) or higher threshold. Therefore, BAL should be used for the diagnosis of TAP based on clinical rationale and not the CPIS.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Patel CB,Gillespie TL,Goslar PW,Sindhwani M,Petersen SRdoi
10.1016/j.amjsurg.2010.10.010subject
Has Abstractpub_date
2011-07-01 00:00:00pages
66-70issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(11)00029-8journal_volume
202pub_type
杂志文章abstract:BACKGROUND:The aim of the current study was to identify predictors of pathologic complete response (pCR) following neoadjuvant therapy. METHODS:From 2000 to 2007, 518 breast cancer patients received neoadjuvant therapy. Data were compared using chi(2) and Fisher's exact tests and multivariate analysis of variance, as ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.06.004
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:It was hypothesized that splenectomy following trauma results in hypercoagulability. METHODS:A prospective, nonrandomized, single-center study was performed to evaluate coagulation parameters in trauma patients with splenic injury. RESULTS:Patients with splenectomy (n = 30) and nonoperative management (n =...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.01.015
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Bariatric patients may not always obtain long-term care by their primary surgeon. Our aim was to evaluate weight loss outcomes in patients who had surgery elsewhere. METHODS:We conducted a retrospective analysis. Postreferral management included nonsurgical, revision, or conversion. Primary outcomes were pe...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.04.025
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:We sought to compare outcomes 6-12 months post-injury between patients discharged to an inpatient rehabilitation facility (IRF) and a skilled nursing facility (SNF). METHODS:Trauma patients admitted to 3 Level-I trauma centers were interviewed to evaluate the presence of daily pain requiring medication, fun...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.05.019
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:Primary hyperparathyroidism (HPT) is an undertreated disease. This study's purpose is to determine if the calcium levels correlate with prevalence of symptoms and surgical treatment in patients with primary HPT. METHOD:Patients treated in 2006-2015 with serum calcium≥10.0 mg/dL and PTH>65 pg/mL were identif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.09.010
更新日期:2019-03-01 00:00:00
abstract::The accepted approach to patients with intermittent calf claudication is nonoperative unless the symptoms are truly incapacitating, in which case arteriography and either percutaneous angioplasty or operation is indicated. Arteriography is considered a preoperative procedure. However, with improvements in percutaneous...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80300-9
更新日期:1990-08-01 00:00:00
abstract::In a prospective, randomized trial, selective proximal vagotomy with complete ulcer excision was compared with partial gastrectomy with gastroduodenostomy for the treatment of primary corporeal gastric ulcer in 30 patients. The results were evaluated by clinical follow-up examinations at regular intervals, endoscopy, ...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(83)90300-8
更新日期:1983-11-01 00:00:00
abstract::Parastomal hernia repair remains a significant surgical challenge. Recurrence after standard "keyhole" or primary suture repair is common. We adopted and modified a new technique using a construct shaped like an inverted top hat. We review our experience over the last six years in the first 30 patients (31 consecutive...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.02.018
更新日期:2018-09-01 00:00:00
abstract::The popliteal artery entrapment syndrome is increasingly recognized as a cause of arterial insufficiency in the leg. Diagnosis is based on a clinical history of claudication, which may be atypical, physical examination, noninvasive exercise testing and angiography. Patients with normal ankle pulses and resting ankle/b...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90285-8
更新日期:1980-03-01 00:00:00
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...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(06)80057-7
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Preoperative imaging for early-stage cutaneous melanoma is not recommended by current guidelines. Our goal was to investigate our institutional usage and utility. METHODS:Patients with clinically node-negative cutaneous melanoma undergoing surgery with sentinel lymph node biopsy were identified retrospectiv...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.08.017
更新日期:2013-12-01 00:00:00
abstract::One hundred seventeen patients with threatened limb loss were evaluated. Seventy-three of these patients underwent vascular reconstruction. Diabetics had a significantly higher incidence of ischemic ulceration and gangrene when compared with nondiabetics. Nondiabetics typically presented with rest pain. The outcome of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80534-8
更新日期:1988-12-01 00:00:00
abstract::The results of aggressive surgical treatment of primary lip cancer and advanced and recurrent carcinoma of the lip are illustrated and discussed. Early detection of involved lymph nodes before capsular penetration occurs and careful and complete dissection of the submental and submandibular regions are advocated as po...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90326-3
更新日期:1976-10-01 00:00:00
abstract::A modification of the procedure of laparostomy with palisade dorsoventral lavage for treating neglected peritonitis is described. It consists of adding a polyethylene foil to cover the intestines and thus avoiding the direct contact between them from one side, and the suction drains and the palisade laparostomy screen...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00411-4
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Because the abdominal insufflation and desufflation associated with laparoscopic procedures may adversely effect a compromised myocardium, patients with significant cardiopulmonary disease should be closely monitored during these procedures. The utility of intraoperative pulmonary artery catheter (PAC) and t...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80137-8
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the incidence rate, identify the risk factors, and describe the clinical outcome of perioperative acute kidney injury (AKI) in patients undergoing noncardiac, nonvascular surgery (NCS). METHODS:A total of 1,200 adult consecutive patients undergoing NCS were prospective...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.04.006
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Approximately 30% to 50% of appendicitis in children is already perforated at presentation. The optimal management of these children remains controversial. METHODS:Ninety-six children (aged 2 to 16 years) were treated for perforated appendicitis. Seventy-one underwent immediate appendectomy and drainage of ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.08.027
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Perianal fistula disease (PAD) occurs in up to 40% of patients with Crohn's disease (CD). Medical therapy is often unsuccessful, and, with surgical therapy, healing is unreliable and management is frequently painful and unsatisfactory. Outpatient CO(2) laser ablation of PAD has emerged as an alternative. ME...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.10.050
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:A large number of necrotizing soft tissue infections (NSTI) treated at a single institution over an 8-year period were analyzed with respect to microbial pathogens recovered, treatment administered, and outcome. Based on this analysis, optimal empiric antibiotic coverage is proposed. METHODS:A retrospective ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00360-3
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to identify patient-related and/or disease-related factors that influence outcomes in patients with vascular prosthetic graft infections. METHODS:Through the hospital patient administration system, between January 1997 and December 2007, a total of 44 patients were diagnosed with c...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.05.018
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Postoperative pain management with a continuous preperitoneal infusion (CPI) for locoregional anesthesia has been shown to have improved postoperative outcomes. This is the first direct comparison of CPI versus epidural infusion (EPI), both in conjunction with systemic analgesia. METHODS:A retrospective rev...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.05.016
更新日期:2011-12-01 00:00:00
abstract:PURPOSE:To determine the cause of a marked rise in cholecystectomy at a regional children's hospital. METHODS:Retrospective review of 185 patients undergoing cholecystectomy since 1984. The years 1984 to 1990 (group I) and 1991 to 1996 (group II) were compared. RESULTS:Cholecystectomy for gallbladder disease increase...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00063-x
更新日期:1999-05-01 00:00:00
abstract::Sequential intraarterial chemotherapy using bleomycin and methotrexate followed by high dose radiation and surgery was evaluated in 10 patients with stage III and IV squamous carcinomas of the maxillary sinus. Seven of 10 patients had extensive tumor necrosis in the surgical specimen, and no evidence of residual tumor...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90037-4
更新日期:1981-05-01 00:00:00
abstract:BACKGROUND:Patients with spinal cord injury (SCI) frequently have pressure ulcers. Surgery is sometimes needed to close them. In rare cases, hemipelvectomy is warranted for extremely severe complications. METHODS:We conducted a retrospective study using national Department of Veterans Affairs (DVA) computer data sets ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01123-6
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:This study was designed to establish whether the spatial structure of a prosthesis conditions its behavior at the peritoneal level. METHODS:Abdominal defects comprising all the wall (except skin) were created in rabbits and repaired with a laminar (DM) or reticular (CV-4) ePTFE-prosthesis. Fourteen days pos...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)00907-8
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:On surgical simulators, measures of economy of hand motion have been shown to be reliable, valid, and objective measures of technical competence. Our goal was to validate hand-motion analysis (HMA) as an objective measure of surgical skill on real patients. METHODS:HMA (hand movement frequency, hand travel ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.033
更新日期:2010-01-01 00:00:00
abstract::The effects of epinephrine on the vascular perfusion of solitary Walker tumors implanted in the liver were studied in Sprague-Dawley rats. Colored silicone rubber (Microfil) solutions were injected into the arterial and portal circulations in each animal, and specimens were studied under a stereomicroscope. Internal v...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90044-6
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:Open and laparoscopic antireflux surgeries are standard for the treatment of gastroesophageal reflux disease (GERD). The in-hospital outcomes of laparoscopic and open antireflux procedures were analyzed and compared at US academic medical centers. METHODS:Using International Classification of Diseases, Nint...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2008.07.041
更新日期:2008-12-01 00:00:00
abstract::Emergency center thoracotomy is a heroic technique of resuscitation and treatment which was revived in the 1960s to improve the survival of patients presenting with cardiac wounds. With excellent survival rates attained in such patients, the technique was extended to victims of trauma with other mechanisms and locatio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90443-5
更新日期:1986-12-01 00:00:00
abstract::The effects of ranitidine, a new H2-receptor antagonist, on liver regeneration were investigated using a protocol described previously. The animals in Group I had standard two-thirds hepatectomy. In Group II, the rats received an 8 mg/kg intramuscular dose of ranitidine immediately and 24 and 48 hours after two-thirds...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80074-x
更新日期:1985-02-01 00:00:00