Abstract：
BACKGROUND:The pathophysiology of adrenal insufficiency, common in surgical intensive care units, has not been fully elucidated. METHODS:Patients at risk (age > 55 years, in the surgical intensive care unit >1 week, baseline cortisol < 20 μg/dL) were enrolled. After measuring cortisol and adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH) was administered. ACTH and cortisol were measured over 120 minutes. Short and long cosyntropin stimulation tests determined adrenal function. Area under the curve (AUC) and mixed linear models were used to compare cortisol and ACTH responses. Patients were grouped according to survival and response to stimulation testing. Chi-square and t tests were performed, and P values < .05 were considered statistically significant. RESULTS:Six of 25 patients responded poorly to cosyntropin, and 5 died compared with 3 after a normal response (P < .01). ACTH (AUC) and ACTH peak were increased in nonsurvivors after CRH administration. Cortisol peak and AUC were not different. CONCLUSIONS:ACTH responsiveness was increased in nonsurvivors and may predict mortality.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Schuster KM,Macleod JB,Fernandez JB,Kumar M,Barquist ESdoi
10.1016/j.amjsurg.2010.11.015subject
Has Abstractpub_date
2012-02-01 00:00:00pages
205-10issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(11)00259-5journal_volume
203pub_type
杂志文章abstract：:Blunt trauma to the neck requires a systematic analysis of the laryngotrachea, the esophagus and the cervical spine in addition to general trauma considerations. Acute airway decompensation is best managed by tracheotomy, although if the situation permits, an orderly physical examination including indirect laryngoscop...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90132-x
更新日期：1981-04-01 00:00:00
abstract：BACKGROUND:A gender-neutral threshold aneurysm diameter (AD) of more than 5.5 cm for surgical intervention in abdominal aortic aneurysms (AAA) ignores the fact that women have a smaller baseline AD. We hypothesized that women have a greater AD relative to body surface area (BSA) at the time of surgery and that this wor...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.07.008
更新日期：2015-02-01 00:00:00
abstract：:To assess the usefulness of ultrasound and ultrasound-guided fine-needle aspiration cytology in detecting occult cervical lymph node metastases, 107 patients with squamous cell carcinoma of the head and neck, who underwent 132 elective neck dissections, had preoperative ultrasound examination. During the assessment of...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90149-8
更新日期：1991-10-01 00:00:00
abstract：BACKGROUND:To prevent hepatic failure after major hepatectomy, it is important to assess preoperative factors related to liver failure. METHODS:We examined 80 patients who underwent right-sided hepatectomy. Hyperbilirubinemia, uncontrolled ascites, and prolonged postoperative hospital stay were defined as liver failur...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.12.013
更新日期：2013-09-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to determine the indications and outcome of surgery in patients with Hashimoto's thyroiditis (HT). METHODS:All patients who underwent thyroidectomy from 1990 to 2009 with pathologically confirmed HT were identified. Patients whose principle diagnosis was HT were evaluated for s...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.08.021
更新日期：2011-03-01 00:00:00
abstract：:Metastatic malignancies of the hand are rare and usually develop from lung, breast, or kidney tumors. Metastases from tumors and sarcomas of the gastrointestinal system are even more uncommon. The authors report a case of differentiated adenocarcinoma of the colon in a 76-year-old man who presented with distal phalang...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.02.016
更新日期：2010-11-01 00:00:00
abstract：:A personal experience of thirty-five consecutive patients with congenital anomalies of the diaphragm is reported. The anomalies included twenty-five Bochdalek hernias, seven diaphragmatic eventrations, and three esophageal hiatal hernias. Except for the patients with esophageal hiatal hernias, virtually all patients p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90449-9
更新日期：1976-12-01 00:00:00
abstract：:The dose response curves for acid and pepsin output to increasing intravenous doses of pentagastrin (0.01, 0.02, 2, 8, and 16 micrograms/kg per hour) were determined in six male patients with duodenal ulcer and six with type 1 corporeal gastric ulcer before and 3 to 6 months after selective proximal vagotomy and excis...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90433-7
更新日期：1985-11-01 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:The use and outcomes of laparoscopic sigmoid resection during emergency admissions for diverticulitis are unknown. METHODS:The Nationwide Inpatient Sample was queried for colorectal resections performed for diverticulitis during emergent hospital admissions (2003-2007). Univariate and multivariate analyses ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.01.004
更新日期：2012-05-01 00:00:00
abstract：BACKGROUND:Intestinal obstruction (IO) is a common pediatric surgical emergency in sub-Saharan Africa with high morbidity and mortality, but little is known about its etiopathogenesis in Malawi. METHODS:Retrospective analysis of patients seen from February 2012 to June 2014 at Kamuzu Central Hospital in Lilongwe, Mala...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.024
更新日期：2016-04-01 00:00:00
abstract：BACKGROUND:Hemorrhagic shock (HS) often causes coagulopathy due, in part, to decreased coagulation proteins. This study assessed the efficacy of fresh frozen plasma (FFP) in preventing this coagulopathy following a canine model of HS designed to mimic bleeding with shock as seen in the emergency department followed by ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(97)89618-3
更新日期：1996-04-01 00:00:00
abstract：BACKGROUND:Laparoscopic Roux-en-Y gastric bypass (LRYGB) produces durable and clinically significant weight loss. We aim to characterize the trajectory of weight loss, and demonstrate the predictive ability of three-month performance on final weight loss. METHODS:Retrospective analysis of 1097 consecutive LRYGB patien...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.10.024
更新日期：2018-07-01 00:00:00
abstract：BACKGROUND:in 2008, the Surgical Council on Resident Education selected 33 residency programs to pilot its General Surgery Resident Curriculum Website Portal. The portal aims to reduce program variability in curricula, align teaching and learning with essential content, and improve resident study and performance. METH...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.05.011
更新日期：2011-01-01 00:00:00
abstract：BACKGROUND:Motility disturbances in the Roux loop can negatively influence the outcome of reflux gastritis; the uncut Roux loop does not have these disadvantages, but is less suitable for clinical application because of staple dehiscence. The reported "cut-closed-reconnected" Roux loop has the same physiological starti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00246-4
更新日期：2000-02-01 00:00:00
abstract：:The effect of preoperative irradiation on the healing of low colorectal anastomoses was studied experimentally. In 12 dogs in whom preoperative irradiation of 4,000 rads was given before low colorectal stapled anastomosis was performed, anastomotic leakage occurred in 66 percent. More than half of the anastomotic leak...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90099-0
更新日期：1984-02-01 00:00:00
abstract：BACKGROUND:Temporary abdominal wound closure is sometimes desirable when tension-free approximation of the wound edges is impractical or when reexploration is planned. METHODS:The behavior of a composite prosthesis (PL-PU99) designed by our group was evaluated as a method of temporary abdominal closure in white New Ze...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.06.014
更新日期：2004-09-01 00:00:00
abstract：:Technetium 99m-pyridoxylideneglutamate (99mTc-PG) administered intravenously is excreted by hepatocytes into the bile canaliculi and enters the gallbladder through the cystic duct and consequently, can be used for scanning the hepatobiliary ductal system. A total of 166 patients representing 27 normal subjects, 84 pat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90204-5
更新日期：1977-01-01 00:00:00
abstract：BACKGROUND:Axillary lymph node status is still considered the most significant prognostic factor for breast cancer outcome, and treatment decisions are based on the presence or absence of nodal disease. Intramammary lymph nodes (IMLNs) can be a site of regional spread. Is this a marker for more aggressive disease? MET...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.05.011
更新日期：2006-10-01 00:00:00
abstract：:Various reports have demonstrated that the intraoperative utilization of the choledochoscope has significantly reduced the incidence of unsuspected retained common duct stones from approximately 10 percent to 0 to 2 percent. Our series revealed a 4 percent incidence of retained stones before choledochoscopy was utiliz...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90406-3
更新日期：1983-09-01 00:00:00
abstract：:We review herein our experience in the management of bleeding esophageal varices in cirrhotic patients and consider our findings in light of the dramatic changes in the treatment of cirrhosis resulting from the more widespread use of orthotopic liver transplantation (OLT). It does not seem realistic, at present, to pr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80878-5
更新日期：1990-07-01 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：:Our experience from 1960 to 1976 with total infrarenal aortic thrombosis (Leriche syndrome) was reviewed. Sixteen heavy smokers (14 men and 2 women) with an average age of fifty-four years underwent thrombectomy with aortoiliac (12 patients) or aortofemoral (4) Dacron bypasses. The last ten patients were hydrated for ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90331-2
更新日期：1977-12-01 00:00:00
abstract：BACKGROUND:This study attempts to determine if enough pathological abnormalities in gastric remnants from sleeve gastrectomy exist to warrant full pathologic evaluation in all remnants. METHODS:Data was collected on patients undergoing sleeve gastrectomy between 08/01/2011 and 06/30/2014. Significant abnormalities wer...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.06.029
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:Circumportal pancreas is a rare congenital pancreatic anomaly. The aim of this study was to clarify the clinical characteristics of patients with circumportal pancreases undergoing pancreatectomy. METHODS:The medical records of 508 patients who underwent pancreatectomy were retrospectively reviewed. The pre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.11.018
更新日期：2017-08-01 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：BACKGROUND:Although 90% of patients with neurogenic thoracic outlet syndrome (NTOS) experience "excellent" or "good" results after thoracic outlet decompression, recurrent symptoms may develop in certain patients. METHODS:This is a retrospective review of patients with NTOS who developed recurrent symptoms of upper ex...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.12.050
更新日期：2004-04-01 00:00:00
abstract：BACKGROUND:Despite the development of several prediction rules to guide head CT imaging, determining whom to screen for head trauma in the geriatric population after a ground level fall remains controversial. The purpose of this study was to assess the impact of head CT on the management of older adult patients who pre...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.07.038
更新日期：2017-12-01 00:00:00
abstract：:A successfully treated case of a duodenal hamartoma is presented. A review of the literature has shown that this is the largest such tumor so far described, and the first time a mass was palpable on abdominal examination. Its large size resulted in pyloric obstruction, and its wide attachment to the duodenum necessita...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90090-3
更新日期：1977-02-01 00:00:00
abstract：:This study aims to evaluate the intestinal mucosal permeability in patients with acute pancreatitis. The lactulose:mannitol (L:M) ratio was used to assess permeability. It is an inexpensive and quite reliable method. The intestinal permeability was increased in patients with acute pancreatitis compared with the contro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.02.001
更新日期：2006-07-01 00:00:00
