Abstract:
BACKGROUND:Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI). METHODS:Twenty-four patients with sTBI were treated to maintain intracranial pressure (ICP) less than or equal to 20 mm Hg, cerebral perfusion pressure (CPP) greater than or equal to 60 mm Hg, brain oxygen greater than or equal to 20 mm Hg, and near infrared spectroscopy greater than or equal to 60%. Flow/BrOx crisis events were recorded. The 14-day predicted mortality was compared with actual mortality. RESULTS:Nonsurvivors had a significantly higher number of crisis events nonresponsive to treatment (P < .05). Mortality was 87.5% in patients with greater than or equal to 20 events versus 6.3% in patients with less than 20 events. The predicted mortality was 58%, whereas actual mortality was 33.3% (8/24), yielding a 42% reduction in mortality. CONCLUSIONS:A multimodality monitoring and goal-directed therapy may decrease mortality in sTBI. However, Flow/BrOx crisis events still occur and predict a poor outcome.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Marini CP,Stoller C,Shah O,Policastro A,Lombardo G,Asensio JA,Hu YC,Stiefel MFdoi
10.1016/j.amjsurg.2014.08.003subject
Has Abstractpub_date
2014-12-01 00:00:00pages
1071-7; discussion 1076-7issue
6eissn
0002-9610issn
1879-1883pii
S0002-9610(14)00427-9journal_volume
208pub_type
杂志文章abstract::Mentoring has been recognized as a critical aspect of the professional and/or personal development of the student, resident or faculty member. This career development resource discusses strategies for building effective mentoring relationships and outlines some of the challenges to contemporary mentoring. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.08.001
更新日期:2013-11-01 00:00:00
abstract::Fourteen infants with intestinal stenosis as a late sequela of necrotizing enterocolitis were treated at Texas Children's and Ben Taub General Hospitals from 1972 to 1979. Barium enema studies are the keystone in making the diagnosis and should be performed in any infant with abdominal distention or poor feeding after...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90320-2
更新日期:1981-12-01 00:00:00
abstract:BACKGROUND:The US Food and Drug Administration recently approved a transcatheter aortic valve for patients for whom open heart surgery is prohibitively risky. METHODS:A multidisciplinary heart valve team partnered with administration to launch a transcatheter aortic valve replacement (TAVR) program. Clinical registrie...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.017
更新日期:2012-11-01 00:00:00
abstract::The records of more than 1,000 patients who underwent colonoscopy were reviewed. The study group consisted of 55 of these 1,000 patients who had persistent unexplained bleeding per rectum and negative radiographic examinations. Colonoscopy was helpful in defining the site of bleeding in approximately 50 per cent of th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90332-5
更新日期:1979-11-01 00:00:00
abstract::This commentary identifies important differences in patient groups that affect the observations in the accompanying article. ...
journal_title:American journal of surgery
pub_type: 评论,杂志文章
doi:10.1016/j.amjsurg.2007.11.014
更新日期:2008-07-01 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::The lower esophageal high pressure zone (HPZ) was characterized manometrically and reflux status determined in eight male rhesus monkeys. The studies were repeated six weeks and six months after 50 per cent distal small bowel resection. At the same time fasting serum gastrin and gastric inhibitory polypeptide values w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90002-2
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:Accurate assessment is imperative for learning, feedback and progression. The aim of this study was to examine whether surgeons can accurately self-assess their technical and nontechnical skills compared with expert faculty members' assessments. METHODS:Twenty-five surgeons performed a laparoscopic cholecys...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.01.024
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Splenectomy is generally a second-line therapy in patients with immune thrombocytopenic purpura (ITP) and autoimmune hemolytic anemia (AHA) refractory to medical therapy. Our objective was to evaluate outcomes after splenectomy for these disorders. METHODS:A retrospective review of the medical records of pa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.05.030
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:The Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) model and its Portsmouth modification (P-POSSUM) are used extensively to predict postoperative mortality and morbidity in general surgery. The aim of this study was to undertake the first systematic review ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2012.06.011
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Patients with recurrent pelvic malignancy have few treatment options, and surgery is fraught with complications. We sought to characterize the relationship between radiographic pelvic volume and postoperative complications after pelvic salvage surgery. METHODS:A retrospective chart review of all patients un...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.015
更新日期:2014-12-01 00:00:00
abstract::Histiocytosis X describes a disease characterized by histiocytic infiltration of the reticuloendothelial system, skin, bones, and pituitary gland. The disseminated form frequently occurs in infants and children. Chemotherapy has significantly improved the prognosis in this disorder. Sixty-three per cent of survivors, ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90431-1
更新日期:1976-01-01 00:00:00
abstract:INTRODUCTION:The integrity of the medical literature about robotic surgery remains unclear despite wide-spread adoption. We sought to determine if payment from Intuitive Surgical Incorporated (ISI) affected quality of the research produced by surgeons. METHODS:Publicly available financial data from the CMS website reg...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2017.08.017
更新日期:2018-07-01 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 stainless steel 316 mesh tray with cancellous bone offers a method of mandibular reconstruction which theoretically is appealing from the viewpoint of basic osseous healing. The results in fity-two patients at twenty different institutions indicates encouraging results. Further evaluation of this method is recomme...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90378-6
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:Five percent of patients who undergo fundoplication will require reoperation. The cause of this high failure rate and the best management for these patients remains poorly understood. The aim of this study was to identify patterns and causes of failure of primary antireflux procedures. METHODS:Retrospective...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2004.08.062
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:We surveyed surgeons to document their attitudes, practice, and risk tolerance regarding the treatment of appendicitis. METHODS:A web-based survey was sent to the EAST membership. The primary composite endpoint was defined as 1-year incidence of perioperative complications, antibiotic failure, infections, E...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.019
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Postoperative expectations after stapled hemorrhoidopexy are still being clarified. Our purpose was to evaluate how outcome is affected by staple line height (SLH) above the dentate line and specimen histology. METHODS:A prospective database identified demographics, SLH, histology, narcotic use, return to w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.09.015
更新日期:2007-03-01 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::Our experience with 184 previously untreated patients who had adenoid cystic carcinoma of salivary gland origin is reviewed. Retrospective staging was possible in all but nine patients who had minor salivary gland primary tumors. Sixty-three percent of patients were diagnosed as having stage I or stage II disease (sta...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80721-4
更新日期:1992-12-01 00:00:00
abstract::The need to effectively manage hemostasis and tissue sealing during surgery has had a strong influence on the development of modern surgical techniques. A group of agents known as surgical tissue adhesives has been developed to promote hemostasis and tissue sealing during surgery, and these comprise both natural and s...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(01)00770-x
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abstract::A 5 year experience of 248 patients with isolated penetrating lower chest injury was reviewed. Twenty-two (15 percent) of the stab wounds and 46 (46 percent) of the gunshot wounds caused associated intraabdominal injury. Among those taken to the operating room for laparotomy, physical examination proved misleading in ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90104-x
更新日期:1980-12-01 00:00:00
abstract::The antiproliferative effects of somatostatin on hepatocytes stimulated by hepatocyte growth factor (HGF) or epidermal growth factor (EGF) were investigated using primary cultures of adult rat hepatocytes. Somatostatin inhibits HGF-induced (at a dose of 10 ng/mL) or EGF-induced (at a dose of 100 ng/mL) 3H-thymidine in...
journal_title:American journal of surgery
pub_type: 杂志文章
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更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:The objective of this study was to compare the outcome of patients presenting with heel ulcers or gangrene (HEEL group) with those having lesions in other parts of the foot (non-HEEL group). METHODS:Treatment and outcomes of all HEEL and non-HEEL patients between June 2001 and October 2006 were compared. R...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.08.008
更新日期:2007-11-01 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::The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroide...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90412-3
更新日期:1982-10-01 00:00:00
abstract:BACKGROUND:We reviewed Nissen fundoplications performed in a single practice from January 1989 to March 1997, encompassing our transition from open to laparoscopic procedures. Because all operations were done by two surgeons in the same two hospitals, the study is well controlled for comparisons. METHODS:Records of 27...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(98)00049-X
更新日期:1998-05-01 00:00:00
abstract::Small intestinal epithelium digests and absorbs nutrients. Crypt stem cell transplantation can generate neomucosa with normal morphology, but the digestive and absorptive capacities of this neomucosa are unknown. This study evaluates stem cell induced neomucosal brush border digestive enzyme activity and nutrient tran...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80119-6
更新日期:1995-01-01 00:00:00
abstract::During the last 100 years, since César Roux began utilizing his "Ansa-en-Y" procedure for gastric outlet obstruction, the procedure at first fell into disuse but was later adapted for other applications. This article discusses the background of the procedure and compares the original indications with the author's curr...
journal_title:American journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1016/0002-9610(91)91142-6
更新日期:1991-02-01 00:00:00
abstract::Review of the diagnosis and treatment of patients with pancreatic pseudocysts over the past 8 years has led us to three conclusions regarding controversial aspects of their treatment. We found that patients who present with chronic pseudocysts can be identified with the help of computerized axial tomography and prompt...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80275-7
更新日期:1988-01-01 00:00:00