Abstract:
BACKGROUND:The need for mechanical ventilation (MV) after spinal cord injury (SCI) is a risk factor for prolonged critical care. The "purpose" of this study was to identify the level of cervical SCI that requires MV, thereby defining candidates for tracheostomy. METHODS:Patients with cervical SCI over a 15-year period were reviewed. RESULTS:One hundred sixty-three patients sustained cervical SCI. Of 76 complete injuries, 91% required MV for greater than 48 hours. By injury level, MV incidence was 100% for C2-4, 91% for C5, 79% for C6, and 80% for C7. Only one quarter of patients with incomplete SCI required MV for greater than 48 hours; Glascow Coma Score and Injury Severity Score were significantly worse compared with patients not requiring MV. CONCLUSIONS:Factors influencing the decision for tracheostomy in cervical SCI patients include the presence of a complete SCI, anatomic level of injury, Glascow Coma Score, Injury Severity Score, and associated thoracic injury. Patients with complete cervical SCI often require prolonged MV. Conversely, the minority of incomplete SCI required MV; the need for tracheostomy was likely performed for associated injuries. Utilizing identified factors permits a thoughtful approach to tracheostomy in this patient population.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Jones TS,Burlew CC,Johnson JL,Jones E,Kornblith LZ,Biffl WL,Stovall RT,Pieracci FM,Stahel PF,Moore EEdoi
10.1016/j.amjsurg.2014.07.016subject
Has Abstractpub_date
2015-02-01 00:00:00pages
363-8issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(14)00514-5journal_volume
209pub_type
杂志文章abstract::The efficacy of photodynamic therapy tumor destruction is dependent upon both the interruption of the tumor vasculature and the resultant production of unstable oxygen species causing cellular oxidation and death. Chloroaluminum sulfonated phthalocyanine (CASP) is a recently developed photosensitizer. In order to stud...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80543-4
更新日期:1990-10-01 00:00:00
abstract::Diabetic neuropathic ulcers are thought to arise from repetitive injury during normal walking in areas of high plantar pressures. It has been suggested that metatarsal head (MTH) resection alleviates elevated pressures at the site of the ulcer and, thus, expedites healing and prevents recurrence. We investigated the e...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90203-8
更新日期:1994-03-01 00:00:00
abstract::Intestinal infarction is a condition with a high rate of mortality. Progress in the fields of anesthesia, maintenance of electrolyte balance, and intensive postoperative care has made survival possible in a number of patients subjected to extensive resection of the small intestine. Many of these patients, however, lat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90322-0
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to characterize patients readmitted following inpatient general surgery procedures. We hypothesized that a decreased length of stay would increase risk for readmission. METHODS:We utilized our institutional National Surgical Quality Improvement Project database from 2006 to 2011. T...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.10.022
更新日期:2014-04-01 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::Much of the confusion surrounding the repair of asymptomatic abdominal aortic aneurysms related to inaccuracies in their measurement, both preoperatively and intraoperatively. Multiple measurements of aneurysms at operation have convinced us that the largest and least variable diameter is the anteroposterior diameter ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90539-6
更新日期:1982-12-01 00:00:00
abstract:BACKGROUND:Bioethics education has been recommended as a formal component of surgical residency training. The best method for teaching bioethics to residents is unclear. We compared the effectiveness of a standardized patient (SP)-based seminar to a traditional seminar format for teaching bioethics to surgical resident...
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.2004.08.066
更新日期:2005-04-01 00:00:00
abstract::Tube pancreatostomy for complete external drainage of pancreatic juice following pancreatoduodenectomy and a subsequent second-stage pancreatojejunostomy were carried out in four high-risk patients without morbidity. This procedure avoids the fatal outcome associated with pancreatojejunal anastomotic leakage following...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80073-x
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:The treatment of idiopathic anal ulcerations in AIDS patients is still evolving. These patients suffer with severe incapacitating anal pain. PATIENTS AND METHODS:Relief of pain was achieved with the use of intralesional steroid injections. Twenty-one patients from 1990 to 1993 presented with severe anal pai...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00117-7
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Hawaii has the highest incidence of hepatocellular cancer (HCC) in the United States and the largest proportion of Asians and Pacific Islanders. HCC studies generally combine these groups into 1 ethnicity, and we sought to examine differences between Asian and Pacific Islander subpopulations. METHODS:Demogr...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.06.055
更新日期:2012-06-01 00:00:00
abstract::Gastric emptying was delayed preoperatively in 9 of 19 patients with duodenal ulcer disease, but all 9 patients with evidence of retention by scan were asymptomatic; gastric emptying was normal in the remaining 10 patients. A significant delay in gastric emptying was documented by scan in 17 of 19 patients immediately...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90134-9
更新日期:1982-01-01 00:00:00
abstract::The insertion of pancreaticobiliary drains at the time of endoscopic retrograde cholangiopancreatography can provide access to the bile or pancreatic duct, decompress an obstructed biliary tree, and allow infusion of solubilizing agents to effect gallstone dissolution. Twenty-six patients underwent 32 attempts at drai...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90384-7
更新日期:1983-08-01 00:00:00
abstract:BACKGROUND:We report here the results of combined coronary artery bypass grafting (CABG) and abdominal aortic aneurysm (AAA) repair and the factors associated with higher mortality following this procedure. METHODS:The authors performed a retrospective chart review of 26 patients who underwent combined CABG and AAA re...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00164-0
更新日期:1998-08-01 00:00:00
abstract::Over a 2 year period, 34 limbs were revascularized in 33 patients. The in situ saphenous vein technique was used. Improved instrumentation and patency rates have encouraged the use of this method. Eighteen patients were insulin-dependent diabetics. The indication for operation was limb salvage in 25 limbs (73 percent)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90108-3
更新日期:1983-05-01 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::A 5 year retrospective study of the use of cholangioscopy in 153 difficult biliary cases including stones, strictures, tumors, and anomalies has been reported. In the 88 patients (58 percent) who underwent both operative cholangiography and cholangioscopy, the cholangioscope revealed 11 lesions (13 percent) missed by ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90048-5
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:The results and advantages of laparoscopic cholecystectomy in the geriatric population have received minimal attention. Several early reports related high conversion rates complications and mortality. This case series review is focused on the results of laparoscopic cholecystectomy in the geriatric populatio...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.11.031
更新日期:2004-06-01 00:00:00
abstract::DNA is the fundamental guide for the cell's processes. The alterations in DNA that can lead to abnormal or absent proteins and the role of chromosomal alterations in changing the function of the DNA are reviewed. The role of viruses in derailing a cell's normal functions, the major mechanisms of oncogene action, and t...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80911-0
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Despite significant advantages to patients, less than 5% of all colorectal surgeries for cancer are performed laparoscopically. A minimally invasive colorectal cancer program was created in our Veterans' Affairs hospital with the intent of increasing access and improving quality of patient care while maintai...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.07.016
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:To improve surgical training standards, it is necessary to first define the elements of high-quality training and methods for measuring them. METHODS:Semistructured interviews were conducted with attending (n = 10) and resident (n = 10) general surgeons. An interview topic guide was used to elicit end users...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.07.044
更新日期:2014-04-01 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::This investigation was designed to study the effects of home health care (HHC) on patients who have been hospitalized with peripheral vascular disease. For a patient to have HHC, the patient had to have a defined wound, educational needs, or both. Sixty patients, 30 with HHC and 30 without, were contacted approximatel...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80302-2
更新日期:1990-08-01 00:00:00
abstract::We evaluated the hormonal and metabolic responses of denervated pancreas allografts in nine volunteers 3 to 12 months after the transplant (initial) and again 1 year later (follow-up). Eight of the patients received simultaneous pancreas-kidney transplants. The glucose clamp technique was used to create a square wave ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80398-8
更新日期:1993-01-01 00:00:00
abstract::The presence of cholelithiasis, steatorrhea, diabetes mellitus, and a pancreatic tumor initiated a diagnostic workup for somatostatinoma in a 43 year old black woman. The hypothesis of somatostatinoma was supported by a high level of plasma-like immunoreactivity and secretory granules resembling D-cell granules by ele...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90309-4
更新日期:1983-11-01 00:00:00
abstract:BACKGROUND:Tracheostomal recurrence after total laryngectomy for laryngeal carcinoma has a poor prognosis. The independent risk factors of tracheostomal recurrence are, however, not well documented. METHODS:This is a multivariate analysis of the risk factors of tracheostomal recurrence after total laryngectomy for 322...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00162-6
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:In the surgical management of lower gastrointestinal tract peritonitis (LGTP), drainage of the peritoneal cavity is often recommended. The objective of the study was to evaluate the impact of drainage of the abdominal cavity during management of LGTP. METHODS:From January 2009 to January 2012, patients unde...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.09.031
更新日期:2017-07-01 00:00:00
abstract::Feeding gastrostomy can be troublesome, inconvenient and painful to the patient, especially if the catheter is redundant, thereby causing deformity of the opening ad leakage of gastric juice and food around the tube. A skin level permanent feeding gastrostomy was fashioned in four patients with neurologic disease. The...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90205-1
更新日期:1981-03-01 00:00:00
abstract:BACKGROUND:While vascular patency and overall viability of the gut can be evaluated perioperatively, damage to the mucosal barrier can hardly be judged in the perioperative setting and, moreover, will probably determine the clinical course. METHODS:In 19 consecutive cases with intestinal ischemia, the clinical course ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00048-2
更新日期:1997-07-01 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:Incidental abnormalities are increasingly being detected. The pathology and clinical outcome of patients with pancreatic incidentalomas have not been well characterized. METHODS:We reviewed the records of 356 patients with pancreatic abnormalities from August 2001 to June 2007. Clinical and pathologic data ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.12.027
更新日期:2008-03-01 00:00:00