Abstract:
BACKGROUND:Bloodstream infections in critically ill patients are associated with mortality as high as 60% and a prolonged hospital stay. We evaluated the impact of inappropriate antibiotic therapy (IAAT) in a critically ill surgical cohort with bacteremia. METHODS:This retrospective study evaluated adults with intensive care unit admission greater than 72 hours and bacteremia. Two groups were evaluated: appropriate antibiotic therapy (AAT) vs IAAT. RESULTS:In 72 episodes of bacteremia, 57 (79%) AAT and 15 (21%) IAAT, mean age was 54 ± 17 years and APACHE II of 17 ± 8. Time to appropriate antibiotics was longer for IAAT (3 ± 5 IAAT vs 1 ± 1 AAT days, P = .003). IAAT was seen primarily with Acinetobacter spp (33% IAAT vs 9% AAT, P = .01) and Enterococcus faecium (26% IAAT vs 7% AAT, P = .03). If 2 or more bacteremic episodes occurred, Acinetobacter spp. was more likely, 32% vs 2%, P = .001. CONCLUSIONS:AAT selection is imperative in critically patients with bacteremia to reduce the significant impact of inappropriate selection. Repeated episodes of bacteremia should receive special attention.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Abraham K,Dolman HS,Zimmerman LH,Faris J,Edelman DA,Baylor A,Wilson RF,Tyburski JGdoi
10.1016/j.amjsurg.2015.10.025subject
Has Abstractpub_date
2016-03-01 00:00:00pages
593-8issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(15)30017-9journal_volume
211pub_type
杂志文章abstract::We reviewed 574 endoscopic sphincterotomy procedures. Fifty-six precut papillotomies were performed. Presenting conditions included choledocholithiasis, cholangitis, benign and malignant papillary strictures, and stenosing papillitis. Complications were identified in 16 percent: perforation in 9 percent, pancreatitis ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80618-x
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Video broadcasting of surgical procedures is an important tool for education, training, and consultation. Current video conferencing systems are expensive and time-consuming and require preplanning. Real-time Internet video is known for its poor quality and relies on the equipment and the speed of the connec...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00203-2
更新日期:1999-11-01 00:00:00
abstract::A simple classification of inguinal hernias is presented which can be valuable to surgeons as a (1) blueprint for dissecting the canal, (2) means for choosing the most appropriate operative procedure, (3) means for evaluating and correlating the prognosis of postoperative symptoms, time of convalescence, and degree of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90564-3
更新日期:1989-03-01 00:00:00
abstract::With the purpose of facilitating liver biopsy during upper abdominal procedures, an adaptation of the percutaneous one-second needle biopsy technic is proposed. A simple device, consisting of a three-way deviator, allows the utilization of the standard needles for percutaneous biopsy. The entire procedure requires fro...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90551-7
更新日期:1977-03-01 00:00:00
abstract::From 1980 to 1984, 500 asymptomatic patients with anterior abdominal stab wounds found to have penetrated the anterior peritoneal cavity on local wound exploration in the emergency center were evaluated by the technique of open peritoneal tap, quantitative diagnostic peritoneal lavage, or both. The technique was found...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90435-5
更新日期:1984-12-01 00:00:00
abstract:BACKGROUND:Besides alcohol and gallstones, pancreatic ischemia can cause acute pancreatitis (AP). This entity should be considered when no other reasons can be defined. The aim of the current study was to define ischemic AP with its pathophysiologic, radiologic, and clinical conditions. METHODS:Eleven patients with is...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2008.04.011
更新日期:2009-04-01 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 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::From April 1, 1990, to March 31, 1992, 8,899 patients who were 65 years of age and older underwent an anesthetic and surgical procedure in a 1,000-bed community hospital in Victoria, British Columbia, Canada. The hospital has been using a proprietary system called MedisGroups for assessing the severity of illness on a...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80438-6
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:The study investigates the relationship between motor coordination errors and total errors using a human factors framework. We hypothesize motor coordination errors will correlate with total errors and provide validity evidence for error tolerance as a performance metric. METHODS:Residents' laparoscopic ski...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.07.003
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:An assessment was made of the change and the effect of a histamine H(2)-receptor blocker (H(2)-blocker) or omeprazole on gastric pH after surgery. METHODS:Eighty patients who underwent colon resection for colorectal cancer were divided into groups of 20. Group I received neither H(2)-blocker nor omeprazole....
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.2002.10.002
更新日期:2004-01-01 00:00:00
abstract::Postoperative gastric retention may be minimized by avoiding the use of the Billroth I reconstruction when a large duodenal ulcer must be retained. Postoperative gastric retention is more likely to remit with conservative therapy if the procedure was a Billroth I reconstruction with a vagotomy. In other instances wher...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90262-x
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to examine the outcomes of checklist-driven preoperative briefings and postoperative debriefings during the Veterans Health Administration (VHA) medical team training program. METHODS:A briefing score (1, never started; 2, started then discontinued; 3, maintained on original ta...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.07.011
更新日期:2010-11-01 00:00:00
abstract::A new technique has been described for the placement of an implantable percutaneous triple-lumen catheter. This procedure eliminates the need for a large bore introducer. It also provides a mechanism to change these catheters over a wire if necessary. This cannot be accomplished with the Hickman or Broviac catheters. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80116-1
更新日期:1985-03-01 00:00:00
abstract::Pretreatment staging and posttreatment follow-up of the breast cancer patient consists of physical examination of the breasts and regional node-bearing areas, routine laboratory studies, chest radiography, and bilateral mammography. For palpable tumors, mammography is used to determine tumor size and to identify nonpa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90539-4
更新日期:1989-02-01 00:00:00
abstract:BACKGROUND:The effect of postsurgical radiotherapy (PSRT) among T1-3 gallbladder cancer (GBC) patients with one to three lymph node metastases remains controversial. The aim of this study was to assess the impact of PSRT on gallbladder cancer-specific survival (GBCSS) in patients with stage IIIB. METHODS:The data of G...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.08.007
更新日期:2020-08-15 00:00:00
abstract::The portal-superior mesenteric vein (PV/SMV) is occasionally involved by a microscopic level of cancer invasion from pancreatic cancer even when it seems to be intact by a macroscopic inspection during surgery. Therefore, contact endoscopy, with which a high-magnification image of the methylene blue-stained PV/SMV wal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.03.009
更新日期:2009-11-01 00:00:00
abstract::A controlled prospective study was conducted to compare the results of kidney preservation and transplantation in regard to the type of perfusate used for perfusion preservation. Cryoprecipitated plasma, plasma protein fraction and serum albumin solution were used as perfusate. Between February 1979 and July 1980, 176...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9610(81)90137-9
更新日期:1981-04-01 00:00:00
abstract:BACKGROUND:The insertion and subsequent removal of chest tubes are frequently performed procedures. We hypothesize that routine chest radiographs obtained after chest tube removal to confirm the absence of any post-procedure complications have little impact on clinical management. MATERIALS AND METHODS:A 5-year retros...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)00260-3
更新日期:2000-01-01 00:00:00
abstract::Mesenteric vascular disease continues to be associated with an extremely high mortality. It is not necessarily a disease of old age: 20 of the 75 patients in our series were less than 60 years of age. In retrospect, earlier diagnosis and a more aggressive approach could have improved the survival rate of 17.3 percent....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90251-2
更新日期:1980-02-01 00:00:00
abstract::Twenty-five patients with ulcerative colitis were treated between 1959 and 1986 at the Mount Sinai Hospital, with severe gastrointestinal hemorrhage as their major complaint. Twenty-two patients required operation, while three patients were treated medically. Total proctocolectomy with ileostomy was carried out in 5 p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(06)80064-4
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:Although informed consent is vital to patient-physician communication, little training is provided to surgical trainees. We hypothesized that highlighting critical aspects of informed consent would improve resident performance. METHODS:Eighty (out of 88) surgical postgraduate year 1 surgical residents were ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2014.12.044
更新日期:2015-09-01 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::A retrograde method for mastectomy that performs the axillary dissection first is described, and experience with eighty-six cases of infiltrating carcinomas of the breast treated in that manner is presented. The method has reduced the number of standard radical procedures by more than half, and a decrease in operative...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(76)90182-3
更新日期:1976-06-01 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
doi:10.1016/0002-9610(92)90271-r
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Surgical quality improvement (QI) is a global priority. We report the design and proof-of concept testing of a QI skills curriculum for urology residents. METHODS:'Umbrella review' of QI curricula (Phase-1); development of draft QI curriculum (Phase-2); curriculum review by Steering Committee of urologists ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2018.11.008
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:To assess the impact of adding a surgical oncologist to our faculty we examined the operative experience in our program before and after the addition. METHODS:Operative case numbers reported to the American Board of Surgery over a 10-year period were analyzed. This time period encompassed 5 years before and...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.01.001
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Residents are more likely to learn from educational experiences when properly prepared from the start of instruction and expectations are clear and consistent. The purpose of this study was to examine what first year residents need to know and be able to perform before starting their rotation in the intensiv...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(96)00029-3
更新日期:1996-06-01 00:00:00
abstract::Four hundred seventy-eight patients with hand burns (786 hands) were treated at the burn service of the Massachusetts General Hospital. Long-term evaluation showed that early incision and immediate autografting of deep second degree, mixed second and third degree, and third degree full-thickness hand burns resulted in...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(85)80049-0
更新日期:1985-04-01 00:00:00
abstract::It has been shown that truncal vagotomy with pyloroplasty (TVP), but not highly selective vagotomy (HSV), delays the onset, decreases the extent, and changes the pattern of gallbladder emptying. The aim of the present study was to investigate any alterations in gallbladder emptying after a variety of antiulcer gastric...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-9610(05)80160-6
更新日期:1994-10-01 00:00:00