Abstract:
:AbdCT for the evaluation of AAP in the ED in the US may be excessive and is potentially (although rarely) misleading and harmful. A selective policy of 'AbdUS first' combined with an observation unit and/or surgeon evaluation prior to AbdCT is preferred to a 'routine AbdCT' policy. Repeated AbdCTs for abdominal pain are not recommended because of cumulative radiation exposure. Standardized and complete history and physical examination, such as that originally designed for computer-aided diagnosis of AAP, along with select laboratory testing and higher utilization of AbdUS lessens the necessity of AbdCT. 'Routine AbdCT' is particularly not necessary for the evaluation of suspected appendicitis. 'Routine AbdCT' lowers the negative appendectomy rate but at the expense of exposure to radiation. Right lower quadrant US and selective use of observation prior to AbdCT for suspected appendicitis, particularly in children, adolescents, and young adults, are warranted. MRI should substitute for AbdCT for the evaluation of suspected appendicitis during pregnancy.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Bax T,Macha M,Mayberry Jdoi
10.1016/j.amjsurg.2019.02.003subject
Has Abstractpub_date
2019-05-01 00:00:00pages
959-966issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(18)31313-8journal_volume
217pub_type
杂志文章,评审abstract:BACKGROUND:Surgical safety and quality initiatives have now moved to the front of the agenda for contemporary surgery. METHODS:Sixty-two surgical specialists began to study quality and cost control in 1998, and those efforts grew into a Centers for Medicare and Medicaid Services-funded pilot study of the Surgical Care...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.04.005
更新日期:2010-07-01 00:00:00
abstract::Mean fasting preoperative pancreatic polypeptide levels in a group of 18 patients with duodenal ulcer disease were 462 +/- 88 pg/ml, with 13 patients having markedly elevated levels (mean 600 +/- 106 pg/ml) and 5 patients having normal or minimally elevated levels (mean 112 +/- 32 pg/ml). Mean fasting postoperative pa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90040-1
更新日期:1986-06-01 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:Studies of gender disparity in surgical training have yielded conflicting results. We hypothesize that there is no influence of gender on resident self-evaluation Milestone (SEM) scores and those assigned by the Clinical Competency Committee (CCC). METHODS:42 residents (25 male & 17 female) and faculty comp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.12.020
更新日期:2020-12-13 00:00:00
abstract::Serum transferrin is an important protein used to assess visceral protein status in patients requiring nutritional support. Since serum transferrin assays are not readily available in all institutions and there is a correlation between the serum transferrin level and TIBC, Blackburn's formula to compute the serum tran...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90337-4
更新日期:1984-11-01 00:00:00
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 stud...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.10.010
更新日期:2011-07-01 00:00:00
abstract::Twenty-five patients were treated for retained, recurrent, or primary common duct stones by permanent drainage of the biliary tract with external choledochoduodenostomy. Twenty-one patients had common duct stones which became evident two to fifty years after the initial biliary tract procedure and which may represent ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90136-3
更新日期:1979-02-01 00:00:00
abstract::A patient with acute amebic dilatation of the colon and multiple intrahepatic abscesses was successfully treated by a combination of medical and surgical therapy. Creation of a loop ileostomy and blow-hole colostomy facilitated complete healing of the colon. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90317-7
更新日期:1980-03-01 00:00:00
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 intensi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.10.025
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Randomized controlled trials have shown equivalent outcomes for laparoscopic-assisted colectomy (LAC) and open colectomy (OC) when performed by well-trained surgeons experienced in both techniques. Our goal was to evaluate the outcomes of LAC at a population level. METHODS:Using the prospectively collected ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.11.015
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:We present a 4-year update on the efficacy, cosmetic results, and complications of MammoSite breast brachytherapy in patients enrolled in the American Society of Breast Surgeons registry trial. METHODS:A total of 1,449 breasts in 1,440 patients with early stage breast cancer undergoing breast-conserving the...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.amjsurg.2008.09.016
更新日期:2009-07-01 00:00:00
abstract::We studied 48 patients with laryngeal or hypopharyngeal primary tumors with DNA flow cytometry. Twenty-four of the tumors were glottic, 18 were supraglottic, and 6 were from the pyriform sinus. Patients were followed for a minimum of 12 months, with a mean follow-up of 23 months. Twenty-three of the 48 primary tumors ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(86)90311-9
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:Diabetes mellitus (DM) is associated with adverse events or complications in various gastrointestinal diseases. In this study, we examined whether diabetic patients had higher risk for the development of complicated acute appendicitis than nondiabetic patients. The relevant risk factors also were determined....
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.05.042
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Pancreatic cancer is a leading cause of financial insolvency and cancer related deaths in the United States. The risk of catastrophic health expenditure (CHE) was calculated for patients undergoing pancreatic resection at an academic institution. METHODS:Patients who underwent pancreatic resection between 2...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.11.040
更新日期:2020-11-20 00:00:00
abstract:BACKGROUND:Symptomatic hypocalcemia remains the main postoperative complication after total thyroidectomy. The aim of the present study was to evaluate the role of oral supplementation of calcitriol and calcium salts in preventing severe postoperative hypocalcemia after total thyroidectomy. METHODS:A consecutive serie...
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.2005.04.017
更新日期:2005-09-01 00:00:00
abstract::A new break-away needle for subclavian catheter insertion has been described. This needle functions exactly as the usual 14 gauge needle, but it can be completely removed from the catheter while leaving the integral Luer adaptor intact. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90210-1
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:The laparoscopic approach to surgical diseases of the foregut is rapidly gaining acceptance. These new approaches, however, pit the unwary surgeon against potentially devastating complications. PATIENTS AND METHODS:Based on a retrospective review of 153 consecutive laparoscopic foregut surgeries performed a...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1016/S0002-9610(99)80206-2
更新日期:1995-05-01 00:00:00
abstract::Abdominal angina that is characterized by postprandial pain, and often associated with weight loss, is a well-recognized symptom complex of mesenteric artery insufficiency (mesenteric territory symptoms). In the past 5 years, we have observed six patients with atypical symptoms who had mesenteric artery occlusion comb...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81061-x
更新日期:1993-08-01 00:00:00
abstract::Mediastinal tracheostomy has been associated with high morbidity and mortality, often due to skin necrosis, with resultant exposure of the great vessels and subsequent hemorrhage. During a 4 year period, 11 patients underwent mediastinal tracheostomy. Reconstruction included the use of a pectoralis major musculocutane...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90377-5
更新日期:1984-10-01 00:00:00
abstract:BACKGROUND:We proposed to develop a novel virtual reality (VR) team training system. The objective of this study was to determine the feasibility of creating a VR operating room to simulate a surgical crisis scenario and evaluate the simulator for construct and face validity. METHODS:We modified ICE STORM (Integrated ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.01.024
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:A critical outcome analysis of a large, single-institution experience provides a better frame of reference for an assessment of the role of laparoscopic colectomy for colorectal pathology. METHODS:Review of a prospectively gathered database was performed of a consecutive series of laparoscopic colectomy pat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.10.039
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method for diagnosing choledocholithiasis. It is said to be as accurate as the gold standard endoscopic retrograde cholangiopancreatography (ERCP) for detecting common bile duct (CBD) stones. A study was needed to look at the accuracy of MRC...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.033
更新日期:2013-04-01 00:00:00
abstract::Treatment failure and survival in 209 patients with squamous cell carcinoma of the floor of the mouth treated with surgery as the single curative modality are reported. Fifty percent of the patients had stage III and IV disease. The primary tumor was excised with 1 to 2 cm margins and the mandible was resected in 73 p...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90118-9
更新日期:1989-10-01 00:00:00
abstract::All carotid arteriograms performed between January 1, 1986 and December 31, 1991 were reviewed for instances of midcervical carotid stenosis. Sixteen cases were identified. A stenosis related to the hypoglossal nerve was specifically identified in three operative reports in the retrospective review. Pathologic examina...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(94)80061-8
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND:One of the issues in the debate surrounding the extent of thyroid excision for localized, well-differentiated thyroid cancer is the low morbidity rate reported after all degrees of thyroid resection. This study was conducted to determine morbidity and mortality after surgical resection for thyroid cancer. M...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)80085-6
更新日期:1994-11-01 00:00:00
abstract::There has been a continuing evolution of the clinical spectrum of Candida infection in nonneutropenic patients. With better understanding of the predisposing factors for fungemia in critically ill patients, interest now centers on indications for early therapy, prior to the progression of colonization to fungemia. Rec...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(96)00350-9
更新日期:1996-12-01 00:00:00
abstract::Common duct stones retained after choledocholithotomy were removed in 11 patients under intravenous sedation using the Olympus fiberoptic choledochoscope passed through a T-tube tract. A total of 39 stones were removed during 12 procedures, with one patient requiring 2 procedures for complete stone removal. All common...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90332-3
更新日期:1980-04-01 00:00:00
abstract:BACKGROUND:We previously reported on a pilot trauma multidisciplinary crisis resource course titled S.T.A.R.T.T. (Simulated Trauma and Resuscitative Team Training). Here, we study the course's evolution. METHODS:Satisfaction was evaluated by postcourse survey. Trauma teams were evaluated using the Ottawa global rating...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.07.024
更新日期:2016-07-01 00:00:00
abstract::Seven patients who had typical and persistent symptoms of gallbladder disease but repeatedly normal oral cholecystograms were seen in an 18 month period. Ultrasound examination of the gallbladder was diagnostic of cholelithiasis in all seven patients. Six patients were found to have gallstones at operation, and the se...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90339-8
更新日期:1979-11-01 00:00:00
abstract:BACKGROUND:In contrast to conventional cytotoxic chemotherapy and radiation therapy, a new method of targeted cancer therapeutics is being directed towards molecular pathways that underlie the malignant phenotype. These therapies target specific tumor cell receptors or signaling events that are critical to tumor progre...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(03)00212-5
更新日期:2003-09-01 00:00:00