Abstract:
:In a 2 year period, 60 consecutive feeding enterostomies were placed in malnourished patients. The major complication rate was 1.6 percent. Total complications were 8 percent. Thirty day mortality was 13 percent. Nearly all patients were given isosmotic nonelemental diets. The incidence of diarrhea was 2 percent with this regimen. Four of five patients given elemental diets had diarrhea. Serum albumin levels increased significantly from a preoperative mean of 2.75 to 3.03 g/dl. Best overall results were achieved in patients undergoing upper gastrointestinal surgery or pancreatobilary procedures for nonmalignant lesions. More than $60,000 was saved in 2 years by substituting isosmotic formulas for elemental ones. It appears that many patients are given elemental formulas who do not actually require them. Since isosmotic solutions will not infuse through needle catheters, we advocate placing 12 F. catheters and have documented the safety of this change. By using these larger catheters, the surgeon will not lose the option of using isosmotic preparations. We have shown these preparations to be nutritionally effective with a marked lessening of diarrhea and a cost approximately a sixth of that of elemental products.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Hinsdale JG,Lipkowitz GS,Pollock TW,Hoover EL,Jaffe BMdoi
10.1016/s0002-9610(85)80102-1subject
Has Abstractpub_date
1985-03-01 00:00:00pages
334-8issue
3eissn
0002-9610issn
1879-1883pii
S0002-9610(85)80102-1journal_volume
149pub_type
杂志文章abstract:BACKGROUND:Prior studies have demonstrated that African-American (AA) donor kidneys are independently associated with an increased risk for graft loss. METHODS:We examined outcomes in comparable groups of AA deceased-donor (DD) kidney transplant patients receiving an AA donor (n=35) versus a Caucasian donor (C group; ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.08.025
更新日期:2010-03-01 00:00:00
abstract::The salient clinical and pathological features of verrucous carcinoma, as first described by Ackerman in 1948, are reviewed. Two case reports are presented. The first concerns a personal experience with a patient who had five surgical procedures for multifocal oral verrucous carcinoma and remains alive and well 28 yea...
journal_title:American journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1016/s0002-9610(98)00232-3
更新日期:1998-11-01 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:BACKGROUND:Necrotizing pancreatitis is a common condition with high mortality; the acute care surgeon is frequently consulted for management recommendations. Furthermore, there has been substantial change in the timing, approach, and frequency of surgical intervention for this group of patients. METHODS:In this articl...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2020.08.027
更新日期:2020-08-26 00:00:00
abstract:BACKGROUND:We sought to determine the number of patients with known breast cancer who were found to have an additional, mammographically occult lesion detected on breast-specific gamma imaging (BSGI). METHODS:An institutional review board-approved review of all patients who underwent BSGI at Beth Israel Medical Center...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.06.016
更新日期:2009-10-01 00:00:00
abstract::A combination of heparin and dihydroergotamine mesylate (Heparin-Dihydergot) has been shown to be more effective than either of these drugs alone in preventing postoperative venous thromboembolism. The possible mechanism for the synergistic effect of heparin and dihydroergotamine was assessed. Phlebograms obtained aft...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:
更新日期:1985-10-08 00:00:00
abstract::The influence of pancreatic acinar cell atrophy and fibrosis on islet tissue autotransplantation was studied in dogs. Thirty-nine dogs underwent pancreatic duct ligation. After 6 weeks marked acinar cell atrophy and fibrosis developed, similar to that in human chronic pancreatitis. Intravenous glucose tolerance testin...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90248-2
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:For female breast cancer (BC) patients undergoing mastectomy, post-mastectomy breast reconstruction (PMBR) confers significant psychosocial benefits and improved cosmetic outcomes. The objective of this study is to explore whether the utilization of PMBR varies by race, marital status, and geographical locat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.07.025
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Students report that their operating room experience during specialty clerkships has been less than satisfactory. To deal with this and other problems in a 1-week cardiothoracic clerkship, a video conference system was introduced. METHODS:Three teaching strategies were used: a seminar dealing with the disea...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(96)00387-x
更新日期:1997-04-01 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:BACKGROUND:Mesenteric vein thrombosis (MVT) is an uncommon type of intestinal ischemia associated with significant mortality and morbidity because of its delay in diagnosis. METHODS:A retrospective analysis of 9 patients treated surgically for MVT during 1982 to 1997 was performed. RESULTS:Nine patients underwent sur...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00532-8
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine whether minimally invasive radioguided parathyroidectomy (MIRP) and intraoperative parathyroid hormone-guided parathyroidectomy (ioPTH) have equivalent intermediate-term outcomes in primary hyperparathyroidism (PHPT). METHODS:A retrospective study of 244 patients who u...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.10.015
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:It has been suggested that division of the short gastric vessels (SGV) provides a more floppy Nissen fundoplication, for the treatment of reflux disease. The aim of the study was to assess whether Nissen fundoplication with division of SGV is associated with improved clinical outcome and laboratory findings....
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/s0002-9610(01)00695-x
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disorder of unknown pathophysiology. The role of splenectomy in the multimodality therapy of TTP is controversial. MATERIALS AND METHODS:All charts of patients with TTP at the University of Utah between 1984 and 1994 were reviewed to eval...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80015-4
更新日期:1995-12-01 00:00:00
abstract::Silver biopsies of the common bile duct were obtained from 15 patients with clinical and surgical evidence of cholangitis. The most pronounced histologic changes were edema, congestion, and marked mucous gland hypertrophy and hyperplasia. No ulceration, intramural abscess, or areas of necrosis were found. Clinical cho...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90089-8
更新日期:1979-06-01 00:00:00
abstract::One hundred patients with advanced, recurrent, or metastatic squamous cell carcinoma of the head and neck were treated with chemotherapy and BCG as adjuvant immunotherapy. The overall response rate was 35 per cent, and the median duration of response was seventeen weeks. BCG does not prolong duration of remission or s...
journal_title:American journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9610(77)90381-6
更新日期:1977-10-01 00:00:00
abstract:BACKGROUND:Lack of exposure to surgery in the preclinical years of medical school contributes to students' negative opinions of the field and to low application rates to categorical surgical programs. METHODS:Forty preclinical medical students attended a series of 16 seminars and practice sessions covering the gamut o...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.12.038
更新日期:2007-08-01 00:00:00
abstract::The effects of epinephrine on the vascular perfusion of solitary Walker tumors implanted in the liver were studied in Sprague-Dawley rats. Colored silicone rubber (Microfil) solutions were injected into the arterial and portal circulations in each animal, and specimens were studied under a stereomicroscope. Internal v...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90044-6
更新日期:1980-11-01 00:00:00
abstract:BACKGROUND:We hypothesized that early use of external mechanical compression (EMC) reduces hemorrhage and mortality associated with pelvic fractures. METHODS:Patients with pelvic fractures and one of the following risk factors for hemorrhage were studied retrospectively: (1) unstable fracture pattern, or (2) any fract...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.08.040
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Rurality adversely impacts the continuum of cancer care. However, investigations of rural cancer surgery are notably absent. We examined patterns and outcomes of oncologic resections at rural US hospitals. METHODS:We identified 928,370 hospital admissions in which 1 of 20 oncologic resections was performed ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.07.012
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Professionalism and ethics are Accreditation Council for Graduate Medical Education (ACGME) core competencies, but there is little evidence regarding the effectiveness of ethics education. METHODS:General surgery residents at the University of Pittsburgh completed questionnaires measuring attitudes and know...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2010.08.002
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:We hypothesized that team communication with unmatched grammatical form and communicative intent (mixed mode communication) would correlate with worse trauma teamwork. METHODS:Interdisciplinary trauma simulations were conducted. Team performance was rated using the TEAM tool. Team communication was coded fo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.11.008
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Stress can negatively impact surgical performance, but mental skills may help. We hypothesized that a comprehensive mental skills curriculum (MSC) would minimize resident performance deterioration under stress. METHODS:Twenty-four residents were stratified then randomized to receive mental skills and FLS tr...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2017.09.039
更新日期:2018-02-01 00:00:00
abstract::The reported incidence of hypotension after carotid reconstruction ranges from 21 to 50 percent. To evaluate baroreceptor dysfunction, 283 carotid reconstructions were studied. During 181 consecutive reconstructions, a transcutaneous Teflon catheter was positioned intraoperatively at the carotid bifurcation for postop...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90196-x
更新日期:1984-06-01 00:00:00
abstract:BACKGROUND:A nonintrusive e-mail reminder incorporating teaching tips and manuscripts was developed to supplement resident-as-teacher curricula. METHODS:Ten high-yield manuscripts and 10 teaching tips exemplifying the themes of mentorship or role modeling, teaching methods, adult learning theory, feedback, and the res...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.05.004
更新日期:2017-01-01 00:00:00
abstract::A series of 168 patients who underwent 177 inguinal lymph node dissections from 1979 to 1989 were retrospectively reviewed to determine the incidence and severity of postoperative complications as well as the perioperative risk factors associated with them. Operative mortality was 0%, whereas the incidence of moderate...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81181-x
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:This study examined the impact of intraoperative myocardial acidosis and adverse postoperative outcomes on the cost of cardiac surgical care. METHODS:Myocardial tissue pH corrected to 37 degrees C (pH(37C)) was measured in 162 patients with cross-clamp (XC) duration of 119 minutes or longer. Perioperative d...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2008.01.023
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Percutaneous endoscopic gastrostomy and jejunostomy tube placement have long been considered the standard for supplying enteral nutrition when oral intake is not possible. Both have well-documented roles and limitations and are associated with a higher than generally appreciated incidence of aspiration. A di...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00298-0
更新日期:1999-01-01 00:00:00
abstract::Noninvasive screening of the lower extremities for deep vein thrombosis was performed bilaterally on 1,118 patients. Impedance plethysmography alone was used in 868. Venography in 135 revealed an accuracy of 88%, with a false-negative rate of 5.3% and a false-positive rate of 18.6%. A combined ultrasonic Doppler and m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90032-6
更新日期:1978-04-01 00:00:00
abstract::Paraplegia or paraparesis after operations on the thoracic and abdominal aorta is a devastating event, both for the patient and the surgeon. While its incidence varies from under 1% with operations at the top and bottom of the aorta, its occurrence in the midportion of the aorta, just above the diaphragm, even in the ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(98)00133-0
更新日期:1998-08-01 00:00:00