Abstract:
BACKGROUND:Aggressive screening for blunt cerebrovascular injury (BCVI) and prompt anticoagulation for documented injuries has resulted in a significant reduction in ischemic neurologic events. An association between vertebral artery injuries (VAIs) and specific cervical spine fracture patterns has been suggested; however, current screening guidelines would subject all patients with cervical spine fractures to imaging because no distinction has been made for carotid artery injuries (CAIs). We hypothesized that specific cervical spine fracture patterns that warrant screening evaluation exist, hence limiting unwarranted diagnostic imaging. METHODS:Patients undergoing screening for BCVI on the basis of injury patterns and mechanism have been prospectively followed at our regional trauma center since January 1996. RESULTS:During the study period from January 1996 to January 2005, there were 17,007 blunt trauma admissions. Twenty-three patients presented with symptoms of BCVI. Screening angiography was performed in 766 patients (4.5%), and diagnosed 258 (34%) patients with BCVI. One hundred twenty-five patients with BCVI had cervical spine fractures; 18 patients had isolated CAI; 84 had isolated VAI, and 23 had combined CAI and VAI. Eight patients with VAI had minor cervical fractures but underwent screening for other injury patterns. Fractures in the remaining patients with BCVI were 1 of 3 patterns. Subluxations in 56 (48%) patients, C1 to C3 cervical spine fractures in 42 (36%), or extension of the fracture through the foramen transversarium in 19 (16%). Cervical spine fractures were the sole indication for screening in 90% of the study population. Screening yield of all patients admitted with 1 of these 3 fracture patterns was 37%. CONCLUSIONS:Blunt cerebrovascular injury is associated with complex cervical spine fractures that include subluxation, extension into the foramen transversarium, or upper C1 to C3 fractures. Patients sustaining such cervical fractures should undergo prompt screening.
journal_name
Surgeryjournal_title
Surgeryauthors
Cothren CC,Moore EE,Ray CE Jr,Johnson JL,Moore JB,Burch JMdoi
10.1016/j.surg.2006.04.005subject
Has Abstractpub_date
2007-01-01 00:00:00pages
76-82issue
1eissn
0039-6060issn
1532-7361pii
S0039-6060(06)00270-4journal_volume
141pub_type
杂志文章相关文献
SURGERY文献大全abstract:BACKGROUND:Major postoperative complications are associated with a substantial increase in hospital costs. Trauma patients are known to have a higher rate of complications than the general surgery population. We used the National Surgical Quality Improvement Program (NSQIP) methodology to evaluate hospital costs, durat...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.05.003
更新日期:2008-08-01 00:00:00
abstract::Human platelets suspended in autologous plasma do not respond to nonspecific immune complexes as do platelet suspensions from rabbits and dogs. However, platelets of all three species do undergo aggregation and the release reaction when exposed to antibodies directed against platelets. Antithymocyte globulin (ATG) con...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1975-04-01 00:00:00
abstract::The effect of cimetidine and ranitidine (histamine type-2 receptor antagonists) on the production of interleukin-2 (IL-2) by mitogen-activated, normal murine spleen cells was studied in vitro. Cimetidine (10(-4) mol/L to 10(-6) mol/L) increased IL-2 production to a maximal 8.8 +/- 1.6 U (IL-2 activity), as compared wi...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract:BACKGROUND:Despite the accumulation of favorable results from laparoscopic liver resection (LLR), centrally located tumors close to the hilum, major hepatic veins, or inferior vena cava (IVC) are still considered contraindications for LLR. We evaluated the feasibility and safety of LLR for centrally located tumors. ME...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2012.10.004
更新日期:2013-04-01 00:00:00
abstract::The fields of computer vision (CV) and artificial intelligence (AI) have undergone rapid advancements in the past decade, many of which have been applied to the analysis of intraoperative video. These advances are driven by wide-spread application of deep learning, which leverages multiple layers of neural networks to...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2020.10.039
更新日期:2020-11-30 00:00:00
abstract:BACKGROUND:In primary hyperparathyroidism, successful parathyroidectomy leads to improved bone mineral density in the majority of cases. Our aim was to further explore the relationship between hypercalciuria, kidney function, and bone recovery after parathyroidectomy. METHODS:Bone mineral density, estimated glomerular...
journal_title:Surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.surg.2017.02.017
更新日期:2017-08-01 00:00:00
abstract::A case of paraprosthetic-enteric fistula is presented and the total reported literature of 21 cases is reviewed. Paraprosthetic-enteric fistula is a complication of aortic revascularization with synthetic prostheses. The entity is characterized by erosion of the gastrointestinal tract by an underlying prosthesis but a...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract:BACKGROUND:Outcome for most abdominal wall defects is related to the presence or absence of additional anomalies or prematurity. In gastroschisis, outcome is almost as closely related to the severity of the inflammatory "peel" on bowel that is thought to result from direct contact with amniotic fluid. Improving eviscer...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Apoptosis, a mechanism of cell death prominent in critical illnesses including disseminated inflammation and multiorgan dysfunction syndrome, is characterized by morphologic changes including cell shrinkage, condensation of organelles, blebbing, and chromatin fragmentation. These phenomena suggest substantia...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1998-08-01 00:00:00
abstract:INTRODUCTION:Rapid thrombelastography (rTEG) has been advocated as a point-of-care test to manage trauma-induced coagulopathy. rTEG activated clotting time (T-ACT) results become available much sooner than other rTEG values, thus offering an attractive tool to guide blood component transfusion in a hemorrhagic shock. W...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2014.04.017
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Resection for hepatocellular carcinoma in patients with cirrhosis and impaired liver function is usually unjustified because of higher surgical risks and poorer long-term prognosis. METHODS:A retrospective comparison of the background and resectional results of patients with cirrhosis and hepatocellular car...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80238-8
更新日期:1996-07-01 00:00:00
abstract:BACKGROUND:Major operative injury initiates immunologic changes that may result in a systemic inflammatory response, leading to organ dysfunction/sepsis. Catecholamines seem to be key mediators. The effects of beta(2) receptor blockade in vitro and in vivo before and after operative injury were studied to clarify their...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.09.013
更新日期:2009-02-01 00:00:00
abstract::A randomized trial involving 50 patients has demonstrated that a new type of debriding agent, cross-linked dextran beads with the trade name Debrisan (dextranomer, Pharmacia, Inc.), will produce rapid healing of cutaneous ulcers which have been resistant to conventional therapy over the long-term. Evaluation in terms ...
journal_title:Surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1979-02-01 00:00:00
abstract:BACKGROUND:In this study of laparoscopic splenectomy (LS), we evaluate prospectively gathered perioperative patient data and review lessons learned in the evolution of this procedure. METHODS:At 2 university medical centers between November 1993 and March 2000, there were 203 patients (122 female patients and 81 male ...
journal_title:Surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1067/msy.2000.109065
更新日期:2000-10-01 00:00:00
abstract:BACKGROUND:Adhesion of polymorphonuclear leukocytes (PMNs) to endothelial cells is mediated partially by CD11/CD18 integrins. The purpose of this study was to define (1) the response of PMNs to anti-CD18 monoclonal antibody binding, and (2) the mechanism responsible for anti-CD18 monoclonal antibody-mediated decreases ...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1992-08-01 00:00:00
abstract::In this study, we have compared a bioassay procedure with high-pressure liquid chromatography (HPLC) for the determination of metronidazole levels in serum and urine. Plasma and urine of volunteers with normal or impaired renal function were obtained at various intervals after a single intravenous dose of 500 mg metro...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:Gender differences have been noted in acute ischemia/reperfusion injury. Estrogen and the estrogen receptors (ER) appear to play a critical role in cardiovascular gender differences, given that females have improved myocardial functional recovery associated with decreased tissue inflammation. It has been sug...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2008.03.009
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Recent interest in cyst fluid analysis (CFA) for carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA), and the introduction of laparoscopic surgery (LS) in the management of hepatic cysts have resulted in sporadic reports of elevated CA 19-9 and CEA levels in intrahepatic biliary cystadenom...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2004.06.031
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:The long-term outcome of bilateral adrenalectomy in the management of patients with Cushing's syndrome has not been previously well studied. METHODS:We reviewed our long-term results in 34 patients treated with bilateral adrenalectomy between 1983 and the present. Fourteen presented with occult or metastati...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::The diagnosis of multiple endocrine neoplasia (MEN) in patients with presumed hyperparathyroidism has important ramifications for patient management especially since as many as 20% of patients with hyperparathyroidism may have associated MEN. Gut hormone levels were measured before and after surgery in 28 patients who...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::Peripheral lymphocytes, T cells, and T cell subsets of 141 consecutive patients with colorectal cancer were measured preoperatively to determine whether infectious complications could be predicted from derangements of T cell subsets. T cell subset abnormalities reportedly precede sepsis in patients with burn injuries....
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1988-02-01 00:00:00
abstract:BACKGROUND:The proportion of positive among examined lymph nodes (lymph node ratio [LNR]) has been recently proposed as an useful and easy-to-calculate prognostic factor for patients with cutaneous melanoma. However, its independence from the standard prognostic system TNM has not been formally proven in a large series...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2011.02.021
更新日期:2011-07-01 00:00:00
abstract::To prevent aneurysm rupture, avoid pseudoaneurysm formation, and preserve intercostal arteries, a new procedure for repair of DeBakey type 3 dissecting aneurysm was developed. Since January 1977, 28 patients have undergone repair of type 3 dissecting aneurysm. Fifteen patients with type 3b underwent this new procedure...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::We studied the role of hypoproteinemia, induced by a major burn injury, on the edema process in burned and nonburned tissues including the lung in the adult sheep. We used lymph flow (QL) and the lymph-plasma (L/P) protein ratio as indicators of the rate of fluid and protein flux across the microcirculation and into t...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND:Bioresorbable membranes composed of hyaluronic acid and carboxymethylcellulose (HA/CMC) are the most effective method to prevent intra-abdominal adhesions; however, their efficacy may be limited to the site of application. Previous studies in our laboratory have shown that the intraperitoneal administration ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2010.01.024
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:The number of dendritic cells (DC) in the local tumor environment correlates with patient survival in numerous tumors. The relationship of DC infiltration in the tumor microenvironment and prognosis was examined in patients with pancreatic adenocarcinoma. METHODS:Forty-seven pancreatectomy specimens with a ...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2002.119937
更新日期:2002-02-01 00:00:00
abstract:BACKGROUND:In living donor liver transplantation, variations in donor vascular anatomy, recipient portal vein thrombosis, short donor vessel length, and reconstitution of the anterior sector outflow in right lobe grafts often make complex and innovative vascular reconstructions necessary, which require the use of exten...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/j.surg.2007.10.008
更新日期:2008-07-01 00:00:00
abstract:BACKGROUND:Autotransplanted parathyroid tissue is capable of inducing neovascularization in vivo, restoring calcium homeostasis with regulatory control. The mechanisms of parathyroid-induced neovascularization remain to be determined. Using an unique three-dimensional in vitro model, we tested the ability of parathyroi...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1016/s0039-6060(96)80060-2
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:Apoptotic cell death and c-Jun N-terminal kinase (JNK) activation occur after hepatic ischemia/reperfusion injury. In other cell types, JNK activation was shown to be required for apoptosis. This study tested the hypotheses that JNK contributes to hepatocellular apoptosis, and that inhibition of JNK activity...
journal_title:Surgery
pub_type: 杂志文章
doi:10.1067/msy.2003.237
更新日期:2003-08-01 00:00:00
abstract::The acquired failure of host immunocompetence that may result from significant protein and caloric malnutrition has been associated with an increased incidence of septic complications in patients undergoing operation. Wound infection in patients undergoing vascular surgical procedures may lead to exposure or contamina...
journal_title:Surgery
pub_type: 杂志文章
doi:
更新日期:1983-06-01 00:00:00