Abstract:
BACKGROUND:Antiphospholipid (APL) antibodies are a heterogenous group of antibodies that have been associated with an increase in bleeding complications and a marked increase in thrombotic events, both of which result in significant patient morbidity and mortality. PATIENTS AND METHODS:A retrospective analysis of patients identified to be positive for APL via a university thrombosis registry who had cardiovascular surgery between 1989 and 1994. RESULTS:Seventy-one patients positive for APL antibodies were identified. Of those patients, 19 had cardiovascular surgical procedures (11 women and 8 men, mean age 58.4 years, range 38 to 78). A total of 48 cardiovascular surgical procedures (mean 2.5 procedures/patient) were performed in the 19 patients. These procedures included 13 lower-extremity reconstructions, 11 upper-extremity reconstructions/fistulas, 8 cardiac valve replacements, 5 coronary artery bypass procedures, 5 major amputations, 4 infrarenal aortic reconstructions, and 2 carotid endarterectomies. Sixteen of the 19 patients (84.2%) suffered major postoperative complications. These included 16 thrombosed grafts, 5 strokes, 5 major bleeding events, 2 pulmonary emboli, and 2 myocardial infarctions. Ultimately, 12 of the 19 patients (63.2%) died of complications related to surgery. CONCLUSIONS:This series of patients confirms that patients with circulating APL antibodies are prone to excessive postoperative morbidity and mortality after cardiovascular surgical procedures. The presence of APL antibodies may be a maker of increased risk of complications after cardiovascular surgery.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Ciocca RG,Choi J,Graham AMdoi
10.1016/s0002-9610(99)80285-2subject
Has Abstractpub_date
1995-08-01 00:00:00pages
198-200issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(99)80285-2journal_volume
170pub_type
杂志文章abstract::The popliteal artery entrapment syndrome is increasingly recognized as a cause of arterial insufficiency in the leg. Diagnosis is based on a clinical history of claudication, which may be atypical, physical examination, noninvasive exercise testing and angiography. Patients with normal ankle pulses and resting ankle/b...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90285-8
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:Recent literature suggests that peritoneal drainage (PD) is not helpful after elective pancreatectomy and may be detrimental. Data specific to distal pancreatectomy (DP) have not received prior evaluation. METHODS:We performed a retrospective review of patients who underwent DP. Factors examined included po...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.02.005
更新日期:2012-10-01 00:00:00
abstract::Cardiac decompensation is clearly the major complication of aortic reconstructive surgery that leads to morbidity. Major changes in intravascular volume, third spacing, and increased systemic vascular resistance are extremely stressful to the diseased heart. Hemodynamic monitoring is readily available to provide an ac...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90367-7
更新日期:1983-08-01 00:00:00
abstract::The hospital and office records of 86 patients who underwent proctectomy for cancer of inflammatory bowel disease with primary closure of the perineal wound were reviewed. Almost one fourth of all patients suffered a significant perineal wound complication, the majority of which were infections. The incidence of posto...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90187-3
更新日期:1983-01-01 00:00:00
abstract:BACKGROUND:This study aimed to assess the transferability of basic laparoscopic skills between a virtual reality simulator (MIST-VR) and a video trainer box (D-Box). METHODS:Forty-six medical students were randomized into 2 groups, training on MIST-VR or D-Box. After training with one modality, a crossover assessment ...
journal_title:American journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.amjsurg.2009.05.016
更新日期:2010-06-01 00:00:00
abstract::The orthopedic surgeon has several options available for blood conservation. Preoperative autologous donation (PAD) of blood is a cost-effective measure when the cost of managing transfusion-transmitted infectious disease is considered; overuse and underuse are expensive problems, however. Hemodilution, while used suc...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(99)80061-0
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:The role of sentinel lymph node status (SLNS) in thick melanoma is evolving. The purpose of this study was to determine the prognostic value of SLNS in thick melanoma. METHODS:A retrospective analysis of 120 prospectively collected clinically node-negative thick melanomas over 5 years was performed. Patient...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2013.12.022
更新日期:2014-05-01 00:00:00
abstract::The value of bacteriologic findings in patients with acute appendicitis was studied. Routine urinary culture specimens were taken preoperatively from 194 children (mean age 11 +/- 3 years) undergoing emergency appendectomy. Bacteria were found in culture specimens of urine from 26 of 156 patients with acute appendicit...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80731-1
更新日期:1988-02-01 00:00:00
abstract::Gaucher's disease is an inherited metabolic disorder caused by the defective activity of acid beta-glucosidase and the resultant accumulation of glucosyl ceramide-laden macrophages in the liver, bone, and spleen. Splenectomy is the preferred treatment for patients with Gaucher's disease who develop massive splenomegal...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90363-i
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Coagulopathy is frequently encountered during supraceliac aortic clamping. Patients are routinely heparinized during these operations. This experiment was undertaken to evaluate the effect of supraceliac aortic cross-clamping (XC) on heparin pharmacodynamics. MATERIAL AND METHODS:Fourteen mongrel dogs were ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/S0002-9610(96)00140-7
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:Invasive lobular carcinoma (ILC) presents special challenges to treating physicians because of the diffuse infiltrative growth pattern. As sentinel lymph node dissection (SLND) is rapidly replacing axillary lymph node dissection (ALND) in the management of patients with early-stage breast cancer, we sought to...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.06.021
更新日期:2005-10-01 00:00:00
abstract::Five hundred twenty-six patients who underwent carotid endarterectomy were separated by reviewing those 81 (15%) patients with an occluded contralateral carotid artery and those 445 (85%) with nonocclusion. The population characteristics and surgical indications were similar between the occluded and nonoccluded groups...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81050-5
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:Administrative databases oversimplify the relationship of factors such as volume or training on surgical outcomes. METHODS:A prospective statewide surgeon-initiated database was queried to obtain incident cases of rectal cancer in Vermont from April 1999 to June 2001. Demographics, procedure performed, meth...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.01.029
更新日期:2007-10-01 00:00:00
abstract::Angioaccess procedures at one institution over a 4-year period were retrospectively reviewed to ascertain the frequency of major limb- or life-threatening complications. A total of 435 angioaccess procedures were performed, including 81 Cimino-Brescia fistulas, 166 polytetrafluoroethylene grafts, and 111 thrombectomy/...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81076-1
更新日期:1992-09-01 00:00:00
abstract::Between 1971 and 1976, ninety-three patients with a clinical diagnosis of pseudocyst confirmed by ultrasonography were identified from a group of 923 patients admitted for pancreatic disease. Uncertainties in diagnosis and/or rapid progression of underlying pancreatitis led to urgent laparotomy and drainage in eleven ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90024-2
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:Patients with spinal cord injury (SCI) frequently have pressure ulcers. Surgery is sometimes needed to close them. In rare cases, hemipelvectomy is warranted for extremely severe complications. METHODS:We conducted a retrospective study using national Department of Veterans Affairs (DVA) computer data sets ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01123-6
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:We propose a simple algorithm for management of patients with challenging abdominal fascial defects. METHODS:The medical records of 64 patients with complicated abdominal wall defects representing a consecutive series by a single surgeon over a 4-year period were reviewed. Group I patients presented with ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(00)00566-3
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:Sentinel lymph node (SLN) biopsy (SLNB) is an accurate and proven axillary staging procedure for early breast cancer. The aim of this study was to determine if the "10% rule" is applicable to the performance of SLNB at the investigators' institution and if the criteria used for SLNB at their institution coul...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.01.010
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Wound healing and chronic wounds are serious public health issues. While wounds heal, cellular stores of antioxidants are depleted. d-ribose-l-cysteine (DRLC) is a precursor to the antioxidant glutathione. The effect of oral supplementation with DRLC on wound healing was studied in rats. METHODS:A rodent mo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.11.014
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:For locally advanced Siewert type II and III tumors we have performed total gastrectomy including resection of the distal 2/3 of the esophagus, through separate abdominal and right chest incisions (THX-ABD). The procedure involves wide lymphadenectomy in the abdomen/chest and a Roux-en-Y jejunostomy to the l...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.11.049
更新日期:2019-08-01 00:00:00
abstract::Significant salvage of patients with a wide variety of cysts and benign tumors of the liver and of some patients with biliary strictures can be achieved by hepatic resection in carefully selected clinical situations with a low operative mortality rate and an acceptable postoperative complication rate. Still to be dete...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90123-5
更新日期:1979-04-01 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:Intraoperative blood loss has been shown to be an important factor correlating with morbidity and mortality in liver surgery. A 5-cm long instrument with variably deployable metal electrodes using in-line radiofrequency ablation (ILRFA) energy was used for hepatic transection in an attempt to reduce bleeding...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.04.011
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To identify risk factors predictive of pulmonary embolus (PE) timing after a traumatic injury. METHODS:One hundred eight traumatic injury patients with a confirmed diagnosis of PE were classified as early PE (≤4 days, n = 54) or late PE (>4 days, n = 54). Independent predictors of early versus late PE were i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.12.005
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Despite blood-conservation techniques, hemorrhage during burn excision remains substantial. It is difficult to predict the blood loss that will occur per operation and how many units the patient will require during surgery. This may result in high cross-match-to-transfusion ratios (CMTRs). METHODS:A retrosp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2004.11.030
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:The authors evaluated outcomes and treatment costs of stereotactic core needle biopsy (SCNB) and ultrasound core needle biopsy (UCNB), and needle localization biopsy (NLB) in managing patients with mammographic abnormalities presenting to the surgeon. METHODS:Data for all patients with mammographic lesions ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(97)00199-2
更新日期:1997-12-01 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:During liver transplantation, an oversized graft or active bleeding in the hepatic area can make performance of the suprahepatic caval anastomosis extremely difficult or even impossible. In other instances, a brief as possible warm ischemia is desired to provide a marginal graft with maximum chances of good ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00875-3
更新日期:2002-02-01 00:00:00
abstract::Rectal prolapse that is intractable to the usual medical therapy was successfully managed without significant complications in 10 patients by simple subcutaneous encirclement of the anus with a heavy nonabsorbable suture, which was in place until the suture was removed or broke after 4 to 6 months. Four patients requi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(05)81022-0
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to describe the admission characteristics of trauma victims that are predictive of the development of delirium during hospitalization. METHODS:In this case-control study, data (demographics, injury type, medical histories, admission laboratory values, medications, and outcomes)...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2003.12.027
更新日期:2004-03-01 00:00:00