Abstract:
:A prospective (Part I) and a retrospective (Part II) study were used to determine the safety and efficacy of corticosteroids in the treatment of septic shock. In Part I, 172 consecutive patients in septic shock admitted over an 8-year period were treated with either steroid or saline: 43 received dexamethasone (DMP), 43 received methylprednisolone (MPS), and 86 received saline. The study was double-blind and randomized, and the three groups were compared for age, severity of shock, presence of underlying disease, and year of study. In the 86 saline-treated patients, the mortality rate was 38.4% (33/86); in the steroid-treated patients, it was 10.4% (9/86). With MPS the mortality rate was 11.6% (5/43), and with DMP it was 9.3% (4/43). Thus, overall mortality was significantly less in the steroid-treated group than in the control group. Further, there was no significant difference in mortality rate between the DMP- and the MPS-treated patients. In Part II, 328 patients were studied retrospectively. One-hundred sixty were treated without steroid, and 168 were treated with either DMP or MPS. Again, the two groups of patients were compared for severity of shock, underlying disease, age, and year of study. Mortality among patients treated without steroid was 42.5% (68/160) and among patients treated with steroid was 14% (24/168); there was no significant difference in mortality rate between DMP- and MPS-treated patients. In Parts I and II combined, complications occurred in 6% of steroid-treated patients with no significant difference between DMP- and MPS-treated groups. :A 2-part study, prospective and retrospective, was conducted to determine the safety and efficacy of corticosteroids in the treatment of septic shock. In part 1, 172 consecutive patients in septic shock admitted over an 8-year period were treated with either steroid or saline: 43 received (DMP) dexamethasone; 43 received (MPS) methylprednisolone; and 86 received saline. The study was double-blind and randomized, and the 3 groups were compared for age, severity of shock, presence of underlying disease, and year of study. In the 86 saline-treated patients, the mortality rate was 38.4% (33/86); in the steroid-treated patients, it was 10.4% (9/86). With MPS the mortality rate was 11.6% (5/43), and with DMP it was 9.3 (4/43). Thus, overall mortality was significantly less in the steroid-treated group than in the control group. Further, there was no significant difference in mortality rate between those treated with DMP and MPS. In part 2, 328 patients were studied retrospectively. 168 were treated without steroid, and 168 were treated with either DMP or MPS. Again, the 2 groups of patients were compared for severity of shock, underlying disease, age, and year of study. Mortality among patients treated without steroids was 42.5% (68/160) and among patients treated with steroids was 14% (24/168). There was no significant difference in mortality rate between DMP- and MPS-treated patients. In parts 1 and 2 combined, complications occurred in 6% of steroid-treated patients with no significant difference between DMP- and MPS-treated patients.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Schumer Wdoi
10.1097/00000658-197609000-00011subject
Has Abstractpub_date
1976-09-01 00:00:00pages
333-41issue
3eissn
0003-4932issn
1528-1140journal_volume
184pub_type
临床试验,杂志文章,随机对照试验abstract::Between June 1977 and November 1981, 26 children and adults with ulcerative colitis have undergone a total colectomy, an endorectal dissection of the rectal mucosa, and an ileoanostomy. A combined abdominoperineal approach was used to perform the operation, and the mucosal-submucosal rectal tube was dissected out inta...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract:OBJECTIVE:To examine the surgical and pathologic findings of 15 patients who had initially unresectable hepatocellular carcinoma (HCC) and received preoperative systemic chemoimmunotherapy and sequential resection. SUMMARY BACKGROUND DATA:More than 80% of patients with HCC present for treatment at an unresectable stag...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200102000-00013
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:To compare the long-term outcomes of surgical resection and radiofrequency ablation for the treatment of small hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA:Radiofrequency ablation (RFA) is a promising, emerging therapy for small HCC. Whether it is as effective as surgical resection (RES) for long-...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0b013e3181efc656
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Hereditary hemorrhagic telangiectasia (HHT) or Rendu-Osler-Weber disease is a rare disease characterized by the presence of arteriovenous malformations. Hepatic involvement can lead to life-threatening conditions. MATERIAL AND METHODS:Forty patients, reported to the European Liver Transplant Registry, were ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000247258.35406.a4
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:Arginine transport was characterized and studied in human liver. SUMMARY BACKGROUND DATA:Plasma arginine uptake may regulate hepatocyte intracellular availability and the subsequent biosynthesis of nitric oxide (NO), but little is known about arginine transport across the human hepatocyte plasma membrane. M...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199309000-00014
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Controversy exists on the use of mesh in the repair of paraesophageal hernias (PEH). This debate centers around the type of mesh used, its value in preventing recurrence, its short- and long-term complications, and the consequences of those complications compared with primary repair. Decision analysis is a m...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3182822c8c
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To review the Department of Veteran Affairs (VA) and the Society of Thoracic Surgeons (STS) national databases over the past 10 years to evaluate their relative similarities and differences, to appraise their use as quality improvement tools, and to assess their potential to facilitate improvements in quality...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200110000-00006
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:To determine whether surgical subspecialty training in colorectal surgery or frequency of rectal cancer resection by the surgeon are independent prognostic factors for local recurrence (LR) and survival. SUMMARY BACKGROUND DATA:Variation in patient outcome in rectal cancer has been shown among centers and am...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/00000658-199802000-00001
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare silicone-banded sleeve gastrectomy (BSG) to nonbanded sleeve gastrectomy (SG) regarding weight loss, obesity-related comorbidities, and complications. SUMMARY BACKGROUND DATA:As a primary bariatric procedure, SG leads to excellent weight loss, yet weight regain is a relev...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000004174
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:To characterize factors predictive of improved survival following gastrectomy with additional organ resection for the treatment of gastric cancer. SUMMARY BACKGROUND DATA:Recent large series have reported significant survival disadvantages to patients who have undergone gastrectomy with splenectomy or pancre...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200208000-00003
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:A randomized controlled trial to confirm the non-inferiority of laparoscopic surgery to open surgery in terms of overall survival was conducted, and short-term surgical outcomes are demonstrated. BACKGROUND:The efficacy and safety outcome of laparoscopic surgery for clinical stages II/III colon cancer underg...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000000499
更新日期:2014-07-01 00:00:00
abstract::This study was conducted to elucidate plasma cholecystokinin (CCK) and pancreatic polypeptide (PP) response after pancreatoduodenectomy and to compare response of CCK and PP in patients who had pancreatoduodenectomy with Billroth I and Billroth II type of reconstruction. Basal levels of plasma CCK were significantly l...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198708000-00006
更新日期:1987-08-01 00:00:00
abstract::Ambulatory venous pressure (AVP) and ascending and retro-grade phlebography have been used to elucidate the precise pathogenetic factors in cases of venous stasis. On the bases of this information, procedures aimed at the correction of the particular pathophysiological alterations were carried out. Fifty-two lower ext...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198201001-00004
更新日期:1982-01-01 00:00:00
abstract::In order to determine which factors most influence late survival after the coronary bypass procedure, a review was made of the initial experience of one surgeon who performed 792 operations between 1968 and 1972. The initial 250 patients were compared with the subsequent 542 patients. The two groups were of similar ag...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197806000-00013
更新日期:1978-06-01 00:00:00
abstract:OBJECTIVE:This study provided an objective survey by an outside auditing group of a large, complete patient population undergoing laparoscopic cholecystectomies, determined the frequency of complications, especially bile duct injuries, and presented a system for classifying and comparing the severity of bile duct injur...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199411000-00005
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the psychosocial outcomes and body image of patients 2 years postmastectomy reconstruction using a multicenter, multisurgeon approach. BACKGROUND:Although breast reconstruction has been shown to confer significant psychosocial benefits in breast cancer patients at year 1 postreconst...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e3181728a5c
更新日期:2008-06-01 00:00:00
abstract::The understanding of the association of mammalian ovarian function with lactation was common knowledge to dairy-men early in the 19th century or earlier. This thesis reviews the application of these empiric observations to lactation in humans by Beatson of Glasgow, supported by his preliminary laboratory investigation...
journal_title:Annals of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/00000658-197612000-00009
更新日期:1976-12-01 00:00:00
abstract:OBJECTIVE:The outcome of pelvic exenteration was compared in patients with locally advanced primary (LAP) cancer and recurrent rectal cancer (RRC). BACKGROUND:There are few reports comparing the results of pelvic exenteration for primary advanced rectal cancer and RRC. METHODS:Consecutive patients undergoing pelvic e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828a0d22
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:The role for neoadjuvant systemic therapy in resectable pancreas adenocarcinoma remains undefined. OBJECTIVE:We evaluated the efficacy of gemcitabine and oxaliplatin administered as preoperative therapy in patients with resectable pancreas adenocarcinoma. METHODS:Eligible patients were screened using compu...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0000000000000251
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To validate the global features of postoperative adverse outcomes for surgical patients with schizophrenia. BACKGROUND:Patients with schizophrenia were known to have a higher risk of complications during hospitalization. Quality of care has become the key factor in reducing their potential mortality afterwar...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e31827b9b25
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the influence of preoperative dysplasia grade, appearance, and site on risk and location of cancer in patients with colitis. BACKGROUND:The ability to predict the presence and location of cancer in colitis patients with dysplasia is essential to facilitate recommendations regarding the necessity ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828e7417
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Patients frequently voice concerns regarding wait times for cancer treatment; however, little is known about the length of wait times from diagnosis to surgery in the United States. Our objectives were (1) to assess changes in wait times over the past decade and (2) to identify patient, tumor, and hospital f...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318211cc0f
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:To prospectively evaluate the oncologic and functional outcomes of laparoscopic total mesorectal excision (TME) with colonic J-pouch reconstruction. BACKGROUND:TME is considered the established gold standard in rectal cancer surgery. However, data on laparoscopic sphincter-preserving TME are limited. METHOD...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000202180.16723.03
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:To quantitate disease-specific hospital-based medical costs in 34 patients with chronic pancreatitis before and after treatment by either duodenal-preserving pancreatic head resection (DPPHR) or pylorus-preserving pancreaticoduodenectomy (PPPD). SUMMARY BACKGROUND DATA:Pancreatic head resection in selected p...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200111000-00012
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:The effects of total parenteral nutrition (TPN) administration on pulmonary macrophage function and host response to gram-negative pulmonary infection were evaluated. SUMMARY BACKGROUND DATA:Administration of TPN resulted in increased infectious complications in traumatized and perioperative patients, but un...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199403000-00009
更新日期:1994-03-01 00:00:00
abstract:SUMMARY BACKGROUND DATA:The value of laparoscopy in appendicitis is not established. Studies suffer from multiple limitations. Our aim is to compare the safety and benefits of laparoscopic versus open appendectomy in a prospective randomized double blind study. METHODS:Two hundred forty-seven patients were analyzed fo...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000179648.75373.2f
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:This study determined how scar formation develops in a non-human primate model of fetal skin repair. SUMMARY BACKGROUND DATA:A transition from healing scarlessly to healing with scar formation characterizes skin repair in rat and sheep fetuses. New knowledge of the regulatory processes occurring in the fetal...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199304000-00011
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:The authors investigate the recovery of gastrointestinal motility in the fed and fasted state after laparoscopic and open cholecystectomy. SUMMARY BACKGROUND DATA:Clinical recovery after laparoscopic cholecystectomy is known to be more rapid than after conventional open cholecystectomy. However, the actual e...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199604000-00010
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVES:To investigate the effect of preoperative chemoradiotherapy on surgical complications in patients after pancreatic resection for (borderline-)resectable pancreatic cancer. SUMMARY OF BACKGROUND DATA:Preoperative chemoradiotherapy is increasingly used in patients with (borderline-)resectable pancreatic cance...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004313
更新日期:2020-11-12 00:00:00
abstract::Among hypertensive and diabetic patients undergoing elective noncardiac surgery, preoperative status and intraoperative changes in mean arterial pressure (MAP) were evaluated as predictors of postoperative ischemic complications. Of 254 patients evaluated before operation and monitored during operation, 30 (12%) had p...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198911000-00012
更新日期:1989-11-01 00:00:00