Abstract:
OBJECTIVE:To evaluate dynamic contrast enhanced computed tomography for detecting and localising pancreatic necrosis in acute pancreatitis. DESIGN:Prospective evaluation with blind reporting of scans. SETTING:Single teaching hospital. PATIENTS:60 Consecutive patients with acute pancreatitis suspected to have pancreatic necrosis because of major organ system failure (13); slow recovery five to seven days after admission with raised scores on the acute physiological and chronic health evaluation (APACHE-II) system (27); or findings on previous ultrasonography or computed tomography (20). MAIN OUTCOME MEASURE:Pancreatic necrosis proved histologically--that is, greater than 30 g necrotic tissue debrided at laparotomy (for life threatening sepsis or peritonitis) or necropsy. RESULTS:Dynamic computed tomography correctly localised pancreatic necrosis in 11 patients (confirmed at laparotomy in nine and at necropsy in two). Of nine patients with low enhancement of peripancreatic tissues alone, eight recovered after conservative management; necropsy confirmed viable pancreas and necrosis of peripancreatic fat in one patient. Of 40 patients with normal contrast enhancement, none required laparotomy to debride pancreatic necrosis. CONCLUSION:Dynamic contrast enhanced computed tomography seems to be a safe and accurate method of identifying and localising pancreatic and peripancreatic necrosis, which cannot be predicted accurately by conventional imaging techniques.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Larvin M,Chalmers AG,McMahon MJdoi
10.1136/bmj.300.6737.1425subject
Has Abstractpub_date
1990-06-02 00:00:00pages
1425-8issue
6737eissn
0959-8138issn
1756-1833journal_volume
300pub_type
杂志文章abstract::This paper summarizes the key findings of a U.S. study of 48 primary care physicians acting as gatekeepers in a large health maintenance organization to determine the effects of their cost containment role on the doctor patient relationship. Taylor highlights some of the findings and conclusions that he believes are ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6711.1323
更新日期:1989-11-25 00:00:00
abstract:OBJECTIVE:To estimate changes in the risk of autism and assess the relation of autism to the mumps, measles, and rubella (MMR) vaccine. DESIGN:Time trend analysis of data from the UK general practice research database (GPRD). SETTING:General practices in the United Kingdom. SUBJECTS:Children aged 12 years or younger...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.322.7284.460
更新日期:2001-02-24 00:00:00
abstract:OBJECTIVES:To estimate the prevalence and incidence of divorce among US physicians compared with other healthcare professionals, lawyers, and non-healthcare professionals, and to analyze factors associated with divorce among physicians. DESIGN:Retrospective analysis of nationally representative surveys conducted by th...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h706
更新日期:2015-02-18 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7029.501
更新日期:1996-02-24 00:00:00
abstract:OBJECTIVES:To investigate the possible influence of attendance at cultural events, reading books or periodicals, making music or singing in a choir as determinants for survival. DESIGN:A simple random sample was drawn of 15,198 individuals aged 16-74 years. Of these, 85% (12,982) were interviewed by trained non-medica...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7072.1577
更新日期:1996-12-21 00:00:00
abstract:OBJECTIVE:To evaluate systematically the review literature on type 2 diabetes to assess transmission of the findings of the United Kingdom prospective diabetes study (UKPDS), an important source of recent valid patient oriented evidence that matters (POEMs). DESIGN:Inception cohort analysis of the recent medical liter...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.327.7409.266
更新日期:2003-08-02 00:00:00
abstract:OBJECTIVE:To determine patient, institution, and machine characteristics that contribute to variation in radiation doses used for computed tomography (CT). DESIGN:Prospective cohort study. SETTING:Data were assembled and analyzed from the University of California San Francisco CT International Dose Registry. PARTICI...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.k4931
更新日期:2019-01-02 00:00:00
abstract:OBJECTIVE:To determine whether the use of inhaled corticosteroids during pregnancy increases the risk of pregnancy induced hypertension and pre-eclampsia among asthmatic women. DESIGN:Nested case-control study. SETTING:Three administrative health databases from Quebec: RAMQ, MED-ECHO, and Fichier des evenements demog...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.38313.624352.8F
更新日期:2005-01-29 00:00:00
abstract:OBJECTIVE:To assess the association between genotype at the insertion or deletion polymorphism of the angiotensin converting enzyme gene and risk of coronary restenosis after percutaneous coronary intervention. DESIGN:Meta-analysis of studies before July 2001 that reported on these genotypes and risk of coronary reste...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.325.7363.517
更新日期:2002-09-07 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7353.1549
更新日期:2002-06-29 00:00:00
abstract:OBJECTIVES:To compare the frequency of discrepancies in retracted reports of clinical trials with those in adjacent unretracted reports in the same journal. DESIGN:Blinded case-control study. SETTING:Journals in PubMed. POPULATION:50 manuscripts, classified on PubMed as retracted clinical trials, paired with 50 adja...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h4708
更新日期:2015-09-20 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6648.601
更新日期:1988-09-03 00:00:00
abstract:OBJECTIVE:To measure the effect of brief behavioural counselling in general practice on patients' consumption of fruit and vegetables in adults from a low income population. DESIGN:Parallel group randomised controlled trial. SETTING:Primary health centre in a deprived, ethnically mixed inner city area. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2003-04-19 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2013-02-04 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1997-05-10 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.324.7349.1299
更新日期:2002-06-01 00:00:00
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doi:10.1136/bmj.321.7268.1057
更新日期:2000-10-28 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-08-17 00:00:00
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更新日期:2009-04-09 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2011-05-19 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2009-08-12 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
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更新日期:1996-07-20 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
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更新日期:1997-03-01 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
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更新日期:2004-07-10 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h5397
更新日期:2015-10-21 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
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更新日期:2010-10-06 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.325.7368.805
更新日期:2002-10-12 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6982.768
更新日期:1995-03-25 00:00:00
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pub_type: 杂志文章
doi:10.1136/bmj.l969
更新日期:2019-03-27 00:00:00
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journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6890.1444
更新日期:1993-05-29 00:00:00