Current surgery最新文献_第4页

Novel Techniques in Hernia Repair 疝修补的新技术

Current surgery Pub Date : 2006-09-01 DOI: 10.1016/j.cursur.2006.05.009

Anuja K. Antony MD (Guest Reviewer) , Fernando A. Herrera MD (Guest Reviewer) , David W. Easter MD (Guest Reviewer) , Michael T. Longaker MD (Guest Reviewer) , H. Peter Lorenz MD (Guest Reviewer)

引用次数: 1

Intestinal Fatty Acid Binding Protein (I-FABP) for the Detection of Strangulated Mechanical Small Bowel Obstruction 肠脂肪酸结合蛋白(I-FABP)检测绞窄性机械性小肠梗阻

Current surgery Pub Date : 2006-09-01 DOI: 10.1016/j.cursur.2006.05.006

Daniel R. Cronk MD , Troy P. Houseworth MD , Daniel G. Cuadrado MD , Garth S. Herbert MD , Patrick M. McNutt PhD , Kenneth S. Azarow MD

{"title":"Intestinal Fatty Acid Binding Protein (I-FABP) for the Detection of Strangulated Mechanical Small Bowel Obstruction","authors":"Daniel R. Cronk MD , Troy P. Houseworth MD , Daniel G. Cuadrado MD , Garth S. Herbert MD , Patrick M. McNutt PhD , Kenneth S. Azarow MD","doi":"10.1016/j.cursur.2006.05.006","DOIUrl":"10.1016/j.cursur.2006.05.006","url":null,"abstract":"<div><h3>Objective</h3><p>Intestinal fatty acid binding protein (I-FABP), a protein released by necrotic enterocytes, is a useful marker for the detection of ischemia from mechanical small bowel obstruction.</p></div><div><h3>Design</h3><p>Validation cohort.</p></div><div><h3>Setting</h3><p>Academic medical center.</p></div><div><h3>Participants</h3><p>Cohort of 21 patients admitted with a clinical diagnosis of mechanical small bowel obstruction. Plasma and urine samples were collected from patients upon hospital admission and again immediately before laparotomy if surgical intervention was delayed.</p></div><div><h3>Results</h3><p>Plasma and urine I-FABP levels (pg/ml by enzyme-linked immunosorbent assay) in patients found to have small bowel necrosis at the time of laparotomy were compared with those without significant ischemia upon laparotomy and those that did not require laparotomy and, by default, did not have small bowel ischemia. A positive test was defined as 1000-pg/ml I-FABP in urine and 100-pg/ml I-FABP in plasma. Small bowel necrosis was confirmed in 3 of 21 enrolled patients. Urine I-FABP levels were positive in 3 of 3 patients with necrosis and 3 of 18 patients without necrosis (sensitivity 100%, specificity 83%, PPV 50%, NPV 100%). Plasma I-FABP levels were positive in 3 of 3 patients with necrosis and 4 of 18 patients without necrosis (sensitivity 100%, specificity 78%, PPV 43%, NPV 100%).</p></div><div><h3>Conclusions</h3><p>I-FABP is a sensitive marker for ischemia in mechanical small bowel obstruction. Additional work should be done to validate I-FABP in a variety of clinical settings and to develop a rapid I-FABP laboratory assay.</p></div>","PeriodicalId":75762,"journal":{"name":"Current surgery","volume":"63 5","pages":"Pages 322-325"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cursur.2006.05.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26252033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 94

Adenocarcinoma of the Distal Pancreas Presenting as an Intrathoracic Mass 胰腺远端腺癌表现为胸内肿块

Current surgery Pub Date : 2006-09-01 DOI: 10.1016/j.cursur.2006.05.002

Bradley Hart MD , Richard Erickson MD , Christen LeBlanc MD , Staci Hix-Hernandez MD , Mohsen Shabahang MD

引用次数: 1

The Risk of Carotid Endarterectomy in Patients with Chronic Renal Insufficiency 慢性肾功能不全患者颈动脉内膜切除术的风险

Current surgery Pub Date : 2006-09-01 DOI: 10.1016/j.cursur.2006.06.006

Ahmad Tarakji MD, Amy McConaughy PA-C, Gary G. Nicholas MD

{"title":"The Risk of Carotid Endarterectomy in Patients with Chronic Renal Insufficiency","authors":"Ahmad Tarakji MD, Amy McConaughy PA-C, Gary G. Nicholas MD","doi":"10.1016/j.cursur.2006.06.006","DOIUrl":"10.1016/j.cursur.2006.06.006","url":null,"abstract":"<div><h3>Objective</h3><p>Carotid endarterectomy (CEA) has been associated with less favorable outcome in patients with chronic renal insufficiency (CRI). The authors compared results of CEA in the presence and absence of CRI at their institution over a 5-year period.</p></div><div><h3>Design/setting/participants</h3><p>This article is a retrospective review of 1351 patients who underwent CEA between 1998 and 2004. Chronic renal insufficiency was present in 143 patients. Renal insufficiency was graded as <em>mild</em> (creatinine 1.6-2.9 mg/dL) or <em>severe</em> (creatinine ≥3.0 mg/dL or on hemodialysis). The composite endpoint was stroke or death within 30 days postoperatively. The results were compared with 150 consecutive patients having CEA in the absence of renal insufficiency between 2002 and 2003.</p></div><div><h3>Results</h3><p>For the 143 patients with CRI, the composite endpoint was 9.0%, whereas the composite endpoint for the 150 control patients without CRI was 2.6% (p = 0.032). For patients with severe CRI (creatinine ≥3.0 or on hemodialysis), the composite endpoint was 19.0% (p = 0.08). For those with mild CRI (creatinine 1.6-2.9), the composite endpoint was 7.3% (p = 0.06).</p></div><div><h3>Conclusions</h3><p>Chronic renal insufficiency is associated with increased incidence of stroke, myocardial infarction, and death after CEA. For patients with advanced CRI, carotid artery stenting (CAS) or aggressive medical management may be alternative treatment options.</p></div>","PeriodicalId":75762,"journal":{"name":"Current surgery","volume":"63 5","pages":"Pages 326-329"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cursur.2006.06.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26251956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 22

A New World 新世界

Current surgery Pub Date : 2006-09-01 DOI: 10.1016/j.cursur.2006.06.013

John A. Weigelt MD (Editor-in-Chief, Current Surgery)

引用次数: 99

Current surgery Pub Date : 2006-09-01 DOI: 10.1016/j.cursur.2006.02.007

Sherwin Schrag MD

引用次数: 0

Right Lower Quadrant Pain in a Young Adult Male 一例年轻成年男性右下腹疼痛

Current surgery Pub Date : 2006-09-01 DOI: 10.1016/j.cursur.2006.06.009

CAPT Shaun M. Gifford MC, USAF , CAPT Jonathan Bowman MC, USAF , LTC W. Brian Perry MC, USAF , Melanie Richards MD

引用次数: 4