World journal of surgery
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World journal of surgery · Apr 2012
Pilot testing of a population-based surgical survey tool in Sierra Leone.
The prevalence of surgical diseases in low income countries is thought to be very large, but to date no population-based survey has documented the need. The Surgeons OverSeas Assessment of Surgical Need (SOSAS) is a survey tool programmed for use with iPads to measure the prevalence of surgical conditions. ⋯ Pilot testing of SOSAS showed that a population-based survey measuring the prevalence of surgical disease could be undertaken in a low income country. It is recommended that SOSAS be used with a larger sample size to calculate the prevalence of surgical disease in low income countries.
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World journal of surgery · Apr 2012
Randomized Controlled Trial Comparative StudyComparison of dexamethasone with ondansetron or haloperidol for prevention of patient-controlled analgesia-related postoperative nausea and vomiting: a randomized clinical trial.
Patient-controlled analgesia (PCA) with parenteral opioids is associated with a high incidence of postoperative nausea and vomiting (PONV). The aim of the present study was to compare the efficacy of dexamethasone plus haloperidol with dexamethasone plus ondansetron for the prevention of PCA-related PONV. Patients who received dexamethasone alone were used as controls. ⋯ The incidences of total PONV in the first 24 h in groups DH (35%) and DO (30%) were significantly lower than those of group D (57%) (p < 0.05 for each comparison). The differences between groups DH and DO were insignificant. The incidence of PONV was significantly smaller in the DH and DO groups than predicted by the patients’ underlying risks. Pain scores, sedation scores, and recovery times were similar among the three study groups, and no clinically relevant prolongation of the electrocardiographic QTc interval was observed in any patient. conclusions: Dexamethasone 5 mg with either haloperidol 2 mg or ondansetron 4 mg provides a better antiemetic effect than dexamethasone 5 mg alone in patients receiving postoperative morphine PCA.
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World journal of surgery · Apr 2012
Utility of drain fluid amylase measurement on the first postoperative day after pancreaticoduodenectomy.
Early detection of pancreatic fistula (PF) may improve the outcome after pancreaticoduodenectomy, and exclusion of PF may allow earlier drain removal and accelerate recovery. The aim of the present study was to evaluate the relationship between drain fluid amylase on the first postoperative day (DFA(1)) and PF. ⋯ Drain fluid amylase on the DFA(1) after pancreaticoduodenectomy stratifies patients according to likelihood of developing a PF.
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World journal of surgery · Apr 2012
Accuracy of BRCA1/2 mutation prediction models for different ethnicities and genders: experience in a southern Chinese cohort.
BRCA1/2 mutation prediction models (BRCAPRO, Myriad II, Couch, Shattuck-Eidens, BOADICEA) are well established in western cohorts to estimate the probability of BRCA1/2 mutations. Results are conflicting in Asian populations. Most studies did not account for gender-specific prediction. We evaluated the performance of these models in a Chinese cohort, including males, before BRCA1/2 mutation testing. ⋯ The variation in model performance underscores the need for research on larger Asian cohorts as prediction models, and the possible need for customizing these models for different ethnic groups and genders.
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World journal of surgery · Apr 2012
Selective computed tomography and angioembolization provide benefits in the management of patients with concomitant unstable hemodynamics and negative sonography results.
The FAST (focused assessment of sonography for trauma) examination can rapidly identify free fluid in the abdominal or thoracic cavity, which is indicative of hemorrhage requiring emergency surgery in multiple-trauma patients. In patients with negative FAST examination results, it is difficult to identify the site of the hemorrhage and to plan treatment accordingly. We attempted to delineate the role of selective computed tomography (CT) and transarterial angioembolization (TAE) in the management of such unstable patients. ⋯ Transarterial angioembolization is suggested in the management of patients with concomitant unstable hemodynamics and negative FAST examination results. During the time interval required for angiography preparation, a CT scan can be performed. This approach provides valuable information for further decision making without delaying definitive treatment.