Journal of the American College of Surgeons
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Decreased antithrombin III (ATIII) activity and large splenic vein diameter (SVD) are risk factors for portal vein thrombosis (PVT) after splenectomy in liver cirrhosis with portal hypertension. Antithrombin III concentrates can prevent PVT. This study was designed to stratify risks for PVT after splenectomy in cirrhotic patients and to develop prophylactic protocols for PVT. ⋯ Risk stratification of PVT after splenectomy and prophylaxis with ATIII concentrates and danaparoid sodium dramatically reduced the incidence of PVT.
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Minimally invasive parathyroidectomy for primary hyperparathyroidism is dependent on preoperative localization, commonly with ultrasound and sestamibi imaging. This study sought to determine if preoperative serum calcium and parathyroid hormone (PTH) levels correlate with localization sensitivity and positive predictive value (PPV). ⋯ Surgeon-performed ultrasound and sestamibi have higher localization rates and PPV, with increasing preoperative serum calcium and PTH levels. Surgeon-performed ultrasound may be a better initial test for patients with lower calcium (<10.5 mg/dL) and PTH (<90 pg/mL) values due to significantly higher localization rates; however, a localizing sestamibi has higher PPV.
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Protocadherin-10 (PCDH10) has been identified as a tumor suppressor gene in multiple carcinomas. In this study, we intended to elucidate the clinical applicability of the methylation of CpG sites of PCDH10 promoter for prognostic prediction in gastric cancer (GC). ⋯ The methylated CpG sites of PCDH10 promoter had significant applicability for clinical evaluation of the prognosis of GC.
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Comparative Study
Do models incorporating comorbidities outperform those incorporating vital signs and injury pattern for predicting mortality in geriatric trauma?
Geriatric trauma is becoming a significant public health concern. The most commonly used prediction models for mortality benchmarking are based on vital signs and injury pattern, including the Trauma and Injury Severity Score (TRISS), which is less accurate in the elderly. The ICD-9-based prediction models incorporating injuries and comorbidities, such as the University Health System Consortium Expected Mortality (UHC-EM), may be more accurate for the elderly. ⋯ An ICD-9-based algorithm, such as the UHC-EM, which incorporates injuries and comorbidities, may be superior to algorithms based on vital signs and injury patterns without comorbidities in predicting mortality after trauma in the geriatric population.