Annals of surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective comparison of simultaneous kidney-pancreas transplantation with systemic-enteric versus portal-enteric drainage.
To compare pancreas transplantation with systemic-enteric (SE) versus portal-enteric (PE) drainage in a prospective fashion. ⋯ These results suggest that simultaneous kidney and pancreas transplantation with SE or PE drainage can be performed with comparable short-term outcomes.
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Randomized Controlled Trial Clinical Trial
Attenuation of posttraumatic muscle catabolism and osteopenia by long-term growth hormone therapy.
To determine whether the beneficial effects of growth hormone persist throughout the prolonged hypermetabolic and hypercatabolic response to severe burn. ⋯ Low-dose recombinant human growth hormone successfully abates muscle catabolism and osteopenia induced by severe burn.
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To compare the characteristics and outcomes of patients with intraabdominal infections enrolled in prospective randomized trials (PRTs) with those of a cohort of patients not enrolled in a trial. ⋯ Patients with intraabdominal infection enrolled in PRTs have an increased likelihood of cure and survival. This is due in part to a lower incidence of antibiotic resistance, which may reflect improved drug selection. Patients not enrolled in PRTs are at greater risk for treatment failure and death because of concomitant illness. Outcomes from PRTs may not be applicable to all patients with intraabdominal infections.
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To assess the demographics and characteristics of infections in surgical patients to define areas that deserve emphasis in surgical education. ⋯ Most infections treated by surgeons are hospital-acquired. Infections with gram-positive cocci and fungi are common, with pulmonary infections becoming more common. Fluoroquinolones have become important therapeutic agents. Depending on the type of practice, these data should be helpful to direct educational efforts so that surgeons can remain knowledgeable and active in the nonsurgical care of their patients.
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Comparative Study
Does optimal timing for spine fracture fixation exist?
To evaluate the effect of timing of spine fracture fixation on outcome in multiply injured patients. ⋯ Early spine fracture fixation is safely performed in multiply injured patients. Early fixation is preferred in patients with thoracic spine fractures because it allows earlier mobilization and reduces the incidence of pneumonia. Although delaying fixation in the less severely injured may be convenient for scheduling, it increases hospital resource utilization and patient complications.