Annals of surgery
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Review Meta Analysis
Fetal Tracheal Occlusion for Severe Pulmonary Hypoplasia in Isolated Congenital Diaphragmatic Hernia: A Systematic Review and Meta-analysis of Survival.
To evaluate fetal survival after tracheal occlusion in fetuses with severe pulmonary hypoplasia and isolated congenital diaphragmatic hernia (CDH). ⋯ FETO improves survival in isolated CDH with severe pulmonary hypoplasia compared with the standard perinatal management.
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This study aimed to establish the incidence of postesophagectomy columnar metaplasia and dysplasia, and the timescale over which it develops. It also aimed to assess if this epithelium is molecularly similar to sporadic Barrett esophagus, thereby confirming suitability as a research model. ⋯ Columnar metaplasia is common following esophagectomy, but the absence of dysplasia in this large cohort is reassuring. Presence of specialized intestinal metaplasia is associated with increased time from surgery, suggesting this represents later disease. Immunohistochemistry staining is similar to sporadic Barrett, suggesting that this group of patients represent an accurate human model for the development of Barrett.
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To assess how informed patients are about breast reconstruction, and how involved they are in decision making. ⋯ Women undergoing mastectomy in this sample were highly involved in decision making, but had major deficits in knowledge about the procedure. Knowledge about the risk of complications was particularly low. Providers seemed to have discussed the advantages of reconstruction more than its disadvantages.
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To determine whether restrictive fluid resuscitation results in increased rates of acute kidney injury (AKI) or infectious complications. ⋯ Restrictive resuscitation is associated with increased AKI, without changes in infectious complications.
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We tested the primary hypothesis that surgical site infections (SSIs) are more common in patients who had longer periods of intraoperative low blood pressure. Our secondary hypothesis was that hospitalization is prolonged in patients experiencing longer periods of critically low systolic blood pressure (SBP) and/or mean arterial pressure (MAP). ⋯ Intraoperative hypotension does not seem to be a clinically important predictor of SSI after colorectal surgery, probably because the outcomes are overwhelmingly determined by other baseline and surgical factors-and perhaps postoperative hypotension.