The British journal of surgery
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Review Meta Analysis
Meta-analysis of colorectal cancer follow-up after potentially curative resection.
After potentially curative resection of primary colorectal cancer, patients may be monitored by measurement of carcinoembryonic antigen and/or CT to detect asymptomatic metastatic disease earlier. ⋯ Based on pooled data from randomized trials published from 1995 to 2016, the anticipated survival benefit from surgical treatment resulting from earlier detection of metastases has not been achieved.
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Randomized Controlled Trial
Randomized clinical trial of the use of glyceryl trinitrate patches to aid arteriovenous fistula maturation.
Arteriovenous fistulas are critical for haemodialysis, but maturation rates remain poor. Experimental and anecdotal evidence has supported the use of transdermal glyceryl trinitrate (GTN) patches. The aim of this RCT was to determine whether use of a GTN patch aids arteriovenous fistula maturation. ⋯ NCT01685710 (http://www.clinicaltrials.gov).
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Comparative Study
Comparison of a national early warning score in non-elective medical and surgical patients.
The National Early Warning Score (NEWS) is used to identify deteriorating patients in hospital. NEWS is a better discriminator of outcomes than other early warning scores in acute medical admissions, but it has not been evaluated in a surgical population. The study aims were to evaluate the ability of NEWS to discriminate cardiac arrest, death and unanticipated ICU admission in patients admitted to surgical specialties, and to compare the performance of NEWS in admissions to medical and surgical specialties. ⋯ NEWS discriminated deterioration in non-elective surgical patients at least as well as in non-elective medical patients.
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Chronic kidney disease is an important preoperative risk factor. However, the association between renal dysfunction and risk of death has not been well explored in non-cardiac surgery. ⋯ Renal dysfunction is an important risk factor for death after non-cardiac surgery and the risk increases steeply for patients with moderate to severe kidney dysfunction.