The British journal of surgery
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With increasing antibiotic usage Clostridium difficile colitis is becoming more common. Surgery for fulminating C. difficile colitis, however, is rare because of the effectiveness of specific anticlostridial chemotherapy. Surgical outcome in five patients with fulminating C. difficile colitis involved in a recent outbreak of this disease is reported. ⋯ These results indicate that this increasingly common disease frequently leads to a fatal outcome in patients requiring surgery and implies that earlier surgical consultation may be necessary to improve survival in patients with fulminating C. difficile colitis unresponsive to antibiotic therapy.
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Clinical Trial Controlled Clinical Trial
Matrix metalloproteinase 9 level predicts optimal collagen deposition during early wound repair in humans.
This study examined two matrix metalloproteinases (MMPs) and their association with deposition of collagen during wound repair. ⋯ These results indicate that the level of MMP-9 in the early inflammatory phase can predict the amount of collagen deposited later in the wound healing process.
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Several diagnostic aids have been developed to improve diagnosis in suspected appendicitis including ultrasonography and clinical diagnostic scoring. The aim of this study was to elaborate a new scoring system and to measure its accuracy in the preoperative diagnosis of appendicitis, comparing it with the available scoring systems. ⋯ Ultrasonography increases the diagnostic accuracy in patients with suspected acute appendicitis.
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To obtain information on the contemporary management of colorectal cancer in the UK to assist in the development of management guidelines, an independent, 1-year population audit was carried out in Trent Region and Wales. ⋯ This initial report from a comprehensive, independent audit of colorectal cancer management shows improvement in some aspects of treatment as evidenced by improved anastomotic dehiscence and stoma rates when compared with previous studies. However, there has been little improvement in the proportion of patients presenting with advanced disease, and curative resection rates remain low.