The British journal of surgery
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Burn care has changed considerably. Early surgery, nutritional support, improved resuscitation and novel skin replacement techniques are now well established. The aim of the study was to establish whether changes in management have improved survival following burn injury and to determine the contributory factors leading to non-survival. ⋯ Modern burn care has decreased the mortality rate. Increasing burn size, increasing age, inhalation injury and female sex increased, while operative intervention and an upper limb burn decreased, the risk of death. Presented to the 10th Congress of the International Society for Burn Injuries, in Jerusalem, November 1998
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Unrepaired aortic coarctation is known to have a detrimental effect on survival. The benefit of coarctation repair on systolic hypertension in adults has been questioned. This retrospective study was conducted to evaluate the impact of repair of aortic coarctation on systolic hypertension in adults. ⋯ Surgical repair of coarctation of the aorta in adults leads to regression of systolic hypertension and a decreased requirement for antihypertensive medication.
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In papillary thyroid carcinoma (PTC), presence of the oncogenes RET/PTC has been described, but their correlation with prognosis is debated. The aim of this study was to investigate the expression of the RET proto-oncogene (RET) and correlate it with clinical outcome. ⋯ Almost half of the PTCs showed RET-TK expression; in only three was this explained by expression of a RET/PTC rearrangement. Instead, expression of WT-RET was detected in 45 per cent of the RET-TK-positive tumours and this expression was an independently significant risk factor for aggressive PTC. Presented in abstract form to the Millennium Meeting of Endocrine Surgeons held by the American Association of Endocrine Surgeons, British Association of Endocrine Surgeons and Swedish Association of Endocrine Surgeons, London, UK, May 2000
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Patients with cachexia suffer from anorexia, weight loss and hypermetabolism. This study examined the relationship between plasma leptin concentration, leptin gene expression, weight loss and the acute-phase response in a group of surgical patients. ⋯ Plasma leptin levels appear to be influenced by proinflammatory cytokines. Omental fat may have more influence on plasma leptin than subcutaneous fat. Accelerated weight loss in patients with cancer with an ongoing inflammatory response could be mediated in part by inappropriately high plasma levels of leptin.
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Rates of lower extremity amputation vary significantly both between and within countries. The variation does not appear to support differences in need as an explanation. This study set out to see if variations in clinical decision making might contribute to the explanation. ⋯ Variations in the clinical decisions made by vascular surgeons given the same patient are likely to explain at least a part of the observed geographical variation in rates of lower extremity amputation. Consensus guidelines may enable more consistent decision making for this problem.