Surgical infections
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The inherent risks of blood transfusion have led to concerted efforts to find alternatives to allogeneic blood transfusion. Among these alternatives are supplementation with iron and treatment with erythropoietin, autologous pre-donation before major elective surgery, intraoperative blood salvage (particularly for emergency cases or when major blood loss is unanticipated), acute normovolemic hemodilution, and artificial blood substitutes. ⋯ Acute normovolemic hemodilution achieves equivalent outcomes at lower cost compared with autologous pre-donation. Patient safety is increased, and if pharmacologic strategies are combined with acute normovolemic hemodilution, allogeneic blood transfusion may be eliminated entirely.
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Surgical infections · Jan 2005
ReviewClinical challenges and unmet needs in the management of complicated skin and skin structure, and soft tissue infections.
Skin and soft tissue infections remain among the most frequently encountered infections in surgery, and their severity ranges from mild cellulitis to severe, necrotizing infections with high incidences of morbidity and mortality. Most commonly, these disorders result from skin lesions in a susceptible host, but sometimes develop following hematogenous spread from a previously unknown focus. ⋯ New, promising agents, with activity against multi-drug resistant gram-positive and gram-negative organisms, are aimed at filling the gap in the treatment of complicated skin and skin-structure infections.
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Surgical infections · Jan 2004
Review Case ReportsCryptococcal myositis and vasculitis: an unusual necrotizing soft tissue infection.
Cryptococcus neoformans var. neoformans is an opportunistic yeast that typically infects immunocompromised patients. ⋯ Cryptococcal soft tissue infection serves as a marker of disseminated cryptococcosis in immunocompromised hosts. Owing to its rarity as a cause of soft tissue infections, diagnosis is difficult and mortality is high.
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Surgical infections · Jan 2004
Review Comparative StudyNew strategies to improve outcomes in the surgical intensive care unit.
Over the last half-decade, substantial breakthroughs have taken place in terms of routine therapy of critically ill patients. The combination of these strategies has the potential to result in improvement in the overall outcomes for patients in intensive care units. ⋯ Appropriate incorporation of these strategies into everyday practice will likely result in improvements in the care of critically ill surgical patients.
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Surgical infections · Jan 2001
ReviewNitric oxide synthase inhibition as therapy for sepsis: a decade of promise.
Inhibition of nitric oxide synthase (NOS) has held promise as a novel and important therapeutic target for sepsis for over a decade. However, the question as to whether an inhibitor of NOS will prove to be efficacious in human septic shock remains unanswered. ⋯ A better understanding of the effects of NOS and its inhibitors is needed as is an understanding of the underlying pathophysiology of sepsis. Moreover, a nontoxic, short-acting, titratable, specific inhibitor of NOS2 has yet to be identified and tested. Until then, efforts should be designed to describe more completely the role of NO in the pathophysiology of sepsis.