The Journal of surgical research
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Comparative Study
Is less more? Laparoscopic versus open Ladd's procedure in children with malrotation.
With the advent of minimally invasive techniques, laparoscopic Ladd's procedure is increasingly used to treat children with malrotation, yet evidence regarding its safety and efficacy is lacking. We hypothesize that operative and postoperative outcomes with the open technique are superior to the laparoscopic Ladd's procedure. ⋯ Although minimally invasive approaches are becoming increasingly used, no evidence supports laparoscopic superiority over open Ladd's procedure. We found that open surgery was associated with shorter operating times and fewer clinic visits. Furthermore, laparotomy remains the favored procedure for patients presenting with volvulus.
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Surgery for anorectal diseases is thought to cause significant pain postoperatively. There is little known regarding standardized opioid-prescribing trends and patient use following surgery for anorectal diseases. We aimed to evaluate and analyze opioid-prescribing trends and patient use for outpatient anorectal operations. ⋯ Most patients had adequate pain control after anorectal surgery with little to no use of opioids and that more than 80% of opioid pills prescribed were not consumed. We intend to standardize our prescribing opioid quantities for outpatient anorectal operations to reflect this reduced use.
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Increasing mortality from opioid overdoses has prompted increased focus on prescribing practices of physicians. Unfortunately, resident physicians rarely receive formal education in effective opioid prescribing practices or postoperative pain management. Data to inform surgical training programs regarding the utility and feasibility of formal training are lacking. ⋯ This pilot study shows wide variability in opioid prescribing practices and attitudes toward pain management among surgical trainees, illustrating the potential utility of formal education in pain management and effective prescribing of these medications. A broader assessment of surgical trainees' knowledge and perception of opioid prescribing practices is warranted to facilitate the development of such a program.
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Comparative Study
Comparison of two different models of sepsis induced by cecal ligation and puncture in rats.
The present study was designed to explore the difference between two rat models of sepsis and to establish a more stable rat model. ⋯ These results suggested that the cecal ligation combined with puncture drainage model of sepsis is more stable than that of the simple cecal ligation and puncture model of sepsis in the rat, which resolved the problem of puncture wrapped in the traditional CLP model of sepsis in rat.
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Multicenter Study Observational Study
Assessment of the predictive value of the International Classification of Diseases Injury Severity Score for trauma mortality in urban India.
Trauma is the cause of 1.2 million deaths in India annually. Injury severity scores play an important role in trauma research and care because these scores enable the adjustment of trauma severity when comparing mortality outcomes. The generalizability of the International Classification of Diseases Injury Severity Score (ICISS) between different populations is not fully known, and the validity of the ICISS has not been assessed in the Indian context. The aim of this study was to assess the predictive performances of three international versions of the ICISS, derived from data from Australia, New Zealand and pooled data from seven different high-income countries, in trauma patients admitted to four public hospitals in urban India. ⋯ None of the international versions of the ICISS adequately predicted mortality within the study population, indicating the need for an ICISS version specifically adapted to the Indian context.