The Journal of surgical research
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Comparative Study
Different tissue distribution of paclitaxel with intravenous and intraperitoneal administration.
Paclitaxel is considered to be suitable for disseminated cancer in the peritoneal cavity because of its high molecular weight and lipophilic characteristics. However, the difference in pharmacokinetics of paclitaxel after intraperitoneal (i.p.) and intravenous (i.v.) administration is not fully defined. Here, we investigated the tissue concentration of paclitaxel in various organs at various time points after i.p. or i.v. administration. ⋯ Compared with i.v. administration, paclitaxel concentration was maintained at a high level in the whole body by i.p. administration. Repeated i.p. paclitaxel can produce more marked clinical effects than i.v. administration for metastatic lymph nodes and primary lesions as well as peritoneal dissemination.
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Few studies have analyzed the impact of mentoring on general surgical graduates' future career choices. We attempted to characterize the impact mentoring had on choices made by graduates from our residency program regarding surgical subspecialty training. ⋯ Mentored surgical residency graduates were likely to enter the same specialty and practice type as their mentor. Also, the timing of identifying a mentor was strongly correlated with future practice type. With increasing concerns about "the impending disappearance of the general surgeon" along with increasing growth in surgical sub-specialization, it is essential that all types of surgeons provide early and sustained mentorship to medical students and residents to help shape the future of surgery.
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Controlled Clinical Trial
A prospective study on the influence of a fast-track program on postoperative fatigue and functional recovery after major colonic surgery.
Enhanced Recovery After Surgery (ERAS) programs have demonstrated significant reduction in hospital stay for patients undergoing colonic surgery; however, their impact on long-term outcomes, such as postoperative fatigue (POF), has not been fully established. ⋯ The impact of ERAS programs may extend beyond the commonly reported short-term outcomes, and ERAS may accelerate overall recovery and return to normal function.
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Comparative Study
Efficacy of three topical hemostatic agents applied by medics in a lethal groin injury model.
Advanced topical hemostatic agents are increasingly utilized to control traumatic hemorrhage. We sought to determine the efficacy of three chitosan based hemostatic agents in a lethal groin injury model when applied by combat medic first responders. ⋯ Chitosan based bandages are significantly more effective at hemorrhage control compared to standard gauze field dressings. The dual-sided chitosan dressing demonstrated better hemorrhage control than the one-sided dressing and the chitosan powder, and was less likely to fail despite application errors.
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Thoracoabdominal aortic aneurysm open surgery is accompanied by a significant incidence of renal failure due to renal ischemia. The effect of remote ischemic preconditioning (RIPC) in renal ischemia/reperfusion (IR) injury during a thoracoabdominal aortic aneurysm open repair approach was examined on an animal model. ⋯ RIPC induced by a temporary infrarenal aortic occlusion decreased the IR renal injury caused by subphrenic aortic cross-clamping.