The Journal of surgical research
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Recent reports, following upon the reported outcomes of European randomized prospective trials of endovascular abdominal aortic aneurysm repair (EVAR), have brought into question the appropriateness of some of the trials' main conclusions, particularly in patients deemed at high-risk for surgical intervention. Based on the data of these trials, specifically EVAR 2, it has been suggested that EVAR should not be performed in high-risk individuals due to the likelihood of poor outcomes and the lack of improved survival, both associated with higher costs. ⋯ Although prospective, randomized United States trial data on such patients are not currently available, some large retrospective studies and registry reviews provide a basis for comparison of these trials with US EVAR experiences. In this review, the European EVAR trials are analyzed along with these other US studies and the rationale for modifying some of the conclusions drawn from the trials is presented and general guidelines for the selective management of abdominal aortic aneurysm patients presenting with potential indications for intervention are proposed.
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Safety practices in the aviation industry are being increasingly adapted to healthcare in an effort to reduce medical errors and patient harm. However, caution should be applied in embracing these practices because of limited experience in surgical disciplines, lack of rigorous research linking these practices to outcome, and fundamental differences between the two industries. ⋯ This paper serves as a review of strategies adapted to improve surgical safety, including the following: implementation of crew resource management in training operative teams; incorporation of simulation in training of technical and nontechnical skills; and analysis of contributory factors to errors using surveys, behavioral marker systems, human factors analysis, and incident reporting. Avenues and challenges for future research are also discussed.
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Writing and publishing are key to career development and academic success for surgeons who have less time than ever to devote to these activities. To improve the scientific writing skills of its faculty and trainees and to help them complete their manuscripts and grant proposals more quickly, the Department of Surgery at the University of California, San Francisco (UCSF) established a service dedicated to scientific writing and editing. Through coursework in scientific writing, individual writing consultations, and editorial review, the service helps academic surgeons with the difficult tasks of writing and publishing their research and seeking extramural funding. The service has rapidly become a successful adjunct to the academic mission of the UCSF Department of Surgery and could offer a model for other academic surgery departments to increase scientific productivity and advance the academic surgical mission.
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Sweat glands play some key roles in homeostasis maintenance and body temperature regulation. In full-thickness burn wounds, sweat glands cannot regenerate to form their three-dimensional organization via the division and terminal differentiation of sweat gland cells. However, the plasticity of mesenchymal stem cells (MSCs) may offer the hope and potentiality to regenerate sweat glands after severe burn injury.
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Regenerating protein (reg) and pancreatic stone protein (PSP) have been discovered independently in the fields of diabetes and pancreatitis. ⋯ In this review we discuss the debate on the localization and functional roles of PSP/reg and PAP/regIII. Therefore, we have summarized hypotheses and experimental results supporting such hypotheses.