Surgery
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This study aimed to evaluate the effects of indications for thyroidectomy on patient outcomes and to examine the impact of surgical volume on these outcomes. ⋯ Surgery for Graves disease is associated with a higher risk for complications when performed by less experienced surgeons. This finding should prompt recommendations for increasing surgical specialization and referrals to high-volume surgeons in the management of Graves disease.
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The role of prophylactic central neck dissection in the management of papillary thyroid cancer (PTC) is controversial. We report our experience of an observational approach to the cN0 neck in PTC. ⋯ Our results suggest that properly selected patients can be managed safely with observation of the central neck rather than prophylactic central neck dissection, which has a higher complication rate.
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The electronic medical record (EMR) of a large, tertiary referral center was examined to study the prevalence of undiagnosed and unrecognized primary hyperparathyroidism (PHPT). ⋯ PHPT is a more common disorder than previously documented. It is crucial to evaluate even mild hypercalcemia, because 43% of these patients have PHPT. PHPT is underdiagnosed and undertreated.
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Controversy persists as to whether positive operative margins are an independent prognostic factor for resected pancreatic cancer. This study evaluated the impact of the resection margin status on the patterns of recurrence and prognosis after resection for pancreatic cancer. ⋯ In the setting of pancreatectomy, when we evaluated the definitions of R0 resection, the margin status influenced the local recurrence rate but had no impact on the patients' survival.
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Lung contusion (LC) is a unique direct and focal insult that is considered a major risk factor for the initiation of acute lung injury and acute respiratory distress syndrome. We have shown recently that consumption of nitric oxide (due to excess superoxide) resulting in peroxynitrite formation leads to decreased vascular reactivity after LC. In this study, we set out to determine whether the superoxide scavenger Mn (III) tetrakis (4-benzoic acid) porphyrin chloride (MnTBAP) plays a protective role in alleviating acute inflammatory response and injury in LC. ⋯ Superoxide dismutase mimetic-MnTBAP reduced permeability and oxidative injury in LC and may have a therapeutic role in diminishing inflammation in LC.