Current surgery
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Randomized Controlled Trial Clinical Trial
Fluid administration during abdominal surgery influences on coagulation in the postoperative period.
Postoperative coagulopathy is an important concern for patients after major surgery. Our objective was to define the factors that correlate with postoperative deterioration in coagulation. ⋯ Administration of more than 3-l crystalloids or 500-ml colloids during abdominal surgery correlates with postoperative coagulopathy.
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Case Reports
Negative pressure post-extubation pulmonary edema complicating appendectomy in a young patient: case report.
Negative-pressure pulmonary edema after endotracheal intubation is an uncommon and potentially serious complication of patients undergoing general anesthesia for different surgical procedures. We report a case of a healthy 20-year-old male patient with the diagnosis of acute appendicitis. The patient was submitted to appendectomy under general anesthesia and developed negative-pressure pulmonary edema immediately after extubation. The present paper reports this potentially serious complication illustrating the main radiological findings consistent with alveolar hemorrhage in this setting and the treatment performed.
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The Accreditation Council for Graduate Medical Education (ACGME) has challenged program directors to assess their residents' core competencies, including communication and interpersonal skills (CIS). We report our institution's experience using a series of standardized patient encounters in an objective structured clinical examination (OSCE) to evaluate CIS in surgical residents. ⋯ The standardized patient-based OSCE is an effective method to assess communication and interpersonal skills and provides useful information for curriculum review.
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Case Reports
Abdominal apoplexy: a case study of the spontaneous rupture of the gastroepiploic artery.
This is a case report of abdominal apoplexy (AA) or spontaneous rupture of a visceral vessel, without associated aneurysmal dilation of the vessel. Spontaneous rupture of the left gastroepiploic artery (LGEA) resulting in a hemoperitoneum is discussed. The clinical presentation of left lower quadrant abdominal pain, along with the histologic findings of medial degeneration of the LGEA, makes this case an unusual one. The incidence, origin, associated predisposing medical conditions, clinical presentation, and treatment of abdominal apoplexy are discussed.