| 1. |
|
|
| 2. |
- Ansari, Daniel, et al.
(författare)
-
Artificial neural networks predict survival from pancreatic cancer after radical surgery.
- 2013
-
Ingår i: The American Journal of Surgery. - : Elsevier BV. - 1879-1883 .- 0002-9610. ; 205:1, s. 1-7
-
Tidskriftsartikel (refereegranskat)abstract
- Artificial neural networks (ANNs) are nonlinear pattern recognition techniques that can be used as a tool in medical decision making. The objective of this study was to develop an ANN model for predicting survival in patients with pancreatic ductal adenocarcinoma (PDAC).
|
|
| 3. |
- Apelqvist, Jan, et al.
(författare)
-
Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds.
- 2008
-
Ingår i: The American Journal of Surgery. - : Elsevier BV. - 1879-1883 .- 0002-9610. ; 195, s. 782-788
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: To evaluate resource utilization and direct economic costs of care for patients treated with negative-pressure wound therapy (NPWT), using the Vacuum-Assisted Closure (V.A.C.) system, compared to standard moist wound therapy (MWT). METHODS: A total of 162 diabetic patients with post-amputation wounds (up to the trans-metatarsal level) entered a 16-week, randomized clinical trial. Patients randomized to V.A.C. (n = 77) received therapy with dressing changes every 48 hours. Control patients (n = 85) received standard MWT. Resource utilization, procedures, and direct costs were calculated and analyzed in this post hoc retrospective study. RESULTS: There was no difference between groups for in-patient hospital stay (number of admissions or length of stay). More surgical procedures (including debridement) were required in the MWT group (120 vs 43 NPWT, P <.001). The average number of dressing changes performed per patient was 118.0 (range 12-226) for MWT versus 41 (6-140) for NPWT (P = .0001). The MWT group had 11 (range 0-106) outpatient treatment visits during the study versus 4 (range 0-47) in the NPWT group (P <.05). The average direct cost per patient treated for 8 weeks or longer (independent of clinical outcome) was $27,270 and $36,096 in the NPWT and MWT groups, respectively. The average total cost to achieve healing was $25,954 for patients treated with NPWT (n = 43) compared with $38,806 for the MWT group (n = 33). CONCLUSION: Treatment of diabetic patients with post amputation wounds using NPWT resulted in lower resource utilization and a greater proportion of patients obtaining wound healing at a lower overall cost of care when compared to MWT.
|
|
| 4. |
- Arnbjörnsson, Einar, et al.
(författare)
-
Role of obstruction in the pathogenesis of acute appendicitis
- 1984
-
Ingår i: The American Journal of Surgery. - : Elsevier BV. - 1879-1883 .- 0002-9610. ; 147:3, s. 390-392
-
Tidskriftsartikel (refereegranskat)abstract
- The role of obstruction in the pathogenesis of acute appendicitis was studied by measuring the pressure in the appendix perioperatively in 24 patients operated on with an appendectomy because of suspected acute appendicitis. The technique used involved inserting a fine needle through the apex into the appendix lumen and measuring the hydrostatic pressure required to inject saline solution. In three patients with a gangrenous appendix found at operation, and in two patients with a phlegmonous appendix, there were signs of obstruction of the appendix lumen as revealed by increased pressure within it. In 14 patients with a phlegmonous appendix found at operation, no signs of obstruction were found. These experimental data suggest that obstruction is not an important causative agent of acute appendicitis, but might develop as a result of the inflammatory process.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Elmér, Olle, et al.
(författare)
-
Prevention of posttraumatic pulmonary platelet trapping by portacaval transposition
- 1988
-
Ingår i: The American Journal of Surgery. - 1879-1883. ; 155:2, s. 289-292
-
Tidskriftsartikel (refereegranskat)abstract
- Significant soft-tissue trauma induces platelet activation, aggregation, and sequestration in the lungs. This pulmonary trapping is due either to the size of the platelet aggregates or to changes in the pulmonary microvasculature. To evaluate which one of these mechanisms is responsible for the trapping, we performed portacaval transposition in one group of pigs, making the liver the first receiving capillary bed for blood from the trauma sites in the lower extremities. One week after the operation, the platelets were labeled with indium oxine and reinfused, and the operated animals and a group of six control animals were subjected to standardized soft-tissue trauma to the lower extremities. Sequestration of platelets in the lungs and in the liver was registered dynamically before and for 90 minutes after the trauma. Soft-tissue trauma induced platelet sequestration in the liver in the operated group (p less than 0.01) and in the lungs in the control group (p less than 0.01). Trapping was paralleled by a decrease in the number of circulating platelets. This study has indicated that posttraumatic pulmonary platelet trapping is caused by platelet activation at the trauma sites and not by changes in the pulmonary microvasculature.
|
|
| 8. |
- Enochsson, Lars, et al.
(författare)
-
The location of bile duct stones may affect intra- and postoperative cholecystectomy outcome : a population-based registry study
- 2020
-
Ingår i: American Journal of Surgery. - : Elsevier. - 0002-9610 .- 1879-1883. ; 220:4, s. 1038-1043
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Treatment for bile duct stones (BDS) depends largely on anatomical circumstances; yet, whether the outcome of cholecystectomies is impacted by the localization of intraoperatively discovered BDS remains largely unknown.METHODS: A population-based registry study using data from the national Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks). 115,084 cholecystectomies 2006-2016 with the indications gallstone colic or complications were included. The surgical outcome between patients with distal BDS and those with at least one stone above the confluence was compared.RESULTS: 10,704 met the inclusion criteria. Patients with stones above the confluence had 16% longer operation times and significantly higher rates of intraoperative complications (OR 1.47), gut perforation (OR 4.60), and cholangitis (OR 1.96) compared to patients with distal BDS. The highest clearance rate (96%), as reflected by the need for re-ERCP, was seen after intraoperative ERCP, regardless of the localization of the BDS.CONCLUSIONS: Stones located above the confluence are associated with increased complication risks. These findings stress the importance of carefully considering the optimal methods for BDS removal during surgery.
|
|
| 9. |
- Escobar Kvitting, John-Peder, et al.
(författare)
-
A phytobezoar in the acute abdomen
- 2009
-
Ingår i: American Journal of Surgery. - : Elsevier. - 0002-9610 .- 1879-1883. ; 197:2, s. e21-e22
-
Tidskriftsartikel (refereegranskat)abstract
- A phytobezoar is a rare differential diagnosis in the acute abdomen. An 89-year-old woman presented with lower abdominal pain. A computed tomography scan and ultrasound suggested the presence of a bezoar. A phytobezoar was extracted surgically, and a resection was performed of the perforated small bowel segment. The etiology and management of phytobezoars are discussed.
|
|
| 10. |
- Jansson, Kjell, 1958-, et al.
(författare)
-
Intraperitoneal cytokine response after major surgery : higher postoperative intraperitoneal versus systemic cytokine levels suggest the gastrointestinal tract as the major source of the postoperative inflammatory reaction
- 2004
-
Ingår i: American Journal of Surgery. - : Elsevier BV. - 0002-9610 .- 1879-1883. ; 187:3, s. 372-377
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cytokine response is an important factor in the development of shock and organ failure. The aim of this study was to investigate intraperitoneal (peritoneal) and venous (systemic) postoperative cytokine release after major surgery.METHODS: Major abdominal surgery was performed in 19 patients. Preoperative systemic measurements and postoperative systemic and peritoneal measurements of C-reactive protein (CRP) and the cytokines tumor necrosis factor-alpha (TNF-alpha), interleukin (IL-6), and IL-10 were performed.RESULTS: Significantly higher TNF-alpha, IL-6, and IL-10 peritoneal values were recorded compared with systemic values, whereas peritoneal CRP was significantly decreased. CRP increased significantly over time, whereas postoperative values of IL-6, IL-10, and peritoneal TNF-alpha decreased. Systemic TNF-alpha was constant over time, but values after emergent abdominal surgery showed a more extensive response. An additional effect of surgery and emergent abdominal disease was seen in increased TNF-alpha and IL-10 levels.CONCLUSIONS: Compared with systemic cytokines, peritoneal cytokines respond extensively after major surgery, indicating that measurement of peritoneal cytokines is a more sensible method to determine postoperative inflammatory reaction. A normal postoperative course is characterized by decreasing levels of peritoneal cytokines.
|
|
