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BACKGROUND After trauma, up to 60 per cent of immobilized patients have been reported to develop a silent deep vein thrombosis (DVT). No large, prospective randomized trials have tested the efficacy of intermittent pneumatic compression (IPC) devices in these patients. METHODS A prospective randomized trial was performed of 442 patients who received(More)
Traumatic mesenteric arterioportal fistulas (APF) are rare but serious and life-threatening. This article reports the case of a 24-year-old female who suffered a gunshot wound to the abdomen and subsequently developed a superior mesenteric artery (SMA) pseudoaneurysm and APF, which caused secondary right heart failure and pulmonary hypertension. The patient(More)
BACKGROUND The purpose of this study was to determine whether the incidence of recovery and patterns of antibiotic susceptibility of pathogenic bacteria vary between intensive care units (ICUs) in a single teaching hospital. METHODS Culture and susceptibility results were collected prospectively for a 3-month period (April through June 1999) in each of(More)
OBJECTIVE To determine the optimal method of wound closure for dirty abdominal wounds. SUMMARY BACKGROUND DATA The rate of wound infection for dirty abdominal wounds is approximately 40%, but the optimal method of wound closure remains controversial. Three randomized studies comparing delayed primary closure (DPC) with primary closure (PC) have not(More)
Video-thoracoscopy was used to evaluate and manage patients after thoracic trauma. It was used in 29 patients. Indications included retained hemothorax in 16 patients, empyema in 11, evaluation for the source of thoracic bleeding in 1, and an airleak in 1. The mechanism of injury was blunt trauma in 8 cases, 10 with stab wounds, and 11 with gunshot wounds.(More)
OBJECTIVE To compare intraoperative findings and/or angiography with color-flow duplex scan. DESIGN This prospective double-blind study was performed on all stable patients with zone 1, 2, or 3 penetrating neck trauma. Results of angiographic or intraoperative findings were compared with the results of duplex ultrasonographic scans. MAIN OUTCOME(More)
OBJECTIVE To determine whether computed tomography (CT) is an accurate diagnostic modality for the triage of hemodynamically stable patients with gunshot wounds of the abdomen and flank. METHODS A chart review of 83 trauma patients for whom abdominal CT was used as initial screening. RESULTS In 53 patients, CT revealed no evidence of peritoneal(More)
BACKGROUND Reported mortality for open cholecystectomy in patients with cirrhosis ranges from 10% to 80%. Laparoscopic cholecystectomy has gained acceptance in the general population and has become the procedure of choice for symptomatic cholelithiasis. We reviewed our experience with the use of laparoscopic cholecystectomy in this group. STUDY DESIGN We(More)
Ten months after the earthquake in Haiti, the beleaguered public health system is worse than ever. In a country that spent $58 per person per year on health care prior to the earthquake, the Ministry of Health must now deal with the excess morbidity from the disaster with even fewer resources. The healthcare system will be burdened with the increased(More)