Surg Infect (Larchmt)
October 2016
Background: Sepsis is the primary cause of perioperative mortality among general surgery patients and is the leading cause of death in non-cardiac intensive care units. To address this issue, the Surviving Sepsis Campaign Guidelines advocate for sepsis screening. However, there is little information in the current medical literature to suggest which sepsis screening tool is optimal.
View Article and Find Full Text PDFBackground: Hemorrhage remains the leading cause of mortality in preventable trauma deaths. Earlier recognition of hemorrhagic shock decreases the time to implementation of life-saving interventions improves patient survival. The presence of hemorrhagic shock is not always apparent using standard vital signs monitoring, a clinical state referred to as occult shock.
View Article and Find Full Text PDFThiazide-type diuretics have been recommended for initial treatment of hypertension in most patients, but should this recommendation differ for patients with and without coronary heart disease (CHD)? The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) was a randomized, double-blind hypertension treatment trial in 42,418 participants with high risk of combined cardiovascular disease (CVD) (25% with preexisting CHD). This post hoc analysis compares long-term major clinical outcomes in those assigned amlodipine (n = 9048) or lisinopril (n = 9,054) with those assigned chlorthalidone (n = 15,255), stratified by CHD status. After 4 to 8 years, randomized treatment was discontinued.
View Article and Find Full Text PDFBackground: Hemorrhage remains the leading cause of death in trauma patients. Proximal aortic occlusion, usually performed by direct aortic cross-clamping via thoracotomy, can provide temporary hemodynamic stability, permitting definitive injury repair. Resuscitative endovascular balloon occlusion of the aorta (REBOA) uses a minimally invasive, transfemoral balloon catheter, which is rapidly inserted retrograde and inflated for aortic occlusion, and may control inflow and allow time for hemostasis.
View Article and Find Full Text PDFTriple-negative breast cancer (TNBC) is characterised by lack of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER)2/neu gene amplification. TNBC patients typically present at a younger age, with a larger average tumor size, higher grade and higher rates of lymph node positivity compared to patients with ER/PR-positive tumors. Cyclooxygenase (COX)-2 regulates the production of prostaglandins and is overexpressed in a variety of solid tumors.
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