Antiplatelet and anticoagulation therapies do not increase mortality in the absence of traumatic brain injury.

Background: : As the population continues to age, the number of patients undergoing traumatic injury while on antiplatelet or anticoagulation therapies is increasing. Mortality has been shown to increase in traumatic brain injury patients on warfarin therapy. Whether this increased mortality is seen in trauma patients without traumatic brain injury remains controversial.

Effect of Center of Excellence requirement by Centers for Medicare and Medicaid Services on practice trends.

Background: To report the effect of the American Society of Bariatric Surgery or American College of Surgeons-designated Centers of Excellence designation in Michigan on our practice trends and patient populations. As of February 2006, weight loss surgery for Medicare beneficiaries are reimbursed when procedures are performed at American Society of Bariatric Surgery or American College of Surgeons-designated Centers of Excellence.

Methods: Patients who underwent laparoscopic Roux-en-Y gastric bypass surgery by an individual surgeon from June 1 to October 31 in 2004, 2005, and 2006 were stratified according to use of private third-party insurance versus Medicare (MC) insurance.

The protective effect of the blood brain barrier from systemic cytokines in an animal femur fracture model.

Background: Previous studies of head trauma have shown profound release of cytokines in the brain. These changes were not expressed in peripheral tissues. The intent of this study was to take an animal model of femur fracture, monitor the expression of biochemical markers in the periphery, and compare this to their expression in the brain.

A double-blinded, prospective randomized controlled trial of intraperitoneal bupivacaine in laparoscopic Roux-en-Y gastric bypass.

Background: Intraperitoneal local anesthetics have been investigated in several laparoscopic procedures that demonstrate improved postoperative pain control and reduced length of hospital stay. No published studies to date address the effectiveness of IP local anesthetics in laparoscopic gastric bypass patients (LRYGB).

Study Design: Between October 2004 and March 2005, 133 patients were prospectively studied to evaluate the efficacy of IP bupivacaine (IPB) in LRYGB.

Radiation exposure in trauma patients.

Background: Trauma patients are exposed to a large amount of ionizing radiation. Radiologic examinations may include a multitude of plain films, computed tomography scans, and/or fluoroscopic examination. Previous studies have assessed radiation exposure to staff members at trauma centers, and in pregnant trauma patients.

The effect of traumatic brain injury upon the concentration and expression of interleukin-1beta and interleukin-10 in the rat.

Background: Using a model of traumatic brain injury (TBI) in the rat, this study was undertaken to characterize the short-term biochemical changes of IL-1beta, IL-10, and tumor necrosis factor TNF-alpha to determine whether injury in the brain elicits a systemic cytokine response.

Methods: Sprague-Dawley rats were subjected to a TBI using a weight-drop model and then killed at various time points after injury. Samples of blood, brain, and liver were recovered and analyzed for concentrations of IL-1beta, IL-10, and TNF-alpha as well as IL-1beta and IL-10 mRNA expression in liver and brain.

Recombinant factor VIIa for the treatment of severe postoperative and traumatic hemorrhage.

Background: The aim of this study was to determine the dose of recombinant factor VIIa (rFVIIa) that has been used in our institution to successfully control hemorrhage in trauma and postoperative patients.

Methods: This was an 8-month retrospective cohort study of 13 patients with acute hemorrhage and no known history of coagulopathic disorders.

Results: Administration of factor VIIa resulted in the cessation of life-threatening hemorrhage at dosages approximately one half those recommended for the management of hemophilia.

Early tracheostomy versus late tracheostomy in the surgical intensive care unit.

Background: This study's purpose was to determine if early tracheostomy (ET) of severely injured patients reduces days of ventilatory support, the frequency of ventilator-associated pneumonia (VAP), and surgical intensive care unit (SICU) length of stay (LOS).

Methods: This 2-year retrospective review included 185 SICU patients with acute injuries requiring mechanical ventilation and tracheostomy. ET was defined as 7 days or less, and late tracheostomy (LT) as more than 7 days.

Resident and faculty perceptions of a surgical residency program merger.

To evaluate resident and faculty perceptions of a residency merger process.Survey of faculty and residents of a recently merged general surgical residency. Nineteen separate program characteristics were evaluated via a numerical scoring system, and additional written commentary regarding dominant perceived benefits and detriments of the merger was solicited.