scholarly journals National Trends in the Adoption of Laparoscopic Cholecystectomy over 7 Years in the United States and Impact of Laparoscopic Approaches Stratified by Age

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Anahita Dua ◽  
Abdul Aziz ◽  
Sapan S. Desai ◽  
Jason McMaster ◽  
SreyRam Kuy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Elderly Patients ◽  
Open Cholecystectomy ◽  
Age Groups ◽  
The United States ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Discharge Disposition ◽  
Open Versus ◽  
National Trends

Introduction. The aim of this study was to characterize national trends in adoption of laparoscopic cholecystectomy and determine differences in outcome based on type of surgery and patient age.Methods. Retrospective cross-sectional study of patients undergoing cholecystectomy. Trends in open versus laparoscopic cholecystectomy by age group and year were analyzed. Differences in outcomes including in-hospital mortality, complications, discharge disposition, length of stay (LOS), and cost are examined.Results. Between 1999 and 2006, 358,091 patients underwent cholecystectomy. In 1999, patients aged ≥80 years had the lowest rates of laparoscopic cholecystectomy, followed by those aged 65–79, 64–50, and 49–18 years (59.7%, 65.3%, 73.2%, and 83.5%, resp.,P<0.05). Laparoscopic cholecystectomy was associated with improved clinical and economic outcomes across all age groups. Over the study period, there was a gradual increase in laparoscopic cholecystectomy performed among all age groups during each year, though elderly patients continued to lag significantly behind their younger counterparts in rates of laparoscopic cholecystectomy.Conclusion. This is the largest study to report trends in adoption of laparoscopic cholecystectomy in the US in patients stratified by age. Elderly patients are more likely to undergo open cholecystectomy. Laparoscopic cholecystectomy is associated with improved clinical outcomes.

Feasibility and safety in difficult laparoscopic cholecystectomies; a single surgeon experience.

2020 ◽  
Vol 11 (4) ◽  
pp. 12-16
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Bile Leakage ◽  
Cross Sectional Study ◽  
City Hospital ◽  
Class Iii ◽  
Cross Sectional ◽  
Surgeon Experience ◽  
Conversion To Open Cholecystectomy ◽  
Duration Of Surgery

Background: laparoscopic cholecystectomy is commonly used for the treatment of gallstones. Objective: To determine the feasibility and safety of difficult laparoscopic cholecystectomies. Methodology: This cross sectional study was based on retrospective collection of data from patient records, including 323 patients with difficult laparoscopic cholecystectomies was conducted in Department of Surgery, Sharif Medical City Hospital, and Rasheed Hospital, Lahore from June 2010 to December 2019. Difficult cholecystectomy was defined on intraoperative findings based on Nassar intraoperative scoring system. Feasibility was defined as successful accomplishment of procedure without complication and safety was defined as having no intraoperative or postoperative complications. Results: There were 75 (23.21%) male and mean age was 48±8 years. Class I difficulty was observed in 185 (57.3%) patients, class II difficulty in 83 (25.7%) patients, class III difficulty in 44 (13.6%) patients and class IV difficulty in 11 (3.4%) patients. Mean duration of surgery and mean hospital stay were 98.87±11.76 minutes and 1.91±1 days, respectively. Conversion to open cholecystectomy was done in 10 (3.1%). The procedure was feasible in 313 (96.9%) patients. Overall complications were seen in 19 (5.9%) patients. The complications included Common Bile Duct injury in 1 (0.31%) patient, intraoperative bleeding in 1 (0.3%) patients, bile leakage in 2 (0.62%) patients, postoperative jaundice in 3 (0.93%) patients, superficial infections in 10 (3.1%) patients and deep infections in 2 (0.62%) patients. Safety of laparoscopic surgery was seen in 304 (94.1%) patients. Conclusion: Laparoscopic cholecystectomy in difficult situations was found to be feasible and safe in majority of patients. However, it was associated with a longer operative time.

scholarly journals National trends in hospitalization and mortality rates for patients with HIV, HCV, or HIV/HCV coinfection from 1996–2010 in the United States: a cross-sectional study

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Christine U Oramasionwu ◽  
Joshua C Toliver ◽  
Terence L Johnson ◽  
Heather N Moore ◽  
Christopher R Frei
Keyword(s):  
United States ◽  
The United States ◽  
Mortality Rates ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hcv Coinfection ◽  
National Trends

scholarly journals The Public’s Perception of the Severity and Global Impact at the Start of the SARS-CoV-2 Pandemic: A Crowdsourcing-Based Cross-Sectional Analysis (Preprint)

2020 ◽  
Author(s):  
Orr Shauly ◽  
Gregory Stone ◽  
Daniel Gould
Keyword(s):  
Age Groups ◽  
The United States ◽  
Cross Sectional Study ◽  
Amazon Mechanical Turk ◽  
Cross Sectional ◽  
The Us ◽  
Control And Prevention ◽  
Novel Coronavirus ◽  
Study Participants ◽  
Sectional Analysis

BACKGROUND COVID-19 is a rapidly developing threat to most people in the United States and abroad. The behaviors of the public are important to understand, as they may have a tremendous impact on the course of this novel coronavirus pandemic. OBJECTIVE This study intends to assess the US population’s perception and knowledge of the virus as a threat and the behaviors of the general population in response. METHODS A prospective cross-sectional study was conducted with random volunteers recruited through Amazon Mechanical Turk, an internet crowdsourcing service, on March 24, 2020. RESULTS A total of 969 participants met the inclusion criteria. It was found that the perceived severity of the COVID-19 pandemic significantly differed between age groups (<i>P</i>&lt;.001) and men and women (<i>P</i>&lt;.001). A majority of study participants were actively adhering to the Centers for Disease Control and Prevention guidelines. CONCLUSIONS Though many participants identified COVID-19 as a threat, many failed to place themselves appropriately in the correct categories with respect to risk. This may indicate a need for additional public education for appropriately defining the risk of this novel pandemic.

scholarly journals Increase in emergency department visits related to cannabis reported using syndromic surveillance system

2019 ◽  
Vol 29 (4) ◽  
pp. 621-625 ◽  
Author(s):  
G N Noel ◽  
A M Maghoo ◽  
F F Franke ◽  
G V Viudes ◽  
P M Minodier
Keyword(s):  
Emergency Department ◽  
Surveillance System ◽  
Syndromic Surveillance ◽  
Age Groups ◽  
The United States ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Cross Sectional ◽  
Syndromic Surveillance System ◽  
Icd 10

Abstract Background Cannabis is illegal in France but, as in many countries, legalization is under debate. In the United States, an increase of emergency department (ED) visits related to cannabis exposure (CE) in infants and adults was reported. In France, a retrospective observational study also suggested an increase of CE in children under 6 years old. This study only included toddlers and the data sources used did not allow repeated analysis for monitoring. Methods Our study aimed to evaluate the trend in visits for CE in ED in patients younger than 27 years old in Southern France. A cross-sectional study using the Electronic Emergency Department Abstracts (EEDA) included in the national Syndromic Surveillance System. CE visits were defined using International Classification of Disease (ICD-10). Results From 2009 to 2014, 16 EDs consistently reported EEDA with <5% missing diagnosis code. Seven hundred and ninety seven patients were admitted for CE including 49 (4.1%) children under 8 years old. From 2009–11 to 2012–14, the rate of CE visits increased significantly across all age groups. The highest increase was in the 8–14 years old (+144%; 1.85–4.51, P < 0.001) and was also significant in children under 8 (0.53–1.06; P = 0.02). Among children under 8, hospitalization rate (75.5% vs. 16.8%; P < 0.001) and intensive care unit admissions (4.1% vs. 0.1%; P < 0.001) were higher compared with patients older than 8 years. Conclusion These trends occurred despite cannabis remaining illegal. EEDA could be useful for monitoring CE in EDs.

scholarly journals Differential Association Between Actual and Perceived Obesity Between African-Americans and Whites in the United States

2020 ◽  
Vol 7 (3) ◽  
pp. 107-114
Author(s):  
Shervin Assari
Keyword(s):  
African Americans ◽  
Racial Differences ◽  
The United States ◽  
Cross Sectional Study ◽  
Effect Modifier ◽  
Cross Sectional ◽  
Interaction Terms ◽  
Independent Variable ◽  
Logistic Regressions ◽  
National Trends

Background and aims: Although actual and perceived obesity are associated, some research has shown that this association may differ across racial and ethnic groups. Accordingly, this cross-sectional study tested racial differences regarding the association between actual and perceived obesity among American adults. Methods: The Health Information National Trends Survey (HINTS 5- Cycle 3) is a representative survey of American adults conducted in 2019. A total number of 3731 adults entered our analysis, including 3054 (81.9%) non-Hispanic Whites and 677 (18.1%) African-Americans (AAs). The independent variable was actual obesity, which was defined as a body mass index of equal or more than 30. The outcome was perceived as obesity. In addition, age, gender, marital status, education, and income were considered as control variables (confounders), and the race was the focal effect modifier. Finally, logistic regressions without and with interaction terms were utilized to analyze the data. Results: Overall, actual and perceived obesity were associated with individuals with obesity having higher odds of finding self as obese (odds ratio [OR]=25.82, 95% CI=18.58-35.89, P<0.001). Further, race showed a statistical interaction with actual on perceived obesity (OR=0.27, 95% CI=0.14-0.55, P< 0.001), indicating a weaker link between the two for AAs compared to non-Hispanic Whites. Race-stratified models also confirmed the same pattern with the actual and perceived obesity, showing a weaker association for AAs (OR=15.61, 95% CI=9.53-25.59, P<0.001) in comparison with nonHispanic Whites (OR=46.23, 95% CI=27.01-709.14, P<0.001). Conclusion: AAs compared to non-Hispanic Whites differed in the effect of their actual obesity on their perceived obesity. This may explain the looser association of obesity and depression in AAs as compared to Whites.

scholarly journals Laparoscopic Cholecystectomy - A Cross Sectional Study

2015 ◽  
Vol 2 (1) ◽  
pp. 53
Author(s):  
Pari A. Pulate ◽  
Tushar Narkhede ◽  
Sushma S. Chandak
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Complication Rate ◽  
Open Cholecystectomy ◽  
Cross Sectional Study ◽  
Chronic Cholecystitis ◽  
Histopathological Diagnosis ◽  
Early Recovery ◽  
Cross Sectional ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Bladder Polyp

<strong>Aims and Objectives:</strong> 1. To study the clinical profile of patients undergoing laparoscopic cholecystectomy. 2. To study the post operative complications of laparoscopic cholecystectomy. <strong>Methodology:</strong> Ultrasound confirmed 48 cases of either sex admitted in department of surgery with cholelithiasis, gall bladder polyp, acute or chronic cholecystitis were included in this survey. These patients underwent laparoscopic cholecystectomy after preoperative preparation during August 2011-December 2013. <strong>Results:</strong> Highest age incidence was seen in 4<sup>th</sup> decade with female preponderance. Most common presenting symptom was pain in abdomen followed by nausea, vomiting, dyspepsia and fever. Only 1 procedure was converted to open cholecystectomy with conversion rate of 2.08%. It was due to dense adhesions from chronic infection. The overall post-operative complication rate was 6.25% with wound infection being the most common occurring in 2 cases and prolonged ileus in 1 case. Chronic cholecystitis was the major histopathological diagnosis. The median post-operative stay in our study was 3 days. <strong>Conclusion:</strong> Chronic cholecystitis is the most common presentation of cholelithiasis with female pre-ponderance and incidence more in the 4<sup>th</sup> decade. Laparoscopic cholecystectomy is safe and feasible treatment with less complication rate and early recovery.

scholarly journals Age and Hospitalization Risk in People with Type 1 Diabetes and COVID-19: Data from the T1D Exchange Surveillance Study

2021 ◽  
Author(s):  
Carla Demeterco-Berggren ◽  
Osagie Ebekozien ◽  
Saketh Rompicherla ◽  
Laura Jacobsen ◽  
Siham Accacha ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Age Groups ◽  
The United States ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Study Population ◽  
Few Data

Abstract Context COVID-19 morbidity and mortality are increased in type 1 diabetes (T1D), but few data focus on age-based outcomes. Objective To quantify the risk for COVID-19 related hospitalization and adverse outcomes by age in people with T1D. Design, Setting and Patients For this observational, multisite, cross-sectional study of patients with T1D and laboratory-confirmed COVID-19 from 56 clinical sites in the United States, data were collected from April 2020 to March 2021. The distribution of patient factors and outcomes across age groups (0-18, 19-40 and &gt; 40 years) was examined. Descriptive statistics were used to describe the study population, and multivariate logistic regression models were used to analyze the relationship between age, adverse outcomes, and hospitalization. Main Outcome Measures Hospitalization for COVID-19. Results A total of 767 patients were analyzed. Fifty-four percent (n=415) were aged 0-18 years, thirty-two percent (n=247) were aged 19-40 years and fourteen percent (n=105) were aged &gt;40 years. One-hundred and seventy patients were hospitalized, and 5 patients died. Compared to the 0-18 years age group, those &gt;40 years of age had an adjusted odds ratio of 4.2 (95% confidence interval 2.28-7.83) for hospitalization after adjustment for gender, A1c, race, insurance type and comorbidities. Conclusions Age &gt;40 years is a risk factor for patients with T1D and COVID-19, with children and younger adults experiencing milder disease and better prognosis. This indicates a need for age-tailored treatments, immunization, and clinical management of individuals affected by T1D.

scholarly journals The Public’s Perception of the Severity and Global Impact at the Start of the SARS-CoV-2 Pandemic: A Crowdsourcing-Based Cross-Sectional Analysis

10.2196/19768 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e19768
Author(s):  
Orr Shauly ◽  
Gregory Stone ◽  
Daniel Gould
Keyword(s):  
Age Groups ◽  
The United States ◽  
Cross Sectional Study ◽  
Amazon Mechanical Turk ◽  
Cross Sectional ◽  
The Us ◽  
Control And Prevention ◽  
Novel Coronavirus ◽  
Study Participants ◽  
Sectional Analysis

Background COVID-19 is a rapidly developing threat to most people in the United States and abroad. The behaviors of the public are important to understand, as they may have a tremendous impact on the course of this novel coronavirus pandemic. Objective This study intends to assess the US population’s perception and knowledge of the virus as a threat and the behaviors of the general population in response. Methods A prospective cross-sectional study was conducted with random volunteers recruited through Amazon Mechanical Turk, an internet crowdsourcing service, on March 24, 2020. Results A total of 969 participants met the inclusion criteria. It was found that the perceived severity of the COVID-19 pandemic significantly differed between age groups (P<.001) and men and women (P<.001). A majority of study participants were actively adhering to the Centers for Disease Control and Prevention guidelines. Conclusions Though many participants identified COVID-19 as a threat, many failed to place themselves appropriately in the correct categories with respect to risk. This may indicate a need for additional public education for appropriately defining the risk of this novel pandemic.

scholarly journals Factors Affecting Conversion From Laparoscopic Cholecystectomy to Open Cholecystectomy at a Tertiary Care Facility in Saudi Arabia: A Cross-Sectional Study

2020 ◽  
Vol 104 (3-4) ◽  
pp. 166-170
Author(s):  
Thamer Nouh ◽  
Faris Alanazi ◽  
Abdulellah S. Abunayan ◽  
Abdallah F. Alsaadoun ◽  
Mohamed A. Alsehly ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Conversion Rates ◽  
Conversion To Open Cholecystectomy ◽  
Preoperative Factors

Background: Despite the growing importance and increased use of laparoscopy for gallbladder diseases in Saudi Arabia, several factors reportedly result in conversion to open surgery. This leads to increased operative time and increased hospital resource utilization, and, importantly, it impacts patient welfare. Although laparoscopic cholecystectomy and its conversion rates have been investigated in Saudi Arabia, there is little information on the factors associated with this conversion. Therefore, we analyzed the prevalence and factors associated with the conversion from laparoscopic to open cholecystectomy. Materials and methods: This was a quantitative, retrospective, observational, cross-sectional study. We reviewed the health care records of all patients who underwent laparoscopic cholecystectomy during the study period (January 2014–December 2015). We analyzed patient demographics, preoperative factors, ultrasound findings, and intraoperative factors associated with higher conversion rates. We calculated means, SDs, and medians for numerical variables and percentages and frequencies for nominal variables. The χ2 and two-tailed t tests were used to compare the categorical and continuous variables, respectively, between patients who underwent laparoscopic cholecystectomy and those who underwent conversion to open cholecystectomy to analyze their relationship with the possibility of conversion. Statistical significance was considered at P &lt; 0.05. Results: Age &gt; 40 years, diabetes, history of admission for gallstones, and increased total bilirubin, direct bilirubin, and alkaline phosphatase levels were the preoperative factors and adhesions, bleeding, and stone spillage were the intraoperative factors associated with conversion. Conclusion: Recognizing the factors for conversion would improve treatment planning and help predict when conversion may be necessary.

Does a Graduate Course in Fluency Disorders Make a Difference?

2010 ◽  
Vol 20 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Evelyn R. Klein ◽  
Barbara J. Amster
Keyword(s):  
Undergraduate Students ◽  
Graduate Programs ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Graduate Course ◽  
Cross Sectional ◽  
Fluency Disorders ◽  
Introductory Course ◽  
Communicative Disorders

Abstract A study by Yaruss and Quesal (2002), based on responses from 134 of 239 ASHA accredited graduate programs, indicated that approximately 25% of graduate programs in the United States allow students to earn their degree without having coursework in fluency disorders and 66% of programs allow students to graduate without clinical experience treating people who stutter (PWS). It is not surprising that many clinicians report discomfort in treating PWS. This cross-sectional study compares differences in beliefs about the cause of stuttering between freshman undergraduate students enrolled in an introductory course in communicative disorders and graduate students enrolled and in the final weeks of a graduate course in fluency disorders.

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