scholarly journals Potential considerations in decision making on laparoscopic colorectal resections in Hungary based on administrative data

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257811
Author(s):  
Zsófia Benedek ◽  
Cecília Surján ◽  
Éva Belicza
Keyword(s):  
Colorectal Surgery ◽  
Age Groups ◽  
Insurance Fund ◽  
Preoperative Treatment ◽  
Medicine Department ◽  
International Data ◽  
Short Time ◽  
Colorectal Resections ◽  
Laparoscopic Colorectal Resections ◽  
Selection Of

Background Laparoscopic colorectal surgeries offer numerous advantages over their open counterparts. To compare these measurable short-time outcomes of open and laparoscopic resections in Hungary, data of colorectal surgeries were collected and analysed. The study focused on identifying patients’ characteristics that can influence the decision on laparoscopic colorectal resections and on comparing efficiency of Hungarian colorectal operations with international data. Methods Using patients’ data of laparoscopic and open colorectal surgery performed in 2015 and 2016 from the National Health Insurance Fund of Hungary, a countrywide retrospective comparative analysis was done. Logistic regression was used to explore main influencing factors for laparoscopic colorectal surgery. Results A total of 17,876 colorectal surgical cases, including 14,876 open and 3,000 laparoscopic resections were selected and analysed. Laparoscopy was used only in 16.78% of all cases. Comparison of age groups showed that odds ratio (OR) of laparoscopic colorectal resections was significantly lower in over 40 years than in younger patients (18–39 years). In university institutes patients had higher odds (OR: 2.23 p<0.0001) for laparoscopic colorectal resections. Presence of comorbidity codes and preoperative treatment in internal medicine department decreased odds for laparoscopic colorectal operations. Conclusions Patients’ age, comorbidities and hospital type influenced the likelihood of decision on laparoscopic colorectal resection. Selection of patients contributed to improved laparoscopic outcomes.

scholarly journals Primary Outcome of Laparoscopic Colorectal Resections in a Northern Finnish Hospital: A Single Center Study

2018 ◽  
Vol 108 (2) ◽  
pp. 137-143
Author(s):  
H. Huhta ◽  
S. Vuolio ◽  
I. Typpö ◽  
A. Rahko ◽  
K. Suokanerva ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Open Surgery ◽  
Primary Outcome ◽  
Laparoscopic Colorectal Surgery ◽  
Surgical Complication ◽  
Hospital Data ◽  
Patient Registries ◽  
American Society ◽  
Colorectal Resections ◽  
Laparoscopic Colorectal Resections

Background and Aims: Over the past decades, laparoscopic colorectal surgery has become widely used for various indications. Large multicenter studies have demonstrated that laparoscopy has clear advantages over open surgery. Compared to open procedures, laparoscopy decreases perioperative blood loss, post-operative pain, and hospitalization time, but provides equivalent long-term oncological and surgical results. Most studies have been conducted in high-volume institutions with selected patients, which may have influenced the reported outcome of laparoscopy. Here, we investigated the primary outcome of all laparoscopic colorectal resections performed between 2005 and 2015 in a low-volume center. Materials and Methods: This retrospective study included bowel resections performed between 2005 and 2015 in the Lapland Central Hospital. Data were retrieved from electronic patient registries, and all operations that began as a laparoscopy were included. Patient records were investigated to determine the primary surgical outcome and possible complications within the first 30 days after surgery. Results: During 2005–2015, 385 laparoscopic colorectal resections were performed. Indications included benign (n = 166 patients, 43.1%) and malignant lesions (n = 219 cases, 56.9%). The median patient age was 68 years, and 50.4% were male. The median American Society of Anesthesiologist score was III, and 48.5% of patients had an American Society of Anesthesiologist class of III or IV. The median hospital stay after surgery was 6 days (interquartile range: 3.8). The conversion rate to open surgery rate was 13%. The total surgical complication rate was 24.2%, and re-operation was required in 11.2% of patients. A total of 26 patients had anastomotic leakage, of which 16 required re-operations. The 30-day mortality was 0.8%. Conclusion: Our results showed that laparoscopic colorectal surgery in a peripheral hospital resulted in primary outcome rates within the range of those reported in previous multicenter trials. Therefore, the routine use of laparoscopic colorectal resections with high-quality outcome is feasible in small and peripheral surgical units.

scholarly journals Compliance with enhanced recovery protocols in elderly patients undergoing colorectal resection

2018 ◽  
Vol 100 (7) ◽  
pp. 570-579 ◽  
Author(s):  
S Hallam ◽  
F Rickard ◽  
N Reeves ◽  
D Messenger ◽  
J Shabbir
Keyword(s):  
Multivariate Analysis ◽  
Colorectal Surgery ◽  
Elderly Patients ◽  
Open Surgery ◽  
Enhanced Recovery ◽  
Age Groups ◽  
Conversion To Open Surgery ◽  
Delayed Discharge ◽  
Significant Difference ◽  
Colorectal Resections

Introduction Enhanced recovery after surgery (ERAS) is associated with reduced length of stay (LOS) and improved outcomes in colorectal surgery. It is unclear whether ERAS can be safely implemented in elderly patients undergoing complex colorectal resections. The aim of this study was to evaluate the feasibility of ERAS in patients of all ages undergoing colorectal surgery. Methods A prospective database of a consecutive series of patients undergoing colorectal resections with ERAS between August 2012 and December 2014 was evaluated. Patients were divided into four age groups. Outcomes studied were compliance with ERAS elements, LOS, morbidity and mortality. Results Of the 294 patients in the study cohort, 79 were <60 years, 81 were 60–69 years, 86 were 70–79 years and 48 were ≥80 years of age. There was no significant difference between age groups in compliance with ERAS elements. Age was not predictive of delayed discharge (LOS >6 days) or morbidity. Factors that were predictive of delayed discharge on multivariate analysis were open surgery (odds ratio [OR]: 2.23, p=0.003), conversion to open surgery (OR: 3.23, p=0.017), stoma formation (OR: 2.10, p=0.019) and chronic obstructive pulmonary disease (OR: 4.12, p=0.038). Factors predictive of morbidity on multivariate analysis comprised conversion to open surgery (OR: 7.72, p=0.004), high creatinine (OR: 1.03 per unit increase in creatinine, p=0.008) and stoma education (OR: 0.31, p=0.030). Conclusions ERAS can be successfully implemented in older patients. There was equal compliance with the ERAS programme across the four age groups and no significant effect of age on LOS or morbidity.

Assessment of the Dietary Intakes of 6- and 12-Month-Old Infants in Saudi Arabia

2017 ◽  
Vol 87 (1-2) ◽  
pp. 37-48
Author(s):  
Riyadh A. Alzaheb ◽  
Norah Alatawi ◽  
Khawla A. Daoud ◽  
Naema Altawil
Keyword(s):  
Vitamin D ◽  
Saudi Arabia ◽  
Age Groups ◽  
Dietary Intakes ◽  
Dietary Survey ◽  
Daily Energy ◽  
Omega 6 ◽  
24 Hour Recall ◽  
Adequate Nutrient ◽  
Selection Of

Abstract.Background: Establishing understanding of infants’ dietary intakes can support interventions to improve their diets and overall health. Because information on the dietary intakes of infants aged ≤12 months in Saudi Arabia is scarce, this study examined the diets of infants aged 6 and 12 months in Saudi Arabia and determined their main dietary sources of total energy and macronutrients. Methods: A crosssectional dietary survey employing a single 24-hour recall was performed between May and December 2015 with a sample of mothers of 278 healthy 6-month-old and 259 12-month-old infants. An analysis of the dietary intake data determined the nutrient intake adequacy and the percentage contributions of foods to energy and macronutrient intakes. Results: The respective mean daily energy intakes of the 6-month-old and 12-month-old infants in the study were 703 kcal and 929 kcal. Both age groups recorded adequate nutrient intakes, with the exception that the 6-month-olds’ mean vitamin D intake fell below the recommended Adequate Intake (AI), and the 12-month-olds’ intakes of omega-6 fatty acids and vitamin D were also below the AI, along with their iron intake which fell short of the Recommended Dietary Allowance (RDA). Conclusion: The data generated here will assist health professionals in planning interventions which aim to improve infants’ diets and to offer guidance to parents on the appropriate selection of food for their infants.

The Adult as Foe or Friend?: Childism in Guus Kuijer's Criticism and Fiction

2013 ◽  
Vol 6 (2) ◽  
pp. 205-217 ◽  
Author(s):  
Vanessa Joosen
Keyword(s):  
Children's Literature ◽  
Children’S Literature ◽  
Age Groups ◽  
Children's Books ◽  
Children’S Books ◽  
Memorial Award ◽  
Adult Reader ◽  
Shed Light ◽  
Selection Of

Compared to the attention that children's literature scholars have paid to the construction of childhood in children's literature and the role of adults as authors, mediators and readers of children's books, few researchers have made a systematic study of adults as characters in children's books. This article analyses the construction of adulthood in a selection of texts by the Dutch author and Astrid Lindgren Memorial Award winner Guus Kuijer and connects them with Elisabeth Young-Bruehl's recent concept of ‘childism’ – a form of prejudice targeted against children. Whereas Kuijer published a severe critique of adulthood in Het geminachte kind [The despised child] (1980), in his literary works he explores a variety of positions that adults can take towards children, with varying degrees of childist features. Such a systematic and comparative analysis of the way grown-ups are characterised in children's texts helps to shed light on a didactic potential that materialises in different adult subject positions. After all, not only literary and artistic aspects of children's literature may be aimed at the adult reader (as well as the child), but also the didactic aspect of children's books can cross over between different age groups.

scholarly journals Health status and regularity of preventive activities among working population in Bulgaria

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S Georgieva ◽  
M Kamburova ◽  
P Stefanova ◽  
D Tsanova
Keyword(s):  
Age Groups ◽  
Blood Cholesterol ◽  
Health Improvement ◽  
Insurance Fund ◽  
Working Population ◽  
Active Population ◽  
Study Results ◽  
Working People ◽  
Population Potential ◽  
Knowledge And Attitude

Abstract Background Prevention is an important instrument for public health improvement and maintaining workability of active age people. National Health Insurance Fund of Bulgaria (NHIF) finances an annual regular check-up for people over 18 years of age. In addition, working people have access to preventive activities at their workplace. The aim of the study is to explore an actual regularity of preventive activities at active population in Bulgaria. Materials and Methods Data were collected by documents review and direct individual self-administered questionnaire, within a larger research project on health of active population in Bulgaria. It includes 326 employees in a study representing different branches, companies and professions. The questionnaire consists of questions about: a) distribution of risk factors, b) knowledge and attitude to prevention as a tool for better health c) types and regularity of preventive activities. Data processing was performed by SPSS v.24. Results Three of four respondents have been diagnosed with chronic disease, 49.4% of them suffer from more than one disease. One third of observed people take more than one medicine. Despite NHIF offers free of charge and obligatory annual check-ups, only 46% of study subjects have undergone a preventive examination within the last year, 49.7% - between 2 and 5 years and 4.3% have done so more than 5 years ago or never, which decrease the effectiveness of preventive measures. Visiting regular check-ups is significantly lower for younger age groups (below 44 years; p &lt; 0.05). Relatively large part of people measured blood pressure (88.5%), blood glucose (67%) and blood cholesterol (51.5%) during the last year in relation to any symptoms, but not within the regular check-up. Conclusions Study results confirm the current tendency for low coverage of annual check-ups of working population in Bulgaria. Potential of preventive activities is not rationally used because recommended regularity is not observed. Key messages Phenomena as polymorbidity and polypragmasia are widely distributed in Bulgarian active population. Potential of preventive activities is not fully used because recommended regularity is not observed. Despite Bulgarian NHIF finances obligatory annual check-up for people aged over 18 years, most people become subjects of medical examination in case of disease symptoms, rather than regular check-ups.

scholarly journals Review of Studies on Older Drivers’ Behavior and Stress—Methods, Results, and Outlook

Sensors ◽  
2021 ◽  
Vol 21 (10) ◽  
pp. 3503
Author(s):  
Yanning Zhao ◽  
Toshiyuki Yamamoto
Keyword(s):  
Age Groups ◽  
Older Drivers ◽  
Driving Simulators ◽  
Driving Experience ◽  
Older Driver ◽  
Vehicle Data ◽  
Vehicle Systems ◽  
Questionnaire Surveys ◽  
Definition Of ◽  
Short Time

This paper presents a review on relevant studies and reports related to older drivers’ behavior and stress. Questionnaires, simulators, and on-road/in-vehicle systems are used to collect driving data in most studies. In addition, research either directly compares older drivers and the other drivers or considers participants according to various age groups. Nevertheless, the definition of ‘older driver’ varies not only across studies but also across different government reports. Although questionnaire surveys are widely used to affordably obtain massive data in a short time, they lack objectivity. In contrast, biomedical information can increase the reliability of a driving stress assessment when collected in environments such as driving simulators and on-road experiments. Various studies determined that driving behavior and stress remain stable regardless of age, whereas others reported degradation of driving abilities and increased driving stress among older drivers. Instead of age, many researchers recommended considering other influencing factors, such as gender, living area, and driving experience. To mitigate bias in findings, this literature review suggests a hybrid method by applying surveys and collecting on-road/in-vehicle data.

scholarly journals Influence of Patient Age on Streptococcus pneumoniae Serotypes Causing Invasive Disease

2001 ◽  
Vol 8 (3) ◽  
pp. 556-559 ◽  
Author(s):  
Jaime Inostroza ◽  
Ana Maria Vinet ◽  
Gloria Retamal ◽  
Pedro Lorca ◽  
Gonzalo Ossa ◽  
...  
Keyword(s):  
Age Groups ◽  
Invasive Disease ◽  
Bacterial Virulence ◽  
Host Factors ◽  
Invasive Infection ◽  
Age Group ◽  
Southern Chile ◽  
Age Related ◽  
Sterile Site ◽  
Selection Of

ABSTRACT All clinical S. pneumoniae specimens isolated from patients with invasive or sterile-site infections admitted to one regional general hospital in southern Chile were collected during a 5-year period (February 1994 to September 1999). A total of 247 strains belonging to 50 serotypes were isolated in this survey: 69 in patients under 5 years of age, 129 in patients 5 to 64 years old, and 49 from patients 65 years and older. Eight serotypes were identified in all age groups, while all other serotypes were found exclusively in one age group or in patients over 4 years of age. Serotype 3 was never found in patients under 5 years old, and serotype 14 was not found in patients >64 years of age. There was no difference in the serotypes causing infection in each one of the 5 years of the survey. Our results suggest that both bacterial virulence factors and host factors play an important role in the selection of S. pneumoniae serotypes causing invasive infection. Possible host factors include age-related differences in the immune response. Comparative studies with other areas of the world may help to further understanding of our observations in southern Chile.

Chronic Urticaria: A Canadian Perspective on Patterns and Practical Management Strategies

2000 ◽  
Vol 4 (2) ◽  
pp. 89-93 ◽  
Author(s):  
Jasdeep K. Sharma ◽  
Robert Miller ◽  
Scott Murray
Keyword(s):  
Chronic Urticaria ◽  
Complete Blood Count ◽  
Management Strategies ◽  
Age Groups ◽  
Diagnostic Methods ◽  
Channel Blockers ◽  
Prick Test ◽  
Allergy Test ◽  
Causative Factors ◽  
Selection Of

Background: Chronic urticaria is a common condition and is a source of great frustration to patients. It has been suggested that there may be differences among physicians in their approach to this common clinical entity. Objective and Method: A questionnaire was distributed Canada-wide to allergists, dermatologists, and a selection of practitioners with an interest in alternative medicine. The survey included questions on demographics, epidemiology, causative factors, diagnostic methods, therapeutic strategies, follow-up advice, and efficacy of therapies, with emphasis on personal experience. Results: The response rates of allergists and dermatologists were 31% and 36%, respectively. There was wide representation from all regions of Canada and from physicians from all age groups, both genders, different types of practice, and years in practice. The reported incidence per month was 13 and 4 patients for allergists and dermatologists, respectively. The prevalence was 199 and 44 patients by allergists and dermatologists, respectively. Comparison of causative factors showed differences in the experiences of the two groups. Diagnostic investigations were requested in a similar pattern with respect to timing. The specific tests ordered by the groups showing statistical difference were complete blood count (CBC), differential, C4 complement, antinuclear antibodies, and IgE antibody assay. Allergists chose the skin prick test (100%) as the most important allergy test. Dermatologists ranked skin prick (50%), radioallergosorbent test (RAST) (20%), and skin patch (30%) as the most important tests. The top six choices of pharmaceutical therapies chosen by the groups were similar, but in a slightly different order. The responders ranked their personal selection of antihistamines according to effectiveness. Hydroxyzine (Atarax®) and cetirizine (Reactine®, Allegra®) were selected as first and second most effective agents by both groups. The results also show effective experience by both groups with nonsedating and sedating antihistamines. Also, doxepin, ketotifen, and cimetidine are used frequently by both groups. The experience of dermatologists in Canada with respect to other modalities including psoralen ultraviolet A (PUVA) therapy, danazol, chelation, calcium channel blockers, and acyclovir is limited and efficacy is ranked either neutral or ineffective. Allergists reported even less experience with these therapies. Conclusion: Allergists and dermatologists across Canada show interesting similarities and differences in their practical approach to the management of chronic urticaria. With the sharing of this information, these two specialties will be better equipped to effectively manage patients suffering from chronic urticaria.

Anaphoric devices in written and spoken narrative discourse

2010 ◽  
Vol 13 (2) ◽  
pp. 236-259 ◽  
Author(s):  
Aurora Bel ◽  
Joan Perera ◽  
Naymé Salas
Keyword(s):  
Age Groups ◽  
Narrative Discourse ◽  
Subject Position ◽  
Narrative Texts ◽  
Discourse Function ◽  
Subject Pronouns ◽  
Overt Pronouns ◽  
Written Texts ◽  
Pronominal Anaphora ◽  
Selection Of

In this study, we focus on pronominal anaphora and we investigate the referential properties of null and overt subject pronouns in Catalan, in the semi-spontaneous production of narrative spoken and written texts by three groups of speakers/writers (9–10, 12–13, and 15–16 year olds). We aimed at determining (1) pronoun preferences for a specific type of antecedent; (2) their specialization in a certain discourse function; and (3) whether the pattern is affected by text modality (spoken vs. written texts). We analyzed 30 spoken and 30 written narrative texts, produced by the same 30 subjects, divided into the age groups mentioned above. Results seem fairly consistent across age groups and modalities, showing that null pronouns tend to select antecedents in subject position and are well specialized in maintaining reference, while overt pronouns offer a less clear pattern both in their selection of antecedents and in the discourse function they perform. Our findings partially support those of previous research on other null-subject languages, in particular, the Position of Antecedent Hypothesis (PAH) formulated by Carminati (2002) for Italian.

scholarly journals Effect of Breed and Age on Histopathological Changes in Pig M. Semimembranosus

2012 ◽  
Vol 12 (3) ◽  
pp. 311-321 ◽  
Author(s):  
Dorota Wojtysiak ◽  
Katarzyna Połtowicz ◽  
Władysław Migdał
Keyword(s):  
Connective Tissue ◽  
Age Groups ◽  
Histopathological Change ◽  
Histopathological Changes ◽  
Age Changes ◽  
Large White ◽  
Fibre Size ◽  
Giant Fibres ◽  
Fibre Shape ◽  
Selection Of

Effect of Breed and Age on Histopathological Changes in Pig M. SemimembranosusThe aim of the study was to determine the type and extent of histopathological changes in m. semimembranosus of Polish Landrace (PL), Polish Large White (PLW), Duroc, Pietrain, and Puławska pigs at 60, 90, 120, 150, 180 and 210 days of age. Changes in fibre size (atrophy, hypertrophy - giant fibres), changes in fibre shape (angular fibres), degenerative lesions (necrosis with phagocytosis) and connective tissue hypertrophy were evaluated. The presence of giant fibres was the only histopathological change observed in all age groups of PL, PLW, Duroc and Pietrain pigs, with the percentage of pigs with this type of pathology and the frequency of giant, atrophic and angular fibres increasing significantly with age. In Puławska pigs, giant fibres were only found in the oldest pigs aged 210 days. In these animals, giant fibres as well as atrophic fibres (at 180 and 210 days of age) and angular fibres (at 120, 150, 180 and 210 days of age) occurred in the smallest number of animals and were least extensive. Meanwhile, Pietrain pigs were characterized by a greater number of animals, a significantly greater proportion of giant fibres in all analysed age groups, and a greater proportion of atrophic fibres at 180 and 210 days of age compared to the other pig breeds under analysis. For connective tissue hypertrophy and necrosis with phagocytosis, the changes were not extensive. It is concluded that both the advancing age of the animals and selection of the pigs for increased leanness significantly increases the incidence of histopathological changes in muscle tissue, which may directly translate into pork quality.

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