scholarly journals Relationship between age and outcome in thyroid surgery: a prospective observational study

2017 ◽  
Vol 2 (4) ◽  
pp. 211-217
Author(s):  
Navid Tabriz ◽  
Verena Nicole Uslar ◽  
Inga Tabriz ◽  
Dirk Weyhe
Keyword(s):  
Thyroid Surgery ◽  
Perioperative Complications ◽  
Perioperative Morbidity ◽  
Resected Tissue ◽  
Interactive Relationship ◽  
Secondary Endpoints ◽  
The One ◽  
Benign Thyroid ◽  
Surgery Duration

AbstractBackground:The occurrence of thyroid nodules and goiter increases with age. In general, surgery age is a predictor of perioperative morbidity. In thyroid surgery, there are different data on the role of age on morbidity. We investigated the influence of age on the outcome in thyroid surgery in a prospective single cohort study with a follow-up after 1 year.Methods:Total thyroidectomy or hemithyroidectomy was performed in euthyroid benign thyroid goiters (n=152). The primary endpoint was surgery duration. The secondary endpoints were weight of resected tissue, body mass index (BMI), amount and type of perioperative and long-term complications, and quality of life (QoL) preoperatively and 1 year postoperatively.Results:A significant three-way interactive relationship between age, surgery duration, and amount of resected tissue was found. An increase in any of these variables results in an increase in both other variables. The amount of perioperative complications was associated with resected tissue size. The QoL increases significantly after surgery by up to 10% and decreases significantly with age (mean QoL after surgery=84.9 of 100 for the youngest group and 75.7 of 100 for the oldest group). No long-term complications were recorded.Conclusion:The number of thyroid operations, especially of benign thyroid goiters, decreases annually in Germany. This can be explained by the fact that, on the one hand, the surgical indications are made more restrictive as conspicuous nodes are better clarified by improved technical aids. On the other hand, conservative measures (i.e. L-thyroxine and iodide administration) are used to achieve a size regimen of the goiter. Our results show that perioperative complications increase with patients’ age and surgery duration. However, the more restrictive surgical decision also entails the risk that patients will have to be operated at an older age and possibly with a bigger goiter, which is associated with higher operative morbidity. Therefore, in addition to the possibility of conservative therapy of the symptomatic goiter, the affected patients should also be thoroughly informed about the option to perform elective early thyroid surgery with regard to improved postoperative QoL and to keep the overall stress at a minimum for elderly patients.

Perioperative Complications Following Surgery for Necrotizing Enterocolitis

2018 ◽  
Vol 28 (02) ◽  
pp. 148-151 ◽  
Author(s):  
Annika Mutanen ◽  
Agostino Pierro ◽  
Augusto Zani
Keyword(s):  
Surgical Treatment ◽  
Necrotizing Enterocolitis ◽  
Premature Infants ◽  
Perioperative Complications ◽  
Neurodevelopmental Outcome ◽  
Wound Infections ◽  
Perioperative Morbidity

AbstractNecrotizing enterocolitis (NEC) is a devastating condition that mainly affects premature infants. Advanced cases of NEC require surgical treatment, which in up to 70% of infants is associated with significant perioperative morbidity including anastomosis- or enterostomy-related complications, sepsis, peritonitis, and wound infections. Moreover, the perioperative complications may compromise the long-term gastrointestinal and neurodevelopmental outcome of patients requiring surgery for NEC.

FOxTROT: an international randomised controlled trial in 1052 patients (pts) evaluating neoadjuvant chemotherapy (NAC) for colon cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3504-3504 ◽  
Author(s):  
Matthew T. Seymour ◽  
Dion Morton ◽  
Keyword(s):  
Colon Cancer ◽  
Large Scale ◽  
Controlled Trial ◽  
Statistical Significance ◽  
The Novel ◽  
Perioperative Morbidity ◽  
Secondary Endpoints ◽  
Randomised Controlled

3504 Background: NAC is well established in many solid tumours but has not undergone large-scale evaluation in colon cancer. Methods: Pts had operable, non-obstructed colon cancer; CT-predicted stage T3-4, N0-2, M0, and were fit for FOLFOX and surgery. They were randomised 2:1 to the novel sequence (6 wk FOLFOX NAC, then surgery, then 18 wk FOLFOX) or control (surgery then 24 wk FOLFOX). RAS-wt pts allocated to the novel arm could optionally be sub-randomized 1:1 to ± panitumumab (pan) during the NAC phase. Two "dealer’s choices" allowed total chemo duration 12 wk instead of 24 (in older/low-risk pts) and OxCap in place of FOLFOX (except in pts randomized ± pan). Primary endpoint is freedom from recurrent or persistent disease after 2 yrs, by ITT. Secondary endpoints include safety, histological stage, completeness of resection, OS. Results: 1052 pts were randomised, Jun 2008-Dec 2016, at 85 centres in UK, Denmark and Sweden. Conclusions: NAC was well tolerated and safe, with no increase in perioperative morbidity and a trend toward fewer serious postoperative complications. Evidence of histological regression was seen in 59% pts after NAC, including some pCRs. This resulted in marked histological downstaging and a halving of the rate of incomplete resections. We observed an improvement in 2-yr failure rate (HR=0.77), but this fell short of statistical significance (p=0.11). NAC for colon cancer improves surgical outcomes and can now be considered as a treatment option; longer follow-up and further trials are required to confirm the long-term benefits, refine its use and optimise case selection. Clinical trial information: 87163246. [Table: see text]

scholarly journals The Interactive Relationship between Sci-Tech Innovation and Economic Growth: An Empirical Study Based on China Macroeconomic Data

2018 ◽  
Vol 5 (3) ◽  
pp. 82
Author(s):  
QiTong Yu ◽  
WenYu Dong
Keyword(s):  
Economic Growth ◽  
Rapid Development ◽  
Dramatic Improvement ◽  
Dynamic Relationship ◽  
Long Run ◽  
Policy Suggestions ◽  
Interactive Relationship ◽  
The One ◽  
The Relationship

In the past decades, China has embraced a rapid development in its economy. And the sci-tech innovation has also gained unprecedented prosperity during the period. The progress in sci-tech innovation has boosted larger output in multiple industries of China, and thus having great contributions to the dramatic improvement in China’s economy. The studies on the relationship between sci-tech innovation and economic growth has long been existed, however, most of which only focus on the one-way research, namely the effects of sci-tech innovation on the economic growth. Based on this status quo, this paper innovates from the research method to focus on the interactive relationship between sci-tech innovation and economic growth, establishing a VAR model to analyze their immediate structural relationship and long-term dynamic relationship, and finds out that the effects of sci-tech innovation on economic growth are immediate positive, while those on sci-tech innovation achievements appear in the long run. In the last part, this paper puts forward policy suggestions on the maximization of sci-tech innovation and economic growth based on the results.

The Durability of Carotid Endarterectomy

Neurosurgery ◽  
2013 ◽  
Vol 72 (5) ◽  
pp. 835-839 ◽  
Author(s):  
Maya A. Babu ◽  
Irene Meissner ◽  
Fredric B. Meyer
Keyword(s):  
Carotid Endarterectomy ◽  
Perioperative Complications ◽  
Recurrent Stenosis ◽  
Perioperative Morbidity ◽  
Stenosis Rate ◽  
Carotid Occlusive Disease ◽  
The Mean ◽  
Risk Treatment

Abstract BACKGROUND: Carotid endarterectomy is a low-risk treatment for carotid occlusive disease. Recent clinical trials have suggested that carotid angioplasty may be a viable alternative. One important issue that has not been evaluated is the long-term recurrent stenosis rate after either intervention. OBJECTIVE: To examine the risk of recurrent stenosis after carotid endarterectomy and to provide long-term data on the durability of carotid endarterectomy. METHODS: A total of 1335 sequential patients were followed up prospectively with annual carotid ultrasonography. All patients were maintained on antiplatelet therapy, and arteriotomies were closed with a patch graft. Operations were performed under general anesthesia with electroencephalographic monitoring and selective shunting. There were no changes in surgical technique during this study. RESULTS: Two-thirds of the patients were men; the mean age was 70 years. Approximately 60% were symptomatic. The 90-day perioperative morbidity and mortality rate was 0.9% (0.4% stroke and 0.5% death). Five patients (0.4%) developed recurrent stenosis >70% over a mean follow-up of 15.8 years. Twelve patients (0.9%) had documentation of late stroke in the ipsilateral carotid distribution. The mean follow-up was 15.8 years. CONCLUSION: Carotid endarterectomy is an extremely safe treatment for carotid stenosis with very low perioperative complications and low rates of recurrent stenosis or late stroke. When endarterectomy is compared with angioplasty, in addition to periprocedural complications, the durability of both interventions needs to be considered, given the risks and costs of repeat interventions.

Radioimmunotherapy for treatment of acute myeloid leukaemia and myelodysplastic syndrome

2005 ◽  
Vol 44 (03) ◽  
pp. 107-117
Author(s):  
R. G. Meyer ◽  
W. Herr ◽  
A. Helisch ◽  
P. Bartenstein ◽  
I. Buchmann
Keyword(s):  
Acute Myeloid Leukaemia ◽  
Myeloid Leukaemia ◽  
Primary Tumour ◽  
The Other ◽  
Haematopoietic Stem Cell ◽  
Other Hand ◽  
Primary Reduction ◽  
The One ◽  
Acute Myeloid

SummaryThe prognosis of patients with acute myeloid leukaemia (AML) has improved considerably by introduction of aggressive consolidation chemotherapy and haematopoietic stem cell transplantation (SCT). Nevertheless, only 20-30% of patients with AML achieve long-term diseasefree survival after SCT. The most common cause of treatment failure is relapse. Additionally, mortality rates are significantly increased by therapy-related causes such as toxicity of chemotherapy and complications of SCT. Including radioimmunotherapies in the treatment of AML and myelodyplastic syndrome (MDS) allows for the achievement of a pronounced antileukaemic effect for the reduction of relapse rates on the one hand. On the other hand, no increase of acute toxicity and later complications should be induced. These effects are important for the primary reduction of tumour cells as well as for the myeloablative conditioning before SCT.This paper provides a systematic and critical review of the currently used radionuclides and immunoconjugates for the treatment of AML and MDS and summarizes the literature on primary tumour cell reductive radioimmunotherapies on the one hand and conditioning radioimmunotherapies before SCT on the other hand.

Hidden “holes” in the capital of banks and the supply of credit to the real sector of economy

2018 ◽  
pp. 49-68 ◽  
Author(s):  
M. E. Mamonov
Keyword(s):  
Credit Risk ◽  
The Other ◽  
Real Sector ◽  
Capital Management ◽  
Loan Loss ◽  
Short Term ◽  
The Real ◽  
Ex Post ◽  
The One

Our analysis documents that the existence of hidden “holes” in the capital of not yet failed banks - while creating intertemporal pressure on the actual level of capital - leads to changing of maturity of loans supplied rather than to contracting of their volume. Long-term loans decrease, whereas short-term loans rise - and, what is most remarkably, by approximately the same amounts. Standardly, the higher the maturity of loans the higher the credit risk and, thus, the more loan loss reserves (LLP) banks are forced to create, increasing the pressure on capital. Banks that already hide “holes” in the capital, but have not yet faced with license withdrawal, must possess strong incentives to shorten the maturity of supplied loans. On the one hand, it raises the turnovers of LLP and facilitates the flexibility of capital management; on the other hand, it allows increasing the speed of shifting of attracted deposits to loans to related parties in domestic or foreign jurisdictions. This enlarges the potential size of ex post revealed “hole” in the capital and, therefore, allows us to assume that not every loan might be viewed as a good for the economy: excessive short-term and insufficient long-term loans can produce the source for future losses.

Interrelationships between municipal spatial policy strategy and airport operation and development. Lodz Airport case study

2018 ◽  
Vol 59 (1) ◽  
pp. 65-79
Author(s):  
Katarzyna Nikorowicz-Zatorska
Keyword(s):  
Land Use ◽  
Urban Planning ◽  
Cultural Development ◽  
The Other ◽  
Local Authorities ◽  
Spatial Management ◽  
The One ◽  
Surrounding Areas

Abstract The present paper focuses on spatial management regulations in order to carry out investment in the field of airport facilities. The construction, upgrades, and maintenance of airports falls within the area of responsibility of local authorities. This task poses a great challenge in terms of organisation and finances. On the one hand, an active airport is a municipal landmark and drives local economic, social and cultural development, and on the other, the scale of investment often exceeds the capabilities of local authorities. The immediate environment of the airport determines its final use and prosperity. The objective of the paper is to review legislation that affects airports and the surrounding communities. The process of urban planning in Lodz and surrounding areas will be presented as a background to the problem of land use management in the vicinity of the airport. This paper seeks to address the following questions: if and how airports have affected urban planning in Lodz, does the land use around the airport prevent the development of Lodz Airport, and how has the situation changed over the time? It can be assumed that as a result of lack of experience, land resources and size of investments on one hand and legislative dissonance and peculiar practices on the other, aviation infrastructure in Lodz is designed to meet temporary needs and is characterised by achieving short-term goals. Cyclical problems are solved in an intermittent manner and involve all the municipal resources, so there’s little left to secure long-term investments.

Aspects of the Evolution of the Romanian Tourists’ Preferences Concerning the Domestic Tourist Destinations

2019 ◽  
Vol 10 (1) ◽  
pp. 21-28
Author(s):  
Aniela Bălăcescu ◽  
Radu Șerban Zaharia
Keyword(s):  
Logistic Model ◽  
Local Level ◽  
Medium Term ◽  
Tourist Destinations ◽  
Tourism Management ◽  
Production And Consumption ◽  
On Line ◽  
The One ◽  
Long Term Studies

Abstract Tourist services represent a category of services in which the inseparability of production and consumption, the inability to be storable, the immateriality, and last but not least non-durability, induces in tourism management a number of peculiarities and difficulties. Under these circumstances the development of medium-term strategies involves long-term studies regarding on the one hand the developments and characteristics of the demand, and on the other hand the tourist potential analysis at regional and local level. Although in the past 20 years there has been tremendous growth of on-line booking made by household users, the tour operators agencies as well as those with sales activity continue to offer the specific services for a large number of tourists, that number, in the case of domestic tourism, increased by 1.6 times in case of the tour operators and by 4.44 times in case of the agencies with sales activity. At the same time, there have been changes in the preferences of tourists regarding their holiday destinations in Romania. Started on these considerations, paper based on a logistic model, examines the evolution of the probabilities and scores corresponding to the way the Romanian tourists spend their holidays on the types of tourism agencies, actions and tourist areas in Romania.

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