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1.
Jason B. Liu Marshall S. Baker Vanessa M. Thompson E. Molly Kilbane Henry A. Pitt 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2019,21(1):121-131
Background
Whether the choice of antibiotic prophylaxis, the type of incision, or the use of wound protectors decreases surgical site infections (SSIs) in patients undergoing pancreatoduodenectomy (PD) remains unknown.Methods
Patients undergoing open, elective PD between January 1, 2016 and June 30, 2017 were identified from the American College of Surgeons’ National Surgical Quality Improvement Program registry. Multivariable logistic regression models were constructed to determine the association of antibiotic prophylaxis type, incision type, and wound protector use on the incidence of any, superficial, and organ/space SSIs, and to profile hospitals.Results
Overall, 5969 patients were included from 140 hospitals. The overall rate of SSI was 20.3% (n = 1213). Superficial SSIs occurred in 432 (7.2%) patients and organ/space SSIs in 841 (14.1%). Wound protector use was associated with 23% lower odds of experiencing any SSIs (OR 0.77, 95% CI 0.60–0.98), reflective of the decreased odds associated with superficial SSIs (OR 0.65, 95% CI 0.44–0.97), but not organ/space SSIs (OR 0.89, 95% CI 0.68–1.17). Highest-performing hospitals frequently utilized broad-spectrum antibiotics, midline incisions, and wound protectors.Conclusion
Wound protectors reduced superficial, but not organ/space, infections in patients undergoing pancreatoduodenectomy. Routine use of wound protectors in patients undergoing proximal pancreatectomy is recommended. 相似文献2.
A. Vérine Ch. Merger J. Boyer 《Clinica chimica acta; international journal of clinical chemistry》1980,100(2):143-148
Apolipoprotein B (apo B) was measured by a sensitive and specific double antibody radioimmunoassay in plasma from 15 normal women and 47 women taking oral contraceptives. The plasma apo B concentration in normal women was 0.90 ± 0.10 g/l (mean ±S.D.) whereas the overall value for all women taking contraceptives was 0.69 ± 0.19 g/l. The maximum decrease (p < 0.001) occurred in women investigated within three months after the beginning of the steroid intake, whose mean apo B value was 0.60 ± 0.12 g/l (n = 12); decreases found after 3–24 months of contraception were of lesser magnitude. Apo B decreases were associated with significant decreases (p < 0.01) in total plasma cholesterol, although the latter regained normal values after one year of contraception. Apo B and cholesterol values were in the normal range in women investigated after two years of steroid intake. An inverse trend was observed for plasma triglycerides, which showed a mean increase of 29% (p < 0.01) after three months of steroid intake, and then stayed elevated without significant change with time. 相似文献
3.
Ethnobotanical survey of herbal remedies traditionally used in Kohghiluyeh va Boyer Ahmad province of Iran 总被引：1，自引：0，他引：1
Mosaddegh M Naghibi F Moazzeni H Pirani A Esmaeili S 《Journal of ethnopharmacology》2012,141(1):80-95
Ethnopharmacological relevance
Medicinal plants are an important element of medical system. These resources are usually regarded as part of cultural traditional knowledge. We present for the first time the results of an ethnobotanical survey in Kohghiluyeh va Boyer Ahmad province of Iran, conducted between 2008 and 2010. This information could be the basis of an evidence based investigation to discover new drugs.Materials and methods
Ethnobotanical data were analyzed by use-reports in addition important indices like relative frequency of citation (RFC) and cultural importance index (CI) were calculated. Totally 23 informants were interviewed.Results
Our study reports 138 traditionally used plant species, belonging to 52 plant families from this province. Asteraceae and Lamiaceae are the dominant locally used families. The highest number of species and application were reported for digestive system disorder, metabolic disorder and respiratory system, respectively. The part of the plant most frequently used was the aerial part (31.9%), leaves (14.8%) and fruits (11.7%). The plants are used both for medicinal and non-medicinal purposes. Daphne mucronata Royle. and Teucrium polium L. have the largest value of relative frequency of citation and cultural importance index, respectively.Conclusion
Kohghiluyeh va Boyer Ahmad has good ethnobotanical potential for medicinal plants. This study is the first contribution to the ethnobotany of this region. We have gathered from this province some considerable knowledge about local medicinal plants for treating common health problem that is ready to be further investigated in the laboratory. 相似文献4.
《Teaching and Learning in Nursing》2020,15(2):152-154
Boyer’s model of scholarship reflects an educator’s impact within the areas of teaching, discovery, integration, and application. The scholarship of engagement, a subset of application, presents an opportunity for academic faculty to showcase knowledge and skills that could promote the health of communities. The Nurses on Boards Coalition is one example to engage nurse faculty in the scholarship of application and engagement through board service. 相似文献
5.
Joal D. Beane Michael G. House Susan C. Pitt Ben Zarzaur E. Molly Kilbane Bruce L. Hall Taylor S. Riall Henry A. Pitt 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2017,19(3):254-263
Introduction
Vascular resection during pancreatoduodenectomy (PD) is being performed more frequently. Our aim was to analyze the outcomes of PD with and without vascular resection in a large, multicenter cohort.Methods
Patient data were gathered from 43 institutions as part of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Pancreatectomy Demonstration Project. Over a 14-month period, 1414 patients underwent PD without (82.2%) or with major venous (PD + V; 13.7%) or arterial (PD + A; 4.0%) vascular resection.Results
Postoperative morbidity and mortality following PD + A (51.0% and 3.6%) was comparable to PD + V (46.9% and 3.6%) and PD (44.3 and 1.5%, p = 0.50 and 0.43). A propensity score matched analysis revealed that vascular resection was associated with significant increases (p ≤ 0.05) in operative time (7:37 vs 6:11), need for blood transfusion (42.2% vs 18.1%), deep venous thromboembolism (6.9% vs 0.9%), postoperative septic shock (6.9% vs 1.7%), and length of stay (12.2 vs 10 days) while overall morbidity (45.7% vs 46.6) and mortality (1.0% vs 0%) were comparable.Conclusions
Compared to PD alone, PD + VR was associated with increased operative time, perioperative transfusions, deep venous thrombosis, septic shock, as well as length of stay, but overall morbidity and mortality were not increased. 相似文献6.
7.
Elizabeth M. Gleeson John R. Clarke William F. Morano Mohammad F. Shaikh Wilbur B. Bowne Henry A. Pitt 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2019,21(3):283-290
Background
Failure to rescue (FTR) is a recently described outcome metric for quality of care. However, predictors of FTR have not been adequately investigated, particularly after pancreaticoduodenectomy. We aim to identify predictors of FTR after pancreaticoduodenectomy.Methods
We reviewed all patients who developed serious morbidity after pancreaticoduodenectomy from 2005 to 2012 in the ACS-NSQIP database. Logistic regression was used to identify preoperative and postoperative risks for 30-day mortality within a development cohort (randomly selected 80%). A score was created using weighted beta coefficients. Predictive accuracy was assessed on the validation cohort (remaining 20%) using a receiver operator characteristic curve and calculating the area under the curve (AUC).Results
The FTR rate was 7.2% after pancreaticoduodenectomy (n = 5,027). We identified 5 independent risk factors: age ≥65 and albumin ≤3.5 g/dL, preoperatively; and development of shock, renal failure, and reintubation, postoperatively. The generated score had an AUC = 0.83 (95% CI, 0.77–0.89) in the validation cohort. Using the score: 1*Albumin ≤3.5 g/dL + 2*Age ≥ 65 + 2*Shock + 5*Renal failure + 5*Reintubation, FTR rates increased with increasing score (p < 0.001).Conclusion
FTR rates have previously been shown to be associated with hospital factors. We show that FTR is also associated with preoperative and postoperative patient-specific factors. 相似文献8.
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