Vincenttimmons8667
We explored the male-female health-survival paradox in the context of health expectancy (HE) at age 65 and thereafter, using three different morbidity measures and different severity cut-offs with and without adjustments for the share of nursing home residents.
HE at ages 65, 70, 75, 80, and 85 was estimated with the Sullivan method, linking morbidity prevalence from the KORA (Cooperative Health Research in the Region of Augsburg)-Age study to 2016 Bavarian mortality data. Morbidity measures comprised deficit accumulation (Frailty Index, FI, cut-offs 0.08 and 0.25), disability (Health Assessment Questionnaire-Disability Index, HAQ-DI, cut-off >0) and participation (Global Activity Limitation Indicator, GALI, "limited" vs "not limited").
Morbidity data were available for 4083 participants (52.7% female). HE was lower in women than in men at all ages. Differences in morbidity prevalence, absolute HE, and health proportions of life expectancy (relative HE) increased with age for FI≥0.25 and GALI, but not for HAQ-DI>0 and FI>0.08. CFI-400945 supplier Accounting for the share of nursing home residents resulted in a slight reduction of HE estimates but had no impact on estimated sex differences.
In HE at age 65 and thereafter, women's health disadvantage was larger than their life expectancy advantage over men.
In HE at age 65 and thereafter, women's health disadvantage was larger than their life expectancy advantage over men.
To ascertain the short-and long-term results of total pericardiectomy for chronic constrictive pericarditis via modified left anterolateral thoracotomy without cardiopulmonary bypass on postoperative low cardiac output, normalization of intracardiac pressures, survival, and reoperations.
Between January 2005 and December 2019, a series of 127 consecutive patients (91males), aged between 4 and 72 years (median 25; IQR18-38 years) underwent radical total pericardiectomy via modified left anterolateral thoracotomy without utilizing cardiopulmonary bypass.
Operative and late mortalities were 3.1% and 1.6% respectively. Thirty-one (24.4%) patients had postoperative low cardiac output and none required reoperations. At a median follow-up of 99 months (IQR 56-141), the actuarial survival was 97.6%±0.01% months (95%CI; 92.8,99.2). At their last follow-up, 113 (93.4%) and 8(6.6%) survivors were in NYHA Class I and II respectively.
Total pericardiectomy is associated with lower perioperative and late mortality, decreased low cardiac output syndrome and confers significant long-term advantage of superior hemodynamics.
Total pericardiectomy is associated with lower perioperative and late mortality, decreased low cardiac output syndrome and confers significant long-term advantage of superior hemodynamics.
There is an increasing prevalence of chronic kidney disease in the population of adults currently living with congenital heart disease. A significant proportion of children who undergo congenital heart surgery experience post-operative acute kidney injury. Whether there is an association between acute kidney injury following cardiac surgery in childhood and development of chronic kidney disease is unclear.
Three electronic databases were searched to capture relevant studies exploring the relationship between acute kidney injury following congenital heart surgery in children and progression to chronic kidney disease.
A literature search identified a total of 212 research articles, of which seven were selected for in-depth review.
There is a likely association between acute kidney injury in children undergoing congenital heart surgery and progression to chronic kidney disease. Research should be developed to mitigate factors contributing to postoperative acute kidney injury in neonates, infants and children undergoing cardiac surgery. Better targeted follow-up protocols to monitor renal function in children undergoing cardiac surgery should be implemented. A universal definition for acute kidney injury and chronic kidney disease is needed to improve detection and research in this field.
There is a likely association between acute kidney injury in children undergoing congenital heart surgery and progression to chronic kidney disease. Research should be developed to mitigate factors contributing to postoperative acute kidney injury in neonates, infants and children undergoing cardiac surgery. Better targeted follow-up protocols to monitor renal function in children undergoing cardiac surgery should be implemented. A universal definition for acute kidney injury and chronic kidney disease is needed to improve detection and research in this field.
Frequent emergency department (ED) visits occur after esophagectomy. We aimed to identify the incidence of and risk factors for conversion from ED visit to inpatient admission.
A retrospective cohort study was performed of consecutive esophagectomies at a tertiary Canadian center (1999-2014). Multivariable regression analyses identified factors associated with conversion from ED visit to admission.
There were 520 esophagectomies with 6% in-hospital mortality (n=31). Of those discharged , 29.7% (n=145) had ≥1 emergency visit and 43.4% (n = 63) of these patients were re-admitted to the hospital. First-time ED visits resulted in inpatient conversion 23.4% (n =34) of the time; successive ED visits resulted in increasing conversion. On multivariable analysis, anastomotic leak (adjusted odds ratio [aOR]=2.45 [1.00-6.01], p=0.05) was independently associated with higher odds of conversion to admission. Sensitivity analysis using Poisson regression to model conversion as a rate identified that living in regionsoscopy may help reduce the incidence of ED visits and admission. While living in regions further away is associated with lower conversion rates to admission at the index hospital, this may be due to patients utilizing closer local hospitals.
To review the current status of robotic training and the impact of various training platforms on the performance of robotic surgical trainees.
Literature review of Google Scholar and PubMed. The search terms included a combination of the following "robotic training," "simulation," "robotic curriculum," "obgyn residency robotic training," "virtual reality robotic training," "DaVinci training," "surgical simulation," "gyn surgical training." The sources considered for inclusion included peer-reviewed articles, literature reviews, textbook chapters, and statements from various institutions involved in resident training.
A literature search of Google Scholar and PubMed using terms related to robotic surgery and robotics training, as mentioned in the "Data Sources" section.
Multiple novel platforms that use machine learning and real-time video feedback to teach and evaluate robotic surgical skills have been developed over recent years. Various training curricula, virtual reality simulators, and other robotic training tools have been shown to enhance robotic surgical education and improve surgical skills.