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Emily Cerier, Eliza W Beal, Jeffery Chakedis, Qinyu Chen, Anghela Paredes, Steven Sun, Jordan M Cloyd, Timothy M Pawlik
BACKGROUND: The patient-provider relationship (PPR) is an important element of health care delivery and may influence patient outcomes. The objective of the present study was to identify clinical predictors of PPR among patients with hepatopancreatobiliary (HPB) diseases and assess the association of PPR and health care utilization. MATERIALS AND METHODS: The Medical Expenditure Panel Survey database from 2008-2014 was used to identify adult patients with HPB diagnoses...
August 2018: Journal of Surgical Research
Hua Fang, Lingxi Han, Houpu Zhang, Zhengnan Long, Lin Cai, Yunlong Yu
The dissemination of antibiotic resistance genes (ARGs), human pathogenic bacteria (HPB), and antibiotic-resistant HPB (ARHPB) from animal feedlot to nearby environment poses a potentially high risk to environmental ecology and public health. Here, a metagenomic analysis was employed to explore the dissemination of ARGs, HPB, and ARHPB from a pig feedlot to surrounding stream and agricultural soils. In total, not detectable (ND)-1,628.4 μg/kg of antibiotic residues, 18 types of ARGs, 48 HPB species, and 216 ARB isolates were detected in all samples...
May 29, 2018: Journal of Hazardous Materials
Martín A Bolívar-Rodríguez, Adrián Pamanes-Lozano, Jaime Matus-Rojas, Marcel A Cázarez-Aguilar, Rodolfo Fierro-López
Introduction: Laparoscopic cholecystectomy is the most frequent procedure for the general surgeon. Biliary injury is a concern that must be addressed with the purpose of lowering the rate. The critical view of safety (CVS) is a target of dissection that impulses safety during the procedure. Objective: Determine by an ambispective analysis the safety during dissection of laparoscopic cholecystectomy in Hospital Civil de Culiacán (México). Methods: Descriptive, ambispective, observational, cross-sectional...
2018: Cirugia y Cirujanos
Graziano Ceccarelli, Enrico Andolfi, Andrea Fontani, Fulvio Calise, Aldo Rocca, Antonio Giuliani
BACKGROUND: The aim of this study was to evaluate safety, feasibility and short-term outcomes of our first 70 consecutive patients treated by robotic-assisted liver resection after a reversal proctoring between a high HPB volume centre and our well-trained centre in minimally invasive General Surgery. Six surgeons were involved in this Hub&Spoke learning program. METHODS: From September 2012 to December 2016, 70 patients underwent robotic-assisted liver resections (RALR)...
May 24, 2018: Minerva Chirurgica
Heather L Williams, Teresa Costley, Lanell M Bellury, Jasmine Moobed
OBJECTIVE: The aim of this study was to explore the relationships between nurse-reported health-promoting behaviors (HPBs), job stress, and job satisfaction in a hospital setting. BACKGROUND: Job stress and satisfaction are key components of the nursing work environment; however, evidence of the relationship between HPB and job stress and satisfaction is lacking. METHODS: A cross-sectional, 144-item survey was administered to nurses working in an acute care, community hospital in the southeastern United States...
June 2018: Journal of Nursing Administration
Wenjun Cao, Guoqiang Hou, Chongzheng Guo, Ying Guo, Jianzhong Zheng
Hypertension (HTN) related to health-promoting behaviors (HPB) and quality of life (QOL) in older Chinese has not been clearly identified. We sought to compare the HPB and QOL of elderly adults (aged ≥60) living with HTN in China to a community normotensive control group. Using multistage stratified cluster sampling, a sample of 543 elderly people with HTN and 550 with normotension were randomly selected and asked to complete questionnaires. The Chinese version of the Health Promoting Lifestyle Profile (HPLP-IICR) and The World Health Organization Quality of life-BREF instrument (WHOQOL-BREF) were used to evaluate the HPB and QOL of elderly adults...
May 23, 2018: Journal of Human Hypertension
Giovanni Battista Levi Sandri, Gabriele Spoletini, Giovanni Vennarecci, Elisa Francone, Mohammed Abu Hilal, Giuseppe Maria Ettorre
OBJECTIVE: In this study, we aim to assess the impact of tumor size on clinical and oncological outcomes in patients undergoing laparoscopic liver resection (LLR) for hepatocellular carcinoma (HCC). BACKGROUND: LLR has been shown to be feasible, safe, and oncologically efficient. However, it has been slow to develop in patients with HCC who often suffer from chronic liver disease which represents an additional challenge for the surgeon. The experience with large HCCs is even more limited...
May 16, 2018: Surgical Endoscopy
Xiujun Cai
Dramatic progresses had been made in the operation in the past 26 years. Procedure was extended to major liver resection, isolated resection of caudate lobe, living donor liver resection and associating liver partition with portal vein ligation for staged hepatectomy (ALPPS). Laparoscopic liver resection became a new group of HPB surgery and the international laparoscopic liver society was established in Paris followed by the first international congress of the society held in Paris in July 2017. This biannual congress would be top convention for surgeons specialized in laparoscopic liver surgery...
April 2018: Hepatobiliary Surgery and Nutrition
Katiuscha Merath, Fabio Bagante, Qinyu Chen, Eliza W Beal, Ozgur Akgul, Jay Idrees, Mary Dillhoff, Jordan Cloyd, Carl Schmidt, Timothy M Pawlik
OBJECTIVE: Decreasing hospital length-of-stay (LOS) may be an effective strategy to reduce costs while also improving outcomes through earlier discharge to the non-hospital setting. The objective of the current study was to define the impact of discharge timing on readmission, mortality, and charges following hepatopancreatobiliary (HPB) surgery. METHODS: The Nationwide Readmissions Database (NRD) was used to identify patients undergoing HPB procedures between 2010 and 2014...
May 7, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Thomas Hanna, Charles Imber
No abstract text is available yet for this article.
May 2018: Annals of the Royal College of Surgeons of England
Min Gao, Tianlei Qiu, Yanmei Sun, Xuming Wang
Composting is considered to reduce the introduction of antimicrobial resistance genes (ARGs) into the environment through land application of manure; however, the possible pollution of ARGs in the atmospheric environment of composting plants is unknown. In this study, 29 air samples including up- and downwind, composting, packaging, and office areas from 4 composting plants were collected. Dynamic concentrations of 22 subtypes of ARGs, class 1 integron (intl1), and 2 potential human pathogenic bacteria (HPB), and bacterial communities were investigated using droplet digital PCR and 16S rRNA gene sequencing, respectively...
April 23, 2018: Environment International
Midori A Arai, Ryuta Akamine, Narumi Hayashi, Takashi Koyano, Thaworn Kowithayakorn, Masami Ishibashi
Notch signaling plays a crucial role in differentiation and cell maintenance, but once aberrantly activated, it contributes to cancer progression. Notch inhibitors were isolated from plant extracts and tested using an originally constructed cell-based assay system. We isolated eight compounds from Nerium indicum that showed inhibition of the Notch signaling pathway. HES1 and HES5 are target genes of the Notch signaling pathway, and oleandrin (1) decreased the protein levels of HES1 and HES5 in assay cells. Oleandrin (1) showed potent cytotoxicity against HPB-ALL cells and decreased HES1 and the Notch intracellular domain in these cells...
May 25, 2018: Journal of Natural Products
Qinyu Chen, Eliza W Beal, Charles W Kimbrough, Fabio Bagante, Katiuscha Merath, Mary Dillhoff, Carl Schmidt, Susan White, Jordan Cloyd, Timothy M Pawlik
BACKGROUND: It is unclear how either the successful or failed rescue of hepato-pancreato-biliary (HPB) patients from complications impacts costs. METHODS: A retrospective cohort study of HPB surgical patients was performed using claims data from 2013 to 2015 in the Medicare Provider Analysis and Review (MEDPAR) database. Patient demographics, characteristics, outcomes and risk-adjusted Medicare payments were compared. RESULTS: 11,596 patients were identified...
April 21, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Morsal Samim, Timothy H Mungroop, Mohammed AbuHilal, Cas J Isfordink, Quintus I Molenaar, Marcel J van der Poel, Thomas A Armstrong, Arjun S Takhar, Neil W Pearce, John N Primrose, Scott Harris, Helena M Verkooijen, Thomas M van Gulik, Jeroen Hagendoorn, Olivier R Busch, Colin D Johnson, Marc G Besselink
BACKGROUND: Several studies advise the use of risk models when counseling patients for hepato-pancreato-biliary (HPB) surgery, but studies comparing these models to the surgeons' assessment are lacking. The aim of this study was to assess whether risk prediction models outperform surgeons' assessment for the risk of complications in HPB surgery. METHODS: This prospective study included adult patients scheduled for HPB surgery in three centers in the UK and the Netherlands...
April 17, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Naohiro Yanagisawa, Naoyoshi Nagata, Kazuhiro Watanabe, Tatsuhiro Iida, Mariko Hamada, Sakurako Kobayashi, Takuro Shimbo, Junichi Akiyama, Naomi Uemura
AIM: To verify the validity of the endoscopy guidelines for patients taking warfarin or direct oral anticoagulants (DOAC). METHODS: We collected data from 218 patients receiving oral anticoagulants (73 DOAC users, 145 warfarin users) and 218 patients not receiving any antithrombotics (age- and sex-matched controls) who underwent polypectomy. (1) We evaluated post-polypectomy bleeding (PPB) risk in patients receiving warfarin or DOAC compared with controls; (2) we assessed the risks of PPB and thromboembolism between three AC management methods: Discontinuing AC with heparin bridge (HPB) (endoscopy guideline recommendation), continuing AC, and discontinuing AC without HPB...
April 14, 2018: World Journal of Gastroenterology: WJG
Midori A Arai, Ryuta Akamine, Anna Tsuchiya, Tatsuro Yoneyama, Takashi Koyano, Thaworn Kowithayakorn, Masami Ishibashi
Aberrant activation of Notch signaling contributes to the pathogenesis of several different types of cancer, and Notch pathway inhibitors may have significant therapeutic potential. Using a unique cell-based assay system, we isolated twelve compounds, including one new natural product from Garcinia speciosa, that inhibit the Notch signaling pathway. HES1 and HES5 are target genes of the Notch cascade, and compound 2, referred to as cowanin, decreased the protein levels of HES1 and HES5 in assay cells. Furthermore, cowanin (2) showed potent cytotoxicity against human leukemic HPB-ALL cells...
March 29, 2018: Scientific Reports
Brooke Vuong, Ahmed Dehal, Abhineet Uppal, Stacey L Stern, Juan Mejia, Roshanthi Weerasinghe, Vandana Kapoor, Evan Ong, Paul D Hansen, Anton J Bilchik
BACKGROUND: An initiative was established to improve value-based care for pancreatic surgery in a large nonprofit health system. Cost data were presented bimonthly to a hepatobiliary clinical performance group via videoconference. STUDY DESIGN: The direct costs were calculated for all patients undergoing distal pancreatectomy (DP) and pancreaticoduodenectomy (PD) between January 2014 and July 2017. Median length of stay, 30-day and 90-day mortality rates, readmission rate, and costs were stratified by surgeon volume using 2 published criteria: "volume pledge" criteria (≥5 PDs/year) and Leapfrog criteria (≥11 PDs/year)...
March 23, 2018: Journal of the American College of Surgeons
Qinyu Chen, Fabio Bagante, Katiuscha Merath, Jay Idrees, Eliza W Beal, Jordan Cloyd, Mary Dillhoff, Carl Schmidt, Adrian Diaz, Susan White, Timothy M Pawlik
BACKGROUND: The association of hospital teaching status and overall expenditures has not been studied among patients undergoing hepato-pancreato-biliary (HPB) surgery. We sought to define the impact of hospital teaching intensity on payments and charges associated with (HPB) surgery from the payer perspective. METHODS: Surgical patients undergoing HPB procedures were identified using 2013-2015 Medicare Provider Analysis and Review (MEDPAR) data. Hospital teaching intensity was categorized based on hospital resident-to-bed ratio: non-teaching (NTH: 0), minor teaching (minor-TH: 0-0...
March 21, 2018: World Journal of Surgery
M Mizandari, J Kumar, M Pai, T Chikovani, T Azrumelashvili, I Reccia, N Habib
Background: Malignant biliary and/or pancreatic obstruction has often encountered in the advanced stages of periampullary and cholangicarcinomas. HabibTM Radiofrequency (RF) ablation has been successfully used in the management of various cancers of liver and pancreas. Percutaneous HPB probe (EMcision Ltd, London, UK) is a new addition to this class of tools. It is an endoluminal Radiofrequency (RF) catheter which works on the principle of ablation and induces coagulative necrosis to recanalize the obstructed duct...
2018: Journal of Cancer
H Boyd-Carson, G Irving, A P Navarro, I C Cameron, D S Gomez
AIM: To evaluate the impact of anti-platelet therapy on the outcomes of patients undergoing liver resection for CRLM. Secondary aim was to determine whether anti-platelet therapy influenced histo-pathological changes in CRLM. METHODS: Patients treated with liver resection for CRLM were identified from a prospectively maintained hepatobiliary database during an 11-year period. Collated data included demographics, primary tumour treatment, surgical data, histopathology analysis and clinical outcome...
May 2018: International Journal of Surgery
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