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| 1 | Operative complications and economic outcomes of cholecystectomy for acute cholecystitis显示文摘BACKGROUND Recent management of acute cholecystitis favors same admission(SA)or emergent cholecystectomy based on overall shorter hospital stay and therefore cost savings.We adopted the practice of SA cholecystectomy for the treatment of acute cholecystitis at our tertiary care center and wanted to evaluate the economic benefit of this practice.We hypothesized that the existence of complications,particularly among patients with a higher degree of disease severity,during SA cholecystectomy could negate the cost savings.AIM To compare complication rates and hospital costs between SA vs delayed cholecystectomy among patients admitted emergently for acute cholecystitis.METHODS Under an IRB-approved protocol,complications and charges for were obtained for SA,later after conservative management(Delayed),or elective cholecystectomies over an 8.5-year period.Patients were identified using the acute care surgery registry and billing database.Data was retrieved via EMR,operative logs,and Revenue Cycle Operations.The severity of acute cholecystitis was graded according to the Tokyo Guidelines.TG18 categorizes acute cholecystitis by Grades 1,2,and 3 representing mild,moderate,and severe,respectively.Comparisons were analyzed withχ2,Fisher’s exact test,ANOVA,ttests,and logistic regression;significance was set at P<0.05.RESULTS Four hundred eighty-six(87.7%)underwent a SA while 68 patients(12.3%)received Delayed cholecystectomy.Complication rates were increased after SA compared to Delayed cholecystectomy(18.5%vs 4.4%,P=0.004).The complication rates of patients undergoing delayed cholecystectomy was similar to the rate for elective cholecystectomy(7.4%,P=0.35).Mortality rates were 0.6%vs 0%for SA vs Delayed.Patients with moderate disease(Tokyo 2)suffered more complications among SA while none who were delayed experienced a complication(16.1%vs 0.0%,P<0.001).Total hospital charges for SA cholecystectomy were increased compared to a Delayed approach($44500±$59000 vs$35300±$16700,P=0.019).The relative risk of developing a complication was 4.2x[95%confidence interval(CI):1.4-12.9]in the SA vs Delayed groups.Among eight patients(95%CI:5.0-12.3)with acute cholecystitis undergoing SA cholecystectomy,one patient will suffer a complication.CONCLUSION Patients with Tokyo Grade 2 acute cholecystitis had more complications and increased hospital charges when undergoing SA cholecystectomy.This data supports a selective approach to SA cholecystectomy for acute cholecystitis. | Christopher P Rice Krishnamurthy B Vaishnavi Celia Chao Daniel Jupiter August B Schaeffer Whitney R Jenson Lance W Griffin William J Mileski | 2019 | World Journal of Gastroenterology2019，25，48： | 8 |
| 2 | Dietary advanced glycation end-products aggravate non-alcoholic fatty liver disease显示文摘AIM To determine if manipulation of dietary advanced glycation end product(AGE), intake affects nonalcoholic fatty liver disease(NAFLD) progression and whether these effects are mediated via RAGE. METHODS Male C57Bl6 mice were fed a high fat, high fructose, high cholesterol(HFHC) diet for 33 wk and compared with animals on normal chow. A third group were given a HFHC diet that was high in AGEs. Another group was given a HFHC diet that was marinated in vinegar to prevent the formation of AGEs. In a second experiment, RAGE KO animals were fed a HFHC diet or a high AGE HFHC diet and compared with wildtype controls. Hepatic biochemistry, histology, picrosirius red morphometry and hepatic mR NA were determined. RESULTS Long-term consumption of the HFHC diet generated significant steatohepatitis and fibrosis after 33 wk. In this model, hepatic 4-hydroxynonenal content(a marker of chronic oxidative stress), hepatocyte ballooning, picrosirius red staining, α-smooth muscle actin and collagen type 1A gene expression were all significantly increased. Increasing the AGE content of the HFHC diet by baking further increased these markers of liver damage, but this was abrogated by pre-marination in acetic acid. In response to the HFHC diet, RAGE-/-animals developed NASH of similar severity to RAGE+/+ animals but were protected from the additional harmful effects of the high AGE containing diet. Studies in isolated Kupffer cells showed that AGEs increase cell proliferation and oxidative stress, providing a likely mechanism through which these compounds contribute to liver injury. CONCLUSION In the HFHC model of NAFLD, manipulation of dietary AGEs modulates liver injury, inflammation, and liver fibrosis via a RAGE dependent pathway. This suggests that pharmacological and dietary strategies targeting the AGE/RAGE pathway could slow the progression of NAFLD. | Christopher Leung Chandana B Herath Zhiyuan Jia Sof Andrikopoulos Bronwyn E Brown Michael J Davies Leni R Rivera John B Furness Josephine M Forbes Peter W Angus | 2016 | World Journal of Gastroenterology2016，22，35： | 7 |
| 3 | Clinical outcomes following salvage Gamma Knife radiosurgery for recurrent glioblastoma显示文摘Glioblastoma multiforme(GBM) is the most common malignant primary brain tumor with a survival prognosis of 14-16 mo for the highest functioning patients. Despite aggressive, multimodal upfront therapies, the majority of GBMs will recur in approximately six months. Salvage therapy options for recurrent GBM(r GBM) are an area of intense research. This study compares recent survival and quality of life outcomes following Gamma Knife radiosurgery(GKRS) salvage therapy. Following a Pub Med search for studies usingGKRS as salvage therapy for malignant gliomas, nine articles from 2005 to July 2013 were identified which evaluated rG BM treatment. In this review, we compare overall survival following diagnosis, overall survival following salvage treatment, progression-free survival, time to recurrence, local tumor control, and adverse radiation effects. This report discusses results for rG BM patient populations alone, not for mixed populations with other tumor histology grades. All nine studies reported median overall survival rates(from diagnosis, range:16.7-33.2 mo; from salvage, range:9-17.9 mo). Three studies identified median progression-free survival(range:4.6-14.9 mo). Two showed median time to recurrence of GBM. Two discussed local tumor control. Six studies reported adverse radiation effects(range:0%-46% of patients). The greatest survival advantages were seen in patients who received GKRS salvage along with other treatments, like resection or bevacizumab, suggesting that appropriately tailored multimodal therapy should be considered with each rG BM patient. However, there needs to be a randomized clinical trial to test GKRS for rG BM before the possibility of selection bias can be dismissed. | Erik W Larson Halloran E Peterson Wayne T Lamoreaux Alexander R MacKay Robert K Fairbanks Jason A Call Jonathan D Carlson Benjamin C Ling John J Demakas Barton S Cooke Christopher M Lee | 2014 | World Journal of Clinical Oncology2014，5，2： | 5 |
| 4 | Service recovery: a framework and empirical investigation显示文摘 | Janis L Miller Christopher W Craighead Kirk R Karwan | 2000 | Journal of Operations Management2000，，4： | 3 |
| 5 | Effect of Ginkgo biloba (EGb 761) and aspirin on platelet aggregation and platelet function analysis among older adults at risk of cardiovascular disease: a randomized clinical trial显示文摘 | Christopher D Gardner James L Zehnder Alison J Rigby Joel R Nicholus John W Farquhar | 2007 | Blood Coagulation & Fibrinolysis2007，，8： | 2 |
| 6 | A multibit E A modulator in floating-body SOS/SOI CMOS for extreme radiation environments显示文摘 | CHRISTOPHER F E WILLIAM R W MARK B | 1999 | IEEE J of Solid State Circuits1999，34，7： | 1 |
| 7 | Expression of indoleamine 2, 3- dioxygenase in tumor endothelial cells correlates with Long-term survival of patients with renal cell carcinoma 显示文摘 | Rainer R Christoph W Oliver S | 2007 | Clin Cancer Res2007，13，23： | 1 |
| 8 | The chemistry of graphene oxide 显示文摘 | Daniel R Dreyer Sungjin Park Christopher W Bielawski | 2010 | Chem Soe Rev2010，39，1： | 1 |
| 9 | Visible light photoredox catalysis with transition metal complexes:applications in organic synthesis显示文摘 | Christopher K P Danica A R David W C M | 2013 | Chem Rev2013，113，： | 1 |
| 10 | Effects of using accurate climatic conditions for mechanistic-empirical pavement design显示文摘 | Tamer M B Christopher W R Daryl E H | 2011 | Journal of Transportation Engineering2011，137，： | 1 |
| 11 | Connell integrate the effects of climate change across entire systems that predicting ecosystem shifts requires new approaches显示文摘 | Bayden D R Christopher D G H Thomas W | | 0，，10： | 1 |
| 12 | Vitrificationg enhancement by synthetic ice blocking agents 显示文摘 | Brain W Eugen L Christopher M R | 2000 | Cryobiology2000，，： | 1 |
| 13 | Stroke Volume Variation as an Indicator ofFluid Responsiveness Using Pulse Contour Analysis in Mechanically Ventilated Patients显示文摘 | Christopher P Gabriele R | 2003 | Anesth Analg2003，96，5： | 1 |
| 14 | The effect of body contact series resistance on SOI CMOS amplifier stages显示文摘 | CHRISTOPHER F E WILLIAM R W BERNARD M T | 1997 | IEEE Trans Electron Devices1997，44，12： | 1 |
| 15 | Service recovery:a framework and empirical investigation显示文摘 | Janis L Miller Christopher W Craighead Kirk R Karwan | 2000 | Journal of Operations Management2000，，18： | 1 |
| 16 | Pfinder: real-time tracking of the human body显示文摘 | Christopher R W Ali A Trevor D | 1997 | IEEE Transactions on PAMI1997，19，7： | 1 |
| 17 | The influence of morphology, hydrophobicity and charge upon the long-term performance of ultrafiltration membranes fouled with spent sulphite liquor显示文摘 | Andreas W Michael R B Marianne N Christopher W | 2005 | Desalination2005，175，： | 1 |
| 18 | Pfinder:real-time tracking of the human body显示文摘 | CHRISTOPHER R W AZARBAYEJANI A DARRELL T | 1997 | IEEE Transactions on Pattern Analysis and Machine Intelligence1997，19，7： | 1 |
| 19 | Detecting Trichodesmium blooms in SeaWiFS imagery显示文摘 | AJIT Subramaniam CHRISTOPHER W Brown RALEIGH R Hood | 2002 | Deep-Sea Resereh: II2002，49，： | 1 |
| 20 | High coverage of hydrogen on (10,0), (9,0) and (5,5) carbon nanotubes 显示文摘 | BAUSCHLICHER C W CHRISTOPHER R | 2002 | Nano Lett2002，2，： | 1 |
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