scholarly journals Finite Element Analysis and Experiment on Large Intestine End-to-End Anastomosis

2018 ◽  
Author(s):  
Ai Liao-yuan ◽  
Ge Shu-chen ◽  
Xu Jing-jing ◽  
Li Ming-yang ◽  
Mao Lin ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Postoperative Bleeding ◽  
Standard Of Care ◽  
Tissue Type ◽  
Tissue Thickness ◽  
Compression Pressure ◽  
Element Analysis ◽  
Inflammatory Bowel ◽  
The Impact ◽  
The Relationship

Colorectal surgery is widely performed to re-establish the bowel, the part of which is removed because of diverticulitis, intestinal polyps, inflammatory bowel and cancer. Stapled anastomosis is a highly standardized technique and considered the standard of care. However, complications like leakage, stenosis and postoperative bleeding cannot be completely avoided [1,2]. There is limited understanding of the impact of staplers on tissue and basic mechanics of tissue stapling. According to the previous research, compression, staple height, tissue thickness, tissue compressibility, and tissue type have an effect on the patient outcomes [3]. Hence, we conducted this prospective study to analyze the effect of staple height on tissue damage and compression pressure. An attempt was made to determine the relationship between the tissue height and the optimal closed staple height.

Abstract P274: Relationship Between Stroke Quality Metrics and Patient Outcomes: A Systematic Review

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Carol J Parker ◽  
Mathew J Reeves
Keyword(s):  
Systematic Review ◽  
Acute Care ◽  
Patient Outcomes ◽  
Stroke Care ◽  
Evidence Base ◽  
Quality Metrics ◽  
Care Quality ◽  
Stroke Recurrence ◽  
The Impact ◽  
The Relationship

Background: Stroke quality metrics play an increasingly important role in quality improvement efforts and policies, but the relationship between quality metrics and patient-orientated outcomes are not well described. We conducted a systematic review of observational hospital-based studies examining this relationship. Methods: We searched MEDLINE and EMBASE for studies published before December 31, 2010 that examined the relationship between 2 or more stroke quality metrics and patient-oriented outcomes in acute stroke admissions. Outcomes included mortality, length of stay, discharge to home, functional status, and stroke recurrence. Results: A total of 470 hits were identified. After screening the titles and abstracts, 27 studies underwent full review, and 14 were deemed eligible. Given the variation in study characteristics, quality metrics, and outcomes utilized, it was not possible to generate summary estimates describing the relationship between quality metric compliance and patient-oriented outcomes. Evidence of a positive relationship between quality metrics and improved patient outcomes was limited by the lack of high quality studies. Four of the 14 studies found a statistically significant relationship between increased compliance with acute care quality metrics and improved patient-oriented outcomes. Two studies failed to find an association between acute care measures and improved outcomes, but did find statistically significant positive relationships between compliance with post-acute rehabilitation measures and improved patient outcomes. Five other studies reported mixed findings, while the remaining three found no relationships. Conclusions: We found a limited evidence-base addressing the impact of compliance on stroke quality metrics and patient-oriented outcomes. Generation of data clarifying the relationship between compliance with stroke quality metrics and stroke-related outcomes should be prioritized so that the current investments undertaken to improve stroke care can be sustained.

Baseline and change from baseline in tumor burden compared with patient outcomes

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17530-e17530
Author(s):  
L. Kaiser ◽  
J. Fridlyand ◽  
G. Fyfe
Keyword(s):  
Patient Outcomes ◽  
Positive Relationship ◽  
Objective Response ◽  
Tumor Burden ◽  
Cox Models ◽  
Strong Positive Relationship ◽  
Oncology Clinical Trials ◽  
The Impact ◽  
The Relationship ◽  
Negative Predictor

e17530 Background: The impact of baseline tumor burden (bTB) and percentage reduction in tumor burden (dTB) on patient outcome has not been systematically studied in oncology clinical trials. We assess the relationship between both bTB and dTB and objective response (OR), progression free and overall survival (PFS and OS) in bevacizumab (B) and trastuzumab (T) trials. Methods: We analyzed 3 B and 1 T Ph 3 mBC and mCRC trials of > 1800 patients total. We used correlations and Cox models for the relationships between pairs of variables and multivariate Cox models to evaluate TB and PFS as independent predictors of OS. Here, we present the minimum dTB value until progression. Results: bTB is not related to dTB, OR rate or PFS time; it is negatively related to OS. dTB shows a strong positive relationship with PFS and OS. TB and PFS are independent predictors of OS, with PFS the better predictor. Results at earlier dTB assessments and within treatment arms are similar. Conclusions: Patients with high bTB are equally likely to respond to treatment and to have prolonged PFS as those with lower bTB, but high bTB is a negative predictor for OS. In contrast, greater percentage reductions in TB are strongly associated with better PFS and OS outcomes. Tumor burden and PFS are independent predictors of OS. Owing to these relationships, assessing bTB and dTB, as well as OR, PFS and OS, may improve the interpretation of phase II data. [Table: see text] [Table: see text]

scholarly journals Gastroenterocardiology: Or what do the gut and the heart have in common?

2021 ◽  
Vol 46 (1) ◽  
pp. 11-22
Author(s):  
Zoran Joksimović ◽  
Dušan Bastać ◽  
Snežana Pavlović
Keyword(s):  
Cardiovascular Diseases ◽  
Gut Microbiota ◽  
Metabolic Diseases ◽  
Chronic Inflammatory Bowel Disease ◽  
Nonalcoholic Fatty Liver ◽  
Inflammatory Bowel ◽  
The Impact ◽  
The Relationship ◽  
Gut Microbiota Composition

The gut microbiota of our organism is a community of bacteria, archaea, fungi, viruses and parasites that make up a unique ecosystem in the digestive tract, which consists of about 1014 microorganisms. The diversity of this community between individuals occurs because of the differences in the host genome and the impact of environmental factors, including hygiene, diet, lifestyle and the use of different drugs. Significant evidence suggests that changes in the microbiota could play a role in cardiovascular diseases. The results of research papers for the last two decades have confirmed that altered gut microbiota composition (dysbiosis) contributes to the development of various diseases, including cardiovascular diseases, type 2 diabetes, chronic kidney disease, nonalcoholic fatty liver disease, chronic inflammatory bowel disease and even certain types of cancer. There is growing evidence that in the future, apart from current predisposing factors for cardiovascular and metabolic diseases, including genetic, environmental and lifestyle factors, one should count on new risk factors such as nutritional disproportion and gut dysbiosis. Thus, we look upon the relationship between the gastrointestinal tract and cardiovascular system, i.e. the "gut-heart axis" in a new way.

scholarly journals Role of Digital Health and Artificial Intelligence in Inflammatory Bowel Disease: A Scoping Review

Genes ◽  
2021 ◽  
Vol 12 (10) ◽  
pp. 1465
Author(s):  
Kamila Majidova ◽  
Julia Handfield ◽  
Kamran Kafi ◽  
Ryan D. Martin ◽  
Ryszard Kubinski
Keyword(s):  
Artificial Intelligence ◽  
Scoping Review ◽  
Digital Health ◽  
Medication Management ◽  
Standard Of Care ◽  
Preliminary Evidence ◽  
Clinical Environment ◽  
Inflammatory Bowel ◽  
The Impact

Inflammatory bowel diseases (IBD), subdivided into Crohn’s disease (CD) and ulcerative colitis (UC), are chronic diseases that are characterized by relapsing and remitting periods of inflammation in the gastrointestinal tract. In recent years, the amount of research surrounding digital health (DH) and artificial intelligence (AI) has increased. The purpose of this scoping review is to explore this growing field of research to summarize the role of DH and AI in the diagnosis, treatment, monitoring and prognosis of IBD. A review of 21 articles revealed the impact of both AI algorithms and DH technologies; AI algorithms can improve diagnostic accuracy, assess disease activity, and predict treatment response based on data modalities such as endoscopic imaging and genetic data. In terms of DH, patients utilizing DH platforms experienced improvements in quality of life, disease literacy, treatment adherence, and medication management. In addition, DH methods can reduce the need for in-person appointments, decreasing the use of healthcare resources without compromising the standard of care. These articles demonstrate preliminary evidence of the potential of DH and AI for improving the management of IBD. However, the majority of these studies were performed in a regulated clinical environment. Therefore, further validation of these results in a real-world environment is required to assess the efficacy of these methods in the general IBD population.

scholarly journals Quality of Life Impact and Special Issues in Women with Inflammatory Bowel Diseases

2021 ◽  
Author(s):  
Gabriel Constantinescu ◽  
Gina Gheorghe ◽  
Ecaterina Rinja ◽  
Oana Plotogea ◽  
Vasile Sandru ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inflammatory Bowel Diseases ◽  
Standard Of Care ◽  
Cross Sectional ◽  
Men And Women ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
The Impact ◽  
Gender Specific

Abstract Background: The impact of inflammatory bowel diseases (IBD) on quality of life (QoL) of patients is significant and has important social and professional consequences. Methods: We aimed to describe the patients’ perspective regarding the impact of IBD on their overall QoL and to evaluate the differences between men and women. An observational cross-sectional study, that included 180 patients with IBD in clinical remission, was conducted. All the patients completed a number of 3 questionnaires in order to evaluate the general aspects of their QoL. A separate questionnaire was created regarding gender-specific issues in women with IBD encounter. Also, particular features such as the incidence of anemia and osteoporosis among IBD patients were documented. The data obtained were analyzed and compared between the two gender-classified groups. Results: According to the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), patients had a general perception of a good QoL, but the impact was higher in women. Fatigue and tiredness were severely perceived almost to the same degree regardless of gender, whereas anxiety and unemployment were more present in men. No significant differences in women with IBD during active disease and during disease remission were found. Conclusions: The overall quality of life of IBD patients is affected in many aspects, leading to the deterioration of their social and professional lives, for both men and women, but some aspects remain gender-specific and require a personalized standard of care.

scholarly journals What evidence is there for a relationship between organisational features and patient outcomes in congenital heart disease services? A rapid review

2014 ◽  
Vol 2 (43) ◽  
pp. 1-120 ◽  
Author(s):  
Janette Turner ◽  
Louise Preston ◽  
Andrew Booth ◽  
Colin O’Keeffe ◽  
Fiona Campbell ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Patient Outcomes ◽  
Observational Studies ◽  
Congenital Heart ◽  
Evidence Synthesis ◽  
Rapid Review ◽  
Cochrane Library ◽  
The Impact ◽  
The Relationship

BackgroundThe purpose of this rapid evidence synthesis is to support the current NHS England service review on organisation of services for congenital heart disease (CHD). The evidence synthesis team was asked to examine the evidence on relationships between organisational features and patient outcomes in CHD services and, specifically, any relationship between (1) volume of cases and patient outcomes and (2) proximity of colocated services and patient outcomes. A systematic review published in 2009 had confirmed the existence of this relationship, but cautioned this was not sufficient to make recommendations on the size of units needed.ObjectivesTo identify and synthesise the evidence on the relationship between organisational features and patient outcomes for adults and children with CHD.Data sourcesA systematic search of medical- and health-related databases [MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), The Cochrane Library and Web of Science] was undertaken for 2009–14 together with citation searching, reference list checking and stakeholder recommendations of evidence from 2003 to 2014.Review methodsThis was a rapid review and, therefore, the application of the inclusion and exclusion criteria to retrieved records was undertaken by one reviewer, with 10% checked by a second reviewer. Five reviewers extracted data from included studies using a bespoke data extraction form which was subsequently used for evidence synthesis. No formal quality assessment was undertaken, but the usefulness of the evidence was assessed together with limitations identified by study authors.ResultsThirty-nine papers were included in the review. No UK-based studies were identified and 36 out of 39 (92%) studies included only outcomes for paediatric patients. Thirty-two (82%) studies investigated the relationship between volume and mortality and seven (18%) investigated other service factors or outcomes. Ninety per cent were from the USA, 92% were multicentre studies and all were retrospective observational studies. Twenty-five studies (64%) included all CHD conditions and 14 (36%) included single conditions or procedures. Although the evidence does demonstrate a relationship between volume and outcome in the majority of studies, this relationship is not consistent. The relationship was stronger for single-complex conditions or procedures. A mixed picture emerged revealing a range of factors as well as volume that influence outcome, including condition severity, individual centre and surgeon effects and clinical advances over time. We found limited (seven studies) evidence about the impact of proximity and colocation of services on outcomes, and about volume on non-mortality outcomes.LimitationsThis was a rapid review that followed standard methods to ensure transparency and reproducibility. The main limitations of the included studies were the retrospective nature, reliance on routine data sets, completeness, selection bias and lack of data on key clinical and service-related processes.ConclusionsThis review identified a substantial number of studies reporting a positive relationship between volume and outcome, but the complexity of the evidence requires careful interpretation. The heterogeneity of findings from observational studies suggests that, while a relationship between volume and outcome exists, this is unlikely to be a simple, independent and directly causal relationship. The effect of volume on outcome relative to the effect of other as yet undetermined health system factors remains a complex and unresolved research question.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Enterotoxigenic Bacteroides fragilis: a Rogue among Symbiotes

2009 ◽  
Vol 22 (2) ◽  
pp. 349-369 ◽  
Author(s):  
Cynthia L. Sears
Keyword(s):  
Epithelial Cell ◽  
Diarrheal Disease ◽  
Bacteroides Fragilis ◽  
Cell Receptor ◽  
Intestinal Cell ◽  
Intestinal Epithelial ◽  
Full Spectrum ◽  
Inflammatory Bowel ◽  
The Impact ◽  
The Relationship

SUMMARY Enterotoxigenic Bacteroides fragilis (ETBF) strains are strains of B. fragilis that secrete a 20-kDa heat-labile zinc-dependent metalloprotease toxin termed the B. fragilis toxin (BFT). BFT is the only recognized virulence factor specific for ETBF. ETBF strains are associated with inflammatory diarrheal disease in children older than 1 year of age and in adults; limited data suggest an association of ETBF colonization with inflammatory bowel disease flare-ups and colorectal cancer. ETBF secretes one of three highly related BFT isoforms. The relationship between BFT isoform and disease expression is unknown. Although the mechanism of action of BFT is incompletely understood, available data suggest that BFT binds to a specific intestinal epithelial cell receptor, stimulating intestinal cell signal transduction pathways that result in cell morphology changes, cleavage of E-cadherin, reduced colonic barrier function, and increased epithelial cell proliferation and cytokine expression (such as the proinflammatory chemokine interleukin-8). Together, the data suggest that in some hosts, ETBF acts via secretion of BFT to induce colitis. However, the full spectrum of clinical disease related to ETBF and the impact of chronic ETBF colonization on the host remain to be defined.

scholarly journals The Impact of Human Herpesviruses in Clinical Practice of Inflammatory Bowel Disease in the Era of COVID-19

2021 ◽  
Vol 9 (9) ◽  
pp. 1870
Author(s):  
Shuhei Hosomi ◽  
Yu Nishida ◽  
Yasuhiro Fujiwara
Keyword(s):  
Inflammatory Bowel Disease ◽  
Clinical Practice ◽  
Bowel Disease ◽  
Intestinal Barrier Function ◽  
Varicella Zoster ◽  
Inflammatory Bowel ◽  
Human Herpesviruses ◽  
The Impact ◽  
The Relationship ◽  
Hsv 1

Human herpesviruses (HHVs): herpes simplex virus (HSV) types 1 (HSV-1) and 2 (HSV-2), varicella-zoster virus (VZV), Epstein-Barr virus (EBV), cytomegalovirus (CMV), HHV-6, HHV-7, and HHV-8, are known to be part of a family of DNA viruses that cause several diseases in humans. In clinical practice of inflammatory bowel disease (IBD), the complication of CMV enterocolitis, which is caused by CMV reactivation under disruption of intestinal barrier function, inflammation, or strong immunosuppressive therapy, is well known to affect the prognosis of disease. However, the relationship between other HHVs and IBD remains unclear. In the transplantation field, reactivation of other viruses, such as HHV-6, could cause colitis under immunosuppressed condition. Recent research revealed that combined infection of some HHVs could be a risk factor for colectomy in patients with ulcerative colitis. This suggests that it would be important to clarify HHV behavior in the treatment for patients with IBD, especially in those under immunosuppressive therapies. Looking at the relationship with recently emerged novel coronaviruses (SARS-CoV-2), there are reports describe that SARS-CoV-2 might induce reactivation of HSV-1, EBV, VZV (herpes zoster), and HHV-6/7. If SARS-CoV-2 infection becomes common, vigilance against HHV reactivation may become more crucial. In this review, we discuss the impact of HHVs in clinical practice of inflammatory bowel diseases, especially during the SARS-CoV-2 pandemic.

Sign in / Sign up

Export Citation Format

Share Document