scholarly journals Effect of Resident and Fellow Involvement on Outcomes of Sarcoma Surgery: A NSQIP Database Cross-Sectional Study

Sarcoma ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Eugene S. Jang ◽  
Michael G. Artin ◽  
Venkat Boddapati ◽  
Chung Min Chan ◽  
Andre R. Spiguel ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Cross Sectional Study ◽  
Independent Effect ◽  
Academic Training ◽  
Complication Rates ◽  
Improvement Program ◽  
Cross Sectional ◽  
Surgical Assistants ◽  
Level Of Training ◽  
Musculoskeletal Oncology

Background. The complexity of sarcoma surgery often justifies surgical assistants of higher levels of academic training: senior residents, fellows, or co-surgeons. The association between the level of training of assistants and outcomes of these procedures has yet to be studied. Methods. The Current Procedural Terminology (CPT) codes comprising the “core” procedures for musculoskeletal oncology fellowships were gathered. After CPTs primarily capturing nononcologic procedures were excluded, the National Surgical Quality Improvement Program (NSQIP) database was used to find procedures with these CPTs. The severity of complications was assessed using the Severity Weighting of Postoperative Adverse Events in Orthopedic Surgery (SWORD) score. Resident/fellow presence was analyzed both as a binary variable and stratified by level of training. Results. In 159 cases meeting inclusion criteria, higher-level assistants were associated with increased rate of any complication ( p = 0.006 ) and greater need for transfusion ( p = 0.001 ) but also tended to be used in cases of longer duration ( p = 0.001 ) and with higher total work relative value units (wRVUs) ( p = 0.001 ). Multivariate analysis showed that while higher-wRVU procedures persisted as an independent predictor of increased complications (OR 1.028 per RVU unit, p = 0.002 ), neither the presence nor level of training of assistants had an independent effect on complication rates. Other independent predictors of 30-day complications were treatment comorbidity (OR 3.433, p = 0.010 ) and lower extremity location of the tumor (OR 4.393, p = 0.006 ). Severity of complications did not differ between any of the groups on either univariate or multivariate analysis. Conclusions. Trainees of higher levels of academic training tend to be present for longer, higher-complexity musculoskeletal oncology cases, but the overall severity of complications from these do not significantly differ from lower-risk cases without trainees. Orthopedic oncologists may reassure patients that the presence of trainees and co-surgeons is not only safe but it may also help reduce the severity of complications in more complex procedures.

scholarly journals Influence ofABCC2andABCC4Polymorphisms on Tenofovir Plasma Concentrations in Thai HIV-Infected Patients

2015 ◽  
Vol 59 (6) ◽  
pp. 3240-3245 ◽  
Author(s):  
Kanokrat Rungtivasuwan ◽  
Anchalee Avihingsanon ◽  
Narukjaporn Thammajaruk ◽  
Siwaporn Mitruk ◽  
David M. Burger ◽  
...  
Keyword(s):  
Body Weight ◽  
Multivariate Analysis ◽  
Plasma Concentration ◽  
Protease Inhibitors ◽  
Demographic Data ◽  
Plasma Concentrations ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
The Mean

ABSTRACTTenofovir (TFV) is eliminated by renal excretion, which is mediated through multidrug-resistant protein 2 (MRP2) and MRP4, encoded byABCC2andABCC4, respectively. Genetic polymorphisms of these transporters may affect the plasma concentrations of tenofovir. Therefore, the aim of this study was to investigate the influence of genetic and nongenetic factors on tenofovir plasma concentrations. A cross-sectional study was performed in Thai HIV-infected patients aged ≥18 years who had been receiving tenofovir disoproxil fumarate at 300 mg once daily for at least 6 months. A middose tenofovir plasma concentration was obtained. Multivariate analysis was performed to investigate whether there was an association between tenofovir plasma concentrations and demographic data, including age, sex, body weight, estimated glomerular filtration rate (eGFR), hepatitis B virus coinfection, hepatitis C virus coinfection, duration of tenofovir treatment, concomitant use of ritonavir-boosted protease inhibitors, and polymorphisms ofABCC2andABCC4. A total of 150 Thai HIV-infected patients were included. The mean age of the patients was 43.9 ± 7.2 years. The mean tenofovir plasma concentration was 100.3 ± 52.7 ng/ml. In multivariate analysis, a low body weight, a low eGFR, the concomitant use of ritonavir-boosted protease inhibitors, and theABCC44131T → G variation (genotype TG or GG) were independently associated with higher tenofovir plasma concentrations. After adjusting for weight, eGFR, and the concomitant use of ritonavir-boosted protease inhibitors, a 30% increase in the mean tenofovir plasma concentration was observed in patients having theABCC44131 TG or GG genotype. Both genetic and nongenetic factors affect tenofovir plasma concentrations. These factors should be considered when adjusting tenofovir dosage regimens to ensure the efficacy and safety of a drug. (This study has been registered at ClinicalTrials.gov under registration no. NCT01138241.)

scholarly journals Increase in the Risk of Respiratory Disorders in Adults and Children Related to Crop-Growing in Niger

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ali Mamane ◽  
Jean-François Tessier ◽  
Ghislaine Bouvier ◽  
Roger Salamon ◽  
Pierre Lebailly ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Environmental Factors ◽  
Respiratory Symptoms ◽  
Respiratory Health ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Face To Face ◽  
Increased Risk ◽  
Adults And Children ◽  
Agricultural Areas

Background and Objective. Environmental factors are an increasing concern for respiratory health in developing countries. The objective of this study was to investigate whether Nigerien people living in cultivated areas have more respiratory symptoms than those living in pastoral areas. Method. A cross-sectional study was conducted in 2013 in two populations during the rainy season when land is cultivated. Environmental factors including pesticide use and respiratory symptoms were collected in adults and children during face-to-face interviews. Multivariate analysis between exposures and symptoms was performed in children and in adults separately. Results. The study included 471 adults and 229 children. Overall, none of the households reported the use of pesticides for agricultural purposes. However, 87.2% reported the use of insecticides at home. Multivariate analysis showed that people living in agricultural areas compared to those in pastoral areas had an increased risk of respiratory symptoms in adults (wheezing, dyspnea, sudden shortness of breath, and cough without fever) and in children (cough without fever). The use of insecticides showed no effect on respiratory symptoms after adjustment. Conclusion. This first epidemiological study on the environment and respiratory health conducted in Niger demonstrates a significant relationship between respiratory manifestations and the agricultural characteristics of the living area. However only the effect of insecticides in the home on respiratory health was observed.

The Relationship of Mode and Intensity of Training on Resting Metabolic Rate in Women

2001 ◽  
Vol 11 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Heidi K. Byrne ◽  
Jack H. Wilmore
Keyword(s):  
Metabolic Rate ◽  
Resting Metabolic Rate ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Women Subjects ◽  
Present Cross Sectional Study ◽  
Significant Difference ◽  
Level Of Training ◽  
The Relationship ◽  
Aerobically Trained

The present cross-sectional study was designed to investigate the relationship between exercise training and resting metabolic rate (RMR). The focus of this investigation was to compare RMR in aerobically trained (AT), resistance trained (RT), and untrained (UNT) women. Subjects were also classified as highly trained (HT), moderately trained (MT), or untrained (UNT) in order to examine the relationship between RMR and level of training. Sixty-one women between the ages of 18 and 46 years volunteered to serve as subjects in this study. Each subject completed measurements of body composition, maximal oxygen uptake (V̇O2max), and two consecutive measurements of RMR. The data presented show that there was no significant difference in resting metabolic rate between resistance-trained, aerobically trained, and control subjects. However, when grouped by intensity of training, there was a trend for an increased resting metabolic rate (kcal/day) in the highly trained subjects, regardless of mode of training.

scholarly journals A cross-sectional study of long-term satisfaction after surgery for congenital syndactyly: does skin grafting influence satisfaction?

2018 ◽  
Vol 44 (3) ◽  
pp. 296-303 ◽  
Author(s):  
Bien R. Ferrari ◽  
Paul M.N. Werker
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Cross Sectional Study ◽  
Complication Rates ◽  
Skin Grafts ◽  
Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Scar Assessment

Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV

scholarly journals Application of smartphones in dermatology practice: a cross-sectional survey

2021 ◽  
Vol 7 (2) ◽  
pp. 171
Author(s):  
Priya Prabhakaran Nair ◽  
Leela Manju
Keyword(s):  
Point Of Care ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Tool ◽  
Clinical Photography ◽  
Inappropriate Use ◽  
Phone Calls ◽  
Smartphone Use ◽  
Level Of Training

<p><strong>Background:</strong> Smartphones have revolutionised medical practice including dermatology because of its multiple functions assisting practitioners at the point of care and beyond. We aimed to analyse the pattern of smartphone use by dermatologists and to explore their opinions and difficulties faced while using smartphone</p><p><strong>Methods:</strong> This cross-sectional study included a population of dermatology consultants and residents in Kerala, India. A validated self-reported questionnaire was emailed to them using a survey tool to collect the data</p><p><strong>Results:</strong> Overall 100 practitioners responded to the questionnaire with a response rate 10.6%. Consultants and residents accounted for 81% and 19% of the participants respectively. Females (78%) outnumbered males. Most (58.6%) belonged to age group 31-40 years. Everyone owned a smartphone with the most prevalent operating system (OS) being android (85.9%). Medical communication was done mostly using phone calls (92%). Drug reference (94%) was the most popular noncommunicative application. Most participants (85%) used smartphone camera for clinical photography. OS freezing was the biggest technical issue whereas inappropriate use and distraction were the biggest nontechnical challenges of smartphone use. Clinical photography was taken by 95% for disease monitoring with significantly higher usage in females. Those upto 40 years of age significantly took and shared clinical photographs for second opinion more than older ones. Only 17.2% with significantly higher males than females took written consent for photography.</p><p><strong>Conclusions:</strong> Dermatologists use smartphone extensively for communication, information and photography with preferences varying with age, gender and level of training.</p>

scholarly journals Impacto del grado de satisfacción en las expectativas del estudiante universitario. El caso de la Universidad Autónoma de Chiapas (UNACH)

2019 ◽  
pp. 20-27
Author(s):  
Marco Antonio Ovando Díaz ◽  
Octavio Grajales Castillejos
Keyword(s):  
Decision Making ◽  
Human Resources ◽  
Cross Sectional Study ◽  
Academic Training ◽  
Sectional Study ◽  
Cross Sectional ◽  
Institutional Services ◽  
Bachelor's Degrees ◽  
Degree Of Satisfaction ◽  
The University

The general objective of the article is to determine the degree of satisfaction of the students of the Autonomous University of Chiapas, Mexico, through a cross-sectional study to assess the institutional services offered and their impact on their academic training. The specific objectives are: 1) Analyze the opinion of students regarding their curriculum and teachers, 2) Analyze the opinion of students regarding the knowledge of university regulations and 3) Describe the conditions of University infrastructure: physical and technological. The methodology used was the explanatory method of qualitative-quantitative and transverse cutting, for this it was necessary to design and apply a Likert-type survey, which was applied to 3,842 enrolled students of the 5th. to the 8th. semester of 22 Bachelor's degrees from the various UNACH headquarters. The contribution that this research has is: a) Provide academic elements to university authorities for decision making in their accreditation processes, b) Training of human resources through the participation of students in the development of research and c) Sensitize the university community through the publication of research results.

scholarly journals Association between maternal satisfaction and other indicators of quality of care at childbirth: a cross-sectional study based on the WHO standards

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037063
Author(s):  
Marzia Lazzerini ◽  
Ilaria Mariani ◽  
Chiara Semenzato ◽  
Emanuelle Pessa Valente
Keyword(s):  
Multivariate Analysis ◽  
Quality Of Care ◽  
Cross Sectional Study ◽  
Maternal Satisfaction ◽  
Sectional Study ◽  
Cross Sectional ◽  
Correlated Variables ◽  
Care Experience ◽  
Who Standards

ObjectivesThis study aimed to explore the association between maternal satisfaction and other indicators of quality of care (QoC) at childbirth, as defined by WHO standards.DesignCross-sectional study.SettingReferral hospital in Northeast Italy.Participants1244 consecutive mothers giving birth in the hospital participated in a survey.Data collection and analysisUnivariate analyses were performed to evaluate the association between maternal satisfaction and 61 variables, including measures of ‘provision of care’, ‘experience of care’, ‘availability of resources’ and other maternal characteristics. Exploratory factor analysis was performed to create groups of correlated variables, which were used in multivariate analysis.ResultsOverall, 509 (40.9%) of women were >35 years of age, about half (52.7%) were highly educated, most (95.2%) were married/living with partner and employed (79.3%) and about half (52.9%) were primiparous. Overall, 189 (15.2%) were not born in Italy and 111 (8.9%) did not have Italian citizenship. Most women (84.2%) were highly satisfied (score ≥7/10) with the care received. Among the 61 variables explored, 46 (75.4%) were significantly associated with women’s satisfaction, 33 with higher satisfaction and 13 with lower satisfaction. Multivariate analysis largely confirmed univariate findings, with six out of eight groups of correlated variables being statistically significantly associated with women’s satisfaction. Factors most strongly associated with women’s satisfaction were ‘effective communication, involvement, listening to women’s needs, respectful and timely care’ (OR 16.84, 95% CI 9.90 to 28.61, p<0.001) and ‘physical structure’ (OR 6.51, 95% CI 4.08 to 10.40, p<0.001). Additionally, ‘victim of abuse, discrimination, aggressiveness’ was inversely associated with the wish to return to the facility or to recommend it to a friend (OR 0.35, 95% CI 0.17 to 0.70, p<0.003).ConclusionThis study suggested that many variables are strongly associated with women’s satisfaction with care during childbirth and support the use of multiple measures to monitor the QoC at childbirth.

scholarly journals Serum Ferritin Is Inversely Correlated with Serum Adiponectin Level: Population-Based Cross-Sectional Study

2009 ◽  
Vol 27 (6) ◽  
pp. 303-310 ◽  
Author(s):  
Bon-Jeong Ku ◽  
Seul-Young Kim ◽  
Tae-Yong Lee ◽  
Kang-Seo Park
Keyword(s):  
Multivariate Analysis ◽  
Serum Ferritin ◽  
Adiponectin Level ◽  
Ferritin Level ◽  
Hdl Cholesterol ◽  
Population Based ◽  
Cross Sectional Study ◽  
Serum Adiponectin ◽  
Cross Sectional ◽  
Hs Crp

Background: The serum concentrations of ferritin and adiponectin are associated with several metabolic disorders and have been used as predictors of insulin resistance and metabolic syndrome. But there have been no reports demonstrating a direct correlation between serum ferritin and adiponectin levels. We performed this study to evaluate the association between serum ferritin and adiponectin concentrations.Subjects and methods: We evaluated a total of 995 subjects from the Korea Rural Genomic Cohort Study in a population-based cross-sectional study. Extensive clinical and laboratory measurements, including adiponectin and ferritin concentrations, were recorded.Results: Univariate analysis revealed that the serum adiponectin level was correlated with age, sex, BMI, diastolic blood pressure, triglyceride, HDL-cholesterol, fasting blood glucose, fasting insulin, HOMA-IR, hs-CRP, and ferritin. Multivariate analysis demonstrated that the adiponectin concentration was correlated with age, BMI, fasting glucose, hs-CRP, and ferritin. The ferritin concentration was the most powerfully associated with serum adiponectin. In non-diabetic subgroups, the adiponectin level was correlated with BMI, triglyceride, HDL-cholesterol, fasting glucose, and ferritin level in multivariate analysis. In diabetic subgroups, the adiponectin level was correlated with BMI, triglyceride, hs-CRP, and ferritin level in multivariate analysis.Conclusions: The serum adiponectin concentration was correlated with conventional clinical variables, but the most powerfully associated factor was the serum ferritin level.

scholarly journals Assessment of the Severity of Carpal Tunnel Syndrome in Patients With Acromegaly: A Focus on Clinical, Biochemical and Image Outcomes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A638-A638
Author(s):  
Diego Fernando Paredes Vinueza ◽  
Gómez-Caballero María del Socorro ◽  
Andrea Paola Solis-Pazmino ◽  
Jorge Luis Salazar-Vega
Keyword(s):  
Multivariate Analysis ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Tunnel Syndrome ◽  
Severe Grade

Abstract This is a descriptive cross-sectional study designed to analyze the prevalence and severity of carpal tunnel syndrome (CTS) in addition to its association with clinical, biochemical, and imaging variables in a cohort of patients with acromegaly. Data collection was performed by entering them in our database and we subsequently analyzed in the SPSS system. Of the 71 patients registered with acromegaly, 68 met the inclusion criteria. Among the results, 97.8% presented CTS evidenced by electroconduction. Of these, 43 (63.1%) showed moderate involvement, followed by 17 severe cases (25%) and 6 mild cases (8.8%). The level of GH in serum, the years of delay in diagnosis, and the size of the adenoma were related to the presence and severity of CTS (p less than 0.05). The multivariate analysis showed that severe grade had a significant association with these variables compared with moderate and mild grade.

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