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Quality-adjusted life years and surgical waiting list:Systematic review of the literature

World Journal of Gastrointestinal Surgery 2024年第4期16卷 1155-1164页

作者： roberto de la p.aza llamas Lorena Ortega Azor Marina Hernández Yuste Ludovica Gorini Raquel Aránzazu latorre-Fragua Daniel Alejandro Díaz Candelas Farah Al Shwely Abduljabar Ignacio Antonio Gemio del Rey department of General and Digestive Surgery Hospital Universitario de GuadalajaraGuadalajara 19002Spain department of Surgery Medical and Social SciencesFaculty of Medicine and Health SciencesUniversity of AlcaláAlcaláde Henares 28871MadridSpain

BACKGROUND The quality-adjusted life year(QALY)is a metric that is increasingly used today in the field of health economics to evaluate the value of different medical treatments and *** waiting lists(SWLs)represent a pressing problem in public *** QALY measure has rarely been used in the context of *** would be interesting to know how many QALYs are lost by patients on *** To investigate the relationship between QALYs and SWLs in a systematic review of the scientific *** The study was conducted in accordance with the preferred Reporting Items for Systematic Reviews and Meta-Analyses *** unlimited search was carried out in pubMed,updated on January 19,*** on the following variables were investigated and analyzed:Specialty,country of study,procedure under study,scale used to measure QALYs,the use of a theoretical or real-life model,objectives of the study and items measured,the economic value assigned to the QALY in the country in question,and the results and conclusions *** Forty-eight articles were selected for the *** data were found regarding QALYs lost on *** specialties in which QALYs were studied the most in relation to the waiting list were urology and general surgery,with 15 articles *** country in which the most studies of QALYs were carried out was the United States(n=21),followed by the United Kingdom(n=9)and Canada(n=7).The most studied procedure was organ transplantation(n=39),including 15 kidney,14 liver,5 heart,4 lung,and 1 ***(n=4),cataract surgery(n=2),bariatric surgery(n=1),mosaicplasty(n=1),and septoplasty(n=1)completed the surgical interventions ***-nine of the models used were theoretical(the most frequently applied being the Markov model,n=34),and nine were *** survey used to measure quality of life in 11 articles was the European Quality of Life-5 dimensions,but in 32 articles the survey was not specified.T

关键词： Quality-adjusted life year Waitlist Quality of life Surgery Systematic review

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Association between lifestyle factors and thyroid function in young euthyroid adults

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Food Science and Human Wellness 2024年第1期13卷 265-275页

作者： Elisa Merchan-Ramirez Guillermo Sanchez-delgado Lucas Jurado-Fasoli Francisco M Acosta Manuel Munoz-Torres Jose M.llamas-Elvira Jonatan R Ruiz Sport and Health University Research Institute(iMUDS) Faculty of Sports ScienceUniversity of GranadaGranada 18016Spain pennington Biomedical Research Center Baton Rouge 70808USA Faculty of Medicine University of GranadaGranada 18071Spain Turku pET Centre University of TurkuTurku 20500Finland Turku pET Centre Turku University HospitalTurku 20520Finland Biosanitary Research Institute of Granada(Ibs.Granada) Granada 18012Spain CIBERFES Instituto de Salud CarlosⅢMadrid 28029Spain Endocrinology and Nutrition Service University Hospital San CecilioGranada 18016Spain Nuclear Medicine Service "Virgen de las Nieves"University HospitalGranada 18014Spain

purpose:The present work examines the associations of dietary habits,sedentarism,physical activity(pA)levels and sleep habits,with thyroid function in young euthyroid ***:A total of 105 young euthyroid adults participated in this cross-sectional *** function was determined in fasting conditions(>6 h).Dietary habits were measured by a food frequency questionnaire and three non-consecutive 24 h recalls,and different dietary intake and patterns were then *** time spent in sedentary,pA levels and sleep habits were objectively measured using a wrist-worn ***:Energy and carbohydrate intake were positively associated with thyroid stimulating hormone(TSH)(β=0.222;R^(2)=0.102;p=0.022 andβ=0.425;R^(2)=0.129;p=0.007,respectively)whereas fat intake was negatively associated with TSH(β=-0.428;R^(2)=0.137;p=0.004).Energy intake was also positively associated with free triiodothyronine(β=0.277;R^(2)=0.137;p=0.004).Further,adherence to the Mediterranean diet was negatively related to TSH and free thyroxine(FT4)(β=-0.221;R^(2)=0.113;p=0.020 andβ=-0.268;R^(2)=0.071;p=0.007,respectively).Vigorous-intensity and overall pA were negatively associated with FT4(β=-0.227;R^(2)=0.052;p=0.022 andβ=-0.204;R^(2)=0.042;p=0.041,respectively).In contrast,no associations were found between sleep parameters and thyroid ***:Lifestyle factors such as dietary intake and pA levels seems to be related to thyroid function even in young euthyroid adults.

关键词： Thyroid hormones Dietary intake Sleep physical activity Euthyroid

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Cost of postoperative complications:How to avoid calculation errors

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World Journal of Gastroenterology 2020年第21期26卷 2682-2690页

作者： roberto de la p.aza llamas JoséM Ramia department of General and Digestive Surgery Hospital Universitario de GuadalajaraGuadalajara 19002Spain

postoperative complications(pC)are a basic health outcome,but no surgery service in the world records and/or audits the pC associated with all the surgical procedures it *** studies that have assessed the cost of pC suffer from poor quality and a lack of transparency and *** payment system in place often rewards the volume of services provided rather than the quality of patients’clinical *** a thorough registration of pC,the economic costs involved cannot be *** accurate,reliable appraisal would help identify areas for investment in order to reduce the incidence of pC,improve surgical results,and bring down the economic *** article describes how to quantify and classify pC using the Clavien-Dindo classification and the comprehensive complication index,discusses the perspectives from which economic evaluations are performed and the minimum postoperative follow-up established,and makes various *** availability of accurate and impartially audited data on pC will help reduce their incidence and bring down ***,the health authorities,and society as a whole are sure to benefit.

关键词： Morbidity postoperative complications Costs and cost analysis Economic evaluation Healthcare costs Opportunity cost Clavien-Dindo classification Comprehensive complication index

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postoperative complications in gastrointestinal surgery: A “hidden” basic quality indicator

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World Journal of Gastroenterology 2019年第23期25卷 2833-2838页

作者： roberto de la p.aza llamas JoséM Ramia department of General and Digestive Surgery Hospital Universitario de GuadalajaraGuadalajara 19002Spain

postoperative complications represent a basic quality indicator for measuring outcomes at surgical units. At present, however, they are not systematically measured in all surgical procedures. A more accurate assessment of their impact could help to evaluate the real morbidity associated with different surgical interventions, establish measures for improvement, increase efficiency and identify benchmarking services. The Clavien-Dindo Classification is the most widely used system worldwide for assessing postoperative ***, the postoperative period is summarized by the most serious complication without taking into account others of lesser magnitude. Recently,two new scoring systems have emerged, the Comprehensive Complication Index and the Complication Severity Score, which include all postoperative complications and quantify them from 0(no complications) to 100(patient’s death), These allow the comparison of results. It is important to train surgical staff to report and classify complications and to record 90-d morbidity rates in all patients. Comparisons with other services must take into account patient comorbidities and the complexity of the particular surgical procedure. To avoid subjectivity and bias, external audits are necessary. In addition, ensuring transparency in the reporting of the results is an urgent obligation.

关键词： Morbidity postoperative complications Health policy Comprehensive Complication Index Clavien-Dindo Classification Complication Severity Score

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laparoscopic gastrojejunostomy for gastric outlet obstruction in patients with unresectable hepatopancreatobiliary cancers: A personal series and systematic review of the literature

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World Journal of Gastroenterology 2018年第18期24卷 1978-1988页

作者： Alba Manuel-Vázquez Raquel latorre-Fragua Carmen Ramiro-pérez Aylhin López-Marcano roberto de la p.aza-llamas José Manuel Ramia department of General and Digestive Surgery University Hospital of Guadalajara

The major symptoms of advanced hepatopancreaticbiliary cancer are biliary obstruction, pain and gastric outlet obstruction(GOO). For obstructive jaundice, surgical treatment should de consider in recurrent stent complications. The role of surgery for pain relief is marginal nowadays. On the last, there is no consensus for treatment of malignant GOO. Endoscopic duodenal stents are associated with shorter length of stay and faster relief to oral intake with more recurrent symptoms. Surgical gastrojejunostomy shows better long-term results and lower re-intervention rates, but there are limited data about laparoscopic approach. We performed a systematic review of the literature, according pRISMA guidelines, to search for articles on laparoscopic gastrojejunostomy for malignant GOO treatment. We also report our personal series, from 2009 to 2017. A review of the literature suggests that there is no standardized surgical technique either standardized outcomes to report. Most of the studies are case series, so level of evidence is low. decisionmaking must consider medical condition, nutritional status, quality of life and life expectancy. Evaluation ofthe patient and multidisciplinary expertise are required to select appropriate approach. Given the limited studies and the difficulty to perform prospective controlled trials, no study can answer all the complexities of malignant GOO and more outcome data is needed.

关键词： Duodenal obstruction Gastrojejunostomy Gastroenterosmy Gastric outlet obstruction Gastric bypass laparoscopy laparoscopic surgery Sytematic review

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Ninety-day readmissions after inpatient cholecystectomy: A 5-year analysis

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World Journal of Gastroenterology 2017年第16期23卷 2972-2977页

作者： Alba Manuel-Vázquez Raquel latorre-Fragua Carmen Ramiro-pérez Aylhin López-Marcano Farah Al-Shwely roberto de la p.aza-llamas JoséManuel Ramia department of General and Digestive Surgery University Hospital of Guadalajara19002 GuadalajaraSpain

AIM To determine the incidence of readmission after cholecystectomy using 90 d as a time limit. METHODS We retrospectively reviewed all patients undergoing cholecystectomy at the General Surgery and Digestive System Service of the University Hospital of Guadalajara, Spain. We included all patients undergoing cholecystectomy for biliary pathology who were readmitted to hospital within 90 d. We considered readmission to any hospital service as cholecystectomyrelated complications. We excluded ambulatory cholecystectomy, cholecystectomy combined with other procedures, oncologic disease active at the time of cholecystectomy, finding of malignancy in the resection specimen, and scheduled re-admissions for other unrelated pathologies. RESULTS We analyzed 1423 patients. There were 71 readmissions in the 90 d after discharge, with a readmission rate of4.99%. Sixty-four point seven nine percent occurred after elective surgery(cholelithiasis or vesicular polyps) and 35.21% after emergency surgery(acute cholecystitis or acute pancreatitis). Surgical non-biliary causes were the most frequent reasons for readmission, representing 46.48%; among them, intra-abdominal abscesses were the most common. In second place were non-surgical reasons, at 29.58%, and finally, surgical biliary reasons, at 23.94%. Regarding time for readmission, almost 50% of patients were readmitted in the first week and most second readmissions occurred during the second month. Redefining the readmissions rate to 90 d resulted in an increase in re-hospitalization, from 3.51% at 30 d to 4.99% at 90 d. CONCLUSION The use of 30-d cutoff point may underestimate the incidence of complications. The current tendency is to use 90 d as a limit to measure complications associated with any surgical procedure.

关键词： Cholecystectomy 90-d Hospital readmission Readmission rate Cholelithiasis

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post-Traumatic Stress Disorder among defence and Security Forces in Northern Benin (2023)

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Open Journal of psychiatry 2024年第2期14卷 142-161页

作者： Ireti Nethania Elie Ataigba Guy Gérard aza Gnandji David Sinet Koivogui Dalmace Fauste Adjaho Eurydice Elvire Djossou Anselme Djidonou Francis Tognon Tchegnonsi prosper Gandaho Josiane Ezin Houngbe Faculté de Médecine & Institut de Formation en Soins Infirmiers et Obstétricaux Université de Parakou Parakou Bénin Service de psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori Parakou Bénin Organisation Non Gouvernementale de Soutien Réhabilitation Insertion et Réinsertion (SouRIR ONG) Parakou Bénin Faculté des Sciences de la Santé Université d’Abomey-Calavi Cotonou Bénin Centre Nationale Hospitalier Universitaire Hubert Koutoucou Maga de Cotonou Cotonou Bénin Faculté des Sciences et Techniques de Santé Université Gamal Abdel Nasser de Conakry Conakry Guinée

Introduction: post-traumatic stress disorder (pTSD) is defined as “actual exposure to death or the threat of death, serious injury or sexual violence”, either directly or indirectly, resulting in a symptomatic procession of repetition, avoidance, neurovegetative hyperactivity and individualized symptoms, with or without negative cognitive and mood changes. It therefore goes without saying that the defence and security forces constitute a high-risk population in need of attention. Objective: To study post-traumatic stress disorder in defence and security forces in the city of parakou in 2023. Methods: descriptive cross-sectional study conducted from december 2022 to July 2023. The study population consisted of active military, republican police and firefighters in the city of parakou in 2023. Non-proportional stratified sampling was used, given the inaccessibility of the source population size for national security reasons. post-traumatic stress disorder was assessed using the “post-traumatic stress disorder checklist-5 (pCLS-5) scale. Results: A total of 305 subjects participated in the survey. Males dominated 90.2%. The most represented corps was the Republican police (41.6%), most of whom were non-commissioned officers (46.6%). The majority count between 11 and 20 years of service (48.9%), with 2 to 5 missions completed (67.5%). The calculated prevalence of post-traumatic stress disorder was 11.8%, based on the post-traumatic stress disorder checklist-5 (pCL-5). Of the 36 respondents with post-traumatic stress disorder, 20 (55.6%) had experienced an armed attack, 25 (69.4%) had witnessed a violent death, 18 (50.0%) had witnessed the agony of a colleague, 15 (41.7%) had been exposed to a fire or explosion, while 26 (72.2%) had been traumatized by physical and/or verbal aggression. 5 (13.9%) had consulted a specialist psychiatrist, while 6 (16.7%) were on medication and 26 (72.2%) used sport as a means of maintaining physical and mental health. Respectively 22 (61.1

关键词： post-Traumatic Stress Disorder Forces defence Security Benin 2023

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Eating Disorders among Students in Northern Benin (2023)

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Open Journal of psychiatry 2024年第1期14卷 11-28页

作者： Ireti Nethania Elie Ataigba Guy Gérard aza-Gnandji David Sinet Koïvogui Wifrieda Aguidissou Eurydice Elvire Djossou Anselme Djidonou Francis Tognon Tchegnonsi prosper Gandaho Josiane Ezin Houngbe Institut de Formation en Soins Infirmiers et Obstétricaux Faculté de Médecine Université de Parakou Parakou Bénin Service de psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori Parakou Bénin Organisation Non Gouvernementale de Soutien Réhabilitation Insertion et Réinsertion (SouRIR ONG) Parakou Bénin Faculté des Sciences de la Santé Université d’Abomey-Calavi Cotonou Bénin Service de psychiatrie Centre National Hospitalier Universitaire Hubert Koutoucou Maga de Cotonou Cotonou Bénin Faculty of Health Sciences and Techniques Université Gamal Abdel Nasser de Conakry Conakry Guinée

Introduction: From their earliest hours, human beings are able to identify a source of food and to feed themselves. Feeding is therefore one of the most instinctive human functions. It is regulated by several factors (physiological, psycho-affective and environmental) whose disruption can lead to eating disorders. Objective: The aim of this study was to investigate eating disorders among students in the town of parakou in 2023. Method: descriptive cross-sectional study conducted from January to July 2023 in various universities in the city of parakou, Benin. The study population consisted of all students in grades 1 to 7 at these universities. A two-stage non-proportional stratified sampling technique combined with a simple random draw was adopted. The Eating Attitude Test-26, Bulimia Inventory Test Edinburgh and a set of questions focusing on the diagnostic criteria for pica were used to screen for pica and other disorders such as anorexia, bulimia nervosa and binge eating disorder. Data were analyzed using SpSS (Statistical package for Social Sciences) version 25. Results: A total of 607 students were surveyed, 323 of whom had eating disorders. A prevalence of 53.21% of students at risk of eating disorders was found. In relation to the total population, the prevalences of anorexia, bulimia nervosa, binge eating disorder and pica were 45.96%, 0.82%, 15.48% and 12.68% respectively. In multivariate analysis, seven factors explained the risk to develop at least one eating disorder among the students surveyed. These were: urban area of residence (OR (95% CI) = 5.059 (1.75 - 14.65);p = 0.003);year of study (OR (95% CI) = 0.47 (0.28 - 0.79);p = 0.035);type of university attended (private university: OR (95% CI) = 1.63 (1.08 - 2.44);p = 0.019);parents’ marital status (couple or not) (OR (95% CI) = 1.50 (1.01 - 2.24);p = 0.046);father’s level of education: secondary (OR (CI 95%) = 3.85 (1.96 - 7.54);p 0.001)/higher (OR (CI 95%) = 2.83 (1.36 - 5.86);p = 0.005);mother’s one:

关键词： Eating Disorders Benin 2023

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Maternal Burnout: prevalence and Associated Factors in Northern Benin (2023)

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Open Journal of psychiatry 2024年第1期14卷 29-44页

作者： Ireti Nethania Elie Ataigba Guy Gérard aza Gnandji David Sinet Koivogui Owèrè Charlotte Dagan Coovi Ignace Tokpanoude Kwamé Abdias Adoufou Anselme Djidonou Francis Tognon Tchegnonsi prosper Gandaho Institut de Formation en Soins Infirmiers et Obstétricaux Faculté de Médecine Université de Parakou Parakou Bénin Service de psychiatrie Centre Hospitalier Universitaire Départemental du Borgou Alibori Parakou Bénin Organisation Non Gouvernementale de Soutien Réhabilitation Insertion et Réinsertion (SouRIR ONG) Parakou Bénin Faculté des Sciences de la Santé Université d’Abomey-Calavi Cotonou Bénin Service de psychiatrie Centre National Hospitalier Universitaire Hubert Koutoucou Maga de Cotonou Cotonou Bénin Faculté des Sciences et Techniques de la Santé Université Gamal Abdel Nasser de Conakry Conakry Guinée

Introduction: Also known as maternal burnout syndrome, maternal burnout is a state of physical, emotional and mental exhaustion generated by prolonged stress in the family environment. It is experienced by women in their role as mothers. Those affected can develop psychological disorders, sleep disturbances, etc., all of which impair their day-to-day lives, and thus their maternal role. The repercussions affect both the child and other family members. Objective: The aim of the present study was to investigate maternal burnout among female users of public and private health facilities in the commune of parakou in 2023. Methods: descriptive cross-sectional study was conducted from december 2022 to July 2023 among all mothers using public and private health facilities in the commune of parakou. All healthy mothers with at least one biological or adoptive child fully dependent on them and living at home, who came for a consultation in one of the health facilities or for an appointment at the Expanded program on Immunization (EpI) and gave their free and informed consent. Sampling was done for non-exhaustive convenience were included in the study. Burnout was assessed using the parental Burnout Assessment (pBA) scale. Results: A total of 888 mothers meeting the inclusion criteria were surveyed. The prevalence of burnout calculated using the parental Burnout Assessment (pBA) scale was 6.19%. The risk factors for maternal burnout were poor relationships with family and friends (OR = 8.90;p = 0.045), moderate (OR = 11.71;p = 0.020) and severe depression (OR = 40.85;p = 0.001), followed by the presence of repeated nocturnal awakening (OR = 5.14;p = 0.014). Conclusion: This is a subject that is almost never discussed in African society, but whose reality is revealed by the present study, which provided statistical data on maternal burnout. From now on, the risk of burnout will no longer be discussed solely in the family context. It will also need to be explored within the fam

关键词： Burnout Maternal Benin 2023

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Kinetics and thermodynamic studies of Methyl Orange removal by polyvinylidene fluoride-pEDOT mats

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Journal of Environmental Sciences 2021年第2期33卷 62-73页

作者： Romario J.da Silva Lizeth Carolina Mojica-Sanchez Filipe D.S.Gorza Graciela C.pedro Bruna G.Maciel Gabriela p.Ratkovski Herica D.daRocha Kamila T.O.do Nascimento Juan CMedina-llamas Alicia E.Chavez-Guajardo Jose J.Alcaraz-Espinoza Celso p.de Melo program a de pos-Graduagao em Ciencia de Materials U niversidade Federal de Pernambuco50670-901 RecifePEBrazil departamento de Ffsica Uniuersidade Federal de Pemambiico50670-901 Reci/ePEBrazil Centro de Estudios Cientificosy Tecnologicos No.18 Instituto Politecnico Nacional98160 ZacatecasZacMexico Unidad Academica de Ciencias de la Tierra Uniuersidad Aut6noma de Zacatecas98058 ZacatecasZacMexico departamento de Quimica Universidad Autonoma Metropolitana09340Ciudad de MexicoMexico

We report the preparation of poly(3,4-ethylene dioxythiophene)(pEDOT)-modified polyvinylidene fluoride electrospun fibers and their use as a novel adsorbent material for the removal of the anionic dye Methyl Orange(MO)from aqueous *** novel adsorbent material can be used to selectively remove MO on a wide p H range(3.0-10.0),with a maximum capacity of 143.8 mg/g at p H *** used in a recirculating filtration system,the maximum absorption capacity was reached in a shorter time(20 min)than that observed for batch mode experiments(360 min).Based on the analyses of the kinetics and adsorption isotherm data,one can conclude that the predominant mechanism of interaction between the membrane and the dissolved dye molecules is ***,considering the estimated values for the Gibbs energy,and entropy and enthalpy changes,it was established that the adsorption process is spontaneous and occurs in an endothermic *** good mechanical and environmental stability of these membranes allowed their use in at least 20 consecutive adsorption/desorption cycles,without significant loss of their *** suggest that the physical-chemical characteristics of pEDOT make these hybrid mats a promising adsorbent material for use in water remediation protocols and effluent treatment systems.

关键词： Electrospinning Composite mats pedot pvdf mats Dye removal Water remediation

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