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Rural implementation of the perioperative surgical home:A case-control study

World Journal of Orthopedics 2023年第3期14卷 123-135页

作者： srinivasan sridhar Amy Mouat-Hunter Bernadette McCrory Center for Health Outcomes and Policy Evaluation College of Public HealthThe Ohio State UniversityColumbusOH 43210United States Preanesthesia Clinic Bozeman HealthBozemanMT 59715United States Mechanical and Industrial Engineering Montana State UniversityBozemanMT 59715United States

BACKGROUND Perioperative surgical home(PSH)is a novel patient-centric surgical system developed by American Society of Anesthesiologist to improve outcomes and patient *** has proven success in large urban health centers by reducing surgery cancellation,operating room time,length of stay(LOS),and readmission ***,only limited studies have assessed the impact of PSH on surgical outcomes in rural *** To evaluate the newly implemented PSH system at a community hospital by comparing the surgical outcomes using a longitudinal case-control *** The research study was conducted at an 83-bed,licensed level-III trauma rural community hospital.A total of 3096 TJR procedures were collected retrospectively between January 2016 and December 2021 and were categorized as PSH and non-PSH cohorts(n=2305).To evaluate the importance of PSH in the rural surgical system,a case-control study was performed to compare TJR surgical outcomes(LOS,discharge disposition,and 90-d readmission)of the PSH cohort against two control cohorts[Control-1 PSH(C1-PSH)(n=1413)and Control-2 PSH(C2-PSH)(n=892)].Statistical tests including Chi-square test or Fischer’s exact test were performed for categorical variables and Mann-Whitney test or Student’s t-test were performed for continuous *** general linear models(Poisson regression and binomial logistic regression)were performed to fit adjusted *** The LOS was significantly shorter in PSH cohort compared to two control cohorts(median PSH=34 h,C1-PSH=53 h,C2-PSH=35 h)(P value<0.05).Similarly,the PSH cohort had lower percentages of discharges to other facilities(PSH=3.5%,C1-PSH=15.5%,C2-PSH=6.7%)(P value<0.05).There was no statistical difference observed in 90-d readmission between control and PSH ***,the PSH implementation reduced the 90-d readmission percentage(PSH=4.7%,C1-PSH=6.1%,C2-PSH=3.6%)lower than the national average 30-d readmission percentage which is 5.5%.The PSH system was effecti

关键词： Perioperative surgical home Rural medicine Case-control study Total joint replacements Health equity

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Impact of poly chlorinated biphenyl (Aroclor 1254) and vitamin C on antioxidant system of rat ventral prostate

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Asian Journal of Andrology 2004年第1期6卷 19-22页

作者： M. sridhar P. Venkataraman S. Dhanammal A. Arunkumar M.M. Aruldhas N. srinivasan J. Arunakaran Department of Endocrinology Dr. ALM Post Graduate Institute of Basic Medical Sciences University of MadrasTaramani Chennai 600 113 India

Aim: To evaluate the effect of polychlorinated biphenyls (PCB) and vitamin C on ventral prostatic antioxidant system in adult male rats. Methods: A group of 20 adult male rats were administered ip Aroclor 1254 in corn oil at a dose of 2 mg·kg-1·day-1 for 30 days. Ten control rats were administered only the vehicle. After 30 days the treated rats were divided at random into 2 sub-groups of 10 animals each. One sub-group received vitamin C at a dose of 500 mg·kg-1·day-1 for 10 days. The other group was maintained as Aroclor 1254 control. Twenty-four hours after the last treatment the rats were killed by decapitation. Ventral prostatic homogenate was prepared and used for the estimation of enzymatic antioxidants, including superoxide dismutase (SOD), catalase (CAT) and glutathione-S-transferase (GST) and hydrogen peroxide (H2O2), lipid peroxidation (LPO) and prostatic acid phosphatase. The serum levels of total T3, total T4, TSH, testosterone and estradiol were also assayed. Results: The body weight and ventral prostatic weight were reduced in PCB treated rats. The activities of SOD, CAT, GST and acid phosphatase were decreased while the levels of H2O2 and lipid peroxidation were increased in the ventral prostate of PCB treated rats. Administration of vitamin C restored these parameters. Serum levels of thyroid hormones, estradiol and testosterone were decreased in PCB treated animals. Administration of vitamin C restored the thyroid hormone levels. Conclusion: PCB induces oxidative stress and decreases the antioxidant enzymes in the ventral prostate of adult male rats; the effects could be reversed by the administration of vitamin C.

关键词： polychlorinated biphenyls Aroclor 1254 ventral prostate antioxidants lipid peroxidation thyroid hormone vitamin C

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