检索结果-南通市图书馆

Cost burden following esophagectomy:A single centre observational study

World Journal of Gastrointestinal Surgery 2024年第7期16卷 2255-2269页

作者： Vered Buchholz Dong Kyu Lee David S Liu Ahmad Aly Stephen A Barnett Riley Hazard Peter Le Benjamin Kioussis vijayaragavan muralidharan Laurence Weinberg Department of Surgery Austin HealthMelbourne 3084VictoriaAustralia Department of Anesthesiology and Pain Medicine Dongguk University Ilsan HospitalSeoul 14566GoyangSouth Korea Department of Surgery Austin HealthThe University of MelbourneMelbourne 3084VictoriaAustralia Department of Anesthesia Austin HealthMelbourne 3084VictoriaAustralia Department of Anesthesia Austin HospitalHeidelberg 3084VictoriaAustralia Department of Critical Care The University of MelbourneMelbourne 3084VictoriaAustralia

BACKGROUND Cost analyses of patients undergoing esophagectomy is valuable for identifying modifiable expenditure drivers to target and curtail costs while improving the quality of *** aimed to define the cost-complication relationship after esophagectomy and delineate the incremental contributions to *** To assess the relationship between the hospital costs and potential cost drivers post esophagectomy and investigate the relationship between the cost-driving variables(predicting variables)and hospital costs(dependent variable).METHODS In this retrospective single center study,the severity of complications was graded using the Clavien-Dindo(CD)classification *** esophagectomy complications were categorized and defined according to consensus *** costing data included the in-hospital costs of the index admission and any unplanned admission within 30 postoperative *** used correlation analysis to assess the relationship between key clinical variables and hospital costs(in United States dollars)to identify cost drivers.A mediation model was used to investigate the relationship between these variables and hospital *** A total of 110 patients underwent primary esophageal *** median admission cost was $47822.7(interquartile range:35670.2-68214.0).The total effects on costs were $13593.9(95%CI:10187.1-17000.8,P<0.001)for each increase in CD severity grade,$4781(95%CI:3772.7-5789.3,P<0.001)for each increase in the number of complications,and $42552.2(95%CI:8309-76795.4,P=0.015)if a key esophagectomy complication *** esophagectomy complications drove the costs directly by $11415.7(95%CI:992.5-21838.9,P=0.032).CONCLUSION The severity and number of complications,and the development of key esophagectomy complications significantly contributed to total hospital *** institutional initiatives and strategies are needed to enhance patient outcomes and minimize costs.

关键词： Anesthesia Esophagectomy Complications Cancer Surgery

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Statin, aspirin and metformin use and risk of hepatocellular carcinoma related outcomes following liver transplantation: A retrospective study

引用

World Journal of Transplantation 2024年第3期14卷 120-131页

作者： William Chung Kevin Wong Noel Ravindranayagam Lauren Tang Josephine Grace Darren Wong Danny Con Marie Sinclair Avik Majumdar Numan Kutaiba Samuel Hui Paul Gow vijayaragavan muralidharan Alexander Dobrovic Adam Testro Department of Gastroenterology Austin HealthHeidelberg 3084VictoriaAustralia Victorian Liver Transplant Unit Austin HealthHeidelberg 3084VictoriaAustralia Department of Radiology Austin HealthHeidelberg 3084VictoriaAustralia Department of Gastroenterology Monash HealthClayton 3168VictoriaAustralia Department of Surgery University of MelbourneAustin HealthHeidelberg 3048VictoriaAustralia Department of Surgery Beacon LaboratoryAustin PrecinctThe University of MelbourneAustin HospitalHeidelberg 3048VictoriaAustralia

BACKGROUND Liver transplantation(LT)is a potentially curative therapy for patients with hepatocellular carcinoma(HCC).HCC-recurrence following LT is associated with reduced *** is increasing interest in chemoprophylaxis to improve HCC-related outcomes *** To investigate whether there is any benefit for the use of drugs with proposed chemoprophylactic properties against HCC,and patient outcomes following *** This was a retrospective study of adult patients who received Deceased Donor LT for HCC from 2005-2022,from a single Australian *** use was defined as statin,aspirin or metformin therapy for≥29 days,within 24 months post-LT.A cox proportional-hazards model with time-dependent covariates was used for survival *** measures were the composite-endpoint of HCC-recurrence and all-cause mortality,HCC-recurrence and HCC-related *** analysis was performed to account for immortality time bias and statin *** Three hundred and five patients were included in this study,with 253(82.95%)males with a median age of 58.90 *** of liver disease were 150(49.18%)hepatitis C,73(23.93%)hepatitis B(HBV)and 33(10.82%)non-alcoholic fatty liver disease(NAFLD).56(18.36%)took statins,51(16.72%)aspirin and 50(16.39%)*** a median follow-up time of 59.90 months,34(11.15%)developed HCC-recurrence,48(15.74%)died,17(5.57%)from HCC-related ***,aspirin or metformin use was not associated with statistically significant differences in the composite endpoint of HCC-recurrence or all-cause mortality[hazard ratio(HR):1.16,95%CI:0.58-2.30;HR:1.21,95%CI:0.28-5.27;HR:0.61,95%CI:0.27-1.36],HCC-recurrence(HR:0.52,95%CI:0.20-1.35;HR:0.51,95%CI:0.14-1.93;HR 1.00,95%CI:0.37-2.72),or HCC-related mortality(HR:0.32,95%CI:0.033-3.09;HR:0.71,95%CI:0.14-3.73;HR:1.57,95%CI:0.61-4.04)*** dosing was not associated with statist-ically significant differences in HCC-related ***

关键词： Liver transplantation Hepatocellular carcinoma Transplant oncology Statins HMG-Co-A reductase Aspirin Metformin Mammalian target of rapamycin

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Stereotactic radiotherapy and the potential role of magnetic resonance-guided adaptive techniques for pancreatic cancer

引用

World Journal of Gastroenterology 2022年第7期28卷 745-754页

作者： Tai Ermongkonchai Richard Khor vijayaragavan muralidharan Niall Tebbutt Kelvin Lim Numan Kutaiba Sweet Ping Ng Department of Radiation Oncology Olivia Newton-John Cancer Centre at Austin HealthHeidelberg 3084VictoriaAustralia Department of Surgery Austin HealthHeidelberg 3084VictoriaAustralia Department of Medical Oncology Olivia Newton-John Cancer Centre at Austin HealthHeidelberg 3084VictoriaAustralia Department of Diagnostic Radiology Austin HealthHeidelberg 3084VictoriaAustralia

BACKGROUND Pancreatic cancer is a malignancy with one of the poorest prognoses amongst all *** with unresectable tumours either receive palliative care or undergo various chemoradiotherapy *** techniques are often associated with acute gastrointestinal toxicities,as adjacent critical structures such as the duodenum ultimately limits delivered *** body radiotherapy(SBRT)is an advanced radiation technique that delivers highly ablative radiation split into several fractions,with a steep dose fall-off outside target *** To discuss the latest data on SBRT and whether there is a role for magnetic resonance-guided techniques in multimodal management of locally advanced,unresectable pancreatic *** We conducted a search on multiple large databases to collate the latest records on radiotherapy techniques used to treat pancreatic *** of 1229 total records retrieved from our search,36 studies were included in this *** Studies indicate that SBRT is associated with improved clinical efficacy and toxicity profiles compared to conventional radiotherapy *** dose escalation to the tumour with SBRT is limited by the poor soft-tissue visualisation of computed tomography imaging during radiation planning and treatment *** resonance-guided techniques have been introduced to improve imaging quality,enabling treatment plan adaptation and re-optimisation before delivering each *** Therefore,SBRT may lead to improved survival outcomes and safer toxicity profiles compared to conventional techniques,and the addition of magnetic resonance-guided techniques potentially allows dose escalation and conversion of unresectable tumours to operable cases.

关键词： Magnetic resonance imaging Pancreatic cancer Radiotherapy Stereotactic Adaptive techniques

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

From minimal to maximal surgery in the treatment of hepatocarcinoma:A review

引用

World Journal of Hepatology 2015年第1期7卷 93-100页

作者： Marcos Vinicius Perini Graham Starkey Michael A Fink Ramesh Bhandari vijayaragavan muralidharan Robert Jones Christopher Christophi Department of Surgery University of MelbourneHeidelbergVIC 3084Australia

Hepatocellular carcinoma represents one of the most challenging frontiers in liver surgery. Surgeons have to face a broad spectrum of aspects,from the underlying liver disease to the new surgical techniques. Safe liver resection can be performed in patients with portal hypertension and well-compensated liver function witha 5-year survival rate of 50%,offering good longterms results in selected patients. With the advances in laparoscopic surgery,major liver resections can be performed with minimal harm,avoiding the wound and leak complications related to the laparotomies. Studies have shown that oncological margins are the same as in open surgery. In patients submitted to liver resection(either laparoscopic or open) who experience recurrence,re-resection or salvage liver transplantation has been showing to be an alternative approach in well selected cases. The decision making approach to the cirrhotic patient is becoming more complex and should involve hepatologists,liver surgeons,radiologists and oncologists. Better understanding of the different risk factors for recurrence and survival should be aimed in these multidisciplinary discussions. We here in discuss the hot topics related to surgical risk factors regarding the surgical treatment of hepatocellular carcinoma: anatomical resection,margin status,macrovascular tumor invasion,the place of laparoscopy,salvage liver transplantation and liver transplantation.

关键词： Hepatectomy Liver resection Cirrhosis Liver transplantation Hepatocellular carcinoma Survival

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Donor-specific cell-free DNA as a biomarker in liver transplantation:A review

引用

World Journal of Transplantation 2020年第11期10卷 307-319页

作者： Tess McClure Su Kah Goh Daniel Cox vijayaragavan muralidharan Alexander Dobrovic Adam G Testro Liver Transplant Unit Austin HealthHeidelberg 3084VICAustralia Department of Surgery Austin HealthHeidelberg 3084VICAustralia Department of Surgery The University of MelbourneHeidelberg 3084VICAustralia

Due to advances in modern medicine,liver transplantation has revolutionised the prognosis of many previously incurable liver *** progress has largely been due to advances in immunosuppressant ***,despite the judicious use of immunosuppression,many liver transplant recipients still experience complications such as rejection,which necessitates diagnosis via invasive liver *** is a clear need for novel,minimally-invasive tests to optimise immunosuppression and improve patient *** emerging biomarker in this‘‘precision medicine’‘liver transplantation field is that of donorspecific cell free *** this review,we detail the background and methods of detecting this biomarker,examine its utility in liver transplantation and discuss future research directions that may be most impactful.

关键词： Biomarkers Precision medicine Donor-specific cell-free DNA Liver transplantation Rejection Review

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Outcomes of central hepatectomy versus extended hepatectomy

引用

Hepatobiliary & Pancreatic Diseases International 2019年第3期18卷 249-254页

作者： Jenny Chan Luke Bradshaw Nezor Houli Laurence Weinberg Marcos V Perini Michael Fink vijayaragavan muralidharan Graham Starkey Robert Jones Bao Zhong Wang Christopher Christophi Mehrdad Nikfarjam Department of Surgery University of Melbourne Austin Health Heidelberg Melbourne Victoria Australia Department of Surgery University of Melbourne Northern Health Epping Victoria Australia Department of Anaesthesia University of Melbourne Austin Health Heidelberg Melbourne Victoria Australia

Background: Central hepatectomy(CH) is more difficult than extended hepatectomy(EH) and is associated with greater morbidity. In this modern era of liver management with aims to prevent posthepatectomy liver failure(PHLF), there is a need to assess outcomes of CH as a parenchyma-sparing procedure for centrally located liver tumors. Methods: A total of 178 major liver resections performed by specialist surgeons from two Australian tertiary institutions between June 2009 and March 2017 were reviewed. Eleven patients had CH and 24 had EH over this study period. Indications and perioperative outcomes were compared between the groups. Results: The main indication for performing CH was colorectal liver metastases. There was no perioperative mortality in the CH group and four(16.7%) in the EH group( P = 0.285). No group differences were found in median operative time [CH vs. EH: 450 min(290–840) vs. 523 min(310–860), P = 0.328], intraoperative blood loss [850 mL(40 0–150 0) vs. 650 mL(10 0–20 0 0), P = 0.746] or patients requiring intraoperative blood transfusion [1(9.1%) vs. 7(30.4%), P = 0.227]. There was a trend towards fewer hepatectomyspecific complications in the CH group [3(27.3%) vs. 13(54.2%), P = 0.167], including PHLF(CH vs. EH: 0 vs. 29.2%, P = 0.072). Median length of stay was similar between groups [CH vs. EH: 9 days(5–23) vs. 12 days(4–85), P = 0.244]. Conclusions: CH has equivalent postoperative outcomes to EH. There is a trend towards fewer hepatectomy-specific complications, including PHLF. In appropriate patients, CH may be considered as a safe parenchyma-sparing alternative to EH.

关键词： Central hepatectomy Mesohepatectomy Central bisectionectomy Central bisegmentectomy Extended hepatectomy

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Ensemble Based Temporal Weighting and Pareto Ranking (ETP) Model for Effective Root Cause Analysis

引用

Computers, Materials & Continua 2021年第10期69卷 819-830页

作者： Naveen Kumar Seerangan S.vijayaragavan Shanmugam Department of Computer Science(Category-B) Bharathiar UniversityCoimbatore641046Tamil NaduIndia CSE Muthayammal Engineering CollegeRasipuram637408Tamil NaduIndia

Root-cause identification plays a vital role in business decision making by providing effective future directions for the *** extraction and sentiment extraction plays a vital role in identifying the *** paper proposes the Ensemble based temporal weighting and pareto ranking(ETP)model for Root-cause *** extraction is performed based on rules and is followed by opinion identification using the proposed boosted ensemble *** obtained aspects are validated and ranked using the proposed aspect weighing ***-rule based aspect selection is performed as the final selection mechanism and the results are presented for business decision *** were performed with the standard five product benchmark *** on all five product reviews indicate the effective performance of the proposed *** are performed using three standard state-of-the-art models and effectiveness is measured in terms of F-Measure and Detection *** results indicate improved performances exhibited by the proposed model with an increase in F-Measure levels at 1%–15%and detection rates at 4%–24%compared to the state-of-the-art models.

关键词： Root cause analysis sentiment analysis aspect extraction ensemble modelling temporal weighting pareto ranking

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Ceramic bodies with rock processing residues(RPR)for constructing materials

引用

Waste Disposal and Sustainable Energy 2020年第4期2卷 321-327页

作者： R.vijayaragavan S.Mullainathan S.Nithiyanantham Department of Physics Arasu Engineering CollegeKumbakonamTamilnaduIndia Post Graduate and Research Department of Physics Applied Energy Resource DivisionsThiru.Vi.Kalyanasundaram Govt Arts and Science College(Affiliated to Bharathidasan UniversityThiruchirapalli)ThiruvarurTamilnadu 610002India

The rock processing residue(RPR)waste is used for part of the ceramic *** present work deals with the unused waste useful for making ceramic materials and save the area and the dump *** residues are initially analyzed with the chemical and spectroscopic *** residues are mixed with clay of proportions 0-50 wt%in steps of 10%.The prepared specimens are characterized with Fourier transform infrared(FTIR),X ray fluorescence(XRF)for chemical,mechanical,and physiochemical properties,such as density,compressive strength,weight loss on ignition and porous nature,which are measured through the selective *** thermal stability of the product was tested by firing at 950℃.This says the rock residues are useful for making ceramic and related materials with high concentrations.

关键词： Recycling Ceramic product Waste material Rock processing residue Mechanical property

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Groundwater Potential Zoning in Thirumanimuttar Sub-Basin Tamilnadu, India—A GIS and Remote Sensing Approach

引用

Geo-Spatial Information Science 2011年第1期14卷 17-26页

作者： MURUGESAN Vasanthavigar KRISHNARAJ Srinivasamoorthy KANNUSAMY vijayaragavan SELVARAJ Gopinath SUBRAMANYA Sarma Department of Earth Sciences Annamalai UniversityAnnamalai Nagar-608 002Tamil NaduIndia National Geophysical Research Institute(NGRI) Uppal RoadHyderabad-500 007India

The main objective of the study is to identify groundwater potential zones in Thirumanimuttar basin with an integrated approach using Remote Sensing and geographical information system(GIS).FCC Image of Landsat TM 30 m resolution data and topographic maps has been used to generate thematic maps like geology,geomorphology,lineament and lineament density,drain-age,drainage density,and slope map of the study area.A number of geomorphic units such as Denudational hills,structural hills,Bajadas,Colluvial plain,Pediplain,Deep Pediment and Alluvial plains have been observed.A composite groundwater potential map has been generated as very high,high,medium,low and very low based on the groundwater availability *** upper,mid-dle and downstream of the basins have been identified as potential zones for groundwater *** regions of lineaments and intersecting lineaments proved for groundwater potential *** data generated was validated with field checks and ob-served to be in conformity with the same.

关键词： geomorphology groundwater Landsat potential zones remote sensing GIS

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Anterior resection for rectal carcinoma-risk factors for anastomotic leaks and strictures

引用

World Journal of Gastroenterology 2011年第11期17卷 1475-1479页

作者： Ashok Kumar Ram Daga Paari vijayaragavan Anand Prakash Rajneesh Kumar Singh Anu Behari Vinay K Kapoor Rajan Saxena Department of Surgical Gastroenterology Sanjay Gandhi Post Graduate Institute of Medical Sciences Lucknow 226014India

AIM:To determine the incidence and factors responsible for anastomotic leaks and stricture following anterior resection(AR)and its subsequent ***:Retrospective analysis of data from 108 patients with rectal carcinoma who underwent AR or low anterior resection(LAR)to identify the various preoperative,operative,and post operative factors that might have influence on anastomotic leaks and ***:There were 68 males and 40 females with an average of 47 years(range 21-75 years).The median distance of the tumor from the anal verge was 8 cm(range 3-15 cm).Sixty(55.6%)patients underwent handsewn anastomosis and 48(44.4%)were *** median operating time was 3.5 h(range2.0-7.5 h).Sixteen(14.6%)patients had an anastomotic *** these,11 patients required reexploration and five were managed *** anastomotic leak rate was similar in patients with and without diverting stoma(8/60,13.4%with stoma and 8/48;16.7%without stoma).In 15(13.9%)patients,resection margins were positive for ***(17.6%)patients developed anastomotic strictures at a median duration of 8 mo(range 3-20 mo).Among these,15 patients were successfully managed with per-anal *** multivariate analysis,advance age(>60 years)was the only risk factor for anastomotic leak(P=0.004).On the other hand,anastomotic leak(P=0.00),mucin positive tumor(P =0.021),and lower rectal growth(P=0.011)were found as risk factors for the development of an anastomotic ***:Advance age is a risk factor for an anastomotic *** anastomotic leak,a mucin-secreting tumor,and lower rectal growth predispose patients to develop anastomotic strictures.

关键词： Rectal carcinoma Anterior resection Anastomotic leak Stricture

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：