21,802,077 research outputs found
Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection An international audit by ESCP and S-ECCO
Background
Patient and disease-related factors, as well as operation technique all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results.
Aim
To investigate the effect of pre- and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease.
Method
International prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. This study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, re-operation, surgical site infection and length of stay at hospital. Multivariable binary logistic regression analyses were used to produce odds ratios (OR) and 95% confidence intervals (CI).
Results
Three hundred and seventy five resections in 375 patients were included. The median age was 37 and 57.1% were female. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36 95% CI 1.10-4.97)], urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intraoperative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, CI [1.08-1.61]) and those who had urgent/expedited operations (OR 1.21, CI [1.07-1.37]).
Conclusion
Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intraoperative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients
Creating R Packages: A Tutorial
This tutorial gives a practical introduction to creating R packages. We discuss how object oriented programming and S formulas can be used to give R code the usual look and feel, how to start a package from a collection of R functions, and how to test the code once the package has been created. As running example we use functions for standard linear regression analysis which are developed from scratch
John R. Wooden, Stephen R. Covey and Servant Leadership: A Commentary
Ralph Waldo Emerson observed that consistency was the hobgoblin of little minds and that insight well underscores the challenges associated with accurately describing the leadership philosophy (and actions) of anyone - from coaches like John Wooden, leadership gurus like Steve Covey and Peter Drucker, philosophers like Aristotle and Socrates, or you and me. They are not always perfectly consistent, evolving, and even changing as situations and setting shift in both anticipated and unpredictable ways
SAGA SERVICE DISCOVERY US E R S GU I D E F O R C+ + P R O G R A M M E R S
The SAGA Service Discovery API provides a way to find grid services matching particular filter
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