Life-Span Extension Single-Cell Organisms to Man Series: Aging Medicine

In recent years, remarkable discoveries have been made concerning the underlying mechanisms of aging. In Life-Span Extension: Single-Cell Organisms to Man, the editors bring together a range of illuminating perspectives from researchers investigating the aging process in a variety of species. This novel work addresses the aging process in species ranging from yeast to man and, among other subjects, features detailed discussions of the naked mole-rat, an exceptionally long-lived rodent; the relationship between dietary factors/food restriction and aging; and an evolutionary view of the human aging process. Single mutations that extend life span have been identified in yeast, worms, flies, and mice, whereas studies in humans have identified potentially important markers for successful aging. At the same time, it has been discovered that the genes and pathways identified in these studies involve a surprisingly small set of conserved functions, most of which have been the focus of aging research for some time. For example, the mTOR pathway, a regulator of translation and protein synthesis, has been identified as a common longevity pathway in yeast and Caenorhabditis elegans. In mammals, this pathway intersects with neuroendocrine pathways and with the insulin/insulin-like growth factor pathways, which have been identified as major modulators of life span and aging in both invertebrates and mice. Novel, emerging technologies and the increasingly wide variety of systems that are now used to study aging and the mechanisms of aging provide enormous opportunities for the identification of common pathways that modulate longevity. It is these common pathways that are the focus of this important volume. Written for: Gerontologists, geriatricians, pathologists Table of contents Reprogramming Cell Survival and Longevity: The role of Tor, Sch9, Ras, and Sir2.- Common Aging Mechanisms: Energy Metabolism and Longevity in Caenorhabditis elegans.- Conserved Mechanisms of Life-Span Regulation and Extension in Caenorhabditis elegans.- Drosophila melanogaster.- Overview of the Genetic Architecture of Longevity.- Mild Stress and Life Extension in Drosophila melanogaster.- Rodents.- Global Food Restriction.- Growth Hormone and Aging in Mice.- Comparative Biology of Aging.- Exploiting Natural Variation in Life Span To Evaluate Mechanisms of Aging.- Slow aging: Insights from An Exceptionally Long-Lived Rodent, the Naked Mole-Rat.- Life Extension in the Short-lived Fish Nothobranchius furzeri.- Aging in Humans.- Aging and Longevity in Animal Models and Humans.- Human aging and longevity within an evolutionary perspective

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients

Safety of hospital discharge before return of bowel function after elective colorectal surgery

Background: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien\u2013Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9\ub72 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4\u20137) and 7 (6\u20138) days respectively (P &lt; 0\ub7001). There were no significant differences in rates of readmission between these groups (6\ub76 versus 8\ub70 per cent; P = 0\ub7499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0\ub790, 95 per cent c.i. 0\ub755 to 1\ub746; P = 0\ub7659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34\ub77 versus 39\ub75 per cent; major 3\ub73 versus 3\ub74 per cent; P = 0\ub7110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients