53 research outputs found

    The Cholecystectomy As A Day Case (CAAD) Score: A Validated Score of Preoperative Predictors of Successful Day-Case Cholecystectomy Using the CholeS Data Set

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    Background Day-case surgery is associated with significant patient and cost benefits. However, only 43% of cholecystectomy patients are discharged home the same day. One hypothesis is day-case cholecystectomy rates, defined as patients discharged the same day as their operation, may be improved by better assessment of patients using standard preoperative variables. Methods Data were extracted from a prospectively collected data set of cholecystectomy patients from 166 UK and Irish hospitals (CholeS). Cholecystectomies performed as elective procedures were divided into main (75%) and validation (25%) data sets. Preoperative predictors were identified, and a risk score of failed day case was devised using multivariate logistic regression. Receiver operating curve analysis was used to validate the score in the validation data set. Results Of the 7426 elective cholecystectomies performed, 49% of these were discharged home the same day. Same-day discharge following cholecystectomy was less likely with older patients (OR 0.18, 95% CI 0.15–0.23), higher ASA scores (OR 0.19, 95% CI 0.15–0.23), complicated cholelithiasis (OR 0.38, 95% CI 0.31 to 0.48), male gender (OR 0.66, 95% CI 0.58–0.74), previous acute gallstone-related admissions (OR 0.54, 95% CI 0.48–0.60) and preoperative endoscopic intervention (OR 0.40, 95% CI 0.34–0.47). The CAAD score was developed using these variables. When applied to the validation subgroup, a CAAD score of ≤5 was associated with 80.8% successful day-case cholecystectomy compared with 19.2% associated with a CAAD score >5 (p < 0.001). Conclusions The CAAD score which utilises data readily available from clinic letters and electronic sources can predict same-day discharges following cholecystectomy

    Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

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    A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1�70.8) million) to 6.4 (58.3 (47.6�70.7) million), but is predicted to remain above the World Health Organization�s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8�38.5) million) in 2000 to 6.0 (55.5 (44.8�67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)

    Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

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    An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

    Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

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    An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

    Synthesis, kinetics and mechanism of nucleophilic substitution in octahedral (cat)2Sn(py)2

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    Synthesis and characterization of heterobimetallic complexes of the type [Cu(pn)2][MCl4] where M = Co(II), Ni(II), Cu(II), Zn(II), Cd(II), and Hg(II)

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    A series of new bimetallic transition metal complexes of the type [Cu(pn)2] [MCl4] have been synthesized (where M = Co(II), Ni(II), Cu(II), Zn(II), Cd(II) and Hg(II), pn = 1,3-diaminopropane) and characterized by elemental analysis, molar conductance, TGA, IR and electronic spectra. All the compounds are 1:1 electrolyte in DMF. The Cu(II) ion is square-planar while metal ions in the anionic moiety acquire their usual tetrahedral arrangement. On the basis of these studies it is concluded that anionic moiety is electrically stabilized by its cationic counterpart

    Conformational isomers of dichloro bis(1,3-diaminopropane) copper(II): Synthesis, characterization and DFT modeling

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    AbstractThree isomers of [Cu(pn)2Cl2] in solid state have been synthesized, isolated and characterized by elemental analysis, molar conductance, FTIR, TGA, EPR, electronic spectra and DFT calculation. The molar conductance of 1mM solution of the complexes measured in DMSO falls in 40–44Scm2mol−1. All the isomers in aqueous medium show similar absorption pattern in the UV–visible region of the spectra. They are nearly identical in solution although in the solid state they exist in three distinct colors. The change in the color of complexes is due to change in conformations of the propanediamine molecule. Cu(II) in [Cu(pn)2Cl2] lies on an inversion center. It is octahedrally coordinated to four nitrogen of 1,3-diaminopropane (pn) and two chloride ions displaying three different spatial conformations namely chair–chair, chair–boat and boat–boat. The TGA of the complexes suggest that Cu is left as final residue at 600°C. The entire data have been supported by DFT calculation
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