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1.
PLoS One ; 19(7): e0304383, 2024.
Article in English | MEDLINE | ID: mdl-38985742

ABSTRACT

Pre-existing studies suggest that legislators in small districts tend to be more responsive to the electorate than those in large districts, as accountability is typically clearer in a smaller setting. However, it is not clear whether the relationship between district size and legislators' constituency-oriented spending holds in other electoral settings (e.g., South Korea), where pork barrel benefits tend to be determined at the administrative unit, not the electoral district. The present study hypothesizes that as the number of legislators in an administrative unit increases, they are less likely to try to appeal to the voters. Additionally, this study examines the moderating effects of partisan homogeneity and legislators' seniority. The results from the statistical analysis of data from Korean National Assembly members confirm our hypothesis: the number of legislators in an administrative unit turns out to be negatively associated with their vote-seeking behavior. Such a relationship tends to be strong in administrative units co-represented by multiple parties and weak among newly elected legislators.

2.
PLoS One ; 18(11): e0291336, 2023.
Article in English | MEDLINE | ID: mdl-37917719

ABSTRACT

This paper examines the relationship between ideological polarization and party disloyalty, focusing on the moderating role of the status of a political party in the legislature, i.e., the ruling party or the opposition party. It hypothesizes that the ruling party is willing to endorse disloyal candidates whose issue positions are not close to their own party's platform, whereas the opposition party is likely to punish disloyal candidates to demonstrate party unity in the nomination process. The present study tests this hypothesis, using data from South Korea, where the nomination process for the parliamentary election is dominated by party leaders. The results are by and large consistent with the hypotheses. In line with previous studies, our results suggest that party loyalty is one of the driving forces of polarization in politics. In order to fully understand party polarization at the level of political elites, it is necessary to consider heterogeneous effects of party members' behavior on candidate selection, varying across the party's status, either the ruling party or the opposition party.


Subject(s)
Dissent and Disputes , Politics , Republic of Korea , Government Agencies
3.
Public Health ; 222: 178-185, 2023 Sep.
Article in English | MEDLINE | ID: mdl-37556978

ABSTRACT

OBJECTIVES: Art engagement, which includes individual art activities and museum and gallery visits, potentially contributes to improving psychological well-being. However, there is insufficient evidence of its effects on the older population, and few reports are from Asia, including Japan. This study examined the association between art engagement and psychological well-being among older adults in Japan. STUDY DESIGN: An observational cross-sectional study design was used. METHODS: Community-dwelling older adults aged ≥60 years were recruited from the visitors to public facilities (including community centres, sports centres and cultural centres) in Aichi, Japan, in 2022, and completed questionnaires. The psychological well-being assessment included five domains according to Seligman's PERMA framework: Positive emotion, Engagement, Relationship, Meaning and Accomplishment. Regarding art engagement, the frequencies of active art engagement (e.g. activities by individuals and participation in groups, such as music and painting) and receptive art engagement (e.g. visiting museums, galleries and the theatres) were assessed. RESULTS: A total of 522 participants were included in the analysis (mean age = 74.1 years; 78.0% females). Results from the multivariable linear regression analysis, which adjusted for demographic and socio-economic factors, revealed that higher frequencies of active art engagement were significantly associated with higher scores in all five PERMA domain scores. Higher frequencies of receptive art engagement were significantly associated with higher levels of Positive emotion, Engagement and Meaning domain scores, but were only marginally associated with the Accomplishment domain and were not associated with the Relationships domain. CONCLUSIONS: This study indicates that art engagement has the potential to enhance psychological well-being among older adults. National and local government strategies to increase accessibility to art and cultural activities for older adults are recommended.


Subject(s)
Art , Psychological Well-Being , Female , Humans , Aged , Male , Cross-Sectional Studies , Independent Living , Japan
4.
Virol J ; 20(1): 11, 2023 01 18.
Article in English | MEDLINE | ID: mdl-36653807

ABSTRACT

BACKGROUND: Certain types of human papillomavirus (HPV) induce long-lasting infections that cause cervical cancer. This study evaluated the prevalence of HPV infections and the distribution of their genotypes among clinic patients and healthy women in Beijing, China. METHODS: Cervical specimens were collected from 12,100 patients and 1176 subjects who underwent physical examinations at Dongzhimen Hospital, Beijing University of Chinese Medicine, between March 2016 and September 2020. HPV genotyping was performed using commercial kits designed to detect 15 high-risk and 2 low-risk HPV genotypes. RESULTS: There was a higher overall prevalence of HPV among the clinic patients (21.0%) than among the healthy women (11.9%). The most common HPV genotypes among the patients were: HPV-52 (5.4%), HPV-16 (3.4%), HPV-58 (3.2%), HPV-51 (2.6%), HPV-39 (2.0%), HPV-56 (2.0%), and HPV-66 (2.0%). Among the healthy women: HPV-52 (3.0%), HPV-51 (1.8%), HPV-58 (1.6%), HPV-66 (1.5%), HPV-16 (1.2%), HPV-56 (1.2%), and HPV-18 (1.1%). Multiple HPVs were detected in 29.1% of the gynecological outpatients and in 23.6% of the women receiving physical examinations. The most common pairs of HPV types detected were HPV-52 and HPV-16 in the clinic patients, and HPV-52 and HPV-56 in the healthy women. Age-specific HPV positivity and peak prevalence were observed among the individuals in both groups for women aged less than 25 years and those between 61 and 65 years of age. CONCLUSIONS: Our results provide current estimates of HPV prevalence and genotypes in the Beijing region. The epidemiological characteristics observed also provide a reference for the development of cervical cancer screening strategies and selection of HPV vaccine antigen targets for this region. A comparison of these HPV prevalence data with those from other regions suggests that regional vaccines may be an important direction for future research.


Subject(s)
Papillomavirus Infections , Uterine Cervical Neoplasms , Humans , Female , Adult , Human Papillomavirus Viruses , Prevalence , Early Detection of Cancer , Beijing/epidemiology , Papillomaviridae/genetics , Human papillomavirus 16/genetics , Genotype
5.
J Acoust Soc Am ; 145(3): EL243, 2019 Mar.
Article in English | MEDLINE | ID: mdl-31067973

ABSTRACT

In the ocean waveguide, the sediment sound speed has a simple relationship with the group speed of the highest order mode that propagates close to the critical angle. The paper shows that robust estimates of the sound speed are obtained from estimates of the "critical" mode group speed determined from analysis of the energy distribution of the time-warped spectrum of a broadband signal. The method is applied to experimental data collected in the Yellow Sea of China. Estimated sound speeds agreed closely with expected values for clayey slit (1531 m/s) and sandy silt (1593 m/s) sediment at the sites.

6.
Zhonghua Er Ke Za Zhi ; 54(9): 686-91, 2016 Sep.
Article in Chinese | MEDLINE | ID: mdl-27596084

ABSTRACT

OBJECTIVE: To evaluate the clinical efficacy and safety of vancomycin and linezolid for the treatment of gram-positive neonatal bacterial sepsis. METHOD: The data of neonates diagnosed as gram-positive bacterial sepsis in neonatology department of Suzhou Municipal Hospital from June 2009 to December 2015 were retrospectively collected. These neonates were divided into vancomycin group and linezolid group. Propensity score matching (PSM) on baseline variables was used to balance the two groups by identifying a comparable group of neonates who received vancomycin and linezolid therapy. Clinical and microbiologic success rates were compared by chi-square test, and changes of laboratory parameters before and after treatment at the end of treatment were then directly compared by rank-sum test between the matched groups. In vancomycin group, correlation between trough concentration of vancomycin and clinical efficacy were evaluated. RESULT: Totally 108 and 209 cases were respectively selected in vancomycin and linezolid groups; 108 cases with well-matched baseline characteristics were included in matched linezolid group. The clinical success rates of vancomycin vs. linezolid therapy were 86.1%(93/108) and 88.9%(96/108)(P=0.681), and the microbiologic success rates were 91.7%(99/108) and 93.5%(101/108)(P=0.795). The average trough concentration of vancomycin was (12±8) mg/L. The rate of reaching the high trough concentration standard was only 33.3%(36/108). In 50 (46.3%) cases the dose was adjusted according to the initial concentration data. Compared to less than 10 mg/L, the clinical efficacy of trough concentration in 10-20 mg/L was much higher(93.9%(46/49) vs. 78.6%(33/42), P=0.031). Total bilirubin and platelet count had significant difference between the two-matched groups (34.1(14.9, 91.0)µmol/L vs. 53.0(27.0, 121.6)µmol/L, P=0.034; 301.0(198.8, 416.0)×10(9)/L vs. 195.5(94.0, 283.2)×10(9)/L, P=0.000). The incidence of linezolid related thrombocytopenia was 13.4%(28 cases). CONCLUSION: The clinical effect of vancomycin and linezolid on gram-positive bacterial sepsis in neonates is comparable. The rate of trough concentration of vancomycin reaching the high trough concentration standard is low, and the clinical efficacy is related to trough concentration. Linezolid have an effect on bilirubin and platelet count, the risk of thrombocytopenia should be monitored closely during linezolid treatment.


Subject(s)
Vancomycin , Acetamides , Anti-Bacterial Agents , Bacteremia , Chi-Square Distribution , Female , Gram-Positive Bacteria , Gram-Positive Bacterial Infections , Humans , Incidence , Infant, Newborn , Linezolid , Male , Middle Aged , Neonatal Sepsis , Oxazolidinones , Platelet Count , Retrospective Studies , Thrombocytopenia , Treatment Outcome
7.
J Acoust Soc Am ; 138(1): 223-31, 2015 Jul.
Article in English | MEDLINE | ID: mdl-26233021

ABSTRACT

On the basis of the principle of stationary phase, Chuprov [Ocean Acoustics: Current State (Nauka, Moscow, 1982)] proposed a scalar parameter-the waveguide invariant ß, to interpret the dispersive properties of underwater acoustic waveguide. It has been found that ß may be useful in many applications in underwater acoustics. A reasonable prediction of the value of ß is often necessary in such applications. It was known that ß has some "canonical" values for waveguides with simple sound speed profiles (SSP). When a thermocline exists, ß for refractive modes (with a turning point) is no longer constant and can even change its sign. In this paper, by dividing the SSP into the non-refractive part and the refractive part, a clear explanation of how the value of ß is affected by the thermocline is presented. The results show that ß can be positive and increase continually from around 1 to +∞; or negative from -∞ to about -3. An analytic criterion of the sign of ß is developed. This method can also be used to analyze the value of ß for any other kind of SSP.

8.
J Acoust Soc Am ; 136(6): 2976, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25480047

ABSTRACT

The characteristics of scattering due to interface roughness are usually described by the backscattering matrix for reverberation modeling. The backscattering matrix based on the Bass perturbation theory has significant differences from that based on the empirical scattering rule (Lambert's rule), especially at low grazing angles. In a waveguide environment with a point source, it is very difficult to extract the quantitative characteristics of the backscattering matrix at low grazing angles from the experimental data because of the difficulties in acquiring low-grazing-angle scattering data and separating the scattering data between different modes (grazing angles). In contrast, the use of single-mode excitations as sources in shallow-water waveguides enables acquisition of good quality low-grazing-angle scattering data. In this paper, the characteristics of the backscattering matrix were obtained from different single-mode reverberation experiments in shallow-water. The experiments were carried out at different sites during different seasons off the coasts of China. Model-data comparisons were made and the results showed that at low grazing angles (2°-5°), the backscattering matrices based on the Bass perturbation theory were in good agreement with the experimental data, but the backscattering matrices based on Lambert's rule were not.

9.
Genes Brain Behav ; 13(7): 702-12, 2014 Sep.
Article in English | MEDLINE | ID: mdl-25130458

ABSTRACT

Idiopathic generalized epilepsy represents about 30-35% of all epilepsies in humans. The bromodomain BRD2 gene has been repeatedly associated with the subsyndrome of juvenile myoclonic epilepsy (JME). Our previous work determined that mice haploinsufficient in Brd2 (Brd2+/-) have increased susceptibility to provoked seizures, develop spontaneous seizures and have significantly decreased gamma-aminobutyric acid (GABA) markers in the direct basal ganglia pathway as well as in the neocortex and superior colliculus. Here, we tested male and female Brd2+/- and wild-type littermate mice in a battery of behavioral tests (open field, tube dominance test, elevated plus maze, Morris water maze and Barnes maze) to identify whether Brd2 haploinsufficiency is associated with the human behavioral patterns, the so-called JME personality. Brd2+/- females but not males consistently displayed decreased anxiety. Furthermore, we found a highly significant dominance trait (aggression) in the Brd2+/- mice compared with the wild type, more pronounced in females. Brd2+/- mice of either sex did not differ from wild-type mice in spatial learning and memory tests. Compared with wild-type littermates, we found decreased numbers of GABA neurons in the basolateral amygdala, which is consistent with the increase in aggressive behavior. Our results indicate that Brd2+/- haploinsufficient mice show no cognitive impairment but have behavioral traits similar to those found in patients with JME (recklessness, aggression). This suggests that either the BRD2 gene is directly responsible for influencing many traits of JME or it controls upstream regulators of individual phenotypes.


Subject(s)
Aggression , Chromosomal Proteins, Non-Histone/genetics , Cognition , Maze Learning , Myoclonic Epilepsy, Juvenile/physiopathology , Animals , Brain/cytology , Brain/physiopathology , Disease Models, Animal , Female , GABAergic Neurons/metabolism , Haploinsufficiency , Male , Mice , Mice, Inbred C57BL , Myoclonic Epilepsy, Juvenile/genetics , Myoclonic Epilepsy, Juvenile/psychology , Sex Factors , Transcription Factors
10.
Obes Rev ; 13(10): 892-901, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22564306

ABSTRACT

Bariatric surgery is becoming more and more influential as efficient weight loss therapy for the morbidly obese. As many studies propose a relationship between sexual abuse and obesity in general, but especially with regard to weight regain after successful weight loss, sexual abuse might also have a crucial impact on the outcome of the surgical procedures. This review examines the literature comparing weight loss after bariatric surgery in sexually abused and non-abused individuals. We conducted a systematic electronic literature search covering PubMed/Medline, ScienceDirect, PsychInfo and Web of Science. While 13 studies examined prevalence rates of sexual abuse among bariatric patients, eight studies explicitly investigated the effect of sexual abuse on surgery outcome. We hypothesized that individuals with a history of sexual abuse lose less weight compared to individuals with no such abuse history. At first glance, only three out of eight studies demonstrated significantly reduced weight loss in the sexually abused patients. However, a closer investigation of all studies revealed that patients with abuse experiences may indeed tend to lose less weight initially. Still, this sub-population apparently benefits from the surgical procedure, as revealed by increased weight loss over time. Reasons for these mixed results are discussed, as well as the clinical implications that can be drawn from these studies.


Subject(s)
Bariatric Surgery , Obesity, Morbid/psychology , Obesity, Morbid/surgery , Sex Offenses/psychology , Humans , Treatment Outcome , Weight Loss
11.
J Acoust Soc Am ; 131(5): 3691-7, 2012 May.
Article in English | MEDLINE | ID: mdl-22559346

ABSTRACT

The waveguide invariant ß is affected by the shallow-water environment. The effect due to bottom sediment on ß is investigated in this paper. It is found that the effect of sediment bottom can be concentrated on one parameter P-the bottom reflection phase-shift parameter. For a Pekeris waveguide, under Wentzel-Kramers-Brillouin (WKB) approximation, a very simple analytic relation is given: ß ≈ 1 + P/(k(0)H(eff)), where H(eff) is the "effective depth," and H(eff) = H + P/2 k(0). The value of ß related to different high-speed sediments (including layered sediment) ranges from 1.0 to 1.5. Some numerical examples including the layered sediment case are conducted to verify this result. Good agreement between the results calculated by KRAKEN and by WKB with parameter P has been found. Hence, the application of parameter P provides a model-free platform to investigate the bottom effect on the waveguide invariant ß in shallow-water.

13.
Chirurg ; 82(8): 684-90, 2011 Aug.
Article in German | MEDLINE | ID: mdl-21249325

ABSTRACT

BACKGROUND: Open abdomen (OA) treatment has been established worldwide. This survey examines the current status of OA treatment in Germany. MATERIAL AND METHODS: A national survey was conducted between October 2008 and September 2009 by questionnaires sent to 1,219 surgical departments. Data were evaluated descriptively. RESULTS: The response rate was 38% overall and 69% for university departments. Open abdomen treatment is used by 94% of all respondents. Most commonly used are staged abdominal lavage (87%), a commercial abdominal dressing system (82%), planned ventral hernia (69%), and other intra-abdominal dressings (e.g. vacuum pack 15%, Bogotá bag 5%). Nearly half of the respondents (46%) indicated a modification of their strategy towards vacuum techniques during the last 5 years. CONCLUSIONS: Open abdomen procedures are widely used in German surgical departments. This survey indicates a shift of treatment strategies towards vacuum techniques but even though predominant, the effectiveness and safety of these techniques must still be confirmed by prospective controlled trials. This survey helps to identify relevant clinical questions and enables focused trial networking.


Subject(s)
Abdomen/surgery , Abdominal Injuries/surgery , Compartment Syndromes/surgery , Multiple Trauma/surgery , Peritonitis/surgery , Bandages/statistics & numerical data , Data Collection , Germany , Hernia, Ventral/surgery , Hospitals, University , Humans , Intestinal Fistula/etiology , Intestinal Fistula/surgery , Intestine, Small/surgery , Negative-Pressure Wound Therapy/statistics & numerical data , Pancreatitis, Acute Necrotizing/surgery , Peritoneal Lavage/methods , Peritoneal Lavage/statistics & numerical data , Postoperative Complications/etiology , Postoperative Complications/surgery , Prospective Studies , Surgery Department, Hospital , Surgical Mesh/statistics & numerical data , Surveys and Questionnaires , Treatment Outcome , Utilization Review
14.
J Pers Soc Psychol ; 98(4): 550-8, 2010 Apr.
Article in English | MEDLINE | ID: mdl-20307128

ABSTRACT

Psychologists increasingly recommend experimental analysis of mediation. This is a step in the right direction because mediation analyses based on nonexperimental data are likely to be biased and because experiments, in principle, provide a sound basis for causal inference. But even experiments cannot overcome certain threats to inference that arise chiefly or exclusively in the context of mediation analysis-threats that have received little attention in psychology. The authors describe 3 of these threats and suggest ways to improve the exposition and design of mediation tests. Their conclusion is that inference about mediators is far more difficult than previous research suggests and is best tackled by an experimental research program that is specifically designed to address the challenges of mediation analysis.


Subject(s)
Models, Psychological , Psychology, Experimental/methods , Humans
15.
Colorectal Dis ; 12(10 Online): e190-9, 2010 Oct.
Article in English | MEDLINE | ID: mdl-19895595

ABSTRACT

AIM: Patients suffering from advanced colorectal cancer can experience unintended weight loss and/or treatment-induced gastrointestinal toxicity. Based on current evidence, the routine use of parenteral nutrition (PN) for patients with colorectal cancer is not recommended. This study evaluates the effect of PN supplementation on body composition, quality of life (QoL), chemotherapy-associated side effects and survival in patients with advanced colorectal cancer. METHOD: Eighty-two patients with advanced colorectal cancer receiving a palliative chemotherapy were prospectively randomized to either oral enteral nutrition supplement (PN-) or oral enteral nutrition supplement plus supplemental PN (PN+). Every 6 weeks body weight, body mass index (BMI), chemotherapy-associated side effects and caloric intake were assessed, haemoglobin and serum albumin were measured. Body composition was assessed by body impedance analysis, and QoL was evaluated by European Organization for Research and Treatment of Cancer (EORTC) QLQC30 questionnaire. RESULTS: No differences were evident at baseline between the groups for age, sex, diagnosis, weight, BMI or QoL. A difference in BMI was observed by week 36, whereas differences of the mean body cell mass could be observed from week 6, albumin dropped significantly in the PN- group in week 36 and QoL showed significant differences from week 18. Chemotherapy-associated side effects were higher in PN-. The survival rate was significantly greater in the PN+ group. CONCLUSION: A supplementation with PN slows weight loss, stabilizes body-composition and improves QoL in patients with advanced colorectal cancer. Furthermore, it can reduce chemotherapy-related side effects.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/adverse effects , Carcinoma/diet therapy , Colorectal Neoplasms/diet therapy , Malnutrition/diet therapy , Palliative Care , Parenteral Nutrition , Aged , Analysis of Variance , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Body Composition , Body Weight , Carcinoma/drug therapy , Carcinoma/physiopathology , Colorectal Neoplasms/drug therapy , Colorectal Neoplasms/physiopathology , Energy Intake , Energy Metabolism , Female , Fluorouracil/administration & dosage , Hemoglobins/metabolism , Humans , Kaplan-Meier Estimate , Leucovorin/administration & dosage , Male , Malnutrition/prevention & control , Middle Aged , Prospective Studies , Quality of Life , Serum Albumin/metabolism , Survival Analysis
16.
Obes Surg ; 19(7): 928-36, 2009 Jul.
Article in English | MEDLINE | ID: mdl-19415404

ABSTRACT

BACKGROUND: Since January 1st, 2005, the current situation for bariatric surgery has been examined by means of a voluntary quality assurance study in Germany with a multicenter design in which 38 hospitals and surgical departments participated. The data are registered in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University of Magdeburg (Germany). METHODS: Data describing peri-interventional characteristics were prospectively documented in an internet online data registry. All primary bariatric procedures performed since January 1st, 2005, were registered. In addition, reoperations in patients who had previously undergone primary surgical intervention were included. As a representative excerpt from the overall prospective multicenter observational study on obesity surgery, data on the type, regimen, and time course of deep venous thrombosis (DVT) prophylaxis were documented. From the number and spectrum of complications, the incidences of clinically manifest DVT or pulmonary embolism (PE) were derived during the in-hospital course and follow-up in conjunction with the type of surgical procedure and body mass index (BMI). RESULTS: Overall, 3,122 bariatric procedures were performed at 38 German hospitals between January 2005 and December 2007. These procedures were subdivided into 2,869 primary operations and 253 revisions (sex ratio, male to female = 25.6:74.4%). The average BMI of all patients was 48.5 kg/m(2) in 2005, 48.4 kg/m(2) in 2006, and 48.0 kg/m(2) in 2007. In 2005 and 2006, gastric banding (GB) was the most commonly performed operation, followed by Roux-en-Y gastric bypass (RYGBP). In 2007, RYGBP was carried out in 42.1% of all bariatric procedures. Interestingly, the incidence of deep venous thrombosis (DVT) was only 0.06%, whereas PE occurred in 0.06% of patients only after hospital discharge. The DVT prophylaxis protocol used has been changed for the last 2 years: the majority of patients with a BMI above 50 kg/m(2) received low-molecular-weight heparin twice a day. CONCLUSION: In Germany, a trend from GB to sleeve gastrectomy (SG) and malabsorptive approach has been evaluated. This trend is associated with differences of the DVT prophylaxis regimen in the profile of bariatric surgical patients depending on BMI and the type of bariatric procedure. Despite the low incidence of DVT and pulmonary embolism (PE) detected, there is a lack of evidence on a reasonable regimen for sufficient DVT prophylaxis in bariatric surgery; instead, there are only recommendations from the guidelines and statements of a specific medical society. Therefore, prospective studies are necessary to determine the optimal DVT prophylaxis for bariatric surgical patients as well as obese patients undergoing surgery.


Subject(s)
Bariatric Surgery/adverse effects , Postoperative Complications/prevention & control , Thromboembolism/prevention & control , Bariatric Surgery/standards , Bariatric Surgery/trends , Female , Germany , Humans , Male , Prospective Studies , Pulmonary Embolism/prevention & control , Quality Assurance, Health Care , Venous Thrombosis/prevention & control
17.
Obes Surg ; 19(5): 632-40, 2009 May.
Article in English | MEDLINE | ID: mdl-19184256

ABSTRACT

BACKGROUND: Beginning January 1, 2005, the status and outcomes of bariatric surgery were examined in Germany. Data are registered in cooperation with the An-Institute of quality assurance in surgery at the Otto-von-Guericke-University Magdeburg. The objective of this study was to examine the morbidity and mortality rates secondary to sleeve gastrectomy (SG) in Germany since 2006. METHODS: Data collection occurred prospectively in an online data bank. All primary bariatric procedures performed were recorded as were all re-operations in patients that had already undergone a primary operation. Specific data compiled on the sleeve gastrectomy procedure were evaluated with a focus on operative details and complication rates. RESULTS: The total study cohort contains 3,122 patients. From January 2006 to December 2007, 144 sleeve gastrectomy procedures were performed in the 17 hospitals participating in the study. The mean body mass index (BMI) of all patients was 48.8 kg/m(2). The BMI of patients undergoing SG was 54.5 kg/m(2). In total, 73.8% of the patients were female and 26.2% of the patients were male. There were no significant differences between patients undergoing SG. The general complication rate after SG was 14.1%, and the surgical complication rate was 9.4%. The postoperative mortality rate was 1.4%. CONCLUSIONS: The complication rate during the first 2 years after SG in Germany is similar to that published in the literature. In order to improve the quality of bariatric surgery, an evaluation of data from a German multicenter trial is necessary to evaluate the position of SG in the bariatric algorithm.


Subject(s)
Gastrectomy/adverse effects , Gastrectomy/mortality , Obesity, Morbid/surgery , Adult , Body Mass Index , Cohort Studies , Female , Gastrectomy/statistics & numerical data , Germany/epidemiology , Humans , Male , Middle Aged , Obesity, Morbid/complications , Obesity, Morbid/mortality , Reoperation , Risk Factors , Treatment Outcome , Weight Loss
18.
Ger Med Sci ; 7: Doc09, 2009 Nov 18.
Article in English | MEDLINE | ID: mdl-20049066

ABSTRACT

Reduced nutritional state is associated with unfavourable outcomes and a lower quality of life in patients with malignancies. Patients with active tumour disease frequently have insufficient food intake. The resting energy expenditure in cancer patients can be increased, decreased, or remain unchanged compared to predicted values. Tumours may result in varying degrees of systemic pro-inflammatory processes with secondary effects on all significant metabolic pathways. Therapeutic objectives are to stabilise nutritional state with oral/enteral nutrition and parenteral nutrition (PN) and thus to prevent or reduce progressive weight loss. The maintenance or improvement of quality of life, and the increase in the effectiveness and a reduction in the side-effects of antitumor therapy are further objectives. Indications for PN in tumour patients are essentially identical to those in patients with benign illnesses, with preference given to oral or enteral nutrition when feasible. A combined nutritional concept is preferred if oral or enteral nutrition are possible but not sufficient. There are generally no accepted standards for ideal energy and nutrient intakes in oncological patients, particularly when exclusive artificial nutrition is administered. The use of PN as a general accompaniment to radiotherapy or chemotherapy is not indicated, but PN is indicated in chronic severe radiogenic enteritis or after allogenic transplantation with pronounced mucositis or GvH-related gastrointestinal damage for prolonged periods, with particular attention to increased risk of bleeding and infection. No PN is necessary in the terminal phase.


Subject(s)
Neoplasms/complications , Neoplasms/therapy , Nutrition Disorders/etiology , Nutrition Disorders/prevention & control , Parenteral Nutrition/methods , Parenteral Nutrition/standards , Practice Guidelines as Topic , Germany , Humans , Medical Oncology/standards , Neoplasms/surgery
19.
Obes Surg ; 19(1): 105-12, 2009 Jan.
Article in English | MEDLINE | ID: mdl-18941846

ABSTRACT

BACKGROUND: Most studies on bariatric surgery outcomes are performed as clinical trials or reflect the clinical experience in single centers. The status of bariatric surgery in Germany has been examined since January 1st, 2005 with the cooperation of clinics and hospitals at the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University of Magdeburg (Germany). METHODS: In this prospective multicenter observational study, the data obtained for all primary bariatric procedures, including all repeated operations, performed on consecutive patients with morbid obesity at participating hospitals from 2005 to 2007 were prospectively collected using an Internet online data registry. In particular, perioperative characteristics, such as the spectrum of diagnostic measurements, type of surgical procedures, and short- and long-term outcomes, were investigated. RESULTS: During the study period, 629 surgical procedures were performed at 21 hospitals in 2005, 828 procedures at 32 hospitals in 2006, and 1,666 procedures at 35 hospitals in 2007. In 2005 and 2006, gastric banding was the most frequently performed operation, followed by the Roux-en-Y gastric bypass (RYGBP). In 2007, a RYGBP was carried out in 42.1% of all bariatric procedures. Among all patients, 74.4% were female. The mean body mass index (BMI) was 48.5 kg/m(2) in 2005, 48.4 kg/m(2) in 2006, and 48.0 kg/m(2) in 2007. Follow-up data after 12 months were available for 63.8% of the patients in 2005 and 2006; these data showed greater reduction of BMI after malabsorptive rather than restrictive bariatric procedures. The mortality was 0.1% (30 days) and 0.16% (overall). CONCLUSION: As indicated by the worldwide trend, there is an ongoing change from restrictive bariatric procedures to malabsorptive procedures and sleeve gastrectomy. Although the BMIs of German patients undergoing bariatric surgery appear to be substantially higher than those of patients from most other countries, there were no differences in intraoperative and short-term complications or in overall outcomes during follow-up when compared with published studies.


Subject(s)
Bariatric Surgery/statistics & numerical data , Obesity/surgery , Adult , Bariatric Surgery/adverse effects , Bariatric Surgery/mortality , Cohort Studies , Female , Germany , Health Care Surveys , Humans , Male , Middle Aged , Obesity/complications , Obesity/mortality , Quality Assurance, Health Care , Reoperation , Treatment Outcome , Weight Loss
20.
Colorectal Dis ; 11(2): 162-7, 2009 Feb.
Article in English | MEDLINE | ID: mdl-18462237

ABSTRACT

OBJECTIVE: 'Fast-track' rehabilitation has been shown to accelerate recovery, reduce general morbidity and decrease hospital stay after elective colonic surgery. Despite this evidence, there is no information on the acceptance and utilization of these concepts among the entirety of Austrian and German surgeons. METHOD: In 2006, a questionnaire concerning perioperative routines in elective, open colonic resection was sent to the chief surgeons of 1270 German and 120 Austrian surgical centres. RESULTS: The response rate was 63% in Austria (76 centres) and 30% in Germany (385 centres). Mechanical bowel preparation is used by the majority (Austria, 91%; Germany, 94%); the vertical incision is the standard method of approach to the abdomen in Austria (79%) and Germany (83%), nasogastric decompression tubes are rarely used, one-third of the questioned surgeons in both countries use intra-abdominal drains. Half of the surgical centres allow the intake of clear fluids on the day of surgery and one-fifth offer solid food on that day. Epidural analgesia is used in three-fourths of the institutions. CONCLUSION: Although there is an evident benefit of fast-track management, the survey shows that they are not yet widely used as a routine in Austria and Germany.


Subject(s)
Colectomy/rehabilitation , Perioperative Care/methods , Practice Patterns, Physicians' , Anesthesia, Epidural/statistics & numerical data , Austria , Colorectal Surgery , Germany , Health Care Surveys , Humans , Length of Stay
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