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“Patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) often have substantial comorbidities, which must be taken into account to appropriately assess expected postoperative outcomes. The Charlson/Deyo and Elixhauser indices BIIB057 supplier are widely used comorbidity measures, both of which also have revised algorithms based on enhanced ICD-9-CM coding. It is currently
unclear which of the existing comorbidity measures best predicts early postoperative outcomes following LRYGB.\n\nUsing the Nationwide Inpatient Sample, patients 18 years or older undergoing LRYGB for obesity between 2001 and 2008 were identified. Comorbidities were assessed according to the original and enhanced Charlson/Deyo and Elixhauser indices. Using multivariate logistic regression, the following early postoperative outcomes were assessed: overall postoperative Rigosertib complications, length of hospital stay, and conversion to open surgery. Model performance for the four comorbidity indices was assessed and compared using C-statistics and the Akaike’s information criterion (AIC).\n\nA total of 70,287 patients were included. Mean age was
43.1 years (SD, 10.8), 81.6 % were female and 60.3 % were White. Both the original and enhanced Elixhauser indices modestly outperformed the Charlson/Deyo in predicting the surgical outcomes. All four models had similar C-statistics,
but the original Elixhauser index was associated with the smallest AIC for all of the surgical outcomes.\n\nThe original Elixhauser index is the best predictor of early postoperative outcomes in our cohort of patients undergoing LRYGB. However, differences between the Charlson/Deyo and Elixhauser indices are modest, and each of these indices MK-4827 provides clinically relevant insight for predicting early postoperative outcomes in this high-risk patient population.”
“Reliable figures of local distribution and prevalence of cystic echinococcosis (CE) in intermediate hosts are a fundamental prerequisite for implementation of control strategies against cystic echinococcosis (CE), caused by Echinococcus granulosus. With the aim to assess the “true” prevalence of CE in a mountain area of Piedmont region (North-Western Italy), two methods alternative to use of official abattoir data were compared: (i) the necroscopic examination of 117 sheep and goats, killed during wolf attacks while on summer pastures, for presence of hydatid cysts; (ii) the serological examination with an enzyme-linked immuno-electro transfer blot assay (EITB) of 1217 sheep from 9 transhumant flocks for presence of anti-Echinococcus antibodies. EITB was first performed on pooled samples, then each serum sample from positive pools was individually tested. Prevalences were 15.