AIM:To evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy.METHODS:Retrospective data collection from four referral centers,all of which had a formal out-...AIM:To evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy.METHODS:Retrospective data collection from four referral centers,all of which had a formal out-of-hours emergency endoscopy service,even at weekends.A total of 388 patients with bleeding peptic ulcers who were admitted via the emergency room between January 2007 and December 2009 were enrolled.Analyzed parameters included time from patients' arrival until endoscopy,mortality,rebleeding,need for surgery and length of hospital stay.RESULTS:The weekday and weekend admission groups comprised 326 and 62 patients,respectively.There were no significant differences in baseline characteristics between the two groups,except for younger age in the weekend group.Most patients (97%) had undergone early endoscopy,which resulted in a low mortality rate regardless of point of presentation (1.8% overall vs 1.6% on the weekend).The only outcome that was worse in the weekend group was a higher rate of rebleeding (12% vs 21%,P = 0.030).However,multivariate analysis revealed nighttime admission and a high Rockall score (≥ 6) as significant independent risk factors for rebleeding,rather than weekend admission.CONCLUSION:Early endoscopy for peptic ulcer bleeding can prevent the weekend effect,and nighttime admission was identified as a novel risk factor for rebleeding,namely the nighttime effect.展开更多
Aims:To determine whether day and time of admission influences the practice patterns of the admitting general surgeon and subsequent outcomes for patients diagnosed with small bowel obstruction.Methods:A retrospective...Aims:To determine whether day and time of admission influences the practice patterns of the admitting general surgeon and subsequent outcomes for patients diagnosed with small bowel obstruction.Methods:A retrospective database review was carried out,covering patients admitted with the presumed diagnosis of partial small bowel obstruction from 2004–2011.Results:A total of 404 patients met the inclusion criteria.One hundred and thirty-nine were admitted during the day,93 at night and 172 on the weekend.Overall 30.2%of the patients were managed operatively with no significant difference between the groups(P=0.89);however,of patients taken to the operating room,patients admitted during the day received operative intervention over 24 hours earlier than those admitted at a weekend,0.79 days vs 1.90 days,respectively(P=0.05).Overall mortality was low at 1.7%,with no difference noted between the groups(P=0.35).Likewise there was no difference in morbidity rates between the three groups(P=0.90).Conclusions:Despite a faster time to operative intervention in those patients admitted during the day,our study revealed that time of admission does not appear to correlate to patient outcome or mortality.展开更多
Analysis of observed ozone data in 2006 from five monitoring sites (Xujiahui, Chongming, Baoshan, Pudong, Jinshan) in Shanghai reveals that ozone (O_3) concentrations in Xujiahui are higher at week-ends than those on ...Analysis of observed ozone data in 2006 from five monitoring sites (Xujiahui, Chongming, Baoshan, Pudong, Jinshan) in Shanghai reveals that ozone (O_3) concentrations in Xujiahui are higher at week-ends than those on weekdays, despite the fact that emissions of ozone precursor substances, such as oxides of nitrogen (NOx), carbon monoxide (CO) and volatile organic compounds (VOCs) are lower at weekends than those on weekdays. The possible chemical cause of ozone "weekend effect" is that NO_2/NO ratio increases at weekends by 25.61% compared with those on weekdays. In addition, because of an average 12.13% reduction in NOx (NO + NO_2) in the early morning (05:00-09:00) at weekends compared with that on weekdays, the ozone inhibition period ends 0.5 h earlier at weekends resulting in the longer duration of ozone accumulation and the higher ozone production rate. The rate of ozone production is a function of VOCs and NOx in the atmosphere. VOCs/NOx ratio in Xujiahui is 4.55 at weekends, and 4.37 on weekdays, belonging to the "NOx-limited". The increasing VOCs/NOx ratio at weekends leads to ozone enhancement from 73 ppbv to 80 ppbv, which are consistent with ozone "weekend effect" in Xujiahui. Furthermore, combining with MICAPS cloud amount data, the fact that ozone "weekend effect" in Xujiahui weakens gradually along with the increasing of cloud amount indicates that ozone photochemical production leads to ozone "weekend effect" in Xujiahui of Shanghai.展开更多
文摘AIM:To evaluate whether weekend or nighttime admission affects prognosis of peptic ulcer bleeding despite early endoscopy.METHODS:Retrospective data collection from four referral centers,all of which had a formal out-of-hours emergency endoscopy service,even at weekends.A total of 388 patients with bleeding peptic ulcers who were admitted via the emergency room between January 2007 and December 2009 were enrolled.Analyzed parameters included time from patients' arrival until endoscopy,mortality,rebleeding,need for surgery and length of hospital stay.RESULTS:The weekday and weekend admission groups comprised 326 and 62 patients,respectively.There were no significant differences in baseline characteristics between the two groups,except for younger age in the weekend group.Most patients (97%) had undergone early endoscopy,which resulted in a low mortality rate regardless of point of presentation (1.8% overall vs 1.6% on the weekend).The only outcome that was worse in the weekend group was a higher rate of rebleeding (12% vs 21%,P = 0.030).However,multivariate analysis revealed nighttime admission and a high Rockall score (≥ 6) as significant independent risk factors for rebleeding,rather than weekend admission.CONCLUSION:Early endoscopy for peptic ulcer bleeding can prevent the weekend effect,and nighttime admission was identified as a novel risk factor for rebleeding,namely the nighttime effect.
文摘Aims:To determine whether day and time of admission influences the practice patterns of the admitting general surgeon and subsequent outcomes for patients diagnosed with small bowel obstruction.Methods:A retrospective database review was carried out,covering patients admitted with the presumed diagnosis of partial small bowel obstruction from 2004–2011.Results:A total of 404 patients met the inclusion criteria.One hundred and thirty-nine were admitted during the day,93 at night and 172 on the weekend.Overall 30.2%of the patients were managed operatively with no significant difference between the groups(P=0.89);however,of patients taken to the operating room,patients admitted during the day received operative intervention over 24 hours earlier than those admitted at a weekend,0.79 days vs 1.90 days,respectively(P=0.05).Overall mortality was low at 1.7%,with no difference noted between the groups(P=0.35).Likewise there was no difference in morbidity rates between the three groups(P=0.90).Conclusions:Despite a faster time to operative intervention in those patients admitted during the day,our study revealed that time of admission does not appear to correlate to patient outcome or mortality.
基金the National Natural Science Foundation of China (Grant Nos. 40575060 and 40705046)the Special Research Project of China Meteorological Bureau
文摘Analysis of observed ozone data in 2006 from five monitoring sites (Xujiahui, Chongming, Baoshan, Pudong, Jinshan) in Shanghai reveals that ozone (O_3) concentrations in Xujiahui are higher at week-ends than those on weekdays, despite the fact that emissions of ozone precursor substances, such as oxides of nitrogen (NOx), carbon monoxide (CO) and volatile organic compounds (VOCs) are lower at weekends than those on weekdays. The possible chemical cause of ozone "weekend effect" is that NO_2/NO ratio increases at weekends by 25.61% compared with those on weekdays. In addition, because of an average 12.13% reduction in NOx (NO + NO_2) in the early morning (05:00-09:00) at weekends compared with that on weekdays, the ozone inhibition period ends 0.5 h earlier at weekends resulting in the longer duration of ozone accumulation and the higher ozone production rate. The rate of ozone production is a function of VOCs and NOx in the atmosphere. VOCs/NOx ratio in Xujiahui is 4.55 at weekends, and 4.37 on weekdays, belonging to the "NOx-limited". The increasing VOCs/NOx ratio at weekends leads to ozone enhancement from 73 ppbv to 80 ppbv, which are consistent with ozone "weekend effect" in Xujiahui. Furthermore, combining with MICAPS cloud amount data, the fact that ozone "weekend effect" in Xujiahui weakens gradually along with the increasing of cloud amount indicates that ozone photochemical production leads to ozone "weekend effect" in Xujiahui of Shanghai.
