Articles: adult.
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To assess the incidence of posthepatectomy liver failure (PHLF) and the role of the future liver remnant (FLR) in children undergoing major hepatectomy. ⋯ This is the largest reported single-center series of pediatric major hepatectomies. PHLF is exceedingly rare in children. The liver volume-to-body weight ratio is higher in children compared to adults, and the FLR is sufficient even in extreme resections with less than 20% of liver remnant. These findings strongly question the use of ALPPS, portal vein embolization, or transplantation based on suspected insufficient liver remnant in children.
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Observation stays in Medicare have grown over the last 15 years, yet limited research exists on how observation may impact outcomes for older adults. ⋯ Among Medicare beneficiaries hospitalized for fewer than 5 days, observation stay was associated with higher rates of 30-day unplanned hospital returns compared to inpatient admission. However, we simultaneously observed lower out-of-pocket costs among those hospitalized under an observation stay. The mixed results suggest that additional research and engagement with relevant parties is needed to optimize observation stay policy.
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Multimorbidity is associated with lower physical function in older adults. Less is known about multimorbidity and physical activity earlier in the life-course. This study examined multimorbidity trajectories across adulthood with physical activity and explores if multimorbidity accelerates age-related activity decline. ⋯ Early onset and faster accumulation of chronic conditions was associated with lower activity in midlife. Lower intensity activity for people with multimorbidity may be a feasible target for healthy aging.
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J Neurosurg Anesthesiol · Nov 2024
Intraoperative Burst Suppression by Analysis of Raw Electroencephalogram Postoperative Delirium in Older Adults Undergoing Spine Surgery: A Retrospective Cohort Study.
Postoperative delirium is a common complication in older adults, associated with poor outcomes, morbidity, mortality, and higher health care costs. Older age is a strong predictor of delirium. Intraoperative burst suppression on the electroencephalogram (EEG) has also been linked to postoperative delirium and poor neurocognitive outcomes. ⋯ Intraoperative burst suppression identified by visual analysis of the EEG was more strongly associated with delirium than age in older adults undergoing spine surgery. Further research is needed to determine the clinical importance of these findings.
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About 25% of people who currently smoke cigarettes in the United States (US) smoke non-daily, and relatively little is known about their intentions or attempts to quit. Active surveillance is essential to identify services needed to support smoking cessation efforts and reduce the burden of disease. ⋯ Given the substantial number of adults who smoke non-daily in the US and their interest in quitting, developing targeted interventions and communication is an important public health priority.