Impact of Centralization on Pancreas Surgery

Abu-Hilal, Mohammed; Elberm, Hassan; Pearce, Neil; Scibelli, T.; Fong, F.; Dowell, John K.; Johnson, Chris

doi:10.1097/01.mpa.0000335329.95804.64

Cited by 2 publications

(2 citation statements)

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“…1 For the past decades, MDA has been widely studied as an experimental or diagnostic index of peroxidative tissue injury. [1][2][3]6 According to large number of studies, many diseases such as asthma, 6 Sikkimese diabetics, 7 prostate cancer, 8 coronary artery disease, 9 atheroma, 10 visceral abdominal obesity, 11 acute pancreatitis, 12 smoking, 13 and pulmonary diseases 14 were known to be associated with increased oxidative stress, depending on the extent of shift either mild or severe. 15 Measurement of MDA have crucial role in the assessment of oxidative stress.…”

Section: Introductionmentioning

confidence: 99%

“…There have been several methods for the determination of MDA, mainly including gas chromatography, 5,25 HPLC, 1,4,7,10,16 and liquid chromatography with mass spectrometry (LC-MS or LC-MS/MS). 12,17 But, some of these methods require expensive equipments or complicated procedures of pretreatment because of desultory preparation of MDA. 3,25 In this study, the derivatization reaction between DNPH and MDA was examined in order to develop the rapid, simple, and low cost method using the appropriate internal standard (IS) in human urine.…”

Section: Introductionmentioning

confidence: 99%

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Quantification of Malondialdehyde in Human Urine by HPLC‐DAD and Derivatization with 2,4‐Dinitrophenylhydrazine

Kim

Jung

Kho

2017

Bulletin Korean Chem Soc

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This study demonstrated that human urine can be derivatized in a simple manner and the proposed method can be suitable for the routine and noninvasive evaluation of oxidative stress. A rapid and sensitive method for the determination of malondialdehyde (MDA) concentrations in human urine has been developed using high‐performance liquid chromatography. The MDA concentration in pooled human urine samples was determined after its conversion with 2,4‐dinitrophenylhydrazine (DNPH) to a hydrazone (MDA‐DNPH). The MDA‐DNPH was separated on C18 column and quantified by diode array detection at 310 nm. The method was validated by the use of spiked human urine. The calibration curves of analyte showed good linearity (r 2 > 0.999) in the ranges. The limit of detection was estimated as 0.16 µg/mL. In addition, accuracy was from 104.0 to 112.7% and the precision was less than 3.2%. In this study, the developed method was applied to the analysis of real human urine samples. The level of MDA in urine of adults was 1.3 ± 0.6 µg/mg creatinine.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Quantification of Malondialdehyde in Human Urine by HPLC‐DAD and Derivatization with 2,4‐Dinitrophenylhydrazine

Kim

Jung

Kho

2017

Bulletin Korean Chem Soc

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Defining Standards for Hepatopancreatobiliary Cancer Surgery in Ontario, Canada: A Population-Based Cohort Study of Clinical Outcomes

Hirpara,

Irish,

Rashid

et al. 2023

Journal of the American College of Surgeons

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Background: In 2006, Cancer Care Ontario created Surgical Oncology Standards for the delivery of HPB surgery including hepatectomy and pancreaticoduodenectomy (PD). Our objective was to identify the impact of standardization on outcomes after hepatopancreatobiliary (HPB) surgery in Ontario, Canada. Study Design: Population-level analysis of patients undergoing hepatectomy or PD (2003–2019). Logistic regression models were used to compare 30- and 90-day mortality and length of stay (LOS), before (2003-2006), during (2007-2011) and after (2012-2019) standardization. Interrupted time series (ITS) models were used to co-analyze secular trends. Results: A total of 7,904 hepatectomies and 5,238 PDs were performed. >80% of all cases were performed at a designated center (DC) before standardization. This increased to >98% in the post-standardization era. Median volumes at DCs increased from 55 to 67 hepatectomies/year, and 22 to 50 PDs/year over time. 30-day mortality after hepatectomy was 2.6% before, and 2.3% post-standardization (p=0.9). 30-day mortality after PD was 3.6% before, and 2.4% post-standardization (p=0.1). Multivariable analyses revealed a significant difference in 90-day mortality following PD post-standardization (4.3% vs. 6.3%; aOR 0.7, p=0.03). Median LOS was shorter for hepatectomy (6 days vs. 8 days) and PD (9 days vs. 14 days; p<0.0001), after standardization. Immediate and late effects on mortality and LOS were likely attributable to secular trends, which pre-dated standardization. Conclusion: Standardization was associated with a higher volume of hepatectomy and PDs with further concentration of care at DCs. Pre-existing quality initiatives may have attenuated the effect of standardization on quality outcomes. Our data highlight the merits of a multi-faceted provincial system for enabling consistent access to high quality HPB care throughout a region of 15-million people over a 16-year period.

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Impact of Centralization on Pancreas Surgery

Cited by 2 publications

References 0 publications

Quantification of Malondialdehyde in Human Urine by HPLC‐DAD and Derivatization with 2,4‐Dinitrophenylhydrazine

Quantification of Malondialdehyde in Human Urine by HPLC‐DAD and Derivatization with 2,4‐Dinitrophenylhydrazine

Defining Standards for Hepatopancreatobiliary Cancer Surgery in Ontario, Canada: A Population-Based Cohort Study of Clinical Outcomes

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