Hospitals with volumes above the mean (43 radical prostatectomies

Hospitals with volumes above the mean (43 radical prostatectomies per year)

had lower surgery related mortality (rate of difference 0.62, 95% CI 0.47-0.81)and morbidity (rate difference -9.7%, 95% CI -15.8, -3.6). Teaching hospitals had an 18% (95% selleck chemicals llc CI -26, -9) lower rate of surgery related complications. Surgeon volume was not significantly associated with surgery related mortality or positive surgical margins. However, the rate of late urinary complications was 2.4% lower (95% CI -5, -0.1) and the rate of long-term incontinence was 1.2% lower (95% CI -2.5, -0.1) for each 10 additional radical prostatectomies performed by the surgeon annually. Length of stay was lower, corresponding to surgeon volume.\n\nConclusions: Higher provider volumes are associated with better outcomes after

radical prostatectomy. Greater understanding of factors leading to this volume-outcome relationship, and the potential benefits and harms of increased regionalization is needed.”
“The Sichuan takin (takin; Budorcas taxicolor tibetana) is distributed Volasertib in the Gansu and Sichuan providences of southern China and along eastern Tibet. Because of their ecology, few data on takin reproductive biology exist, with the exception of its mating season in the Sichuan province, which occurs from July through August. Therefore, the objectives were to: 1) characterize reproductive hormones in zoo-housed male and female takin, including pregnancy in the female, using non-invasive fecal steroid hormonal monitoring; 2) characterize behaviors of zoo-housed takin, emphasizing reproductive behaviors and activity budget; and 3) assess the influence of season on births in North America and reproductive hormonal and behavioral activity. Fecal samples were collected 3 to 5 times per week from two adult males and three adult females. Extracted hormones were analyzed using an enzyme immunoassay for progestagen RSL3 supplier and androgen concentrations. Behavioral

observations were collected for 2 yrs using an ethogram. In this study, season affected reproduction, specifically birth occurrences, reproductive cyclicity in females and androgen production in males. The duration of the estrous cycle was approximately 35 d and cycles occurred June through December. Androgen concentrations peaked in May through August. Season did not influence behavior; however, age and sex may affect some behaviors, including activity level, foraging and drinking, social affiliative behavior, and visibility from the visitor’s viewpoint. In conclusion, fecal hormonal and behavioral analyses can provide information for management and conservation of this herd species. (C) 2012 Elsevier Inc. All rights reserved.

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