5 research outputs found
Interaction between estrogen receptor-α and PNPLA3 p.I148M variant drives fatty liver disease susceptibility in women
- Author
- Baselli Guido
- Bugianesi Elisabetta
- Casirati Elia
- Cherubini Alessandro
- Chokshi Shilpa
- Della Torre Sara
- Dondossola Daniele
- Dongiovanni Paola
- Jamialahmadi Oveis
- Meda Clara
- Norouziesfahani Marjan
- Ostadreza Mahnoosh
- Passignani Giulia
- Pelusi Serena
- Pennisi Grazia
- Petta Salvatore
- Prati Daniele
- Romeo Stefano
- Rrapaj Eniada
- Sinopoli Elena
- Tourna Aikaterini
- Valenti Luca
- Youngson Neil
- Publication venue
- NATURE PORTFOLIO
- Publication date
- 01/10/2023
- Field of study
Fatty liver disease (FLD) caused by metabolic dysfunction is the leading cause of liver disease and the prevalence is rising, especially in women. Although during reproductive age women are protected against FLD, for still unknown and understudied reasons some develop rapidly progressive disease at the menopause. The patatin-like phospholipase domain-containing 3 (PNPLA3) p.I148M variant accounts for the largest fraction of inherited FLD variability. In the present study, we show that there is a specific multiplicative interaction between female sex and PNPLA3 p.I148M in determining FLD in at-risk individuals (steatosis and fibrosis, P < 10(-10); advanced fibrosis/hepatocellular carcinoma, P = 0.034) and in the general population (P < 10(-7) for alanine transaminase levels). In individuals with obesity, hepatic PNPLA3 expression was higher in women than in men (P = 0.007) and in mice correlated with estrogen levels. In human hepatocytes and liver organoids, PNPLA3 was induced by estrogen receptor-a (ER-a) agonists. By chromatin immunoprecipitation and luciferase assays, we identified and characterized an ER-a-binding site within a PNPLA3 enhancer and demonstrated via CRISPR-Cas9 genome editing that this sequence drives PNPLA3 p.I148M upregulation, leading to lipid droplet accumulation and fibrogenesis in three-dimensional multilineage spheroids with stellate cells. These data suggest that a functional interaction between ER-a and PNPLA3 p.I148M variant contributes to FLD in women
Maternal and Neonatal Characteristics and Outcomes of COVID-19 in Pregnancy: An Overview of Systematic Reviews
- Author
- Publication venue
- 'MDPI AG'
- Publication date
- 12/01/2021
- Field of study
(1) Background: A considerable number of systematic reviews, with substantial heterogeneity regarding their methods and included populations, on the impact of COVID-19 on infected pregnant women and their neonates, has emerged. The aim was to describe the obstetric-perinatal and neonatal outcome of infected pregnant women and their newborns during the COVID-19 pandemic; (2) Methods: Three bibliographical databases were searched (last search: 10 September 2020). Quality assessment was performed using the AMSTAR-2 tool. Primary outcomes included mode of delivery, preterm delivery/labor, premature rupture of membranes (PROM/pPROM) and abortions/miscarriages. Outcomes were mainly presented as ranges. A separate analysis, including only moderate and high-quality systematic reviews, was also conducted. The protocol was registered with PROSPERO (CRD42020214447); (3) Results: Thirty-nine reviews were analyzed. Reported rates, regarding both preterm and term gestations, varied between 52.3 and 95.8% for cesarean sections; 4.2–44.7% for vaginal deliveries; 14.3–63.8% specifically for preterm deliveries and 22.7–32.2% for preterm labor; 5.3–12.7% for PROM and 6.4–16.1% for pPROM. Maternal anxiety for potential fetal infection contributed to abortion decisions, while SARS-CoV-2-related miscarriages could not be excluded. Maternal ICU admission and mechanical ventilation rates were 3–28.5% and 1.4–12%, respectively. Maternal mortality rate was <2%, while stillbirth, neonatal ICU admission and mortality rates were <2.5%, 3.1–76.9% and <3%, respectively. Neonatal PCR positivity rates ranged between 1.6% and 10%. After accounting for quality of studies, ranges of our primary outcomes remained almost unchanged, while among our secondary outcomes, maternal ICU admission (3–10%) and mechanical ventilation rates (1.4–5.5%) were found to be relatively lower; (4) Conclusions: Increased rates of cesarean sections and preterm birth rates were found, with iatrogenic reasons potentially involved. In cases of symptomatic women with confirmed infection, high maternal and neonatal ICU admission rates should raise some concerns. The probability of vertical transmission cannot be excluded. Further original studies on women from all trimesters are warranted
Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study
- Author
- Abad Gurumeta Alfredo
- Abernethy Caroline
- Abigail Patrick
- Achaibar Kira
- Adam Emily
- Afshari Arash
- Agudelo Montoya María Elizabeth
- Akgün Fatma Nur
- Aletti Gabriele
- Alkış Neslihan
- Allan Ashley
- Allan Katie
- Allaouchiche Bernard
- Allcock Clare
- Almasy Emoke
- Amey Isobel
- Amigoni Maria
- Andersen Elin
- Andersson Peder
- Anipchenko Natalya
- Antunes Pedro
- Armstrong Earlene
- Aslam Tayyba
- Assunção José-Pedro
- Ausserer Julia
- Avvai Mary
- Awad Nahla
- Ayas Montero Begoña
- Ayuso Mercedes
- Azevedo Patricia
- Badarau Victoria
- Badescu Roxana
- Baiardo Redaelli Martina
- Baird Colin
- Baird Yolanda
- Baker Tim
- Balaji Packianathaswamy
- Balan Cristina
- Balandin Alina
- Balescu-Arion Carmen
- Baliuliene Vilda
- Baltasar Isabel Jorge
- Baluch Saif Nasr
- Bandrabur Daniela
- Bankewitz Carla
- Barber Katrina
- Barbera Francesco
- Barcraft-Barnes Helena
- Barletti Valentina
- Barnett Gill
- Baron Kirsty
- Barros Ana
- Barsan Victoria
- Bartlett Pauline
- Batistaki Chrysanthi
- Baumgarten Georg
- Baumüller Eva
- Baytaş Volkan
- Beauchamp Nigel
- Becerra Cayetano Isabel A.
- Bell Stephanie
- Bellandi Mattia
- Belletti Alessandro
- Belmonte Cuenca Julio
- Benitez-Cano Adela
- Beretta Luigi
- Berger Marc Moritz
- Bergmann Nicole
- Bergmark Kristina
- Bermudez Lopez Maria
- Bernotaite Monika
- Beurskens Charlotte
- Bidd Heena
- Bifulco Francesca
- Bignami Elena
- Bilic Aleksandar
- Bilskiene Diana
- Bischoff Petra
- Bishop Luke
- Bjønness Therese
- Blaylock Heather
- Blethyn Kate
- Blincoe Thomas
- Blobner Manfred
- Blobner Manfred
- Blobner Manfred
- Blokhin Ivan
- Blunt Nadia
- Boer Christa
- Bois Grégory
- Bonicolini Eleonora
- Booth Joanna
- Borecka-Kedzierska Miraslawa
- Borstnar Katarina
- Borys Michal
- Boselli Emmanuel
- Bouvet Lionel
- Bouwman Arthur
- Bowen Leonora
- Bowrey Sarah
- Boxall Leigh
- Bozić Teodora
- Bradley Tom
- Branco Teresa
- Brazzi Luca
- Brazzoni Marcella
- Brear Tracy
- Brogly Nicolas
- Brohi Farooq
- Broms Jacob
- Bubliauskas Andrius
- Bucolo Gea Erika
- Buerkle Hartmut
- Buggy Donal
- Buhre Wolfgang F.
- Bukauskas Tomas
- Butturini Francesco
- Byttner Anders
- Cabrera Díaz Itahísa
- Calderon Adriana
- Calhau Ricardo
- Callejo Angel
- Cammu Guy
- Campesato Manuela
- Camsooksai Julie
- Can Özlem Selvi
- Cantor Andreea
- Carise Elsa
- Carmona Cristina
- Carreteiro Joana
- Carrieri Cosima
- Carter Anna
- Casal Manuela
- Casanova Irene
- Cascella Marco
- Casero Luis M.
- Casiraghi Giuseppina Maria
- Castelo-Branco Laila
- Castro Arranz Carlos
- Cernea Daniela
- Cervantes Oriol
- Chandler Ben
- Charnock Robert
- Chatzimicali Aikaterini
- Chervjakov Igor
- Chinery Elaine
- Chishti Ahmad
- Chondhury Priyakam
- Christie Emily
- Christodoudiles George
- Ciardo Stefano
- Cimpeanu Luminata
- Cinnella Gilda
- Cirstea Emanuel
- Clark Sebastian
- Clayton Matthew
- Cocu Simona
- Collyer Thomas
- Colvin Carrie
- Cope Sean
- Copeta Filomena
- Copotoiu Sanda
- Correia de Barros Filinto
- Corso Ruggero Massimo
- Cortegiani Andrea
- Costa Gabriela
- Cowton Amanda
- Cox Nicola
- Craig James
- Cricca Valentina
- Cronin John
- Cunha Mariana
- Cuomo Arturo
- Curley Katherine
- Czuczwar Miroslaw
- Cîndea Iulia
- Dabrowska Dominika
- Damster Sandrine
- Danguy des Déserts Marc
- Daniliuc Aura
- Danninger Thomas
- Darwish Imad
- Dascalu Corina
- Davies Kirsty
- Davies Simon
- De Boer Hans D.
- De Flaviis Adelisa
- De Salut Mar Parc
- de Selincourt Gabrielle
- Deana Cristian
- Debaene Bertrand
- Debreceni Gabor
- Dedhia Jatin
- Delgado Garcia Isabel
- Della Rocca Giorgio
- Delroy-Buelles Ilana
- Desai Tejal
- Dhillon Parveen
- Di Giacinto Ida
- Di Mauro Piero
- Diaz Gomez Tamara V.
- Dimitrovski Aleksandar
- Dinic Vesna
- Divander Mona-Britt
- Dolinar Janez
- Domingues Susana
- Doolan James
- Downes Charlotte
- Dragoescu Alice
- Droc Gabriela
- Dum Elisabeth
- Dumitrescu Alexandra
- Duncan Louise
- Dzurňáková Paula
- Dîrzu Dan-Sebastian
- Eberl Susanne
- Edwards Jayne
- Edwards Mark
- Ekelund Kim
- Ekengren Patrik
- Elghouty Eyad
- Ellerkmann Richard
- Ellis Helen
- Elme Andreas
- Eriksson Lars I
- Eriksson Lars I
- Eriksson Lars I.
- Ernst Thomas
- Errando Carlos Luis
- Esteves Simao
- Ewaldsson Callis
- Farid Nahla
- Featherstone James
- Febres Daniela
- Fedorov Sergey
- Feggeler Johanna
- Feijten Prisca
- Fellmann Tobias
- Fernando Aruna
- Fernández Castineira Adrian
- Fernández-Candil Juan
- Ferrando Carlos
- Ferreira Leonia
- Ferreira Patrick
- Feyling Anders
- Filipescu Daniela
- Fleischer Andreas
- Floris Leda
- Foerster Urs
- Fox Benjamin
- Franke Uwe
- Frasca Denis
- Frey Christian
- Frost Victoria
- Fullin Giorgio
- Fumagalli Jacopo
- Furneval Julie
- Fusari Maurizio
- Gallacher Stuart
- Galushka Svetlana
- Gambale Giorgio
- Gambino Irene
- Garcia-Perez Maria Luisa
- Garg Sanjeev
- Garlak Justyna
- Gavranović Zeljka
- Gavrilov Roman
- Gaynor James
- Gecaj-Gashi Agreta
- Georghiou Maria
- Gerjevic Bozena
- Gferer Gudrun
- Giarratano Antonino
- Gibson Andy
- Gievski Vanja
- Giles Julian
- Gillberg Lars
- Gilowska Katarzyna
- Gilsanz Rodriguez Fernando
- Gioia Antonio
- Giovannoni Cecilia
- Girotra Vandana
- Gkinas Dimitrios
- Gkiokas George
- Godoroja Daniela
- Goebel Ulrich
- Goel Vandana
- Gonzalez Matilde
- Goranović Tatjana
- Gornik-Wlaszczuk Ewa
- Gosavi Smita
- Gottfridsson Peter
- Gottschalk Andre
- Granell Manuel
- Granstrom Anna
- Grassetto Alberto
- Greenwood Anna
- Grigoras Ioana
- Grintescu Ioana
- Gritsan Alexey
- Gritsan Galina
- Grynyuk Andriy
- Guadagnin Giovanni Maria
- Guarnieri Marcello
- Guerrero Diez Maria
- Gunenc Ferim
- Gupta Pawan
- Guttenthaler Vera
- Günther Ulf
- Güçlü Çiğdem
- Hack Yvonne
- Hafisayena Ade
- Hagău Natalia
- Haldar Jagannath
- Hales Dawn
- Hales Dawn
- Hancı Volkan
- Hanna-Jumma Sameer
- Harazim Hana
- Harlet Pierre
- Harper Daniel
- Harris Benjamin
- Harvey Orla
- Hashimi Medita
- Hawkins Lesley
- Hayes Conrad
- Heaton James
- Heier Tom
- Helliwell Laurence
- Hemmes Sabrine
- Henderson Kate
- Hermanides Jeroen
- Hermanns Henning
- Herrera Hueso Berta
- Hestenes Siv
- Hettiarachchi Roshane M
- Highgate Judith
- Hodgson Keith
- Hoeft Andreas
- Hoeft Andreas
- Hoelbling Daniel
- Holland Jonathan
- Hollmann Markus
- Hollmann Markus
- Horhota Lucian
- Hormis Anil
- Hribar Renata
- Hua Alina
- Humphreys Sally
- Humphries Ryan
- Humplíková Simona
- Hunt Jane
- Hunter Jennifer
- Hunter Jennifer
- Hunter Jennifer M
- Husnain Ali
- Hussein Ahmed
- Hyams Benjamin
- Iannuccelli Fabrizio
- Ilett Katie
- Ilyas Carl
- Inan Turgay
- India Inmaculada
- Ionităv Victor
- Irwin Foo
- Jain Vipul
- Janez Benedik
- Jankovic Radmilo
- Jenkins Sarah
- Jenko Matej
- Jimenez Gomez Barbara
- Jimenez Raquel
- Joachim Suganthi
- Joelsson-Alm Eva
- John John
- Jonikaite Lina
- Jonsson Fagerlund Malin
- Jonsson Fagerlund Malin
- Jonsson Fagerlund Malin
- Jovic Miomir
- Junke Etienne
- Kabakov Borys
- Kadaoui Salah-Din
- Kanski Andrzej
- Karadağ Süheyla
- Karbonskiene Aurika
- Karjagin Juri
- Kasnik Darja
- Katanolli Fatos
- Katsika Eleni
- Kaufmann Kai
- Keane Helen
- Kelly Martin
- Kent Melanie
- Keraitiene Grazina
- Khudhur Ahmed
- Khuenl-Brady Karin
- Kidd Laurie
- King Siobhan
- Kirchgäßner Katharina
- Kirmeier Eva
- Kirmeier Eva
- Klancir Tino
- Klucniks Andris
- Knotzer Johann
- Knowlden Peter
- Koers Lena
- Kompan Janez
- Koneti Kiran Kumar
- Kooij Fabian
- Koolen Eric
- Koopman - van Gemert Anna Wilhelmina Margaretha Maria
- Kopp Kristen
- Korfiotis Dimitrios
- Korolkov Oleg
- Kosinová Martina
- Kotzinger Oskar
- Kovačević Marko
- Kranke Eva
- Kranke Peter
- Kraus Christiane
- Kraus Stephanie
- Kubitzek Christiane
- Kucharski Rafal
- Kucukguclu Semih
- Kudrashou Aliaksandr
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- Kushakovsky Vlad
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- Liperi Corrado
- Lipski Fabian
- Lirk Philipp
- Lisi Alberto
- Lišková Katarina
- Lluch Oltra Aitana
- Loganathan Vinothan
- Lombardi F. Stefania
- Lopez Lopez Eloisa
- Lopez Rodríguez Maria
- Lorenzini Laura
- Lowicka Malgorzata
- Lugovoy Alexander
- Luippold Madeleine
- Lumb Andrew
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- López Eliana
- Mac Gregor Mark Gordon
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- Maciariello Maria
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- Martinez Esther
- Martino Enrico Antonio
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- Mazul Sunko Branka
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- Mcgill Neil
- Mckee Raymond
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- Metterlein Thomas
- Meço Başak Ceyda
- Michalov Martin
- Michlig Sam
- Midgley Susan
- Milić Morena
- Milojevic Milan
- Minto Gary
- Mirabella Lucia
- Mirea Liliana
- Mittelstädt Ludger
- Miñana Amanda
- Moeglen Aude
- Moise Alida
- Mokini Zhirajr
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- Moltó Luis
- Monea Maria Concetta
- Montalto Francesca
- Montgomery Claire
- Montgomery Jane
- Montillo Gerardo
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- Pickering David
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- Trepenaitis Darius
- Trethowan Brian
- Tsaousi Georgia
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- Turan Guldem
- Turhan Sanem Çakar
- Ulm Kurt
- Ulm Kurt
- Umc Radboud
- Unic-Stojanovic Dragana
- Unterbuchner Christoph
- Unzueta Carmen
- Uranjek Jasna
- Ursic Tomaz
- v Tiesenhausen Anna
- Vaida Simona
- Valldeperas Ferrer Silvia
- Valldeperas Hernandez Maria Inmaculada
- Valsamidis Dimitrios
- Van Beek Rienk
- van Dasselaar Nick
- van der Beek Tim
- Van Duivenvoorde Yoni
- van Klei Wilton A.
- Van Poorten Frans
- Van Zaane Bas
- Van Zundert Tom
- van Zyl Rebekka
- Vargas Munoz Ana Milena
- Varsani Nimu
- Vasconcelos Pedro
- Vassilakis George
- Vecchiatini Tommaso
- Vercauteren Marcel
- Verdouw Bas
- Verheyen Veerle
- Verri Marco
- Večeřa Lubomir
- Vicari Sottosanti Luigi Giancarlo
- Vico Manuel
- Vidal Mitjans Patricia
- Vilardi Anna
- Vissicchio Daniela
- Vitale Giovanni
- Vitković Bibiana
- Vizcaychipi Marcela Paola
- Voicu Alexandra
- Voje Minca
- Volfová Ivana
- Volta Carlo Alberto
- Von Lutterotti Theresia
- Vrecič-Slabe Simona
- Vukcevic Dejan
- Vukovic Rade
- Vullo P. Agostina
- Wade Andrew
- Wallberg Hanna
- Wallden Jakob
- Wallner Johann
- Walther Sturesson Louise
- Watson Davina
- Weber Stefan
- Wegiel Leskiewicz Anna
- Weller Debbie
- Wensing Carin
- Werkmann Markus
- Westberg Henrik
- Wikström Erik
- Willett Emma
- Williams Benedict
- Wilson Robin
- Wirth Steffen
- Wittmann Maria
- Wood Laura
- Wright Stella
- Zachoval Christian
- Zambon Massimo
- Zampieri Silvia
- Zampone Salvatore
- Zangrillo Alberto
- Zani Gianluca
- Zavackiene Asta
- Ziegleder Raphael
- Zonneveldt Harry
- Zsisku Lajos
- Zucker Tom-Philipp
- Zuleika Mehrun
- Zupančič Darja
- Åslin Bjorn
- Şanli Karip Ceren
- Štourač Petr
- Żukowski Maciej
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2019
- Field of study
Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general
anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use
of neuromuscular blocking agents is associated with postoperative pulmonary complications.
Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in
28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital
procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge
were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination
within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative
pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were
adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and
adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513.
Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular
blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who
had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI
–5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised
without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49;
ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7)
were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex
instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at
a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes.
Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an
increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of
neuromuscular blockade against the increased risk of postoperative pulmonary complications
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
- Author
- Aarts Frits
- Ababneh Hazim
- Abad-Motos Ane
- Abaidalla Ahmed
- Abbakar Malaz
- Abd El Aal Ahmed
- Abd-Errazik Mohammad Ahmad
- Abdalradiy Abdalrahmman G
- Abdelkhalek Mohamed
- Abdelkhalek Mostafa
- Abdellatif Ahmed
- Abdellatif Mohamed
- Abdelsaid Kirolas
- Abdou Khaled
- Abdulfatah Mustapha
- Abdullah Mohammad Amer
- Abdullahi Mustapha Miko Mohammed
- Abellán Antonio Melero
- Abeysinghe Nayana
- Abiyere Henry
- Achimas-Cadariu Patriciu Andrei
- Adakaya Sıla
- Adam Nicolas
- Adams Benita
- Adams Ferdinand
- Adegboye Kazeem
- Adeyeye Ademola
- Adra Lama
- Adu-Poku Patricia
- Afuwape Oludolapo
- Afzal Ameer
- Afzal Muhammad Farooq
- Agapov Mihail
- Agara Daniel
- Aggarwal Manisha
- Agger Erika
- Aghadi Ifeanyi Kene
- Ahmed Amjed Yassir
- Ahmed Haleemasahdia
- Ahmed Khalil
- Ahmed Manar
- Ahmed Masood
- Ahmed Safia
- Ahn Hong Min
- Aibe Raquel
- Aigner Felix
- Aissat Abdenour
- Aitbaeva Arai
- Akay Omer
- Akbar Ali
- Akbas Ahmet
- Akere Abidemi
- Akesen Selcan
- Akgun Erhan
- Akhtar Naseem
- Akın Emrah
- Akova Elif
- Aktas Serhat
- Akçay Özlem
- Al Masri Mahmoud
- Al-Alnsi Ahmed
- Al-Hutheifi Roqia'A
- Al-Jarrah Amar
- Al-Naggar Hamza
- Al-Shehari Mohammed
- Alamin Nadeen
- Alawi Raneen
- Alawlaqi Dina
- Alawneh Fade
- Alberola Maria José
- Albers Michael
- Alcolea Natalia González
- Aleem Muhammad
- Alegre Inês
- Alegre Javier Martinez
- Alexandre Flavia
- Alexandrescu Corina
- Alexnder Abelevich
- Alexopoulou Kalliopi
- Alfonso Beatriz Amorós
- Ali Ahmed
- Ali Che Saniati Che
- Ali Danish
- Ali Madeeha
- Ali Mahmoud Abdelwahab
- Ali Manhal Hashim
- Ali Noura Al
- Alikhanli Jhale
- Aliyeva Zumrud
- Aliyu Mohammed
- Aljawder Hasan
- Allen Kate
- Almahmeed Ebrahim
- Alonso Alfredo
- Alonso Javier Etreros
- Alsamneh Muneer
- Alsayadi Ramzi
- Altinel Yuksel
- Altintoprak Fatih
- Altomare Donato F
- Alvarenga Isabella
- Alvarez Laura Jimenez
- Alvarez-Bautista Francisco Emmanuel
- Alvarez-Díez Marcos
- Alves Brenda Chayanny
- Amadigwe Rita
- Amado Andreia
- Amado Fabíola
- Amador Cristina García
- Amanullah Nazli
- Amaral Hélida Aline Tomacheski
- Amaral Luis
- Amin-Tai Hizami
- Aminu Bashiru
- Amir Ahmad Suhaimi
- Ammar Ahmed Siddique
- Ammar Mona Ahmed
- Ammendola Michele
- Ammerata Giorgio
- Amorim Edgar
- Ancans Guntis
- Anderson Tom
- Andrade Diogo
- Andrejevic Predrag
- Andrés Beatriz Díaz San
- Anestiadou Elissavet
- Ang Chin Wee
- Angelo Franceschi
- Anokhin Evgeny
- Anoldo Pietro
- Antakia Ramez
- Anton Majd
- Antonelli Serena
- Antropoli Carmine
- Anula Rocio
- Anwar Jamal
- Anyadike Florence
- Apostolakidou Magda
- Apostolidi Eirini
- Aprea Giovanni
- Arabadzhiev Angel
- Arakawa Satoshi
- Arauz Jazmin
- Aravindan U
- Aremu Abdurrahman
- Aremu Isiaka
- Argawy Osama
- Arican Can
- Arida Zahed Abu
- Armellin Claudia
- Arnaoutoglou Eleni
- Arreguy-Borges Kanthya
- Artigot Mariano
- Arturi Alessandro
- Arulappan Nirupama
- Arya Shobhit
- Arynov Ardak
- Asaad Peter
- Asano Yukio
- Ascari Francesca
- Asgarov Mohsum
- Ashmawy Soad
- Aslam Muhammad Imran
- Assimakopoulou Elena
- Assis Ana
- Astilleta Romina
- Atanasov Boyko
- Atendido Tiffany
- Athanasakis Elias
- Atici Semra Demirli
- Avellaneda Nicholas
- Avellaneda Nicolas
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- Aybar Engin
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- Aytaç Erman
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- Azevedo Patricia
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- Aziz Gowhar
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- Babatunde Olanrewaju
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- Hooper Richard L
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- Yew Chor Kuan
- Yılmaz Gülseren
- Yilmazlar Tuncay
- Yiğit Direnç
- Yoldas Tayfun
- Yonekura Hiroshi
- Yorkmui Liu
- Yoshino Kenji
- Younes Lina
- Young Trudi
- Yule Michael
- Yusoff Zakiah Mohd
- Zaari Fatimazahraa
- Zabiyaka Mikhail
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- Zafar Madiha
- Zagaynov Eugeny
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- Zakaria Maheen
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- Zarzava Eirini
- Zatari Dirar
- Zawadzki Marek
- Zayakov Georgi
- Zaycev Andrey
- Zazo Aya
- Zazo Rama
- Zdravkovic Maja
- Zengin Abdullah Kağan
- Zeringa Georgia
- Zimmerman David D E
- Zuhdy Mohammad
- Zvirych Vitalii
- Zywicka Ewa
- Álvarez-Llano Laura
- Ângelo Miguel Duarte
- ÓSullivan Sara Nuñez
- Özçelik Mehmet Faik
- Ćoza Ivo
- Şanlı Ahmet Necati
- Publication venue
- Publication date
- 01/01/2023
- Field of study
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)
Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study
- Author
- Abad Gurumeta Alfredo
- Abernethy Caroline
- Abigail Patrick
- Achaibar Kira
- Adam Emily
- Afshari Arash
- Agudelo Montoya María Elizabeth
- Akgün Fatma Nur
- Aletti Gabriele
- Alkış Neslihan
- Allan Ashley
- Allan Katie
- Allaouchiche Bernard
- Allcock Clare
- Almasy Emoke
- Amey Isobel
- Amigoni Maria
- Andersen Elin
- Andersson Peder
- Anipchenko Natalya
- Antunes Pedro
- Armstrong Earlene
- Aslam Tayyba
- Assunção José-Pedro
- Ausserer Julia
- Avvai Mary
- Awad Nahla
- Ayas Montero Begoña
- Ayuso Mercedes
- Azevedo Patricia
- Badarau Victoria
- Badescu Roxana
- Baiardo Redaelli Martina
- Baird Colin
- Baird Yolanda
- Baker Tim
- Balaji Packianathaswamy
- Balan Cristina
- Balandin Alina
- Balescu-Arion Carmen
- Baliuliene Vilda
- Baltasar Isabel Jorge
- Baluch Saif Nasr
- Bandrabur Daniela
- Bankewitz Carla
- Barber Katrina
- Barbera Francesco
- Barcraft-Barnes Helena
- Barletti Valentina
- Barnett Gill
- Baron Kirsty
- Barros Ana
- Barsan Victoria
- Bartlett Pauline
- Batistaki Chrysanthi
- Baumgarten Georg
- Baumüller Eva
- Baytaş Volkan
- Beauchamp Nigel
- Becerra Cayetano Isabel A.
- Bell Stephanie
- Bellandi Mattia
- Belletti Alessandro
- Belmonte Cuenca Julio
- Benitez-Cano Adela
- Beretta Luigi
- Berger Marc Moritz
- Bergmann Nicole
- Bergmark Kristina
- Bermudez Lopez Maria
- Bernotaite Monika
- Beurskens Charlotte
- Bidd Heena
- Bifulco Francesca
- Bignami Elena
- Bilic Aleksandar
- Bilskiene Diana
- Bischoff Petra
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- Buggy Donal
- Buhre Wolfgang F.
- Bukauskas Tomas
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