57 research outputs found
A Protocol is not Enough:Enhanced Recovery Program-Based Care and Clinician Adherence Associated with Shorter Stay After Colorectal Surgery
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 20/10/2020
- Field of study
Acute Renal Failure in Association with Community-Acquired Clostridium difficile Infection and McKittrick-Wheelock Syndrome
- Author
- Publication venue
- S. Karger AG
- Publication date
- 01/01/2011
- Field of study
We report the case of a 65-year-old Caucasian woman who experienced two separate episodes of acute renal failure within an 18-month period, both requiring emergency admission and complicated treatment. Each episode was precipitated by hypovolaemia from intestinal fluid losses, but from two rare and independent pathologies. Her first admission was attributed to community-acquired Clostridium difficile-associated diarrhoea (CDAD) and was treated in the intensive therapy unit. She returned 18 months later with volume depletion and electrolyte disturbances, but on this occasion a giant hypersecretory villous adenoma of the rectum (McKittrick-Wheelock syndrome) was diagnosed following initial abnormal findings on digital rectal examination by a junior physician. Unlike hospital-acquired C. difficile, community-acquired infection is not common, although increasing numbers are being reported. Whilst community-acquired CDAD can be severe, it rarely causes acute renal failure. This case report highlights the pathological mechanisms whereby C. difficile toxin and hypersecretory villous adenoma of the rectum can predispose to acute renal failure, as well as the values of thorough clinical examination in the emergency room, and early communication with intensivist colleagues in dire situations
Gametocyte carriage in uncomplicated Plasmodium falciparum malaria following treatment with artemisinin combination therapy: a systematic review and meta-analysis of individual patient data
- Author
- Abdulla S
- Achan J
- Adam I
- Alemayehu BH
- Allan R
- Allen EN
- Anvikar AR
- Arinaitwe E
- Ashley EA
- Asih PBS
- Awab GR
- Barnes KI
- Bassat Q
- Baudin E
- Bjorkman A
- Bompart F
- Bonnet M
- Borrmann S
- Bousema T
- Carrara VI
- Cenci F
- Checchi F
- Cot M
- D'Alessandro U
- Dahal P
- Deloron P
- Djimde A
- Dondorp A
- Dorsey G
- Doumbo OK
- Drakeley CJ
- Duparc S
- Espie E
- Faiz A
- Falade CO
- Fanello C
- Faucher J-F
- Faye B
- Filler S
- Fofana B
- Fogg C
- Gansane A
- Gaye O
- Genton B
- Gething PW
- Gonzalez R
- Grandesso F
- Greenwood B
- Grivoyannis A
- Guerin PJ
- Hamed K
- Hatz C
- Hay SI
- Hodel EM
- Humphreys GS
- Hwang J
- Janssens B
- Jima D
- Juma E
- Kachur SP
- Kager P
- Kamya MR
- Kapulu M
- Karema C
- Kayentao K
- Kiechel JR
- Kofoed P-E
- Lameyre V
- Lee SJ
- Lell B
- Lima N
- Marsh K
- Martensson A
- Massougbodji A
- Mayxay M
- McGready R
- Menan H
- Menendez C
- Mens P
- Meremikwu M
- Mockenhaupt FP
- Moreira C
- Nabasumba C
- Nambozi M
- Ndiaye J-L
- Newton PN
- Ngasala BE
- Nosten F
- Nsanzabana C
- Offianan AT
- Oguike M
- Ogutu BR
- Olliaro P
- Omar SA
- Osorio L
- Owusu-Agyei S
- Penali LK
- Pene M
- Peshu J
- Piola P
- Premji Z
- Price RN
- Ramharter M
- Rombo L
- Roper C
- Rosenthal PJ
- Sagara I
- Sawa P
- Schallig HDFH
- Schramm B
- Shekalaghe SA
- Sibley CH
- Sirima S
- Smithuis F
- Sow D
- Staedke SG
- Stepniewska K
- Sutanto I
- Sutherland CJ
- Swarthout TD
- Syafruddin D
- Sylla K
- Talisuna AO
- Taylor WR
- Temu EA
- Ter Kuile F
- Tinto H
- Tjitra E
- Ursing J
- Valecha N
- van den Broek I
- van Herp M
- van Vugt M
- Ward SA
- White NJ
- Winstanley PA
- Woodrow CJ
- Yeka A
- Zwang J
- Publication venue
- BMC
- Publication date
- 24/05/2016
- Field of study
BACKGROUND:
Gametocytes are responsible for transmission of malaria from human to mosquito. Artemisinin combination therapy (ACT) reduces post-treatment gametocyte carriage, dependent upon host, parasite and pharmacodynamic factors. The gametocytocidal properties of antimalarial drugs are important for malaria elimination efforts. An individual patient clinical data meta-analysis was undertaken to identify the determinants of gametocyte carriage and the comparative effects of four ACTs: artemether-lumefantrine (AL), artesunate/amodiaquine (AS-AQ), artesunate/mefloquine (AS-MQ), and dihydroartemisinin-piperaquine (DP).
METHODS:
Factors associated with gametocytaemia prior to, and following, ACT treatment were identified in multivariable logistic or Cox regression analysis with random effects. All relevant studies were identified through a systematic review of PubMed. Risk of bias was evaluated based on study design, methodology, and missing data.
RESULTS:
The systematic review identified 169 published and 9 unpublished studies, 126 of which were shared with the WorldWide Antimalarial Resistance Network (WWARN) and 121 trials including 48,840 patients were included in the analysis. Prevalence of gametocytaemia by microscopy at enrolment was 12.1 % (5887/48,589), and increased with decreasing age, decreasing asexual parasite density and decreasing haemoglobin concentration, and was higher in patients without fever at presentation. After ACT treatment, gametocytaemia appeared in 1.9 % (95 % CI, 1.7–2.1) of patients. The appearance of gametocytaemia was lowest after AS-MQ and AL and significantly higher after DP (adjusted hazard ratio (AHR), 2.03; 95 % CI, 1.24–3.12; P = 0.005 compared to AL) and AS-AQ fixed dose combination (FDC) (AHR, 4.01; 95 % CI, 2.40–6.72; P < 0.001 compared to AL). Among individuals who had gametocytaemia before treatment, gametocytaemia clearance was significantly faster with AS-MQ (AHR, 1.26; 95 % CI, 1.00–1.60; P = 0.054) and slower with DP (AHR, 0.74; 95 % CI, 0.63–0.88; P = 0.001) compared to AL. Both recrudescent (adjusted odds ratio (AOR), 9.05; 95 % CI, 3.74–21.90; P < 0.001) and new (AOR, 3.03; 95 % CI, 1.66–5.54; P < 0.001) infections with asexual-stage parasites were strongly associated with development of gametocytaemia after day 7.
CONCLUSIONS:
AS-MQ and AL are more effective than DP and AS-AQ FDC in preventing gametocytaemia shortly after treatment, suggesting that the non-artemisinin partner drug or the timing of artemisinin dosing are important determinants of post-treatment gametocyte dynamics
The effect of dose on the antimalarial efficacy of artemether-lumefantrine: a systematic review and pooled analysis of individual patient data
- Author
- Abdulla S
- Achan J
- Adam I
- Adjei GO
- Alemayehu BH
- Aliu P
- Anstey NM
- Arinaitwe E
- Ashley EA
- Ashley EA
- Ba MS
- Barnes KI
- Barnes KI
- Bassat Q
- Bassat Q
- Baudin E
- Bjorkman A
- Borrmann S
- Borrmann S
- Bousema T
- Bousema T
- Bukirwa H
- Carrara VI
- Carrara VI
- Checchi F
- Cot M
- Cot M
- D'Alessandro U
- D'Alessandro U
- Dahal P
- Dahal P
- Davis TME
- Deloron P
- Deloron P
- Djimde AA
- Dondorp AM
- Dondorp AM
- Dorsey G
- Doumbo OK
- Drakeley CJ
- Duparc S
- Espie E
- Faiz AM
- Falade CO
- Faucher J-F
- Faucher J-F
- Faucher J-F
- Faye B
- Faye O
- Filler S
- Flegg JA
- Flegg JA
- Fofana B
- Gadalla NB
- Gadalla NB
- Gadalla NB
- Gaye O
- Genton B
- Genton B
- Gething PW
- Gil JP
- Gil JP
- Gil JP
- Gonzalez R
- Gonzalez R
- Greenhouse B
- Greenwood B
- Grivoyannis A
- Guerin PJ
- Guerin PJ
- Guthmann J-P
- Hamed K
- Hay SI
- Hodel EM
- Hodel EM
- Hwang J
- Hwang J
- Ibrahim ML
- Jima D
- Juma E
- Kachur PS
- Kager PA
- Kamugisha E
- Kamya MR
- Karema C
- Karunajeewa HA
- Karunajeewa HA
- Khanthavong M
- Kironde F
- Kofoed P-E
- Kofoed P-E
- Kone M
- Lee SJ
- Lee SJ
- Lell B
- Lell B
- Lima A
- Malik EFM
- Marsh K
- Marsh K
- Martensson A
- Massougbodji A
- Mayxay M
- Mayxay M
- McGready R
- McGready R
- Menan H
- Menendez C
- Menendez C
- Mens PF
- Mens PF
- Meremikwu M
- Meremikwu M
- Moreira C
- Moreira C
- Mueller I
- Mueller I
- Nabasumba C
- Nabasumba C
- Nambozi M
- Ndiaye J-L
- Newton PN
- Newton PN
- Newton PN
- Ngasala BE
- Ngasala BE
- Nikiema F
- Nosten F
- Nosten F
- Nsanzabana C
- Nsanzabana C
- Oguike M
- Ogutu BR
- Olliaro P
- Olliaro P
- Omar SA
- Ouedraogo J-B
- Ouedraogo J-B
- Penali LK
- Pene M
- Peshu J
- Pinoges L
- Piola P
- Premji Z
- Price RN
- Price RN
- Price RN
- Resistance WA
- Rombo L
- Rombo L
- Rombo L
- Rosenthal PJ
- Sagara I
- Same-Ekobo A
- Sawa P
- Schallig HDFH
- Schramm B
- Shekalaghe SA
- Shekalaghe SA
- Sibley CH
- Sibley CH
- Smith JJ
- Smithuis F
- Smithuis F
- Sow D
- Staedke SG
- Staedke SG
- Stepniewska K
- Sutherland CJ
- Sylla K
- Talisuna AO
- Talisuna AO
- Tarning J
- Tarning J
- Tarning J
- Tine RCK
- Tinto H
- Tinto H
- Tjitra E
- Toure AO
- Ursing J
- Ursing J
- Van den Broek I
- Van den Broek I
- Van Vugt M
- Ward SA
- White NJ
- White NJ
- Winstanley PA
- Workman LJ
- Workman LJ
- Yavo W
- Yavo W
- Yeka A
- Zongo I
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2015
- Field of study
Background: Artemether-lumefantrine is the most widely used artemisinin-based combination therapy for malaria, although treatment failures occur in some regions. We investigated the effect of dosing strategy on efficacy in a pooled analysis from trials done in a wide range of malaria-endemic settings. Methods: We searched PubMed for clinical trials that enrolled and treated patients with artemether-lumefantrine and were published from 1960 to December, 2012. We merged individual patient data from these trials by use of standardised methods. The primary endpoint was the PCR-adjusted risk of Plasmodium falciparum recrudescence by day 28. Secondary endpoints consisted of the PCR-adjusted risk of P falciparum recurrence by day 42, PCR-unadjusted risk of P falciparum recurrence by day 42, early parasite clearance, and gametocyte carriage. Risk factors for PCR-adjusted recrudescence were identified using Cox's regression model with frailty shared across the study sites. Findings: We included 61 studies done between January, 1998, and December, 2012, and included 14 327 patients in our analyses. The PCR-adjusted therapeutic efficacy was 97·6% (95% CI 97·4-97·9) at day 28 and 96·0% (95·6-96·5) at day 42. After controlling for age and parasitaemia, patients prescribed a higher dose of artemether had a lower risk of having parasitaemia on day 1 (adjusted odds ratio [OR] 0·92, 95% CI 0·86-0·99 for every 1 mg/kg increase in daily artemether dose; p=0·024), but not on day 2 (p=0·69) or day 3 (0·087). In Asia, children weighing 10-15 kg who received a total lumefantrine dose less than 60 mg/kg had the lowest PCR-adjusted efficacy (91·7%, 95% CI 86·5-96·9). In Africa, the risk of treatment failure was greatest in malnourished children aged 1-3 years (PCR-adjusted efficacy 94·3%, 95% CI 92·3-96·3). A higher artemether dose was associated with a lower gametocyte presence within 14 days of treatment (adjusted OR 0·92, 95% CI 0·85-0·99; p=0·037 for every 1 mg/kg increase in total artemether dose). Interpretation: The recommended dose of artemether-lumefantrine provides reliable efficacy in most patients with uncomplicated malaria. However, therapeutic efficacy was lowest in young children from Asia and young underweight children from Africa; a higher dose regimen should be assessed in these groups. Funding: Bill and Melinda Gates Foundation
Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer
- Author
- Adam Dziki
- Ahmed Abdile
- Ahmer A Karimuddin
- Alaa El-Hussuna
- Albert Wolthuis
- Alejandro Solis-Peña
- Aleksandar Sekulic
- Aleksandra Edmundson
- Aleksei Karachun
- Alexander Zakharenko
- Alexandra M Zaborowski
- Alexandra Olkina
- Alexandra Shlomina
- Alexei Petrov
- Alexis Ulrich
- Anastasia Novikova
- Andre Dias
- Andrea Jiménez Salido
- Andrea Álvarez
- Andrei Moiseenko
- Andrew Beggs
- Andrew Hill
- André D'Hoore
- Ann Hanly
- Anna Lepisto
- Anna Martling
- Annalisa Maroli
- Antonino Spinelli
- Augustinas Bausys
- Avanish Saklani
- Barisic Goran
- Benjamin A Weinberg
- Biniam Teklay
- Brodie Elliott
- Bruna B Vailati
- Caio Nahas
- Cameron Wells
- Campbell S Roxburgh
- Carl Brown
- Caterina Allmer
- Caterina Foppa
- Cherry Koh
- Christiane Bruns
- Christoph Reissfelder
- Christopher Lieu
- Christos Kontovounisios
- Cihan Ozen
- Cornelis Verhoef
- Craig Lynch
- Daniel D Buchanan
- Daniel Duek
- Daniela Rega
- David Clark
- David Larson
- David Proud
- Deborah S Keller
- Deborah Saraste
- Demetris Papamichael
- Des C Winter
- Dieter Hahnloser
- Dimitri Christoforidis
- Eloy Espin-Basany
- Emma Greenwood
- Evangelos Xynos
- Evgeniy Drozdov
- Fabiano Iaquinandi
- Felipe Bellolio
- Felix Aigner
- Fergal Fleming
- Frank Frizelle
- Frank McDermott
- Frank Pfeffer
- Frederic Ris
- Gabriela Möslein
- Gabriele Bislenghi
- George Fowler
- Giovanni Dapri
- Gleb Khrykov
- Guilherme Pagin São Julião
- Guillaume Meurette
- Guiseppe Sica
- György Lázár
- Hartwig Korner
- Heather Hampel
- Heather Pringle
- Helene Maillou-Martinaud
- Hidde Maarten Kroon
- Hirotoshi Hasegawa
- Homero Rodriguez-Zentner
- Hwee-Hoon Chew
- Ian R Daniels
- Ida Gutlic
- Ionut Negoi
- Irmgard Kronberger
- Ivana Raguz
- Jacobus Wa Burger
- Jaime Otero
- James Hill
- Jiri Hoch
- Joep Knol
- John Rt Monson
- Jose Gellona
- Juan Carlos Patrón Uriburu
- Juan Carlos Reyes Meneses
- Julio Mayol
- Justin Davies
- Justin Kelly
- Justino Zeballos
- Jérémie H Lefèvre
- Kai-Yin Lee
- Katrina A Knight
- Ker-Kan Tan
- Kieran Sheahan
- Klaus E Matzel
- Koji Okabayashi
- Konosuke Moritani
- Kyle G Cologne
- Laura d'Allens
- Leandro Siragusa
- Lene Hjerrild Iversen
- Lidiia Panaiotti
- Luis Hurtado
- Luis Oñate-Ocaña
- Lynette Loi
- Malcolm Dunlop
- Manoj J Raval
- Marc Bludau
- Marianne G Guren
- Marie Barussaud
- Marius Kryzauskas
- Marta Climent
- Marta Jiménez-Toscano
- Martin Mitteregger
- Martin Schneider
- Martino Munini
- Martyn Evans
- Matteo Frasson
- Matthias Turina
- Maylis Capdepont
- Mehrenah D Jafari
- Meike van Harten
- Melissa-Rose Bennett
- Michael Deutsch
- Michael J Stamos
- Michel Adamina
- Michela Campanelli
- Michele Carvello
- Miguel Pera
- Mihailo Andric
- Miklosh Bala
- Miranda Kusters
- Misael Ocares
- Monica Millan
- Nancy You
- Neil Smart
- Neils Kok
- Nikita Burlov
- Nuno Figueiredo
- Nuno Rama
- Omar Faiz
- Pamela Buchwald
- Paolo Delrio
- Paris Tekkis
- Petr Kocian
- Petr Tsarkov
- Pieter J Tanis
- Quentin Denost
- REACCT Collaborative: Lauren V O'Connell
- Rocio Anula
- Rodrigo O Perez
- Roel Hompes
- Roland Croner
- Rory Kennelly
- Rowan Collinson
- Roxane D Staiger
- Rumana Islam
- Ryo Seishima
- Sabrina Tengku
- Said Kural
- Sam Atallah Simon Bach
- Sameh Emile
- Satish Warrier
- Scott Steele
- Sean T Martin
- Sebastiano Biondo
- Seraina Faes
- Sergey Efetov
- Sergio Nahas
- Shahnawaz Rasheed
- Shamil Gadaev
- Sica G
- Stefan Morarasu
- Stefan Riss
- Stephanie Guillon
- Steven Wexner
- Suk Hwan Lee
- Swati Patel
- Sze-Lin Peng
- Tamara Glyn
- Tarik Sammour
- Terry P Phang
- Tim Forgan
- Timur Lankov
- Tomas Contreras
- Tomas Poskus
- Tongplaew Singnomklao
- Toni Seppala
- Ugne Imbrasaite
- Ugo Pace
- Vicki Bevan
- Youzhi Zhou
- Yukihide Kanemitsu
- Yves Panis
- Zaher Lakkis
- Zoran Krivokapic
- Publication venue
- 'Frontiers Media SA'
- Publication date
- 01/01/2022
- Field of study
Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (<50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, <50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters
Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries
- Author
- Aamir Faiqa Binte
- Aamir Syed Roohan
- Ababneh Adnan
- Abbal Muhammad Anas
- Abbas Ahmed M
- Abbas Mostafa
- Abd-Albain Montasir A
- Abdalei Abdulwahab
- Abdalla Ahmed
- Abdalla Ahmed Yassir
- Abdalla Mohamed Galal Ali
- Abdalla Zainab
- Abdallah Mohamed M
- Abdalmahmoud Noon Ezzeldien
- Abdalsadeg Rowa
- Abdelaal Ahmed M
- Abdelbagi Alnazeer Y
- Abdelbaky Mostafa
- Abdelbaset Doaa
- AbdElbaset Esraa
- Abdelbast Menhag
- Abdelfatah Mohammed Abdelnasser
- Abdelgawad Samia
- Abdelhamid Mohamed M
- Abdeljaber Mahmoud
- Abdelkhalig Mubarak
- Abdelmaksoud Mohamed
- Abdelmeguid Rana
- Abdelmelek Dhia Errahmane
- Abdelnaeam Samah
- Abdelnasser Mohammad K
- Abdelrahim Najwa
- Abdelrahman Amira
- Abdelrahman Ayman
- Abdelsalam Hebatalla
- Abdelsamed Enas Abdelbaset
- Abdelwahab Khaled
- Abdoun Meriem
- Abdulali Fatima
- Abdulaziz Mohamed
- Abdulla Dheba Almukhtar
- Abdullah Bahiyah
- Abdullah Bahiyah
- Abdullah Walaa
- Abdullahi Habiba Ibrahim
- Abdulrahman Ahmed
- Abdulrasheed Lubabatu
- Abdulwahed Eman
- Abdulwahed Eman
- Abeysirigunawardana Dewmi
- Abidin Muhammad Fihmi Zainal
- Abiola Olukayode
- Abiyere Henry
- Abodina Ahmed Mohammed
- Aboelela Reham
- AboElfarh Hadeer Elsaeed
- Aboudlal Husein
- AbouHiekal Osama
- Aboulfotouh Ahmed
- Abozid Anwaar
- Abubaker Noora
- Abubaker Noora
- Abufanas Asma
- Abughanima Mahmoud
- Abuhashem Shehab
- Abulafia Daniel
- Abushaala Fatima
- Abushanab Khaled
- AbuShawareb Issa
- Abuuqteish Hamza
- Abuzaho Amany
- Achem Arome
- Adam Eithar
- Adam Mohammed
- Adam Mohammed A
- Addalla Mohamed
- Addley Jordan
- Adeleye Gbadebo
- Adeniyi Adebayo
- Adewole Nathaniel
- Adeyemo Olabisi
- Adeyeye Ademola
- Adeyeye Ademola
- Adly Michael
- Adnan Siti Nasyirah Nisya
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adze Joel Amwe
- Afeikhena Ehis
- Agida Teddy
- Agilla Hamza
- Agnew Emilie
- Agu Joy Onyekachi
- Ahmad Zatul Akmar
- Ahmed Abdalla
- Ahmed Ahmed
- Ahmed Ahmed
- Ahmed Alaaaldeen
- Ahmed Entisar
- Ahmed Habeeba
- Ahmed Hatem
- Ahmed Reem
- Ahmed Rehab
- Ahmed Rihab
- Ahmed Rogia Ahmed Abdalla
- Ahmed Ruaa
- Ahmed Sharwany
- Ahmed Uzair
- Ahmed Wahiba
- Ahmeed Sultan
- Airede Lydia Regina
- Aitchison Lori
- Ajredini Mirac
- Ajulo Adeshina A
- Akaba Godwin
- Akasha Mazin
- Akbar Maha Ghulam
- Akbuz Seyma Orcan
- Akdere Hakan
- Akın Bilge
- Akkaya Ege Nur
- Akpamgbo Chukwunonso Nnamdi
- Akwaisah Ayoub
- Al Hammoud Amr
- Al Rawashdeh Toka
- Al-Baw Mahmoud
- Al-Dahdouh Mosheer
- Al-Haek Safa’
- Al-Hazaimeh Mo'ath
- Al-issawi Dima
- Al-Issawi Subhi
- Al-jammal Maryam
- Al-Juaifari Maytham A
- Al-Mwajeh Tesneem
- Al-Omary Sohaib
- Al-Quossi Mohammed
- Al-Shambaty Yasir Babkir Ali
- Al-Shami Qotadah
- Al-Smirat Heba
- Al-Tahayneh Sief-Addeen
- Al-Touny Aiman
- Al-Touny Shimaa
- Al-zawaydeh Alia
- Alaa Ali
- Alabed Ebtihal
- Alagelli Fatma
- Alagoz Ahmet Can
- Alameen Hind
- Alameen Maram
- Alamlih Laith
- Alaqoubi Retaj
- Alarabi Rehab
- Alariby Fatima
- Alatefi Dawood
- Alathameen Nassar
- Albakosh Bashir Abobaker
- Albanopoulos Konstantinos
- Albarhomy Osama
- Albarki Aisha
- Albashaireh Alaa
- Albatni Safa Sasi
- Albayadi Eslam
- Alboon Mosab
- Alboridy Muneera
- Alboueishi Asraa Ali
- Aldeges Marwan
- Aldreawi Mohammed
- Alflite Asil Omar Saleh
- Alfrijat Tamam
- Alfrjani Tariq
- Algabbasi Salima
- Algatanesh Nassib
- Alhadad Qamrah
- Alhaddad Hoda Salem
- Alhaleem Ayah
- Alhaleeq Saif
- Alharam Abtisam
- Alhashimi Abdulhadi Mohammed Alhadi
- Alhassan Monzer
- Alhudhairy Sara
- Ali Ahmed
- Ali Aml
- Ali Doua
- Ali Eithar M
- Ali Iqra Fatima Munawar
- Ali Maab
- Ali Manal
- Ali Muhammad
- Ali Radwa
- Ali Rawan Alsheikh
- Ali Rzan Ali Hamedelneel
- Ali Shehroz
- Aliosin Oleg
- Aljamal Mohammad
- Aljamal Sarah
- Alkaraja Layth
- Alkaseek Akram
- Alkazali Mustafa
- Alkchr Hayat Ben Hasan Mohamed A A
- Alkhatib Abed Alazeez
- Allam Shereen
- Almahroush Marin
- Almakki Doha Mohammed Ahmed
- Alnajjar Lara
- Alnajjar Majjd
- Alnatsheh Wesam
- Alnour Ammar
- Alomar Rabiaa
- Alomari Yazan
- Alqaarh Aya
- Alragig Zahra
- Alrifae Ghaliya Mohamed H
- Alrosan Risan
- Alsagoff Sharifah Nor Amirah Syed Abdul Latiff
- Alsaid Hamza
- Alsaify Esmat
- Alsaih Sawsan
- Alsari Najah
- Alshareea Entisar
- Alshawadfy Abdelrhman
- Alshawesh Aisha
- Alsheik Ahmad
- Alsori Mohamed
- Alsoudani Ali
- Altabbaa Hashem
- Altahir Mohamed
- Altair Mawadda
- Altaweel Ahmad
- Altughar Bushra
- Alvarez Matias
- Alvarez-Lozada Luis Adrian
- Alvarez-Lozada Luis Adrian
- Alwahaib Anas
- Alwash Mohammed
- Alzarga Ali
- Alzarouq Ebtisam
- Alzarroug Amal
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- Zaed Moahmed
- Zafar Fatima
- Zaghloul Ahmed
- Zaheer Adil
- Zaidi Faseeh
- Zain Ahmad
- Zakaria Ahmed
- Zakaria Andee Dzulkarnaen
- Zakaria Mohd Zaim
- Zalloum Jihad
- Zamanbandhon Bushra
- Zambon Mattia
- Zapsalis Konstantinos
- Zargar Kamran
- Zarzour Mohamed A
- Zeng Raymond
- Zeng Raymond
- Zengin Kagan
- Zertuche Juventino Tadeo Guerrero
- Zhang Caitlin
- Zhang Edward
- Zhang Shane
- Zhang Yichi
- Zhao Hailin
- Zheng Helen
- Zhou Karen
- Zhou Yida
- Ziergiebel Felix
- Zou Peishan
- Zuylekom Kate Van
- Zuylekom Katie Van
- Zwain Yasir Adnan
- Zyul'korneeva Sof'ya
- Aladna Abdallah
- Aljoumaa Abdullah
- Nawfal Hamdi
- Niazi Ammar
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
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- Abad-Motos A.
- Abbas A.M.
- Abbas M.
- Abbasi M.
- Abbott T.
- Abdalaal I.
- Abdel-Galil K.
- Abdelemam R.
- Abdelgawad A.
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- Abdelmawgoud S.
- Abdelmohsen S.
- Abdelrahman A.S.
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- Abdou H.
- Abdulai D.R.
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- Wijeyaratne M.
- Wijeysundera D.
- Wiles M.
- Wilkin R.
- Wilkins A.
- Wilkins J.
- William T.G.
- Williams O.M.
- Williams S.
- Windsor J.
- Winnand P.
- Wittmann M.
- Wolde A.
- Wolfenden J.W.D.
- Wong B.N.X.
- Wong E.
- Wong E.G.
- Wong G.K.C.
- Wong H.Y.F.
- Wong K.Y.
- Wormald J.
- Wright D.
- Wright J.
- Wu F.
- Wurm M.
- Xenaki S.
- Yadev I.
- Yahaya A.S.
- Yakubu M.
- Yang W.
- Yanık Ö
- Yanowsky-Reyes G.
- Yassin A.
- Yates E.
- Yebes A.
- Yenli E.M.T.-A.
- Yeoh T.
- Yeung J.
- Yiallourou A.
- Yigit B.
- Yildirim A.
- Yim G.
- Yiu A.
- Yonekura H.
- Yotsov T.
- Younis M.U.
- Yunus A.
- Yusefi H.
- Zabaleta J.
- Zabkiewicz C.
- Zaccaria G.
- Zacharia B.
- Zafar S.N.
- Zago M.
- Zaheen Z.
- Zahid Z.
- Zaimis T.
- Zakaria A.D.
- Zambon M.
- Zamora L.
- Zampogna B.
- Zancana G.
- Zani A.
- Zanin L.
- Zanini N.
- Zapardiel I.
- Zapata C.S.
- Zarif P.
- Zaránd A.
- Zehnder P.
- Zenger S.
- Zenha H.
- Zhu M.Z.L.
- Ziemann S.
- Zimak D.M.
- Zimak Z.
- Zivkovic D.
- Zizzo M.
- Zucker B.
- Zwain Y.
- Zyskowski M.
- Ávila C.C.
- Älgå A.
- Çakıcı MÇ
- Çelik E.
- Çelik M.N.
- Özçay N.
- Şevi̇k H.
- Šantak G.
- Šimko K.
- Žatecký J.
- Publication venue
- Oxford University Press (OUP)
- Publication date
- 01/07/2023
- Field of study
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Recommended from our members
Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
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- Aali Amirali
- Ababneh Hazim S
- Abate Yohannes Habtegiorgis
- Abbafati Cristiana
- Abbasgholizadeh Rouzbeh
- Abbasi-Kangevari Mohsen
- Abbasian Mohammadreza
- Abbastabar Hedayat
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdelmasseh Michael
- Abdelwahab Ahmed
- Abdollahi Mohammad
- Abdollahifar Mohammad-Amin
- Abdoun Meriem
- Abdulah Deldar Morad
- Abdullahi Auwal
- Abebe Mesfin
- Abebe Samrawit Shawel
- Abedi Aidin
- Abegaz Kedir Hussein
- Abhilash E S
- Abidi Hassan
- Abiodun Olumide
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abolmaali Meysam
- Abouzid Mohamed
- Aboye Girma Beressa
- Abreu Lucas Guimarães
- Abrha Woldu Aberhe
- Abtahi Dariush
- Abu Rumeileh Samir
- Abu-Gharbieh Eman
- Abu-Rmeileh Niveen ME
- Abu-Zaid Ahmed
- Abualruz Hasan
- Abubakar Bilyaminu
- Aburuz Salahdein
- Accrombessi Manfred Mario Kokou
- Adal Tadele Girum
- Adamu Abdu A
- Addo Isaac Yeboah
- Addolorato Giovanni
- Adebiyi Akindele Olupelumi
- Adekanmbi Victor
- Adepoju Abiola Victor
- Adetunji Charles Oluwaseun
- Adetunji Juliana Bunmi
- Adeyeoluwa Temitayo Esther
- Adeyinka Daniel Adedayo
- Adeyomoye Olorunsola Israel
- Admass Biruk Adie Adie
- Adnani Qorinah Estiningtyas Sakilah
- Adra Saryia
- Afolabi Aanuoluwapo Adeyimika
- Afzal Muhammad Sohail
- Afzal Saira
- Agampodi Suneth Buddhika
- Agasthi Pradyumna
- Aggarwal Manik
- Aghamiri Shahin
- Agide Feleke Doyore
- Agodi Antonella
- Agrawal Anurag
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahmad Aqeel
- Ahmad Danish
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- Ahmad Muayyad M
- Ahmad Sajjad
- Ahmad Shahzaib
- Ahmad Tauseef
- Ahmadi Keivan
- Ahmadzade Amir Mahmoud
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- Ahmed Ayman
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- Ahmed Mehrunnisha Sharif
- Ahmed Meqdad Saleh
- Ahmed Muktar Beshir
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- Ajami Marjan
- Aji Budi
- Akara Essona Matatom
- Akbarialiabad Hossein
- Akinosoglou Karolina
- Akinyemiju Tomi
- Akkaif Mohammed Ahmed
- Akyirem Samuel
- Al Hamad Hanadi
- Al Hasan Syed Mahfuz
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- Al-amer Rasmieh Mustafa
- Al-Azzam Sayer
- Al-Gheethi Adel Ali Saeed
- Al-Hanawi Mohammed Khaled
- Al-Marwani Sabah
- Al-Maweri Sadeq Ali Ali
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- Al-Omari Basem
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- Alema Haileselasie Berhane
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- Ali Amjad
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- Shehabeldine Amr Mohamed Elsayed
- Sheikh Aziz
- Sheikhi Rahim Ali
- Shen Jiabin
- Shetty Adithi
- Shetty B Suresh Kumar
- Shetty Pavanchand H
- Shi Peilin
- Shibuya Kenji
- Shiferaw Desalegn
- Shigematsu Mika
- Shin Min-Jeong
- Shin Youn Ho
- Shiri Rahman
- Shirkoohi Reza
- Shitaye Nebiyu Aniley
- Shittu Aminu
- Shiue Ivy
- Shivakumar K M
- Shivarov Velizar
- Shokraneh Farhad
- Shokri Azad
- Shool Sina
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- Shrestha Sunil
- Shuval Kerem
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- Sleet David A
- Socea Bogdan
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- Solanki Ranjan
- Solanki Shipra
- Soleimani Hamidreza
- Soliman Sameh S M
- Song Suhang
- Song Yimeng
- Sorensen Reed J D
- Soriano Joan B
- Soyiri Ireneous N
- Spartalis Michael
- Spearman Sandra
- Sreeramareddy Chandrashekhar T
- Srivastava Vijay Kumar
- Stanaway Jeffrey D
- Stanikzai Muhammad Haroon
- Stark Benjamin A
- Starnes Joseph R
- Starodubova Antonina V
- Stein Caroline
- Stein Dan J
- Steinbeis Fridolin
- Steiner Caitlyn
- Steinmetz Jaimie D
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- Stevanović Aleksandar
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- Stokes Mark A
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- Subramaniyan Vetriselvan
- Suleman Muhammad
- Suliankatchi Abdulkader Rizwan
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- Sunkersing David
- Sunnerhagen Katharina S
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- Szarpak Lukasz
- Szeto Mindy D
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- TADAKAMADLA JYOTHI
- Tadakamadla Santosh Kumar
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- Takahashi Ken
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- Tan Ker-Kan
- Tandukar Sarmila
- Tang Haosu
- Tang Hong K
- Tarigan Ingan Ukur
- Tariku Mengistie Kassahun
- Tariqujjaman Md
- Tarkang Elvis Enowbeyang
- Tavakoli Oliaee Razieh
- Tavangar Seyed Mohammad
- Taveira Nuno
- Tefera Yibekal Manaye
- Temsah Mohamad-Hani
- Temsah Reem Mohamad Hani
- Teramoto Masayuki
- Tesler Riki
- Teye-Kwadjo Enoch
- Thakur Rishu
- Thangaraju Pugazhenthan
- Thankappan Kavumpurathu Raman
- Tharwat Samar
- Thayakaran Rasiah
- Thomas Nihal
- Thomas Nikhil Kenny
- Thomson Azalea M
- Thrift Amanda G
- Thum Chern Choong Chern
- Thygesen Lau Caspar
- Tian Jing
- Tichopad Ales
- Ticoalu Jansje Henny Vera
- Tillawi Tala
- Tiruye Tenaw Yimer
- Titova Mariya Vladimirovna
- Tonelli Marcello
- Topor-Madry Roman
- Toriola Adetunji T
- Torre Anna E
- Touvier Mathilde
- Tovani-Palone Marcos Roberto
- Tran Jasmine T
- Tran Nghia Minh
- Trico Domenico
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- Vaithinathan Asokan Govindaraj
- Valizadeh Rohollah
- Van de Velde Sarah M
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- Vervoort Dominique
- Villafañe Jorge Hugo
- Villanueva Gabriela Ines
- Vinayak Manish
- Violante Francesco S
- Viskadourou Maria
- Vladimirov Sergey Konstantinovitch
- Vlassov Vasily
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- Vollset Stein Emil
- Vongpradith Avina
- Vos Theo
- Vujcic Isidora S
- Vukovic Rade
- Wafa Hatem A
- Waheed Yasir
- Wamai Richard G
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- Wang Shu
- Wang Song
- Wang Yanzhong
- Wang Yuan-Pang
- Waqas Muhammad
- Ward Paul
- Wassie Emebet Gashaw
- Watson Stefanie
- Watson Stephanie Louise Watson
- Weerakoon Kosala Gayan
- Wei Melissa Y
- Weintraub Robert G
- Weiss Daniel J
- Westerman Ronny
- Whisnant Joanna L
- Wiangkham Taweewat
- Wickramasinghe Dakshitha Praneeth
- Wickramasinghe Nuwan Darshana
- Wilandika Angga
- Wilkerson Caroline
- Willeit Peter
- Wilson Shadrach
- Wojewodzic Marcin W
- Woldegebreal Demewoz H
- Wolf Axel Walter
- Wolfe Charles D A
- Wondimagegene Yohannes Addisu
- Wong Yen Jun
- Wongsin Utoomporn
- Wool Eve E
- Wu Ai-Min
- Wu Chenkai
- Wu Felicia
- Wu Xinsheng
- Wu Zenghong
- Xia Juan
- Xiao Hong
- Xie Yang
- Xu Suowen
- Xu Wang-Dong
- Xu Xiaoyue
- Xu Yvonne Yiru
- Yadollahpour Ali
- Yamagishi Kazumasa
- Yang Danting
- Yang Lin
- Yano Yuichiro
- Yao Yao
- Yaribeygi Habib
- Ye Pengpeng
- Yehualashet Sisay Shewasinad
- Yesiltepe Metin
- Yesuf Subah Abderehim
- Yezli Saber
- Yi Siyan
- Yigezu Amanuel
- Yip Paul
- Yismaw Malede Berihun
- Yismaw Yazachew
- Yiğit Arzu
- Yiğit Vahit
- Yon Dong Keon
- Yonemoto Naohiro
- Yoon Seok-Jun
- You Yuyi
- Younis Mustafa Z
- Yousefi Zabihollah
- Yu Chuanhua
- Yu Yong
- Yuh Faith H
- Zadey Siddhesh
- Zadnik Vesna
- Zafari Nima
- Zakham Fathiah
- Zaki Nazar
- Zaman Sojib Bin
- Zamora Nelson
- Zand Ramin
- Zangiabadian Moein
- Zar Heather J
- Zare Iman
- Zarrintan Armin
- Zeariya Mohammed G M
- Zeinali Zahra
- Zhang Haijun
- Zhang Jianrong
- Zhang Jingya
- Zhang Liqun
- Zhang Yunquan
- Zhang Zhi-Jiang
- Zhao Hanqing
- Zhong Chenwen
- Zhou Juexiao
- Zhu Bin
- Zhu Lei
- Ziafati Makan
- Zielińska Magdalena
- Zitoun Osama A
- Zoladl Mohammad
- Zou Zhiyong
- Zuhlke Liesl J
- Zumla Alimuddin
- Zweck Elric
- Zyoud Samer H
- Ärnlöv Johan
- Šekerija Mario
- Publication venue
- Elsevier
- Publication date
- 01/01/2024
- Field of study
BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado Héctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
- Ajiya Abdulrazak
- Akeel Nouf
- Akin Emrah
- Akinajo Opeyemi
- Akinyemi Tosin
- Akrida Ioanna
- Aktokmakyan Talar Vartanoglu
- Akwaisah Ayoub
- Al Bettar Osama
- Al-Badawi Ismail A.
- Al-Juaifari Maytham
- Al-Khyatt Waleed
- Al-Mallah Abdullah
- Al-Nusairi Ahmed
- Al-Saadi Nina
- Al-Sayaghi Khaled
- Al-Shaiji Tariq
- Al-Shehari Mohammed
- Al-Touny Aiman
- Al-Touny Shimaa A.
- Aladawi Omar
- Aladna Abdallah
- Alali Mahmoud
- Alam Mahmood
- Alam Mohammed Shadrul
- Alarabi Rehab
- Alawneh Yazan
- Alayande Barnabas
- Albanese Erminia
- Albayadi Eslam
- Albdour Maram
- Alconchel Felipe
- Alderazi Amer
- Alegbeleye Bamidele
- Alekberli Tural
- Alemu Misganaw Alemu Adimass
- Alexander Philip
- Alfieri Alex
- Algahtany Khaled
- Algarni Kamal
- Alhamad Ameen
- Alhamid Mohammad
- Alharmi Rawan A. Rahman
- Alharthi Mohammed
- Alhazmi Barrag
- Ali Mohamed Shafi Mahboob
- Ali Stephen
- Alibrahim Hidar
- Aljaaly Hattan
- Aljaiuossi Anas
- Aljanadi Firas
- Aljiffry Murad
- Aljirdabi Noof
- Alkahlan Mohammed
- Alkhalifa Elmustafa
- Alkhatib Sondos
- Alkhatieb Maram
- Allan Anna
- Almarshad Felwa
- Almgla Naser
- Almhimid Ali
- Almiqlash Bushray
- Almoshantaf Mohammad Badr
- Almutairi Abdulmjeed
- Alnsour Abed Alfattah Mahmoud
- Alobied Majd
- Alomar Osama
- Alonso Jesús Aarón Martínez
- Alonso Manuel Diez
- Alonso Nestor Fabian Pedraza
- Alonso Veronica
- Alqallaf Abdullah
- Alqaseer Asma
- Alrayes Bourhan
- Alsefri Maryam
- Alser Osaid
- Alsharif Mohammed
- Alsori Mohamed
- Altaf Abdulmalik
- Altinel Yuksel
- Altiner Saygin
- Altouny Ahmad
- Altun Demet
- Alvarez Natalia
- Alvarez-Lozada Luis Adrian
- Alvi Abdul
- Alwael Athari
- Alwash Mohammed
- Alyami Ziyad
- Alyousef Mohammed
- Alzahrani Saud
- Alzerwi Nasser
- Amin Shivang
- Amir Mohammed
- Ammar Ahmed Siddique
- Ammendola Michele
- Amores Remedios Revilla
- Amrayev Sultan
- Anastasiadou Sofia
- Ancans Guntis
- Anderson Caroline
- Andreani Lorenzo
- Andreotti Dario
- Andreuccetti Jacopo
- Andrianakis Alexandros
- Andro Christophe
- Anesi Alexandre
- Angamuthu Stephen
- Angeles Martina Aida
- Angelico Roberta
- Angelis Fragkiskos
- Angelou Dimitrios
- Angelou Kyveli
- Angulo Victor Pinto
- Anjum Arfa
- Anjum Muhammad Ayyub
- Annicchiarico Alfredo
- Anoldo Pietro
- Ansaloni Luca
- Anthoulakis Christos
- Antonelli Amedeo
- Anwar Mohamed
- Anwar Sumadi Lukman
- Anwer Mariyah
- Anyanwu Lofty-John
- Apostolou Christos
- Apostolou Konstantinos
- Appiah-Kubi Adu
- Aprea Giovanni
- Arbab Hana
- Archer James
- Ardura Francisco
- Aremu Muyiwa
- Arif Tahera
- Arkani Samara
- Armatura Giulia
- Armijos Daniel
- Arnaout Ali
- Arnaoutoglou Eleni
- Arnaud Alexis P.
- Arneja Jugpal
- Arrangoiz Rodrigo
- Arshad Muhammad
- Arthur Joshua
- Ashcroft James
- Ashford Bruce
- Ashraf Fariha
- Asiimwe Daniel
- Asirifi Samuel Amoako
- Asla Amir
- Aslam Ramisha
- Aspide Raffaele
- Ataya Karim
- Ateca Ibabe Villalabeitia
- Atici Semra Demirli
- Atis Gokhan
- Atkins William
- Atkinson Kate
- Attwood Joseph
- Auerkari Aino
- Augestad Knut Magne
- Augustin Goran
- Aujayeb Avinash
- Avella Pasquale
- Awad Ahmed K.
- Awad Hadeel
- Awad Rabih
- Awad Selmy
- Ayad Kusay
- Ayana Birhanu
- Aydin Yener
- Ayeni Funbi
- Aytac Erman
- Azab Ahmed
- Azami Rizwan
- Azize Diallo Abdoul
- Azzam Ahmed Y.
- Azzis Olivier
- Baba Yabasin Iddrisu
- Babis George
- Bacalbasa Nicolae
- Badiani Sarit
- Badran Saif
- Baduell Albert
- Baeesa Saleh
- Baertschiger Reto
- Bafaquh Mohammed
- Bahassan Omar Mohammed
- Bahrami-Hessari Michael
- Baia Marco
- Baidoo Ebikela Ivie
- Bailey Karen
- Baili Efstratia
- Bains Lovenish
- Baiocchi Gian Luca
- Baiocchi Glauco
- Baiyewu Lateef Ayodele
- Bajaj Ankur
- Bajunaid Khalid
- Balagobi Balasingam
- Balasubramanian Ishwarya
- Balduzzi Alberto
- Baldwin Alexander
- Balla Andrea
- Balogh Zsolt J.
- Balogun James A.
- Balogun Simon
- Baloyiannis Ioannis
- Ban Vin Shen
- Bandyopadhyay Samik Kumar
- Bandyopadhyay Soham
- Banerjee Sumit
- Banipal Gurpreet Singh
- Banky Balazs
- Bannone Elisa
- Bansal Sujesh
- Barberis Andrea
- Barbosa-Breda Joao
- Bareka Metaxia
- Barišić Tatjana
- Barlas Aziz Mutlu
- Barlow Ciaran
- Barmayehvar Behrad
- Baroffio Paolo
- Barone Mirko
- Barra Fabio
- Barranquero Alberto G.
- Barugola Giuliano
- Basendowah Mohammed
- Bashir Mahmod
- Basnayake Oshan
- Bass Gary Alan
- Basu Somprakas
- Bateman Antony
- Bateman Kellie
- Batista Sylvia
- Batstone Martin
- Bauer Marlies
- Bauset Juan Carlos Catalá
- Bawa Ashvind
- Bawa Sayesha
- Bayhan Hüseyin
- Bayo Heura Llaquet
- Bazzi Nagham
- Beamish Andrew
- Beasley Nigel
- Beatty Jasmine Winter
- Becerra Angel
- Bedada Alemayehu Ginbo
- Bedzhanyan Arkady
- Begum Farzana
- Beisenov Bekzat
- Bellio Gabriele
- Bello Usman Mohammed
- Bellés Ana Ciscar
- Belzile Etienne
- Benamar Safia
- Bence Matthew
- Benshetrit Guy
- Bensoltane Khadidja
- Bergkvist David Julià
- Beristain-Hernandez Jose-Luis
- Bernante Paolo
- Bernardi Daniele
- Beron Reinaldo Isaacs
- Berselli Bruno
- Berselli Mattia
- Bertelli Giacomo
- Bertoglio Pietro
- Bertolaccini Luca
- Beswick Daniel
- Bette Birgit
- Bezirci Rifat
- Bhangu Aneel
- Bharathan Rasiah
- Bhat Vivek
- Bhatti Khalid
- Bianchi Valentina
- Bianco Francesco
- Bianco Giuseppe
- Bijou Walid
- Bilfaqirah Majed
- Biloslavo Alan
- Bin Alhassan Baba Alhaji
- Binnawara Muhannud
- Bissacco Daniele
- BİŞGİN TAYFUN
- Blair James
- Blanco Jose
- Blencowe Natalie
- Bloemers Frank
- Board Timothy
- Bobak Peter
- Boccalatte Luis
- Boedo Maria Jesus Maroño
- Bohmer Rob
- Boira Mar Achalandabaso
- Boisson Matthieu
- Boligo Sofia
- Bolton William
- Bombardini Cristina
- Bonavina Luigi
- Bonci Eduard-Alexandru
- Bondurri Andrea
- Bonilla Antonio Ramos
- Bonsaana Gilbert Batieka
- Booth L.
- Borg Elaine
- Borges Miguel Fróis
- Borges Nuno
- Bork Ulrich
- Borselle Dominika
- Bortul Marina
- Botelho Pedro
- Bottari Andrea
- Bouchagier Konstantinos
- Bouliaris Konstantinos
- Bowan Antoinette Bediako
- Bowen Joel
- Bozbiyik Osman
- Bracale Umberto
- Brachini Gioia
- Bramis Konstantinos
- Branagan Graham
- Branzan Daniela
- Brasset Camille
- Bratus Dejan
- Bravo Ana Maria Minaya
- Bravo Sybil Lizanne
- Bright Tim
- Brisinda Giuseppe
- Brodkin Edgar
- Broglia Alessandro
- Brolese Alberto
- Browning Rebecca
- Bruzzaniti Placido
- Brzeszczyński Filip
- Bsisu Isam
- Bua Emmanuel
- Budd Gabrielle
- Bukhari Syed Imran
- Bulian Dirk Rolf
- Bumbasirevic Uros
- Bumber Boris
- Burgos-Blasco Barbara
- Burlov Nikita
- Bussu Francesco
- Bàmbina Fabrizio
- Börner Nikolaus
- Böttcher Arne
- Cabeza Leticia
- Cabrera Marino
- Cais Simon
- Cakmak Guldeniz Karadeniz
- Calabretto Francesca
- Calabrò Marcello
- Calavia Pablo
- Calculli Federica
- Calini Giacomo
- Callan Rory
- Callcut Rachael
- Calu Valentin
- Calvache Jose Andres
- Calvache Nieto
- Calvo Francisco Javier Redondo
- Cama Jitoko
- Camacho Barbosa
- Camarena Ana Isabel Avellaneda
- Camargo-Parra Katherin
- Cammarata Emanuele
- Cammarata Francesco
- Cammarata Roberto
- Campagnaro Tommaso
- Campanelli Michela
- Campennì Paola
- Campisi Giuseppina
- Campo Flaminia
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- Kauppila Joonas H
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- Mahečić Tina Tomić
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- Mayo-Yáñez Miguel
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- Yeung Justin
- Yiallourou Anneza
- Yigit Banu
- Yildirim Asif
- Yim Guang
- Yiu Andrew
- Yonekura Hiroshi
- Yotsov Tsanko
- Younis Muhammad Umar
- Yunus Alif
- Yusefi Hossein
- Zabaleta Jon
- Zabkiewicz Catheriner
- Zaccaria Giulia
- Zacharia Bincy
- Zafar Syed Nabeel
- Zago Mauro
- Zaheen Zakia
- Zahid Zahra
- Zaimis Tilemachos
- Zakaria Andee Dzulkarnaen
- Zambon Martina
- Zamora Lindsey
- Zampogna Biagio
- Zancana Giuseppa
- Zani Augusto
- Zanin Luca
- Zanini Nicola
- Zapardiel Ignacio
- Zapata Carlos Shiraishi
- Zarif Pierre
- Zaránd Attila
- Zehnder Philipp
- Zenger Serkan
- Zenha Horácio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ávila Clara Castro
- Älgå Andreas
- Çakici Mehmet Çaǧlar
- Çelik Enes
- Çelik Meryem Nur
- Özçay Necdet
- Şevik Hüsnü
- Šantak Goran
- Šimko Kristián
- Žatecký Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Outlier Identification in Colorectal Surgery Should Separate Elective and Nonelective Service Components
- Publication venue
- Publication date
- 01/01/2014
- Field of study
- …