44 research outputs found
Biomimetic biosensor based on lipidic layers containing tyrosinase and lutetium bisphthalocyanine for the detection of antioxidants
- Author
- Publication venue
- Amsterdam
- Publication date
- Field of study
This paper describes the preparation of a biomimetic Langmuir-Blodgett film of tyrosinase incorporated in a lipidic layer and the use of lutetium bisphthalocyanine as an electron mediator for the voltammetric detection of phenol derivatives, which include one monophenol (vanillic acid), two diphenols (catechol and caffeic acid) and two triphenols (gallic acid and pyrogallol). The first redox process of the voltammetric responses is associated with the reduction of the enzymatically formed o-quinone and is favoured by the lutetium bisphthalocyanine because significant signal amplification is observed, while the second is associated with the electrochemical oxidation of the antioxidant and occurs at lower potentials in the presence of an electron mediator. The biosensor shows low detection limit (1.98 × 10-6 - 27.49 × 10-6 M), good reproducibility, and high affinity to antioxidants (KM in the range of 62.31-144.87 μM).\ud
The excellent functionality of the enzyme obtained using a biomimetic immobilisation method, the selectivity afforded by enzyme catalysis, the signal enhancement caused by the lutetium bisphthalocyanine mediator and the increased selectivity of the curves due to the occurrence of two redox processes make these sensors exceptionally suitable for the detection of phenolic compounds.MICINN (AGL2009-12660/ALI)FAPESPCNPqCAPE
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A.
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R.
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
- Adel Israa
- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O.
- Ademuyiwa Adesoji O.
- Adenekan Babajide
- Adeniran James
- Adeniyi Adewale
- Adesanya Opeoluwa
- Adesina Alaba
- Adeyeye Ademola
- Adeyeye Ademola
- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O.
- Adiyaman Can
- Adu-Aryee Niiarmah
- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
- Aglan Amro
- Aguado Suarez Nuria
- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
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- Ahmed Sara
- Ahmed Saraibrahim
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- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
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- Al-Saqqa Sara W.
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- Alhazmi Wedyan
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- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- Elsevier
- Publication date
- 01/06/2003
- Field of study
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
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- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2022
- Field of study
Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised
Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.
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- Publication venue
- J Clin Oncol
- Publication date
- 01/01/2020
- Field of study
PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study
- Author
- Aawsaj Y.
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- Publication venue
- 'American Society of Clinical Oncology (ASCO)'
- Publication date
- 01/01/2021
- Field of study
PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
- Author
- Aahlin EK
- Aamer A
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- El Shoura Y
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- El-Dien KS
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- El-Kashef H
- El-Latif NK
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- El-Sagheer N
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- El-Shahat NS
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- Elazoul M
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- Eldafrawy M
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- Elebute O
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- Elena G
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- Elfiky M
- Elfil M
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- Elfouly Y
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- Elgheriany M
- Elhadad A
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- Elhalawany E
- Elhamouly S
- Elhelbawy MS
- Elhendawy A
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- Elhoseny G
- Elhusseiny AAE
- Elizabeth Lopez C
- Elkadsh I
- Elkady F
- Elkelany A
- Elkelany A
- Elkelany A
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- Elkhadrawi M
- Elkhalek EA
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- Elsawahly DME
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- Elsemelawy R
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- Elsherbiny AS
- Elsherif FA
- Elshobary M
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- Elsorogy DEAA
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- Elwy E
- Elzahed N
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- Elzowawi F
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- Emile S
- Eng C
- English W
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- Escalante Salas MDC
- Espin-Basany E
- Espinoza F
- Essam A
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- Etienne S
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- Evajelista CV
- Evans D
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- Faccincani R
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- Farouk SAM
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- Farrugia A
- Farrugia A
- Faruq A
- Fathy AM
- Fattah AA
- Fatuga A
- Faturoti O
- Faturoti O
- Faure A
- Fautz T
- Favero A
- Fawzy A
- Feidantsis T
- Felipe CO
- Fergany A
- Fergusson SJ
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- Kabariti R
- Kabariti R
- Kabba J
- Kabongo K
- Kache S
- Kaci AA
- Kadiwar S
- Kalakouti E
- Kalles V
- Kalles V
- Kalles V
- Kamarajah SK
- Kamarulzamil SNA
- Kamil R
- Kamya S
- Kanani A
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- Kandil H
- Kang MK
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- Karabacak U
- Karabelias G
- Karabulut K
- Karahan SR
- Karakahya M
- Karandikar S
- Karandikar S
- Kariem N
- Karim A
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- Karjiker P
- Karkeet M
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- Karlo R
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- Karousos D
- Karumnas P
- Kaselis N
- Kaselis N
- Kasem E
- Kasem EA
- Kasputyte S
- Kaul A
- Kazanavicius D
- Kedar A
- Kefalidi E
- Keke KR
- Kelany M
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- Kennedy ED
- Kennedy M
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- Kerley R
- Kershaw S
- Kesinger M
- Khafagy T
- Khairy H
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- Khajanchi M
- Khaled H
- Khalifah E
- Khalili M
- Khalique A
- Khallaf S
- Khamajeet A
- Khan A
- Khan K
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- Khatri C
- Khatri C
- Khattab K
- Khedr AE-RH
- Khoja A
- Khoja A
- Khokha D
- Khokha V
- Khosla S
- Khouri Ferreira SA
- Khreishi R
- Khreishi R
- Khulu LB
- Khyrallh A
- Kiasat A
- Kidd T
- Kielty P
- Kim MY-H
- Kim S-H
- Kim SB
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- Kinandu K
- King R
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- Kiran RP
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- Kirishnan A
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- Klappenbach R
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- Kojo ATT
- Kojo ATT
- Kojo ATT
- Kolosov A
- Komolafe O
- Kondrotas P
- Kong C
- Kong SN
- Kong V
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- Konstantina K
- Kontos M
- Kordorwu HEK
- Korkolis D
- Kosai NR
- Kosai NR
- Kose E
- Koskenvuo L
- Kostov E
- Kotb AHE-B
- Kotecha D
- Koto MZ
- Kotobi H
- Koumpa F
- Kouraklis G
- Kourdouli A
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- Kretzmann H
- Krishna K
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- Kyriazanos I
- Kyrou G
- Kyziridis D
- L'Heveder A
- La Brocca A
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- Labib P
- Ladukas A
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- Lam WH
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- Lap G
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- Laurie K
- Lauzikas G
- Law JH
- Lawal A
- Lawal AO
- Lawal T
- Lawal TA
- Lawani I
- Lawther R
- Lazzari G
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- Lazzarini Cury AD
- Le VTH
- Leal A
- Leal M
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- Lecompte J-F
- Lee C
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- Lee F
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- Leusink A
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- Li KKK
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- Lilford R
- Lilford R
- Lim G
- Lim H
- Lim J
- Lim PJ
- Lim SJ
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- Lim SY
- Limache S
- Limaye N
- Limoges B
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- Macchitella Y
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- Macfarlane A
- Machaca M
- Machain Vega GM
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- Maciejec L
- Madiba T
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- Madrid Barrientos LA
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- Manfreda S
- Mangan C
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- Manipal CE
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- Marroquin Rodriguez DE
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- Menegussi J
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- Mironescu A
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- Mirza A
- Mirza S
- Mistry A
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- Mitroudi M
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- Moe TT
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- Mohamed B
- Mohamed F
- Mohamed I
- Mohamed M
- Mohamed MA
- Mohamed MAEH
- Mohamed MM
- Mohamed O
- Mohamed SR
- Mohameden A
- Mohammad A
- Mohammad A
- Mohammed A
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- Mohammed H
- Mohammed MM
- Mohammed MMH
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- Monteleone M
- Monteleone M
- Montes I
- Montes I
- Montoya Botero JA
- Montrimaite M
- Montrimaite M
- Moodley Y
- Moore R
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- Mora JJV
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- Moreira G
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- Mosalum O
- Mostafa HA
- Mostafa M
- Mostafa M
- Mousa M
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- Mshelbwala P
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- Negida A
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- Nepogodiev D
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- Nevieraite V
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- Nnajiuba H
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- Nwabuoku E
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- Primavesi F
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- Punja V
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- Sahel S
- Saidbadr A
- Sakr A
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- Salma U
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- Samalavicius NE
- Samaraweera DI
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- Sammarco G
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- Samy S
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- Sandler S
- Sandoval Barrantes AM
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- Semeda N
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- Publication venue
- Publication date
- 15/10/2018
- Field of study
Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe
Multi-messenger observations of a binary neutron star merger
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- Li X
- Li X
- Li XB
- Li XF
- Li YG
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- Pant BC
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- Parra A
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- Passuello D
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- Pearlstone BL
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- Pekeur NW
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- Piccinni OJ
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- Piergiovanni F
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- Piran T
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- Piranomonte S
- Pirello M
- Piro AL
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- Pirronello V
- Pisanu T
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- Pollmann A Obertacke
- Poolakkil S
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- Popolizio P
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- Prado RR
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- Principe G
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- Prodi GA
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- Prokoph H
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- Rojas-Bravo C
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- Romero M Dominguez
- Romie JH
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- Rumyantsev VV
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- Sahakian V
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- Salamida F
- Salazar H
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- Salvadori I
- Salvaterra R
- Samajdar A
- Sammut L
- Sampedro L
- Sampson LM
- Samtleben DFE
- Sanchez B
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- Sanchez E
- Sanchez EJ
- Sanchez F
- Sanchez LE
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- Sanchez-Lucas P
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- Sand DJ
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- Sanders JR
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- Santangelo A
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- Schneider A
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- Schoenell W
- Schoenen S
- Schofield RMS
- Scholten O
- Schonbeck A
- Schoneberg S
- Schoorlemmer H
- Schovnek P
- Schreiber E
- Schroder FG
- Schroder S
- Schroder SL
- Schssler F
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- Schulz A
- Schulz A
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- Schwalbe SG
- Schwanke U
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- Sciutto SJ
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- Segreto A
- Seidel E
- Seitenzahl IR
- Sekiguchi Y
- Sellers D
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- Sengupta AS
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- Sergeev A
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- Seunarine S
- Sevilla-Noarbe I
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- Shahriar MS
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- Shang Z
- Shannon RM
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- Shimizu Y
- Shimomukai R
- Shingles LJ
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- Shoemaker DH
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- Siegel MH
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- Siemens X
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- Slagmolen BJJ
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- Starling RLC
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- Zimmerman AB
- Zimmermann B
- Zimnukhov DS
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- Zucker ME
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- Zweizig J
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- Publication venue
- 'American Astronomical Society'
- Publication date
- 01/01/2017
- Field of study
On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
- Author
- Aahlin Eirik Kjus
- Aamer Ahmed
- Aaniana Kenneth
- Ababneh Ali
- Abaliksta Tomas
- Abantanga Francis
- Abbas Athar
- Abbasy Jibran
- Abbo Olivier
- Abbott Tom
- Abbouch Meryem
- Abd El-Latif Nadia Khalid
- Abd Elkhalek Esraa
- Abd-Elmawla Manar
- Abdallah Emad
- Abdel-Aty Abdulrahman
- Abdel-Hameed Noran
- Abdel-Kader Sara Mahmoud
- Abdelaal Abdelaziz
- Abdelaty Mohamed
- Abdelazeam Anan Rady
- Abdelazim Galaleldin
- Abdelaziz Mohamed A
- Abdelbadeai Kholoud
- Abdelfatah Afnan
- Abdelhady Samar
- Abdelhamed Rasha
- Abdelhamid Amina
- Abdelhaq Aram
- Abdelkader Mostafa
- Abdelkader Omar
- Abdelkhalek Mohamed
- Abdelmageed Eman
- Abdelmotaleb Ibrahem
- Abdelraouf Ahmed Mahmoud
- Abdelrouf Doaa Maher
- Abdelshakour Mahmoud
- Abdrabou Abdulshafi Khaled
- Abdul-Latif Saiba
- Abdulaziz Hager
- Abdulaziz Mustafa
- Abdulbagi Omar
- Abdulhakeem Eman Mahmoud
- Abdullah Mohamed Abozed
- Abdullah Nik Azim Nik
- Abdullah Noha
- Abdullahi Lawal
- Abdurrazzaaq Abdussemiu
- Abem Owusu Emmanuel
- Abiola Olajide
- Aboelella Majed
- Aboelmagd Omnia
- Aboelsoud Moustafa R
- Aboul-Naga Mariam Saad
- Abouzaid Arwa
- Abu Qumbos Amjad
- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
- Abusalem Lana
- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
- Adel Badr Eldin
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- Adella Fidelis Jacklyn
- Adelshone Abdelrahman
- Ademuyiwa Adesoji
- Ademuyiwa Adesoji O
- Ademuyiwa Adesoji O
- Adenekan Babajide
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- Adesina Alaba
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- Adhitama Novia
- Adil Muhammad
- Adisa Adewale O
- Adiyaman Can
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- Afana Samah
- Agalianos Christos
- Agarwal Arnav
- Agarwal Arnav
- Agbedinu Kwabena
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- Aguilera Maria Lorena
- Aguilera Maria Lorena
- Aguilera-Arevalo Maria-Lorena
- Ahlonsou Germain
- Ahlqvist Sandra
- Ahlqvist Sandra
- Ahmed Asdaq
- Ahmed Ataa
- Ahmed Hayam
- Ahmed Hussien
- Ahmed Lopna Ahmed Mohamed
- Ahmed Sara
- Ahmed Saraibrahim
- Ahounou Ernest Yemalin Stephane
- Ajah Jonathan
- Ajai Olalekan
- Ajao Akinlabi
- Ajiboye Anthony
- Akoto Elliot
- Akpenyi Onyinye
- Al Amin Shadid
- Al Attar Samaa Mahmoud
- Al Barraw Fayez Elian
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- Al Rafati Ahmad Abdel Razaq
- Al Raouf Eman Abd
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- Al Subaie Norah
- Al-Bahrani Ahmed
- Al-Buhaisi Alaa
- Al-Dakka Emad
- Al-faqawi Maha
- Al-farram Hadeel
- Al-khatib Ahmed
- Al-Marakby Dina
- Al-saqqa Sara
- Al-Saqqa Sara W
- Al-Slaibi Ibrahim
- Al-taher Taher
- AlaaelDein Shahinaz
- Alada Muslimat
- Alakaloko Felix
- Alaloul Enas
- Alamin Shadid
- Alamoudi Mohammed
- Albiety Adel
- Alcca Ticona Willy
- Alejos Bermudez Ysabel Esthefany
- Alexander Philip
- Alexander Philip
- Alexandre Challine
- Alghamdi Ahmed
- Alghamdi Mohammed Saleh A
- Alhady Khaled
- Alhammali Tariq
- Alhassan Basmah
- Alhazmi Wedyan
- Alherz Mohammad
- Ali Ahmed
- Ali Citra Dewi Mohd
- Ali Elsayed
- Ali Safia
- Ali Syed Abdul Wahhab Eusoffee Wan
- Ali Tebian Hassanein Ahmed
- Ali Wadah
- Alihonou Thierry
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- Alnaby Mohamed Hassab
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- Alqahtani Saleh
- Alsaggaf Mohammed Ubaid
- Alser Osaid H
- Alshareef Reham
- Altaf Abdulmalik
- Altamimi Abdullah
- Altamimi Afnan
- Altamini Afnan
- Altarayra Marwa
- Altibi Ahmed
- Altinel Yuksel
- Altinel Yuksel
- Altwijri Abdulaziz
- Alvi Abdul Rehman
- Aly Mohammed Yahia Mohamed
- Alyacoubi Said
- Alyahya Reem
- Alzahrani Ahmed
- Aman Nowrin F
- Amandito Radhian
- Amandito Radhian
- Ambrona-Zafra David
- Amin Hager Abdul Aziz
- Amjad Mohammadasim
- Amoah Michael
- Amoako Joachim
- Amoako Philip Taah
- Amoako-Boateng Mabel
- Amole Isaac
- Amreia Mahmoud
- Anderson Frank
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- Ang Yun Lin
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- Anwar Nourhan
- Anyanwu Lofty-John
- Aonzo Paolo
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- Wilson Michael
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- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
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- Wong Francisca
- Wong Hong Yee
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- Worku Mengistu
- Worku Tewodros
- Wright Naomi
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- Ye Joselyn
- Yeang Li Jing
- Yeung Man Hon Andrew
- Yifieyeh Abiboye
- Yildirim Reyyan
- Yip Chingwan
- Ymeri Shpetim
- Yoganathan Pigeneswaren
- Yolcu Sinem
- Yong Guo Liang
- Younis Abobaker
- Youssef Mohamed
- Yuksek Mahmut Arif
- Yusufali Taha
- Zaa'treh Rula
- Zadoroznas Antanas
- Zahran Diaaaldin
- Zakaria Esraay
- Zakaria Mahmoud
- Zakaria Yehia
- Zaki Ahmed
- Zammit Stefan
- Zampitis Nikolaos
- Zani Augusto
- Zani Augusto
- Zanini Nicola
- Zapata Felipe
- Zarb Ciskje
- Zeta Solis Ludwing Alexander
- Zielinski Martin
- Zilinskas Justas
- Zilinskas Justas
- Zilinskas Justas
- Zilinskiene Reda
- Ziubryte Greta
- Zohair Ahmed
- Zuber Markus
- Zuk Grzegorz
- Zulkifli Athirah
- Zumbuhl Lucius
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2018
- Field of study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
Mortality of emergency abdominal surgery in high-, middle- and low-income countries
- Author
- A A Ahmed Ata
- A A Ibrahem
- A A Maghrabi
- A A Nasir
- A A Ne'ma Abdullah
- A Abd El Galeel
- A Abdel-Rahman Al-Aarag
- A AbdelFattah
- A Abdelgelil
- A Abdelkareem
- A Abdelmotaleb Ghazy
- A Aber
- A Abo El Magd
- A Abo Elazayem
- A Aboarab
- A Abouelnasr
- A Abouzahra
- A Adebanjo
- A Adekoya
- A Adel
- A Adel
- A Ademuyiwa
- A Adeniyi
- A Adesina
- A Adesuyi
- A Adeyeye
- A Afandy
- A Agarwal
- A Ahmed
- A Al-Mallah
- A Al-Shammari
- A Aldalaq
- A Ali
- A Ali
- A Alkammash
- A Allegri
- A Almallah
- A Almoflihi
- A Alrifaie
- A Altaf
- A Altamimi
- A Althwainy
- A Arenas
- A Ashton
- A Atef Omar
- A Austraite
- A B Zerihun
- A Badr
- A Badwy
- A Baird
- A Bamicha
- A Benevento
- A Bhangu
- A Bhargava
- A Birring
- A Boddy
- A Bondurri
- A Bonnard
- A C Manchego Bautista
- A C Manchego Bautista
- A C Roslani
- A C Snaith
- A Cacurri
- A Chambers
- A Chambers
- A Chapman
- A Chowdhury
- A Chun
- A Daltri Lazzarini Cury
- A Daqeeq
- A Das
- A Diab
- A Driscoll
- A Dubois
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- A E Ajao
- A E K Musa
- A E Ward
- A Echevarria Rosas Moran
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- A El Kholy
- A Elbatahgy
- A Elgebaly
- A Elkelany
- A Elkelany
- A Elkelany
- A Elkelany
- A Elkholy
- A Elshafay
- A Elwaey
- A Elwan
- A Essam Elnemr
- A Eysa
- A F Palma
- A Fadel
- A Fahiem
- A Farah
- A Faraz
- A Farquharson
- A Faure
- A Fawzy
- A Fouad
- A G N Robertson
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- A Garland
- A Gerosa
- A Gharib
- A Gharib
- A Gheith
- A Gomaa
- A Gouda
- A Grant
- A Gudal
- A Habeebullah
- A Hafez El-Badri Kotb
- A Hagar
- A Hammad
- A Hanks
- A Haroun
- A Hasan
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- A Hashish
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- A Kirupagaran
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- A Kyaw Tun
- A L Contreras Vergara
- A L Mclean
- A Lasheen
- A Leal
- A Leppäniemi
- A Livesey
- A M Afifi
- A M Altwigry
- A M Attia
- A M Elkorashy
- A M Hammad
- A M Mphatsoe
- A M Saeed
- A M Shariffuddin
- A M Warwick
- A Macdonald
- A Macfarlane
- A Maffioli
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- A Mcphee
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- A Nasr
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- A Nesaratnam
- A Niragire
- A Nocito
- A Novak
- A Ogunyemi
- A Oluwagbemiga Lawal
- A Oosterkamp
- A Osama Elsebaaye
- A Osinowo
- A Osman Abdelaziz Elhendawy
- A P Arnaud
- A Popoola
- A Powell
- A Prabhudesai
- A R Mitul
- A Ragab Nayel
- A Ragab Soliman
- A Ramadan
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- A Rasendran
- A Rasendran
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- A Rashid
- A Raslan
- A Riaz
- A Rotundo
- A Rslan
- A Rudzenskaite
- A S Mironescu
- A S North
- A Sabry
- A Sabry El-Hamouly
- A Sadek
- A Safwan Marey
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- A Salleh
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- A Sayed
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- A Shabkah
- A Shah
- A Shalaby
- A Sheshe
- A Skardžiukaitė
- A Solaiman El-Ma'doul
- A Spina
- A Sreedharan
- A Sriram
- A Stephen
- A Strazdas
- A Szczap
- A Tade
- A Tammam
- A Tanase
- A Tanase
- A Tang
- A Tarek
- A Tarek Hafez
- A Thorell
- A Usaityte
- A Vega Carreiro De Freitas
- A Venâncio De Sousa
- A Vlachogiorgos
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- A Watts
- A Williamson
- A Wilson
- A Zani
- A Zardab
- A Zeynel A Balkan
- A Zil-E-Ali
- Abid Bin Mahamood
- B Albeladi
- B Alghamdi
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- B F Hon Khi Chong
- B Frisk
- B Magdy
- B Mansour
- B Mijuskovic
- B Nighat
- B Odeyemi
- B Pereira
- B Pereira Silvestre
- B S Kumar
- B Sieda
- B Skelly
- B Thompson
- B Van Duren
- B Weber
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- C A Azmitia Mendizabal
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- C E Lopez
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- C Hinojosa
- C Houlden
- C I Pérez Velásquez
- C J Mcintyre
- C Jenvey
- C Jones
- C Khatri
- C Koh
- C Lee
- C Leung Chong
- C Leung Chong
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- C Lopez-Arevalo
- C López
- C M Rees
- C Magee
- C Mangan
- C Mangan
- C Marinos
- C Mason
- C Milagros Herrera Puma
- C Morales
- C Morgan
- C Muller
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- C Normile
- C Normile
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- C Oliveira Felipe
- C Ou Yong
- C P García Torres
- C P Major
- C Raslan
- C S Wong
- C Sampson
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- C Smith
- C Tedjaatmadja
- C Tolg
- C Venugopal
- C Vinícius Barroso de Lima
- C W Ho
- C Wredberg
- C Y Chen
- C Y Tan
- D A Amin Elsorogy
- D A Raptis
- D A Romani Pozo
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- D Anderson
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- D-C Zachariades
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- E Farinella
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- E Y A Palkhi
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- F Abantanga
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- M Zidan
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- N A Nik Abdullah
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- N Ahmed Attallah
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- N D'aguzan
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- N Hall
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- N M Urbina Rojas
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- N Seyoum Abebe
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- N Yosri Elsayed Abdel-Wahab
- N Zanini
- O Abbo
- O Adesanya
- O Aguilera
- O Al-Obaedi
- O Alahmady
- O Algohary
- O Azzam
- O Bouali
- O Elebute
- O Faturoti
- O Garaycochea
- O Javed
- O Javed
- O Komolafe
- O Mohamed
- O Mosalum
- O Nasher
- O O Ayandipo
- O Oshodi
- O Osman
- O Saadeldeen Ebrahim
- O Salah
- O Seifelnasr
- O Sherief Abd El Hameed
- O Taiwo
- O Todd
- O Warren
- O Wiliams
- O Ziff
- P A Assouto
- P Acharya
- P Alves Bezerra Morais
- P C Munipalle
- P Capleton
- P Danelli
- P De Bono
- P Eduard
- P Harbord
- P Harrison
- P Holton
- P J Lim
- P Jackson
- P Jain
- P Karumnas
- P Kielty
- P Labib
- P Malik
- P Mentula
- P Paolo Grandinetti
- P Patel
- P Pitigala Arachchi
- P Ramazzini
- P Sarmah
- P Silvani
- P Singh
- P Sodde
- P Stassen
- P Sutton
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- P Ugalde
- P Weber
- P Weber
- P Witherspoon
- P-O Lundgren
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- Q Alimi
- R Adams
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- R Alyami
- R Alyami
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- R Balmaceda
- R Barrionuevo Ojeda
- R Beyene
- R Blundell
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- R D'cruz
- R Darío Arias Pacheco
- R Davenport
- R Dean
- R Elmelegy
- R F Staerkle
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- R George
- R Gilbert
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- R Gratton
- R Guevara
- R Harrison
- R K M Jawad Al-Hasani
- R Kamil
- R Karlo
- R Kennedy
- R Kerley
- R King
- R Lages Simoes
- R Lawther
- R Lilford
- R M H Balila
- R Macchiavello
- R Mcdonald
- R Mcintosh
- R Mcintyre
- R Melo
- R Moore
- R Morton
- R Osuoji
- R Oumer
- R Pranevicius
- R Rackauskas
- R Rajan
- R Rakauskas
- R Riauka
- R Rivas
- R Rodríguez-Uría
- R Sakr
- R Satoskar
- R Schmid
- R Shah
- R Shaker
- R Shaker
- R Slade
- R Soley
- R Som
- R Spence
- R Thurairaja
- R Tyler
- R Villa
- R W Gilbert
- R Zilinskiene
- R-M Bratu
- S A Alnuqaydan
- S A Durand
- S Abd Elmageed Barakat
- S Abdelghany
- S Abdoun Ishag Idris
- S Ahlqvist
- S Al Awwad
- S Al-Nahrawi
- S Aldhafeeri
- S Aljohani
- S Almuallem
- S Altaf Naqvi
- S Anderson Khouri Ferreira
- S Antar
- S Aql
- S Arman
- S Ayad
- S Ayyar
- S B Shu Yip
- S Basson
- S Batista Lemaire
- S Bhat
- S Bhattacharya
- S Binna Kim
- S Bokhari
- S Botes
- S Bradulskis
- S Braungart
- S Breitenstein
- S Chhabra
- S Chidambaram
- S Chiu
- S Chung
- S Corro-Diaz Gonzalez
- S Cucumazzo
- S Das
- S Desta
- S Di Saverio
- S Dias
- S Dindyal
- S Doughan
- S El Mesery
- S El-Rabaa
- S Elshanwany
- S Elsheikh
- S Elsobky
- S Estupinian
- S F Ashraf
- S Fergusson
- S G Gosling
- S Galloway
- S Germanos
- S Ghanem
- S Giuliani
- S Gokani
- S Gosling
- S Hafiz
- S Haines
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- S Itopa Suleiman
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- S Ramzi
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- S Said Elkolaly
- S Samy
- S Sani Ali
- S Sarsik
- S Sarwary
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- S Stock
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- S Talukder
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- S Vivekanantham
- S Ward
- S Wondimu
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- S Zeidan
- S-H Kim
- S-P Hosein
- T A M Malik
- T Akeem Lawal
- T Alzayat
- T Arulampalam
- T B Wold
- T Barker
- T Boyce
- T Brogden
- T Chun
- T Clark
- T E Glover
- T Ebogo Ngwa
- T F Jones
- T Falconer Hall
- T Farooq
- T Fautz
- T Fernandes Giuriato
- T Fozard
- T Fozard
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- T Mak
- T Muhammad Yaseen
- T Naqvi
- T Newton
- T Nouh
- T O'Connor
- T Pezas
- T Poskus
- T Razek B Marinkovic
- T S Hettiarachchi
- T Sherman
- T Stasinou
- T Urbonas
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- T White
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- U Alamoudi
- U Gunnarsson
- U Gustafsson
- U Hantour
- U Karabacak
- U Walsh
- V Ambrozeviciute
- V Beisa
- V D Palomino Castillo
- V Despotidis
- V Gadhvi
- V Graffeille
- V Graffieille
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- V Thanusan
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- W Hawkins
- W Ho
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- W J Lossius
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- W L Messa Aguilar
- W Milligan
- W Milligan
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- W S Li
- W S M Kithsiri Janakantha Senanayake
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- Y Abd Elrasoul
- Y Abd-Elrasoul
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- Y N Neo
- Y P Mogan
- Y Rajjoub
- Y Reddy
- Y Salama
- Y Sinha
- Z Chan
- Z Dambrauskas
- Z Hassan
- Z Iftikhar
- Z Jaffry
- Z Mikwar
- Z Oof
- Z Urniezius
- Z Zhang
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2016
- Field of study
Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI).
Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression.
Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days.
Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
- Author
- Abbas Sh
- Abbas Sh
- Abbassi Oa
- Abbott T
- Abdelgadir Am
- Abdelrahman A
- Abdelrahman M
- Abdelrahman M
- Abdelwahed A
- Abellan M
- Abellán Am
- Abellán Am
- Abulafi M
- Acharya A
- Acosta A
- Adam Me
- Adams Re
- Adegbola So
- Adegbola So
- Adimonye A
- Adnan M
- Afshar S
- Agresta F
- Agua Ia
- Aguayo Jl
- Agudo Ar
- Ahad A
- Ahel J
- Ahern Dp
- Ahmad A
- Ahmed B
- Ahmed G
- Ahmed Os
- Ahmed Os
- Ahmed S
- Ainsworth P
- Ais G
- Ais G
- Aisoni F
- Akbari K
- Akhtar K
- Akinsola O
- Akram F
- Al-Faham Z
- Al-Khafaji N
- Al-Khyatt W
- Al-Musawi S
- Al-Sarireh B
- Al-Sheikh M
- Alagna V
- Alani M
- Alberca-Paramo A
- Aldrey I
- Alexander R
- Alhammali T
- Alhammali T
- Ali M
- Aljorfi A
- Allen M
- Allington J
- Alonzo A
- Alshafei A
- Altomare Ma
- Alvarez Cm
- Alvarez E
- Alvarez-Gallego M
- Amaducci E
- Amarasinghe R
- Amayo A
- Ambrona-Zafra D
- Amin V
- Ammendola M
- Amtul N
- Amtul N
- Amuthalingam T
- Anandan L
- Anania G
- Anania M
- Anderson Dj
- Anderson O
- Andolfi E
- Andreani Sm
- Andreani Sm
- Andrews B
- Ang A
- Ang A
- Angelieri D
- Angelini M
- Angrisani M
- Anguita F
- Ansaloni L
- Ansari A
- Aravind B
- Archer Je
- Arcuri Ga
- Arcuri Ga
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- Bagga R
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- Bailey S
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- Balasubramaniam A
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- Ball A
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- Ballabio M
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- Bandyopadhyay Sk
- Banks A
- Bansal H
- Baraghini M
- Barbosa L
- Barker T
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- Barnieh W
- Baronio G
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- Barrie A
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- Bartoli A
- Bascuas-Rodrigo B
- Baseggio M
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- Bazán-Hinojo Mc
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- Beltran-De-Heredia J
- Beltran-De-Heredia J
- Belvedere A
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- Berry B
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- Bevan V
- Beverstock A
- Bhanderi S
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- Bhangu A. Nepogodiev D
- Bhangu A
- Bhangu A
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- Bhargava A
- Biancafarina A
- Biancafarina A
- Bianchi Cl
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- Bianco A
- Bilku D
- Birindelli A
- Birindelli A
- Birindelli A
- Blackford Od
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- Blanco F
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- Bogdan M
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- Bolger Jc
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- Bolton W
- Bolzon S
- Bond S
- Bond-Smith G
- Bondurri A
- Bonfante P
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- Borges Fc
- Borghi F
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- Boshier Pr
- Botelho P
- Bowen J
- Bowerman H
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- Bowman Cr
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- Boyd-Carson H
- Boza K
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- Branagan G
- Bravo-Gutiérrez Af
- Bravo-Gutiérrez Af
- Brennan S
- Brett M
- Brewer H
- Brewer Hk
- Brewer Hk
- Brews R
- Brien Jo
- Bronder C
- Brown A
- Brown Ag
- Brown Ce
- Brown Ce
- Brown Ce
- Brown M
- Brown M
- Brown Od
- Brown R
- Bruce Js
- Brunelli Db
- Bryan Es
- Buckley-Jones S
- Bukhari W
- Bull C
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- Busuttil A
- Byrne Be
- Byrnes Ck
- Caballero A
- Caldeira Ab
- Caldwell M
- Callan R
- Calussi M
- Calvo H
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- Cameron Fc
- Campagnaro T
- Campagnaro T
- Campbell U
- Campbell Um
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- Cannata G
- Cannavò M
- Cantafio S
- Capelli P
- Carcoforo P
- Carden Ca
- Carder C
- Cardona R
- Cardoso D
- Carlucci M
- Carney K
- Caro A
- Carral-Freire M
- Carrano Fm
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- Cartwright H
- Carvalho Lc
- Carvalho N
- Casimiro C
- Castagnoli G
- Castagnoli G
- Caula C
- Caula C
- Cavallo D
- Cavero A
- Cay P
- Ceccarelli G
- Cerdán-Santacruz C
- Cerdán-Santacruz C
- Cerdán-Santacruz C
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- Cervellera M
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- Chalk A
- Chambers B
- Chan D
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- Chandratreya N
- Chandratreya N
- Chapman J
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- Charalabopoulos A
- Charalambous Mp
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- Chatzikonstantinou M
- Chatzikonstantinou M
- Chauhan P
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- Cheng Sa
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- Chillitupa Cz
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- Chitsabesan P
- Chng S
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- Chong B
- Choolani-Bhojwani E
- Choong Jh
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- Chowdhury F
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- Collado-Roura F
- Collier-Wakefield O
- Colombo F
- Colombo F
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- Compagnoni B
- Conci S
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- Contine Ac
- Contreras Rg
- Contreras-Saiz E
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- Cormenzana Ob
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- Cortés Gv
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- Cynthia G
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- D'Auria M
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- Danquah-Boateng D
- Dar Fa
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- Davidson Jr
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- De Chaves-Rodríguez Pg
- De Freitas S
- De Luca E
- De Marchi F
- De Marco P
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- De Prizio M
- De-La-Herranz-Guerrero P
- De-Manzoni-Garberini A
- De-Manzoni-Garberini A
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- De-Marchi Ja
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- Dean Ea
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- Delgado-Plasencia Lj
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- Depalma N
- Deserra A
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- Devezas V
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- Di Saverio S
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- Donohoe No
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- Easdon S
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- Erdas E
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- Eretta Co
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- Fareleira A
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- Farina V
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- Faulkner G
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- Feleppa C
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- Feroci F
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- Ferrer-Vilela I
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- García M
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- García V
- García-Carrero M
- García-Catalá L
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- García-Granero A
- García-Granero A
- García-Gutierrez C
- García-Novoa A
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- García-Pérez Jm
- García-Rivera Co
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- Ghazala R
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- Ikram S
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- Pareja-Ciuró F
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- Pascual-Miguelañez I
- Pasquali S
- Pata F
- Pata F
- Pata F
- Pata F
- Pata F
- Pata F.
- Pata G
- Pata G
- Pata G
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- Patel By
- Patel By
- Patel C
- Patel H
- Patel Mm
- Patel N
- Patel Pk
- Patel Rt
- Patil Sd
- Patti S
- Pau R
- Payne Cj
- Payne Re
- Payá-Llorente C
- Payá-Llorente C
- Peacock M
- Pearce J
- Pearce J
- Pearce L
- Pearce L
- Pearson R
- Pedder A
- Peirce Cb
- Peiris Gb
- Peixoto R
- Peleki A
- Peleki A
- Pellegrino L
- Pellicanò Ga
- Pellicer-Franco E
- Pellino G
- Pento V
- Pento V
- Peponis C
- Peprah D
- Pereira A
- Pereira Am
- Pereira J
- Pereira-Mosquera E
- Perera Mi
- Perez-Calvo J
- Perin A
- Pertile D
- Pertile D
- Peña-Barturen C
- Phelan L
- Photiou D
- Pierre R
- Pietrabissa A
- Pigem A
- Pila U
- Pilkington Jp
- Pineño-Flores C
- Pinillos-Somalo A
- Pinkney Td
- Pinkney Td
- Pinkney Td
- Pinna E
- Pino-Perez O
- Pirari Pf
- Pisanu A
- Piu F
- Planellas P
- Plua-Muniz Kt
- Poacher A
- Podda F
- Podda M
- Podda M
- Podda M
- Poillucci G
- Pollard H
- Ponchietti L
- Popova D
- Poudevigne M
- Prats Ma
- Prideaux A
- Prieto-Nieto Mi
- Primo Jc
- Pronin S
- Provenza G
- Puerta E
- Pulighe F
- Pullabatla-Venkata Up
- Punj S
- Pérez-Sanchez Le
- Quddus A
- Quill S
- Quinn Em
- Quinn Hc
- Rabie M
- Rabie Ma
- Rabie Mr
- Radwan Rw
- Radwan Rw
- Rahim A
- Rahman M
- Rahmani Ls
- Rajagopal S
- Rajaram R
- Rajaretnam N
- Rajjoub Y
- Rallage H
- Ramcharan S
- Ramirez L
- Ramirez-Redondo Aa
- Ramos Xh
- Ramos-Bernado Mi
- Ramírez-Faraco M
- Ranathunga S
- Rangarajan K
- Rao M
- Rao V
- Raofi A
- Rashid M
- Rate A
- Ravindran R
- Raymond M
- Raza Ss
- Recreo Ac
- Reddy A
- Reddy A
- Redmond Ae
- Redondo E
- Redondo E
- Redondo-Calvo Fj
- Reese G
- Regina G
- Rehman S
- Rehman S
- Rekhraj S
- Ren Kz
- Renshaw S
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- Renzi Cr
- Resende Fm
- Rezacova M
- Rezvani S
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- Ribaudo M
- Ribeiro B
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- Richardson Td
- Ridaura N
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- Robertson C
- Robinson A
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- Rocha R
- Rodger V
- Rodicio-Miravalles Jl
- Rodriguez L
- Rodriguez-Lopez M
- Rodriguez-Lopez M
- Rodriguez-Lopez M
- Rodríguez Ec
- Rojo Ja
- Roldán-Ortiz S
- Rolph R
- Romano J
- Romano R
- Romario Uf
- Romoli L
- Roncero Ls
- Ronda Rn
- Roomi S
- Rosa Mj
- Rosat A
- Roscio F
- Roscio F
- Roscio F
- Rossi C
- Rossi D
- Rossi Gm
- Roth N
- Rothnie K
- Roxburgh C
- Roy C
- Ruano A
- Rubbini M
- Rudland I
- Ruffolo C
- Rufo E
- Ruggiu Gv
- Ruiz-Marín M
- Ruiz-Marín M
- Rupani S
- Rupasinghe Sn
- Rupasinghe Sn
- Rutherford Dg
- Ruzvidzo F
- Ruzzenente A
- Saad M
- Saad M
- Saavedra-Chacón M
- Saba A
- Sabia D
- Sacco R
- Sacks R
- Sadek S
- Saghir N
- Sagnotta A
- Sagnotta A
- Saha A
- Sahay Sj
- Sahnan K
- Sahnan K
- Sainz B
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- Sajid Ms
- Salama Y
- Salamone G
- Salamone G
- Salamone G
- Salamone G
- Salandini Mc
- Salem A
- Salim S
- Salva Ab
- Salvador H
- Samartin C
- Sammarco G
- Sammarco G
- Samuel M
- Sana S
- Sanchez Er
- Sanchez Er
- Sanchez L
- Sanchez-Garcia S
- Sanchez-Guillen L
- Sanchez-Guillen L
- Sanchez-Martinez A
- Sancho-Muriel J
- Sandu L
- Sanna S
- Santamaria C
- Santamaría Pc
- Santarrufina-Martínez S
- Santos Sc
- Santurro L
- Sanz-Navarro S
- Sarmah P
- Sarmah P
- Sarmah P
- Sarveswaran J
- Sasia D
- Sasia D
- Saunders S
- Savill A
- Savino G
- Savino G
- Savioli F
- Scabini S
- Scabini S
- Scabini S
- Scandroglio Is
- Scanlon K
- Scatizzi M
- Scialandrone G
- Scricciolo M
- Sebastian Jf
- Sebastián-Tomás Jc
- Seddon Tc
- Segalini E
- Segura-Sampedro Jj
- Sena G
- Sena-Ruiz F
- Seneviratne N
- Sepe C
- Serventi F
- Serventi F
- Seth M
- Setshwaelo T
- Sezen E
- Sgardelis P
- Sgrò A
- Sgrò A
- Sgrò A
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- Shah K
- Shah Sm
- Shah Sm
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- Siaw O
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- Sihra N
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- Silva I
- Silvestri V
- Simioni A
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- Simmonds L
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- Smoker H
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- Soares As
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- Sooriyamoorthy T
- Soria-Aledo V
- Soria-Aledo V
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- Sparta C
- Spaziani A
- Speake D
- Speake D
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- Stecca T
- Stella M
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- Stevenson R
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- Strachan E
- Strange Ja
- Stubbs Bm
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- Stupalkowska W
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- Szucs A
- Szucs A
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- Tague Le
- Tahir W
- Tailor K
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- Yang P
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- Yen Sk
- Yeung K
- Yeung K
- Yoganathan S
- Yoong S
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- Zelazek M
- Zerpa C
- Zhang Ay
- Zhou S
- Zorrilla L
- Zuin M
- Zurleni Tz
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2019
- Field of study
Background
Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis.
Methods
A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis).
Results
Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent).
Conclusion
Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified