12 research outputs found

    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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    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

    Efeito inibidor do soro urêmico sobre o metabolismo oxidativo dos neutrófilos de cães

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    Foi testada a hipótese de que, à semelhança do que ocorre em humanos, os componentes do soro urêmico inibem o metabolismo oxidativo dos neutrófilos de cães. Para isto, o sangue total de 10 cães foi incubado com soro homólogo urêmico e não urêmico e posteriormente comparado quanto à produção neutrofílica de superóxido estimada pelo método citoquímico de redução do tetrazólio nitroazul (NBT). A produção de superóxido gerada pelo metabolismo oxidativo dos neutrófilos tratados com soro urêmico apresentou significante redução (P<0,05) em relação aos tratados com plasma autólogo e homólogo com níveis normais de ureia. Concluiu-se que os componentes presentes no soro urêmico inibem ex vivo o metabolismo oxidativo dos neutrófilos de cães portadores de insuficiência renal e que, portanto, têm sua imunidade inata comprometida
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