103 research outputs found
COMPARATIVE EFFECTS OF THERMAL TREATMENTS AND -IRRADIATION ON THE VOLATILE, NON-VOLATILE AND ANTIRADICAL ACTIVITY OF EGYPTIAN ANISE ESSENTIAL OIL
- Author
- Publication venue
- The Union of Arab Universities
- Publication date
- 01/03/2015
- Field of study
The effect of various thermal treatments (electric oven, microwave) and g-irradiation at three doses (6, 8 and 10 KGy) on the composition of volatile and non-volatile of anise essential oil and also their antioxidant properties were considered. The hydrodistilled oil (HD) of control and treated samples were subjected to gas chromatography–mass spectrometry (GC/MS) analysis. The volatile profile of raw HD oil of anise consisted mainly of transe-anethole (79.68%) followed by hexahydrofarnesyl acetone (6.95%), para-anisaldehyde (5.49%); g-himachalene (2.53%) and estragole (0.76%). Although the effect of roasting didn’t cause significant changes in the total yield of major compounds of HD anise oil which are phenylpropanoid derivative (transe anethole , para-anisaldehyde, cis-anethole and estragole (=methylchavicol), it is found that gamma irradiation revealed the same behavior at the 10 KGy irradiated sample but decrease the total yield of these compounds in 6.8 KGy irradiated sample compared to control one. also the thermal and g- irradiation caused drastic increase in the total yield of sesquiterpenes whereas decreased oxygenated compounds in all samples under investigation compared to control one. Such changes affected the antioxidant activity of the treated samples 1.1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging as well as β-carotene bleaching test against butylated hydroxy toluene (BHT). The strongest effect of reduction of DPPH radical as well as the highest inhibiting effect of the oxidation of linoleic acid and the subsequent bleaching of β-carotene was by 8 KGy irradiated sample which comprised (84.57%±1.43); (85.21% ± 0.12) respectively, in comparison to BHT (98% ± 0.0) at the same concentration 30 µg/mL besides all samples under investigation revealed high antioxidant activities due to their high content of phenylpropanoid and oxygenated compounds. These confirmed by total phenolic content. High performance liquid chromatography (HPLC) method was used for the analysis of phenolic compounds in the selected sample. Polyphenolic compounds were analysed on C18 Reversed Phase (RP) HPLC. A total of 9 phenolic compounds were identified, the obtained results showed that the predominant compound was P-qumaric acid (43.36%) followed by ferulic acid (21.06%)
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
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- Abu-toyour Maram
- Abubakr Marwan
- Abuowda Yousef
- Abuqwaider Eman
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- Abushamleh Soha
- Ackom Eric
- Acquah Emmanuel
- Adam Ali
- Adam Nourhan
- Adamu Ahmed
- Adawi Ihdaa
- Adawi Mohammad
- Adebanjo Ademola
- Adebola Oluwaseyi
- Adedeji Adesina
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- Ademuyiwa Adesoji O.
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- Ahlqvist Sandra
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- 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
- 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
Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey
- Author
- Abbas Ahmed Hosam Eldin Hasan
- Abbas Ghanem
- Abbas Hazem
- Abbatini Francesca
- Abdalbakheet Duaa
- Abdallah Emad
- Abdelazim Tarek
- Abdelaziz Nabil Yassin Tammam
- Abdelglil Momen
- Abdelhalim Ahmed
- Abdelhalim Mostafa Mohammed
- Abdelhamid Ahmed
- Abdelhamid Mohamed Sayed
- Abdelkhalik Morsi Mohamed Morsi
- Abdellatif Ahmed
- Abdelmageed Mohammed Elkassaby
- Abdelmaksoud Mohamed
- Abdelmohsen Ahmed
- Abdelmomen Ahmed Ezzat Elghrieb
- Abdelmoneim Ibrahim Tharwat Mohamed
- Abdelmonem Mohamed Ahmed
- Abdelmotaleb Hussien Ali
- Abdelrafee Ahmed
- Abdelrasheed Sayed
- Abdelsayed Emad Fahim
- Abdo Nael
- Abdulatef Shehab Ahmed Ali
- Abdullah Alqahtani Ali
- Abdulrahman Chadi
- Abdur-Rahman Lukman
- Abduraboh Abdullah Fayez
- Abed Ali Ibrahim Eldawy
- Abiodun Azeez Lateef
- Abiyere Henry
- Aboelmagid Hamdy Haggag Ebrahim
- Abolnasr Khaled Samir
- Abosi-Appeadu Kessewa
- Abouelnagah Galal
- Abozeid Ahmad Mahmoud
- Abozeid Mahmoud
- Abualkhair Wael
- Abualnaja Yousra
- Abualsel Abdulmenem
- Abuosba Abdelrahman
- Abusalem Osama
- Abusiam Wael
- Abutalib Raid Abdullah
- Abuzeid Mohamed Mostafa
- Addari Giulio
- Adebowale Yusuf
- Adejumo Adeyinka
- Adel Mohammed
- Adeoluwa Ojajuni
- Adeyeye Ademola
- Adly Ramy Magdy
- Adorisio Ottavio
- Agbonrofo Peter
- Agrawal Abhishek
- Ahmad Farooq
- Ahmad Misbahu Haruna
- Ahmad Mustafa
- Ahmad Sufian
- Ahmad Suhaib
- Ahmed Abeer Abdul Hameed
- Ahmed Arooj
- Ahmed Emad Ali
- Ahmed Hassan
- Ahmed Mohamed
- Ahmed Mostafa Mahmoud
- Aitali Abdelmounaim
- Akeel Nouf
- Akhtar Khalid
- Akin Furkan Atakan
- Akinmade Akinola
- Al Eisa Abdulmohsen
- Al Hassn Ibrahim
- Al Naeb Mohamed
- Al Turki Neamat Ahmed Ali
- Al-Bahrani Ahmed
- Al-Kubati Waheeb
- Al-Masari Hayder Makki
- Al-Sadery Humood
- Alaa Mohammed
- Alabbas Haytham
- Alafghani Haitham
- Alarabi Rayan
- Alawadhi Abdulbari Mohammed
- Alawady Mohammed
- Alawfi Homoud
- Alazzam Saleh
- Albadry Ali Almahdy Ali
- Albahooth Khalid
- Albalawi Ibrahim Altedlawi
- Albeshri Khalid A.
- Aleksandr Ogoreltsev
- Alfalah Haitham
- Algatanesh Nassib
- Alghamdi Faisal Saleh
- Alghamdi Saleh
- Alghuliga Abdullah
- Alhamdany Arkan Shubber
- Alharbi Abdulhamid
- Alhazmi Barrag
- Alhazmi Waleed
- Alhedaithy Alhanouf
- Alhendawey Moaaz
- Alhussaini Mohammed Khalid
- Alhussien Fade Ahmed
- Ali Ali Sayed
- Ali Bandar Idrees A.
- Ali Doaa
- Ali Mahmoud
- Ali Mohamed Anwar Abdel Razik
- Ali Muhammad Zulfiqar
- Ali Shabeer
- Ali Syed Muhammad
- Aliyu Yakubu
- Aljathlany Yousef
- Aljawhari Adel Ali
- Alkhalegy Ayman
- Alkhayat Ali
- Alkhayat Mohammed Amer
- Allaeys Mathias
- Almaghrabi Alhassan Hesham
- Almasri Mahmoud
- Almulhim Abdulrhman
- Alnabarawi Mahmoud
- Alnahas Yousef
- Alnashar Ahmed
- Alnoqaidan Emad
- Alomieri Adil
- Alotaibi Abdullah
- Alotaibi Abdulrahman
- Alotaibi Abdulrahman
- Alowairdhi Tumadher
- Alqarni Ahmed
- Alqasaby Abdallah
- Alqudaihi Heba
- Alrashidi Yousef
- Alsallum Ofays
- Alsawat Salem
- Alshabi Yaser Ahmad
- Alshehari Mohammed Mohammed Hasan
- Alshukr Sarah
- Alsuwaimel Munir A.
- Althobaiti Majid
- Althumali Abdullah
- Altomare Donato F.
- Alvarez Gallesio José Maria
- Alwan Ahmed
- Alwusaibie Ahmed
- Alyami Mohammad
- Alzahrani Khalid H.
- Alzahrani Saud
- Alzamanan Mahdi
- Alzamel Heythem
- Amal Benzakour
- Amary Mohamed Mokhtar
- Amen Mohamed Mohsen
- Amer Nasser Mohammed
- Amir Mohammed
- Amr Wesam
- Andrea Chierici
- Andrea Police
- Andriola Valeria
- Angrisani Marco
- Angulo Victor Manuel Pinto
- Antonio D’Alessandro
- Anwer Mariyah
- Aoun Rany
- Arbutina Dragana
- Archid Rami
- Aremu Isiaka
- Argenio Giulio
- Arnold Marion
- Arnouse Mohamed Mohamed Hamdy
- Asar Khalid Mohammad Ibrahim
- Ashimov Erkin
- Ashraf Tamer
- Asif Muhammad
- Aslam Mohammad
- Ateeb Mujammad
- Atef Gehad
- Atici Semra Demirli
- Attia Ahmed Mohamed
- Ayoub Larissa
- Azer Mina
- Aziz Mina
- Aziz Muhammad Akram Abdul
- Ba Mamadou
- Bacher Annica
- Bafaraj Ahmed
- Bagaglini Giulia
- Balla Andrea
- Barbary Hesham
- Barberis Andrea
- Barbon Carlotta
- Basendowah Mohammed
- Bashah Moataz M.
- Bashir Umar
- Bashlachev Andrey
- Bassuni Majid
- Bàmbina Fabrizio
- Bellato Vittoria
- Belli Andrea
- Bensaad Ahmed
- Berchtold Valeria
- Bernante Paolo
- Bertels Laurie
- Beshir Hatem
- Bhatt Nikita
- Bogdan Stoica
- Bonci Eduard-Alexandru
- Borasi Andrea
- Botros Ibram
- Botteri Emanuele
- Bouchrika Amal
- Boukorou Garyfallia
- Brahmachari Swagata
- Bruzzaniti Placido
- Calik Bulent
- Calvo Mikel Prieto
- Campagnaro Tommaso
- Campanelli Michela
- Campennì Paola
- Canfora Alfonso
- Capizzi Vita
- Carrano Francesco Maria
- Castaldi Antonio
- Cavallaro Giuseppe
- Chacón Mario Franco
- Charalabopoulos Alexandros
- Cherfa Harieche Abdennour Abderahim
- Chiarella Vito
- Chipaila Jackson
- Cianci Pasquale
- Cillara Nicola
- Cirillo Bruno
- Ciubotaru Cezar
- Colás-Ruiz Enrique
- Colleoni Ramiro
- Colombo Francesco
- Coniglio Denise
- Costanzo Federico
- Cuk Vladica
- Curtis Nathan
- Dagorno Claire
- Daibes Adel Goda Hussein
- Danilov Michail
- Dare Julius Kolajo
- Daudi Irfan
- Davies Justin
- Dawdi Salahaldeen
- De Falco Nadia
- De Fatico GSerena
- De La Hermosa Alicia Ruiz
- De Lucia Francesca
- De Sousa Xavier
- Del Muslim Ka
- Demeester Steve
- Depuydt Martijn
- Dere Ümit Akın
- Derinov Aleksandr
- Di Bartolomeo Alessandro
- Di Carlo Sara
- Di Lorenzo Nicola
- Di Martino Marcello
- Di Saverio Salomone
- Diamantopoulou Angela
- Díaz Andrés Vega
- Díaz Jeancarlos J. Trujillo
- Doerner Johannes
- Dogjani Agron
- Don Cristine
- Duran Erik Efrain Sosa
- Durayb Norah
- Dursun Ayberk
- Dziakova Jana
- Echevarria Miguel Jose Pinto
- Edassy Mohammed El
- Efetov Sergey
- Eke Grace
- El-Hussuna Alaa
- El-Wakeel Ayman
- Elalfy Khaled
- Elbahrawy Aly
- Elbatal Amira Alsayed Abdelhai
- Eldeeb Ahmed
- Eldemery Mohamed
- Eldesouki Mohammed Nabil
- Eldesouky Omnia
- Eleshra Ahmed
- Elfeki Hossam
- Elgaly Maher Elesawi Kamel
- Elgamal Hesham
- Elganash Abdelazim
- Elgazar Amr
- Elgazar Elsayed Aly
- Elgendy Hesham
- Elghadban Hosam
- Elhafez Raheem El-Gohary Abd
- Elhattab Ahmad
- Elhawary Ahmed Adel
- Elkafoury Ahmed
- Elkased Ahmed Farag
- Elkatt Mahmoud Mohamed
- Elkhouly Ahmed G.
- Elmesery Mohamed
- Elmetwally Ashraf S.
- Elmoghazy Mohamed Ibrahim
- Elnaghi Hisham
- Elnakash Ahmed Mostafa
- Elnemr Islam
- Elnour Ahmed Abd Elbaset Elsayed Abu
- Elrefai Mohamad
- Elsaied Adham
- Elsanhoury Kareem
- Elsanosi Abdelrhman Azhari Mohammed
- Elsayed Mohamed Abdelmoneim
- Elsayed Mohamed Ahmed Abdelhalim Ahmed
- Elseberbihy John Rezk Hanna
- Elshaer Ahmed Mohammed
- Elshazli Mostafa
- Elsheik Ahmed
- ElSheikh Ahmed M.
- Elsherbiny Osama
- Elshikh Essam
- Elsorogy Mohamed
- Elvira Tartaglia
- Elzayady Hany M.
- Elzayat Ibrahim
- Elzeftawy Shady Ahmed
- Emile Sameh Hany
- Enad Farazdaq
- Epifani Angelo Gabriele
- Eral Burak
- Ezz Ahmed
- Fadel Bashir A.
- Fahiem Andrew
- Fakhr Ibrahim
- Falaschi Federica
- Familiari Pietro
- Farag Mohamed
- Farid Ahmed Mohammed
- Farid Mohamed
- Farouk Mohamed
- Farouk Nehal
- Fathy Mohammad
- Fatima Tauseef
- Fawzy Ahmed
- Faye Papa Mamadou
- Fayed Mohamed Abdelaziz Mohamed Abdalla M
- Fazli Mohammad Rafi
- Felix Marcos José Serrato
- Ferrara Francesco
- Ferrario Luca
- Ferri Lorenzo
- Fieturi Nura Ahmed
- Fikry Mohamed
- Fiore Antonio
- Flores Manuel SSalas
- Foppa Caterina
- Fouad Amgad
- Franceschilli Marzia
- Fransvea Pietro
- Frasson Matteo
- Frauenfelder Claire
- Frazzetta Giuseppe
- Freitas Carla
- Frigerio Isabella
- Frontali Alice
- Gaarour Osama
- Gabr Mohamed A.
- Gad Hamada
- Galala Ahmed
- Gallo Gaetano
- Gamal Ehab
- Gamal Sameh
- Ganau Mario
- Garino Mauro
- Garmanovs Tatiana
- Garoufalia Zoe
- Garreffa Emanuele
- Gazia Carlo
- Gehwolf Philipp
- Gendy Samuel Elkess Morcos
- George Ihediwa
- Ghabisha Saif Ali
- Ghafoor Tariq
- Ghanem Ahmed
- Gharbia Mohamed
- Ghazala Mohamed Jomma
- Ghonim Mostafa
- Ghunaim Mohammed
- Giani Alessandro
- Giardino Alessandro
- Giarratano Gabriella
- Giuffrida Maria Carmela
- Giugliano Marco
- Golea Smain
- Gomez Caroina Gonzalez
- Gondal Zafar
- Gonzales Erick Ivan Huaman
- Gorin David
- Gots Alexander
- Grappelli Virgilio Michael Ambrosi
- Guaitoli Eleonora
- Guerci Claudio
- Guerrero José Eaazim Flores
- Guida Anna
- Gulcu Baris
- Gurung Binay
- Haddad Feras
- Hadi Sabah Anwar
- Hamdi Salah
- Hamed Esmael Ali
- Hamed Hosam
- Hamed Mohamed Korayem Fattouh
- Hammad Muhammed Alaa Moukhtar
- Hamza Ahmed
- Hanif Muhammad Amir
- Hasani Ariola
- Hassan Mohamed Ali Gad
- Hassan Mohamed Salah Eldin
- Hassan Redan
- Hatm Mohamed
- Haydal Ashraf
- Hegazy Mostafa
- Hejazi Soha
- Helal Mohamed Alaa Abdelmoez
- Helmy Ahmed Hazem I.
- Hemidan Ahmed Gamal Abouelfetouh Ibrahim
- Henes Mohsen Michael
- Hesham Hosai Todd
- Hijazi Bilal Ahmed
- Hilling Denise
- Holubar Stefan D.
- Hussain Marwah
- Hussein Abdinafic Mohamud
- Ibrahim Ahmed
- Ibrahim Hamed
- Ibrahim Yaser
- Ibrahim Yassin
- Ignatov Ivan
- Ilkul Jh.
- Inam Aatif
- Inama Marco
- Ioan Tanase
- Ioannidis Argyrios
- Iossa Angelo
- Ippoliti Simona
- Isaiah Isaac A.
- Isci Sevim
- Islam S. M. Nazmul
- Ismail Ahmed Mahmoud Ahmed
- Izzo Giuliano
- Jain Amita
- Jallad Fadi Sami
- Jaman Ismail
- Jameel Muhammad Khurram
- Japhet Ntezamizero
- Jarboa Lutfi
- Jarvis Bennie L.
- Jasso Manuel Meza
- Javed Ayesha
- Jawad Fassi Fihri Mohamed
- Jeffery James
- Jolayemi Edward
- Jooma Uzair
- Juloski Jovan
- Junaid Sheikh
- Kaldarov Ayrat
- Kandel Mohamed Mosaad
- Karbovnichaya Elena
- Kassem Amr
- Kateb Abdullah
- Kaur Mandeep
- Kaya Tayfun
- Kazachenko Ekaterina
- Kazim Shuiab
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- Kewulere Raji Taofiq
- Khadwardi Faisal
- Khafagy Tamer
- Khafagy Wael
- Khalaf Mohsen George
- Khalil Medhat M. H. A.
- Khan Irfan Jan
- Khan Roaa Ghazi
- Khare Ritu
- Khashshan Sohib Mohammed Mohammed
- Khawar Mahwish
- Khoj Mohammed
- Khokhar Muhammad Imran
- Khudhayr Essa
- Khuller Somyaa
- Kilinc Gizem
- Kırmızı Yasemin
- Kiselev Michail
- Kitsenko Yury
- Klein Mads Falk
- Koc Mehmet Ali
- Koirala Dinesh Prasad
- Kostakis Ioannis D.
- Kress Melissa
- Kropshofer Stephan
- Kumar Sanjeev
- La Torre Filippo
- Laina Juan Luis Blas
- Lakshmi Harish Neelamraju
- Landaluce-Olavarria Aitor
- Lapolla Pierfrancesco
- Larbi Noureddine
- Lateef Nawras Falah
- Lathan Sanaz
- Lawal Bashir
- Lederhuber Hans
- Lelpo Benedettao
- Leo Cosimo Alex
- Leventoğlu Sezai
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- Liakakos Theodore
- Light Alexander
- Lisi Giorgio
- Litta Francesco
- Lotfy Ahmad
- Loukil Issam
- Luc Jessica G. Y.
- Lule Herman
- Lund Jon
- Lutfi Basma Waseem
- Machairas Nikolaos
- Madbouly Khaled
- Madhuri Thumuluru Kavitha
- Maffioli Anna
- Maghrebi Houcine
- Mahadel Osama Abdel Salam
- Majeed Mudassar
- Majid Haroon Javaid
- Makasarwala Murtaza
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- Malibary Nadim
- Maliki-Alaoui Mohamed
- Manetti Andrea
- Mangiameli Giuseppe
- Mansour Khaled Yousery Ibrahim
- Marafante Chiara
- Marano Alessandra
- Marcos Alberto
- Mariani Aurora
- Mariani Nicolò Maria
- Mariateresa Grasso
- Marino Marco V.
- Marra Angelo Alessandro
- Marsanic Patrizia
- Martin Linda W.
- Martin-Perez Beatriz
- Martinelli Fabio
- Marzouk Ahmed Msm
- Marzouk Khalid
- Matarangolo Antonio
- Maurizi Angela
- Mazingi Dennis
- Mbatani Nomonde
- Mbiine Ronald
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- Medkova Iuliia
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- Metwally Mohamed
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- Mikrish Amir
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- Milana Flavio
- Milford Karen
- Milic Ljiljana
- Millan Monica
- Mingoli Andrea
- Minoldo Javier
- Mirza Mohammad Amin
- Mitul Ashrarur Rahman
- Moeslein Gabriela
- Mohamed Mohamed Mohamed Adel
- Mohamed Anwar Yahya A.
- Mohamed Omnia Y.
- Mohammad Mohammad Aminu
- Mohammed Khalid Fathelrahman Bakier
- Mohammed Mahfoudh
- Mohammed Mahmoud M.
- Mohammed Mohammed Mustafa Hassan
- Mohammed Ouazni
- Mohmmed Mona Mhmoud
- Molena Daniela
- Montalbán Beatriz Cros
- Monti Alessio
- Montuori Mauro
- Mora-Guzmán Ismael
- More Vinal
- Morini Andrea
- Moustafa Mohammad Montaser Hassan
- Mpaili Eustratia
- Mubarak Ashraf Abdelazeem Mohamed
- Mudawi Ishag M.
- Muhammad Aneeqah Din
- Muresan Mihai-Stefan
- Mussa Haidar Aal
- Musthafa Shameel
- Nabeeh Mohamed Adel
- Nabil Tamer
- Nabwana Ambrose
- Nadeem Munawar
- Nadeem Uqba
- Nageeb Ashraf
- Nageeb Ramy Mikhael
- Najm Ghadah
- Nakazwe Mildred
- Nasef Hazem
- Nasir Muhammad
- Ndong Abdourahmane
- Negida Ahmed
- Negoi Ionut
- Nekhala Islam
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- Ng Jen Siang
- Niaz Khurram
- Nimir Nessrein
- Ninkovic Marijana
- Nittala Rigved
- Njau Aidan
- Njokanma Iloba Gabriel
- Njoroge Githu
- Novikova Anastasia
- null null
- Obadiel Yasser Abdurabo
- Obure Ralph Ombati
- Ocklind Miranda E. K.
- Odion Clement
- Okunlola Abiodun Idowu
- Oludara Mobolaji Adewale
- Oluwasuyi Ige
- Oluyomi Ayodele Samuel
- Omar Mohamed I.
- Omar Tilioua
- Oosthuizen Pj
- Orecchia Luca
- Orlando Francesco
- Osman Khalid Abdalla Abdelgadir
- Osman Luqman
- Ouadii Mouaqit
- Oyedepo Charles Olajide
- Paci Marco
- Pagano Gianluca
- Pakula Andrea M.
- Palkhi Yusuf
- Pandey Diwakar
- Papadopoulos Georgios
- Parello Angelo
- Parente Alessandro
- Parida Lalit
- Pata Francesco
- Peediyakkal Saidalavi Padinhare
- Pellino Gianluca
- Perra Teresa
- Petagna Lorenzo
- Pérez-Bertólez Sonia
- Picciariello Arcangelo
- Pignatelli Marcello Filograna
- Pinotti Enrico
- Pio Luca
- Pirovano Riccardo
- Pirozzi Brunella
- Pitoni Ludovica
- Pohl Linda
- Ponholzer Florian
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- Porcu Alberto
- Portela Carlos Antonio Sanchez
- Pouwels Sjaak
- Prodromidou Anastasia
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- Puzenko Dmitriy
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- Qurashi Kamran
- Qureshi Ahmad Uzair
- Rabea Mohamed
- Rachid Mohamed Ghassane
- Rao Satish
- Raptis Dimitri
- Rashid Arshad
- Rashid Shahid
- Ratto Carlo
- Rayamajhi Shreya
- Raza Muhammad Asif
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- Rihan Eslam
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- Robles Eloy Morasen
- Rodimov Sergey
- Romic Ivan
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- Rubio-Perez Ines
- Ruiz Luis Angel Garcia
- Saad Ahmad
- Saadeldin Abdelhalim
- Saber Wael
- Sabet Khaled
- Sacchi Matteo
- Saeed Muhammad Ahmad
- Sahnan Kapil
- Said Khalid Babieker
- Saklani Avanish
- Sakr Ahmad
- Saleh Amr
- Salem Eman Abdalla Mohamed
- Salem Mohamed Abouelmagd
- Salim Mohammed Said Mahmoud
- Salim Omer El Faroug H.
- Salim Sami
- Sallam Ibrahim
- Salman Usama
- Samadov Elgun
- Samaha Mahmoud Yahia
- Sanad Aly
- Sanad Mohammed
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- Sapienza Paolo
- Sarhan Fetoh Alaaeldin Fetoh
- Sarmah Panchali
- Sasia Diego
- Sauri Fozan
- Sayouh Mohammad
- Sbaih Mohammed
- Scafa Anthony Kevin
- Schuldes Alejandro Daniel Lira
- Sciaudone Guido
- Sebelik Merry
- Seiam Moham
- Selvaggi Francesco
- Sembawa Hatem A.
- Semilan Anmar
- Senent-Boza Ana
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- Sergeevich Kochetkov Viktor
- Shafique Muhammad Salman
- Shah Rahmat Ullah
- Shah Shahzad Alam
- Shaheen Abelnasser
- Shahein Mostafa
- Shahin Yasser
- Shaikh Abdul Razaque
- Shaker George Samir Habib
- Shalaby Mostafa
- Shams Maher
- Sharaf Hesham
- Sharafeldin Hatem Abdelrahman Ahmed
- Sharma Meenakshi
- Shawer Sami
- Shawer Sherif
- Shehata Mina
- Shemes Ayman
- Sherbiny Kareem El
- Sherif Ahmed Elshawadfy
- Shetiwy Mosab
- Shittu Asimiyu Adekunle
- Shomoye El-Zaki
- Sibiany Abdulrahman
- Siboe Mark M. W.
- Sidorova Lyudmila
- Sileri Pierpaolo
- Silva Jesús
- Simioni Andrea
- Sindy Abdullah
- Singh Baljit
- Siragusa Leandro
- Situ Oladele
- Skandalakis Georgios P.
- Slavchev Mihail
- Sleilati Fadi
- Sobh Mohamed Ramadan
- Sofan Mostafa
- Soggiu Fiammetta
- Sokmen Selman
- Soliman Ahmed
- Spinelli Antonino
- Spolverato Gaya
- Ssenono Kavuma Daniel
- Stanislav Berelavichus
- Stavrou George
- Stijns Jasper
- Styliani Vasileiadou
- Subramanian Sivaraman
- Suliman Omar AAbu
- Tabasi Hani
- Tagg Gamal Hassan El
- Tairab Elsanousi Ibrahim Sabir
- Taki-Eldin Ahmed
- Tallon-Aguilar Luis
- Taman Mohamed
- Tamburrini Alessandro Paolo
- Tamini Nicolò
- Tanda Cinzia
- Tarabay Ahmed
- Tashkandi Wail
- Tashkandi Waleed
- Tecchio Piero
- Tejedoe Patricia
- Tesik Philip
- Testa Valentina
- Thakrar Dixa
- Thein Nyan
- Tohamy Aley Eldin
- Toma Omar
- Tong Kin Seng
- Torky Radwan Abdelsabour
- Towfigh Shirin
- Troci Albert
- Tropeano Francesca Paola
- Tsounaki Efthymia
- Tuncer Korhan
- Turrado-Rodríguez Víctor
- Uccelli Matteo
- Ugarte-Sierra Bakarne
- Uggeri Fabio
- Uraiqat Ahmad
- Uranitsch Stefan
- Uslu Gülberk
- Valente Marina
- Valery Nekoval
- Van Daele Elke
- Van Praet Charles
- Van Ramshor Gabrielle H.
- Vanlander Aude
- Vanommeslaeghe Hanne
- Varma Gopala Pillay
- Vázquez-Melero Alba
- Vella Ivan
- Veltri Marco
- Venturelli Paolina
- Vikrantmr Sharma
- Villwock Jennifer
- Visconti Diego
- Vishwakarma Kushagra
- Vosloo Susan
- W Njoroge P.
- Waleed Aasma
- Wali Zubair
- Waqar Shahzad Hussain
- Warusavitarne Janindra
- Waseem Talat
- Wexner Steven
- Wuraola Funmilola Olanike
- Yacir El Alami
- Yakar Fatih
- Yanaga Katsuhiko
- Yassin Nouf
- Yassine Wassim Abou
- Yeşilyurt Değercan
- Yildiz Alp
- Yousef Yousef Mohamed
- Youssef Mohamed
- Youssef Youssef Abdel Aziz
- Yves Van Nieuwenhove
- Zafar Noman
- Zahra Tarek
- Zaidi Mariam
- Zaieem Mohammad
- Zakaria Hazem M.
- Zakharenko Alexander
- Zancana Giuseppa
- Zentar Aziz
- Zese Monica
- Zewar Karem Shahin Mohamed
- Zidan Ahmed Azmy
- Zigiotto Daniele
- Zubayraeva Albina
- Zuhdy Mohammad
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020
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
- 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
- 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
- Al Bastawis Fatema
- Al Meligy Amgad
- Al Rafati Ahmad Abdel Razaq
- Al Raouf Eman Abd
- Al Saied Ghiath
- 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
- Alis Halil
- Aliyu Halima
- Aliyu Mohammad
- Aliyu Shamsudeen
- Aljboor Khaled
- Aljiffry Murad
- Alkaaki Aroub
- Alkelani Muhammad
- Allam Meran
- Allam Yomna
- Alnaby Mohamed Hassab
- Alnusairat Aseel
- 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
- Andika Ferry Fitriya Ayu
- Andreotti Dario
- Andress Cedar
- Andriola Valeria
- Ang Yun Lin
- Angelieri Daniele
- Anis Echaieb
- Ansaloni Luca
- Ansaloni Luca
- Ansaloni Luca
- Antezana Diego
- Anthoulakis Christos
- Antoniozzi Angelo
- Anwar Nourhan
- Anyanwu Lofty-John
- Aonzo Paolo
- Appeadu-Mensah William
- Appiah Eric Kofi
- Aquilino Fabrizio
- Arafa Omar
- Arafa Sara
- Arango Maria Clara Mendoza
- Arcudi Claudio
- Armellini Andrea
- Arnaud Alexis
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- Arshad Mohammad Mohsin
- Arslan Ekin
- Arsyad Hasbi Maulana
- Arthur Tom
- Aruldas Neerav
- Asar Yomna Hosny
- Asare-Bediako Kwasi
- Ashour Ahmad
- Ashour Ahmad
- Ashour Khlood
- Ashtari Morvarid
- Asi Fatema
- Asilah Siti Mohd Desa
- Assal Abdelrahman
- Asturias Sabrina
- Asumah Hamza
- Ata Ahmed
- Ata Aya Yehia
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- Atkins Ebenezer Takyi
- Attia Attia
- Augestad Knut Magne
- Aviles Susan
- Avoka Anthony
- Awad Israa
- Awad Sawsan Adel
- Awadallah Salwa
- Ayandipo Omobolaji
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- Aziz Dayang Nita Abdul
- Aziz Mohamed Rezal Abdul
- Aziz Nora Abdul
- Azizeldine Mohammed G
- Azzie Georges
- Azzis Olivier
- Baba Suleiman
- Bachri Houda
- Badawy Mahmoud
- Badenjki Mohamed Adel
- Badicel Maria
- Badr Mohamed Fawzy Mahrous
- Badwi Nermin Mohamed
- Bahar Suraya
- Baillie Katie
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- Cengiz Yucel
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- Chabok Abbas
- Chai Chu-Ann
- Chai Feng Yih
- Chan Luke
- Chan Tsz-Yan Katie
- Chan Xue Wei
- Charles Angeline
- Cheah Alvin Ee Zhiun
- Chen Kar Yan
- Chen Tzu-Ling
- Cheong Yih Jeng
- Chetta Nicola
- Cheung Yuk Hong Eric
- Chibuye Chali
- Chiesa Deborah
- Chilton Gareth
- Chin Pui Xin
- Chin Ye Ru
- Chiu Seehui
- Choi Philip
- Chong Choon Seng
- Chong Hoong-Yin
- Choudhry Asad
- Chow Crystal Yern Nee
- Chowdhury Debkumar
- Chu Kathryn
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- Coccolini Federico
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- Cox Michael
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- Cullen Fraser
- Curletti Gianluca
- Currow Chelise
- D'Amours Scott
- D'Souza Michelle S
- Dabboor Majd
- Dabbour Kareem
- Dagoe Enoch
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- Drake Thomas M
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- Feidantsis Thomas
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- Vicario Erika
- Vicenta Collado Maria
- Vida Lucian Corneliu
- Vilcinskas Mantas
- Villalobos Santiago
- Violi Paola
- Visinskas Petras
- Voulgaris Evangelos
- Wael Noha
- Wakefield Rebecca
- Waledziak Maciej
- Walker Michael
- Walker Nathan
- Walls Luke
- Walsh Michael
- Waqar Muhammad
- Warren Oliver
- Waterman Ade
- Werder Gabriela
- Whitaker John
- White Rebecca
- Whitehurst Katharine
- Wiborg Joachim
- Widiastini T Ariani
- Widmer Lukas Werner
- Wijayarathna LS
- Williams Omolara
- Wilson Ling
- Wilson Michael
- Wilson Michael
- Wimalge PMSN
- Wogensen Fredrik
- Wolf Bernhard
- Wondoh Paul
- Wondoh Paul
- Wong Chui Yee
- Wong Francisca
- Wong Hong Yee
- Wood Greta
- Worku Mengistu
- Worku Tewodros
- Wright Naomi
- Yahaya Muhammad Taqiyuddin
- Yakubu Musah
- Yam Sir Young
- Yang James
- Yap Suhhuey
- Yau Jih Dar
- 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
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.
- Author
- Abantanga F
- Abbas M
- Abbo O
- Abd El Galeel A
- Abd El Hameed OS
- Abd El Hamid N
- Abd El Salam Y
- Abd El Slam M
- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elrasoul Y
- Abdallah E
- Abdel-Wahab NYE
- AbdelFattah I
- Abdelgelil A
- Abdelghany S
- Abdelkader M
- Abdelkareem A
- Abdelraheim M
- Abdelshafy M
- Abdulgawad M
- Abdullah AAN
- Abdullah NAN
- Abebe NS
- Abebe NS
- Aber A
- Abington E
- Aboarab A
- Aboraya M
- Aboraya M
- Abouelnasr A
- Abouzahra A
- Abozaid M
- Abozeid K
- Abozyed MAF
- Abudeeb H
- Abuseif M
- Acharya P
- Adams R
- Adebanjo A
- Adekoya A
- Adel A
- Adel A
- Ademuyiwa A
- Ademuyiwa AO
- Adeniran J
- Adeniyi A
- Adesanya O
- Adesina A
- Adesuyi A
- Adeyeye A
- Adham W
- Afandy A
- Afifi AM
- Afzal M
- Agalianos C
- Agarwal A
- Agius M
- Aguilar-Jimenez J
- Aguilera M
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2018
- Field of study
BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
- Author
- Aahlin EK
- Aamer A
- Aaniana K
- Ababneh A
- Abaliksta T
- Abantanga F
- Abantanga F
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- Abbasy J
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- Abd El Hameed OS
- Abd El Hamid N
- Abd El Salam Y
- Abd El Slam M
- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elmawla M
- Abd-Elrasoul Y
- Abdallah E
- Abdallah E
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- Abdel-Hameed N
- Abdel-Kader SM
- Abdel-Wahab NYE
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- Abdelfatah A
- AbdelFattah I
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- Abdelhamed R
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- Azmitia Mendizabal CA
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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
Global economic burden of unmet surgical need for appendicitis
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- Publication venue
- Oxford University Press
- Publication date
- 01/01/2022
- Field of study
Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 92492millionusingapproach1and73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 95004millionusingapproach1and75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially
Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants
- Author
- Abbas Dehghan
- Abdonas Tamosiunas
- Abdullatif S Husseini
- Abhijit Sen
- Abla M Sibai
- Adela Chirita-Emandi
- Adolfo Rubinstein
- Afshin Ostovar
- Ahmad Ali Noorbala
- Ahmad Ali Zainuddin
- Ahmad Faudzi Yusoff
- Aicha Soumare
- Aida Pilav
- Akihiro Yoshihara
- Akram Pourshams
- Ala'a Alkerwi
- Alain Morejon
- Albert Hofman
- Albertino Damasceno
- Alberto Barceló
- Alejandro Diaz
- Aleksandar Džakula
- Aleksander Giwercman Wu
- Aleksandra Piwonska
- Alet H Wijga
- Aletta E Schutte
- Alexandre C Pereira
- Alicia Matijasevich
- Alina Kerimkulova
- Aline Meirhaeghe
- Aline Wagner
- Alireza Ahmadvand
- Alisha N Wade
- Alison J Hayes
- Allan Linneberg
- Altan Onat
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- Songhomitra Panda-Jonas
- Soon-Woo Park
- Sophie Visvikis-Siest
- Sounnia Mediene-Benchekor
- Stefaan De Henauw
- Stefan Kiechl
- Stefan Söderberg
- Stefania Maggi
- Steinar Krokstad
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- Sudha Ramachandra Rao
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- Thor Aspelund
- Thorkild I A Sørensen
- Tien Yin Wong
- Tiffany K Gill
- Tiina Laatikainen
- Tiina Vlasoff
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- Tomasz Zdrojewski
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- Valérie Deschamps
- Vanina Bongard
- Vanja Ivkovic
- Veikko Salomaa
- Ver Bilano
- Vera Grujic
- Vera Lanska
- Vera Musil
- Vesna Jureša
- Vilma E Irazola
- Vilmundur Gudnason
- Vilnis Dzerve
- Vinay B Nangia
- Vincenzo Capuano
- Vincenzo Solfrizzi
- Virginija Dulskiene
- Viswanathan Mohan
- Viviane C Cardoso
- W M Monique Verschuren
- Wan Mohamad Wan Bebakar
- Wan Nazaimoon Wan Mohamud
- Wan Zhu Zhang
- Wei Zheng
- Wei-Yen Lim
- Weili Yan
- Wen-Harn Pan
- Wenhua Zhao
- Wichai Aekplakorn
- William A Neal
- Winsome R Parnell
- Wojciech Drygas
- Wolfgang Ahrens
- Xenophon Theodoridis
- Xiaoguang Yang
- Xingwang Ye
- Xu Lin
- Xun Tang
- Ya Xing Wang
- Yadlapalli S Kusuma
- Yannis Manios
- Yanping Li
- Yeon-Yong Kim
- Yi Song
- Yi Zeng
- Ying-Wei Wang
- Yingfeng Zheng
- Yn-Tz Sung
- Yong Tao
- Yonghua Hu
- Youchan Shin
- Young-Ho Khang
- Young-Ho Khang
- Yousef Saleh Khader
- Yufang Bi
- Yuki Fujita
- Yumi Cho
- Yuna He
- Yvonne T van der Schouw
- Zbigniew Gaciong
- Zbigniew Kulaga
- Zhengming Chen
- Zhengming Chen
- Ziad A Abdeen
- Publication venue
- ZU Scholars
- Publication date
- 01/01/2018
- Field of study
© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups
Repositioning of the global epicentre of non-optimal cholesterol
- Author
- Aadahl Mette
- Abarca-Gómez Leandra
- Abu-Rmeileh Niveen M.
- Acosta-Cazares Benjamin
- Adams Robert J.
- Aekplakorn Wichai
- Agdeppa Imelda A.
- Aghazadeh-Attari Javad
- Aguilar-Salinas Carlos A.
- Agyemang Charles
- Ahluwalia Tarunveer S.
- Ahmad Noor Ani
- Ahmadi Ali
- Ahmadi Naser
- Ahmed Soheir H.
- Ahrens Wolfgang
- Ajlouni Kamel
- al-Safi Ismail Aziz
- Alarouj Monira
- AlBuhairan Fadia
- AlDhukair Shahla
- Ali Mohamed M.
- Alkandari Abdullah
- Alkerwi Ala’a
- Aly Eman
- Amarapurkar Deepak N.
- Amouyel Philippe
- Andersen Lars Bo
- Anderssen Sigmund A.
- Anjana Ranjit Mohan
- Ansari-Moghaddam Alireza
- Aounallah-Skhiri Hajer
- Araújo Joana
- Ariansen Inger
- Aris Tahir
- Arku Raphael E.
- Arlappa Nimmathota
- Aryal Krishna K.
- Asghari Golaleh
- Aspelund Thor
- Assunção Maria Cecília F.
- Auvinen Juha
- Avdicová Mária
- Azevedo Ana
- Azizi Fereidoun
- Azmin Mehrdad
- Balakrishna Nagalla
- Bamoshmoosh Mohamed
- Banach Maciej
- Bandosz Piotr
- Banegas José R.
- Bao Tran Quoc
- Barbagallo Carlo M.
- Barceló Alberto
- Barkat Amina
- Bata Iqbal
- Batieha Anwar M.
- Batyrbek Assembekov
- Baur Louise A.
- Beaglehole Robert
- Bebakar Wan Mohamad Wan
- Belavendra Antonisamy
- Ben Romdhane Habiba
- Benet Mikhail
- Benn Marianne
- Bennett James E.
- Berkinbayev Salim
- Bernabe-Ortiz Antonio
- Bernotiene Gailute
- Bettiol Heloisa
- Bhargava Santosh K.
- Bi Yufang
- Bienek Asako
- Bikbov Mukharram
- Bista Bihungum
- Bixby Honor
- Bjerregaard Peter
- Bjertness Espen
- Bjertness Marius B.
- Björkelund Cecilia
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- Krokstad Steiner
- Kromhout Daan
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- Kuulasmaa Kari
- Kyobutungi Catherine
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- Lachat Carl
- Laid Youcef
- Lam Tai Hing
- Lambrinou Christina-Paulina
- Lanska Vera
- Lappas Georg
- Larijani Bagher
- Latt Tint Swe
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- Lee Jeonghee
- Lehmann Nils
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- Lilly Christa L.
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- Margozzini Paula
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- Mediene-Benchekor Sounnia
- Mehdipour Parinaz
- Mehlig Kirsten
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- Meirhaeghe Aline
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- Menon Geetha R.
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- Mereke Alibek
- Meshram Indrapal I.
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- Mohammadi Zahra
- Mohammadifard Noushin
- Mohammadpourhodki Reza
- Mohamud Wan Nazaimoon Wan
- Mohan Viswanathan
- Mohanna Salim
- Mohebbi Iraj
- Mohebi Farnam
- Moitry Marie
- Molnár Dénes
- Momenan Amirabbas
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- Moosazadeh Mahmood
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- Nauck Matthias
- NCD Risk Factor Collaboration (NCD-RisC)
- Neal William A.
- Nejatizadeh Azim
- Nenko Ilona
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- Nguyen Quang Ngoc
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- Nihal Thomas
- Niiranen Teemu J.
- Ning Guang
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- Nuhoğlu Irfan
- Námešná Jana
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- Oh Kyungwon
- Ohtsuka Ryutaro
- Olafsson Örn
- Oliveira Isabel O.
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- Omar Mohd Azahadi
- Onat Altan
- Ong Sok King
- Ordunez Pedro
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- Ostovar Afshin
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- Pajak Andrzej
- Palmieri Luigi
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- Panda-Jonas Songhomitra
- Panza Francesco
- Parnell Winsome R.
- Patel Nikhil D.
- Peer Nasheeta
- Peixoto Sergio Viana
- Peltonen Markku
- Pereira Alexandre C.
- Peters Annette
- Petersmann Astrid
- Petkeviciene Janina
- Peykari Niloofar
- Pham Son Thai
- Pichardo Rafael N.
- Pigeot Iris
- Pilav Aida
- Pilotto Lorenza
- Piwonska Aleksandra
- Pizarro Andreia N.
- Plans-Rubió Pedro
- Plata Silvia
- Pohlabeln Hermann
- Porta Miquel
- Portegies Marileen L. P.
- Poudyal Anil
- Pourfarzi Farhad
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- Punab Margus
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- Ramos Elisabete
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- Rampal Sanjay
- Rao Kodavanti Mallikharjuna
- Rao Sudha Ramachandra
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- Revilla Luis
- Rezaianzadeh Abbas
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- Rubinstein Adolfo
- Ruidavets Jean-Bernard
- Ruiz-Betancourt Blanca Sandra
- Russo Paola
- Rust Petra
- Rutkowski Marcin
- Sabanayagam Charumathi
- Sachdev Harshpal S.
- Sadjadi Alireza
- Safarpour Ali Reza
- Safiri Saeid
- Saidi Olfa
- Saki Nader
- Salanave Benoit
- Salmerón Diego
- Salomaa Veikko
- Salonen Jukka T.
- Salvetti Massimo
- Sans Susana
- Santaliestra-Pasías Alba M.
- Santero Marilina
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- Santos Rute
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- Sarrafzadegan Nizal
- Saum Kai-Uwe
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- Sbaraini Mariana
- Scazufca Marcia
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- Schargrodsky Herman
- Scheidt-Nave Christa
- Schienkiewitz Anja
- Schipf Sabine
- Schmidt Carsten O.
- Schramm Sara
- Schöttker Ben
- Sebert Sylvain
- Sein Aye Aye
- Sen Abhijit
- Sepanlou Sadaf G.
- Servais Jennifer
- Shakeri Ramin
- Shalnova Svetlana A.
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- Sharafkhah Maryam
- Sharma Sanjib K.
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- Shayanrad Amaneh
- Shi Zumin
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- Shimizu-Furusawa Hana
- Shin Dong Wook
- Shin Youchan
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- Shrestha Namuna
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- Siantar Rosalynn
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- Skaaby Tea
- Slowikowska-Hilczer Jolanta
- Slusarczyk Przemyslaw
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- Snijder Marieke B.
- Soemantri Agustinus
- Sofat Reecha
- Solfrizzi Vincenzo
- Somi Mohammad Hossein
- Sonestedt Emily
- Sophiea Marisa K.
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- Sozmen Kaan
- Sparrenberger Karen
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- Stehle Peter
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- Stieber Jutta
- Stokwiszewski Jakub
- Stronks Karien
- Strufaldi Maria Wany
- Stöckl Doris
- Sun Chien-An
- Sundström Johan
- Suriyawongpaisal Paibul
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- Sylva René Charles
- Szklo Moyses
- Sánchez-Abanto Jose
- Söderberg Stefan
- Sørensen Thorkild I. A.
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- Tuomilehto Jaakko
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- Van Minh Hoang
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- Vanderschueren Dirk
- Vanuzzo Diego
- Varbo Anette
- Varona-Pérez Patricia
- Vasan Senthil K.
- Vatten Lars
- Vega Tomas
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- Velasquez-Melendez Gustavo
- Venero-Fernández Silvia J.
- Veronesi Giovanni
- Verschuren W. M. Monique
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- Vidiawati Dhanasari
- Viet Lucie
- Villalpando Salvador
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- Viswanathan Bharathi
- Vlasoff Tiina
- Vollenweider Peter
- Voortman Trudy
- Voutilainen Ari
- Vrkic Tajana Zeljkovic
- Wade Alisha N.
- Wagner Aline
- Walton Janette
- Wang Ming-Dong
- Wang Ningli
- Wang Qian
- Wang Ya Xing
- Wang Ying-Wei
- Wannamethee S. Goya
- Wedderkopp Niels
- Wei Wenbin
- Whincup Peter H.
- Widhalm Kurt
- Widyahening Indah S.
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- Wilks Rainford J.
- Willeit Johann
- Willeit Peter
- Wilsgaard Tom
- Wojtyniak Bogdan
- Wong Andrew
- Wong Norazizah Ibrahim
- Wong Tien Yin
- Wong-McClure Roy A.
- Woo Jean
- Woodward Mark
- Wu Frederick C.
- Wu Shouling
- Xu Haiquan
- Xu Liang
- Yan Weili
- Yang Xiaoguang
- Yasuharu Tabara
- Ye Xingwang
- Yeow Toh Peng
- Yiallouros Panayiotis K.
- Yoosefi Moein
- Yoshihara Akihiro
- You San-Lin
- Younger-Coleman Novie O.
- Yusoff Ahmad Faudzi
- Yusoff Muhammad Fadhli Mohd
- Zainuddin Ahmad A.
- Zakavi Seyed Rasoul
- Zali Mohammad Reza
- Zamani Farhad
- Zambon Sabina
- Zampelas Antonis
- Zaw Ko Ko
- Zdrojewski Tomasz
- Zhang Zhen-Yu
- Zhao Dong
- Zhao Wenhua
- Zhen Shiqi
- Zheng Yingfeng
- Zholdin Bekbolat
- Zhou Bin
- Zhussupov Baurzhan
- Zoghlami Nada
- Publication venue
- Publication date
- 01/01/2020
- Field of study
High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe
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