88 research outputs found
Dopamine, reward learning, and active inference
- Author
- Abbott
- Adamantidis
- Adams
- Adams
- Behrens
- Beierholm
- Berridge
- Berridge
- Berridge
- Bishop
- Cannon
- Chowdhury
- Clark
- Cohen
- Collins
- D'Ardenne
- Danjo
- Darvas
- Daw
- Day
- Dayan
- Dayan
- Diaconescu
- Dickinson
- Dickinson
- Dolan
- Eisenegger
- Fiore
- Fiorillo
- FitzGerald
- FitzGerald
- Flagel
- Fletcher
- Frank
- Frank
- Friston
- Friston
- Friston
- Friston
- Friston
- Friston
- Frydman
- Gillan
- Gläscher
- Guitart-Masip
- Guitart-Masip
- Guitart-Masip
- Hollerman
- Humphries
- Huys
- Karl Friston
- Kiebel
- Kurniawan
- Lee
- Mathys
- Mirenowicz
- Montague
- Moustafa
- Moutoussis
- Mumford
- Nagy
- Pan
- Penny
- Pessiglione
- Pouget
- Raymond J. Dolan
- Reynolds
- Robbins
- Robinson
- Robinson
- Roeper
- Rossi
- Rutledge
- Rutledge
- Salamone
- Saunders
- Schultz
- Schultz
- Schwartenbeck
- Schwartenbeck
- Schwartenbeck
- Sharot
- Shiner
- Smittenaar
- Steinberg
- Stopper
- Sutton
- Tan
- Tenenbaum
- Thomas H. B. FitzGerald
- Tsai
- Voon
- Witten
- Wunderlich
- Publication venue
- 'Frontiers Media SA'
- Publication date
- 01/01/2015
- Field of study
Temporal difference learning models propose phasic dopamine signaling encodes reward prediction errors that drive learning. This is supported by studies where optogenetic stimulation of dopamine neurons can stand in lieu of actual reward. Nevertheless, a large body of data also shows that dopamine is not necessary for learning, and that dopamine depletion primarily affects task performance. We offer a resolution to this paradox based on an hypothesis that dopamine encodes the precision of beliefs about alternative actions, and thus controls the outcome-sensitivity of behavior. We extend an active inference scheme for solving Markov decision processes to include learning, and show that simulated dopamine dynamics strongly resemble those actually observed during instrumental conditioning. Furthermore, simulated dopamine depletion impairs performance but spares learning, while simulated excitation of dopamine neurons drives reward learning, through aberrant inference about outcome states. Our formal approach provides a novel and parsimonious reconciliation of apparently divergent experimental findings
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
- 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
- Arnaud Alexis Pierre
- 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
- Atiyeh Anwar
- Atkins Ebenezer Takyi
- Attia Attia
- Augestad Knut Magne
- Aviles Susan
- Avoka Anthony
- Awad Israa
- Awad Sawsan Adel
- Awadallah Salwa
- Ayandipo Omobolaji
- Aydin Mehmet Can
- 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
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- Banipal Gurpreet Singh
- Baquero Suarez Alibeth Andres
- Baraka Heba
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- Barkolias Christos
- Barmayehvar Behrad
- Barnabas Gandau Naa
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- Bassem Monica
- Bassit Khalil Abdul
- Basso Stefano M. M.
- Bayram Sefa
- Beamon Mieshia
- Bedada Alemayehu Ginbo
- BediakoBowan Antoinette
- Bekhet Amira Hassan
- Bekhet Nada Mohamed
- Beleno Alvaro Enrique Mendoza
- Belkouchi Abdelkader
- Belli Andrea
- Bello Bashir
- Benammi Sarah
- Benevento Angelo
- Bennai Redouane Mammar
- Bentounsi Zineb
- Benyaiche Chaymae
- Berti Stefano
- Bertuello Isaac
- Beuran Mircea
- Bhangu Aneel
- Bhangu Aneel
- Bhangu Anna
- Bhatnagar Ankur
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- Bianco Federica
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- Bjorklund Ida
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- Bustangi Nasir
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- Cengiz Yucel
- Cevik Muazzez
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- 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
- Chung Kuet Jun
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- Ciccioli Eleonora
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- Coccolini Federico
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- Costas-Chavarri Ainhoa
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- Cox Michael
- Coyoy-Gaitan Otto
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- Cullen Fraser
- Curletti Gianluca
- Currow Chelise
- D'Amours Scott
- D'Souza Michelle S.
- Dabboor Majd
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- Darwish Abdelrhman K. Z.
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- Datta Uttaran
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- Davor Anthony
- Dawood Khaled
- Dayie Makafui
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- Deane Chelsea
- Debrah Sam
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- Deutschmann Peter
- Dhillon Dharminder
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- Di Saverio Salomone
- Diaconescu Bogdan
- Diaz Vico Tamara
- Diaz Zorrilla Carmina
- Diaz-Jover Paula
- Dick Lachlan
- Dijan Emilio
- Dimech Thea
- Din Farhat
- Dindyal Shiva
- Dione Parreno-Sacdalan Marie
- Dissanayake Tharindra
- Djivoh Fernande
- Domini Edgar
- Donnelly Philippa
- Dorani Radin Mohd Nurrahman Radin
- Dorisme Asnel
- Dossou Francis
- Dousset Bertrand
- Dragatas Deividas
- Drake Thomas M.
- Drake Thomas M.
- Drungilas Mantas
- du Plooy Flip
- Du Toit Frederick
- Duane Therese
- Duinhouwer Lucia
- Dulskas Audrius
- Ebidy Mai
- Ebidy Mai Mohamed
- Eid Mostafa Mahmoud
- El Dahab Ali Abo
- El Gendy Noran Halim
- El Halawany Mohamed
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- El Kashash Ahmed
- El Sayed Islam Magdy
- El-Dien Khalid Salah
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- El-Sagheer Nada
- El-Sawy Aya
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- Eldeeb Ahmed Zaki
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- Elfiky Mahmoud
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- Elfouly Yasmin
- Elgendy Alyaa Halim
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- Elhadad Alaa
- Elhadary Nourhan Medhat
- Elhadry Shady
- Elhalawany Esraa
- Elhamouly Sara
- Elhelbawy Mohamed Salah
- Elhendawy Abdelaziz
- Elhoseny Ghada
- Elhusseiny Ahmed Abd Elmoen
- Elkholy Shimaa Said
- Ellison Quinn
- Elmashala Amjad
- Elmasry Maha
- Elmihy Sohaila
- Elnagar Ahmedglal
- Elnajjar Mahmoud A.
- Elrazek Aly Abd
- Elsabbagh Nourhan
- Elsameea Ahmed Abd
- Elsawy Amira
- Elsayed Nada Ahmed Reda
- Elsemelawy Rofida
- Elshaar Mohammed
- Elshaer Mohamed
- Elshami Mohamedraed
- Elsharkawy Aya Adel
- Elsherbiney Saged
- Elsherif Fawzia Abdellatif
- Elwy Eman
- Elzahed Nada
- Emadeldin Hossam
- Emara Eman
- Emile Sameh
- Eng Calvin
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- Esam Abeer
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- Espin-Basany Eloy
- Espinoza Fernando
- Essam A. A.
- Essam Ahmed
- Essam Mahitab
- Essoun Samuel
- Esteban Enrique
- Estee Mahnuma Mahfuz
- Etchill Eric
- Etienne Sara
- Etwire Victor
- Evajelista Cicilia Viany
- Evans David
- Evans Elizabeth
- Ezzat Eslam
- Ezzat Tarek
- Faboya Omolara
- Fahim Marwan
- Fairfield Cameron
- Falaschi Federica
- Falco Nicolo
- Falzon Malcolm
- Farag Ahmed
- Farag Sameh
- Farahat Mahitab Morsy
- Fares Mohamed
- Farhan-Alanie Muhamed M. H.
- Farhangmehr Neda
- Farouk Sara Amr Mohamed
- Farrugia Alexia
- Farrugia Alexia
- Faruq Amreen
- Fathy Aya Mohamed
- Fatuga Adedeji
- Faturoti Olubukola
- Favero Alessandro
- Feidantsis Thomas
- Fergany Alaa
- Fergusson Stuart J.
- Fergusson Stuart J.
- Fermani Claudio Gabriel
- Fernandes Cristina
- Fernandez Carmen
- Fernandez-Vega Laura
- Ferousis Christoforos
- Ferrero Esther
- Filatau Aliaksandr
- Firdouse Mohammed
- Firdouse Mohammed
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- Fitzgerald J. Edward
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- Gad Ahmed
- Gad Mariam O.
- Gadelkarim Mohamed
- Gado Ammar
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- Gala Tanzeela
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- Haddad Nadeem
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- Hafez Sarah
- Haffreingue Aurore
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- Haines Morgan
- Hajeh Haidar
- Halhouli Oday
- Halhouli Oday
- Halicioglu Ilkay
- Hall Elisabeth
- Haloho Andreass
- Hamarshi Aseel
- Hamasaki Hamaguchi Jose Luis
- Hamdan Ayah
- Hamdan Marwa
- Hamed Mohamed Fouad
- Hamill Daniel
- Hammad Aya
- Hampton Mark Ian
- Hamsho Ward
- Hanoun Sakhaa
- Hantour Usama
- Hany Ethar
- Haque Muhtarima
- Har Prisca A. L.
- Haraux Elodie
- Harrison Ewen M.
- Harrison Ewen M.
- Harrison Ewen M.
- Hartford Leila
- Harvey Neil
- Hasan Ahmad
- Hasan Doaa
- Hasanah Afifatun
- Hasanain Doaa
- Hascoet Juliette
- Hashad Eman
- Hashim Abdullah
- Haslegrave Aidan
- Hassaan Amr
- Hassaan Ayat
- Hassan Ahmed Tarek Abdelbaset
- Hassan Ihab
- Hassan Osama Mokhtar Mohamed
- Hassanain Mazen
- Hassanein Adel B.
- Heard Rachel
- Hegazy Eman Magdy
- Helene Francois-Coridon
- Helguero-Santin Luis M.
- Hemmila Mark
- Heng Hian Ee
- Henric Nicolas
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- Henshall David Ewart
- Herebat Azher
- Herikstad Ragnar
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- Herrod Philip
- Hervieux Erik
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- Hodonou Fred
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- Hossameldin Amr
- Hrora Abdelmalek
- Hunter Kristina
- Husseiny Reem
- Iacono Calogero
- Iannone Immacolata
- Ibraheem Aya AbdelFatah
- Ibrahem Ahmad Aboelkassem
- Ibrahim Ahmed Mohamed
- Ibrahim Amal
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- Ibrahim Eman Mohamed
- Ibrahim Khaled
- Ibrahim Mohamed
- Idress Tasneem
- Idris Faisal
- Iftekhar Farhana
- Iftikhar Zainab
- Ignatavicius Povilas
- Ihediwa George
- Imoro Osman
- Ingabire J. C. Allen
- Ingabire J. C. Allen
- Ioannidis Orestis
- Iqbal Muhammad Rafaih
- Ireland Philip
- Irtan Sabine
- Irwin Gareth
- Irwin Gareth
- Ishak Norzawani
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- 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
- 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
Role of nucleus accumbens core but not shell in incubation of methamphetamine craving after voluntary abstinence
- Author
- A Rocha
- AE Kelley
- AF Scheyer
- Aldo Badiani
- BJ Everitt
- BJ Everitt
- BM Cox
- BR Lee
- C Kohler
- C Li
- C Nicolas
- C Soares-Cunha
- CL Pickens
- CR Gerfen
- D Caprioli
- D Caprioli
- D Caprioli
- Daniele Caprioli
- Davide Ragozzino
- DS Counotte
- DS Zahm
- E Galaj
- F Weiss
- G Bedi
- G Paxinos
- G Wang
- I Willuhn
- Ingrid Reverte
- J Hall
- J Terrier
- JA Hollander
- JA Loweth
- JD Salamone
- JE McCutcheon
- JI Morgan
- JL Price
- JM Bossert
- JM Delfs
- JM Roll
- JW Grimm
- K Guillem
- K McFarland
- KA Kerstetter
- KL Conrad
- KL Preston
- LH Corbit
- Ludovica Maddalena Rossi
- M Heilig
- M Lenoir
- M Mameli
- M Venniro
- M Venniro
- M Venniro
- M Venniro
- MA Parvaz
- Marco Venniro
- ME Wolf
- ME Wolf
- MK Lobo
- P Bach
- P Di Ciano
- P Di Ciano
- P Li
- P Voorn
- R Ciccocioppo
- R Ito
- RA Fuchs
- RA Wise
- RE Chipkin
- RN Cardinal
- S Ikemoto
- S Ikemoto
- SA Golden
- SH Ahmed
- SH Ahmed
- SL Cole
- ST Higgins
- T Curran
- TC Francis
- U Shalev
- V Pascoli
- X Li
- X Li
- X Li
- YY Ma
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2019
- Field of study
We recently introduced an animal model to study incubation of drug craving after prolonged voluntary abstinence, mimicking the human condition of relapse after successful contingency management treatment. Here we studied the role of the nucleus accumbens (NAc) in this model.
We trained rats to self-administer a palatable solution (sucrose+maltodextrin 1%, 6 h/day, 6 days) and methamphetamine (6 h/day, 12 days). We then evaluated relapse to methamphetamine seeking after 1 and 15 days of voluntary abstinence, achieved via a discrete choice procedure between the palatable solution and methamphetamine (14 days). We used RNAscope in-situ hybridization to quantify the co-labeling of the neuronal activity marker Fos, and dopamine Drd1- and Drd2-expressing medium spiny neurons (MSNs) in NAc core and shell during the incubation tests. Next, we determined the effect of pharmacological inactivation of NAc core and shell by either GABAA and GABAB agonists (muscimol+baclofen, 50+50 ng/side), Drd1-Drd2 antagonist (flupenthixol, 10 µg/side) or the selective Drd1 or Drd2 antagonists (SCH39166 1.0 µg/side or raclopride 1.0 µg/side) during the relapse tests.
Incubated methamphetamine seeking after voluntary abstinence was associated with a selective increase of Fos expression in the NAc core, but not shell, and Fos was co-labeled with both Drd1- and Drd2-MSNs. NAc core, but not shell, injections of muscimol+baclofen, flupenthixol, SCH39166, and raclopride reduced methamphetamine seeking after 15 days of abstinence.
Together, our results suggest that dopamine transmission through Drd1 and Drd2 in NAc core is critical to the incubation of methamphetamine craving after voluntary abstinence
Adjunctive Brivaracetam in Focal Epilepsy: Real-World Evidence from the BRIVAracetam add-on First Italian netwoRk STudy (BRIVAFIRST)
- Author
- Alicino A.
- Ascoli M.
- Assenza G.
- Avorio F.
- Badioni V.
- Banfi P.
- Bartolini E.
- Basili L. M.
- Belcastro V.
- Beretta S.
- Berto I.
- Biggi M.
- Billo G.
- Boero G.
- Bonanni P.
- Bongorno J.
- Brigo F.
- Caggia E.
- Cagnetti C.
- Calvello C.
- Canafoglia L.
- Canevini M. P.
- Casciato S.
- Cesnik E.
- Chianale G.
- Chiesa V.
- Ciampanelli D.
- Ciuffini R.
- Cocito D.
- Colella D.
- Contento M.
- Costa C.
- Cumbo E.
- D'Aniello A.
- Dainese F.
- De Maria G.
- Deleo F.
- Di Bonaventura C.
- Di Gennaro G.
- Di Giacomo R.
- Di Liberto A.
- Didato G.
- DiFrancesco J. C.
- Domina E.
- Donato F.
- Dono F.
- Durante V.
- Elia M.
- Estraneo A.
- Evangelista G.
- Faedda M. T.
- Failli Y.
- Falcicchio G.
- Fallica E.
- Fanella M.
- Fattouch J.
- Ferlazzo E.
- Ferrari A.
- Ferreri F.
- Fisco G.
- Fonti D.
- Fortunato F.
- Foschi N.
- Francavilla T.
- Galli R.
- Gangitano M.
- Gazzina S.
- Giallonardo A. T.
- Giorgi F. S.
- Giuliano L.
- Habetswallner F.
- Irelli E. C.
- Izzi F.
- Kassabian B.
- La Neve A.
- Labate A.
- Lattanzi S.
- Luisi C.
- Magliani M.
- Maira G.
- Mari L.
- Marino D.
- Mascia A.
- Mazzeo A.
- Mecarelli O.
- Meletti S.
- Montalenti E.
- Morano A.
- Nilo A.
- Orlando B.
- Paladin F.
- Pascarella M. G.
- Pastori C.
- Pauletto G.
- Peretti A.
- Perri G.
- Pezzella M.
- Piazza F.
- Piccioli M.
- Pignatta P.
- Pilolli N.
- Pisani F.
- Pisani L. R.
- Placidi F.
- Pollicino P.
- Porcella V.
- Pradella S.
- Puligheddu M.
- Pulitano P.
- Quadri S.
- Quarato P. P.
- Quintas R.
- Ranzato F.
- Renna R.
- Rosati E.
- Rossi J.
- Rum A.
- Salamone E. M.
- Savastano E.
- Sessa M.
- Stokelj D.
- Tartara E.
- Tassi L.
- Tombini M.
- Tumminelli G.
- Ventura M.
- Vigano I.
- Viglietta E.
- Vignoli A.
- Villani F.
- Zambrelli E.
- Zummo L.
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2021
- Field of study
Background: In randomized controlled trials, add-on brivaracetam (BRV) reduced seizure frequency in patients with drug-resistant focal epilepsy. Studies performed in a naturalistic setting are a useful complement to characterize the drug profile. Objective: This multicentre study assessed the effectiveness and tolerability of adjunctive BRV in a large population of patients with focal epilepsy in the context of real-world clinical practice. Methods: The BRIVAFIRST (BRIVAracetam add-on First Italian netwoRk STudy) was a retrospective, multicentre study including adult patients prescribed adjunctive BRV. Patients with focal epilepsy and 12-month follow-up were considered. Main outcomes included the rates of seizure‐freedom, seizure response (≥ 50% reduction in baseline seizure frequency), and treatment discontinuation. The incidence of adverse events (AEs) was also considered. Analyses by levetiracetam (LEV) status and concomitant use of strong enzyme-inducing antiseizure medications (EiASMs) and sodium channel blockers (SCBs) were performed. Results: A total of 1029 patients with a median age of 45 years (33–56) was included. At 12 months, 169 (16.4%) patients were seizure-free and 383 (37.2%) were seizure responders. The rate of seizure freedom was 22.3% in LEV-naive patients, 7.1% in patients with prior LEV use and discontinuation due to insufficient efficacy, and 31.2% in patients with prior LEV use and discontinuation due to AEs (p < 0.001); the corresponding values for ≥ 50% seizure frequency reduction were 47.9%, 29.7%, and 42.8% (p < 0.001). There were no statistically significant differences in seizure freedom and seizure response rates by use of strong EiASMs. The rates of seizure freedom (20.0% vs. 16.6%; p = 0.341) and seizure response (39.7% vs. 26.9%; p = 0.006) were higher in patients receiving SCBs than those not receiving SCBs; 265 (25.8%) patients discontinued BRV. AEs were reported by 30.1% of patients, and were less common in patients treated with BRV and concomitant SCBs than those not treated with SCBs (28.9% vs. 39.8%; p = 0.017). Conclusion: The BRIVAFIRST provided real-world evidence on the effectiveness of BRV in patients with focal epilepsy irrespective of LEV history and concomitant ASMs, and suggested favourable therapeutic combinations
Strategies for preventing group B streptococcal infections in newborns: A nation-wide survey of Italian policies
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- Agosti M
- Agostinelli C
- Albano F
- Allù
- Anastasio Ps
- Ancora G
- Andreoni S
- Anesi A
- Antonucci R
- Arzese A
- Aschbacher R
- Audenio E
- Auriemma A
- Avanzini A
- Azzalli M
- Bacchi Modena A
- Bacelle L
- Baldoni Ml
- Ballardini M
- Balzaretti M
- Banderalli G
- Bandettini R
- Bandini A
- Barresi S
- Bassano M
- Bassini D
- Bellù
- Bellia G
- Bellizia L
- Bernardo L
- Bertino E
- Besozzi M
- Bettinelli A
- Biasini A
- Biasucci G
- Bistoni F
- Boldrini A
- Bonabitacola T
- Bonettini A
- Bonfanti C
- Bonini F
- Bordignon G
- Bottino R
- Bracaglia G
- Brambilla C
- Brattoli M
- Bresciani D
- Bresolin N
- Bruno R
- Buffone E
- Buonocore G
- Busetti M
- Busulini L
- Calipa Mt
- Calonaci N
- Calvi P
- Calzi P
- Camporese A
- Canepa Sa
- Canidio E
- Caoci G
- Capozzi D
- Cappuccia N
- Cardone Ml
- Carillo C
- Carlucci A
- Carrata L
- Carrera G
- Casari E
- Casprini P
- Catania M
- Catania Mr
- Catanoso G
- Catanoso G
- Cava Mc
- Cavalcanti P
- Cavigioli F
- Cera G
- Cerri G
- Cesana E
- Chiara A
- Chirico G
- Ciantelli M
- Ciccotti R
- Cichero P
- Cipollone I
- Clementi M
- Cohen A
- Colla R
- Colombo C
- Colonna F
- Comessatti A
- Confalonieri M
- Conoscenti G
- Conti A
- Coppola R
- Cortis E
- Cuzzone G
- D&apos
- D&apos
- D&apos
- Da Rin G
- Daffara S
- Dall&apos
- De Curtis M
- De Francesco D
- De Francesco M
- De Luca G
- De Rosa R
- Degl&apos
- Delledonne L
- Deloglu A
- Demi M
- Di Fabio S
- Di Lascio N
- Di Mario M
- Di Matteo L
- Di Terlizi L
- Di Vincenzo F
- Diodati R
- Dodero D
- Dragovic D
- E D Perri
- E T Vacchiano
- Ettore G
- Fabozzi F
- Falco S
- Fasano Ma
- Favretti L
- Fedi A
- Felici L
- Ferlini M
- Ferrara F
- Ferrari P
- Ferrero Mp
- Ferrini A
- Filippetti A
- Finocchi M
- Fiore A
- Fogato E
- Fortunato V
- Fossati D
- Franchi L
- Franco C
- Frigerio M
- Furcolo G
- Furlini G
- Galluppi E
- Gancia P
- Gargantini G
- Garzia P
- Gasperoni S
- Gatta A
- Gheller A
- Ghiraldi E
- Giana G
- Gianino P
- Giardini F
- Ginardi C
- Giordano R
- Giraldi C
- Goglia L
- Gramoni A
- Grandi G
- Griessmaier A
- Grimaldi M
- Grosso S
- Gualdi P
- Guastaferro N
- Guercio E
- Haass C
- Iafisco P
- Ianniello C
- Ilardi L
- Imbriani A
- Infriccioli F
- Inghilleri G
- Innocenti P
- Intini C
- Ioppi M
- Iozzia G
- Italian 
- Italian 
- Iula D
- Ivaldi M
- Kemeny A
- Lacchi L
- Lanari M
- Landini Mp
- Lanzini F
- Latino M
- Laureti A
- Lavarda F
- Leone Ra
- Leonetti G
- Liborio M
- Licardi G
- Limongelli O
- Lista G
- Lodolo L
- Lucieri S
- Luehwink A
- Luzzaro F
- Macciò
- Magaldi R
- Maggino T
- Maiolo V
- Malandrino M
- Mancini Al
- Mancini R
- Mangilli G
- Marchesano G
- Marconi Am
- Maritano D
- Martinelli S
- Mascellino Mt
- Massironi E
- Megha M
- Meledandri M
- Melioli G
- Melotti D
- Mencacci A
- Menchini M
- Mesirca P
- Micca G
- Miconi V
- Migliardi M
- Migliavacca D
- Migliorini P
- Milillo F
- Mirri P
- Modolo E
- Molinari F
- Mongelli F
- Montanari E
- Monticone G
- Moresco L
- Morgia S
- Mortillaro F
- Mosca F
- Motta C
- Mura I
- Muraca Mc
- Musaico R
- Mussini P
- Mustoni P
- Natale F
- Neri E
- Neri G
- Nosari N
- Notaris P
- Novarese O
- Nuara C
- Oneto F
- Ortisi G
- Padula D
- Pagani E
- Palladini M
- Palmieri A
- Paludetto R
- Papa I
- Paparella C
- Pappalardo E
- Paradiso R
- Parmigiani S
- Patacchiola F
- Pauri P
- Perathoner C
- Perfetti C
- Perini R
- Pernigotti A
- Perugini A
- Perugini M
- Pesenti A
- Piaserico G
- Picco G
- Piepoli M
- Pieretti B
- Pinto L
- Pirali A
- Pittalis S
- Platzgummer S
- Pogliani L
- Poletti A
- Poli S
- Policicchio G
- Politi A
- Pomero G
- Prasciolu C
- Previato S
- Puggina P
- Pugliese A
- Pugni L
- Puzzolante L
- Quntadamo Pa
- Radillo O
- Raggi Me
- Raimondi F
- Riccardi T
- Rivetti I
- Rocchetti A
- Rondanini Gf
- Rossi Mr
- Rubbi P
- Ruggeri R
- Rumpianesi F
- Russolo M
- Russolo S
- Saccucci P
- Sala E
- Salamone D
- Salvi C
- San Marco L
- Santer P
- Sarti M
- Sartore P
- Scarparo C
- Scattolo N
- Schettini S
- Schinella M
- Sciacca A
- Scozia G
- Scutellà
- Serra D
- Serra L
- Siderini V
- Sinno A
- Spadaro S
- Spadavecchia F
- Spagna L
- Spanò
- Spellecchia D
- Spitaler C
- Stellin G
- Storchi Incerti S
- Stroppiana P
- Suriano G
- Tagliabue P
- Taurino L
- Tauro L
- Teani M
- Tempera A
- Tempra Am
- Terenzani L
- Tibadi C
- Tili E
- Timpani G
- Todros T
- Tota V
- Trabucchi Mc
- Tramacere P
- Travaglio Md
- Tronci M
- Tzialla C
- Usai F
- Valentini M
- Valentino L
- Valmarin M
- Venturelli C
- Verdastro G
- Vetrano G
- Vetrella A
- Vettori C
- Villani P
- Vitacco V
- Vitullo E
- Viviani E
- Zaglio S
- Zanella D
- Zeni B
- Zocco F
- Zonca Mc
- Zoppelletto M
- Zorzi G
- Zorzi M
- Zuccotti Gv
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2017
- Field of study
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
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- 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
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- Mat Tuan Nur'Azmah Tuan
- Mata Lusi Padma Sulistianingsih
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- Upadhyaya Vijaid
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- 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
Global economic burden of unmet surgical need for appendicitis
- Author
- Aahlin E. K.
- Aamer A.
- Aaniana K.
- Ababneh A.
- Abaliksta T.
- Abantanga F.
- Abbas M.
- Abbasy J.
- Abbo O.
- Abbouch M.
- Abd-Elmawla M.
- Abd-Elrasoul Y.
- Abdallah E.
- Abdel-Aty A.
- Abdel-Hameed N.
- Abdel-Kader S. M.
- Abdel-Wahab N. Y. E.
- Abdelaal A.
- Abdelaty M.
- Abdelazeam A. R.
- Abdelazim G.
- Abdelaziz M. A.
- Abdelbadeai K.
- Abdelfatah A.
- AbdelFattah I.
- Abdelgelil A.
- Abdelghany S.
- Abdelhady S.
- Abdelhamed R.
- Abdelhamid A.
- Abdelhaq A.
- Abdelkader M.
- Abdelkader O.
- Abdelkareem A.
- Abdelkhalek M.
- Abdelmageed E.
- Abdelmotaleb I.
- Abdelraheim M.
- Abdelraouf A. M.
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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
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
- Author
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- Mohamed M
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- Strupas K
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- Stuva J
- Styles K
- Suarez A
- Suarez AAB
- Subocius A
- Suleiman SI
- Summerour V
- Sund M
- Sund M
- Sunderland G
- Sundstrom SM
- Suresh S
- Sutandi N
- Sutanto EPR
- Sutton P
- Sutton P
- Suyadi A
- Swann J
- Swaroop M
- Swaroop M
- Syibrah KZ
- Sykes M
- Szczap A
- Szeto CCL
- Szeto KJ-Y
- Tabiri S
- Tabiri S
- Tabiri S
- Tabiri S
- Tabiri S
- Tabiri S
- Tackie E
- Taddei A
- Tade A
- Tafazal H
- Taha EMS
- Tahboub H
- Taher AA
- Taher M
- Taher MM
- Taieb C
- Taiwo A
- Taiwo O
- Taiwo O
- Talaat M
- Tale F
- Tale L
- Talukder S
- Talukder S
- Talving P
- Talving P
- Tammam A
- Tan C
- Tan CL
- Tan CY
- Tan JJ
- Tan JK
- Tan KSK
- Tan RCK
- Tan YK
- Tan YW
- Tanase A
- Tanase A
- Tang A
- Tang L
- Tani SI
- Tansoker I
- Tarek A
- Tarek A
- Tarek D
- Targa S
- Tariq S
- Tata MD
- Tatagiba LS
- Tawfik BA
- Tawfik G
- Tawfik G
- Taylor F
- Teasdale E
- Teasdale E
- Teasdale E
- Teasdale E
- Tedeschi U
- Tedjaatmadja C
- Telfah MM
- Tembo T
- Temoche E
- Tennakoon A
- Teo SY
- Ter EZ
- Tessera G
- Teufelberger G
- Tew YY
- Tew YY
- Tewari S
- Th'ng F
- Thabet W
- Thalgaspitiya SPB
- Tham JC
- Thanusan V
- Tharmalingam S
- Theodosopoulos T
- Thollot A
- Thomas E
- Thomas HS
- Thompson B
- Thomson P
- Thorarinsdottir H
- Thorarinsdottir H
- Thorell A
- Thorell A
- Thorsen K
- Thurairaja R
- Tierney G
- Tilston TW
- Timothy OK
- Ting JRS
- To K
- To K
- Todd KO
- Toeema AG
- Tolba H
- Tolg C
- Tolonen M
- Tolotra TEC
- Tomas K
- Tori SA
- Toribio Orbegozo PA
- Torrance HD
- Torrance HD
- Torres Cardozo J
- Toto OF
- Tou S
- Townsend D
- Tracy J
- Trompetto M
- Tselos A
- Tshisola SK
- Tugnoli G
- Tugnoli G
- Tun AK
- Tun M
- Tun M
- Turati L
- Turati L
- Turkustani S
- Turner M
- Turpo Espinoza K
- Turpo Espinoza K
- Tutino R
- Tverskis Z
- Tyler R
- Tyler R
- Tze RGE
- Tze RGE
- Tzikos G
- Ubhi HK
- Ubiali P
- Ugalde P
- Ukwenya Y
- Ulusahin M
- Upadhyaya V
- Upchurch E
- Urbanavicius L
- Urbina Rojas NM
- Urbonas T
- Urbonas T
- Urniezius Z
- Urniezius Z
- Usaityte A
- Uscinas L
- Utter M
- Uzabumwana N
- Vaicius A
- Valcarcel-Saldana M
- Valente Laufer LA
- Valioulis I
- Van Der Naald N
- Van Duren B
- Van Niekerk M
- Van Straten S
- Varcada M
- Vargas M
- Varkalys K
- Vartanoglu T
- Vartic M
- Vartic M
- Vasquez G
- Vasquez I
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- Velasquez R
- Vella-Baldacchino M
- Venclauskas L
- Vendramin E
- Venskutonis D
- Venskutonis D
- Venskutonis D
- Venskutonis D
- Venugopal C
- Verbeek A
- Vergara Celis JM
- Vergara Mejia AG
- Verjee A
- Vermaas M
- Veronese E
- Vianna JGP
- Vicario E
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- Vida LC
- Vida LC
- Vilcinskas M
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- Vimalachandran D
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- Visinskas P
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- Vlachogiorgos A
- Voulgaris E
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- Wagener M
- Wakefield R
- Waledziak M
- Waleed H
- Walker M
- Walker N
- Walls L
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- Walsh U
- Waqar M
- Ward AE
- Ward S
- Warda M
- Warren O
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- Warwick AM
- Waterman A
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- Watson NF
- Watts A
- Weber B
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- Weinstein MS
- Weiser TG
- Werder G
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- Whitaker J
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- White T
- Whitehurst K
- Wiborg J
- Widiastini TA
- Widmer LW
- Wijayarathna LS
- Wild JRL
- Williams E
- Williams G
- Williams O
- Williams O
- Williamson A
- Wilson A
- Wilson L
- Wilson M
- Wilson M
- Wilson MSJ
- Wilson MSJ
- Wimalge PMSN
- Winstanley J
- Witherspoon P
- Wogensen F
- Wogensen F
- Wogensen F
- Woin E
- Wold TB
- Wolf B
- Wolf B
- Wondimu S
- Wondoh P
- Wondoh P
- Wong CS
- Wong CY
- Wong F
- Wong HY
- Wood G
- Woodward H
- Worku M
- Worku M
- Worku T
- Wredberg C
- Wright N
- Wright NJ
- Xerri T
- Xerri T
- Yahaya MT
- Yakubu M
- Yallop L
- Yam SY
- Yang J
- Yap S
- Yaseen T
- Yaseen TM
- Yau JD
- Yavuz MA
- Ye J
- Yeang LJ
- Yee J
- Yeo LS
- Yeung ENW
- Yeung MHA
- Yifieyeh A
- Yildirim R
- Yip C
- Ymeri S
- Yoganathan P
- Yolcu S
- Yong CO
- Yong GL
- Younis A
- Youssef D
- Youssef H
- Youssef M
- Youssif JH
- Yuksek MA
- Yusufali T
- Zaa'treh R
- Zachariades D-C
- Zadoroznas A
- Zahran D
- Zakaria E
- Zakaria M
- Zakaria Y
- Zaki A
- Zakir M
- Zalabia MF
- Zamarin K
- Zammit S
- Zampitis N
- Zani A
- Zani A
- Zani A
- Zanini N
- Zanini N
- Zapata Ponze De Leon M
- Zapata Ponze De Leon M
- Zapata F
- Zarb C
- Zardab A
- Zegarra S
- Zeidan S
- Zelada Alvarez II
- Zerihun AB
- Zeta Solis LA
- Zhang Z
- Zheng F
- Zidan H
- Zidan H
- Zidan M
- Zielinski M
- Ziff O
- Zikry M
- Zil-E-Ali A
- Zilinskas J
- Zilinskas J
- Zilinskas J
- Zilinskas J
- Zilinskas J
- Zilinskiene R
- Zilinskiene R
- Zimmermann EF
- Ziubryte G
- Zohair A
- Zorrilla CD
- Zuber M
- Zuber M
- Zuk G
- Zulkifli A
- Zumbuhl L
- 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
Cannabinoid-based drugs targeting CB1 and TRPV1, the sympathetic nervous system, and arthritis
- Author
- A Boillat
- A Engler
- A Fassold
- A Miranville
- A Polissidis
- A Rey
- A Samat
- A Szabo
- A Toth
- AB Ginsberg
- AI Idris
- AI Idris
- AM Malfitano
- AN Akopian
- B Kola
- B Malinowska
- B Rossi
- BK Ormerod
- BL Kidd
- C Silvestri
- CA Paronis
- CG Helmick
- CG Ziegler
- CH Ashton
- CJ Hillard
- CL Lubahn
- CM Henstridge
- D Cota
- D Lorton
- D McHugh
- D Navia-Paldanius
- D Ursu
- DJ Morgan
- E Choy
- E Lizanecz
- E Ryberg
- F Borrelli
- F Matcham
- FA Moreira
- FA Russell
- G Pongratz
- G Pongratz
- G Pongratz
- GA Cabral
- GG Szabo
- GR Chopda
- H Tilg
- H Watanabe
- H-L Li
- HK Takahashi
- I Barna
- I Devesa
- IB McInnes
- J Bergman
- J Fichna
- J Francis
- J Joseph
- J Kraus
- J Tam
- J Tam
- JD Levine
- JD Levine
- JD Salamone
- JE Schlosburg
- JM McPartland
- JP Buchweitz
- JP Pereira
- JS Walczak
- K Jin
- K Shoudai
- K Starowicz
- K Sugamura
- K Weller
- KW Falenski
- M Alhouayek
- M Bashashati
- M Bouaboula
- M Duncan
- M Fidaleo
- M Herkenham
- M Kress
- M Murai
- M Nabissi
- M Patil
- M Rinaldi-Carmona
- M Rinaldi-Carmona
- MA Bergstrom
- MA Engel
- MA Gonzalez-Gay
- MA Storr
- MJ Patil
- MN Hill
- MR Boon
- MR Carey
- MY Kochukov
- N Bottini
- N Hatano
- NA Jeske
- NJ Barton
- NR Fuggle
- P Ambrosino
- P Harle
- P Härle
- P Sanchez-Blazquez
- P Urquhart
- PH Dessein
- PL De
- PL De
- PM Lam
- R Guabiraba
- R Mechoulam
- R Ribeiro
- R Sakthiswary
- RA Kohnz
- RA Ross
- RA Ross
- Rainer H. Straub
- RD Situnayake
- RG Pertwee
- RG Pertwee
- RH Straub
- RH Straub
- RH Straub
- RH Straub
- RH Straub
- RH Straub
- RH Straub
- RJ McLaughlin
- RN Spengler
- RS Goodwin
- S Capellino
- S Fukuda
- S Munro
- S Muraoka
- S Petrosino
- S Valdeolivas
- S Zelasko
- SG Kinsey
- SG Kinsey
- SJ Mnich
- SP Raychaudhuri
- T Bandiera
- T Bisogno
- T Lowin
- T Luk
- T Meinel
- T Ohno-Shosaku
- T Pfitzer
- TJ Smeets
- TL Daigle
- TM Bland
- Torsten Lowin
- TR Romero
- VR Cunha da
- W Gonsiorek
- W Jin
- WA Devane
- WJ Redmond
- WS Ho
- X Jia
- XH Yu
- Y Yang
- Z Jenei-Lanzl
- Z Justinova
- Z Pang
- ZY Wang
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
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- Abbas Sh
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- Abdelgadir Am
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- Al-Faham Z
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- Al-Khyatt W
- Al-Musawi S
- Al-Sarireh B
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- Aldrey I
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- Beltran-De-Heredia J
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- Berti S
- Bevan Ke
- Bevan V
- Beverstock A
- Bhanderi S
- Bhanderi S
- Bhanderi S
- Bhanderi S
- Bhanderi S.
- Bhangu A. Nepogodiev D
- Bhangu A
- Bhangu A
- Bhangu A
- Bhangu A
- Bhargava A
- Biancafarina A
- Biancafarina A
- Bianchi Cl
- Bianchi Cl
- Bianco A
- Bilku D
- Birindelli A
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- Blackwell J
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- Blanco F
- Blanco-Colino R
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- Blazeby Jm
- Blencowe N. S.
- Blencowe Ns
- Blencowe Ns
- Blencowe Ns
- Blencowe Ns
- Boddy Ap
- Boereboom C
- Bogdan M
- Bohra P
- Boland M
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- Bolger Jc
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- Bolzon S
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- Borges Fc
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- Bravo-Gutiérrez Af
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- Brunelli Db
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- Cameron Fc
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- Carden Ca
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- Caro A
- Carral-Freire M
- Carrano Fm
- Carrano Fm
- 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
- Cerdán-Santacruz C
- Cervellera M
- Cesari Mc
- Chalk A
- Chambers B
- Chan D
- Chan T
- Chan Wh
- Chandler Sb
- Chandratreya N
- Chandratreya N
- Chapman J
- Chapman Sj
- Chapple Ks
- Charalabopoulos A
- Charalambous Mp
- Chasty B
- Chatzikonstantinou M
- Chatzikonstantinou M
- Chauhan P
- Chauhan P
- Chauhan P.
- Cheah Wl
- Chean Cs
- Chean Cs
- Checcacci P
- Cheng Sa
- Cheruvu M
- Chessa A
- Chessa A
- Chetta G
- Chetta N
- Chianese G
- Chillitupa Cz
- Chimetto A
- Chin My
- Chishti Ia
- Chitsabesan P
- Chng S
- Choi S
- Chok Sm
- Chok Sm
- Chong B
- Choolani-Bhojwani E
- Choong Jh
- Choong Jh
- Choong Jh
- Chowdhary M
- Chowdhury F
- Chowdhury F
- Choy Ch
- Choy Ch
- Chrastek D
- Christian L
- Christides A
- Christopoulos P
- Chudek D
- Chui K
- Cianchi F
- Cidoncha A
- Cillara N
- Cillara N
- Cillara N
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- Cirillo B
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- Clement Kd
- Clements B
- Clements C
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- Clements J.
- Clements Ja
- Clements Jd
- Clements Jm
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- Clements Js
- Clerici F
- Clingan R
- Cloney L
- Clough E
- Coccolini F
- Coccolini F
- Cocorullo G
- Coe Po
- Cohen Ja
- Colangelo E
- Coletta D
- Coletta D
- Coletti M
- Collado-Roura F
- Collier-Wakefield O
- Colombo F
- Colombo F
- Colvin Da
- Colvin Da
- Compagnoni B
- Conci S
- Connelly Tm
- Connor Kl
- Connor Kl
- Connor Mj
- Connor Mj
- Conti D
- Contine Ac
- Contreras Rg
- Contreras-Saiz E
- Cook V
- Cooke F
- Coppola M
- Coratti F
- Corbellini C
- Cordoba E
- Cordoba E
- Cormenzana Ob
- Correia D
- Correia J
- Cortés Gv
- Cosci M
- Cossu F
- Costa Sd
- Costamagna D
- Cotton Ae
- Couch Dg
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- Cox M
- Coyle D
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- Cremades P
- Criado Adc
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- Cuadrado Mm
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- Curtis-Martínez C
- Cynthia G
- Cánovas-Moreno G
- D'Ambra L
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- D'Amico Fe
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- Dalmia S
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- Danquah-Boateng D
- Dar Fa
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- Daureeawoo R
- Davidson Jr
- Davidson S
- Davies Pl
- Davis S
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- De Burgos Cb
- De Chaves-Rodríguez Pg
- De Freitas S
- De Luca E
- De Marchi F
- De Marco P
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- De Padua C
- De Prizio M
- De-La-Herranz-Guerrero P
- De-Manzoni-Garberini A
- De-Manzoni-Garberini A
- De-Manzoni-Garberini A
- De-Marchi Ja
- De-Marchi Ja
- De-Soto-Cardenal B
- Dean Ea
- Dean S
- Del Basso C
- Del Pozo E
- Del-Valle-Ruiz Sr
- Delgado-Plasencia Lj
- Delimpalta C
- Delimpalta C
- Delogu D
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- Dennison G
- Depalma N
- Deserra A
- Desiderio J
- Devezas V
- Devine Aa
- Dhar M
- Dharamavaram S
- Dhari Aa
- Dhesi S
- Di Cintio A
- Di Franco F
- Di Gioia P
- Di Saverio S
- Di Zitti L
- Diaz A
- Dickson Ea
- Divekar Ga
- Dixon F
- Dobbs S
- Dobson C
- Docherty Ja
- Doherty C
- Dominguez-Sanchez C
- Donaldson G
- Donaldson G
- Donohoe No
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- Douka E
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- Drake Tm
- Drye N
- Du Dt
- Dubois As
- Dubois As
- Dudek Jg
- Dujovne P
- Dujovne P
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- Slezak I
- Smallcombe N
- Smart Cj
- Smart Cj
- Smart Nj
- Smart Nj
- Smoker H
- Soares A. S.
- Soares As
- Soares As
- Soares As
- Soares As
- Soares As
- Soh B
- Solaini L
- Solar-García L
- Soliani P
- Solinas L
- Sooriyamoorthy T
- Soria-Aledo V
- Soria-Aledo V
- Soriano Jt
- Sorrentino L
- Sousa Hs
- Souter J
- Sparta C
- Spaziani A
- Speake D
- Speake D
- Springate El
- Sreedharan L
- Sreedharan L
- Staderini F
- Stecca T
- Stella M
- Stephens Gf
- Stephens Gf
- Stevenson R
- Stewart Dj
- Stoica I
- Storey R
- Stoyanov Ti
- Strachan E
- Strange Ja
- Stubbs Bm
- Stupalkowska W
- Stupalkowska W
- Suarez-Cabrera A
- Suero Ca
- Sultana A
- Summerfield L
- Sunter H
- Surg Pt
- Suriyakumar S
- Suárez-Sánchez A
- Swords C
- Symons N
- Szentpali K
- Szucs A
- Szucs A
- Sánchez-Cifuentes A
- Sánchez-Fuentes Mn
- Sánchez-Rubio M
- Tabain V
- Taglietti L
- Tague Le
- Tahir W
- Tailor K
- Tallon-Aguilar L
- Tallon-Aguilar L
- Tamayo-López Mj
- Tamborska A
- Tamini N
- Tamini N
- Tamini N
- Tan Cy
- Tan Cy
- Tan E
- Tan Hl
- Tan S
- Tang Am
- Tapiolas I
- Tarazi M
- Tatulli F
- Tay Yh
- Tayeh S
- Taylor M
- Taylor Ns
- Taylor Ns
- Taze D
- Tee A
- Tejero-Pintor Fj
- Tenconi Sm
- Tezas S
- Thaha Ma
- Thakral N
- Thakur D
- Thava B
- Thavanesan N
- Thavanesan N
- Thaventhiran Aj
- Theodoropoulou K
- Thomas At
- Thomas L
- Thompson C
- Thompson Db
- Thompson Db
- Thompson R
- Thompson R
- Thoukididou Sn
- Tiedt La
- Tiedt La
- Ting N
- Tinoco-González J
- Tinsley Bj
- Tognarelli Jm
- Tojal A
- Tokidis E
- Tomasoni M
- Tonini V
- Toomey D
- Toomey Db
- Torkington J
- Torkington J
- Torrado Aa
- Torrance A
- Torrance A
- Townsend Dc
- Townsend Dc
- Tozer Pj
- Trail M
- Trail M
- Trastulli S
- Trew F
- Trostchansky I
- Trujillo-Diaz Jj
- Tsang B
- Tudyka V
- Tudyka V
- Turnbull A
- Turner Ej
- Tutino R
- Twum-Barima Cs
- Twum-Barima Cs
- Tyler R
- Tyler R
- Ugarte-Sierra B
- Vacca A
- Vaccari S
- Vakis S
- Valente Pm
- Valiani Sv
- Vallejo-Bernad C
- Vallve-Bernal M
- Van Boxel Gi
- Vance-Daniel J
- Vannucchi A
- Varcada M
- Vargas-Pierola Hj
- Vaughan Em
- Vaughan Em
- Vazquez-Fernandez Ap
- Vega L
- Velchuru Vr
- Velho R
- Venkata Up
- Venkatasubramaniam Ak
- Venn Ml
- Venn Ml
- Venugopal R
- Verea S
- Veres T
- Veres T
- Verroiotou M
- Vescio G
- Vettoretto N
- Vigorita V
- Vijay V
- Vila-Zarate C
- Villarejo-Campos P
- Vinnicombe Z
- Viscosi F
- Vitish-Sharma P
- Viviani E
- Viñas Nl
- Vohra R
- Vohra R
- Vulcano I
- Waite K
- Walji Hd
- Walsh E
- Walsh Tn
- Walters Kj
- Walters U
- Wardle Bg
- Wardle Bg
- Wardle Sd
- Warren O
- Warren Oj
- Warusavitarne J
- Watfah J
- Watson N
- Wauchope J
- Weatherburn Lw
- Weaver J
- Weegenaar Cr
- Weegenaar Cr
- Welsh S
- Wensley F
- West H
- West H
- Wheatstone S
- Wheeler C
- Whewell He
- White F
- Whitehorn Se
- Whitehorn Se
- Whitehouse P
- Whiteman E
- Whittaker L
- Wiggill S
- Wijesundera K
- Wilcox G
- Wilkin R
- Wilkin R
- Wilkin R
- Wilkin R
- Wilkin R. J. W.
- Williams Gl
- Williams M
- Williams R
- Williams S
- Wilson Ej
- Wilson M
- Winter Dc
- Winter Dc
- Wolff J
- Wong A
- Wong C
- Wong J
- Wong J
- Wong Ml
- Wong Sy
- Woo R
- Wood Cs
- Woodrow C
- Woodward A
- Woodward B
- Woodward B
- Worku D
- Worku D
- Wright E
- Wright Hl
- Wu F
- Xidas A
- Yalamarthi S
- Yang P
- Yanni F
- Yardimci E
- Yasin T
- Yen Sk
- Yeung K
- Yeung K
- Yoganathan S
- Yoong S
- Youssef H
- Yow L
- Yow L
- Zaborowski A
- Zadi Az
- Zalla T
- Zarka Za
- Zarka Za
- Zarog Ma
- 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
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