34 research outputs found
Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.
BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700
Postcolonial Anxiety and Anti-Conversion Sentiment in the Report of the Christian Missionary Activities Enquiry Committee
Shoulder soreness due to shoulder braces following robotic surgery in steep Trendelenburg position
Treatment of cancer-related fatigue with ginseng: A systematic review and meta-analysis
Cancer-related fatigue is one of the main problems in cancer patients. Physicians and cancer patients might seek complementary treatments to improve well- being since it is believed that ginseng has numerous beneficial effects. The main aim of this paper is to assess the effects of ginseng supplements to improve cancer-related fatigue in cancer patients. A systematic literature review was conducted using the Cochrane Library, MEDLINE, Embase, and Scopus from inspection until December 2018. Keywords and phrases are separated by the Boolean operator "AND". The keywords Ginseng �AND� fatigue �AND� cancer �AND� clinical trial" �randomized clinical trial� "OR" neoplasm in the title, abstract, or keywords of the mentioned websites were searched. All randomized controlled trials (RCTs) and quasi-randomized RCTs were included to compare the use of ginseng alone or with any alternative treatment or placebo in cancer patients. In total five RCTs comprising 347 individuals in the ginseng group and 336 individuals in the control group were included. There was a significant heterogeneity between studies (chi-squared Q = 152.29 (df = 4, p-value � 0.001). Based on the proportion of total variance due to between-study variance, this heterogeneity was high (I2 = 97.4 ). After pooling the data based on the random effect model, the authors observed that ginseng significantly improved fatigue compared to the control group (pooled SMD = 1.24; 95 CI: 0.05�2.42). This study suggests that ginseng can improve fatigue in cancer patient. However more well-designed randomized trials are needed. © 2021 Elsevier Gmb