18 research outputs found
Enxaqueca - revisão literária
- Author
- Publication venue
- Brazilian Journals Publicações de Periódicos e Editora Ltda.
- Publication date
- 11/06/2024
- Field of study
A enxaqueca é uma condição neurológica caracterizada por dores de cabeça intensas e recorrentes, frequentemente acompanhadas de náuseas, vômitos e sensibilidade à luz e ao som. Essas crises podem durar de algumas horas a vários dias, prejudicando significativamente a qualidade de vida dos indivíduos. A enxaqueca tem uma prevalência global de 15-18%, afetando mais mulheres do que homens. Nos Estados Unidos, os custos com o tratamento da enxaqueca chegam a 17 bilhões de dólares, e a produtividade laboral é significativamente reduzida. A fisiopatologia da enxaqueca envolve a ativação do sistema trigeminovascular e a liberação de neuropeptídeos que causam dor e inflamação. A compreensão completa dos mecanismos subjacentes à enxaqueca ainda não foi alcançada, mas os estudos continuam a explorar tanto os aspectos neurológicos quanto os metabólicos dessa condição complexa. Ademais, existem duas formas principais de enxaqueca: com aura e sem aura. A aura envolve sintomas neurológicos como distúrbios visuais e sensoriais que precedem a dor de cabeça. Outrossim, fatores genéticos e ambientais são relevantes na ocorrência de enxaqueca. O histórico familiar e alterações hormonais, especialmente em mulheres, aumentam a incidência. Certos alimentos, como queijos envelhecidos e bebidas alcoólicas, bem como estresse emocional e físico, também podem desencadear crises. Os sintomas mais comuns incluem dor de cabeça unilateral e pulsante, náusea, vômito e sensibilidade à luz e ao som. O tratamento da enxaqueca visa aliviar os sintomas e prevenir episódios futuros. Medicamentos abortivos, como triptanos e anti-inflamatórios não esteroidais, são usados durante as crises. Para prevenção, betabloqueadores, antidepressivos, anticonvulsivantes e anticorpos monoclonais podem ser prescritos. Mudanças no estilo de vida, como dieta equilibrada, regularidade no sono e técnicas de gerenciamento de estresse, também são recomendadas
Incontinência urinária de esforço na mulher: aspectos etiopatogênicos, métodos diagnósticos e manejo cirúrgico com técnicas de sling
- Author
- Publication venue
- Brazilian Journals Publicações de Periódicos e Editora Ltda.
- Publication date
- 03/07/2023
- Field of study
A incontinência urinária (IU) é uma condição em que ocorre perda involuntária de urina e afeta, principalmente, as mulheres, especialmente, após a menopausa. A patogênese da IU ainda não é completamente compreendida, mas sabe-se que está relacionada à disfunção da bexiga ou dos músculos pélvicos. É classificada como incontinência urinária de esforço (IUE), incontinência urinária de urgência (IUU) e incontinência urinária mista (IUM), sendo a primeira a mais prevalente e o foco dessa revisão. Em relação às mulheres, existem fatores de riscos bem estabelecidos, como paridade, obesidade, histerectomia, uso de diurético, hipoestrogenismo e tosse crônica. Tal condição está associada a um impacto significativo no cotidiano e no convívio social dos portadores, sendo imprescindível o diagnóstico precoce e o tratamento adequado. Todavia, por estar associada ao processo natural do envelhecimento, muitas vezes é menosprezada e subdiagnosticada. O diagnóstico inicial da IU envolve determinar se a incontinência é transitória ou crônica e identificar o subtipo a qual pertence. Embora o diagnóstico seja principalmente clínico, o exame físico, exames laboratoriais complementares e estudo urodinâmico podem ser utilizados para confirmação. No que se refere ao tratamento, em especial da IUE, que é a mais comum, pode envolver abordagens farmacológicas, fisioterápicas e, cada vez mais, cirúrgicas. Entre os tratamentos cirúrgicos, os procedimentos de slings tornaram-se a cirurgia padrão-ouro para IUE devido às altas taxas de cura, abordagem minimamente invasiva, recuperação rápida e baixo risco de complicações. Os dois principais tipos de procedimentos de sling para tratamento de IUE em mulheres são slings uretrais e pubovaginais. É o procedimento individual mais investigado com as evidências mais fortes que justificam seu uso
Global economic burden of unmet surgical need for appendicitis
- Author
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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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- Allam M
- Allam Y
- Allegri A
- Allegri A
- Allen JLY
- Allott R
- Almallah A
- Almoflihi A
- Almuallem S
- Almy J
- Alnaby MH
- Alnawam E
- Alnuqaydan SA
- Alnusairat A
- Alomar IN
- Alqahtani E
- Alqahtani S
- Alrahawy M
- Alrajraji M
- Alrifaie A
- AlRowais M
- Alsaggaf M
- Alsaggaf MU
- Alsaggaf MU
- Alser OH
- Alshareef R
- Altaf A
- Altaf A
- Altamimi A
- Altamimi A
- Altamimi A
- Altamimi A
- Altamini A
- Altarayra M
- Althwainy A
- Altibi A
- Altinel Y
- Altinel Y
- Altoe F
- Altwigry AM
- Altwijri A
- Alvarado Jaramillo R
- Alvarez Barreda LM
- Alvi AR
- Alwafai MG
- Aly AK
- Aly MYM
- Alyacoubi S
- Alyahya R
- Alyami R
- Alyami R
- AlYoussef I
- Alzahrani A
- Alzahrani M
- Alzahrani M
- Alzayat T
- Aman NF
- Amandito R
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- Ambrozeviciute V
- Ameen M
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- Amin J
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- Amoako PT
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- Amole I
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- Andreotti D
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- Andress C
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- Ang YL
- Angelieri D
- Anis E
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- Ansaloni L
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- Appeadu-Mensah W
- Appiah EK
- Aql S
- Aquilino F
- Arachchi PP
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- Arafa O
- Arafa S
- Arango MCM
- Arango MCM
- Aranzabal Durand SY
- Araujo R
- Arcudi C
- Ardley R
- Arenas A
- Arevalo Azmitia JR
- Arias Pacheco RD
- Arman S
- Arman S
- Armando ChunguiBravo J
- Armellini A
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- Arnaud AP
- Arnaud AP
- Arnaud AP
- Arroyo Basto CA
- Arshad MM
- Arslan E
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- Arthur T
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- Asele FA
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- Assal A
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- Atiyeh A
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- Avoka A
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- Awad SA
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- Awuku-Asabre J
- Ayad S
- Ayandipo O
- Ayandipo OO
- Aydin MC
- Ayyar S
- Aziz DNA
- Aziz MRA
- Aziz NA
- Azizeldine MG
- Azmitia Mendizabal CA
- Azodo IA
- Azzie G
- Azzie G
- Azzis O
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- Badawy M
- Badenjki MA
- Badicel M
- Badr A
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- Bahar S
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- Baki BE
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- Bala M
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- Baldacchino M
- Balducci G
- Balila RMH
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- Balmaceda R
- Balmaceda R
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- Baltrunas R
- Baluch F
- Bamford R
- Bamicha A
- Bamicha A
- Banaitis VJ
- Bandi A
- Bandoh D
- Bani-Sadar A
- Banipal GS
- Baraka H
- Barakat SAE
- Barendegere V
- Barker T
- Barkolias C
- Barmayehvar B
- Barnabas GN
- Barnacle J
- Barneo L
- Barrionuevo Ojeda RR
- Barrios E
- Barrios E
- Barros De Castro Segundo LC
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- Barry J
- Basilico S
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- Bassit KA
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- Beasley W
- Beaton C
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- Bediako-Bowan A
- Behar N
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- Bekhet AH
- Bekhet NM
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- Belkouchi A
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- Bello B
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- Benevento A
- Benevento A
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- Bennai RM
- Benons N
- Bentounsi Z
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- Berti S
- Bertuello I
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- Beuran M
- Beyene R
- Bezerra Morais PA
- Bezzina M
- Bhang A
- Bhangu A
- Bhangu A
- Bhargava A
- Bharj IS
- Bhat S
- Bhatnagar A
- Bhattacharya S
- Bhopal KF
- Bhopal KF
- Bianco F
- Bigaran A
- Billy M
- Bin Adnan A
- Bin Hasnan M
- Bin Ismail MJ
- Bin Mahamood A
- Birindelli A
- Birring A
- Bisset C
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- Bjorklund I
- Blacker S
- Blackwell J
- Blanco R
- Blanco-Colino R
- Blencowe N
- Blencowe N
- Bliksoen M
- Blower E
- Bluelle R
- Blundell R
- Boakye-Yiadom K
- Boal M
- Bocchetti T
- Boddy A
- Bode C
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- Bondin J
- Bondurri A
- Bondurri A
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- Bonnard A
- Bonney W
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- Borda-Luque G
- Borda-Luque G
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- Bortolasi L
- Bortolasi L
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- Botes S
- Bottini C
- Botto N
- Bouali O
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- Bradulskis S
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- Bratu MR
- Bratu R-M
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- Bray LD
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- Breistrand M
- Breitenstein S
- Breslin R
- Brincat SD
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- Brown D
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- Brown J
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- Burger S
- Burmistrovas A
- Burns H
- Bustangi N
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- Cabala Chiong JA
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- Cadogan DD
- Cahill R
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- Camilleri-Brennan J
- Camilleri-Brennan JF
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- Campagnaro T
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- Castro Mollo M
- Catani M
- Cautiero R
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- Cecilia T
- Celik S
- Cengiz TB
- Cengiz Y
- Cengiz Y
- Cengiz Y
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- Chabok A
- Chachulski W
- Chai C-A
- Chai FY
- Chambers A
- Chambers A
- Chan E
- Chan L
- Chan T-YK
- Chan XW
- Chan Z
- Chandrakumar C
- Chang K
- Chang KY-C
- Chapman A
- Chapman SJ
- Charles A
- Cheah AEZ
- Chen CY
- Chen KY
- Chen T-L
- Chenn R
- Cheong YJ
- Chetta N
- Cheung YHE
- Chew LS
- Chhabra S
- Chibuye C
- Chidambaram S
- Chiesa D
- Chilton G
- Chin PX
- Chin YR
- Chiu S
- Chiu S
- Chiu SMY
- Choi J
- Choi P
- Chong BFHK
- Chong CL
- Chong CL
- Chong CL
- Chong CS
- Chong H-Y
- Chong HY
- Choudhry A
- Chow CYN
- Chowdhury A
- Chowdhury D
- Chu K
- Chun A
- Chun T
- Chung KJ
- Chung S
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- Ciubotaru C
- Claire R
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- Clegg-Lamptey J-N
- Clement KD
- Clements JM
- Clerico G
- Clifford C
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- Coasaca Huaraya R
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- Court E
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- Currow C
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- D'Amours S
- D'amours SK
- D'cruz R
- D'Souza MS
- D'Souza R
- Da Silva LA
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- Dahy A
- Dainius E
- Dakubo J
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- Danelli P
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- Daniyan M
- Danys D
- Dao W
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- Dar M
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- Darweesh M
- Darwish AKZ
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- Decker E
- Dedekind B
- Dedey F
- Deichsel F
- Del Basso C
- del Pilar Paucar A
- Delforge X
- Dell A
- Dempster E
- Denakpo M
- Denewar A
- Depalma N
- Deputy M
- Der Y
- Dervenis C
- Despotidis V
- Desta S
- Deutschmann P
- Devadasar GH
- Dharamshi HA
- Dhillon D
- Di Franco F
- Di Martino N
- Di Saverio S
- Di Saverio S
- Diab A
- Diaconescu B
- Diaconescu I-B
- Dias S
- Diaz Vico T
- Diaz-Jover P
- Diaz-Zorrilla C
- Dick L
- Dickfos M
- Dickson L
- Dijan E
- Dimech T
- Din F
- Dindyal S
- Dindyal S
- Dione Parreno-Sacdalan M
- Dissanayake T
- Djivoh F
- Domini E
- Domini E
- Donnelly P
- Donoghue D
- Dorani RMNR
- Dorisme A
- dos Santos DV
- Dossou F
- Doughan S
- Doughty J
- Dousset B
- Dragatas D
- Drake TM
- Drake TM
- Drake TM
- Driscoll A
- Drungilas M
- Du Plessis D
- du Plooy F
- Du Toit F
- Duane T
- Dubois A
- Duffy L
- Duhoranenayo D
- Duinhouwer L
- Dulskas A
- Dwydar A
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- Ebidy MM
- Ebrahim OS
- Eduard P
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- Ekow M
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- El Dahab AA
- El Deen KN
- El Gendy A
- El Gendy NH
- El Halawany M
- El Jamassi A
- El Kashash A
- El Kholy A
- El Magd AA
- El Mesery S
- El Sayed GS
- El Sayed IM
- El Shoura Y
- El-badawy HA
- El-Dien KS
- El-Dien KS
- El-Din RA
- El-Din SA
- El-Gizawy E
- El-Hamouly AS
- El-Kashef H
- El-Latif NK
- El-Ma'doul AS
- El-Rabaa S
- El-Sagheer N
- El-Sawy A
- El-Sehily A
- El-Shahat NS
- El-Sheemy H
- El-Taher E
- Elabdin HZ
- Elashmawy M
- Elashry R
- Elazab A
- Elazayem AA
- Elazoul M
- Elbanby E
- Elbanby ES
- Elbatahgy A
- Elbe P
- Elbermawy M
- Elbisomy KH
- Eldafrawy M
- Eldamaty L
- Eldeeb AZ
- Eldeen EA
- Eldin MAB
- EldosoukyMohammed A
- Elebute O
- Elebute O
- Elena G
- Elfarargy A
- Elfeki H
- Elfeki H
- Elfiky M
- Elfil M
- Elfouly N
- Elfouly N
- Elfouly Y
- Elfouly Y
- Elgebaly A
- Elgendy AH
- Elgendy FI
- Elgheriany M
- Elhadad A
- Elhadary NM
- Elhadry S
- Elhalawany E
- Elhamouly S
- Elhelbawy MS
- Elhendawy A
- Elhendawy AOA
- Elhoseny G
- Elhusseiny AAE
- Elizabeth Lopez C
- Elkadsh I
- Elkady F
- Elkelany A
- Elkelany A
- Elkelany A
- Elkelany A
- Elkhadrawi M
- Elkhalek EA
- Elkholy A
- Elkholy SS
- Elkolaly SS
- Elkorashy AM
- Ellison Q
- Elmashala A
- Elmasry M
- Elmelegy R
- Elmihy S
- Elnagar A
- Elnajjar MA
- Elnemr AE
- Elrazek AA
- Elsabbagh N
- Elsameea AA
- Elsawahly DME
- Elsawy A
- Elsayed M
- Elsayed M
- Elsayed N
- Elsayed NAR
- Elsayed ZM
- Elsebaaye AO
- Elsehimy M
- Elsemelawy R
- Elshaar M
- Elshaer K
- Elshaer M
- Elshaer M
- Elshafay AE
- Elshami M
- Elshanwany S
- Elsharkawy AA
- Elsheikh S
- Elsherbiney S
- Elsherbiny AS
- Elsherif FA
- Elshobary M
- Elsiddig M
- Elsobky S
- Elsorogy DEAA
- Elwaey A
- Elwakil H
- Elwan A
- Elwan A
- Elwy E
- Elzahed N
- Elzayat I
- Elzayat M
- Elzayyat I
- Elzowawi F
- Emadeldin D
- Emadeldin H
- Emara E
- Emile S
- Eng C
- English W
- Esam A
- Escalante Salas MDC
- Espin-Basany E
- Espinoza F
- Essam A
- Essam AA
- Essam M
- Essoun S
- Esteban E
- Estee MM
- Estupinian S
- Etchill E
- Etchill E
- Etienne S
- Etman M
- Etwire V
- Evajelista CV
- Evans D
- Evans E
- Eysa A
- Eyssartier E
- Ezzat E
- Ezzat T
- Faboya O
- Faccincani R
- Fadel A
- Fahiem A
- Fahim M
- Fahmy MAB
- Fahy C
- Fairfield C
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- Fairfield C
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- Falaschi F
- Falco N
- Falzon M
- Farag A
- Farag S
- Farah A
- Farahat MM
- Faraz A
- Fares M
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- Farhan-Alanie MMH
- Farhangmehr N
- Farinella E
- Farmakis K
- Farooq T
- Farouk SAM
- Farquharson A
- Farrugia A
- Farrugia A
- Faruq A
- Fathy AM
- Fattah AA
- Fatuga A
- Faturoti O
- Faturoti O
- Faure A
- Fautz T
- Favero A
- Fawzy A
- Feidantsis T
- Felipe CO
- Fergany A
- Fergusson SJ
- Fergusson SJ
- Fergusson SJ
- Fergusson SJ
- Fermani C
- Fermani CG
- Fernandes C
- Fernandez C
- Fernandez-Bueno F
- Fernandez-Vega L
- Ferousis C
- Ferrero E
- Fievet L
- Filatau A
- Findlay-Cooper K
- Firdouse M
- Firdouse M
- Firdouse M
- Firwana A
- Fitsum A
- Fitzgerald JE
- Fitzgerald JE
- Florez Farfan ES
- Foco M
- Fok CYJ
- Fontana T
- Foo CC
- Forlin L
- Forno W
- Fouad A
- Fouad D
- Fouad D
- Fourcade L
- Fowler AJ
- Fozard T
- Fozard T
- Frade F
- Fraga GP
- Francisco Roxas M
- Franco H
- Francois P
- Francois-Coridon H
- Francone E
- Freitas AV
- Frey D
- Frisk B
- Fuentes-Rivera L
- Fujii F
- Furqan MM
- Gaafar S
- Gaarder T
- Gad A
- Gad MO
- Gadelkarim M
- Gadhvi V
- Gado A
- Gaignard E
- Gaignard E
- Gaizauskas V
- Gala T
- Gala T
- Galiqi G
- Galleano R
- Gallo G
- Galloway S
- Galvez CP
- Gamal D
- Gamal E
- Gamal H
- Gamal S
- Gamaly E
- Gamil D
- Gan C
- Gan YY
- Gani MA
- Garaycochea O
- Garcia Bernardo C
- Garcia Florez LJ
- Garcia Septiem J
- Garcia Torres CP
- Garcia-Florez L
- Garland A
- Gash K
- Gash K
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- Gastaldi P
- Gasteratos K
- Gaujoux S
- Gavagna L
- Gbessi DG
- Gemeah M
- Gemenetzis G
- Gemenetzis G
- George R
- Germanos S
- Germanos S
- Gerosa A
- Gerosa A
- Geuoshy A
- Ghaben A
- Ghandora N
- Ghanem A
- Ghanem E
- Ghanem S
- Ghanem S
- Ghannam M
- Gharib A
- Gharib A
- Ghazy AA
- Gheith A
- Ghetia M
- Ghetia M
- Ghonaim MA
- Ghoneem M
- Ghoneim O
- Giacci L
- Giardino FR
- Giavarini L
- Giglio MC
- Gilbert R
- Gilbert RW
- Giles J
- Gillespie M
- Gimzewska M
- Giraldo RSR
- Giuliani S
- Giuliani S
- Giuriato TF
- Gkiokas G
- Glasbey J
- Glasbey J
- Glasbey JC
- GlobalSurg Collaborative
- Glover TE
- Glover-Addy H
- Glynn M
- Gobin N
- Gobin N
- Goh CC
- Goh CC
- Goh W
- Gohar ME-SAM
- Gokani S
- Goldin E
- Golding D
- Gomaa A
- Gomah M
- Gonzales Montejo MS
- Gonzales Stuva JP
- Gonzalez M
- Goodstein M
- Gosling S
- Gosling SG
- Gouda A
- Gould L
- Gouldthorpe C
- Gouvas N
- Gouws J
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- Graffieille V
- Gran M
- Grandinetti PP
- Grant A
- Grasset E
- Grasset E
- Grassi V
- Gratton R
- Gravante G
- Gravante G
- Gray D
- Grech N
- Green N
- Grella MG
- Gribauskaite J
- Griffiths E
- Griffiths E
- Griffiths M
- Grima T
- Grisin E
- Grizhja B
- Grobler DC
- Grosos C
- Grossart C
- Gubeli A
- Gudal A
- Gudal A
- Gudal A
- Gudlaugsdottir K
- Guevara Torres S
- Guevara R
- Guglielmo V
- Gui D
- Gul E
- Gulbinas A
- Gulcicek OB
- Gulielmi A
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- Gumar M
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- Gunawan R
- Guner A
- Gunnarsson U
- Guo W
- Gupta A
- Gustafsson U
- Guzman Duenas C
- Gyamfi FE
- Gyanchandani N
- Gyedu A
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- Habeeb O
- Habeebullah A
- Hache-Marliere M
- Haddad N
- Hafez AT
- Hafez M
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- Hafez S
- Haffreingue A
- Hafiz S
- Hagan R
- Hagar A
- Haines M
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- Hajeh H
- Hakim H
- Halhouli O
- Halhouli O
- Halicioglu I
- Hall E
- Hall N
- Hall NJ
- Hall TF
- Hallam S
- Haloho A
- Hamad MGM
- Hamarshi A
- Hamasaki Hamaguchi JL
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- Hamsho W
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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
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
- Author
- Abantanga FA
- Abatli SJ
- Abbas W
- Abbo O
- Abd Elmenam M
- Abd Razak RB
- Abdelbaqi R
- Abdelhady DS
- Abdelhafez MOM
- Abdelhamid SS
- Abdelmaksoud S
- Abdelmoumen R
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- Abdul-Mumin A
- Abduljawad FM
- Abdullah F
- Abdulraheem N
- Abdulrahman A
- Abdulsalam MA
- Abdunomonovich DA
- Abib SDCV
- Aboelela A
- Abouheba M
- Abrahamsson K
- Abu Ajwa AE
- Abu Al-saleem HSH
- Abu Alamrain AA
- Abu Bakar AH
- Abu Farha MS
- Abu Jamie N
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- Abu Mayaleh A
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- Abu Za'nouneh FJ
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- Publication venue
- ELSEVIER SCIENCE INC
- Publication date
- 24/07/2021
- Field of study
Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030
Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019
- Author
- Abbafati Cristiana
- Abbas Kaja M.
- Abbasi Mohammad
- Abbasi-Kangevari Mohsen
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- Yusefzadeh Hasan
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- Publication venue
- Publication date
- 01/01/2020
- Field of study
Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
- Author
- Aali Amirali
- Abbafati Cristiana
- Abbas Jaffar
- Abbasgholizadeh Rouzbeh
- Abbasi Madineh Akram
- Abbasian Mohammadreza
- Abd ElHafeez Samar
- Abd-Elsalam Sherief
- Abdelmasseh Michael
- Abdelwahab Ahmed
- Abdollahi Mohammad
- Abdoun Meriem
- Abdullahi Auwal
- Abdurehman Ame Mehadi
- Abebe Mesfin
- Abedi Aidin
- Abedi Armita
- Abegaz Tadesse M
- Abeldaño Zuñiga Roberto Ariel
- Abhilash E S
- Abiodun Olugbenga Olusola
- Aboagye Richard Gyan
- Abolhassani Hassan
- Abouzid Mohamed
- Abreu Lucas Guimarães
- Abrha Woldu Aberhe
- Abrigo Michael R M
- Abtahi Dariush
- Abu Rumeileh Samir
- Abu-Rmeileh Niveen ME
- Abu-Zaid Ahmed
- Aburuz Salahdein
- Acuna Juan Manuel
- Adair Tim
- Addo Isaac Yeboah
- Adebayo Oladimeji M
- Adegboye Oyelola A
- Adekanmbi Victor
- Aden Bashir
- Adepoju Abiola Victor
- Adetunji Charles Oluwaseun
- Adeyeoluwa Temitayo Esther
- Adeyomoye Olorunsola Israel
- Adha Rishan
- Adibi Amin
- Adikusuma Wirawan
- Adnani Qorinah Estiningtyas Sakilah
- Adra Saryia
- Afework Abel
- Afolabi Aanuoluwapo Adeyimika
- Afraz Ali
- Afyouni Shadi
- Afzal Saira
- Agasthi Pradyumna
- Aghamiri Shahin
- Agodi Antonella
- Agyemang-Duah Williams
- Ahinkorah Bright Opoku
- Ahmad Aqeel
- Ahmad Danish
- Ahmad Firdos
- Ahmad Muayyad M
- Ahmad Tauseef
- Ahmadi Keivan
- Ahmadzade Amir Mahmoud
- Ahmadzade Mohadese
- Ahmed Ayman
- Ahmed Haroon
- Ahmed Luai A
- Ahmed Muktar Beshir
- Ahmed Syed Anees
- Ajami Marjan
- Aji Budi
- Ajumobi Olufemi
- Akalu Gizachew Taddesse
- Akara Essona Matatom
- Akinosoglou Karolina
- Akkala Sreelatha
- Akyirem Samuel
- Al Hamad Hanadi
- Al Hasan Syed Mahfuz
- Al Homsi Ammar
- Al Qadire Mohammad
- AL-Ahdal Tareq Mohammed Ali
- Al-Aly Ziyad
- Al-amer Rasmieh Mustafa
- Al-Eyadhy Ayman
- Al-Gheethi Adel Ali Saeed
- Al-Hanawi Mohammed Khaled
- Al-Jumaily Adel
- Al-Marwani Sabah
- Al-Maweri Sadeq Ali Ali
- Al-Mekhlafi Hesham M
- Al-Sabah Salman Khalifah
- Al-Tawfiq Jaffar A
- Al-Worafi Yaser Mohammed
- Ala Moein
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- Xu Xiaoyue
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- Yaghoubi Sajad
- Yang Lin
- Yano Yuichiro
- Yao Yao
- Ye Pengpeng
- Yesera Gesila Endashaw
- Yesodharan Renjulal
- Yesuf Subah Abderehim
- Yiğit Arzu
- Yiğit Vahit
- Yip Paul
- Yon Dong Keon
- Yonemoto Naohiro
- You Yuyi
- Younis Mustafa Z
- Yu Chuanhua
- Zadey Siddhesh
- Zadnik Vesna
- Zafari Nima
- Zahedi Mohammad
- Zahid Muhammad Nauman
- Zahir Mazyar
- Zakham Fathiah
- Zaki Nazar
- Zakzuk Josefina
- Zamagni Giulia
- Zaman Burhan Abdullah
- Zaman Sojib Bin
- Zamora Nelson
- Zand Ramin
- Zandi Milad
- Zandieh Ghazal G Z
- Zanghì Aurora
- Zare Iman
- Zastrozhin Mikhail Sergeevich
- Zeariya Mohammed G M
- Zeng Youjie
- Zhai Chunxia
- Zhang Chen
- Zhang Haijun
- Zhang Hongwei
- Zhang Yunquan
- Zhang Zhaofeng
- Zhang Zhenyu
- Zhao Hanqing
- Zhao Yang
- Zhao Yong
- Zheng Peng
- Zhong Chenwen
- Zhou Juexiao
- Zhu Bin
- Zhu Zhaohua
- Ziaeefar Pardis
- Zielińska Magdalena
- Zou Zhiyong
- Zumla Alimuddin
- Zweck Elric
- Zyoud Samer H
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
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- de Leó
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- de Lima CVB
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- Dedey F
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- Dell A
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- El Dahab AA
- El Deen KN
- El Galeel AA
- El Gendy NH
- El Gendy A
- El Halawany M
- El Hameed OSA
- El Hamid NA
- El Jamassi A
- El Kashash A
- El Kholy A
- El Magd AA
- El Mesery S
- El Salam YA
- El Sayed GS
- El Sayed IM
- El Shoura Y
- El Slam MA
- El-Badawy Ha
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- El-Din Ra
- El-Din Sa
- El-Gizawy E
- El-Hamouly As
- El-Kashef H
- El-Latif Nka
- El-Ma&apos
- El-Rabaa S
- El-Sagheer N
- El-Salam Fa
- El-Sawy A
- El-Sehily A
- El-Shahat Ns
- El-Sheemy H
- El-Taher E
- Elabdin Hz
- Elashmawy M
- Elashry R
- Elazab A
- Elazayem Aa
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- Elbe P
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- Elbisomy Kh
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- Eldeeb Az
- Eldeen Ea
- Eldin Mab
- Elebute O
- Elebute O
- Elena G
- Elfarargy A
- Elfeki H
- Elfeki H
- Elfiky M
- Elfil M
- Elfouly N
- Elfouly N
- Elfouly Y
- Elfouly Y
- Elgebaly A
- Elgendy Ah
- Elgendy Fi
- Elgheriany M
- Elhadad A
- Elhadary Nm
- Elhadry S
- Elhalawany E
- Elhamouly S
- Elhelbawy Ms
- Elhendawy A
- Elhendawy Aoa
- Elhoseny G
- Elhusseiny Aae
- Elkadsh I
- Elkady F
- Elkelany A
- Elkelany A
- Elkelany A
- Elkelany A
- Elkhadrawi M
- Elkhalek Ea
- Elkholy A
- Elkholy Ss
- Elkolaly Ss
- Elkorashy Am
- Ellison Q
- Elmashala A
- Elmasry M
- Elmelegy R
- Elmihy S
- Elnagar A
- Elnajjar Ma
- Elnemr Ae
- Elrasoul Ya
- Elrazek Aa
- Elsabbagh N
- Elsameea Aa
- Elsawahly Dme
- Elsawy A
- Elsayed M
- Elsayed M
- Elsayed N
- Elsayed Nar
- Elsayed Zm
- Elsebaaye Ao
- Elsehimy M
- Elsemelawy R
- Elshaar M
- Elshaer K
- Elshaer M
- Elshaer M
- Elshafay Ae
- Elshami M
- Elshanwany S
- Elsharkawy Aa
- Elsheikh S
- Elsherbiney S
- Elsherbiny As
- Elsherif Fa
- Elshobary M
- Elsiddig M
- Elsobky S
- Elsorogy Deaa
- Elwaey A
- Elwakil H
- Elwan A
- Elwan A
- Elwy E
- Elzahed N
- Elzayat I
- Elzayat M
- Elzayyat I
- Elzowawi F
- Emadeldin D
- Emadeldin H
- Emara E
- Emile S
- Eng C
- English W
- Esam A
- Escobar Eg.
- Espin-Basany E
- Espinoza F
- Espinoza Kt
- Espinoza Kt
- Essam A
- Essam Aa
- Essam M
- Essoun S
- Esteban E
- Estee Mm
- Estupinian S
- Etchill E
- Etchill E
- Etienne S
- Etman M
- Etwire V
- Evajelista Cv
- Evans D
- Evans E
- Eysa A
- Eyssartier E
- Ezzat E
- Ezzat T
- Faboya O
- Faccincani R
- Fadel A
- Fahiem A
- Fahim M
- Fahy C
- Fairfield C
- Fairfield C
- Fairfield C
- Fakher R
- Falaschi F
- Falco N
- Falzon M
- Farag A
- Farag S
- Farah A
- Farahat Mm
- Faraz A
- Fares M
- Farfan Esf
- Farhad M
- Farhan-Alanie Mmh
- Farhangmehr N
- Farinella E
- Farmakis K
- Farooq T
- Farouk Sam
- Farquharson A
- Farrugia A
- Farrugia A
- Faruq A
- Fathy Am
- Fattah Aa
- Fatuga A
- Faturoti O
- Faturoti O
- Faure A
- Fautz T
- Favero A
- Fawzy A
- Feidantsis T
- Felipe Co
- Fergany A
- Fergusson Sj
- Fergusson Sj
- Fergusson Sj
- Fermani C
- Fermani Cg
- Ferná
- Fernandes C
- Fernandez-Bueno F
- Fernandez-Vega L
- Ferousis C
- Ferreira Sak
- Ferrero E
- Fievet L
- Filatau A
- Findlay-Cooper K
- Firdouse M
- Firdouse M
- Firdouse M
- Firwana A
- Fitsum A
- Fitzgerald Je
- Florez Ljg
- Foco M
- Fok Cyj
- Fontana T
- Foo Cc
- Forlin L
- Forno W
- Fouad A
- Fouad D
- Fouad D
- Fourcade L
- Fowler Aj
- Fozard T
- Fozard T
- Frade F
- Fraga Gp
- Franco H
- Francois P
- Francois-Coridon H
- Francone E
- Freitas Av
- Frey D
- Frisk B
- Fuentes-Rivera L
- Fujii F
- Furqan Mm
- Gü
- Gü
- Gaafar S
- Gaarder T
- Gad A
- Gad Mo
- Gadelkarim M
- Gadhvi V
- Gado A
- Gaiž
- Gaignard E
- Gaignard E
- Gala T
- Gala T
- Galiqi G
- Galleano R
- Gallo G
- Galloway S
- Galvez Cp
- Gamal D
- Gamal E
- Gamal H
- Gamal S
- Gamaly E
- Gamil D
- Gan C
- Gan Yy
- Gani Ma
- Garaycochea O
- Garcí
- Garcí
- Garcí
- Garcia-Florez L
- Garcia-Marin Ja
- Garcia-Perez Jm
- Garland A
- Gash K
- Gash K
- Gash K
- Gastaldi P
- Gasteratos K
- Gaujoux S
- Gavagna L
- Gbessi Dg
- Gemeah M
- Gemenetzis G
- Gemenetzis G
- George R
- Germanos S
- Germanos S
- Gerosa A
- Gerosa A
- Geuoshy A
- Ghaben A
- Ghandora N
- Ghanem A
- Ghanem E
- Ghanem S
- Ghanem S
- Ghannam M
- Gharib A
- Gharib A
- Ghazy Aa
- Gheith A
- Ghetia M
- Ghetia M
- Ghonaim Ma
- Ghoneem M
- Ghoneim O
- Giacci L
- Giardino Fr
- Giavarini L
- Giglio Mc
- Gilbert R
- Gilbert Rw
- Giles J
- Gillespie M
- Gimzewska M
- Giraldo Rsr
- Giuliani S
- Giuliani S
- Giuriato Tf
- Gkiokas G
- Glasbey J
- Glasbey J
- Glasbey Jc
- Glasbey Jc
- Glover Te
- Glover-Addy H
- Glynn M
- Gobin N
- Gobin N
- Goh Cc
- Goh Cc
- Goh W
- Gohar Meam
- Gokani S
- Goldin E
- Golding D
- Gomaa A
- Gomah M
- Gonzalez M
- Gonzalez Sc
- Goodstein M
- Gosling S
- Gosling Sg
- Gouda A
- Gould L
- Gouldthorpe C
- Gouvas N
- Gouws J
- Graffeille V
- Graffieille V
- Gran M
- Grandinetti Pp
- Grant A
- Grasset E
- Grasset E
- Grassi V
- Gratton R
- Gravante G
- Gravante G
- Gray D
- Grech N
- Green N
- Grella Mg
- Gribauskaite J
- Griffiths E
- Griffiths E
- Griffiths M
- Grima T
- Grisin E
- Grizhja B
- Grobler Dc
- Grosos C
- Grossart C
- Guasti Bpsj
- Gudal A
- Gudal A
- Gudal A
- Gudlaugsdottir K
- Guevara R
- Guglielmo V
- Gui D
- Gulbinas A
- Gulcicek Ob
- Gulielmi A
- Gultom Pa
- Gumar M
- Gunaseelan K
- Gunawan R
- Guner A
- Gunnarsson U
- Guo W
- Gupta A
- Gustafsson U
- Gyamfi Fe
- Gyanchandani N
- Gyedu A
- Habeeb Ma
- Habeeb O
- Habeebullah A
- Hache-Marliere M
- Haddad N
- Hafez At
- Hafez M
- Hafez M
- Hafez S
- Haffreingue A
- Hafiz S
- Hagan R
- Hagar A
- Haines M
- Haines S
- Hajeh H
- Hakim H
- Halhouli O
- Halhouli O
- Halicioglu I
- Hall E
- Hall N
- Hall Nj
- Hall Tf
- Hallam S
- Haloho A
- Hamad Mgm
- Hamaguchi Jlh
- Hamarshi A
- Hamasaki J
- Hamdan A
- Hamdan M
- Hamed Mf
- Hamill D
- Hammad A
- Hammad A
- Hammad Am
- Hampton M
- Hampton Mi
- Hamsho W
- Hanafy M
- Hand C
- Hanks A
- Hanley I
- Hanoun S
- Hanrahan M
- Hanrahan M
- Hanrahan M
- Hanrahan M
- Hantour U
- Hantour U
- Hany E
- Haque M
- Har Pa
- Haraux E
- Harbord P
- Haroun A
- Harper E
- Harrison Em
- Harrison Em
- Harrison N
- Harrison P
- Harrison R
- Hartford L
- Harvey N
- Hasan A
- Hasan A
- Hasan D
- Hasanah A
- Hasanain D
- Hascoet J
- Hashad E
- Hasheminia A
- Hashim A
- Hashish A
- Hashish M
- Haslegrave A
- Hasnan Mb
- Hassaan A
- Hassaan A
- Hassan A
- Hassan A
- Hassan A
- Hassan Ata
- Hassan I
- Hassan M
- Hassan Omm
- Hassan S
- Hassan Z
- Hassanain M
- Hassanain M
- Hassanein Ab
- Havemann I
- Hawkins W
- Heard R
- Heath J
- Heffernan D
- Hegazy Em
- Hegazy Y
- Helene Fc
- Helguero-Santin Lm
- Hemeda D
- Hemingway D
- Hemmila M
- Hemmila M
- Henderson L
- Henderson L
- Heng He
- Henric N
- Henry F
- Henshall De
- Herebat A
- Herikstad R
- Herrera N
- Herrera-Matta J
- Herrod P
- Hervieux E
- Hervieux E
- Hesham O
- Hettiarachchi Ts
- Hewage K
- Heywood Eg
- Highcock S
- Hilal K
- Hinojosa C
- Hjertberg M
- Hjertberg M
- Hmila S
- Ho A
- Ho Cw
- Ho W
- Ho Wc
- Hodonou F
- Hogea M
- Holte S
- Holton P
- Homeida A
- Hoogakker E
- Horobjowsky A
- Hosein Sp
- Hosh M
- Hossaini S
- Hossameldin A
- Houlden C
- Howells L
- Howie Ee
- Hrora A
- Huaman E
- Huaraya Rc
- Humm G
- Hunter K
- Hussain M
- Hussein A
- Hussein S
- Husseini M
- Husseiny R
- Hutch W
- Huwait A
- Iş
- Iacono C
- Iannone I
- Ibraheem Aa
- Ibraheem Hi
- Ibrahem Aa
- Ibrahem Aa
- Ibrahim A
- Ibrahim A
- Ibrahim A
- Ibrahim Am
- Ibrahim E
- Ibrahim Em
- Ibrahim I
- Ibrahim K
- Ibrahim M
- Ibrahim Mh
- Ibrahim Y
- Idress T
- Idris F
- Idris Sai
- Iftekhar F
- Iftikhar Z
- Iftikhar Z
- Ignatavicius P
- Ihediwa G
- Imoro O
- Ingabire Jca
- Ingabire Jca
- Ingabire Jca
- Ioannidis O
- Iordache Fm
- Iqbal Fm
- Iqbal Mr
- Ireland P
- Irtan S
- Irtan S
- Irwin G
- Irwin G
- Irwin G
- Irwin G
- Ishak N
- Iskandar F
- Ismaï
- Ismaï
- Ismaï
- Ismaï
- Ismail A
- Ismail M
- Ismail M
- Ismail Mjb
- Ismail Mk
- Ismail Sa
- Israelsson L
- Ivros N
- Iyer D
- Iyer D
- Iyer D
- Jabal Ms
- Jabbar A
- Jaber S
- Jackson P
- Jacobe M
- Jaffry Z
- Jaffry Z
- Jaich R
- Jain P
- Jama Gm
- Jamal L
- Janardha Kc
- Janik M
- Jankus T
- Jaradat D
- Jaramillo Ra
- Jarmin M
- Jasaitis K
- Javaid M
- Javed O
- Javed O
- Jawaid M
- Jayathilake Ab
- Jck Ng
- Jean-Francois C
- Jeffery A
- Jeffery A
- Jenner E
- Jennings L
- Jennings V
- Jennings V
- Jensen E
- Jenvey C
- Jeo Ws
- Jeon H
- Jeremic L
- Jethwani Dl
- Jeyakumar J
- Jeyakumar J
- Jha M
- Jimenez J
- Jimenez-Morillas P
- Joel Lwl
- Johanna N
- Johnson K
- Johnston R
- Jokubauskas M
- Jokubauskas M
- Jokubonis K
- Jones C
- Jones C
- Jones E
- Jones Tf
- Jonnalagadda R
- Joosten J
- Jordan H
- Jotautas V
- Jotautas V
- Jovine E
- Jovine E
- Jubran Af
- Juciute S
- Julaihi R
- Jurdell E
- Kaafarani H
- Kabariti R
- Kabariti R
- Kabba J
- Kabongo K
- Kache S
- Kaci Aa
- Kadiwar S
- Kalakouti E
- Kalles V
- Kalles V
- Kalles V
- Kamarajah Sk
- Kamarulzamil Sna
- Kamil R
- Kamya S
- Kanani A
- Kandil Am
- Kandil H
- Kang Mk
- Kanta Th
- Karabacak U
- Karabelias G
- Karabulut K
- Karahan Sr
- Karakahya M
- Karandikar S
- Karandikar S
- Kariem N
- Karim A
- Karim R
- Karim S
- Karismaningtyas H
- Karjiker P
- Karkeet M
- Karkeet M
- Karlo R
- Karlo R
- Karousos D
- Karumnas P
- Kaselis N
- Kaselis N
- Kasem E
- Kasem Ea
- Kasputyte S
- Kaul A
- Kazanavicius D
- Kedar A
- Kefalidi E
- Keke Kr
- Kelany M
- Kenibar A
- Kennedy Ed
- Kennedy M
- Kennedy R
- Keogh K
- Kerley R
- Kershaw S
- Kesinger M
- Khafagy T
- Khairy H
- Khairy H
- Khajanchi M
- Khaled H
- Khalifah E
- Khalili M
- Khalique A
- Khallaf S
- Khamajeet A
- Khan A
- Khan K
- Khan Ma
- Khan R
- Khan S
- Khan T
- Khan Za
- Kharsa S
- Khatri C
- Khatri C
- Khattab K
- Khedr Aeh
- Khg Li
- Khoja A
- Khoja A
- Khokha D
- Khokha V
- Khosla S
- Khreishi R
- Khreishi R
- Khulu Lb
- Khyrallh A
- Kiasat A
- Kidd T
- Kielty P
- Kim My
- Kim Sb
- Kim Sh
- Kimaro M
- Kinandu K
- King R
- King S
- King S
- Kinnera Sv
- Kiran Rp
- Kirby A
- Kirishnan A
- Kirupagaran A
- Kiudelis M
- Kjellin A
- Kkk Li
- Klappenbach R
- Knight S
- Koay Kl
- Kobal Bb
- Koh C
- Koh H
- Koh Py
- Koh S
- Koh S
- Kojo Att
- Kojo Att
- Kojo Att
- Kolosov A
- Komolafe O
- Kondrotas P
- Kong C
- Kong Sn
- Kong V
- Kong V
- Konstantina K
- Kontos M
- Kordorwu Hek
- Korkolis D
- Kosai Nr
- Kosai Nr
- Kose E
- Koskenvuo L
- Kostov E
- Kotb Ahe
- Kotecha D
- Koto Mz
- Kotobi H
- Koumpa F
- Kouraklis G
- Kourdouli A
- Kourdouli A
- Kretzmann H
- Krishna K
- Kruspi S
- Kufeji D
- Kulasabanathan K
- Kuliavas J
- Kumar B
- Kumar B
- Kumar B
- Kumar Bs
- Kumar Mn
- Kumar S
- Kumar S
- Kumar S
- Kumar S
- Kumar T
- Kumwenda D
- Kushwaha S
- Kushwaha S
- Kusi K
- Kutkevicius J
- Kwakyeafriyie P
- Kwatiwani C
- Kwizera S
- Kwok Sh
- Kyereh M
- Kyriazanos I
- Kyrou G
- Kyziridis D
- Ló
- L&apos
- La Brocca A
- la Medina AR
- la Medina AR
- la Medina AR
- Labib P
- Ladukas A
- Lafferty K
- Lagunavicius K
- Lai Ac
- Lakhani Sm
- Lakshmi Hn
- Lam Fy
- Lam Jcy
- Lam Wh
- Lamanna Gl
- Lanau Miv
- Lando J
- Landolfo G
- Landolfo G
- Lap G
- Lapitan Mc
- Lapitan Mc
- Larsen Jw
- Lasek A
- Lasheen A
- Lasheen Kt
- Latif A
- Laufer Lav
- Laugzemys E
- Laugzemys E
- Laurie K
- Lauzikas G
- Law Jh
- Lawal A
- Lawal Ao
- Lawal T
- Lawal Ta
- Lawani I
- Lawther R
- Lazzari G
- Lazzari V
- Leal A
- Leal M
- Lecompte Jf
- Lee C
- Lee Ex
- Lee F
- Lee K
- Lee Kc
- Lee Ky
- Lee Tsb
- Lemaire Sb
- Leone N
- Leong Fqh
- Leppä
- Leppä
- Leroux J
- Leung Kw
- Leung Mf
- Leusink A
- Lewis J
- Li Ws
- Licari L
- Lieske B
- Lieske B
- Liew I
- Liew I
- Lilford R
- Lilford R
- Lilford Rj
- Lim G
- Lim H
- Lim J
- Lim Pj
- Lim Sj
- Lim Sj
- Lim Sy
- Limache S
- Limaye N
- Limoges B
- Lintin L
- Lipnickas V
- Litvin A
- Liu Q
- Liu Q
- Livesey A
- Livingston M
- Ljuhar D
- Lo Conte A
- Loaloa Mr
- Lockey J
- Lohse Has
- Lohse Has
- Loizides S
- Lokman Maa
- Longstaff L
- Lopez Ce
- Lopez Lip
- Lopez M
- Lopez M
- Lopez-Arevalo C
- Lorenzon L
- Lossius Wj
- Loughran D
- Low X
- Luc Ar
- Luck J
- Luck J
- Luck J
- Luglio G
- Lund J
- Lund J
- Lundgren Po
- Luque Gb
- Luque L
- Luque L
- Lytras D
- Lytras D
- Má
- Mé
- Mü
- Mañ
- Ma J
- Mabitsela Me
- Mabrouk M
- Macchiavello R
- Macchitella Y
- Macchitella Y
- Macdermid E
- Macdonald A
- Macdonald E
- Macdonald L
- Maceviciute K
- Macfarlane A
- Machaca M
- Maciejec L
- Madiba T
- Madkor Mh
- Maffioli A
- Maffioli A
- Magdy A
- Magdy B
- Magdy E
- Magdy H
- Magdy M
- Magdy S
- Magee C
- Maghrabi A
- Maghrabi Aa
- Magri D
- Mahamood Ab
- Mahanty S
- Maharaj G
- Mahdi A
- Mahdi S
- Mahdi S
- Maher Me
- Mahmoud B
- Mahmoud H
- Mahmoud M
- Mahmoud Ma
- Mahmoud Mi
- Mahmoud S
- Mahmoud Sme
- Mahmud K
- Maillot B
- Maimbo M
- Maimbo M
- Mairs Ng
- Maison K
- Maistry N
- Majauskyté
- Majbar A
- Majid Ahha
- Majid K
- Major Cp
- Major P
- Major P
- Mak T
- Mak T
- Makama J
- Makinde M
- Makupe A
- Malavenda M
- Malik K
- Malik P
- Malik Ta
- Mamdouh E
- Mamdouh R
- Manatakis Dk
- Manfreda S
- Mangan C
- Mangan C
- Mangiapane M
- Manipal Ce
- Maniscalco A
- Mann T
- Mannu Gs
- Manriquez-Reyes M
- Mansor Ey
- Mansour B
- Mansour S
- Mansuri A
- Mao P
- Mapasse D
- Maple N
- Maraie N
- Marey A
- Marey As
- Margaritis M
- Mariani A
- Marinkovic B
- Marinos C
- Marks E
- Marples L
- Marret Jb
- Marshall Dc
- Martian Bv
- Martin A
- Mas R
- Mason C
- Mata Lps
- Matheu A
- Mathew Sw
- Matos-Puig R
- Matta Jjh
- Mattar O
- Matter Sm
- Mauro L
- Mayasari M
- Mazelyte R
- Mazrimas P
- Mazzella A
- Mcaleer E
- Mcaleer S
- Mccarthy K
- Mccarthy M
- Mccarthy M
- McCullagh D
- Mcdonald R
- McGarvie S
- Mcguigan A
- McIntosh K
- Mcintosh R
- Mcintyre Cj
- Mcintyre N
- Mcintyre R
- Mckechnie D
- Mclachlan G
- Mclean Al
- Mclean K
- McMorran D
- Mcnish D
- Mcphee A
- Mealy K
- Mehdi A
- Mehrez S
- Mejia Agv
- Melo R
- Melo R
- Mendel H
- Mendez M
- Mendez N
- Mendizabal Caa
- Mendoza I
- Menegussi J
- Mensah E
- Menshawy A
- Mentula P
- Meqbil J
- Mericliler M
- Merlini D
- Merlini D
- Merlo Ms
- Mesbah N
- Meshref A
- Metwally Mm
- Migliore M
- Miguel Gps
- Mihaljevic Al
- Mihanovic J
- Mihanovic J
- Mijuskovic B
- Mikalauskas S
- Mikalauskas S
- Mikuckyte D
- Mikwar Z
- Milligan W
- Milligan W
- Mingrone P
- Minguez G
- Minocha A
- Minocha A
- Miranda C
- Mircea H
- Mirghani D
- Mironescu A
- Mironescu A
- Mironescu As
- Mironescu As
- Mirza A
- Mirza S
- Mistry A
- Mitrasinovic S
- Mitroudi M
- Mitroudis N
- Mittal A
- Mitul Ar
- Mitul Ar
- Miyasato Hs
- Mizzi C
- Mizzi S
- Mlotshwa M
- Moaty M
- Mochet S
- Modolo Mm
- Modolo Mm
- Modolo Mm
- Moe Tt
- Mogan Yp
- Moghazy Me
- Mohamed A
- Mohamed A
- Mohamed Am
- Mohamed Ar
- Mohamed B
- Mohamed F
- Mohamed I
- Mohamed M
- Mohamed Ma
- Mohamed Maeh
- Mohamed Mm
- Mohamed O
- Mohamed Sr
- Mohameden A
- Mohammad A
- Mohammad A
- Mohammed A
- Mohammed A
- Mohammed Ae
- Mohammed Ar
- Mohammed H
- Mohammed Mm
- Mohammed Mmh
- Mohammed S
- Mohan H
- Mohan M
- Mohan M
- Mok Yt
- Mokhtar A
- Molina G
- Mollo Mc
- Monaghan E
- Monaghan E
- Monrad-Hansen Pw
- Montejo Msg
- Monteleone M
- Monteleone M
- Montes I
- Montes I
- Montrimaite M
- Montrimaite M
- Moodley Y
- Moore R
- Moore R
- Mora Jjv
- Morais Pab
- Morales C
- Moran Aer
- Morandi E
- Moreira G
- Moreno Sc
- Morgan C
- Morgan C
- Morshedy Em
- Morsi A
- Morsi M
- Morton D
- Morton D
- Morton R
- Mosad A
- Mosalum O
- Mostafa Ha
- Mostafa M
- Mostafa M
- Mousa M
- Moussa O
- Moustafa A
- Mouttalib S
- Mowafy B
- Mphatsoe Am
- Mshelbwala P
- Msiska N
- Msosa V
- Msosa V
- Muddebihal U
- Mukin Adf
- Muktar U
- Mukuzunga C
- Muller C
- Muller C
- Munera A
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- Publication venue
- 'Wiley'
- Publication date
- 27/11/2018
- Field of study
Background
End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection.
Methods
This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model.
Results
In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001).
Conclusion
Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
- Author
- A. Mohammed Kalakwa
- A. Nemer Ayoub
- Abantanga Francis A.
- Abatli Safa' Jamal
- Abbas Wisam
- Abbo Olivier
- Abdelbaqi Reem
- Abdelhady Dina Sobhy
- Abdelhafez Mohammad Omar Mohammad
- Abdelhamid Sultan S.
- Abdelmaksoud Sherif
- Abdelmoumen Roua
- Abdelmutalib Fakereldeen
- Abdul-Mumin Alhassan
- Abduljawad Fatima Mousa
- Abdullah Fizan
- Abdullah Mohd Yusof bin
- Abdulraheem Nurudeen
- Abdulrahman Alaa
- Abdulsalam Moruf Adekunle
- Abdunomonovich Dekhkonboev Avazjon
- Aboelela Ahmed
- Abouheba Mohamed
- Abrahamsson Kate
- Abrunhosa Matias Marcia
- Abu-Nejmah Fawzi
- Abuajaila Abdulsalam
- Abuattaya Adham Ashraf
- Abubakar Auwal M
- Abueideh Ahmad
- Abuhayyeh Husam Aldean
- Abuhlega Ma'aly A.
- Abukhalaf Sadi
- Abumunshar Ali Abdelhay
- Acuna Gaston
- Adams Stephen
- Adamu Sani
- Adanan Mohd Fitri Shukri bin Mohamed
- Adawi Ihda
- Adawi Samer
- Adawy Ahmad
- Ade-Ajayi Niyi
- Adegboyega Rilwan
- Ademuyiwa Adesoji
- Adesanya Opeoluwa
- Adhiwidjaja Cathline Freya
- Adofo-Ansong Nana
- Agboola Titiloye Hannah
- Agelebe Efeturi
- Aguilar Aguilar Faye
- Aguilar Gargurevich Prince Pamela
- Aguirre-Lopez Pastor
- Agulham Miguel Angelo
- Ahmad Hira
- Ahmad Zahidah Adlynee Haji
- Ahmed Hazem
- Ahmed Mahmoud Abdelfattah
- Ajai Olalekan Temitope
- Ajao Emmanuel Akinlabi
- Ajiboye Olalekan S.
- Ajrami Yara
- Ajwa Ahmad Elian Abu
- Akan M. Eren
- Akhbari Melika
- Akhter Nadeem
- Akova Fatih
- Al-Attar Hala M.
- Al-Halbouni Layana
- Al-Mamun Abdullah
- Al-Mayoof Ali Farooq
- Al-Momani Hashem M.
- Al-Mouakeh Ahmad
- Al-Rayyes Maisara
- Al-saleem Hasan Subhi Hasan Abu
- Al-Salhi Ashraf Ayman
- Al-Shwaikh Samar H.
- Al-Slaibi Ibrahim
- Al-Taher Raed Nael
- Al-Taher Raed Nael
- Al-Tammam Hiba
- Alakaloko Felix
- Alamrain Abdulwhhab Ayman Abu
- Alanguia Chipana Cathy Lee
- Alattas Khalid
- Alberto Carlos
- Albozidi Aya
- Alcántara Elvyn
- ALDIRAWI MOHAMMED A. M.
- Alebbini Mohanad Mutasem
- Alfoghi Mabroka
- Algabri Hayder Nadhim Obaid
- Alglaib Mohammed Meftah
- Alhamid Ahmad
- Alhamid Aos
- Alhassan Priscilla
- Ali Hassan
- Ali Karim Osamy
- Ali Liza
- Ali Mansour
- Alijla Sharif
- Alijla Sharif S.
- Aliwisat Ahmad Hasan
- Aljaboo Hajir
- Aljadidi Wesal Omar F. Saied
- Aljarad Ziad
- Alkareem Raghad mohammad abdu
- Almada Suad Ahmed
- Almadhoun Walaa
- Almasri Murad
- Almeida Aguiar Arthur
- Almeida Giovana
- Almengar Inas
- Almohamady Hisham
- Almosaibli Mohammad
- Almusleh Tasneem Fathi Hasan
- Alnaeri Ali
- Alnahhal Khaled
- Alonso Verónica
- Alosta Hasan Mustafa
- Alqarajeh Firas
- Alqor Mohammad Omar Ibrahim
- Alsaadi Nijmeh Nasser
- Alsaggaf Ameen
- Alsaied Amer
- Alser Mohammed
- Alser Osaid H.
- Alshaikhkhalil Haya Abdulnasser Ali
- Alshehri Abdullah
- Altaweel Ahmed
- Altın Merve
- Altokhais Tariq
- Altomi Mohamed
- Alturki Fahad
- Alvarado Zelada Jackelyne
- Alves Dutra da Silva Érika
- Alwadia Soha Marwan Salem
- Alwaggaa Nouriyah Ali
- Alzamari Ainaa Ata Mohammad
- Alzate Gallego Edgar
- Alzeer Asmahan Mohammad Suliman
- Alzerei Sulaiman T.
- Alzraikat Sayel H.
- Alzubair Afnan
- Alzughayyar Tareq Z.
- Amad Mohamed
- Amado Fernando
- Amaechi Chukwubinyelum
- Amah Christopher Chim
- Amarin Justin Z.
- Amarin Marzouq
- Ambriz-González Gabriela
- Ameh Emmanuel
- Amjad Muhammad Bin
- Amoabin Afua Amoabin
- Anatole Nzanzu
- Anatole Nzanzu Kipata
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- Anaya Firas
- Andrade Jerhy
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- Anicama Elias Rocio
- Annajjar Mohammad hasan
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- Antunez-Mora Alexandra
- Anyomih Theophilus Teddy Kojo
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- Arar Ahmad Samih
- Arauco Jenny
- Arbab Hana
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- Arnaud Alexis P
- Arnold Marion
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- Arrmali Saddam
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- Assi Muath Abdelrahem Fuad
- Astudillo Miguel
- Atatri Yazid yousef mahmoud
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- Bamanga Ahmed
- Baniowda Muath A. M.
- Bao Xiaozhou
- Barauskas Vidmantas
- Barbosa Patricia Reis
- Baseggio Natalia
- Bashir Fatma
- Bashir Muhammad Kashif
- Bassan Gonçalves Paulo César
- Bataineh Ziad A.
- Batal Mohammad Mohannad
- Bazozi Hana Milad
- Beasley Spencer
- Becker Karin
- Belmino Gadelha Aluísio Augusto
- Benaskeur Yousra-Imane
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- Bernaus Marianela
- Berrocal Anaya Waldo
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- Brunero Marco
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- Bujarimin Ahmad Shafiee bin
- Bulnes Mendizabal David
- Burks Stephen S.
- Burns Kate
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- Bvulani Bruce
- C. Nwosu David
- Caamal Lorenzo Juvencio
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- Chung Jae Hee
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- Czauderna Piotr
- Cáceres Aucatoma Freud
- Cárdenas Barón José de Jesús
- Cömert Hatice Sonay Yalçın
- da Silva Augusto Maria Lucia
- Dagilytė Rūta
- Dahman Nesrine Ben Hadj
- Dajia Wang
- Dalek Noor Fa'izatul Rahil Ambok
- Dallegre Maria Belen
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- Darwish Ahmed S
- Darwish Ammar
- Dass Anthony
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- de Assis Silva Murilo
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- de Deus Passos Leles Kamila
- de Guzman Johann
- de Souza Santos Ferreira Mariana
- Dedeke Florence
- Defago Victor Hugo
- Defert Coralie
- Delefortrie Thomas
- Delforge Xavier
- Delft Dirk von
- Delgado Malaga Florangel Patricia
- Delgado Quinteros Edgar Fernando
- Dellenmark Blom Michaela
- Dendusic Nejra
- Derbew Miliard
- Derks Terry
- Deya Corazone
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- Di Siervi Oscar
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- Diaz Gomez Jose Manuel
- Diaz Leon Cesar
- Dieudonné Lemfuka
- Dimatatac Doris Mae
- Djordjevic Ivona
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- Dominguez Danny
- Donglai Hu
- Dornellas do Nascimento Suely
- dos Santos Dias André Iván Bradley
- Dosselman Luke J.
- Douiri Abdel
- Drah Weam
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- Duggan Eileen
- Duote Cai
- Dure Carolina
- Dávila Perez Roberto
- Ebeido Annan
- Egbuchulem Ifeanyichukwu Kelvin
- Ejinkeonye Eze Chukwuemeka
- Ekenze Sebastian Okwuchukwu
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- El-Ghazaly Mohammed
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- Martins Bianca M. R.
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- Massry Nasrallah Ashraf Al
- Matour Bashar M.
- Mayaleh Abdelrazzaq Abu
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- Mbonisweni Akhona
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- Mercado Pedro
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- Millán Carolina
- Miriam Ann
- Mironescu Aurel
- Mirza Muhammad Bilal
- Misk Rami Anwar
- Mitul Ashrarur
- Mitul Ashrarur Rahman
- Modekwe Victor
- Modi Varun
- Mohammad Mohammad Aminu
- Mohammed Abobaker
- Mohammed Azhar Arabi
- Mohammed Hanan Mahmoud
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- Saad Mahmoud M.
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- Sharabati Mutassem
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- Sharif Randa Alamen M
- Shaw Kenneth
- Shehada Mohammed
- Shehu Ibrahim
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- Sherzad Ajmal
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- Sidler Daniel
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- Tobor Szymon
- Toczewski Krystian
- Tom Alan
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- Trainba Sara
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- Tumi Mohamed
- Tuyishime Eugene
- Türkyılmaz Canan
- Türkyılmaz Zafer
- Ubhi Harmony
- Ugwu Jideofor O
- Ugwunne Chuka A
- Ulasi Ikechukwu
- Ullrich Sarah
- Vacek Jonathan
- Vaitkiene Agota
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- Valeria Pelussi
- Valerio-Vazquez Rafael
- Vanis Nedim
- Vaquila Justo
- Varela Maria Florencia
- Vasquez Matos Juan Pedro
- Vatta Fabrizio
- Vega Centen Stephany
- Velaña Junior
- Vellusamy V Muthualhagi M
- Venant Ntakarutimana
- Venkatraman Soundappan Sannappa
- Verdeata Roxana
- Verduga Ivan
- Verduga Leonardo
- Vergara Carolina
- Verkauskas Gilvydas
- Veronica Sofficci
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- Vianney Butoyi Jean Marie
- Vida Lucian
- Vidal Cristian R. Zalles
- Vierboom Liam
- Villalba Villalba Araceli
- Villegas Silva Raúl
- Vinskaite Asta
- Vos Corné de
- Vosoughi Armin
- Wafa Tamer
- Walker Gregor
- Wang Jinhu
- Wang Peng
- Waseem Basma
- Weeratunga Naveen
- Weiszewsk Alicja
- Wen Gang
- Werneck Raposo Juliana
- Wester Tomas
- Wijekoon Naveen
- Wilke Alexandra
- Williams Isabelle
- Williams Omolara
- Williams Regan
- Win Win Sabai Phyu
- Wishah Bisan D. M.
- Wishah Nidal
- Wissanji Hussein
- Wolak Przemyslaw
- Wolny Agnieszka
- Wong Janice
- Wong Marilyn
- Wright Naomi Jane
- Wu Guowei
- Wyrzykowski Dariusz
- Xiaodong Guo
- Xie Hua
- Yacoub Mina A.
- Yaghi Bashar
- Yaghi Dua Hasan
- Yalcinkaya Ali
- Yang Hee-Beom
- Yanis Ahmad H.
- Yanowsky Reyes Guillermo
- Yao Yang
- Yapo Benjamin
- Yarza Fernández Jessica
- Yeniay Aslı Öztürk
- Yola Mariya Mukhtar
- Yong Feng
- Youn Joong Kee
- Yousuf Hina
- Yu Mengnan
- Yu Raisa
- Yuen Quah Soong
- Yuldashev Rustam Z.
- Yunus Aayenah
- Za'nouneh Faris J. Abu
- Zaghlol Louay Y.
- Zahari Dato' Dr Zakaria bin
- Zain Mostafa
- Zaman Azrina SK
- Zanellato Josiane Bernartt
- Zarwawi Ahmad Zulhisyam bin
- Zea-Salazar Luis Enrique
- Zeinelabdeen Ali
- Zhao Xiaoxia
- Zhu Jianming
- Zhu Libin
- Zidan Mazen
- Zivanovic Dragoljub
- Zottis Barcelos Fabricio
- Zreeg Dafer abdulhakim . S.
- Zurikat Rajai O.
- Zvizdic Nada
- Zvizdic Zlatan
- Çekiç Bahanur
- Çelik Müge
- Özçelik Zerrin
- Şeref Kıvanç
- Šafus Antonín
- Škvařil Jan
- Štichhauer Radek
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2021
- Field of study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Global economic burden of unmet surgical need for appendicitis
- Author
- A A Essam
- Abd El-Rahman Hegazy Khedr
- Abd Elkhalek Sallam
- Abd Elrahman Elshafay
- Abdalla Gamal Saad
- Abdalla Gharib
- Abdalla Kenibar
- Abdallah Salah Elsherbiny
- Abdalrahman Adel
- Abdelaziz Abdelaal
- Abdelaziz Osman Abdelaziz Elhendawy
- Abdelfatah Hussein
- Abdelkader Belkouchi
- Abdelmalek Hrora
- Abdelrahman Adelshone
- Abdelrahman Alkammash
- Abdelrahman Assal
- Abdelrahman Geuoshy
- Abdelrahman Haroun
- Abdelrahman Mohammed
- Abdelrahman Sayed
- Abdelrahman Soliman
- Abdelrhman Essam Elnemr
- Abdelrhman Kz Darwish
- Abdelrhman Osama Elsebaaye
- Abdul Khalique
- Abdul Rehman Alvi
- Abdul Wahid Anwar
- Abdulaziz Altwijri
- Abdullah Al-Mallah
- Abdullah Almoflihi
- Abdullah Altamimi
- Abdullah Daqeeq
- Abdullah Dwydar
- Abdullah Gouda
- Abdullah Hashim
- Abdulmalik Altaf
- Abdulmalik Huwait
- Abdulrahman Abdel-Aty
- Abdulrahman M Altwigry
- Abdulrahman Sheshe
- Abdulrasheed A Nasir
- AbdulRazzaq Oluwagbemiga Lawal
- Abdulshafi Khaled Abdrabou
- Abdurrahaman Sheshe
- Abdussemiu Abdurrazzaaq
- Abebe Bekele Zerihun
- Abeer Al-Shammari
- Abeer El Gendy
- Abeer Esam
- Abeer Marey
- Abhishek Mittal
- Abiboye Yifieyeh
- Abid Bin Mahamood
- Abidemi Adesuyi
- Abouelatta Khairy Aly
- Abrar Nawawi
- Adam Gyedu
- Ade Waterman
- Adedapo Osinowo
- Adedeji Fatuga
- Adel Albiety
- Adel B Hassanein
- Adel Denewar
- Adeleke Adekoya
- Ademola Adebanjo
- Ademola Adeyeye
- Ademola Popoola
- Adesina Adedeji
- Adesoji O Ademuyiwa
- Adesoji Tade
- Adewale Adeniyi
- Adewale O Adisa
- Adham Tarek
- Adomas Ladukas
- Adrian F Palma
- Afifatun Hasanah
- Afizah Salleh
- Afnan Abdelfatah
- Afnan Altamimi
- Afnan Altamini
- Agazi Fitsum
- Agboola Taiwo
- Ahamed Hassan
- Ahed Ghaben
- Ahmad Abdel Fattah
- Ahmad Abdel Razaq Al Rafati
- Ahmad Aboelkassem Ibrahem
- Ahmad Aldalaq
- Ahmad Ali
- Ahmad Almallah
- Ahmad Alrifaie
- Ahmad Ashour
- Ahmad Bakr
- Ahmad Bani-Sadar
- Ahmad Bin Adnan
- Ahmad Elbatahgy
- Ahmad Faraz
- Ahmad Gudal
- Ahmad Hasan
- Ahmad Khaled Sabe
- Ahmad Khoja
- Ahmad Nashaat
- Ahmad Qaissieh
- Ahmad Sabe
- Ahmad Saber Sleem
- Ahmad Sakr
- Ahmad Shalabi
- Ahmad Uzair Qureshi
- Ahmed Aamer
- Ahmed Abd El Galeel
- Ahmed Abd Elmoen Elhusseiny
- Ahmed Abd Elsameea
- Ahmed Abdelkareem
- Ahmed Abdelmotaleb Ghazy
- Ahmed Abo El Magd
- Ahmed Abo Elazayem
- Ahmed Adamu
- Ahmed Adel
- Ahmed Afandy
- Ahmed Ahmed
- Ahmed Al-Khatib
- Ahmed Alghamdi
- Ahmed Ali
- Ahmed Altibi
- Ahmed Alzahrani
- Ahmed Ata
- Ahmed Badr
- Ahmed Dahy
- Ahmed Diab
- Ahmed El Kashash
- Ahmed El Kholy
- Ahmed El-Sehily
- Ahmed Elgaili Khalid Musa
- Ahmed Elgebaly
- Ahmed Elkelany
- Ahmed Elkholy
- Ahmed Essam
- Ahmed Fahiem
- Ahmed Farag
- Ahmed Fawzy
- Ahmed Fouad
- Ahmed Gad
- Ahmed Ghanem
- Ahmed Gheith
- Ahmed Gomaa
- Ahmed Hafez El-Badri Kotb
- Ahmed Hammad
- Ahmed Hassan
- Ahmed Hossam Eldin Fouad Rida
- Ahmed Ismail
- Ahmed Karim
- Ahmed Khyrallh
- Ahmed Lasheen
- Ahmed M Rashed
- Ahmed Magdy
- Ahmed Mahmoud Abdelraouf
- Ahmed Menshawy
- Ahmed Meshref
- Ahmed Mohamed Afifi
- Ahmed Mohamed Ibrahim
- Ahmed Mohameden
- Ahmed Mohammed
- Ahmed Mokhtar
- Ahmed Mosad
- Ahmed Moustafa
- Ahmed Moustafa Saeed
- Ahmed Negida
- Ahmed Rabeih Mohammed
- Ahmed Rabie Mohamed
- Ahmed Ragab Nayel
- Ahmed Ragab Soliman
- Ahmed Raslan
- Ahmed Raza
- Ahmed Refaat
- Ahmed Rslan
- Ahmed Sabry
- Ahmed Sabry El-Hamouly
- Ahmed Safwan Marey
- Ahmed Saidbadr
- Ahmed Sakr
- Ahmed Samir
- Ahmed Shahine
- Ahmed Sheta
- Ahmed Soliman
- Ahmed Tammam
- Ahmed Tarek Abdelbaset Hassan
- Ahmed W Shamsedine
- Ahmed Zaki
- Ahmed Zaki Eldeeb
- Ahmed Zohair
- Ahmedali M Kandil
- Ahmedglal Elnagar
- Ahsan Zil-E-Ali
- Aijaz Jabbar
- Ailsa Claire Snaith
- Ainhoa Costas-Chavarri
- Aiste Austraite
- Ajayesh Mistry
- Akin Olaolorun
- Akinlabi E Ajao
- Al Faifi Jubran
- Ala Shamasneh
- Alaa Abouelnasr
- Alaa Al-Buhaisi
- Alaa Bowabsak
- Alaa El Jamassi
- Alaa Elazab
- Alaa Elhadad
- Alaa Fergany
- Alaa Habeebullah
- Alaa Hassan
- Alaa Shabkah
- Alaa Shaheen
- Alaba Adesina
- Alan Baird
- Alan Grant
- Alasdair Ball
- Alban Cacurri
- Albert Mohale Mphatsoe
- Alberto Realis Luc
- Alejandro Matheu
- Alejandro Munera
- Alemayehu Ginbo Bedada
- Alessandro Favero
- Alessio Maniscalco
- Alexander Canta Calua
- Alexander J Fowler
- Alexandra Gerosa
- Alexandre Horobjowsky
- Alexandre Venancio De Sousa
- Alexia Farrugia
- Alexis Pierre Arnaud
- Alfio Alessandro Russo
- Alfredo Gulielmi
- Ali Ababneh
- Ali Abo El Dahab
- Ali Amin Ahmed Ata
- Ali Khan Niazi
- Ali Kiasat
- Ali Mohamed Hammad
- Ali Zardab
- Ali Zeynel Abidin Balkan
- Aliaa Gamal Toeema
- Aliaa Sadek
- Aliaksandr Filatau
- Aliang Latif
- Alibeth Andres Baquero Suarez
- Alice Faure
- Alice Niragire
- Alina Robledo-Rabanal
- Aline Broch
- Alireza Hasheminia
- Alisdair Macdonald
- Aliyu Ndajiwo
- Allan Novak
- Alphonse Zeta Mutabazi
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- Silje Holte
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- Silvia Boni
- Silvia De Franciscis
- Simon George Gosling
- Simon Gosling
- Simon Ng
- Simon Stock
- Simona Juciute
- Simona Kasputyte
- Simone Conci
- Simone Sandler
- Simone Targa
- Sir Young Yam
- Siti Mohd Desa Asilah
- Siti Nur Alia Kamarulzamil
- Sivasuriya Sivaganesh
- Siyaka Itopa Suleiman
- Siyi Chung
- Soaad Elsobky
- Sofia Mouttalib
- Soha Abushamleh
- Sohaila Elmihy
- Soliman Magdy Ahmed
- Sondos Turkustani
- Sophian Hmila
- South Africa
- Srinivas Pai
- Sriram Bhat
- Stassen Paul
- Stavros Parasyris
- Stefan Botes
- Stefan Breitenstein
- Stefan Zammit
- Stefano Berti
- Stefano Cucumazzo
- Stefano M M Basso
- Stefano Roncali
- Stella Binna Kim
- Sten Saar
- Stephanie Hiu-Wai Kwok
- Stephanie Van Straten
- Stephen Dias
- Stephen J Chapman
- Stephen Kache
- Stephen Mcaleer
- Stephen R Knight
- Stephen Tabiri
- Steponas Petrikenas
- Stuart J Fergusson
- Styliani Parpoudi
- Stylianos Germanos
- Sudipta Roy
- Sukrit Suresh
- Sule Burger
- Suleiman Baba
- Sultan Almuallem
- Sung-Hee Kim
- Sunil Kumar
- Suparna Das
- Suraya Bahar
- Susan Aviles
- Susan Limache
- Susan Wndy Mathew
- Susana Yrma Aranzabal Durand
- Svetlana Doris Brincat
- Swantje Kruspi
- Swapnil Roy
- Syed Abdul Wahhab Eusoffee Wan Ali
- Syed Altaf Naqvi
- Syed Asaat Ul Razi
- Sylvia Batista Lemaire
- Sylvie Mochet
- Syrine Rekhis
- T Ariani Widiastini
- Tagang Ebogo Ngwa
- Taha Yusufali
- Taher Al-Taher
- Tahir Muhammad Yaseen
- Tahir Yaseen
- Tahira Naqvi
- Taiwo Akeem Lawal
- Taiwo Lawal
- Tan Arulampalam
- Tanzeela Gala
- Tapan Kumar
- Tara Grima
- Tarek Ezzat
- Tarek Razek
- Tasneem Idress
- Tasnia Hamid Kanta
- Tatsiana Shachykava
- Taufiq Khan
- Tebian Hassanein Ahmed Ali
- Tessa Fautz
- Tewodros Worku
- Thamer Nouh
- Thays Brunelli Pugliesi
- Thea Dimech
- Thelma Tembo
- Thelma Xerri
- Theodore Pezas
- Theodosios Theodosopoulos
- Thiago Fernandes Giuriato
- Thierry Alihonou
- Thomas Feidantsis
- Thomas Fozard
- Thomas G Weiser
- Thomas M Drake
- Thomas Olagboyega Olajide
- Thomas Pinkney
- Thomas Prudhomme
- Thomas Sherman
- Thomas Tetens Moe
- Thuraya Alzayat
- Thusitha Sampath Hettiarachchi
- Tien Seng Bryan Lee
- Timothy White
- Tina Gaarder
- Tobias Schuetz
- Todisoa Emmanuella Christina Tolotra
- Tolg Cecilia
- Tom Am Malik
- Tom Arthur
- Tom Falconer Hall
- Tomas Abaliksta
- Tomas Jankus
- Tomas Poškus
- Tommaso Bocchetti
- Tommaso Campagnaro
- Tommaso Fontana
- Tony Mak
- Toqa Khafagy
- Torhild Veen
- Trude Beate Wold
- Tsz-Yan Katie Chan
- Tuan Nur'Azmah Tuan Mat
- Tunde Sholadoye
- Twc Mak
- Tyler Rouse
- Tzu-Ling Chen
- Uday Muddebihal
- Ufuk Karabacak
- Ulf Gunnarsson
- Ulf Gustafsson
- Umar Muktar
- Umberto Tedeschi
- Umme Salma
- Usama Hantour
- Uthman Alamoudi
- Valdemaras Jotautas
- Valentine Parent
- Vanessa Dina Palomino Castillo
- Vanessa Msosa
- Vania Guglielmo
- Vania Silvestri
- Vasileios Despotidis
- Vasileios Kalles
- Vasiliki Soulou
- Vassilis Kalles
- Veereanna Shatkar
- Venerand Barendegere
- Veronica Grassi
- Veronica Lazzari
- Vicky Jennings
- Victor Dassah
- Victor Etwire
- Victor Kong
- Victor Manuel Quintero Riaza
- Victor Nwinee
- Victoria K Proctor
- Vijaid Upadhyaya
- Vijay Gadhvi
- Viktorija Ambrozeviciute
- Viktorija Nevieraite
- Ville Sallinen
- Vimalakanthan Thanusan
- Vincas Jonas Banaitis
- Virgilijus Beisa
- Viviana Sollazzo
- Vivien Graffieille
- Vizir Jean Paul Nsengimana
- Vladimir Khokha
- Vollmer Sebastian
- Vu Thanh Hien Le
- Vytautas Gaižauskas
- Vytautas Lipnickas
- Wahid Anwer
- Wai Cheong Soon
- Wai Him Lam
- Wairimu Ndegwa
- Waleed Thabet
- Walid Adham
- Walter Forno
- Walter Ruiz Panez
- Wan Nurul 'Ain Wan Mohd Nasir
- Wanigasekara Senanayake Mudiyanselage Kithsiri Janakantha Senanayake
- Ward Hamsho
- Wasim Dar
- Wedyan Alhazmi
- Wei Guo
- Weiguang Ho
- Weihei Dao
- Wendy Leslie Messa Aguilar
- Wennweoi Goh
- Wifanto Saditya Jeo
- Wilfredo Pino
- William Appeadu-Mensah
- William Beasley
- William Bonney
- William Hutch
- William J Lossius
- William Milligan
- Willy Alcca Ticona
- Wing Sum Li
- Witold Chachulski
- Xavier Delforge
- Xianelle Rodriguez
- Xinwei Low
- Xue Wei Chan
- Ya Theng Neo
- Yacoubou Imorou Souaibou
- Yahaya Ukwenya
- Yahya Salama
- Yaseen Rajjoub
- Yasmein Ibrahim
- Yasmin Abd-Elrasoul
- Yasmin Elfouly
- Yasmin Hegazy
- Yasmin Soliman
- Yasser Abd El Salam
- Yee Wen Tan
- Yehia Zakaria
- Yella Reddy
- Yi Koon Tan
- Yi Ting Mok
- Yih Jeng Cheong
- Yiing Yee Gan
- Yishan Der
- Yogendra Praveen Mogan
- Yomna Allam
- Yomna Hosny Asar
- Yong Yong Tew
- Yousef Abuowda
- Yousra El Shoura
- Ysabel Esthefany Alejos Bermúdez
- Yuk Hong Eric Cheung
- Yuksel Altinel
- Yung Kok Ng
- Yuri Macchitella
- Yves Aigrain
- Yücel Cengiz
- Zaher Mikwar
- Zahra Jaffry
- Zain Ali Khan
- Zainab Iftikhar
- Zaynab M Elsayed
- Zhongtao Zhang
- Zi Hao Sam
- Zigmantas Urniežius
- Zilvinas Dambrauskas
- Zineb Bentounsi
- Zygimantas Tverskis
- Publication venue
- 'Oxford University Press (OUP)'
- 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