3 research outputs found

    Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

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    ¬© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study‚ÄĒa multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3¬∑85 [95% CI 2¬∑58‚Äď5¬∑75]; p<0¬∑0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63¬∑0% vs 82¬∑7%; OR 0¬∑35 [0¬∑23‚Äď0¬∑53]; p<0¬∑0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research

    Factores que influyen en la aparici√≥n de halitosis en ni√Īos

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    Introduction: Halitosis known as a disease that affects oral health causing bad breath, this disease has been observed mostly in children, bringing as a cause poor oral hygiene, cavities, sex and age. Methods: The search was carried out between May 21 to 23, 2022, the databases reviewed were Pubmed, Scopus, Sciencedirect, Ebscohost and Proquest, the studies between 2010 and 2022 were analyzed. To carry out the systematic review, Boolean operators AND and OR were used to achieve a good search. The results were recorded in a PRISMA flowchart. Results: After applying the inclusion and exclusion criteria, 10 investigations were selected and evaluated, only 2 of them being raised for review of the 806. The data of the studies were extracted and ordered according to the details of the study, analysis methodology and results. Conclusion: Halitosis is a generalized condition that shows some social and psychological repercussions, which leads to a decrease in a person's quality of life.Introducci√≥n: La halitosis conocida como una enfermedad que afecta la salud bucal provocando el mal aliento, esta enfermedad se ha logrado observar mayormente en ni√Īos trayendo como causa la mala higiene bucal, las caries, el sexo y edad M√©todos: La b√ļsqueda fue realizada entre del 21 al 23 de mayo del 2022, las bases de datos revisadas fueron Pubmed, Scopus, Sciencedirect, Ebscohost y Proquest, se analiz√≥ los estudios entre el 2010 al 2022. Para efectuar la revisi√≥n sistem√°tica se us√≥ operadores booleanos AND y OR para lograr una buena b√ļsqueda. Los resultados fueron registrados en un diagrama de flujo PRISMA, La evaluaci√≥n de calidad Resultados: Despu√©s de aplicar los criterios de inclusi√≥n y exclusi√≥n, se seleccionaron 10 investigaciones las cuales se evaluaron, eligiendo solo 2 de ellas para su revisi√≥n de las 765.&nbsp; Los datos de los estudios se extrajeron y ordenaron obedeciendo los detalles del estudio, metodolog√≠a del an√°lisis y resultados. Conclusi√≥n: La halitosis es una condici√≥n generalizada que muestra algunas repercusiones sociales y psicol√≥gicas, lo cual conlleva una disminuci√≥n en la calidad de vida de una persona

    Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries