Loneliness among women with rheumatoid arthritis:A cross-cultural study in the Netherlands and Egypt

The objective of this study was to explain loneliness as experienced by women with rheumatoid arthritis (RA) in a cross-cultural context. We studied 36 Egyptian female RA patients and 140 female Dutch RA patients.. Self-report data were collected about loneliness, physical and psychological health status, social support and social network, needs for help, attitudes and feelings of guilt. Loneliness was significantly higher among Egyptian (44.2 ± 32.3) than Dutch (12.9 ± 18.9) female RA patients (F = 54.3, p < 0.001). In Egypt, 36% of the variance of loneliness could be explained by worse affect (anxiety and depression; β = 0.51), fewer children (β = 0.31), and higher negative social support for the patients (β = 0.28) in multiple regression analysis. In the Netherlands, 35% of feeling lonely could be explained by worse affect scores (β = 0.52), less positive social support for the patients (β = 0.24), and a higher degree of disability (β = 0.21). Age of the patients and disease duration only explained 4% and 3% of the loneliness of RA patients in Egypt and the Netherlands, respectively. Female Egyptian RA patients experienced more loneliness than Dutch patients. Affect is the most important and constant variable in explaining loneliness in both countries. The role of the family in perceived loneliness is greater in Egypt than the Netherlands. Low social support received by patients is important in explaining loneliness in the Netherlands but not in Egypt

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

Background 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-a 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 2.58-5.75]; p&lt;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 [0.23-0.53]; p&lt;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

Helicobacter pylori inversely related to clinical and functional severity of adult asthma

Background: Helicobacter pylori (H. pylori) are identified as one of the maximum inducing persistent bacterial infection; about 50% of populations were infected. Many studies detected that H. pylori have the ability for affecting extra-intestinal organs like respiratory system. Aim of the study.: is to detect the possible relationship between clinical and functional severity of bronchial asthma and H. pylori infection for better controlling of the disease. Patients and methods: A cross sectional Study carried out at the outpatient clinic of chest department, Zagazig University Hospitals, during the period from February 2015 to December 2015. One hundred and twenty asthmatic patients were selected randomly from bronchial asthma patients attended to outpatient clinic. They were agreed to do spirometry and H. pylori tests. They were (91 females) with mean age ± SD (36.96 ± 5.09) years and (29 males) with mean age ± SD (38.86 ± 4.29) years & with age range from (26–44) years. Results: The more degree of severity of bronchial asthma, the less +ve H. pylori cases, with a highly statistically significant difference between +ve and –ve H. pylori as regard severity of bronchial asthma. There was very highly statistically significant difference between mild, moderate, severe persistent asthma as regard H. plylori IgG. (P value < 0.001). Mild asthma were most +ve H. pylori (58.3%), while moderate and severe cases were (31.3%) and (10.4%) respectively. Conclusion: H. pylori infection was infrequently associated in asthmatic patients and has a prominent inverse relationship with severity of bronchial asthma and better control of the disease