25 research outputs found
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.
- Author
- Abantanga F
- Abbas M
- Abbo O
- Abd El Galeel A
- Abd El Hameed OS
- Abd El Hamid N
- Abd El Salam Y
- Abd El Slam M
- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elrasoul Y
- Abdallah E
- Abdel-Wahab NYE
- AbdelFattah I
- Abdelgelil A
- Abdelghany S
- Abdelkader M
- Abdelkareem A
- Abdelraheim M
- Abdelshafy M
- Abdulgawad M
- Abdullah AAN
- Abdullah NAN
- Abebe NS
- Abebe NS
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- Abington E
- Aboarab A
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- Aboraya M
- Abouelnasr A
- Abouzahra A
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- Abozeid K
- Abozyed MAF
- Abudeeb H
- Abuseif M
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- Aguilera M
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- Aledrisy M
- Alfarsi MA
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- Youssef D
- Youssef H
- Youssif JH
- Zachariades D-C
- Zakir M
- Zalabia MF
- Zamarin K
- Zani A
- Zanini N
- Zapata Ponze De Leon M
- Zapata Ponze De Leon M
- Zardab A
- Zegarra S
- Zeidan S
- Zelada Alvarez II
- Zerihun AB
- Zhang Z
- Zheng F
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- Zilinskiene R
- Zimmermann EF
- Zuber M
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2018
- Field of study
BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial
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- Zuniga JDH
- Zurakowski A
- Zuran I
- Zweiker R
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2019
- Field of study
Aims The third Universal Definition of Myocardial Infarction (MI) Task Force classified MIs into five types: Type 1, spontaneous; Type 2, related to oxygen supply/demand imbalance; Type 3, fatal without ascertainment of cardiac biomarkers; Type 4, related to percutaneous coronary intervention; and Type 5, related to coronary artery bypass surgery. Low-density lipoprotein cholesterol (LDL-C) reduction with statins and proprotein convertase subtilisin–kexin Type 9 (PCSK9) inhibitors reduces risk of MI, but less is known about effects on types of MI. ODYSSEY OUTCOMES compared the PCSK9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome (ACS) and elevated LDL-C (≥1.8 mmol/L) despite intensive statin therapy. In a pre-specified analysis, we assessed the effects of alirocumab on types of MI. Methods and results Median follow-up was 2.8 years. Myocardial infarction types were prospectively adjudicated and classified. Of 1860 total MIs, 1223 (65.8%) were adjudicated as Type 1, 386 (20.8%) as Type 2, and 244 (13.1%) as Type 4. Few events were Type 3 (n = 2) or Type 5 (n = 5). Alirocumab reduced first MIs [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.77–0.95; P = 0.003], with reductions in both Type 1 (HR 0.87, 95% CI 0.77–0.99; P = 0.032) and Type 2 (0.77, 0.61–0.97; P = 0.025), but not Type 4 MI. Conclusion After ACS, alirocumab added to intensive statin therapy favourably impacted on Type 1 and 2 MIs. The data indicate for the first time that a lipid-lowering therapy can attenuate the risk of Type 2 MI. Low-density lipoprotein cholesterol reduction below levels achievable with statins is an effective preventive strategy for both MI types.For complete list of authors see http://dx.doi.org/10.1093/eurheartj/ehz299</p
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
- Author
- Aahlin EK
- Aamer A
- Aaniana K
- Ababneh A
- Abaliksta T
- Abantanga F
- Abantanga F
- Abbas A
- Abbas M
- Abbasy J
- Abbo O
- Abbo O
- Abbott T
- Abbouch M
- Abd El Galeel A
- Abd El Hameed OS
- Abd El Hamid N
- Abd El Salam Y
- Abd El Slam M
- Abd El-Salam F
- Abd Elrasoul Y
- Abd-Elmawla M
- Abd-Elrasoul Y
- Abdallah E
- Abdallah E
- Abdel-Aty A
- Abdel-Hameed N
- Abdel-Kader SM
- Abdel-Wahab NYE
- Abdelaal A
- Abdelaty M
- Abdelazeam AR
- Abdelazim G
- Abdelaziz MA
- Abdelbadeai K
- Abdelfatah A
- AbdelFattah I
- Abdelgelil A
- Abdelghany S
- Abdelhady S
- Abdelhamed R
- Abdelhamid A
- Abdelhaq A
- Abdelkader M
- Abdelkader M
- Abdelkader O
- Abdelkareem A
- Abdelkhalek M
- Abdelmageed E
- Abdelmotaleb I
- Abdelraheim M
- Abdelraouf AM
- Abdelrouf DM
- Abdelshafy M
- Abdelshakour M
- Abdrabou AK
- Abdul-Latif S
- Abdulaziz H
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- Abdulhakeem EM
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- Abdurrazzaaq A
- Abebe NS
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- Abem OE
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- Kiudelis M
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- Klappenbach R
- Knight S
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- Koay KL
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- Komolafe O
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- Kong C
- Kong SN
- Kong V
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- Konstantina K
- Kontos M
- Kordorwu HEK
- Korkolis D
- Kosai NR
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- Kose E
- Koskenvuo L
- Kostov E
- Kotb AHE-B
- Kotecha D
- Koto MZ
- Kotobi H
- Koumpa F
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- Law JH
- Lawal A
- Lawal AO
- Lawal T
- Lawal TA
- Lawani I
- Lawther R
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- Lim G
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- Machaca M
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- Madrid Barrientos LA
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- Mirza A
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- Mohamed B
- Mohamed F
- Mohamed I
- Mohamed M
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- Mohamed MAEH
- Mohamed MM
- Mohamed O
- Mohamed SR
- Mohameden A
- Mohammad A
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- Mohammed A
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- Montoya Botero JA
- Montrimaite M
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- Mosalum O
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- Nevieraite V
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- Nwabuoku E
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- Palomino Castillo VD
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- Papaskarlatos I-A
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- Qureshi AU
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- Samaraweera DI
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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
Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial
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- Zurakowski A
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- Zweiker R
- Publication venue
- 'Ovid Technologies (Wolters Kluwer Health)'
- Publication date
- 04/01/2019
- Field of study
Background: Previous trials of PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitors demonstrated reductions in major adverse cardiovascular events, but not death. We assessed the effects of alirocumab on death after index acute coronary syndrome. Methods: ODYSSEY OUTCOMES (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) was a double-blind, randomized comparison of alirocumab or placebo in 18 924 patients who had an ACS 1 to 12 months previously and elevated atherogenic lipoproteins despite intensive statin therapy. Alirocumab dose was blindly titrated to target achieved low-density lipoprotein cholesterol (LDL-C) between 25 and 50 mg/dL. We examined the effects of treatment on all-cause death and its components, cardiovascular and noncardiovascular death, with log-rank testing. Joint semiparametric models tested associations between nonfatal cardiovascular events and cardiovascular or noncardiovascular death. Results: Median follow-up was 2.8 years. Death occurred in 334 (3.5%) and 392 (4.1%) patients, respectively, in the alirocumab and placebo groups (hazard ratio [HR], 0.85; 95% CI, 0.73 to 0.98; P=0.03, nominal P value). This resulted from nonsignificantly fewer cardiovascular (240 [2.5%] vs 271 [2.9%]; HR, 0.88; 95% CI, 0.74 to 1.05; P=0.15) and noncardiovascular (94 [1.0%] vs 121 [1.3%]; HR, 0.77; 95% CI, 0.59 to 1.01; P=0.06) deaths with alirocumab. In a prespecified analysis of 8242 patients eligible for ≥3 years follow-up, alirocumab reduced death (HR, 0.78; 95% CI, 0.65 to 0.94; P=0.01). Patients with nonfatal cardiovascular events were at increased risk for cardiovascular and noncardiovascular deaths (P<0.0001 for the associations). Alirocumab reduced total nonfatal cardiovascular events (P<0.001) and thereby may have attenuated the number of cardiovascular and noncardiovascular deaths. A post hoc analysis found that, compared to patients with lower LDL-C, patients with baseline LDL-C ≥100 mg/dL (2.59 mmol/L) had a greater absolute risk of death and a larger mortality benefit from alirocumab (HR, 0.71; 95% CI, 0.56 to 0.90; Pinteraction=0.007). In the alirocumab group, all-cause death declined wit h achieved LDL-C at 4 months of treatment, to a level of approximately 30 mg/dL (adjusted P=0.017 for linear trend). Conclusions: Alirocumab added to intensive statin therapy has the potential to reduce death after acute coronary syndrome, particularly if treatment is maintained for ≥3 years, if baseline LDL-C is ≥100 mg/dL, or if achieved LDL-C is low. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01663402
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
- Author
- Abbas Sh
- Abbas Sh
- Abbassi Oa
- Abbott T
- Abdelgadir Am
- Abdelrahman A
- Abdelrahman M
- Abdelrahman M
- Abdelwahed A
- Abellan M
- Abellán Am
- Abellán Am
- Abulafi M
- Acharya A
- Acosta A
- Adam Me
- Adams Re
- Adegbola So
- Adegbola So
- Adimonye A
- Adnan M
- Afshar S
- Agresta F
- Agua Ia
- Aguayo Jl
- Agudo Ar
- Ahad A
- Ahel J
- Ahern Dp
- Ahmad A
- Ahmed B
- Ahmed G
- Ahmed Os
- Ahmed Os
- Ahmed S
- Ainsworth P
- Ais G
- Ais G
- Aisoni F
- Akbari K
- Akhtar K
- Akinsola O
- Akram F
- Al-Faham Z
- Al-Khafaji N
- Al-Khyatt W
- Al-Musawi S
- Al-Sarireh B
- Al-Sheikh M
- Alagna V
- Alani M
- Alberca-Paramo A
- Aldrey I
- Alexander R
- Alhammali T
- Alhammali T
- Ali M
- Aljorfi A
- Allen M
- Allington J
- Alonzo A
- Alshafei A
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- Bianchi Cl
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- Bianco A
- Bilku D
- Birindelli A
- Birindelli A
- Birindelli A
- Blackford Od
- Blackwell J
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- Blanco F
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- Blazeby Jm
- Blencowe N. S.
- Blencowe Ns
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- Boereboom C
- Bogdan M
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- Bolton W
- Bolzon S
- Bond S
- Bond-Smith G
- Bondurri A
- Bonfante P
- Bonomo M
- Borg Cm
- Borges Fc
- Borghi F
- Borghol K
- Boshier Pr
- Botelho P
- Bowen J
- Bowerman H
- Bowley D
- Bowman Cr
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- Boyd-Carson H
- Boza K
- Bradshaw Cj
- Branagan G
- Bravo-Gutiérrez Af
- Bravo-Gutiérrez Af
- Brennan S
- Brett M
- Brewer H
- Brewer Hk
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- Brews R
- Brien Jo
- Bronder C
- Brown A
- Brown Ag
- Brown Ce
- Brown Ce
- Brown Ce
- Brown M
- Brown M
- Brown Od
- Brown R
- Bruce Js
- Brunelli Db
- Bryan Es
- Buckley-Jones S
- Bukhari W
- Bull C
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- Burnside D
- Busuttil A
- Byrne Be
- Byrnes Ck
- Caballero A
- Caldeira Ab
- Caldwell M
- Callan R
- Calussi M
- Calvo H
- Calvo M
- Cameron Fc
- Campagnaro T
- Campagnaro T
- Campbell U
- Campbell Um
- Campbell W
- Cannata G
- Cannavò M
- Cantafio S
- Capelli P
- Carcoforo P
- Carden Ca
- Carder C
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- Cardoso D
- Carlucci M
- Carney K
- Caro A
- Carral-Freire M
- Carrano Fm
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- Cartwright H
- Carvalho Lc
- Carvalho N
- Casimiro C
- Castagnoli G
- Castagnoli G
- Caula C
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- Cavallo D
- Cavero A
- Cay P
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- Cerdán-Santacruz C
- Cerdán-Santacruz C
- Cerdán-Santacruz C
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- Cervellera M
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- Chalk A
- Chambers B
- Chan D
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- Chandratreya N
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- Charalambous Mp
- Chasty B
- Chatzikonstantinou M
- Chatzikonstantinou M
- Chauhan P
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- Cheng Sa
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- Chessa A
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- Chillitupa Cz
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- Choong Jh
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- García-Novoa A
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- Ikram S
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- Pais M
- Pala M
- Palani-Velu Lk
- Palani-Velu Lk
- Pan Y
- Panagiotopoulos Sp
- Panda N
- Panda N
- Panda N
- Pandey V
- Pandya D
- Pandya R
- Paniagua M
- Pankin Gp
- Papandrea M
- Parajó Ae
- Paramasevon Kr
- Pareja-Ciuró F
- Parisi A
- Park Jh
- Park Jh
- Parkola Mj
- Parra Jm
- Parwaiz I
- Pascua-Sole M
- Pascual-Miguelañez I
- Pasquali S
- Pata F
- Pata F
- Pata F
- Pata F
- Pata F
- Pata F.
- Pata G
- Pata G
- Pata G
- Patel As
- Patel By
- Patel By
- Patel C
- Patel H
- Patel Mm
- Patel N
- Patel Pk
- Patel Rt
- Patil Sd
- Patti S
- Pau R
- Payne Cj
- Payne Re
- Payá-Llorente C
- Payá-Llorente C
- Peacock M
- Pearce J
- Pearce J
- Pearce L
- Pearce L
- Pearson R
- Pedder A
- Peirce Cb
- Peiris Gb
- Peixoto R
- Peleki A
- Peleki A
- Pellegrino L
- Pellicanò Ga
- Pellicer-Franco E
- Pellino G
- Pento V
- Pento V
- Peponis C
- Peprah D
- Pereira A
- Pereira Am
- Pereira J
- Pereira-Mosquera E
- Perera Mi
- Perez-Calvo J
- Perin A
- Pertile D
- Pertile D
- Peña-Barturen C
- Phelan L
- Photiou D
- Pierre R
- Pietrabissa A
- Pigem A
- Pila U
- Pilkington Jp
- Pineño-Flores C
- Pinillos-Somalo A
- Pinkney Td
- Pinkney Td
- Pinkney Td
- Pinna E
- Pino-Perez O
- Pirari Pf
- Pisanu A
- Piu F
- Planellas P
- Plua-Muniz Kt
- Poacher A
- Podda F
- Podda M
- Podda M
- Podda M
- Poillucci G
- Pollard H
- Ponchietti L
- Popova D
- Poudevigne M
- Prats Ma
- Prideaux A
- Prieto-Nieto Mi
- Primo Jc
- Pronin S
- Provenza G
- Puerta E
- Pulighe F
- Pullabatla-Venkata Up
- Punj S
- Pérez-Sanchez Le
- Quddus A
- Quill S
- Quinn Em
- Quinn Hc
- Rabie M
- Rabie Ma
- Rabie Mr
- Radwan Rw
- Radwan Rw
- Rahim A
- Rahman M
- Rahmani Ls
- Rajagopal S
- Rajaram R
- Rajaretnam N
- Rajjoub Y
- Rallage H
- Ramcharan S
- Ramirez L
- Ramirez-Redondo Aa
- Ramos Xh
- Ramos-Bernado Mi
- Ramírez-Faraco M
- Ranathunga S
- Rangarajan K
- Rao M
- Rao V
- Raofi A
- Rashid M
- Rate A
- Ravindran R
- Raymond M
- Raza Ss
- Recreo Ac
- Reddy A
- Reddy A
- Redmond Ae
- Redondo E
- Redondo E
- Redondo-Calvo Fj
- Reese G
- Regina G
- Rehman S
- Rehman S
- Rekhraj S
- Ren Kz
- Renshaw S
- Renshaw S
- Renzi Cr
- Resende Fm
- Rezacova M
- Rezvani S
- Riaz W
- Riba-Combatti L
- Ribaudo M
- Ribeiro B
- Rich Je
- Richardson Td
- Ridaura N
- Riera E
- Rigby S
- Rigney B
- Rinkoff S
- Ripoli Mc
- Robb Hd
- Robertson C
- Robinson A
- Robinson A
- Robinson D
- Robinson D
- Rocha R
- Rodger V
- Rodicio-Miravalles Jl
- Rodriguez L
- Rodriguez-Lopez M
- Rodriguez-Lopez M
- Rodriguez-Lopez M
- Rodríguez Ec
- Rojo Ja
- Roldán-Ortiz S
- Rolph R
- Romano J
- Romano R
- Romario Uf
- Romoli L
- Roncero Ls
- Ronda Rn
- Roomi S
- Rosa Mj
- Rosat A
- Roscio F
- Roscio F
- Roscio F
- Rossi C
- Rossi D
- Rossi Gm
- Roth N
- Rothnie K
- Roxburgh C
- Roy C
- Ruano A
- Rubbini M
- Rudland I
- Ruffolo C
- Rufo E
- Ruggiu Gv
- Ruiz-Marín M
- Ruiz-Marín M
- Rupani S
- Rupasinghe Sn
- Rupasinghe Sn
- Rutherford Dg
- Ruzvidzo F
- Ruzzenente A
- Saad M
- Saad M
- Saavedra-Chacón M
- Saba A
- Sabia D
- Sacco R
- Sacks R
- Sadek S
- Saghir N
- Sagnotta A
- Sagnotta A
- Saha A
- Sahay Sj
- Sahnan K
- Sahnan K
- Sainz B
- Sainz B
- Sajid Ms
- Salama Y
- Salamone G
- Salamone G
- Salamone G
- Salamone G
- Salandini Mc
- Salem A
- Salim S
- Salva Ab
- Salvador H
- Samartin C
- Sammarco G
- Sammarco G
- Samuel M
- Sana S
- Sanchez Er
- Sanchez Er
- Sanchez L
- Sanchez-Garcia S
- Sanchez-Guillen L
- Sanchez-Guillen L
- Sanchez-Martinez A
- Sancho-Muriel J
- Sandu L
- Sanna S
- Santamaria C
- Santamaría Pc
- Santarrufina-Martínez S
- Santos Sc
- Santurro L
- Sanz-Navarro S
- Sarmah P
- Sarmah P
- Sarmah P
- Sarveswaran J
- Sasia D
- Sasia D
- Saunders S
- Savill A
- Savino G
- Savino G
- Savioli F
- Scabini S
- Scabini S
- Scabini S
- Scandroglio Is
- Scanlon K
- Scatizzi M
- Scialandrone G
- Scricciolo M
- Sebastian Jf
- Sebastián-Tomás Jc
- Seddon Tc
- Segalini E
- Segura-Sampedro Jj
- Sena G
- Sena-Ruiz F
- Seneviratne N
- Sepe C
- Serventi F
- Serventi F
- Seth M
- Setshwaelo T
- Sezen E
- Sgardelis P
- Sgrò A
- Sgrò A
- Sgrò A
- Shah J
- Shah K
- Shah Sm
- Shah Sm
- Shaikh Ia
- Shakoor Z
- Shanmuganathan V
- Shanmugarajah K
- Sharma A
- Sharma A
- Sharma P
- Sharp Ol
- Sharp Ol
- Shaw Av
- Shepherd Ja
- Sherif Ma
- Shet S
- Shetty Vd
- Shingler G
- Shiwani Mh
- Shrestha D
- Shurlock J
- Sian T
- Siaw O
- Siddique K
- Siddiqui Mn
- Siddiqui Za
- Sierra-Grañón Je
- Siggens Kl
- Sihra N
- Silva A
- Silva I
- Silvestri V
- Simioni A
- Simmonds L
- Simmonds L
- Simo V
- Simoes J
- Simpson Dj
- Singh A
- Singh J
- Singh P
- Singh S
- Singhal T
- Singhal T
- Sivaloganathan P
- Skalamera I
- Skerritt C
- Slezak I
- Smallcombe N
- Smart Cj
- Smart Cj
- Smart Nj
- Smart Nj
- Smoker H
- Soares A. S.
- Soares As
- Soares As
- Soares As
- Soares As
- Soares As
- Soh B
- Solaini L
- Solar-García L
- Soliani P
- Solinas L
- Sooriyamoorthy T
- Soria-Aledo V
- Soria-Aledo V
- Soriano Jt
- Sorrentino L
- Sousa Hs
- Souter J
- Sparta C
- Spaziani A
- Speake D
- Speake D
- Springate El
- Sreedharan L
- Sreedharan L
- Staderini F
- Stecca T
- Stella M
- Stephens Gf
- Stephens Gf
- Stevenson R
- Stewart Dj
- Stoica I
- Storey R
- Stoyanov Ti
- Strachan E
- Strange Ja
- Stubbs Bm
- Stupalkowska W
- Stupalkowska W
- Suarez-Cabrera A
- Suero Ca
- Sultana A
- Summerfield L
- Sunter H
- Surg Pt
- Suriyakumar S
- Suárez-Sánchez A
- Swords C
- Symons N
- Szentpali K
- Szucs A
- Szucs A
- Sánchez-Cifuentes A
- Sánchez-Fuentes Mn
- Sánchez-Rubio M
- Tabain V
- Taglietti L
- Tague Le
- Tahir W
- Tailor K
- Tallon-Aguilar L
- Tallon-Aguilar L
- Tamayo-López Mj
- Tamborska A
- Tamini N
- Tamini N
- Tamini N
- Tan Cy
- Tan Cy
- Tan E
- Tan Hl
- Tan S
- Tang Am
- Tapiolas I
- Tarazi M
- Tatulli F
- Tay Yh
- Tayeh S
- Taylor M
- Taylor Ns
- Taylor Ns
- Taze D
- Tee A
- Tejero-Pintor Fj
- Tenconi Sm
- Tezas S
- Thaha Ma
- Thakral N
- Thakur D
- Thava B
- Thavanesan N
- Thavanesan N
- Thaventhiran Aj
- Theodoropoulou K
- Thomas At
- Thomas L
- Thompson C
- Thompson Db
- Thompson Db
- Thompson R
- Thompson R
- Thoukididou Sn
- Tiedt La
- Tiedt La
- Ting N
- Tinoco-González J
- Tinsley Bj
- Tognarelli Jm
- Tojal A
- Tokidis E
- Tomasoni M
- Tonini V
- Toomey D
- Toomey Db
- Torkington J
- Torkington J
- Torrado Aa
- Torrance A
- Torrance A
- Townsend Dc
- Townsend Dc
- Tozer Pj
- Trail M
- Trail M
- Trastulli S
- Trew F
- Trostchansky I
- Trujillo-Diaz Jj
- Tsang B
- Tudyka V
- Tudyka V
- Turnbull A
- Turner Ej
- Tutino R
- Twum-Barima Cs
- Twum-Barima Cs
- Tyler R
- Tyler R
- Ugarte-Sierra B
- Vacca A
- Vaccari S
- Vakis S
- Valente Pm
- Valiani Sv
- Vallejo-Bernad C
- Vallve-Bernal M
- Van Boxel Gi
- Vance-Daniel J
- Vannucchi A
- Varcada M
- Vargas-Pierola Hj
- Vaughan Em
- Vaughan Em
- Vazquez-Fernandez Ap
- Vega L
- Velchuru Vr
- Velho R
- Venkata Up
- Venkatasubramaniam Ak
- Venn Ml
- Venn Ml
- Venugopal R
- Verea S
- Veres T
- Veres T
- Verroiotou M
- Vescio G
- Vettoretto N
- Vigorita V
- Vijay V
- Vila-Zarate C
- Villarejo-Campos P
- Vinnicombe Z
- Viscosi F
- Vitish-Sharma P
- Viviani E
- Viñas Nl
- Vohra R
- Vohra R
- Vulcano I
- Waite K
- Walji Hd
- Walsh E
- Walsh Tn
- Walters Kj
- Walters U
- Wardle Bg
- Wardle Bg
- Wardle Sd
- Warren O
- Warren Oj
- Warusavitarne J
- Watfah J
- Watson N
- Wauchope J
- Weatherburn Lw
- Weaver J
- Weegenaar Cr
- Weegenaar Cr
- Welsh S
- Wensley F
- West H
- West H
- Wheatstone S
- Wheeler C
- Whewell He
- White F
- Whitehorn Se
- Whitehorn Se
- Whitehouse P
- Whiteman E
- Whittaker L
- Wiggill S
- Wijesundera K
- Wilcox G
- Wilkin R
- Wilkin R
- Wilkin R
- Wilkin R
- Wilkin R. J. W.
- Williams Gl
- Williams M
- Williams R
- Williams S
- Wilson Ej
- Wilson M
- Winter Dc
- Winter Dc
- Wolff J
- Wong A
- Wong C
- Wong J
- Wong J
- Wong Ml
- Wong Sy
- Woo R
- Wood Cs
- Woodrow C
- Woodward A
- Woodward B
- Woodward B
- Worku D
- Worku D
- Wright E
- Wright Hl
- Wu F
- Xidas A
- Yalamarthi S
- Yang P
- Yanni F
- Yardimci E
- Yasin T
- Yen Sk
- Yeung K
- Yeung K
- Yoganathan S
- Yoong S
- Youssef H
- Yow L
- Yow L
- Zaborowski A
- Zadi Az
- Zalla T
- Zarka Za
- Zarka Za
- Zarog Ma
- Zelazek M
- Zerpa C
- Zhang Ay
- Zhou S
- Zorrilla L
- Zuin M
- Zurleni Tz
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2019
- Field of study
Background
Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis.
Methods
A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis).
Results
Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent).
Conclusion
Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified
High Selection Pressure Promotes Increase in Cumulative Adaptive Culture
- Author
- A Kandler
- A Mesoudi
- A Mesoudi
- A Powell
- A Ugan
- AB Marin-Arroyo
- AJ Stutz
- B Fitzhugh
- Carolin Vegvari
- CS Henshilwood
- DW Bird
- DW Read
- DW Read
- DW Read
- E Herrman
- GP Murdock
- GR Pradhan
- GS McCall
- GS McCall
- J Henrich
- JJ Shea
- JL Clark
- JM Beaton
- L Rendell
- L Rendell
- LA Maher
- LG Dean
- LH Keeley
- M Petraglia
- MA Kline
- MC Stiner
- MC Stiner
- RB Lee
- RH McGuire
- RL Bettinger
- Robert A. Foley
- Robin Allaby
- S Ghirlanda
- S Ghirlanda
- S McBrearty
- S Shennan
- SJ Lycett
- V Grimm
- Z Jacobs
- Publication venue
- 'Public Library of Science (PLoS)'
- Publication date
- Field of study
Enhanced Biological Response of AVS-Functionalized Ti-6Al-4V Alloy through Covalent Immobilization of Collagen
- Author
- A Nanci
- AB Moshnikova
- C Roehlecke
- C Yang
- CG Knight
- CS Osborne
- D Becker
- D Gonzalez-Nieto
- D Kim
- DG Castner
- DV Bax
- E Vandenberg
- E Yoshida
- F Grinnell
- H Ao
- HM Powell
- HP Jennissen
- J Dolder van den
- JE Davies
- JE Koblinski
- JS Pieper
- JY Martin
- K Anselme
- K Pugdee
- L Bacakova
- L Guehennec Le
- LF Cooper
- LHHO Damink
- M Arroyo-Hernandez
- M Geetha
- M Hanthamrongwit
- M Nagai
- M Yamamoto
- MJA Vanluyn
- N Marin-Pareja
- P Angele
- P Rezvanian
- QQ Wang
- R Mueller
- R Muller
- RJ Martin-Palma
- S Bierbaum
- SN Park
- U Geissler
- X Yu
- Z Ahmad
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Food for thought: using game cameras to better understand the movement of bones by scavenging in archaeological faunal assemblages
- Author
- AB Marin-Arroyo
- AM Douglas
- AM Kos
- B David
- B Galdikas
- CK Brain
- D Grayson
- D Rosendahl
- D Spennemann
- E Lotan
- EH Reed
- EH Reed
- G Haynes
- G Haynes
- G Haynes
- HJ Greenfield
- I Walters
- J Field
- J Field
- J Field
- J Field
- J Field
- J Garvey
- J O’Connell
- JM Hutson
- JT Faith
- K Walshe
- L Binford
- L Lyman
- L Lyman
- L Lyman
- M Attard
- M Dominguez-Rodrigo
- M Fillios
- M Fillios
- M Fillios
- M Fillios
- M Letnic
- M Owens
- M Stiner
- M Stiner
- Melanie A. Fillios
- N Reeves
- O Brown
- PA Smith
- R Coard
- R Gillespie
- R Gould
- RC O’Brien
- RG Roberts
- S Solomon
- S Ulm
- S Wroe
- S Wroe
- SCS Carro
- SD Dominguez-Solera
- T Pickering
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Occurrence and diversity of waterborne fungi and associated mycotoxins in treated drinking water distribution system in South Africa: implications on water quality and public health
- Author
- A Biedunkiewicz
- A Grabińska-Łoniewska
- A Moretti
- A Warris
- AB Gonçalves
- AR Fox
- AT Mata
- C Gruber-Dorninger
- C Hwang
- C Mains
- C Paulussen
- DV Renwick
- E Göttlich
- EC Okpako
- EFSA
- G Hageskal
- G Hageskal
- G Kinsey
- H Auwal
- HA Assress
- HC Flemming
- Henry Joseph Odour Ogola
- HM Al-gabr
- I Kamika
- Ilunga Kamika
- JH Williams
- JH Williams
- JM Misihairabgwi
- JW Bennett
- KF Shields
- M Sisti
- M Zhuwakinyu
- ME Zain
- Memory Tekere
- MN Babič
- N Arroyo-Manzanares
- N Ludwig
- NA Memon
- ND Pant
- NJ Ashbolt
- NT Mhlongo
- P Chandra Bhomick
- P Crous
- P Frey-Klett
- P Sonigo
- R Bhat
- R Selvarajan
- Ramganesh Selvarajan
- RM Gashgari
- RR Paterson
- S Hurtado-McCormick
- S Kumar
- S Marin
- S Upadhyay
- SG Mulamattathil
- SL Smiley
- SM Lehner
- SP Abbott
- T Bertuzzi
- Thandazile Ntombie Mhlongo
- Timothy Sibanda
- U Singh
- VJ Pereira
- VJ Pereira
- VM Siqueira
- X Ma
- X Zhang
- Y Jiang
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study