55 research outputs found
Diseño, desarrollo e implementación de sofware para validación y asignación de beneficiarios SISBEN
- Publication venue
- Facultad Ciencias Sociales y Empresariales.
- Publication date
- 06/09/2017
- Field of study
Phenotype Algorithms for the Identification and Characterization of Vaccine-Induced Thrombotic Thrombocytopenia in Real World Data: A Multinational Network Cohort Study
- Author
- Alshammari Thamir M
- Blacketer Clair
- Carević Biljana
- DeFalco Frank
- Denaxas Spiros
- Duarte-Salles Talita
- Fraboulet Clement
- Horban Scott
- John Luis H
- Le Carrour Tanguy
- Makadia Rupa
- Maljković Filip
- Mayer Miguel Angel
- Minty Evan
- Morales Daniel R
- Ostropolets Anna
- Papez Vaclav
- Prieto-Alhambra Daniel
- Ramírez-Anguita Juan Manuel
- Rao Gowtham A
- Rijneek Peter R
- Ryan Patrick B
- Sena Anthony G
- Shoaibi Azza
- Suchard Marc A
- Voss Erica A
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 02/06/2022
- Field of study
INTRODUCTION: Vaccine-induced thrombotic thrombocytopenia (VITT) has been identified as a rare but serious adverse event associated with coronavirus disease 2019 (COVID-19) vaccines. OBJECTIVES: In this study, we explored the pre-pandemic co-occurrence of thrombosis with thrombocytopenia (TWT) using 17 observational health data sources across the world. We applied multiple TWT definitions, estimated the background rate of TWT, characterized TWT patients, and explored the makeup of thrombosis types among TWT patients. METHODS: We conducted an international network retrospective cohort study using electronic health records and insurance claims data, estimating background rates of TWT amongst persons observed from 2017 to 2019. Following the principles of existing VITT clinical definitions, TWT was defined as patients with a diagnosis of embolic or thrombotic arterial or venous events and a diagnosis or measurement of thrombocytopenia within 7 days. Six TWT phenotypes were considered, which varied in the approach taken in defining thrombosis and thrombocytopenia in real world data. RESULTS: Overall TWT incidence rates ranged from 1.62 to 150.65 per 100,000 person-years. Substantial heterogeneity exists across data sources and by age, sex, and alternative TWT phenotypes. TWT patients were likely to be men of older age with various comorbidities. Among the thrombosis types, arterial thrombotic events were the most common. CONCLUSION: Our findings suggest that identifying VITT in observational data presents a substantial challenge, as implementing VITT case definitions based on the co-occurrence of TWT results in large and heterogeneous incidence rate and in a cohort of patints with baseline characteristics that are inconsistent with the VITT cases reported to date
Phenotype Algorithms for the Identification and Characterization of Vaccine-Induced Thrombotic Thrombocytopenia in Real World Data:A Multinational Network Cohort Study
- Author
- Alshammari Thamir M.
- Blacketer Clair
- Carević Biljana
- DeFalco Frank
- Denaxas Spiros
- Duarte-Salles Talita
- Fraboulet Clement
- Horban Scott
- John Luis H.
- Le Carrour Tanguy
- Makadia Rupa
- Maljković Filip
- Mayer Miguel Angel
- Minty Evan
- Morales Daniel R.
- Ostropolets Anna
- Papez Vaclav
- Prieto-Alhambra Daniel
- Ramírez-Anguita Juan Manuel
- Rao Gowtham A.
- Rijneek Peter R.
- Ryan Patrick B.
- Sena Anthony G.
- Shoaibi Azza
- Suchard Marc A.
- Voss Erica A.
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2022
- Field of study
INTRODUCTION: Vaccine-induced thrombotic thrombocytopenia (VITT) has been identified as a rare but serious adverse event associated with coronavirus disease 2019 (COVID-19) vaccines. OBJECTIVES: In this study, we explored the pre-pandemic co-occurrence of thrombosis with thrombocytopenia (TWT) using 17 observational health data sources across the world. We applied multiple TWT definitions, estimated the background rate of TWT, characterized TWT patients, and explored the makeup of thrombosis types among TWT patients. METHODS: We conducted an international network retrospective cohort study using electronic health records and insurance claims data, estimating background rates of TWT amongst persons observed from 2017 to 2019. Following the principles of existing VITT clinical definitions, TWT was defined as patients with a diagnosis of embolic or thrombotic arterial or venous events and a diagnosis or measurement of thrombocytopenia within 7 days. Six TWT phenotypes were considered, which varied in the approach taken in defining thrombosis and thrombocytopenia in real world data. RESULTS: Overall TWT incidence rates ranged from 1.62 to 150.65 per 100,000 person-years. Substantial heterogeneity exists across data sources and by age, sex, and alternative TWT phenotypes. TWT patients were likely to be men of older age with various comorbidities. Among the thrombosis types, arterial thrombotic events were the most common. CONCLUSION: Our findings suggest that identifying VITT in observational data presents a substantial challenge, as implementing VITT case definitions based on the co-occurrence of TWT results in large and heterogeneous incidence rate and in a cohort of patints with baseline characteristics that are inconsistent with the VITT cases reported to date. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40264-022-01187-y
The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
- Author
- Adell Serrano Berta
- Agrifoglio Alexander
- Aguilar Cabello María
- Aguilera Luciano
- Albaiceta Guillermo M.
- Alcaraz Serrano Victoria
- Aldecoa César
- Alegre Cynthia
- Almansa Mora Raquel
- Amaya Villar Rosario
- Andrea Rut
- Arrieta Marta
- Ayestarán J. Ignacio
- Añón José M.
- Badia Joan Ramon
- Badía Mariona
- Balsera Begoña
- Barbena Laura
- Barberà Carme
- Barberán José
- Barbeta Enric
- Barbé Ferran
- Bardi Tommaso
- Barral Segade Patricia
- Barroso Marta
- Berezo García José Ángel
- Bermejo Martín Jesús F.
- Bigas Judit
- Blancas Rafael
- Blandino Ortiz Aaron
- Blasco Cortés María Luisa
- Boado María
- Bodi Saera María
- Bofill Neus
- Bouza Vieiro María Teresa
- Bueno Leticia
- Bustamante Munguira Elena
- Bustamante-munguira Juan
- Busto Martínez Cecilia del
- Báez Pravia Orville
- Caballero Jesús
- Cachafeiro Lucia
- Campi Hermoso David
- Campos Fernández Sandra
- Cano Iosune
- Cantón-bulnes Maria Luisa
- Carbajales Cristina
- Carbonell Nieves
- Cardina Fernández Pablo
- Carrión García Laura
- Carvalho Sula
- Casacuberta Barberà Núria
- Castellví Andrea
- Castellà Manuel
- Castro Pedro
- Catalán González Mercedes
- Ceccato Adrián
- CIBERESUCICOVID Project (COV20/00110 ISCIII)
- Cicuendez Ávila Ramon
- Cillóniz Catia
- Clar Luisa
- Climent Cristina
- Codina Jordi
- Conde Pamela
- Contreras Sofía
- Dot Irene
- Díaz Santos Emili
- Díaz Yolanda
- Dólera Moreno Cristina
- Enríquez Giraudo Pedro
- Esmorís Arijón Inés
- Estella Ángel
- Farre Monjo Teresa
- Fernández Barat Laia
- Fernández Javier
- Ferrando Carlos
- Ferrer Roca Ricard
- Figueras Albert
- Forcadell Ferreres Eva
- Forcelledo Espina Lorena
- Franco Nieves
- Furro Àngels
- Gabarrús Albert
- Galbán Cristóbal
- Gallego Elena
- García Garmendia José Luis
- García Gasulla Dario
- García Prieto Emilio
- García Redruello Carlos
- García Sagastume Amaia
- García Beatriz
- García Felipe
- Garnacho Montero José
- Gascón Castillo Maria Luisa
- Gomà Gemma
- Gonzalo Calvo David de
- González Jessica
- Gordo Federico
- Gracia Maria Pilar
- Gumucio Sanguino Víctor D.
- Gómez Casal Vanesa
- Gómez Gonzalez Carmen
- Gómez José M.
- Gómez Silvia
- Herraiz Alba
- Herrán Monge Rubén
- Huerta Arturo
- Ibarz Mercedes
- Iglesias Silvia
- Janer Maria Teresa
- Jiménez Gabriel
- Jorge García Ruth Noemí
- Juan Díaz Mar
- Kiarostami Karsa
- Lazo Álvarez Juan I.
- León Miguel
- Lorente José Angel
- Loza Vázquez Ana
- López Gavín Alexandre
- López Lago Ana
- López Messa Juan
- Macias Guerrero Desire
- Mamolar Herrera Nuria
- Mantellini Cecilia L.
- Marco Naya Gregorio
- Marcos Pilar
- Marin Corral Judith
- Mariño Ana Balan
- Marmol Peis Enrique
- Martin María Cruz
- Martín Vicente Paula
- Martínez de la Gándara Amalia
- Martínez Fernández Carmen Eulalia
- Martínez Juan Maria Dolores
- Martínez Varela Ignacio
- Martínez María
- Masa Jimenez Juan Fernando
- Masclans Joan Ramon
- Maseda Emilio
- Mañez Mendiluce Rafael
- Mendoza Diego de
- Menor Fernández Eva María
- Menéndez Rosario
- Miralbés Mar
- Monclou Josman
- Montejo González Juan Carlos
- Montserrat Neus
- Mora Aznar María
- Moral Parras Pedro
- Morales Dulce
- Moreno Cano Sara Guadalupe
- Mosquera Rodríguez David
- Motos Anna
- Muñoz Bermúdez Rosana
- Nicolás José María
- Nogue Bou Ramon
- Nogueras Salinas Rafaela
- Novo Mariana Andrea
- Ocón Marta
- Ortega Ana
- Ossa Sergio
- Pablo Sánchez Raul de
- Pagliarani Pablo
- Parera Pous Anna
- Parrilla Francisco
- Pestaña Laguna David
- Peñasco Yhivian
- Peñuelas Oscar
- Piñol-tena Àngels
- Pozo Laderas Juan Carlos
- Prados Javier
- Pujol Andrés
- Pérez Arnal Raquel
- Pérez Bastida Leire
- Pérez Planelles Gloria
- Pérez Rubio Eva
- Pérez Purificación
- Ramon Coll Núria
- Renedo Sanchez-Giron Gloria
- Ricart Pilar
- Riera Jordi
- Rivas Vilas María Digna
- Roche Campo Ferran
- Rodriguez Oviedo Alejandro
- Rodriguez Laura
- Rodríguez de Castro Felipe
- Rodríguez Ruiz Covadonga
- Rodríguez Silvia
- Rubio López Alberto
- Rubio Jorge
- Ruiz Miralles Miriam
- Ryan Murúa Pablo
- Saborido Paz Eva
- Salazar Degracia Ana
- Salvador Adell Inmaculada
- Sanchez Miguel
- Sancho Chinesta Susana
- Santacoloma Bitor
- Sariñena Maria Teresa
- Segura Pensado Marta
- Serra Fortuny Mireia
- Serra Lidia
- Serrano Lázaro Ainhoa
- Servià Lluís
- Socias Lorenzo
- Soliva Laura
- Solé Violan Jordi
- Speziale Carla
- Suares Sipmann Fernando
- Sánchez Miralles Angel
- Sánchez Ana
- Tamayo Lomas Luis
- Tognetti Daniel
- Tormos Adrián
- Torre Maria del Carmen de la
- Torres Martí Antoni
- Torres Mateu
- Trefler Sandra
- Trenado José
- Trujillano Javier
- Urrelo Cerrón Luis
- Val Estela
- Valdivia Ruiz Luis
- Vallverdú Montserrat
- Van Der Hofstadt Martin-Montalvo Maria
- Vara Adrio Sabela
- Vengoechea Javier
- Vidal Cortes Pablo
- Vilanova Judit
- Villada Warrington Tatiana
- Vilà Vilardel Clara
- Vázquez Nil
- Yang Hua
- Yang Minlan
- Zapatero Ana
- Álvarez Ruiz Antonjo
- Álvarez Sergio
- Ángel José
- Úbeda Alejandro
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 07/10/2021
- Field of study
Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation
Effects of alirocumab on types of myocardial infarction: insights from the ODYSSEY OUTCOMES trial
- Author
- Abbas J
- Abbate A
- Abdullakutty J
- Abhyanakar AD
- Aboyans V
- Abrantes JAM
- Abu-Fadel M
- Acevedo M
- Adamkova V
- Adhyapak S
- Agarwal H
- Aggarwal R
- Aggarwal RK
- Aguirre A
- Ahmed H
- Ahremark U
- Ahuad Guerrero RA
- Aidar Ayoub JC
- Airaksinen JK
- Aitken D
- Akatova E
- Akhter F
- Ako J
- Akright L
- Akyea-Djamson A
- Al Joundi T
- Al-Windy NYY
- Alan D
- Alcocer Gamba MA
- Alexander JH
- Alexander K
- Alexandru TM
- Alings M
- Alonso Martin JJ
- Alvarisqueta AF
- Alves De Lima AE
- Amarasekera S
- Amarasena N
- Amir O
- Amlani M
- Amosova E
- Amuchastegui M
- Andersen K
- Andersen R
- Anderson J
- Ando K
- Angel Hominal M
- Annam S
- Anscombe R
- Apostolovic SR
- Appel K-F
- Arandjelovic A
- Araneda G
- Arango Benecke JL
- Arbel Y
- Arif I
- Armaganijan L
- Arroyo JAC
- Arstall MA
- Asanin MR
- Atar S
- Athyros V
- Auguadro C
- Ayala CAC
- Aylward PE
- Azizad MM
- Bagai A
- Bagriy A
- Bahit MC
- Bai F
- Balaguer Recena J
- Baldari D
- Balinovac J
- Ball E
- Bang LE
- Banuru S
- Barakovic F
- Baranov E
- Baranova E
- Barbarash OL
- Barbato E
- Barna OM
- Barone-Rochette G
- Barr C
- Barrucco R
- Bartels GL
- Bashir R
- Basson MMDV
- Bastos JM
- Bata I
- Batushkin V
- Bayat J
- Bayram Llamas EA
- Bayron C
- Beauloye C
- Bednarski J
- Behrens S
- Belhassane A
- Benedicto A
- Bengus CM
- Benov HO
- Berger R
- Berglund S
- Berk M
- Berland J
- Berli MA
- Berlowitz M
- Berman B
- Bernan A
- Berti S
- Bhagwat A
- Bhagwat R
- Bhansali P
- Bhatt DL
- Binder R
- Birchem J
- Bittner VA
- Blicharski T
- Blok T
- Blumberg EDS
- Boccara F
- Bodanese LC
- Bodi Peris V
- Boecker D
- Bojovski S
- Bokarev I
- Bokern MJJA
- Bonfanti AJC
- Bono JOE
- Bordonava AP
- Borse R
- Bortnick A
- Bos RJ
- Botas Rodriguez J
- Botelho A
- Botelho RV
- Botia DCL
- Bottcher M
- Bourgeois R
- Brabham D
- Braganza D
- Braun-Dullaeus R
- Breedveld RW
- Brennan JM
- Brodison A
- Bronzwaer PNA
- Brueren BRG
- Bruguera Cortada J
- Budaj A
- Bugan V
- Busmane A
- Bustamante Labarta MH
- Busz-Papiez B
- Butler R
- Bystryk L
- Caccavo A
- Caime GD
- Calabro P
- Camprubi Potau M
- Camsari A
- Caraco Y
- Carey C
- Carlson E
- Carnero GS
- Carranza Madrigal J
- Carrillo Calvillo J
- Carroll PA
- Cartasegna LR
- Carter L
- Caruso OC
- Cassimjee S
- Castadot M
- Cavallini C
- Cequier Fillat AR
- Cerqueira MJAG
- Cestari HG
- Cevc M
- Cha J
- Chae I-H
- Chaitman B
- Chalavarya G
- Chaleff F
- Chambilla JMC
- Chandna H
- Chane M
- Chang M
- Chaudhary S
- Chavez V-CER
- Chen D
- Chen J
- Chen Y
- Cheng S-C
- Cheng X
- Chiang C-E
- Chiang C-E
- Chizhov P
- Chopda M
- Chopra VK
- Christenson S
- Chu A
- Chua T
- Chumakova G
- Chumburidze V
- Civeira Murillo F
- Claeys M
- Clemmensen P
- Clerc J
- Cleveland D
- Clifford P
- Clifton S
- Coching RM
- Codutti OR
- Cohen S
- Collins N
- Colombo HR
- Colquhoun D
- Commerford PJ
- Concha YMR
- Conrad G
- Constantine G
- Constantinescu MCA
- Convens C
- Cools F
- Corbett C
- Cornel JH
- Correa Flores RM
- Cosavalente LAC
- Cosin Sales J
- Costa F
- Coste P
- Cottin Y
- Coufal Z
- Coverdale SGM
- Cristian G
- Cruz Fernandez JM
- Cuccia C
- Cui L
- Cyster HP
- Czerski T
- D'Urso M
- Daboul N
- Dagher G
- Dahl C
- Dai K
- Dalby AJ
- Dalby AJ
- Danchin N
- Dandillaya R
- Daniels C
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- Davidovic G
- Davidsen F
- Davies R
- Davis W
- De Berrazueta Fernandez JR
- De Cesare NB
- De Leo A
- De Luca G
- De Mora Martin M
- De Pellegrin A
- De Salazar DIM
- de Santos MON
- de Silva HA
- de Souza JA
- De Wolf L
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- Deloatch S
- Demirtas M
- Denham D
- Devarapalli SK
- DeVore AD
- Diamantis S
- Diaz Fernandez JF
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- Dickey S
- Dilic M
- Dimkovic S
- Dimov BI
- Dincic DV
- Ding C
- Dion D
- Dodic S
- Dombrowski K
- Doncovska S
- Dong S
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- Dorobantu M
- Dorsel T
- Dran RD
- Drexel H
- Drzewiecka A
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- Ducrocq G
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- Dzupina A
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- Ekanayaka R
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- Falukozy J
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- Fanghanel Salmon G
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- Farrar M
- Fausto Ovando SR
- Fazekas F
- Fazlibegovic E
- Feitosa GS
- Fell D
- Feng Y
- Fernandes Manenti ERF
- Fernandez Portales J
- Fernandez AM
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- Ferratini M
- Ferrolino A
- Filardi PP
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- Florenzano F
- Flores E
- Flores REO
- Fong P
- Forgosh L
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- Franek E
- Fras Z
- French WJ
- Friedman D
- Frost L
- Fu G
- Fuchs S
- Fuentes Jimenez F
- Fujii K
- Fujimoto K
- Fujinaga H
- Fulop P
- Fulwani MC
- Furukawa Y
- Galski T
- Galvani M
- Gapon L
- Garcia Brasca DF
- Garcia Castillo A
- Garcia Duran RO
- Garcia Lledo JA
- Garcia-Dorado D
- Gardner G
- Garrahy PJ
- Garrido M
- Garza Ruiz JA
- Gavish D
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- Gelormini J
- Gerber J
- Gerber R
- Ghitis A
- Ghlonti R
- Gibson P
- Gielen S
- Giesler G
- Gil-Extremera B
- Gilbert JM
- Gillespie E
- Gilmore R
- Gimple L
- Giordano JA
- Giorgeto FE
- Gislason G
- Giuliano ME
- Gniot J
- Goch A
- Goloborodko B
- Gomez Vilamajo OA
- Gonsorcik J
- Gonzales RJV
- Gonzalez Diaz B
- Gonzalez Salas LG
- Gonzalez-Juanatey C
- Gonzalez-Juanatey JR
- Goodman SG
- Goodman SG
- Gordeev I
- Gordienko A
- Gorny J
- Gosselin G
- Gosselink ATM
- Gotcheva NN
- Gotcheva NN
- Govinda RA
- Goyal NK
- Gremmler U
- Grewal JS
- Griffiths H
- Gring C
- Groenemeijer BE
- Groutars RGEJ
- Guardigli G
- Guerrero De Leon M
- Guha S
- Gullestad L
- Guneri S
- Guneri S
- Guo Y
- Gurevich V
- Gusi Tragant G
- Guzman PN
- Haddad T
- Hagstrom E
- Hagstrom E
- Hahalis PIG
- Halabi M
- Halcox J
- Hald F
- Haldis T
- Hall J
- Halvorsen S
- Hameed A
- Haniffa R
- Hanotin C
- Hansen O
- Haraguchi T
- Harding S
- Harkut P
- Harrington RA
- Harris B
- Harris B
- Hart H
- Hata Y
- Hattler B
- Hedman A
- Heidenreich L
- Heinc P
- Heitzer T
- Hemetsberger R
- Henderson D
- Henkin Y
- Herath JI
- Herazo AS
- Hermans K
- Hermans WRM
- Hernandez HAA
- Herrman JPR
- Hersbach FMRJ
- Hess CN
- Higashikata T
- Higuera JD
- Hii CLS
- Hirayama A
- Hirooka K
- Hlatky MA
- Hoag G
- Hodes Z
- Hoffer E
- Hoffman D
- Hong T
- Hoogslag PAM
- Hoppe U
- Horak D
- Horowitz J
- Horvath I
- Horwitz P
- Hove JD
- Hrabar AD
- Hranai M
- Hsieh I-C
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- Huang S
- Huang T-Y
- Huang W
- Huber K
- Huidobro L
- Huikuri H
- Hunter J
- Hurtig U
- Hussein O
- Huynh T
- Hwang J-J
- II TC
- III DG
- III KG
- Ilic S
- Ilieva-Pandeva KA
- Ince C
- Iniguez A
- Investigators ODYSSEYOUTCOMES
- Iqbal SMR
- Irimpen A
- Istratoaie O
- Ito K
- Ivanov IG
- Ivanova R
- Ivanovic N
- Iyengar SS
- Izzo M
- Jacoby D
- Jafar Z
- Jaffrani N
- Jain D
- Janik M
- Janosik D
- Jaramillo N
- Jatin FGM
- Jaworska K
- Jayawardena J
- Jensen SA
- Jensen SA
- Jeong MH
- Jeppesen J
- Jeserich M
- Jiang W
- Jintapakorn W
- Johansen PB
- Jonas M
- Jones WS
- Jordan JD
- Jortveit J
- Joshi AB
- Joshi P
- Jovin I
- Jr CE
- Jr HW
- Jr LC
- Jr MJ
- Jr PW
- Jr RW
- Jr SJ
- Jr SJF
- Jr WD
- Jujjuru S
- Jukema JW
- Juonala M
- Jure HO
- Jurgaitiene R
- Kadr H
- Kaewsuwanna P
- Kahali D
- Kaikkonen K
- Kaiser S
- Kalashetti S
- Kalil R
- Kamensky G
- Kamiya H
- Kandasamy B
- Kapin T
- Kaplan R
- Kapp IE
- Karalis I
- Karlsberg R
- Karna S
- Karpenko O
- Karpenko Y
- Karpov Y
- Karpov Y
- Kartalis A
- Kasim S
- Katona A
- Katsuda Y
- Katz A
- Kaucak V
- Kavaliauskiene R
- Kawasaki T
- Ke Y
- Keating F
- Kedev S
- Keen W
- Kehasukcharoen W
- Kelsey SF
- Kerkar P
- Khabeishvili G
- Khaira AS
- Khaisheva L
- Khan A
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- 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
Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study
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- Zavala G.
- Zawahrah H.
- Zeiton A.
- Zeko A.
- Zeng Z.
- Zeromskas P.
- Zhang G.
- Zhivkov E.
- Zid E.
- Zidan A. M.
- Zielasek C.
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- Zimmermann B.
- Ziprin P.
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- Zoikas A.
- Zorrilla Matilla L. P.
- Zoulamoglou M.
- Zreeg D.
- Zub-Pokrowiecka A.
- Zubiaurre V.
- Zuhdy M.
- Zuikyte D.
- Zuloaga Fernandez del Valle C. J.
- Zulu S.
- Zumbakys
- Zupan D.
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2022
- Field of 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<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<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
4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica
- Author
- Acosta Pedro
- Acurio R.
- Aguaded Ignacio
- Aguilar Ramon Adrián Paolo
- Aguillón Osma Osma
- Aller Castro José Manuel
- Alvarez Mendoza César Iván
- Ampuño Gary
- Arango Varela Sandra Sulay
- Arciniega G.
- Arévalo Bermeo Germán
- Avilés González Kevin Marcelo
- Ayala Carabajo Raquel
- Barrios D.
- Bermeo Naula Andrea Karina
- Bermeo A.
- Bonilla Agualongo Agustín Paul
- Bonilla A.
- Bustos González Juan Daniel
- Caamaño L.
- Caicedo S.
- Cajamarca Rivadeneira Ronald Enrique
- Calle Espinoza Carlos Julio
- Carabali Mariño Jenifer
- Carpio M.
- Castillo Guerrero John Mathews
- Cedeño Tello Alicia María
- Cedillo F.
- Cerrada Lozada Mariela
- Chacón J.
- Chicaiza J.
- Chiluisa-Utreras V.
- Chávez Carlos
- Coque S.
- Cos Farias Valeria Mishelle
- Cuellar Luz Angela
- Cuerva Pareja Carolina
- Cueva E.
- Cueva J.
- Cuzco Calle Irma
- Cárdenas David
- de la Nube Toral Sarmiento Adriana
- Domínguez Federico
- Duque Sarango Paola Jackeline
- Díaz Mónica
- Espinel Ramón
- Fernández de Córdoba Pedro
- Flores Noelia
- Fuentes Espinoza Pablo Gustavo
- Furlan Del Pezo Anggie Margarita
- Galarza Rodriguez Jose Luis
- Gallardo Sandoval Pedro Emilio
- Garabiza Castro Bella Del Rocío
- Garcés Villón Laura
- García C.
- Giovanny Cuzco Edgar
- González Rivera Pedro Luis
- Gordillo Manssur Fabián Alberto
- Guamán Seis Joseph Alexander
- Gómez M.
- Hernando Pérez Elena
- Hincapié Roberto Carlos
- Huerta Mónica
- Hurtado Isaza Sandra
- Inclán Diego
- Jaramillo F.
- Jenaro Río Cristina
- Jiménez Moposita Jorge
- Jurado V.
- Knezevich Palacios Alba Teresa
- Ladinez Gómez Erick Milton
- Lata J.
- León Michael
- Llerena Izquierdo Joe
- Llerena Paz Robinson Dimitri
- Loaiza Martínez María de Lourdes
- Lozano Garzón Carlos
- Lozano Zayda
- Lucín Castillo Virginia Carolina
- López Terán Adrián
- López Alfredo
- López R.
- Macancela J.
- Manzano Villafuerte Santiago
- Martínez Guashima Oswaldo
- Mediavilla Peñaherrera Emerson
- Mendieta Villalba Nadia Mercedes
- Mendoza-Jiménez María J.
- Michinel Humberto
- Miranda Ramos Mónica
- Monsalve Artega Carlos
- Morales Ibarra Rafael
- Morales M.
- Moreno Moisés
- Moret Tatay Carmen
- Moya B.
- Moyano Rodriguez Diego
- Muñoz P.
- Naranjo B.
- Navas Ruilova Gustavo Ernesto
- Nieto-Londoño C.
- Nieto-Londoño César
- Niño Ruiz Zulay
- Ocampo Alvarado Juan Carlos
- Orizaga Trejo José Antonio
- Ortega Pacheco Daniel
- Palacios Bustamante Rafael
- Parra Rosero Pablo
- Peñafiel Caicedo Joseph Adrián
- Peñaherrera S.
- Pillajo Angos Carlos
- Pillajo Angos Carlos Germán
- Pillajo C.
- Pinos Figueroa Blanca
- Pinzón I.
- Pizarro G.
- Pluas Zambrano Vanessa Alexandra
- Portilla Farfán Fredi Leonidas
- Prieto Vélez Patsy Malena
- Pulupa Águila Joyce Stephanie
- Pérez Gosende Pablo
- Pérez Gosende Pablo Alberto
- Pérez Gosende Pablo Alberto
- Quiróz M.
- Quisi-Peralta Diego
- Quitiaquez Sarzosa William
- Quitiaquez W.
- Ramos Avecillas Juan Paul
- Ramírez Cando Lenin Xavier
- Ramírez-Cando L.
- Reyes López Christopher
- Reyes-López C.
- Ribadeneira Ramírez Jefferson
- Rivera Campoverde Néstor Diego
- Rodríguez Manuel
- Rojas Párraga Tania Catalina
- Rojas Zavala Víctor Emilio
- Romero Blacio Fernanda Yamileth
- Romero Paz Manuel de Jesús
- Romero Romero Byron Ramiro
- Romero-Rodríguez Luis Miguel
- Román Párraga Abel
- Rosero Toledo Karina
- Rosero Toledo Wendy
- Samaniego Raúl Arturo
- Santos Edgar Daniel
- Saquicela Victor Saquicela
- Serpa Andrade Luis Javier
- Silva Ariel Osvaldo
- Silva-Yumi Jorge
- Soberon D.
- Sumba N.
- Toapanta Toapanta Segundo Moisés
- Toapanta L.
- Toapanta Luis Fernando
- Torres Capuz Kevin Rolando
- Torres Toukoumidis Angel
- Uribe Yunda Diego Fernando
- Vaca I.
- Valdez Pérez María Eugenia
- Vega Ureta Nino Tello
- Veloz Mayorga Nancy
- Verdugo Romero Walter
- Viasus Germán
- Vidal Mogrovejo Paúl
- Vilches R.
- Villacrés Beltrán Fabián
- Villacrés Beltrán Fabián Isaac
- Vásquez Cevallos Leonel
- Vázquez Martínez Andrea
- Yambay Aulla Ines
- Zapata Narváez Diego
- Álvarez Guale Raúl
- Álvarez Guale Raúl Jimmy
- Álvarez C.
- Álvarez C.
- Ávalos Zambrano Rodrigo
- Publication venue
- Publication date
- 01/07/2018
- Field of study
Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil.
El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país.
La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica.
Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado Héctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
- Ajiya Abdulrazak
- Akeel Nouf
- Akin Emrah
- Akinajo Opeyemi
- Akinyemi Tosin
- Akrida Ioanna
- Aktokmakyan Talar Vartanoglu
- Akwaisah Ayoub
- Al Bettar Osama
- Al-Badawi Ismail A.
- Al-Juaifari Maytham
- Al-Khyatt Waleed
- Al-Mallah Abdullah
- Al-Nusairi Ahmed
- Al-Saadi Nina
- Al-Sayaghi Khaled
- Al-Shaiji Tariq
- Al-Shehari Mohammed
- Al-Touny Aiman
- Al-Touny Shimaa A.
- Aladawi Omar
- Aladna Abdallah
- Alali Mahmoud
- Alam Mahmood
- Alam Mohammed Shadrul
- Alarabi Rehab
- Alawneh Yazan
- Alayande Barnabas
- Albanese Erminia
- Albayadi Eslam
- Albdour Maram
- Alconchel Felipe
- Alderazi Amer
- Alegbeleye Bamidele
- Alekberli Tural
- Alemu Misganaw Alemu Adimass
- Alexander Philip
- Alfieri Alex
- Algahtany Khaled
- Algarni Kamal
- Alhamad Ameen
- Alhamid Mohammad
- Alharmi Rawan A. Rahman
- Alharthi Mohammed
- Alhazmi Barrag
- Ali Mohamed Shafi Mahboob
- Ali Stephen
- Alibrahim Hidar
- Aljaaly Hattan
- Aljaiuossi Anas
- Aljanadi Firas
- Aljiffry Murad
- Aljirdabi Noof
- Alkahlan Mohammed
- Alkhalifa Elmustafa
- Alkhatib Sondos
- Alkhatieb Maram
- Allan Anna
- Almarshad Felwa
- Almgla Naser
- Almhimid Ali
- Almiqlash Bushray
- Almoshantaf Mohammad Badr
- Almutairi Abdulmjeed
- Alnsour Abed Alfattah Mahmoud
- Alobied Majd
- Alomar Osama
- Alonso Jesús Aarón Martínez
- Alonso Manuel Diez
- Alonso Nestor Fabian Pedraza
- Alonso Veronica
- Alqallaf Abdullah
- Alqaseer Asma
- Alrayes Bourhan
- Alsefri Maryam
- Alser Osaid
- Alsharif Mohammed
- Alsori Mohamed
- Altaf Abdulmalik
- Altinel Yuksel
- Altiner Saygin
- Altouny Ahmad
- Altun Demet
- Alvarez Natalia
- Alvarez-Lozada Luis Adrian
- Alvi Abdul
- Alwael Athari
- Alwash Mohammed
- Alyami Ziyad
- Alyousef Mohammed
- Alzahrani Saud
- Alzerwi Nasser
- Amin Shivang
- Amir Mohammed
- Ammar Ahmed Siddique
- Ammendola Michele
- Amores Remedios Revilla
- Amrayev Sultan
- Anastasiadou Sofia
- Ancans Guntis
- Anderson Caroline
- Andreani Lorenzo
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- Kassab Mohamad B.
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- Szabómihályová Katarína
- Szakmany Tamas
- Szatmary Peter
- Sztipits Tamás
- Szyluk Karol
- Sá-Marta Eduarda
- Sánchez Alberto Cabañero
- Sánchez Rosa
- Sánchez-Guillén Luis
- Süleyman Marlen
- Tadic Boris
- Taha Anas
- Taha-Mehlitz Stephanie
- Tailor Bhavesh
- Taj Eldeen Samaher Taj Eldeen Hassan
- Takeda Flavio Roberto
- Takkenberg Marijn
- Talat Nabila
- Tallon-Aguilar Luis
- Talwar Rishi
- Tamayo Beatriz Villota
- Tamburello Sara
- Tamini Nicolò
- Tammo Ömer
- Tamoos Khalil
- Tampaki Ekaterini Christina
- Tampakis Athanasios
- Tan Chih Ying
- Tan Shawn Jia Hwang
- Tanal Mert
- Tanas Yousef
- Tang Alethea
- Tang Yita
- Tani Sobhana Iftekhar
- Tantraworasin Apichat
- Tantri Aida Rosita
- Tapia-Herrero Ana-María
- Tarek Ahmed
- Tariq Aiman
- Tarle Marko
- Tarsitano Achille
- Tartaglia Dario
- Tartaglia Nicola
- Tashkandi Wail
- Taskiran Cagatay
- Tatar Cihad
- Tatsis Dimitris
- Tawalbeh Ra'Fat
- Tawiah Augustine
- Tebha Sameer
- Techapongsatorn Suphakarn
- Teixeira Pedro
- Tejero-Pintor Francisco J.
- Tellez Karla Susana Martin
- Tellez Luis Garcia-Sancho
- Thaha Mohamed Adhnan
- Thakar Sumit
- Thaw May Htoo
- Theivendran Kanthan
- Thekkinkattil Dinesh
- Theochari Nikoletta
- Theodoropoulos George
- Theophilidou Elena
- Thereska Dariel
- Thiruchandran Gajendiran
- Thomakos Nikolaos
- Thomas Bradley
- Thomas Jerin Jose
- Thuduvage Vasanthika
- Thumbadoo Ruben
- Tian Sarah
- Tidjane Anisse
- Tirloni Luca
- Toia Francesca
- Tokidis Evripidis
- Tokocin Merve
- Tolani Musliu Adetola
- Toma Elena Adelina
- Tomasicchio Giovanni
- Tomlinson James
- Tonini Valeria
- Torre Beatrice
- Torregrosa Cristina
- Torun Bahar Canbay
- Tottman R.
- Tousidonis Manuel
- Trabulsi Nora
- Tranca Sebastian
- Trebol Jacobo
- Trejo-Avila Mario
- Triantafyllou Alexandra
- Triantafyllou Tania
- Trifunovski Aleksandar
- Tripathi Manjul
- Tripathi Prashant
- Tripathy Sujit
- Trivik-Barrientos Felipe
- Trostchansky Ivan
- Trulson Alexander
- Trungu Sokol
- Truss Adam
- Tsakiridis Ioannis
- Tsakiridis Nikolaos
- Tsiantoula Paraskevi
- Tsironis Dimitrios
- Tsolakidis Alexandros
- Tsoulfas Georgios
- Tucker Olga
- Tuech Jean Jacques
- Turan Alparslan
- Turi Stefano
- Turna Akif
- Turrado-Rodriguez Victor
- Turri Giulia
- Tutino Roberta
- Tuyishime Eugene
- Tzelves Lazaros
- Tzima Ioanna
- Tzimas George
- Ubiali Paolo
- Ubom Akaninyene Eseme
- Ugwu Aloy Okechukwu
- Ugwu Ebere
- Ugwu Ifeanyichukwu
- Ul Huda Maria Noor
- Ulas Ali Bilal
- Uldry Emilie
- Ulgur Hanife Seyda
- Ulkucu Attila
- Ulman Elif Akbas
- Ulman Hilmican
- Ulutaş Mehmet Eşref
- Underwood Kirk
- Unsworth Richard
- Uprak Tevfik Kivilcim
- Urriza Pablo Vallés
- Usman Muhammad
- Usman Mustapha Ibrahim
- Vaassen Lauretta
- Vaccara Vincenzo La
- Vagena Xanthoula
- Vagge Aldo
- Vailas Michail
- Valadez Andrea Estefania Cueto
- Valadez Tania Abigail Cueto
- Valanci Sofia
- Valdespino Cristina Puentes
- Valeanu Liana
- Valioulis Ioannis
- Valladares Sergio Chávez
- Vallve-Bernal Marc
- Van Acker Jill
- Van Den Eynde Jef
- Van Goor Harry
- Van Vliet Helen
- Van Wyk Naomi Natasha
- Vanni Camilla
- Vas Aurelia
- Vasarhelyi Edward
- Vaschetti Roberto
- Vassiliu Panteleimon
- Vatansever Dogan
- Vatish Jamie
- Vaughan-Shaw Peter G.
- Vaysburg Dennis
- Veglia Antonella
- Velten Markus
- Velázquez Maria Jose Martinez
- Venkatappa Sunil Kumar
- Venketeswaran Meenakshi
- Venskutonis Donatas
- Verbic Milena Senica
- Verdi Daunia
- Vergara-Fernandez Omar
- Verhoeff Kevin
- Veroux Massimiliano
- Verras Georgios-Ioannis
- Verre Luigi
- Vida Lucian
- Vidya Raghavan
- Viglietta Edoardo
- Vijay Vardhini
- Vijgen Guy
- Vilaró Blanca Capdevila
- Villanueva Julio
- Vilz Tim O.
- Vincent Elizabeth
- Vinci Danilo
- Viola Simona
- Violante Tommaso
- Vishnoi Jeewan Ram
- Vissapragada Ravi
- Vivancos Laura Guillamon
- Vives Josep Maria Muñoz
- Vizzielli Giuseppe
- Vohra Lubna
- Vokshi Ismail
- Vosinakis Christos
- Vásquez Javier Alberto Gutiérrez
- Vázquez Gil
- Vázquez Irene Ortega
- Vǎcǎraşu Andrei Bogdan
- Wade Ryckie
- Wafi Omar
- Wagner Gabriela
- Wallis Christopher
- Wanjara Samuel
- Waqar Shahzad Hussain
- Warden Claire
- Warner Christian
- Wasim D.
- Wason Shaun
- Wasserman Isaac
- Watcyn-Jones Tom
- Waterson Ben
- Watson David
- Watson Matthew
- Weber Clemens
- Wheatstone P.
- Wheeler James
- Wheldon Luke
- White Michelle
- White Stuart
- White William
- Wickramasinghe Dakshitha
- Widmer Lukas Werner
- Wiedemann Dominik
- Wiesinger Clemens Georg
- Wijekoon Naveen
- Wijenayake Wasantha
- Wijeyaratne Manuk
- Wijeysundera Duminda
- Wiles Matthew
- Wilkin Richard
- Wilkins Alex
- Wilkins James
- William Tinka George
- Williams Omolara Modupe
- Williams Shekinah
- Windsor John
- Winnand Philipp
- Wittmann Maria
- Wolde Amanuel
- Wolfenden John W. D.
- Wong Benjamin Ngie Xiong
- Wong Enoch
- Wong Evan G.
- Wong George Kwok Chu
- Wong Ho Ying Flora
- Wong Kai Yuen
- Wormald Justin
- Wright Deborah
- Wright Joshua
- Wu Fiona
- Wurm Markus
- Xenaki Sofia
- Yadev Ip
- Yahaya Ahmad Shuib
- Yakubu Mustapha
- Yang Wah
- Yanik Özge
- Yanowsky-Reyes Guillermo
- Yassin Abubaker
- Yates Elizabeth
- Yebes Alvaro
- Yenli Edwin Mwintiereh Ta-Ang
- Yeoh Tien
- Yeung Justin
- Yiallourou Anneza
- Yigit Banu
- Yildirim Asif
- Yim Guang
- Yiu Andrew
- Yonekura Hiroshi
- Yotsov Tsanko
- Younis Muhammad Umar
- Yunus Alif
- Yusefi Hossein
- Zabaleta Jon
- Zabkiewicz Catheriner
- Zaccaria Giulia
- Zacharia Bincy
- Zafar Syed Nabeel
- Zago Mauro
- Zaheen Zakia
- Zahid Zahra
- Zaimis Tilemachos
- Zakaria Andee Dzulkarnaen
- Zambon Martina
- Zamora Lindsey
- Zampogna Biagio
- Zancana Giuseppa
- Zani Augusto
- Zanin Luca
- Zanini Nicola
- Zapardiel Ignacio
- Zapata Carlos Shiraishi
- Zarif Pierre
- Zaránd Attila
- Zehnder Philipp
- Zenger Serkan
- Zenha Horácio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ávila Clara Castro
- Älgå Andreas
- Çakici Mehmet Çaǧlar
- Çelik Enes
- Çelik Meryem Nur
- Özçay Necdet
- Şevik Hüsnü
- Šantak Goran
- Šimko Kristián
- Žatecký Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
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
- Anaya Dominguez Marlene
- Anaya Firas
- Andrade Jerhy
- Andreussi Lorna
- Anicama Elias Rocio
- Annajjar Mohammad hasan
- Anntinea Jessmine
- Antunes Amanda
- Antunez-Mora Alexandra
- Anyomih Theophilus Teddy Kojo
- Anzelewicz Stefan
- Apaza Leon Jose Luis
- Appeadu-Mensah William
- Arabiat Esraa
- Arafa Mohamed Ahmed
- Arafat Hasan
- Aragão Liliana
- Arancibia Gutiérrez Elsa
- Aranda Sánchez Cristian Irela
- Arar Ahmad Samih
- Arauco Jenny
- Arbab Hana
- Arboleda Jenny
- Aremo Anuoluwapo
- Arnadóttir Helena
- Arnaud Alexis P
- Arnold Marion
- Arnoletto Lucia Beatriz
- Arrmali Saddam
- Arrmalli Lina Ali
- Arshad Muhammad
- Arthur Felicity
- Arul Suren
- Ashour Dina Ayman
- Ashour Yara shareef
- Aslan Yakup
- Aspirot Ann
- Assi Ahmadfateh
- Assi Muath Abdelrahem Fuad
- Astudillo Miguel
- Atatri Yazid yousef mahmoud
- Atta Ahmed
- Attia Alaa Mobarak
- Avile Romina
- Avolio Luigi
- Awad Hadeel
- Aydin Emrah
- Aykut Merve
- Ayque Rosas Fernando
- Aziz Dayang Anita Abdul
- Ba'baa' Basheer
- Badr Helmy
- Baertschiger Reto
- Bagbio Dominic
- Bah Abdoulie
- Bai Qiang
- Bai Yu Zuo
- Baistrocchi Valentina
- Bakar Ainal Huda Abu
- Baker Wisam
- Ballouhey Quentin
- Balousha Abrar ghassan
- 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
- Beres Alana
- Berková Klára
- Bernaus Marianela
- Berrocal Anaya Waldo
- Berzanskis Mindaugas
- Beshtawi Doha mustafa saleh
- Beşir Ahmet
- Bianchin Ezequiel
- Bibas Fatma
- Biber Elna
- Bischoff Cristiano
- Bismarck Sylvester von
- Blain Otilia Eva
- Blanc Thomas
- Blazquez-Gomez Eva
- Bobadilla Morales Lucina
- Bode Christopher
- Bonnard Arnaud
- Boonthai Ampaipan
- Borbonet Daniel
- Bouhadiba Nordeen
- Bowder Alex
- Bracho Blanchet Eduardo
- Bradshaw Kate
- Bragagnini Paolo
- Brahmamdam Pavan
- Bravo Mauro Nicolas
- Bright Benedict Paul
- Brito Quevedo Luz Mery
- Broch Aline
- Brolin Santis Isolan Paola Maria
- Brunero Marco
- Bruxel Carla Luisa
- Bsisu Isam
- Bucaram Elena
- Bueno Mazzuca Rafael
- Bueno Motter Sarah
- Bujarimin Ahmad Shafiee bin
- Bulnes Mendizabal David
- Burks Stephen S.
- Burns Kate
- Butler Marilyn
- Bvulani Bruce
- C. Nwosu David
- Caamal Lorenzo Juvencio
- Calancea Calin
- Calderon Moore Antonio
- Calderón Arancibia José Alfredo
- Calistus Nwachukwu
- Cama Jitoko
- Camamra Kajali
- Cameron Fraser
- Camp Lauren
- Canözer Ali
- Caouette-Laberge Louise
- Cardenas Alva Loreley Raquel
- Cardenas Ruiz Velasco Juan Jose
- Carrasco Ana Lucia
- Carrasco-Ortega Cesar
- Carrillo Isabel
- Casado Francis Tanise
- Casal Beloy Isabel
- Caseb Paloma
- Casquero Victor
- Castañeda Espinosa Sergio
- Castaño Avila Daniela
- Castedo Camacho Fabiola Ruth
- Cavaiuolo Silvia
- Cañapataña Sahuanay Veronica Raquel
- Cepeda Rodrigo
- Cesur İlknur Banlı
- Chan Jonathan
- Chang Jeremy
- Charras Maria Delia
- Chaudary Ali Raza
- Chaudhry Muhammad Amjad
- Chauhan Nirav
- Chavez Galvez Patricia
- Chen Lulu
- Chen Rui
- Cheung Maija
- Chipalavela Rossana Francisco
- Chiriboga Elena
- Chitiavi Soita Wycliffe
- Chitnis Milind
- Cho Seok Hyeon
- Choo Candy SC
- Chukwu Isaac
- Chukwuemeka Anyanwu Lofty-John
- Chung Jae Hee
- Cletus Cyril
- Coghill Griffin
- Collins Nwokoro
- Colombo de Holanda Felipe
- Contreras Carla Sofia
- Coon John
- Cordonnier Annelien
- Cornelli Fabio
- Cornwall Hannah
- Corona C. Rivera Jorge Román
- Corona Rivera Alfredo
- Correa Leite Mila Torii
- Correa Armandou
- Correa Catalina
- Corrêa Costa Eduardo
- Cosoreanu Vlad
- Costas-Chavarri Ainhoa
- Cripovich Alejandrina
- Cunningham Aaron
- 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
- Dalloul Hisham
- Damiani Andrea
- Dammagh Nagham Mohammed Al
- Dania Bouguermouh
- Darras Osama Majed
- Darwish Ahmed S
- Darwish Ammar
- Dass Anthony
- Dassonville Martine
- Davenport Kate
- David Kuria
- Davies Justine
- Davis Jenna Kylene
- de Assis Silva Murilo
- de Azevedo Belesa Flavia
- de Campos Vieira Abib Simone
- 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
- Deyab Abdelaziz
- Di Siervi Oscar
- Diaz Castañeda Flor de Maria
- Diaz Echegaray Marlene
- Diaz Gomez Jose Manuel
- Diaz Leon Cesar
- Dieudonné Lemfuka
- Dimatatac Doris Mae
- Djordjevic Ivona
- Dogar Sohail
- Doheim Mohamed Fahmy
- Dominguez Danny
- Donglai Hu
- Dornellas do Nascimento Suely
- dos Santos Dias André Iván Bradley
- Dosselman Luke J.
- Douiri Abdel
- Drah Weam
- Dube Andile Maqhawe
- Duchesne Camille
- Duggan Eileen
- Duote Cai
- Dure Carolina
- Dávila Perez Roberto
- Ebeido Annan
- Egbuchulem Ifeanyichukwu Kelvin
- Ejinkeonye Eze Chukwuemeka
- Ekenze Sebastian Okwuchukwu
- Ekwunife Okechukwu Hyginus
- El-Ghazaly Mohammed
- Elassall Gena Mohamed Hamed
- Elayeb Abdallah
- Elebute Olumide Abiodun
- Elewaily Mohamed
- Elfiky Mahmoud
- Elgammudi Mala
- Elghazaly Shrouk Mahmoud
- Elhadi Ahmed
- Elhadi Muhammed
- Elhajjaji Yasmine Ali
- Elhattab Ahmad
- Elisante Joseph
- Elkaloush Abdullahn Abdousalam
- Elkhazmi Ebtesam Othman Abdulsalam
- Elmenam Mohamed Abd
- Elmzyyen Aya Mahmoud
- Elrais Safa Abdal
- Elsadek Menan Ahmed
- Elsaied Adham
- Elshaer Omar Adly
- Elsherbiny Mohamed
- Elsiraffy Omar Ossama
- Elstad Maria
- Elzohiri Mohamed
- Elzowawi Fathi
- Emam Omar Sameh
- Emil Sherif
- Enbaya Manal Ben
- Ensar Nicholas
- Erdem Melisa
- Eren Elif
- Ergenekon Ebru
- Eroğlu Egemen
- Erturk Nazile
- Erçin Seçil
- Eshkabilov Shukurali
- Espineda Beda
- Essa Tarek Mohamed
- Essamilghi Kamila Almabrouk Mohammed
- Ezidiegwu Ugochukwu S
- Ezomike Uchechukwu Obiora
- Faboya Omolara Moronkeji
- Fachin Camila
- Fadhle Muhamed Jassim
- Faks Vivian
- Falah Eyad Hassan
- Farag Eman mohamed
- Fares Jehad
- Farha Mervat Sufian Abu
- Farion-Aguiar Luiz
- Fawzy Omar Moustafa
- Fayez Mohamed
- Fazli Mohamad Rafi
- Feldens Leticia
- Felix Michael
- Ferdousi Tamanna
- Fernandes de Oliveira Darli
- Fernandes de Souza Rachel
- Fernandez Ferrer Marianelly
- Fernandez Portilla Emilio
- Fernandez Wilson Miriam Daniela
- Ferraz Schopf Luciano
- Flores Carbajal Lenny
- Ford Kat
- Forero Ladino Angelica Maria
- Fouda Mohamed Fayez
- Fouly Mariam Albatoul Nageh
- Fouquet-Languillat Virginie
- Fourcade Laurent
- Fowler Kathryn L
- Fox Sarah
- Franco Helena
- Furtado Meyer Karine
- Furtado Mariana
- Féliz Erick
- Gabriel Comba
- Gad Dalia
- Gadepalli Samir
- Gai A.
- Galdeano Marcelo
- Gall Caroline Le
- Gamage Tharanga
- Gamboa Kcomt Segundo
- Gao Zhigang
- Gao Zhou Chong
- Garcia Martinez Humberto
- Garcia Isidora
- Garcia Virginia
- Garcia-Aparicio Luis
- García Miriam
- Gargum Sondas Ali
- Garnier Hanna
- Garrett-Cox Robin
- Gasana Georges
- Gatzinsky Vladimir
- Gavrila Bogdan
- Gavrilovska-Brzanov Aleksandra
- Gee Oliver
- Gerus Sylwester
- Geze Şükran
- Ghabayen Amir Talat Sheda
- Ghallab Alaa
- Ghaly Khaled Abd elrahman
- Ghanem Waleed H.
- Ghayth Sumayyah
- Ghazzawi Ihsan
- Ghilardi Silva Ximena
- Ghorab Islam Abdelmonem
- Ghosh Dhruv
- Gilardi Jose
- Girão Tauffer Mariana
- Goddard Lucy
- Goebel Peter
- Gohil Hetal
- Gomes Adriano Luis
- Gomez Juanita
- Gomez Oscar
- Gondal Mudassir Fayaz
- Gonzales Brandy
- Gonzalez Cortez Luis Fernando
- Gonzalez Daniel Emilio
- Gonzalez Joann
- González Ojeda Alejandro
- Gonçalves Borges Carolina
- Gonçalves da Cunha
- Gonçalves Victor
- Gosain Ankush
- Grabowski Andrzej
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- Grottling Emma
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- Ullrich Sarah
- Vacek Jonathan
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- Vanis Nedim
- Vaquila Justo
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- Vatta Fabrizio
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- Villalba Villalba Araceli
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- Vosoughi Armin
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- 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
Effect of alirocumab on mortality after acute coronary syndromes. An analysis of the ODYSSEY OUTCOMES randomized clinical trial
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- 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
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