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2. Hypotension during spinal anaesthesia for Caesarean section in a resource-limited setting: towards a consensus definition
- Author
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Zwane, SF, primary, Bishop, DG, additional, and Rodseth, RN, additional
- Published
- 2018
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3. In-hospital clinical outcomes after upper gastrointestinal surgery: Data from an international observational study
- Author
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Ahmad, T, Bouwman, RA, Grigoras, I, Aldecoa, C, Hofer, C, Hoeft, A, Holt, P, Fleisher, LA, Buhre, W, Pearse, RM, Ferguson, M, MacMahon, M, Shulman, M, Cherian, R, Currow, H, Kanathiban, K, Gillespie, D, Pathmanathan, E, Phillips, K, Reynolds, J, Rowley, J, Douglas, J, Kerridge, R, Garg, S, Bennett, M, Jain, M, Alcock, D, Terblanche, N, Cotter, R, Leslie, K, Stewart, M, Zingerle, N, Clyde, A, Hambidge, O, Rehak, A, Cotterell, S, Huynh, WBQ, McCulloch, T, Ben-Menachem, E, Egan, T, Cope, J, Halliwell, R, Fellinger, P, Haisjackl, M, Haselberger, S, Holaubek, C, Lichtenegger, P, Scherz, F, Schmid, W, Hoffer, F, Cakova, V, Eichwalder, A, Fischbach, N, Klug, R, Schneider, E, Vesely, M, Wickenhauser, R, Grubmueller, KG, Leitgeb, M, Lang, F, Toro, N, Bauer, M, Laengle, F, Haberl, C, Mayrhofer, T, Trybus, C, Buerkle, C, Forstner, K, Germann, R, Rinoesl, H, Schindler, E, Trampitsch, E, Bogner, G, Dankl, D, Duenser, M, Fritsch, G, Gradwohl-Matis, I, Hartmann, A, Hoelzenbein, T, Jaeger, T, Landauer, F, Lindl, G, Lux, M, Steindl, J, Stundner, O, Szabo, C, Bidgoli, J, Verdoodt, H, Forget, P, Kahn, D, Lois, F, Momeni, M, Pregardien, C, Pospiech, A, Steyaert, A, Veevaete, L, De Kegel, D, De Jongh, K, Foubert, L, Smitz, C, Vercauteren, M, Poelaert, J, Van Mossevelde, V, Abeloos, J, Bouchez, S, Coppens, M, De Baerdemaeker, L, Deblaere, I, De Bruyne, A, De Hert, S, Fonck, K, Heyse, B, Jacobs, T, Lapage, K, Moerman, A, Neckebroek, M, Parashchanka, A, Roels, N, Van Den Eynde, N, Vandenheuvel, M, Van Limmen, J, Vanluchene, A, Vanpeteghem, C, Wouters, P, Wyffels, P, Huygens, C, Vandenbempt, P, Van de Velde, M, Dylst, D, Janssen, B, Schreurs, E, Aleixo, FB, Candido, K, Batista, HD, Guimaraes, M, Guizeline, J, Hoffmann, J, Lobo, S, Marques Lobo, FR, Nascimento, V, Nishiyama, K, Pazetto, L, Souza, D, Rodrigues, RS, Vilela dos Santos, AM, Jardim, J, Sa Malbouisson, LM, Silva, J, do Nascimento Junior, P, Baio, TH, Pereira de Castro, GI, Watanabe Oliveira, HR, Amendola, CP, Cardoso, G, Ortega, D, Brotto, AF, De Oliveira, MC, Rea-Neto, A, Dias, F, Travi, ME, Zerman, L, Azambuja, P, Knibel, MF, Martins, A, Almeida, W, Neder Neto, C, Tardelli, MA, Caser, E, Machado, M, Aguzzoli, C, Baldisserotto, S, Tabajara, FB, Bettega, F, Rodrigues Junior, LHC, de Gasperi, J, Faina, L, Nolasco, MF, da Costa Fischer, BF, de Campos Ferreira, MF, Hartmann, C, Kliemann, M, Ribeiro, GLH, Fraga, JM, Netto, TM, Pozza, LV, Wendling, PR, Azevedo, C, Garcia, J, Lopes, M, Maia, B, Maselli, P, Melo, R, Mendes, W, Neves, M, Ney, J, Piras, C, Applewhaite, C, Carr, A, Chow, L, Duttchen, K, Foglia, J, Greene, M, Hinther, A, Houston, K, McCormick, TJ, Mikhayel, J, Montasser, S, Ragan, A, Suen, A, Woolsey, A, Yu, HC, Funk, D, Kowalski, S, Legaspi, R, McDonald, H, Siddiqui, F, Pridham, J, Rowe, B, Sampson, S, Thiessen, B, Zbitnew, G, Bernard, A, George, R, Jones, P, Moor, R, Siddiqui, N, Wolfer, A, Tran, D, Winch, D, Dobson, G, McCormick, T, Montasser, O, Hall, R, Baghirzada, L, Curley, G, Dai, SY, Hare, G, Lee, E, Shastri, U, Tsui, A, Yagnik, A, Alvares, D, Choi, S, Dwyer, H, Flores, K, McCartney, C, Somascanthan, P, Beattie, S, Carroll, J, Pazmino-Canizares, J, Wijeysundera, D, Ami, N, Chan, V, Perlas, A, Argue, R, Huang, Y, Lavis, K, Mayson, K, Cao, Y, Gao, H, Hu, T, Lv, J, Yang, J, Yang, Y, Zhong, Y, Zhou, J, Zou, X, He, M, Li, X, Luo, D, Wang, H, Yu, T, Chen, L, Wang, L, Cai, Y, Cao, Z, Li, Y, Lian, J, Sun, H, Wang, S, Wang, Z, Wang, K, Zhu, Y, Du, X, Fan, H, Fu, Y, Huang, L, Hwan, H, Luo, H, Qu, P-S, Tao, F, Wang, G, Zhang, Y, Zhang, X, Chen, C, Wang, W, Liu, Z, Fan, L, Tang, J, Chen, Y, Han, Y, Huang, C, Liang, G, Shen, J, Wang, J, Yang, Q, Zhen, J, Zhou, H, Chen, J, Chen, Z, Meng, B, Ye, H, Bi, Y, Cao, J, Guo, F, Lin, H, Liu, Y, Lv, M, Shi, P, Song, X, Sun, C, Sun, Y, Wang, Y, Zhang, M, Chen, R, Hou, J, Leng, Y, Meng, Q-T, Qian, L, Shen, Z-Y, Xia, Z-Y, Xue, R, Zhao, B, Zhou, X-J, Chen, Q, Guo, H, Guo, Y, Qi, Y, Wei, J, Zhang, W, Zheng, L, Bao, Q, Fei, Y, Hu, N, Hu, X, 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Campbell, M, Chan, P, Jemmett, K, Raj, A, Naik, A, Oshowo, A, Ramamoorthy, R, Shah, N, Sylvan, A, Blyth, K, Burtenshaw, A, Freeman, D, Johnson, E, Lo, P, Martin, T, Plunkett, E, Wollaston, J, Allison, J, Carroll, C, Craw, N, Craw, S, Pitt-Kerby, T, Rowland-Axe, R, Spurdle, K, McDonald, A, Simon, D, Sinha, V, Banner-Goodspeed, V, Boone, M, Campbell, K, Lu, F, Scannell, J, Sobol, J, Balajonda, N, Clemmons, K, Conde, C, Elgasim, M, Funk, B, Hopkins, T, Olaleye, O, Omer, O, Pender, M, Porto, A, Waweru, P, Yeh, E, Bodansky, D, Evans, A, Kleopoulos, S, Maril, R, Mathney, E, Sanchez, A, Tinuoye, E, Bateman, B, Eng, K, Jiang, N, Ladha, K, Needleman, J, Chen, L-L, Lane, R, Robinowitz, D, Ghushe, N, Irshad, M, O'Connor, J, Patel, S, Takemoto, S, Wallace, A, Mazzeffi, M, Rock, P, Wallace, K, Chua, P, Fleisher, L, Mattera, M, Sharar, R, Thilen, S, Treggiari, M, Morgan, A, Sofjan, I, Subramaniam, K, Avidan, M, Maybrier, H, Muench, M, Wildes, T, ISOS, ISOS, Int Surgical Outcomes Study ISOS, Anesthesiology, ACS - Diabetes & metabolism, ACS - Microcirculation, ACS - Amsterdam Cardiovascular Sciences, APH - Quality of Care, ACS - Heart failure & arrhythmias, and International Surgical Outcomes Study (ISOS) group
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Male ,IMPACT ,Cancer ,Complication rate ,Mortality ,Oesophagectomy ,Postoperative care ,Upper gastrointestinal surgery ,SURGICAL COMPLICATIONS ,0302 clinical medicine ,Postoperative Complications ,Risk Factors ,Outcome Assessment, Health Care ,030212 general & internal medicine ,Hospital Mortality ,Prospective Studies ,ESOPHAGOGASTRIC CANCER ,Prospective cohort study ,Digestive System Surgical Procedures ,RISK ,Perioperative medicine ,General Medicine ,Middle Aged ,Oncology ,Length of Stay/statistics & numerical data ,Elective Surgical Procedures ,MORTALITY FOLLOWING ESOPHAGECTOMY ,030220 oncology & carcinogenesis ,Female ,Elective Surgical Procedure ,Cohort study ,medicine.medical_specialty ,ENHANCED RECOVERY ,PERIOPERATIVE MEDICINE ,Postoperative Complications/mortality ,NO ,03 medical and health sciences ,Outcome Assessment (Health Care) ,MORBIDITY ,medicine ,Humans ,Digestive System Surgical Procedures/mortality ,business.industry ,LONG-TERM SURVIVAL ,Odds ratio ,Length of Stay ,CARE ,medicine.disease ,Confidence interval ,Surgery ,Human medicine ,Complication ,business - Abstract
Aims: Previous research suggests that patients undergoing upper gastrointestinal surgery are at high risk of poor postoperative outcomes. The aim of our study was to describe patient outcomes after elective upper gastrointestinal surgery at a global level.Methods: Prospective analysis of data collected during an international seven-day cohort study of 474 hospitals in 27 countries. Patients undergoing elective upper gastrointestinal. surgery were recruited. Outcome measures were in-hospital complications and mortality at 30-days. Results are presented as n(%) and odds ratios with 95% confidence intervals.Results: 2139 patients were included, of whom 498 (23.2%) developed one or more postoperative complications, with 30 deaths (1.4%). Patients with complications had longer median hospital stay 11 (6-18) days vs. 5 (2-10) days. Infectious complications were most frequent, affecting 368 (17.2%) patients. 328 (15.3%) patients were admitted to critical care postoperatively, of whom 161 (49.1%) developed a complication with 14 deaths (4.3%). In a multivariable logistic regression model we identified age (OR 1.02 [1.01-1.03]), American Society of Anesthesiologists physical status III (OR 2.12 [1.44-3.16]) and IV (OR 3.23 [1.72-6.09]), surgery for cancer (OR 1.63 [1.27-2.11]), open procedure (OR 1.40 [1.10-1.78]), intermediate surgery (OR 1.75 [1.12-2.81]) and major surgery (OR 2.65 [1.72-4.23]) as independent risk factors for postoperative complications. Patients undergoing major surgery for upper gastrointestinal cancer experienced twice the rate of complications compared to those undergoing other procedures (224/578 patients [38.8%] versus 274/1561 patients [17.6%]).Conclusions: Complications and death are common after upper gastrointestinal surgery. Patients undergoing major surgery for cancer are at greatest risk. (C) 2017 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
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- 2017
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4. Development and validation of the isiZulu quality of recovery score
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Sikhakhane, S, primary, Kusel, B, additional, and Rodseth, RN, additional
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- 2018
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5. Sample-size determination and adherence in randomised controlled trials published in anaesthetic journals
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Nontshe, M, primary, Khan, S, additional, Mandebvu, T, additional, Merrifield, B, additional, and Rodseth, RN, additional
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- 2018
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6. The silent killer: myocardial injury after non-cardiac surgery (MINS)
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Simpson, GC, primary, Marais, LC, additional, and Rodseth, RN, additional
- Published
- 2018
- Full Text
- View/download PDF
7. Association of postoperative high-sensitivity troponin levels with myocardial injury and 30-day mortality among patients undergoing noncardiac surgery
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Chan, MTV, Writing Committee for the VISION Study Investigators, Devereaux, PJ, Biccard BM, Sigamani, A, Xavier, D, Srinathan, SK, Walsh, M, Abraham, V, Pearse, R, Wang, CY, Sessler, DI, Kurz, A, Szczeklik, W, Berwanger, O, Villar, JC, Malaga, G, Garg, AX, Chow, CK, Ackland, G, Patel, A, Borges, FK, Belley-Cote, EP, Duceppe, E, Spence, J, Tandon, V, Williams, C, Sapsford, RJ, Polanczyk, CA, Tiboni, M, Alonso-Coello, P, Faruqui, A, Heels-Ansdell, D, Lamy, A, Whitlock, R, LeManach, Y, Roshanov, PS, McGillion, M, Kavsak, P, McQueen, MJ, Thabane, L, Rodseth, RN, Buse, GAL, Bhandari, M, Garutti, I, Jacka, MJ, Schünemann, HJ, Cortes, OL, Coriat, P, Dvirnik, N, Botto, F, Pettit, S, Jaffe, AS, Guyatt, GH, Chan, MTV, Writing Committee for the VISION Study Investigators, Devereaux, PJ, Biccard BM, Sigamani, A, Xavier, D, Srinathan, SK, Walsh, M, Abraham, V, Pearse, R, Wang, CY, Sessler, DI, Kurz, A, Szczeklik, W, Berwanger, O, Villar, JC, Malaga, G, Garg, AX, Chow, CK, Ackland, G, Patel, A, Borges, FK, Belley-Cote, EP, Duceppe, E, Spence, J, Tandon, V, Williams, C, Sapsford, RJ, Polanczyk, CA, Tiboni, M, Alonso-Coello, P, Faruqui, A, Heels-Ansdell, D, Lamy, A, Whitlock, R, LeManach, Y, Roshanov, PS, McGillion, M, Kavsak, P, McQueen, MJ, Thabane, L, Rodseth, RN, Buse, GAL, Bhandari, M, Garutti, I, Jacka, MJ, Schünemann, HJ, Cortes, OL, Coriat, P, Dvirnik, N, Botto, F, Pettit, S, Jaffe, AS, and Guyatt, GH
- Abstract
IMPORTANCE: Little is known about the relationship between perioperative high-sensitivity troponin T (hsTnT) measurements and 30-day mortality and myocardial injury after noncardiac surgery (MINS). OBJECTIVE: To determine the association between perioperative hsTnT measurements and 30-day mortality and potential diagnostic criteria for MINS (ie, myocardial injury due to ischemia associated with 30-day mortality). DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study of patients aged 45 years or older who underwent inpatient noncardiac surgery and had a postoperative hsTnT measurement. Starting in October 2008, participants were recruited at 23 centers in 13 countries; follow-up finished in December 2013. EXPOSURES: Patients had hsTnT measurements 6 to 12 hours after surgery and daily for 3 days; 40.4% had a preoperative hsTnT measurement. MAIN OUTCOMES AND MEASURES: A modified Mazumdar approach (an iterative process) was used to determine if there were hsTnT thresholds associated with risk of death and had an adjusted hazard ratio (HR) of 3.0 or higher and a risk of 30-day mortality of 3% or higher. To determine potential diagnostic criteria for MINS, regression analyses ascertained if postoperative hsTnT elevations required an ischemic feature (eg, ischemic symptom or electrocardiography finding) to be associated with 30-day mortality. RESULTS: Among 21 842 participants, the mean age was 63.1 (SD, 10.7) years and 49.1% were female. Death within 30 days after surgery occurred in 266 patients (1.2%; 95% CI, 1.1%-1.4%). Multivariable analysis demonstrated that compared with the reference group (peak hsTnT <5 ng/L), peak postoperative hsTnT levels of 20 to less than 65 ng/L, 65 to less than 1000 ng/L, and 1000 ng/L or higher had 30-day mortality rates of 3.0% (123/4049; 95% CI, 2.6%-3.6%), 9.1% (102/1118; 95% CI, 7.6%-11.0%), and 29.6% (16/54; 95% CI, 19.1%-42.8%), with corresponding adjusted HRs of 23.63 (95% CI, 10.32-54.09), 70.34 (95% CI, 30.60-161.71), and 2
- Published
- 2017
8. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries
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Ahmad, T, Bouwman, RA, Grigoras, I, Aldecoa, C, Hofer, C, Hoeft, A, Holt, P, Fleisher, LA, Buhre, W, Pearse, RM, Ferguson, M, MacMahon, M, Shulman, M, Cherian, R, Currow, H, Kanathiban, K, Gillespie, D, Pathmanathan, E, Phillips, K, Reynolds, J, Rowley, J, Douglas, J, Kerridge, R, Garg, S, Bennett, M, Jain, M, Alcock, D, Terblanche, N, Cotter, R, Leslie, K, Stewart, M, Zingerle, N, Clyde, A, Hambidge, O, Rehak, A, Cotterell, S, Huynh, WBQ, McCulloch, T, Ben-Menachem, E, Egan, T, Cope, J, Halliwell, R, Fellinger, P, Haisjackl, M, Haselberger, S, Holaubek, C, Lichtenegger, P, Scherz, F, Schmid, W, Hoffer, F, Cakova, V, Eichwalder, A, Fischbach, N, Klug, R, Schneider, E, Vesely, M, Wickenhauser, R, Grubmueller, KG, Leitgeb, M, Lang, F, Toro, N, Bauer, M, Laengle, F, Haberl, C, Mayrhofer, T, Trybus, C, Buerkle, C, Forstner, K, Germann, R, Rinoesl, H, Schindler, E, Trampitsch, E, Bogner, G, Dankl, D, Duenser, M, Fritsch, G, Gradwohl-Matis, I, Hartmann, A, Hoelzenbein, T, Jaeger, T, Landauer, F, Lindl, G, Lux, M, Steindl, J, Stundner, O, Szabo, C, Bidgoli, J, Verdoodt, H, Forget, P, Kahn, D, Lois, F, Momeni, M, Pregardien, C, Pospiech, A, Steyaert, A, Veevaete, L, De Kegel, D, De Jongh, K, Foubert, L, Smitz, C, Vercauteren, M, Poelaert, J, Van Mossevelde, V, Abeloos, J, Bouchez, S, Coppens, M, De Baerdemaeker, L, Deblaere, I, De Bruyne, A, De Hert, S, Fonck, K, Heyse, B, Jacobs, T, Lapage, K, Moerman, A, Neckebroek, M, Parashchanka, A, Roels, N, Van Den Eynde, N, Vandenheuvel, M, Van Limmen, J, Vanluchene, A, Vanpeteghem, C, Wouters, P, Wyffels, P, Huygens, C, Vandenbempt, P, Van de Velde, M, Dylst, D, Janssen, B, Schreurs, E, Aleixo, FB, Candido, K, Batista, HD, Guimaraes, M, Guizeline, J, Hoffmann, J, Lobo, S, Marques Lobo, FR, Nascimento, V, Nishiyama, K, Pazetto, L, Souza, D, Rodrigues, RS, Vilela dos Santos, AM, Jardim, J, Sa Malbouisson, LM, Silva, J, Do Nascimento Junior, P, Baio, TH, Pereira de Castro, GI, Watanabe Oliveira, HR, Amendola, CP, Cardoso, G, 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Hare, G, Lee, E, Shastri, U, Tsui, A, Yagnik, A, Alvares, D, Choi, S, Dwyer, H, Flores, K, McCartney, C, Somascanthan, P, Beattie, S, Carroll, J, Pazmino-Canizares, J, Wijeysundera, D, Ami, N, Chan, V, Perlas, A, Argue, R, Huang, Y, Lavis, K, Mayson, K, Cao, Y, Gao, H, Hu, T, Lv, J, Yang, J, Yang, Y, Zhong, Y, Zhou, J, Zou, X, He, M, Li, X, Luo, D, Wang, H, Yu, T, Chen, L, Wang, L, Cai, Y, Cao, Z, Li, Y, Lian, J, Sun, H, Wang, S, Wang, Z, Wang, K, Zhu, Y, Du, X, Fan, H, Fu, Y, Huang, L, Hwan, H, Luo, H, Qu, P-S, Tao, F, Wang, G, Zhang, Y, Zhang, X, Chen, C, Wang, W, Liu, Z, Fan, L, Tang, J, Chen, Y, Han, Y, Huang, C, Liang, G, Shen, J, Wang, J, Yang, Q, Zhen, J, Zhou, H, Chen, J, Chen, Z, Meng, B, Ye, H, Bi, Y, Cao, J, Guo, F, Lin, H, Liu, Y, Lv, M, Shi, P, Song, X, Sun, C, Sun, Y, Wang, Y, Zhang, M, Chen, R, Hou, J, Leng, Y, Meng, Q-T, Qian, L, Shen, Z-Y, Xia, Z-Y, Xue, R, Zhao, B, Zhou, X-J, Chen, Q, Guo, H, Guo, Y, Qi, Y, Wei, J, Zhang, W, Zheng, L, Bao, Q, Fei, Y, Hu, N, Hu, X, 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Abdel Razzaq, Al Hussaini, Sabah, Albaj, Safauldeensalem, Kenber, Maithem, Bettinelli, Alessandra, Spadaro, Savino, Albertovolta, Carlo, Giancarlo, Luigi, Sottosanti, Vicari, Copetti, Elisa, Della Rocca, Giorgio, Spagnesi, Lorenzo, Toretti, Ilaria, Alloj, Chiara, Cardellino, Silvano, Carmino, Livio, Costanzo, Eleonora, Fanfani, Lucia Caterina, Novelli, Maria Teresa, Roasio, Agostino, Bellandi, Mattia, Beretta, Luigi, Bignami, Elena, Bocchino, Speranza, Cabrini, Luca, Corti, Daniele, Landoni, Giovanni, Meroni, Roberta, Moizo, Elena, Monti, Giacomo, Pintaudi, Margherita, Plumari, Valentina Paola, Taddeo, Daiana, Testa, Valentina, Winterton, Dario, Zangrillo, Alberto, Cloro, Luigi Maria, Colangelo, Chiara, Colangelo, Antonio, Rotunno, Giuseppe, Paludi, Miguel Angel, Maria, Cloro Paolo, Pata, Antonio, Parrini, Vieri, Gatta, Alessandro, Nastasi, Mauro, Tinti, Carla, Baroselli, Antonio, Arrigo, Mario, Benevento, Angelo, Bottini, Corrado, Cannavo, Maurizio, Gastaldi, Christian, Marchesi, 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Azam, Ummi Azmira Ahmad, Alias, Abdul Hafiz, Kesut, Saiful Aizar, Lee, Jun May, Ooi, Dar Vin, Sulaiman, Hetty Ayuni, Lih, Tengku Alini Tengku, Mansor, Marzida, Veerakumaran, Jeyaganesh, Luna, Pastor, Rojas, Eder, Resendiz, Gerardo Esteban Alvarez, Zapata, Darcy Danitza Mari, Lã³pez, Julio Cesar Jesús Aguilar, Flores, Armando Adolfo Alvarez, Amador, Juan Carlos Bravo, Avila, Erendira Jocelin Dominguez, Aquino, Laura Patricia González, Rodriguez, Ricardo Lopez, Landa, Mariana Torre, Urias, Emma, Hollmann, Marku, Hulst, Abraham, Preckel, Osne Kirzner Benedikt, Koopman-Van Gemert, Ankie, Bouwman, Arthur, Buise, Marc, Tolenaar, Noortje, Weber, Eric, De Fretes, Jennifer, Houweling, Peter, Ormskerk, Patricia, Van Bommel, Jasper, Buhre, Wolfgang, Lance, Marcu, Smit-Fun, Valerie, Van Zundert, Tom, Baas, Peter, De Boer, Hans Donald, Sprakel, Joost, Elferink-Vonk, Renske, Noordzij, Peter, Van Zeggeren, Laura, Brand, Bastiaan, Spanjersberg, Rob, Ten Bokkel-Andela, Janneke, Numan, Sandra, Van Klei, Wilton, Van Zaane, Ba, Boer, Christa, Van Duivenvoorde, Yoni, Hering, Jens Peter, Van Rossum, Sylvia, Zonneveldt, Harry, Hoare, Siobhan, Santa, Sahayam, Ali, Marlynn, Allen, Sara Jane, Beavis, Vanessa, Bell, Rachel, Choi, Hyun-Min David, Drake, Matthew, Farrell, Helen, Hayes, Katia, Higgie, Kushlin, Holmes, Kerry, Jenkins, Nicole, Kim, Chang Joon, Kim, Steven, Law, Kiew Chai, Mcallister, Davina, Park, Karen, Pedersen, Karen, Pfeifer, Leesa, Pozaroszczyk, Anna, Salmond, Timothy, Steynor, Martin, Tan, Michael, Short, Tim, Waymouth, Ellen, Ab Rahman, Ahmad Sufian, Armstrong, John, Dudson, Rosie, Jenkins, Nia, Nilakant, Jayashree, Richard, Seigne, Virdi, Pardeep, Dixon, Liane, Donohue, Roana, Farrow, Mehreen, Kennedy, Ro, Marissa, Henderson, Mckellow, Margie, Nicola, Delany, Pascoe, Rebecca, Roberts, Stephen John, Rowell, George, Sumner, Matthew, Templer, Paul, Chandrasekharan, Shardha, Fulton, Graham, Jammer, Ib, More, Richard, Wilson, Leona, Chang, Yuan Hsuan, Foley, Julia, Fowler, 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Amabra, Echem, Richard, Obasuyi, Bright, Onajin-Obembe, Bisola, Bandeira, Maria Expedito, Martins, Alda, Tomã©, Miguel, Costa, Ana Cristina Miranda Martin, Krystopchuk, Andriy, Branco, Teresa, Esteves, Simao, Melo, Marco António, Monte, Jãºlia, Rua, Fernando, Martins, Isabel, Pinho-Oliveira, VÃtor Miguel, Rodrigues, Carla Maria, Cabral, Raquel, Marques, Sofia, Rãªgo, Sara, Jesus, Joana Sofia Teixeira, Marques, Maria Conceição, Romao, Cristina, Dias, Sandra, Santos, Ana Margarida, Alves, Maria Joao, Salta, Cristina, Cruz, Salome, Duarte, Cã©lia, Paiva, António Armando Furtado, Do Nascimento Cabral, Tiago, Faria Maia, Dionisio, Correia Da Silva, Rui Freitas Mendonça, Langner, Anuschka, Resendes, Hernâni Oliveira, Da Conceição Soares, Maria, Abrunhosa, Alexandra, Faria, Filomena, Miranda, Lina, Pereira, Helena, Serra, Sofia, Ionescu, Daniela, Margarit, Simona, Mitre, Calin, Vasian, Horatiu, Manga, Gratiela, Stefan, Andreea, Tomescu, Dana, Filipescu, Daniela, Paunescu, Marilena-Alina, 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T., Loots, Emil, Madansein, Rajhmum, Madaree, Anil, Madiba, Thandinkosi E., Manzini, Vukani T., Mbuyisa, Mbali, Moodley, Rajan, Msomi, Mduduzi, Mukama, Innocent, Naidoo, Desigan, Naidoo, Rubeshan, Naidu, Tesuven K., Ntloko, Sindiswa, Padayachee, Eneshia, Padayachee, Lucelle, Phaff, Martijn, Pillay, Bala, Pillay, Desigan, Pillay, Lutchmee, Ramnarain, Anupa, Ramphal, Suren R., Ryan, Paul, Saloojee, Ahmed, Sebitloane, Motshedisi, Sigcu, Noluyolo, Taylor, Jenna L., Torborg, Alexandra, Visser, Linda, Anderson, Philip, Conradie, Alae, De Swardt, Mathew, De Villiers, Martin, Eikman, Johan, Liebenberg, Riaan, Mouton, Johan, Paton, Abbey, Van Der Merwe, Louwrence, Wilscott-Davids, Candice, Barrett, Wendy Joan, Bester, Marlet, De Beer, Johan, Geldenhuys, Jacque, Gouws, Hanni, Potgieter, Jan-Hendrik, Strydom, Magdel, Wilberforceturton, Edwin, Chetty, Rubendraj R., Chirkut, Subash, Cronje, Larissa, De Vasconcellos, Kim, Dube, Nokukhanya Z., Gama, N. Sibusiso, Green, Garyth M., Green-Thompson, Randolph, Kinoo, Suman Mewa, Kistnasami, Prenolin, Maharaj, Kapil, Moodley, Manogaran S., Mothae, Sibongile J., Naidoo, Ruvashni, Noorbhai, M. Aslam F., Rughubar, Vivesh, Reddy, Jenendhiran, Singh, Avesh, Skinner, David L., Smith, Murray J., Singh, Bhagwan, Misra, Ravi, Naidoo, Maheshwar, Ramdharee, Pireshin, Selibea, Yvonne, Sewpersad, Selina, Sham, Shailendra, Wessels, Joseph D., Africander, Cucu, Bejia, Tarek, Blakemore, Stephen P., Botes, Marisa, Bunwarie, Bimalshakth, Hernandez, Carlos B., Jeeraz, Mohammud A., Legutko, Dagmara A., Lopez, Acela G., De Meyer, Jenine N., Muzenda, Tanaka, Naidoo, Noel, Patel, Maryam, Pentela, Rao, Junge, Marina, Mansoor, Naj, Rademan, Lana, Scislowski, Pawel, Seedat, Ismail, Van Den Berg, Bianca, Van Der Merwe, Doreen, Van Wyk, Steyn, Govender, Komalan, Naicker, Darshan, Ramjee, Rajesh, Saley, Mueen, Kuhn, Warren Paul, Matos-Puig, Roel, Moolla, Zaheer, Lisi, Alberto, Perez, Gisela, Beltran, Anna Valle, Lozano, Angel, Navarro, Carlos Delgado, Duca, Alejandro, Ernesto, Ernesto Pastor Martinez, Ferrando, Carlo, Fuentes, Isabel, GarcÃa-Pérez, Maria Luisa, Gracia, Estefania, Palomares, Ana Izquierdo, Katime, Antonio, Miã±ana, Amanda, Incertis, Raul Raul, Romero, Esther, Garcia, Carolina Soledad Romero, Rubio, Concepcion, Artiles, Tania Socorro, Soro, Marina, Valls, Paola, Laguarda, Gisela Alaman, Benavent, Pau, Cuenca, Vicente Chisbert, Cueva, Andreu, Lafuente, Matilde, Parra, Asuncion Marque, Rodrigo, Alejandra Romero, Sanchez-Morcillo, Silvia, Tormo, Sergi, Redondo, Francisco Javier, De Andres, Jose, Diago, Lorena Gómez, Cã¡diz, Maria José Hernández, Manuel, Granell Gil, Peris, Raquel, Saiz, Cristina, Tatay, Jose, Soto, Maria Teresa Tebar, Brunete, Tamara, Cancho, David, Garcãa, David R. 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Luz, Alonso, Eduardo, Anillo, Victor, Maseda, Emilio, Salgado, Patricia, Suarez, Lui, Suarez-De-La-Rica, Alejandro, Villagrã¡n, MarÃa José, Aldecoa, Cesar, Alonso, José Ignacio, Cabezuelo, Estefania, Garcia-Saiz, Irene, Del Moral, Olga Lopez, Martãn, Silvia, Gonzalez, Alba Perez, Doncel, Ma Sherezade Tovar, Vera, Martin Agüero, Sanchez, Francisco José à vila, Castaã±o, Beatriz, Moreira, Beatriz Castaño, Risco, Sahely Flore, Martãn, Daniel Paz, Martãn, Fernando Pérez, Poza, Paloma, Ruiz, Adela, Martãnez, Wilson Fabio Serna, Vicente, Bárbara Vázquez, Dominguez, Saul Velaz, Fernã¡ndez, Salvador, Munoz-López, Alfonso, Bernat, Maria Jose, Mas, Arantxa, Planas, Kenneth, Jawad, Monir, Saeed, Yousif, Hedin, Annika, Levander, Helena, Chew, Michelle, Holmstrã¶m, Sandra, Lonn, David, Zoerner, Frank, à kring, Irene, Widmark, Carl, Zettergren, Jan, Liljequist, Victor Aspelund, Nystrom, Lena, Odeberg-Wernerman, Suzanne, Oldner, Ander, Fagerlund, Malin Jonsson, Reje, Patrik, Lyckner, Sara, Sperber, Jesper, Adolfsson, Anne, Klarin, Bengt, à gren, Katrin, Barras, Jean-Pierre, Bã¼hrer, Thoma, Despotidis, Vasileio, Helmy, Naeder, Holliger, Stephan, Raptis, Dimitri Aristotle, Schmid, Roger, Meyer, Antoine, Jaquet, Yve, Kessler, Ulf, Muradbegovic, Mirza, Nahum, Solange R., Rotunno, Teresa, Schiltz, Bori, Voruz, Franã§oi, Worreth, Marc, Christoforidis, Dimitri, Popeskou, Sotirios Georgio, Furrer, Marku, Prevost, Gian Andrea, Stocker, Andrea, Lang, Klau, Breitenstein, Stefan, Ganter, Michael T., Geisen, Martin, Soll, Christopher, Korkmaz, Michelle, Lubach, Iri, Schmitz, Michael, Zu Schwabedissen, Moritz Meyer, Zu Schwabedissen Moritz, Meyer, Zingg, Ur, Hillermann, Thoma, Wildi, Stefan, Hofer, Christoph, Pinto, Bernardo Bollen, Walder, Bernhard, Hã¼bner, Martin, Mariotti, Giustina, Slankamenac, Ksenija, Namuyuga, Mirioce, Kyomugisha, Edward, Kituuka, Olivia, Shikanda, Anne Wesonga, Kakembo, Nasser, Tom, Charles Otim, Antonina, Webombesa, Bua, Emmanuel, Ditai, Jame, Ssettabi, Eden Michael, Epodoi, Joseph, Kabagenyi, Fiona, Kirya, Fred, Dempsey, Ged, Seasman, Colette, Khan, Raja Basit Nawaz, Kurasz, Claire, Macgregor, Mark, Shawki, Burhan, Francis, Daren, Hariharan, Vimal, Chau, Simon, Ellis, Kate, Butt, Georgina, Chicken, Dennis-Wayne, Christmas, Natasha, Allen, Samantha, Daniel, Gayatri Daniel, Dempster, Angie, Kemp, Juliette, Matthews, Lewi, Mcglone, Philip, Tambellini, Joanne, Trodd, Dawn, Freitas, Katie, Garg, Atul, Gupta, Janesh Kumar, Karpate, Shilpaja, Kulkarni, Aditi, O'Hara, Chloe, Troko, Jtroko, Angus, Kirsty, Bradley, Jacqueline, Brennan, Emma, Brooks, Carolyn, Brown, Janette, Brown, Gemma, Finch, Amanda, Gratrix, Karen, Hesketh, Sue, Hill, Gillian, Jeffs, Carol, Morgan, Maureen, Pemberton, Chri, Slawson, Nicola, Spickett, Helen, Swarbrick, Gemma, Thomas, Megan, Van Duyvenvoorde, Greta, Brennan, Andrew, Briscoe, Richard, Cooper, Sarah, Lawton, Tom, Northey, Martin, Senaratne, Rashmi, Stanworth, Helen, Burrows, Lorna, Cain, Helen, Craven, Rachael, Davies, Keith, Jonas, Attila, Pachucki, Marcin, Walkden, Graham, Davies, Helen, Gudaca, Mariethel, Hobrok, Maria, Arawwawala, Dilshan, Fergey, Lauren, Gardiner, Matthew, Gunn, Jacqueline, Johnson, Lyndsay, Lofting, Amanda, Lyle, Amanda, Mcneela, Fiona, Smolen, Susan, Topliffe, Joanne, Williams, Sarah, Bland, Martin, Balaji, Packianathaswamy, Kaura, Vika, Lanka, Prasad, Naylor, Charde, Smith, Neil, Ahmed, Ahmed, Myatt, John, Shenoy, Ravikiran, Soon, Wai Cheong, Tan, Jessica, Karadia, Sunny, Durant, Emma, Tripathi, Shiva, Bullock, Clare, Campbell, Debbie, Ghosh, Alison, Hughes, Thoma, Zsisku, Lajo, Bengeri, Sheshagiri, Cowton, Amanda, Khalid, Mohammed Shazad, Limb, Jame, Mcadam, Colin, Porritt, Mandy, Rafi, M. 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Andrew, Foot, Jayne, Large, Simon, Claxton, Andrew, Netke, Bhagyashree, Armstrong, Richard, Calderwood, Claire, Kwok, Andy, Mohr, Otto, Oyeniyi, Peter, Patnaik, Lisa, Post, Benjamin, Ali, Sarah, Arshad, Homa, Baker, Gerard, Brenner, Laura, Brincat, Maximilian, Brunswicker, Annemarie, Cox, Hannah, Cozar, Octavian Ionut, Cheong, Edward, Durst, Alexander, Fengas, Lior, Flatt, Jim, Glister, Georgina, Narwani, Vishal, Photi, Evangelo, Rankin, Adeline, Rosbergen, Melissa, Tan, Mark, Beaton, Ceri, Horn, Rachel, Hunt, Jane, Rousseau, Guy, Stancombe, Lucia, Absar, Mohammed, Allsop, Joanne, Drinkwater, Zoe, Hodgkiss, Tracey, Smith, Kirsty, Brown, Jamie, Alexander-Sefre, Farhad, Campey, Lorraine, Dudgeon, Lucy, Hall, Kathryn, Hitchcock, Rachael, James, Lynne, Smith, Kate, Winstone, Ulrika, Ahmad, Norfaizan, Bauchmuller, Kri, Harrison, Jonathan, Jeffery, Holly, Miller, Duncan, Pinder, Angela, Pothuneedi, Sailaja, Rosser, Jonathan, Sanghera, Sumayer, Swift, Diane, Walker, Rachel, Bester, Delia, Cavanagh, Sarah, Cripps, Heather, Daniel, Harvey, Lynch, Julie, Paton, Alison, Pyke, Shirley, Scholefield, John, Whitworth, Helen, Bottrill, Fiona, Ramalingam, Ganesh, Webb, Stephen, Akerman, Nik, Antill, Philip, Bourner, Lynsey, Buckley, Sarah, Castle, Gail, Charles, Rob, Eggleston, Christopher, Foster, Rebecca, Gill, Satwant, Lindley, Kate, Lklouk, Mohamed, Lowery, Tracey, Martin, Oliver, Milne, David, O'Connor, Patrick, Ratcliffe, Andrew, Rose, Alastair, Smith, Annie, Varma, Sandeep, Ward, Jackie, Barcraft-Barnes, Helena, Camsooksai, Julie, Colvin, Carolyn, Reschreiter, Henrik, Tbaily, Lee, Venner, Nicola, Hamilton, Caroline, Kelly, Lewi, Toth-Tarsoly, Piroska, Dodsworth, Kerry, Foord, Denise, Gordon, Paul, Hawes, Elizabeth, Lamb, Nikki, Mouland, Johanna, Nightingale, Jeremy, Rose, Steve, Schrieber, Joe, Al'Amri, Khalid, Aladin, Hafiz, Arshad, Mohammed Asif, Barraclough, Jame, Bentley, Conor, Bergin, Colin, Carrera, Ronald, Clarkson, Aisling, Collins, Michelle, Cooper, Lauren, Denham, Samuel, Griffiths, Ewen, Peter, Ip, Jeyanthan, Somasundaram, Joory, Kavita, Kaur, Satwant, Marriott, Paul, Mitchell, Natalie, Nagaiah, Sukumar, Nilsson, Annette, Parekh, Nilesh, Pope, Martin, Seager, Joseph, Serag, Hosam, Tameem, Alifia, Thomas, Anna, Thunder, Joanne, Torrance, Andrew, Vohra, Ravinder, Whitehouse, Arlo, Wong, Tony, Blunt, Mark, Wong, Kate, Giles, Julian, Reed, Isabelle, Weller, Debbie, Bell, Gillian, Birch, Julie, Damant, Rose, Maiden, Jane, Mewies, Clare, Prince, Claire, Radford, Jane, Reynolds, Tim, Balain, Birender, Banerjee, Robin, Barnett, Andrew, Burston, Ben, Davies, Kirsty, Edwards, Jayne, Evans, Chri, Ford, David, Gallacher, Pete, Hill, Simon, Jaffray, David, Karlakki, Sudheer, Kelly, Cormac, Kennedy, Julia, Kiely, Nigel, Lewthwaite, Simon, Marquis, Chri, Ockendon, Matthew, Phillips, Stephen, Pickard, Simon, Richardson, Jame, Roach, Richard, Smith, Tony, Spencer-Jones, Richard, Steele, Niall, Steen, Julie, Van Liefland, Marck, White, Steve, Faulds, Matthew, Harris, Meredyth, Kelly, Carrie, Nicol, Scott, Pearson, Sally Anne, Chukkambotla, Srikanth, Andrew, Alyson, Attrill, Elizabeth, Campbell, Graham, Datson, Amanda, Fouracres, Anna, Graterol, Juan, Graves, Lynne, Hong, Bosun, Ishimaru, Alexander, Karthikeyan, Arvind, King, Helen, Lawson, Tom, Lee, Gregory, Lyons, Saoirse, Hall, Andrew Macalister, Mathoulin, Sophie, Mcintyre, Eilidh, Mclaughlin, Danny, Mulcahy, Kathleen, Paddle, Jonathan, Ratcliffe, Anna, Robbins, Jame, Sung, Weilin, Tayo, Adeoluwa, Trembath, Lisa, Venugopal, Suneetha, Walker, Robert, Wigmore, Geoffrey, Boereboom, Catherine, Downes, Charlotte, Humphries, Ryan, Melbourne, Susan, Smith, Coral, Tou, Samson, Ullah, Shafa, Batchelor, Nick, Boxall, Leigh, Broomby, Rupert, Deen, Tariq, Hellewell, Alistair, Helliwell, Laurence, Hutchings, Melanie, Hutchins, David, Keenan, Samantha, Mackie, Donna, Potter, Alison, Smith, France, Stone, Lucy, Thorpe, Kevin, Wassall, Richard, Woodgate, Andrew, Baillie, Shelley, Campbell, Tara, James, Sarah, King, Chri, De Araujo, Daniela Marque, Martin, Danial, Morkane, Clare, Neely, Julia, Rajendram, Rajkumar, Burton, Megan, James, Kathryn, Keevil, Edward, Minik, Orsolya, Morgan, Jenna, Musgrave, Anna, Rajanna, Harish, Roberts, Tracey, Szakmany, Tama, Adamson, Michael, Jumbe, Sandra, Kendall, Jennie, Muthuswamy, Mohan Babu, Anderson, Charlotte, Cruikshanks, Andrew, Wrench, Ian, Zeidan, Lisa, Ardern, Diane, Harris, Benjamin, Hellstrom, Johanna, Martin, Jane, Thomas, Richard, Varsani, Nimu, Brown, Caroline Wrey, Docherty, Philip, Gillies, Michael, Mcgregor, Euan, Usher, Helen, Craig, Jayne, Smith, Andrew, Ahmad, Tahania, Bodger, Phoebe, Creary, Thai, Everingham, Kirsty, Fowler, Alexander, Hewson, Russell, Ijuo, Eke, Januszewska, Marta, Jones, Timothy, Kantsedikas, Ilya, Lahiri, Sumitra, Mclean, Aaron Lawson, Niebrzegowska, Edyta, Phull, Mandeep-Kaur, Wang, Difei, Wickboldt, Nadine, Baldwin, Jacqueline, Doyle, Donna, Mcmullan, Sean, Oladapo, Michelle, Owen, Thoma, Williams, Alexandra, Daniel, Hull, Gregory, Peter, Husain, Tauqeer, Kirk-Bayley, Justin, Mathers, Edward, Montague, Laura, Harper, Mark, White, Stuart, Jack, Jame, Ridley, Carrie, Avis, Joanne, Cook, Tim, Dali-Kemmery, Lola, Kerslake, Ian, Lambourne, Victoria, Pearson, Annabel, Boyd, Christine, Callaghan, Mark, Lawson, Cathy, Mccrossan, Roopa, Nesbitt, Vanessa, O'Connor, Laura, Scott, Julia, Sinclair, Rhona, Farid, Nahla, Morgese, Ciro, Bhatia, Kailash, Karmarkar, Swati, Ahmed, Jamil, Branagan, Graham, Hutton, Monica, Swain, Andrew, Brookes, Jamie, Cornell, Jonathan, Dolan, Rachael, Hulme, Jonathan, Van Vuuren, Amanda Jansen, Jowitt, Tom, Kalashetty, Gunasheela, Lloyd, Fran, Patel, Kiran, Sherwood, Nichola, Brown, Lynne, Chandler, Ben, Deighton, Kerry, Emma, Temlett, Haunch, Kirsty, Cheeseman, Michelle, Dent, Kathy, Garg, Sanjeev, Gray, Carol, Hood, Marion, Jones, Dawn, Juj, Joanne, Rao, Roshan, Walker, Tara, Al Anizi, Mashel, Cheah, Clarissa, Cheing, Yushio, Coutinho, Francisco, Gondo, Prisca, Hadebe, Bernard, Hove, Mazvangu Onie, Khader, Ahamed, Krishnachetty, Bobby, Rhodes, Karen, Sokhi, Jagdish, Baker, Katie-Anne, Bertram, Wendy, Looseley, Alex, Mouton, Ronelle, Hanna, George, Arnold, Glenn, Arya, Shobhit, Balfoussia, Danai, Baxter, Linden, Harris, Jame, Jones, Craig, Knaggs, Alison, Markar, Sheraz, Perera, Anisha, Scott, Alasdair, Shida, Asako, Sirha, Ravneet, Wright, Sally, Frost, Victoria, Gray, Catherine, Andrews, Emma, Arrandale, Lindsay, Barrett, Stephen, Cifra, Elna, Cooper, Mariese, Dragnea, Drago, Elna, Cifra, Maclean, Jennifer, Meier, Sonja, Milliken, Donald, Munns, Christopher, Ratanshi, Nadir, Ramessur, Suneil, Salvana, Abegail, Watson, Anthony, Hani, Ali, Campbell, Gill, Critchley, Rebecca, Endersby, Simon, Hicks, Catherine, Liddle, Alison, Pass, Marc, Ritchie, Charlotte, Thomas, Charlotte, Too, Lingxi, Welsh, Sarah, Gill, Talvinder, Johnson, Joanne, Reed, Joanne, Davis, Edward, Papadopoullos, Sam, Attwood, Clare, Biffen, Andrew, Boulton, Kerenza, Gray, Sophie, Hay, David, Mills, Sarah, Montgomery, Jane, Riddell, Rory, Simpson, Jame, Bhardwaj, Neeraj, Paul, Elaine, Uwubamwen, Nosakhare, Alexander, Maini, Arrich, Jame, Arumugam, Swarna, Blackwood, Dougla, Boggiano, Victoria, Brown, Robyn, Chan, Yik Lam, Chatterjee, Devnandan, Chhabra, Ashok, Christian, Rachel, Costelloe, Hannah, Matthewman, Madeline Coxwell, Dalton, Emma, Darko, Julia, Davari, Maria, Dave, Tejal, Deacon, Matthew, Deepak, Shantal, Edmond, Holly, Ellis, Jessica, El-Sayed, Ahmed, Eneje, Philip, English, Rose, Ewe, Renee, Foers, William, Franklin, John, Gallego, Laura, Garrett, Emily, Goldberg, Olivia, Goss, Harry, Greaves, Rosanna, Harris, Rudy, Hennings, Charle, Jones, Eleanor, Kamali, Nelson, Kokkinos, Naomi, Lewis, Cary, Lignos, Leda, Malgapo, Evaleen Victoria, Malik, Rizwana, Milne, Andrew, Mulligan, John-Patrick, Nicklin, Philippa, Palipane, Natasha, Parsons, Thoma, Piper, Rebecca, Prakash, Rohan, Ramesh, Byron, Rasip, Sarah, Reading, Jacob, Rela, Mariam, Reyes, Anna, Robert, Stephen, Rooms, Martin, Shah, Karishma, Simons, Henry, Solanki, Shalil, Spowart, Emma, Stevens, Amy, Thomas, Christopher, Waggett, Helena, Yassaee, Arrash, Kennedy, Anthony, Scott, Sara, Somanath, Sameer, Berg, Andrew, Miguel, Hernandez, Nanda, Rajesh, Tank, Ghanshyambhai, Wilson, Natalie, Wilson, Debbie, Al-Soudaine, Yassr, Baldwin, Matthew, Cornish, Julie, Davies, Zoe, Davies, Leigh, Edwards, Marc, Frewer, Natasha, Gallard, Sian, Glasbey, Jame, Harries, Rhiannon, Hopkins, Luke, Kim, Taeyang, Koompirochana, Vilavan, Lawson, Simon, Lewis, Megan, Makzal, Zaid, Scourfield, Sarah, Ahmad, Yousra, Bates, Sarah, Blackwell, Clare, Bryant, Helen, Collins, Hannah, Coulter, Suzanne, Cruickshank, Ro, Daniel, Sonya, Daubeny, Thoma, Edwards, Mark, Golder, Kim, Hawkins, Lesley, Helen, Bryant, Hinxman, Honor, Levett, Denny, Salmon, Karen, Seaward, Leanne, Skinner, Ben, Tyrell, Bryony, Wadams, Beverley, Walsgrove, Joseph, Dickson, Jane, Constantin, Kathryn, Karen, Markwell, O'Brien, Peter, O'Donohoe, Lynn, Payne, Hannah, Sundayi, Saul, Walker, Elaine, Brooke, Jenny, Cardy, Jon, Humphreys, Sally, Kessack, Laura, Kubitzek, Christiane, Kumar, Suha, Cotterill, Donna, Hodzovic, Emil, Hosdurga, Gurunath, Miles, Edward, Saunders, Glenn, Campbell, Marta, Chan, Peter, Jemmett, Kim, Raj, Ashok, Naik, Aditi, Oshowo, Ayo, Ramamoorthy, Rajarajan, Shah, Nimesh, Sylvan, Axel, Blyth, Katharine, Burtenshaw, Andrew, Freeman, David, Johnson, Emily, Philip, Lo, Martin, Terry, Plunkett, Emma, Wollaston, Julie, Allison, Joanna, Carroll, Christine, Craw, Nichola, Craw, Sarah, Pitt-Kerby, Tressy, Rowland-Axe, Rebecca, Spurdle, Katie, Mcdonald, Andrew, Simon, Davie, Sinha, Vivek, Smith, Thoma, Banner-Goodspeed, Valerie, Boone, Myle, Campbell, Kathleen, Fengxin, Lu, Scannell, Joseph, Sobol, Julia, Balajonda, Naraida, Clemmons, Karen, Conde, Carlo, Elgasim, Magdi, Funk, Bonita, Hall, Roger, Hopkins, Thoma, Olaleye, Omowunmi, Omer, Omer, Pender, Michelle, Porto, Angelo, Stevens, Alice, Waweru, Peter, Yeh, Erlinda, Bodansky, Daniella, Evans, Adam, Kleopoulos, Steven, Maril, Robert, Mathney, Edward, Sanchez, Angela, Tinuoye, Elizabeth, Bateman, Brian, Eng, Kristen, Jiang, Ning, Ladha, Karim, Needleman, Joseph, Chen, Lee-Lynn, Lane, Rondall, Robinowitz, David, Ghushe, Neil, Irshad, Mariam, O'Connor, John, Patel, Samir, Myles, Paul, Hiesmayr, Michael, Fang, Xiangming, Slim, Karem, Sander, Michael, Koulenti, Despoina, Chan, Mathew, Abbas, Muntadhar, Sivasakthi, Datin, Osinaike, Tunde, Matos, Ricardo, Grigoras, Ioana, Hubner, Martyn, Other departments, The International Surgical Outcomes Study, Group, Beretta, L, Landoni, G, and Zangrillo, A
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Critical Care/utilization ,Postoperative Complications/epidemiology ,Male ,cohort studies, critical care/utilisation, operative/mortality, postoperative care/methods, postoperative care/statistics and numerical data, surgery, surgical procedures ,Global Health ,law.invention ,surgery ,Postoperative Complications ,0302 clinical medicine ,Correction Notice ,cohort studies ,Anesthesiology ,030202 anesthesiology ,law ,cohort studiescritical care/utilisationoperative/mortalitypostoperative care/methodspostoperative care/statistics and numerical datasurgerysurgical procedures ,80 and over ,Hospital Mortality ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Aged, 80 and over ,International Surgical Outcomes Study group ,Elective Surgical Procedures/mortality ,HCC NEF ,Middle Aged ,Elective Surgical Procedures/adverse effects ,Intensive care unit ,surgical procedure ,3. Good health ,Treatment Outcome ,Length of Stay/statistics & numerical data ,operative/mortality ,Elective Surgical Procedures ,Female ,Elective Surgical Procedure ,Life Sciences & Biomedicine ,Cohort study ,Adult ,medicine.medical_specialty ,Adolescent ,Critical Care ,critical care/utilisation ,postoperative care/methods ,postoperative care/statistics and numerical data ,surgical procedures ,Aged ,Humans ,Length of Stay ,Poverty ,Socioeconomic Factors ,Young Adult ,Anesthesiology and Pain Medicine ,NO ,Clinical Practice ,03 medical and health sciences ,Intensive care ,Journal Article ,medicine ,postoperative care/method ,Elective surgery ,Science & Technology ,business.industry ,Postoperative complication ,030208 emergency & critical care medicine ,1103 Clinical Sciences ,Surgery ,Global Health/statistics & numerical data ,Emergency medicine ,business ,cohort studie - Abstract
Background:As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. Methods:We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. Results:A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44814 patients with a median hospital stay of 4 (range 2–7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. Conclusions:Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. Study registration:ISRCTN51817007
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- 2016
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9. Periarticular local anaesthetic in knee arthroplasty: A systematic review and meta-analysis of randomised trials
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Gibbins, ML, Kane, C, Smit, RW, and Rodseth, RN
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intra-articular injections ,knee replacement ,arthroplasty ,local anaesthetic ,knee arthroplasty - Abstract
BACKGROUND: This systematic review and meta-analysis aimed to quantify the effect of adding peri-articular local anaesthetic infiltration or infusion to an analgesic strategy in patients undergoing knee arthroplasty. METHODS: A literature search of six data bases was performed. Randomised controlled trials comparing periarticular local anaesthetic infiltration/infusion against other analgesic strategies in adult patients undergoing knee arthroplasty were included. The primary outcome was resting Visual Analogue Scores 24 hours after surgery. RESULTS: In the review, 396 potential studies were identified, of which 35 full text articles were assessed for eligibility. A total of 770 patients from 12 trials were included in the final meta-analysis. Local anaesthetic addition significantly improved pain control (mean difference -0.95 [95% CI -1.68 to -0.21]); however, there was significant heterogeneity (I²: 88%). CONCLUSION: Our analysis suggests that peri-articular local anaesthetic infiltration/infusion improves resting pain scores 24 hours after knee arthroplasty. However, the heterogeneity of these findings urges caution in their interpretation.
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- 2016
10. Aspirin in Patients Undergoing Noncardiac Surgery
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Devereaux, Pj, Mrkobrada, M, Sessler, Di, Leslie, K, Alonso Coello, P, Kurz, A, Villar, Jc, Sigamani, A, Biccard, Bm, Meyhoff, Cs, Parlow, Jl, Guyatt, G, Robinson, A, Garg, Ax, Rodseth, Rn, Botto, F, Lurati Buse, G, Xavier, D, Chan, Mt, Tiboni, M, Cook, D, Kumar, Pa, Forget, P, Malaga, G, Fleischmann, E, Amir, M, Eikelboom, J, Mizera, R, Torres, D, Wang, Cy, Vanhelder, T, Paniagua, P, Berwanger, O, Srinathan, S, Graham, M, Pasin, L, Le Manach, Y, Gao, P, Pogue, J, Whitlock, R, Lamy, A, Kearon, C, Baigent, C, Chow, C, Pettit, S, Chrolavicius, S, Yusuf, S, DeBeer J, POISE 2 I. n. v. e. s. t. i. g. a. t. o. r. s., Patel, A, Dechert, W, Jackson, P, Allard, R, Dumerton Shore, D, Mccourt, J, Jones, Pm, Lavi, R, Lavi, S, Moor, R, Dresser, Gk, Gros, Ml, Schumann, Vc, Baur, M, Macdonald, C, Wirzba, B, Regalado, O, Srinathan, Sk, Ong, Dd, Todd, A, Abbas, S, Beattie, Ws, Chan, Vw, Chin, Kj, Wijeysundera, Dn, Graham, Mm, Irwin, M, Jacka, M, El Beheiry, H, Mcmullen, Sm, Macdonald, P, Akhtar, Z, Ayad, S, Buttar, M, Deroee, A, Eshraghi, Y, Fergany, A, Finnigan, P, Fu, A, Grady, M, Helper, S, Hesler, B, Honar, H, Hutcherson, M, Krebs, V, Lee, J, Malik, M, Podolyak, A, Salmasi, V, Arora, H, Coombs, Rf, Martinelli, Sm, Bergese, Sd, Melibary, Sb, Uribe, Aa, Jordan, M, Miller, Sa, Cata, Jp, Nemergut, Ec, Candiotti, Ka, Memtsoudis, Sg, Mckay, Re, Montes, Fr, Parra, Ga, Rojas, Mf, Plata, R, Vásquez, Sm, Sarquis, T, Haider, Z, Jane, Nb, Lanjewar, Pp, Rahate, Pv, Mehra, Br, Premendaran, B, Abraham, V, George, P, Kumar, P, Gaikwad, Sb, Mohan, Nv, Sidhu, G, Alvarez, J, Gonzalez, R, Maestre, M, Popova, E, Urrutia, G, de Nadal, M, González Suárez, S, González Tallada, A, Plou, P, Mena, E, Riveira, C, del Valle, S, Tena, B, Lang, Sa, Ludbrook, Gl, Painter, Tw, Terblanche, Nc, Osborne, C, Mahood, Jr, Myles, Ps, Sivalingam, P, Riedel, B, Elhalawani, I, Drummond, L, Mugabi, A, Naidoo, P, Myburgh, Al, Porrill, Os, Diedericks, Bj, Turton, Ew, Bøgeskov, M, Dahl, Rm, Madsen, Mv, Søndergaard, Es, Bauer, Ne, Martinsen, Kr, Choi, Gy, Gin, T, Ng, Ss, Bidgoli, Sj, Van der Linden PJ, De Kock, M, Kabon, B, Luf, F, Radonic, M, Ishtiaq, O, Safdar, J, Acuna Villaorduna, A, Barrionuevo, P, Castaneda Guarderas, A, Caballero, Ja, Lau, Ve, Aphang Lam MR, Lembo, R, Gossetti, Bruno, Jara, X, Leon, P, Ong, Gs, Lee, Hs, Seeberger, Ee, Seeberger, Md, Alfonsi, P, Coriat, P, Piriou, V, Vizcaychipi, Mp, Rech, Rl, Bergo, Rr, Walker, S, Rodseth, R, Lemanach, Y, Díaz, R, Cortés, Ol, Wetterslev, J, Hoeft, A, Wittmann, M, Chan, M, Landoni, G, Conen, D, Balaji, P, Sovereign, T, Blake, L, Sephton, J, Serra, A, Agrippa, C, Lawrence, M, Biccard, B, Gluud, C, Karthikeyan, G, Auerbach, A, Beattie, S, Buckley, N, Douketis, J, Gerstein, H, Ghali, W, Hart, R, Hill, M, Mcalister, F, Mcauley, D, Miller, S, O'Donnell, M, Pais, P, Parlow, J, Schricker, T, Sessler, D, Simunovic, M, Teoh, K, Walsh, M, Wijeysundera, D, Yang, H, Alshalash, S, Bessissow, A, Duceppe, E, Khalid, Z, Khan, J, Lauw, M, Martinsen, K, Neary, J, Oczkowski, W, Papina, M, Seeberger, M, Tandon, V, Thomas, S, Friedman, L, Cheng, D, Johnstone, D, Lowenstein, E, Roberts, R., Devereaux, Pj, Mrkobrada, M, Sessler, Di, Leslie, K, Alonso Coello, P, Kurz, A, Villar, Jc, Sigamani, A, Biccard, Bm, Meyhoff, C, Parlow, Jl, Guyatt, G, Robinson, A, Garg, Ax, Rodseth, Rn, Botto, F, Lurati Buse, G, Xavier, D, Chan, Mt, Tiboni, M, Cook, D, Kumar, Pa, Forget, P, Malaga, G, Fleischmann, E, Amir M, Eikelboom J, Mizera, R, Torres, D, Wang, Cy, Vanhelder, T, Paniagua, P, Berwanger, O, Srinathan, S, Graham, M, Pasin, L, Le Manach, Y, Gao, P, Pogue, J, Whitlock, R, Lamy, A, Kearon, C, Baigent, C, Chow, C, Pettit, S, Chrolavicius, S, Yusuf, S, and Landoni, Giovanni
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Male ,Myocardial Infarction ,Kaplan-Meier Estimate ,noncardiac surgery ,postoperative period ,law.invention ,low drug dose ,hazard ratio ,Postoperative Complications ,Randomized controlled trial ,law ,Myocardial infarction ,Treatment Failure ,Aspirin ,Medicine (all) ,Hazard ratio ,drug effect ,article ,risk assessment ,General Medicine ,Middle Aged ,female ,priority journal ,Anesthesia ,drug withdrawal ,factorial design ,Surgical Procedures, Operative ,Platelet aggregation inhibitor ,Female ,medicine.drug ,hospitalization ,heart infarction ,perioperative period ,preoperative treatment ,Postoperative Hemorrhage ,Perioperative Care ,length of stay ,death ,medicine ,Humans ,follow up ,controlled study ,human ,clonidine ,outcome assessment ,Aged ,treatment duration ,Vascular disease ,business.industry ,Platelet Aggregation Inhibitor ,patient care ,acetylsalicylic acid ,medicine.disease ,bleeding ,major clinical study ,Confidence interval ,purl.org/pe-repo/ocde/ford#3.02.00 [https] ,Clinical research ,multicenter study ,randomized controlled trial ,placebo ,Postoperative Complication ,business ,Platelet Aggregation Inhibitors - Abstract
BACKGROUND: There is substantial variability in the perioperative administration of aspirin in patients undergoing noncardiac surgery, both among patients who are already on an aspirin regimen and among those who are not. METHODS: Using a 2-by-2 factorial trial design, we randomly assigned 10,010 patients who were preparing to undergo noncardiac surgery and were at risk for vascular complications to receive aspirin or placebo and clonidine or placebo. The results of the aspirin trial are reported here. The patients were stratified according to whether they had not been taking aspirin before the study (initiation stratum, with 5628 patients) or they were already on an aspirin regimen (continuation stratum, with 4382 patients). Patients started taking aspirin (at a dose of 200 mg) or placebo just before surgery and continued it daily (at a dose of 100 mg) for 30 days in the initiation stratum and for 7 days in the continuation stratum, after which patients resumed their regular aspirin regimen. The primary outcome was a composite of death or nonfatal myocardial infarction at 30 days. RESULTS: The primary outcome occurred in 351 of 4998 patients (7.0%) in the aspirin group and in 355 of 5012 patients (7.1%) in the placebo group (hazard ratio in the aspirin group, 0.99; 95% confidence interval [CI], 0.86 to 1.15; P = 0.92). Major bleeding was more common in the aspirin group than in the placebo group (230 patients [4.6%] vs. 188 patients [3.8%]; hazard ratio, 1.23; 95% CI, 1.01, to 1.49; P = 0.04). The primary and secondary outcome results were similar in the two aspirin strata. CONCLUSIONS: Administration of aspirin before surgery and throughout the early postsurgical period had no significant effect on the rate of a composite of death or nonfatal myocardial infarction but increased the risk of major bleeding. (Funded by the Canadian Institutes of Health Research and others; POISE-2 ClinicalTrials.gov number, NCT01082874.) Copyright © 2014 Massachusetts Medical Society.
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- 2014
11. Clonidine in patients undergoing noncardiac surgery
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Devereaux, Pj, Sessler, Di, Leslie, K, Kurz, A, Mrkobrada, M, Alonso Coello, P, Villar, Jc, Sigamani, A, Biccard, Bm, Meyhoff, Cs, Parlow, Jl, Guyatt, G, Robinson, A, Garg, Ax, Rodseth, Rn, Botto, F, Lurati Buse, G, Xavier, D, Chan, Mt, Tiboni, M, Cook, D, Kumar, Pa, Forget, P, Malaga, G, Fleischmann, E, Amir, M, Eikelboom, J, Mizera, R, Torres, D, Wang, Cy, Vanhelder, T, Paniagua, P, Berwanger, O, Srinathan, S, Graham, M, Pasin, L, Le Manach, Y, Gao, P, Pogue, J, Whitlock, R, Lamy, A, Kearon, C, Chow, C, Pettit, S, Chrolavicius, S, Yusuf, S, Debeer, J, Patel, A, Dechert, W, Jackson, P, Allard, R, Dumerton Shore, D, Mccourt, J, Jones, Pm, Lavi, R, Lavi, S, Moor, R, Dresser, Gk, Gros, Ml, Schumann, Vc, Baur, M, Macdonald, C, Wirzba, B, Regalado, O, Srinathan, Sk, Ong, Dd, Todd, A, Abbas, S, Beattie, Ws, Chan, Vw, Chin, Kj, Wijeysundera, Dn, Graham, Mm, Irwin, M, Jacka, M, El Beheiry, H, Mcmullen, Sm, Macdonald, P, Akhtar, Z, Ayad, S, Buttar, M, Deroee, A, Eshraghi, Y, Fergany, A, Finnigan, P, Fu, A, Grady, M, Helper, S, Hesler, B, Honar, H, Hutcherson, M, Krebs, V, Lee, J, Malik, M, Podolyak, A, Salmasi, V, Arora, H, Coombs, Rf, Martinelli, Sm, Bergese, Sd, Melibary, Sb, Uribe, Aa, Jordan, M, Miller, Sa, Cata, Jp, Nemergut, Ec, Candiotti, Ka, Memtsoudis, Sg, Mckay, Re, Montes, Fr, Parra, Ga, Rojas, Mf, Plata, R, Vásquez, Sm, Sarquis, T, Haider, Z, Jane, Nb, Lanjewar, Pp, Rahate, Pv, Mehra, Br, Premendaran, B, Abraham, V, George, P, Kumar, P, Gaikwad, Sb, Mohan, Nv, Sidhu, G, Alvarez, J, Gonzalez, R, Maestre, M, Popova, E, Urrutia, G, de Nadal, M, González Suárez, S, González Tallada, A, Plou, P, Mena, E, Riveira, C, del Valle, S, Tena, B, Lang, Sa, Ludbrook, Gl, Painter, Tw, Terblanche, Nc, Osborne, C, Mahood, Jr, Myles, Ps, Sivalingam, P, Riedel, B, Elhalawani, I, Drummond, L, Mugabi, A, Naidoo, P, Myburgh, Al, Porrill, Os, Diedericks, Bj, Turton, Ew, Bøgeskov, M, Dahl, Rm, Madsen, Mv, Søndergaard, Es, Bauer, Ne, Martinsen, Kr, Choi, Gy, Gin, T, Ng, Ss, Bidgoli, Sj, Van der Linden PJ, De Kock, M, Kabon, B, Luf, F, Radonic, M, Ishtiaq, O, Safdar, J, Acuna Villaorduna, A, Barrionuevo, P, Castaneda Guarderas, A, Caballero, Ja, Lau, Ve, Aphang Lam MR, Lembo, R, Gossetti, Bruno, Jara, X, Leon, P, Ong, G, Lee, Hs, Seeberger, Ee, Seeberger, Md, Alfonsi, P, Coriat, P, Piriou, V, Vizcaychipi, Mp, Rech, Rl, Bergo, Rr, Walker, S, Rodseth, R, Lemanach, Y, Díaz, R, Cortés, Ol, Wetterslev, J, Hoeft, A, Wittmann, M, Chan, M, Landoni, G, Conen, D, Balaji, P, Sovereign, T, Blake, L, Sephton, J, Serra, A, Agrippa, C, Lawrence, M, Biccard, B, Gluud, C, Baigent, C, Karthikeyan, G, Auerbach, A, Beattie, S, Buckley, N, Douketis, J, Gerstein, H, Ghali, W, Hart, R, Hill, M, Mcalister, F, Mcauley, D, Miller, S, O'Donnell, M, Pais, P, Parlow, J, Schricker, T, Sessler, D, Simunovic, M, Teoh, K, Walsh, M, Wijeysundera, D, Yang, H, Alshalash, S, Bessissow, A, Duceppe, E, Khalid, Z, Khan, J, Lauw, M, Martinsen, K, Neary, J, Oczkowski, W, Papina, M, Seeberger, M, Tandon, V, Thomas, S, Friedman, L, Cheng, D, Johnstone, D, Lowenstein, E, and Roberts, R.
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Male ,hypotension ,drug safety ,Heart disease ,Myocardial Infarction ,Kaplan-Meier Estimate ,high risk patient ,noncardiac surgery ,surgery ,low drug dose ,hazard ratio ,Postoperative Complications ,dose response ,Adrenergic alpha-2 Receptor Agonists ,Myocardial infarction ,Treatment Failure ,risk reduction ,Aspirin ,Hazard ratio ,drug effect ,article ,risk assessment ,General Medicine ,Middle Aged ,Clonidine ,aged ,female ,priority journal ,Anesthesia ,factorial design ,Surgical Procedures, Operative ,Female ,Hypotension ,medicine.drug ,medicine.medical_specialty ,heart infarction ,perioperative period ,preoperative treatment ,Placebo ,bradycardia ,Perioperative Care ,length of stay ,death ,medicine ,Humans ,controlled study ,human ,Aged ,treatment duration ,business.industry ,Perioperative ,Vascular surgery ,acetylsalicylic acid ,medicine.disease ,major clinical study ,purl.org/pe-repo/ocde/ford#3.02.00 [https] ,drug efficacy ,multicenter study ,randomized controlled trial ,incidence ,treatment outcome ,placebo ,business ,heart arrest - Abstract
Background: Marked activation of the sympathetic nervous system occurs during and after noncardiac surgery. Low-dose clonidine, which blunts central sympathetic outflow, may prevent perioperative myocardial infarction and death without inducing hemodynamic instability. Methods: We performed a blinded, randomized trial with a 2-by-2 factorial design to allow separate evaluation of low-dose clonidine versus placebo and low-dose aspirin versus placebo in patients with, or at risk for, atherosclerotic disease who were undergoing noncardiac surgery. A total of 10,010 patients at 135 centers in 23 countries were enrolled. For the comparison of clonidine with placebo, patients were randomly assigned to receive clonidine (0.2 mg per day) or placebo just before surgery, with the study drug continued until 72 hours after surgery. The primary outcome was a composite of death or nonfatal myocardial infarction at 30 days. Results: Clonidine, as compared with placebo, did not reduce the number of primary-outcome events (367 and 339, respectively; hazard ratio with clonidine, 1.08; 95% confidence interval [CI], 0.93 to 1.26; P=0.29). Myocardial infarction occurred in 329 patients (6.6%) assigned to clonidine and in 295 patients (5.9%) assigned to placebo (hazard ratio, 1.11; 95% CI, 0.95 to 1.30; P=0.18). Significantly more patients in the clonidine group than in the placebo group had clinically important hypotension (2385 patients [47.6%] vs. 1854 patients [37.1%]; hazard ratio 1.32; 95% CI, 1.24 to 1.40; P
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- 2014
12. The role of dexamethasone in peripheral and neuraxial nerve blocks for the management of acute pain
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Gordon, KG, primary, Choi, S, additional, and Rodseth, RN, additional
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- 2016
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13. Periarticular local anaesthetic in knee arthroplasty: A systematic review and meta-analysis of randomised trials
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Gibbins, ML, primary, Kane, C, additional, Smit, RW, additional, and Rodseth, RN, additional
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- 2016
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14. Hypotension during spinal anaesthesia for Caesarean section in a resource-limited setting: towards a consensus definition
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Zwane, SF, Bishop, DG, and Rodseth, RN
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Background:Intraoperative hypotension following spinal anaesthesia for Caesarean section is associated with maternal morbidity and mortality. Because of inconsistent definitions the reported incidence of hypotension varies between 7% and 74%, making it almost impossible to set standard targets. Developing and adopting a clinically significant threshold for intraoperative hypotension will allow for benchmarking, comparison between studies, and consistency in guidelines and recommendations.Methods:Common definitions for spinal hypotension were first identified from a recent systematic review of the literature and a consensus statement on spinal hypotension. These definitions were applied to haemodynamic data taken from a prospective interventional obstetric spinal hypotension study conducted at Edendale Hospital, to determine the incidence of hypotension when applying these different thresholds. Finally, a definition was proposed based on these incidences and a review of the relevant literature.Results:Fifteen different definitions were identified. These were then applied to the study population with a resultant incidence of hypotension ranging from 15.8% to 91.4%. Based on a literature review of obstetric and other relevant perioperative and critical care medicine, targeting a mean arterial pressure > 70 mmHg and systolic blood pressure > 100 mmHg is recommended, and it is proposed that the lowest absolute values at which vasopressor therapy should be initiated are a mean arterial blood pressure < 65 mmHg or systolic blood pressure < 90 mmHg. Optimally, practitioners should maintain systolic blood pressure at greater than 90% of the baseline pre-spinal anaesthesia value.Conclusion:This study confirmed a wide variation in the incidence of obstetric spinal hypotension in a South African setting, depending on the definition used. An absolute threshold for intervention with vasopressor and an optimal target relative to baseline blood pressure are suggested. Further work is required to establish the effect of the adherence to these recommendations on important maternal and foetal outcomes.
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- 2019
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15. Mortality reduction in cardiac anesthesia and intensive care: results of the first International Consensus Conference
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Landoni, G, Augoustides, Jg, Guarracino, F, Santini, F, Ponschab, M, Pasero, D, Rodseth, Rn, Biondi Zoccai GG, Silvay, G, Salvi, L, Camporesi, E, Comis, M, Conte, M, Bevilacqua, S, Cabrini, L, Cariello, C, Caramelli, F, De Santis, V, Del Sarto, P, Dini, D, Forti, A, 1, Galdieri, N, Giordano, G, Gottin, L, Greco, M, Maglioni, E, Mantovani, L, Manzato, A, Meli, M, Paternoster, G, Pittarello, D, Rana, Kn, Ruggeri, L, Salandin, V, Sangalli, F, Zambon, M, Zucchetti, M, Bignami, E, Alfieri, O, and Zangrillo, A
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- 2011
16. The Prognostic Value of Pre-Operative and Post-Operative B-Type Natriuretic Peptides in Patients Undergoing Noncardiac Surgery
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Rodseth, RN, Biccard, BM, Le Manach, Y, Sessler, DI, Buse, GAL, Thabane, L, Schutt, RC, Bolliger, D, Cagini, L, Cardinale, D, Chong, CPW, Chu, R, Cnotliwy, M, Di Somma, S, Fahrner, R, Lim, WK, Mahla, E, Manikandan, R, Puma, F, Pyun, WB, Radovic, M, Rajagopalan, S, Suttie, S, Vanniyasingam, T, van Gaal, WJ, Waliszek, M, Devereaux, PJ, Rodseth, RN, Biccard, BM, Le Manach, Y, Sessler, DI, Buse, GAL, Thabane, L, Schutt, RC, Bolliger, D, Cagini, L, Cardinale, D, Chong, CPW, Chu, R, Cnotliwy, M, Di Somma, S, Fahrner, R, Lim, WK, Mahla, E, Manikandan, R, Puma, F, Pyun, WB, Radovic, M, Rajagopalan, S, Suttie, S, Vanniyasingam, T, van Gaal, WJ, Waliszek, M, and Devereaux, PJ
- Abstract
OBJECTIVES: The objective of this study was to determine whether measuring post-operative B-type natriuretic peptides (NPs) (i.e., B-type natriuretic peptide [BNP] and N-terminal fragment of proBNP [NT-proBNP]) enhances risk stratification in adult patients undergoing noncardiac surgery, in whom a pre-operative NP has been measured. BACKGROUND: Pre-operative NP concentrations are powerful independent predictors of perioperative cardiovascular complications, but recent studies have reported that elevated post-operative NP concentrations are independently associated with these complications. It is not clear whether there is value in measuring post-operative NP when a pre-operative measurement has been done. METHODS: We conducted a systematic review and individual patient data meta-analysis to determine whether the addition of post-operative NP levels enhanced the prediction of the composite of death and nonfatal myocardial infarction at 30 and ≥180 days after surgery. RESULTS: Eighteen eligible studies provided individual patient data (n = 2,179). Adding post-operative NP to a risk prediction model containing pre-operative NP improved model fit and risk classification at both 30 days (corrected quasi-likelihood under the independence model criterion: 1,280 to 1,204; net reclassification index: 20%; p < 0.001) and ≥180 days (corrected quasi-likelihood under the independence model criterion: 1,320 to 1,300; net reclassification index: 11%; p = 0.003). Elevated post-operative NP was the strongest independent predictor of the primary outcome at 30 days (odds ratio: 3.7; 95% confidence interval: 2.2 to 6.2; p < 0.001) and ≥180 days (odds ratio: 2.2; 95% confidence interval: 1.9 to 2.7; p < 0.001) after surgery. CONCLUSIONS: Additional post-operative NP measurement enhanced risk stratification for the composite outcomes of death or nonfatal myocardial infarction at 30 days and ≥180 days after noncardiac surgery compared with a pre-operative NP measurement alone.
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- 2014
17. Anaesthesia and ARV
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Rodseth, RN
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No Abstract. Southern African Journal of Anaesthesia and Analgesia Vol. 12(1) 2006: 29
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- 2006
18. Postoperative atrial fibrillation in patients on statins undergoing isolated cardiac valve surgery: a meta-analysis
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Drummond, LW, primary, Torborg, AM, additional, Rodseth, RN, additional, and Biccard, BM, additional
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- 2014
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19. Taking an idea to a research protocol
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Biccard, BM, primary and Rodseth, RN, additional
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- 2014
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20. The opinion of patients at a local South Africa teaching hospital on physician-industry relations
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Wise, R, primary and Rodseth, RN, additional
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- 2013
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21. Preoperative B-type natriuretic peptide risk stratification: do postoperative indices add value?
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Rodseth, RN, primary, Vasconcellos, K, additional, Naidoo, P, additional, and Biccard, BM, additional
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- 2013
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22. A meta-analysis of intraoperative factors associated with postoperative cardiac complications
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Skinner, DL, primary, Goga, S, additional, Rodseth, RN, additional, and Biccard, BM, additional
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- 2012
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23. A survey of corticosteroid use for the management of septic shock
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Govender, K, primary and Rodseth, RN, additional
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- 2012
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24. The treatment of perioperative myocardial infarctions following noncardiac surgery
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Ryan, L, primary, Rodseth, RN, additional, and Biccard, BM, additional
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- 2012
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25. Cardiopulmonary resuscitation: see beyond the guidelines
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Rodseth, RN, primary and Thomas, LM, additional
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- 2011
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26. CPR: What's changed? Are you doing it right?
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Rodseth, RN, primary
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- 2011
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27. The perioperative management of Bernard-Soulier syndrome: a case report and review of the role of perioperative factor VIIa
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Rodseth, RN, primary
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- 2010
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28. Living longer as an anaesthetist: The ‘magic’ lifestyle or the ‘lifestyle polypill’
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Rodseth, RN, primary and Biccard, BM, additional
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- 2009
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29. Fracture stabilisation in a polytraumatised African population-A comparison with international management practice.
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Grey B, Rodseth RN, and Muckart DJ
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- 2012
30. The predictive ability of pre-operative B-type natriuretic Peptide in vascular patients for major adverse cardiac events an individual patient data meta-analysis.
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Rodseth RN, Lurati Buse GA, Bolliger D, Burkhart CS, Cuthbertson BH, Gibson SC, Mahla E, Leibowitz DW, and Biccard BM
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- 2011
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31. Prophylactic antiemetics in oral and maxillofacial surgery: a requiem?--a response.
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Rodseth RN
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- 2010
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32. The surgical safety checklist and patient outcomes after surgery
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T.E.F. Abbott, T. Ahmad, M.K. Phull, A.J. Fowler, R. Hewson, B.M. Biccard, M.S. Chew, M. Gillies, R.M. Pearse, Rupert M. Pearse, Scott Beattie, Pierre-Alain Clavien, Nicolas Demartines, Lee A. Fleisher, Mike Grocott, James Haddow, Andreas Hoeft, Peter Holt, Rui Moreno, Naomi Pritchard, Andrew Rhodes, Duminda Wijeysundera, Matt Wilson, Tahania Ahmed, Kirsty Everingham, Russell Hewson, Marta Januszewska, Mandeep-Kaur Phull, Richard Halliwell, Mark Shulman, Paul Myles, Werner Schmid, Michael Hiesmayr, Patrick Wouters, Stefan de Hert, Suzana Lobo, Xiangming Fang, Lars Rasmussen, Emmanuel Futier, Matthieu Biais, Aurélien Venara, Karem Slim, Michael Sander, Despoina Koulenti, Kostoula Arvaniti, Mathew Chan, Atul Kulkarni, Susilo Chandra, Aida Tantri, Emad Geddoa, Muntadhar Abbas, Giorgio Della Rocca, Datin Sivasakthi, Marzida Mansor, Pastor Luna, Arthur Bouwman, Wolfgang Buhre, Vanessa Beavis, Douglas Campbell, Tim Short, Tunde Osinaike, Ricardo Matos, Ioana Grigoras, Mikhail Kirov, Denis Protsenko, Bruce Biccard, Cesar Aldecoa, Michelle Chew, Christoph Hofer, Martin Hubner, James Ditai, Tamas Szakmany, Lee Fleisher, Marissa Ferguson, Michael MacMahon, Ritchie Cherian, Helen Currow, Kathirgamanathan Kanathiban, David Gillespie, Edward Pathmanathan, Katherine Phillips, Jenifer Reynolds, Joanne Rowley, Jeanene Douglas, Ross Kerridge, Sameer Garg, Michael Bennett, Megha Jain, David Alcock, Nico Terblanche, Rochelle Cotter, Kate Leslie, Marcelle Stewart, Nicolette Zingerle, Antony Clyde, Oliver Hambidge, Adam Rehak, Sharon Cotterell, Wilson Binh Quan Huynh, Timothy McCulloch, Erez Ben-Menachem, Thomas Egan, Jennifer Cope, Paul Fellinger, Markus Haisjackl, Simone Haselberger, Caroline Holaubek, Paul Lichtenegger, Florian Scherz, Franz Hoffer, Veronika Cakova, Andreas Eichwalder, Norbert Fischbach, Reinhold Klug, Elisabeth Schneider, Martin Vesely, Reinhart Wickenhauser, Karl Gernot Grubmueller, Marion Leitgeb, Friedrich Lang, Nancy Toro, Marlene Bauer, Friedrich Laengle, Claudia Haberl, Thomas Mayrhofer, Christoph Trybus, Christian Buerkle, Karin Forstner, Reinhard Germann, Harald Rinoesl, Elke Schindler, Ernst Trampitsch, Gerhard Bogner, Daniel Dankl, Martin Duenser, Gerhard Fritsch, Ilse Gradwohl-Matis, Andreas Hartmann, Thomas Hoelzenbein, Tarkan Jaeger, Franz Landauer, Gregor Lindl, Michael Lux, Johannes Steindl, Ottokar Stundner, Christian Szabo, Jawad Bidgoli, Hans Verdoodt, Patrice Forget, David Kahn, Fernande Lois, Mona Momeni, Caroline Prégardien, Audrey Pospiech, Arnaud Steyaert, Laurent Veevaete, Dirk De Kegel, Karen De Jongh, Luc Foubert, Carine Smitz, Marcel Vercauteren, Jan Poelaert, Veerle Van Mossevelde, Jacques Abeloos, Stefaan Bouchez, Marc Coppens, Luc De Baerdemaeker, Isabel Deblaere, Ann De Bruyne, Kristine Fonck, Bjorn Heyse, Tom Jacobs, Koen Lapage, Anneliese Moerman, Martine Neckebroek, Aliaksandra Parashchanka, Nathalie Roels, Nancy Van Den Eynde, Michael Vandenheuvel, JurgenVan Limmen, Ann Vanluchene, Caroline Vanpeteghem, Piet Wyffels, Christel Huygens, Punitha Vandenbempt, Marc Van de Velde, Dimitri Dylst, Bruno Janssen, Evelien Schreurs, Fábia Berganton Aleixo, Keulle Candido, Hugo Dias Batista, Mario Guimarães, Jaqueline Guizeline, João Hoffmann, Francisco Ricardo Marques Lobo, Vinícius Nascimento, Katia Nishiyama, Lucas Pazetto, Daniela Souza, Rodrigo Souza Rodrigues, Ana Maria Vilela dos Santos, Jaquelline Jardim, Luiz Marcelo Sá Malbouisson, Joao Silva, Paulo do Nascimento Junior, Thalissa Hermínia Baio, Gabriel Isaac Pereira de Castro, Henri Roger Watanabe Oliveira, Cristina Prata Amendola, Gutemberg Cardoso, Daniela Ortega, Ana Flavia Brotto, Mirella Cristine De Oliveira, Álvaro Réa-Neto, Fernando Dias, Maria Eduarda Travi, Luiza Zerman, Pedro Azambuja, Marcos Freitas Knibel, Antonio Martins, William Almeida, Calim Neder Neto, Maria Angela Tardelli, Eliana Caser, Marcio Machado, Crisitiano Aguzzoli, Sérgio Baldisserotto, Fernanda Beck Tabajara, Fernanda Bettega, La Hore Correa Rodrigues Júnior, Julia de Gasperi, Lais Faina, Marcos Farias Nolasco, Bruna Ferreira da Costa Fischer, Mariana Fosch de Campos Ferreira, Cristina Hartmann, Marta Kliemann, Gustavo Luis Hubert Ribeiro, Julia Merladete Fraga, Thiago Motta Netto, Laura Valduga Pozza, Paulo Rafael Wendling, Caroline Azevedo, Juliana Garcia, Marcel Lopes, Bernardo Maia, Paula Maselli, Ralph Melo, Weslley Mendes, Matheus Neves, Jacqueline Ney, Claudio Piras, Christopher Applewhaite, Adrienne Carr, Lorraine Chow, Kaylene Duttchen, Julena Foglia, Michael Greene, Ashley Hinther, Kendra Houston, Thomas Jared McCormick, Jennifer Mikhayel, Sam Montasser, Alex Ragan, Andrew Suen, Adrianna Woolsey, Hai Chuan Yu, Duane Funk, Stephen Kowalski, Regina Legaspi, Heather McDonald, Faisal Siddiqui, Jeremy Pridham, Bernadette Rowe, Sonia Sampson, Barton Thiessen, Geoff Zbitnew, Andre Bernard, Ronald George, Philip Jones, Rita Moor, Naveed Siddiqui, Alexandra Wolfer, Diem Tran, Denyse Winch, Gary Dobson, Thomas McCormick, Osama Montasser, Richard Hall, Leyla Baghirzada, Gerard Curley, Si Yuan Dai, Gregory Hare, Esther Lee, Uma Shastri, Albert Tsui, Anmol Yagnik, Danielle Alvares, Stephen Choi, Heather Dwyer, Kathrina Flores, Colin McCartney, Priya Somascanthan, Jo Carroll, Janneth Pazmino-Canizares, Noam Ami, Vincent Chan, Anahi Perlas, Ruth Argue, Yang Huang, Katie Lavis, Kelly Mayson, Ying Cao, Hong Gao, Tingju Hu, Jie Lv, Jian Yang, Yang Yang, Yi Zhong, Jing Zhou, Xiaohua Zou, Miao He, Xiaoying Li, Dihuan Luo, Haiying Wang, Tian Yu, Liyong Chen, Lijun Wang, Yunfei Cai, Zhongming Cao, Yanling Li, Jiaxin Lian, Haiyun Sun, Sheng Wang, Zhipeng Wang, Kenru Wang, Yi Zhu, Xindan Du, Hao Fan, Yunbin Fu, Lixia Huang, Yanming Huang, Haifang Hwan, Hong Luo, Pi-Sheng Qu, Fan Tao, Zhen Wang, Guoxiang Wang, Shun Wang, Yan Zhang, Xiaolin Zhang, Chao Chen, Weixing Wang, Zhengyuan Liu, Lihua Fan, Jing Tang, Yijun Chen, Yongjie Chen, Yangyang Han, Changshun Huang, Guojin Liang, Jing Shen, Jun Wang, Qiuhong Yang, Jungang Zhen, Haidong Zhou, Junping Chen, Zhang Chen, Xiaoyu Li, Bo Meng, Haiwang Ye, Xiaoyan Zhang, Yanbing Bi, Jianqiao Cao, Fengying Guo, Hong Lin, Yang Liu, Meng Lv, Pengcai Shi, Xiumei Song, Chuanyu Sun, Yongtao Sun, Yuelan Wang, Shenhui Wang, Min Zhang, Rong Chen, Jiabao Hou, Yan Leng, Qing-tao Meng, Li Qian, Zi-ying Shen, Zhong-yuan Xia, Rui Xue, Yuan Zhang, Bo Zhao, Xian-jin Zhou, Qiang Chen, Huinan Guo, Yongqing Guo, Yuehong Qi, Zhi Wang, Jianfeng Wei, Weiwei Zhang, Lina Zheng, Qi Bao, Yaqiu Chen, Yijiao Chen, Yue Fei, Nianqiang Hu, Xuming Hu, Min Lei, Xiaoqin Li, Xiaocui Lv, Fangfang Miao, Lingling Ouyang, Lu Qian, Conyu Shen, Yu Sun, Yuting Wang, Dong Wang, Chao Wu, Liyuan Xu, Jiaqi Yuan, Lina Zhang, Huan Zhang, Yapping Zhang, Jinning Zhao, Chong Zhao, Lei Zhao, Tianzhao Zheng, Dachun Zhou, Haiyan Zhou, Ce Zhou, Kaizhi Lu, Ting Zhao, Changlin He, Hong Chen, Shasha Chen, Baoli Cheng, Jie He, Lin Jin, Caixia Li, Hui Li, Yuanming Pan, Yugang Shi, Xiao Hong Wen, Shuijing Wu, Guohao Xie, Kai Zhang, Bing Zhao, Xianfu Lu, Feifei Chen, Qisheng Liang, Xuewu Lin, Yunzhi Ling, Gang Liu, Jing Tao, Lu Yang, Jialong Zhou, Fumei Chen, Zhonggui Cheng, Hanying Dai, Yunlin Feng, Benchao Hou, Haixia Gong, Chun hua Hu, Haijin Huang, Jian Huang, Zhangjie Jiang, Mengyuan Li, Jiamei Lin, Mei Liu, Weicheng Liu, Zhen Liu, Zhiyi Liu, Foquan Luo, Longxian Ma, Jia Min, Xiaoyun Shi, Zhiping Song, Xianwen Wan, Yingfen Xiong, Lin Xu, Shuangjia Yang, Qin Zhang, Hongyan Zhang, Huaigen Zhang, Xuekang Zhang, Lili Zhao, Weihong Zhao, Weilu Zhao, Xiaoping Zhu, Yun Bai, Linbi Chen, Sijia Chen, Qinxue Dai, Wujun Geng, Kunyuan Han, Xin He, Luping Huang, Binbin Ji, Danyun Jia, Shenhui Jin, Qianjun Li, Dongdong Liang, Shan Luo, Lulu Lwang, Yunchang Mo, Yuanyuan Pan, Xinyu Qi, Meizi Qian, Jinling Qin, Yelong Ren, Yiyi Shi, Junlu Wang, Junkai Wang, Leilei Wang, Junjie Xie, Yixiu Yan, Yurui Yao, Mingxiao Zhang, Jiashi Zhao, Xiuxiu Zhuang, Yanqiu Ai, Fang Du, Long He, Ledan Huang, Zhisong Li, Huijuan Li, Yetong Li, Liwei Li, Su Meng, Yazhuo Yuan, Enman Zhang, Jie Zhang, Shuna Zhao, Zhenrong Ji, Ling Pei, Li Wang, Chen Chen, Beibei Dong, Jing Li, Ziqiang Miao, Hongying Mu, Chao Qin, Lin Su, Zhiting Wen, Keliang Xie, Yonghao Yu, Fang Yuan, Xianwen Hu, Ye Zhang, Wangpin Xiao, Zhipeng Zhu, Qingqing Dai, Kaiwen Fu, Rong Hu, Xiaolan Hu, Song Huang, Yaqi Li, Yingping Liang, Shuchun Yu, Zheng Guo, Yan Jing, Na Tang, Jie Wu, Dajiang Yuan, Ruilin Zhang, Xiaoying Zhao, Yuhong Li, Hui-Ping Bai, Chun-Xiao Liu, Fei-Fei Liu, Wei Ren, Xiu-Li Wang, Guan-Jie Xu, Na Hu, Bo Li, Yangwen Ou, Yongzhong Tang, Shanglong Yao, Shihai Zhang, Cui-Cui Kong, Bei Liu, Tianlong Wang, Wei Xiao, Bo Lu, Yanfei Xia, Jiali Zhou, Fang Cai, Pushan Chen, Shuangfei Hu, Hongfa Wang, Qiong Xu, Liu Hu, Liang Jing, Bin Li, Qiang Liu, Yuejiang Liu, Xinjian Lu, Zhen Dan Peng, Xiaodong Qiu, Quan Ren, Youliang Tong, Jin Wang, Yazhou Wen, Qiong Wu, Jiangyan Xia, Jue Xie, Xiapei Xiong, Shixia Xu, Tianqin Yang, Hui Ye, Ning Yin, Jing Yuan, Qiuting Zeng, Baoling Zhang, Kang Zheng, Jing Cang, Shiyu Chen, Yu Fan, Shuying Fu, Xiaodong Ge, Baolei Guo, Wenhui Huang, Linghui Jiang, Xinmei Jiang, Yi Liu, Yan Pan, Yun Ren, Qi Shan, Jiaxing 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Luz Serrano, Eduardo Alonso, Victor Anillo, Emilio Maseda, Patricia Salgado, Luis Suarez, Alejandro Suarez-de-la-Rica, María José Villagrán, José Ignacio Alonso, Estefania Cabezuelo, Irene Garcia-Saiz, Olga Lopez del Moral, Silvia Martín, Alba Perez Gonzalez, Ma Sherezade Tovar Doncel, Martin Agüero Vera, Francisco José Ávila Sánchez, Beatriz Castaño, Beatriz Castaño Moreira, Sahely Flores Risco, Daniel Paz Martín, Fernando Pérez Martín, Paloma Poza, Adela Ruiz, Wilson Fabio Serna Martínez, Bárbara Vázquez Vicente, Saul Velaz Dominguez, Salvador Fernández, Alfonso Munoz-López, Maria Jose Bernat, Arantxa Mas, Kenneth Planas, Monir Jawad, Yousif Saeed, Annika Hedin, Helena Levander, Sandra Holmström, David Lönn, Frank Zoerner, Irene Åkring, Carl Widmark, Jan Zettergren, Victor Aspelund Liljequist, Lena Nystrom, Suzanne Odeberg-Wernerman, Anders Oldner, Malin Jonsson Fagerlund, Patrik Reje, Sara Lyckner, Jesper Sperber, Anne Adolfsson, Bengt Klarin, Katrin Ögren, Jean-Pierre Barras, Thomas Bührer, Vasileios Despotidis, Naeder Helmy, Stephan Holliger, Dimitri Aristotle Raptis, Roger Schmid, Antoine Meyer, Yves Jaquet, Ulf Kessler, Mirza Muradbegovic, Solange R. Nahum, Teresa Rotunno, Boris Schiltz, François Voruz, Marc Worreth, Dimitri Christoforidis, Sotirios Georgios Popeskou, Markus Furrer, Gian Andrea Prevost, Andrea Stocker, Klaus Lang, Stefan Breitenstein, Michael T. Ganter, Martin Geisen, Christopher Soll, Michelle Korkmaz, Iris Lubach, Michael Schmitz, Moritz Meyer zu Schwabedissen, Meyer zu Schwabedissen Moritz, Urs Zingg, Thomas Hillermann, Stefan Wildi, Bernardo Bollen Pinto, Bernhard Walder, Giustina Mariotti, Ksenija Slankamenac, Mirioce Namuyuga, Edward Kyomugisha, Olivia Kituuka, Anne Wesonga Shikanda, Nasser Kakembo, Charles Otim Tom, Webombesa Antonina, Emmanuel Bua, Eden Michael Ssettabi, Joseph Epodoi, Fiona Kabagenyi, Fred Kirya, Ged Dempsey, Colette Seasman, Raja Basit Nawaz Khan, Claire Kurasz, Mark Macgregor, Burhan Shawki, Daren Francis, Vimal Hariharan, Simon Chau, Kate Ellis, Georgina Butt, Dennis-Wayne Chicken, Natasha Christmas, Samantha Allen, Gayatri Daniel Daniel, Angie Dempster, Juliette Kemp, Lewis Matthews, Philip Mcglone, Joanne Tambellini, Dawn Trodd, Katie Freitas, Atul Garg, Janesh Kumar Gupta, Shilpaja Karpate, Aditi Kulkarni, Chloe O'Hara, Jtroko Troko, Kirsty Angus, Jacqueline Bradley, Emma Brennan, Carolyn Brooks, Janette Brown, Gemma Brown, Amanda Finch, Karen Gratrix, Sue Hesketh, Gillian Hill, Carol Jeffs, Maureen Morgan, Chris Pemberton, Nicola Slawson, Helen Spickett, Gemma Swarbrick, Megan Thomas, Greta Van Duyvenvoorde, Andrew Brennan, Richard Briscoe, Sarah Cooper, Tom Lawton, Martin Northey, Rashmi Senaratne, Helen Stanworth, Lorna Burrows, Helen Cain, Rachael Craven, Keith Davies, Attila Jonas, Marcin Pachucki, Graham Walkden, Helen Davies, Mariethel Gudaca, Maria Hobrok, Dilshan Arawwawala, Lauren Fergey, Matthew Gardiner, Jacqueline Gunn, Lyndsay Johnson, Amanda Lofting, Amanda Lyle, Fiona Mc Neela, Susan Smolen, Joanne Topliffe, Sarah Williams, Martin Bland, Packianathaswamy Balaji, Vikas Kaura, Prasad Lanka, Neil Smith, Ahmed Ahmed, John Myatt, Ravikiran Shenoy, Wai Cheong Soon, Jessica Tan, Sunny Karadia, James Self, Emma Durant, Shiva Tripathi, Clare Bullock, Debbie Campbell, Alison Ghosh, Thomas Hughes, Lajos Zsisku, Sheshagiri Bengeri, Amanda Cowton, Mohammed Shazad Khalid, James Limb, Colin McAdam, Mandy Porritt, M. Amir Rafi, Priya Shekar, David Adams, Catherine Harden, Heidi Hollands, Angela King, Linda March, Gary Minto, Abigail Patrick, Rosalyn Squire, Darren Waugh, Paramesh Kumara, Karen Simeson, Jamie Yarwood, Julie Browning, Jonathan Hatton, Howes Julian, Atideb Mitra, Maria Newton, Pawan Kootelu Pernu, Alison Wilson, Thelma Commey, Helen Foot, Lyn Glover, Ajay Gupta, Nicola Lancaster, Jill Levin, Felicity Mackenzie, Claire Mestanza, Emma Nofal, Lauren Pout, Rosanna Varden, Jonathan Wild, Stephanie Jones, Sarah Moreton, Mark Pulletz, Charlotte Davies, Matthew Martin, Sian Thomas, Karen Burns, Carol McArthur, Panna Patel, Gary Lau, Natalie Rich, Fiona Davis, Rachel Lyons, Beth Port, Rachel Prout, Christopher Smith, Yemi Adelaja, Victoria Bennett, Heena Bidd, Alexandra Dumitrescu, Jacqui Fox Murphy, Abigail Keen, Nhlanhla Mguni, Cheng Ong, George Adams, Piers Boshier, Richard Brown, Izabella Butryn, Jayanta Chatterjee, Alexander Freethy, Geoffrey Lockwood, Maria Tsakok, Sophia Tsiligiannis, William Peat, Lorraine Stephenson, Mike Bradburn, Sara Pick, Pedro Cunha, Olufemi Olagbaiye, Salim Tayeh, Balaji Packianathaswamy, Caroline Abernethy, Madhu Balasubramaniam, Rachael Bennett, David Bolton, Victoria Martinson, Charde Naylor, Stephanie Bell, Blaylock Heather, Vlad Kushakovsky, Liam Alcock, Hazel Alexander, Colette Anderson, Paul Baker, Morag Brookes, Louise Cawthorn, Emanuel Cirstea, Rachel Clarkson, Kerry Colling, Ian Coulter, Suparna Das, Kathryn Haigh, Alhafidz Hamdan, Keith Hugill, Lucksy Kottam, Emily Lisseter, Matthew Mawdsley, Julie McGivern, Krishnaveni Padala, Victoria Phelps, Vineshykaa Ramesh kumar, Kirsten Stewart, Kayley Towse, Julie Tregonning, Ali Vahedi, Alycon Walker, Duncan Baines, Anjali Bilolikar, Shiv Chande, Edward Copley, Nigel Dunk, Raghavendra Kulkarni, Pawan Kumar, Yavor Metodiev, Dumisani Ncomanzi, Bhavesh Raithatha, Parizade Raymode, Jan Szafranski, Linda Twohey, Philip Watt, Lucie Weatherall, J. Weatherill, Zoe Whitman, Elinor Wighton, Chamika Abayasinghe, Alexander Chan, Sharif Darwish, James Gill, Emma Glasgow, Daniel Hadfield, Clair Harris, Phil Hopkins, Arun Kochhar, Gudrun Kunst, Clare Mellis, Andrew Pool, Paul Riozzi, Andrew Selman, Emma-Jane Smith, Liana Vele, Yuksel Gercek, Kramer Guy, Douglas Holden, Nicholas Watson, Karen Whysall, Prematie Andreou, Dawn Hales, Jonathan Thompson, Sarah Bowrey, Shara McDonald, Jemma Gilmore, Vicky Hills, Chan Kelly, Sinead Kelly, Geraint Lloyd, Tom Abbott, Lewis Gall, Hew Torrance, Mark Vivian, Emer Berntsen, Tracey Nolan, Angus Turner, Akbar Vohra, Andrew Brown, Richard Clark, Elaine Coughlan, Conway Daniel, Chinmay Patvardhan, Rachel Pearson, Sheba Predeep, Hesham Saad, Mohanakrishnan Shanmugam, Simon Varley, Katharine Wylie, Lucy Cooper, Arystarch Makowski, Beata Misztal, Eliza Moldovan, Claire Pegg, Andrew Donovan, Jayne Foot, Simon Large, Andrew Claxton, Bhagyashree Netke, Richard Armstrong, Claire Calderwood, Andy Kwok, Otto 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Craw N, Craw S, Pitt-Kerby T, Rowland-Axe R, Spurdle K, McDonald A, Simon D, Sinha V, Smith T, Banner-Goodspeed V, Boone M, Campbell K, Lu F, Scannell J, Sobol J, Balajonda N, Clemmons K, Conde C, Elgasim M, Funk B, Hall R, Hopkins T, Olaleye O, Omer O, Pender M, Porto A, Stevens A, Waweru P, Yeh E, Bodansky D, Evans A, Kleopoulos S, Maril R, Mathney E, Sanchez A, Tinuoye E, Bateman B, Eng K, Jiang N, Ladha K, Needleman J, Chen LL, Lane R, Robinowitz D, Ghushe N, Irshad M, O'Connor J, Patel S, Takemoto S, Wallace A, Mazzeffi M, Rock P, Wallace K, Zhu X, Chua P, Mattera M, Sharar R, Thilen S, Treggiari M, Morgan A, Sofjan I, Subramaniam K, Avidan M, Maybrier H, Muench M, Wildes T., Université de Lille, CHU Lille, Queen Mary University of London [QMUL], Graduate School, Medical Microbiology and Infection Prevention, Clinical Immunology and Rheumatology, 01 Internal and external specialisms, ACS - Heart failure & arrhythmias, AGEM - Endocrinology, metabolism and nutrition, APH - Quality of Care, ACS - Diabetes & metabolism, AII - Amsterdam institute for Infection and Immunity, ACS - Microcirculation, Pearse, R M, International Surgical Outcomes Study (ISO), Group, Zangrillo, A, Landoni, G, Beretta, L., International Surgical Outcomes Study (ISOS) group, Pearse, R.M., Beattie, S., Clavien, P.A., Demartines, N., Fleisher, L.A., Grocott, M., Haddow, J., Hoeft, A., Holt, P., Moreno, R., Pritchard, N., Rhodes, A., Wijeysundera, D., Wilson, M., Ahmed, T., Everingham, K., Hewson, R., Januszewska, M., Phull, M.K., Halliwell, R., Shulman, M., Myles, P., Schmid, W., Hiesmayr, M., Wouters, P., de Hert, S., Lobo, S., Fang, X., Rasmussen, L., Futier, E., Biais, M., Venara, A., Slim, K., Sander, M., Koulenti, D., Arvaniti, K., Chan, M., Kulkarni, A., Chandra, S., Tantri, A., Geddoa, E., Abbas, M., Della Rocca, G., Sivasakthi, D., Mansor, M., Luna, P., Bouwman, A., Buhre, W., Beavis, V., Campbell, D., Short, T., Osinaike, T., Matos, R., Grigoras, I., Kirov, M., Protsenko, D., 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Eskildsen, K.Z., Gätke, M.R., Wibrandt, I., Heintzelmann, S.B., Wiborg Lange, K.H., Lundsgaard, R.S., Amstrup-Hansen, L., Hovendal, C., Larsen, M., Lenstrup, M., Kobborg, T., Larsen, J.R., Pedersen, A.B., Smith, S.H., Oestervig, R.M., Afshari, A., Andersen, C., Ekelund, K., Secher, E.L., Beloeil, H., Lasocki, S., Ouattara, A., Sineus, M., Molliex, S., Legouge, M.L., Wallet, F., Tesniere, A., Gaudin, C., Lehur, P., Forsans, E., de Rudnicki, S., Maudet, V.S., Mutter, D., Sojod, G., Ouaissi, M., Regimbeau, J.M., Desbordes, J., Comptaer, N., Manser, D.E., Ethgen, S., Lebuffe, G., Auer, P., Härtl, C., Deja, M., Legashov, K., Sonnemann, S., Wiegand-Loehnert, C., Falk, E., Habicher, M., Angermair, S., Laetsch, B., Schmidt, K., Von Heymann, C., Ramminger, A., Jelschen, F., Pabel, S., Weyland, A., Czeslick, E., Gille, J., Malcharek, M., Sablotzki, A., Lueke, K., Wetzel, P., Weimann, J., Lenhart, F.P., Reichle, F., Schirmer, F., Hüppe, M., Klotz, K., Nau, C., Schön, J., Mencke, T., Wasmund, C., 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Stafylaraki, M., Gaitanakis, S., Karydakis, P., Paltoglou, J., Ponireas, P., Chaloulis, P., Provatidis, A., Sousana, A., Gardikou, V.V., Konstantivelli, M., Lataniotou, O., Lisari, E., Margaroni, M., Stamatiou, K., Nikolaidis, E., Pnevmatikos, I., Sertaridou, E., Andreou, A., Arkalaki, E., Athanasakis, E., Chaniotaki, F., Chatzimichali, C.A., Christofaki, M., Dermitzaki, D., Fiorentza, K., Frantzeskos, G., Geromarkaki, E., Kafkalaki, K., Kalogridaki, M., Karydi, K., Kokkini, S., Kougentakis, G., Lefaki, T., Lilitsis, E., Makatounaki, A., Malliotakis, P., Michelakis, D., Neonaki, M., Nyktari, V., Palikyra, I., Papadakis, E., Papaioannou, A., Sfakianakis, K., Sgouraki, M., Souvatzis, X., Spartinou, A., Stefanidou, N., Syrogianni, P., Tsagkaraki, G., Arnaoutoglou, E., Arnaoutoglou, C., Bali, C., Bouris, V., Doumos, R., Gkini, K.P., Kapaktsi, C., Koulouras, V., Lena, A., Lepida, D., Michos, E., Papadopoulos, D., Paschopoulos, M., Rompou, V.A., Siouti, I., Tsampalas, S., Ververidou, O., Zilis, G., Charlalampidoy, A., Christodoulidis, G., Flossos, A., Stamoulis, K., Tsang, MSC, Tsang, M.S., Lai, M.L., Yip, C.P., Heymans Chan, H.M., Law, B., Li, W.S., Chu, H.M., Koo, EGY, Lam, CCJ, Cheng, K.H., Lam, T., Chu, S., Lam, W.Y., Wong, KWK, Kwok, D., Hung, CYJ, Chan, WKJ, Wong, W.L., Chung, CKE, Ma, S.K., Kaushik, S., Shah, B., Shah, D., Shah, S., Ar, P., Muthuchellappan, R., Agarwal, V., Divatia, J., Mishra, S., Nimje, G., Pande, S., Savarkar, S., Shrivastava, A., Thomas, M., Yegnaram, S., Hidayatullah, R., Puar, N., Niman, S., Indra, I., Hamzah, Z., Yuliana, A., Abidin, U.N., Dursin, A.N., Kurnia, A., Susanti, A., Handayani, D., Alit, M.A., Arya, A., Senapathi, TGA, Utara, U.H., Wid, W.M., Wima, S., Wir, W.M., Jehosua, B., Kaunang, J., Lantang, E.Y., Najoan, R., Waworuntu, N., Awad, H., Fuad, A., Geddoa, B., Khalaf, A.R., Al Hussaini, S., Albaj, S., Kenber, M., Bettinelli, A., Spadaro, S., AlbertoVolta, C., Giancarlo, L., Sottosanti, V., Copetti, E., Spagnesi, L., Toretti, 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Swift, D., Walker, R., Bester, D., Cavanagh, S., Cripps, H., Daniel, H., Lynch, J., Pyke, S., Scholefield, J., Whitworth, H., Bottrill, F., Ramalingam, G., Webb, S., Akerman, N., Antill, P., Bourner, L., Buckley, S., Castle, G., Charles, R., Eggleston, C., Foster, R., Gill, S., Lindley, K., Lklouk, M., Lowery, T., Martin, O., Milne, D., O'Connor, P., Ratcliffe, A., Rose, A., Smith, A., Varma, S., Ward, J., Barcraft-Barnes, H., Camsooksai, J., Colvin, C., Reschreiter, H., Tbaily, L., Venner, N., Hamilton, C., Kelly, L., Toth-Tarsoly, P., Dodsworth, K., Foord, D., Gordon, P., Hawes, E., Lamb, N., Mouland, J., Nightingale, J., Rose, S., Schrieber, J., Al'Amri, K., Aladin, H., Arshad, M.A., Barraclough, J., Bentley, C., Bergin, C., Carrera, R., Clarkson, A., Collins, M., Denham, S., Griffiths, E., Ip, P., Jeyanthan, S., Joory, K., Kaur, S., Marriott, P., Mitchell, N., Nagaiah, S., Nilsson, A., Parekh, N., Pope, M., Seager, J., Serag, H., Tameem, A., Thomas, A., Thunder, J., Torrance, A., Vohra, R., Whitehouse, A., Wong, T., Blunt, M., Wong, K., Giles, J., Reed, I., Weller, D., Bell, G., Birch, J., Damant, R., Maiden, J., Mewies, C., Prince, C., Radford, J., Reynolds, T., Balain, B., Banerjee, R., Barnett, A., Burston, B., Edwards, J., Evans, C., Ford, D., Gallacher, P., Hill, S., Jaffray, D., Karlakki, S., Kennedy, J., Kiely, N., Lewthwaite, S., Marquis, C., Ockendon, M., Phillips, S., Pickard, S., Richardson, J., Roach, R., Smith, T., Spencer-Jones, R., Steele, N., Steen, J., Van Liefland, M., White, S., Faulds, M., Harris, M., Nicol, S., Pearson, S.A., Chukkambotla, S., Andrew, A., Attrill, E., Campbell, G., Datson, A., Fouracres, A., Graterol, J., Graves, L., Hong, B., Ishimaru, A., Karthikeyan, A., King, H., Lawson, T., Lee, G., Lyons, S., Hall, A.M., Mathoulin, S., Mcintyre, E., Mclaughlin, D., Mulcahy, K., Paddle, J., Robbins, J., Sung, W., Tayo, A., Trembath, L., Venugopal, S., Wigmore, G., Boereboom, C., Downes, C., Humphries, R., Melbourne, S., Tou, S., Ullah, S., Batchelor, N., Boxall, L., Broomby, R., Deen, T., Hellewell, A., Helliwell, L., Hutchings, M., Hutchins, D., Keenan, S., Mackie, D., Potter, A., Smith, F., Stone, L., Thorpe, K., Wassall, R., Woodgate, A., Baillie, S., Campbell, T., James, S., King, C., Marques de Araujo, D., Martin, D., Morkane, C., Neely, J., Rajendram, R., Burton, M., James, K., Keevil, E., Minik, O., Morgan, J., Musgrave, A., Rajanna, H., Roberts, T., Adamson, M., Jumbe, S., Kendall, J., Muthuswamy, M.B., Cruikshanks, A., Wrench, I., Zeidan, L., Ardern, D., Harris, B., Hellstrom, J., Martin, J., Thomas, R., Varsani, N., Brown, C.W., Docherty, P., Gillies, M., McGregor, E., Usher, H., Craig, J., Ahmad, T., Bodger, P., Creary, T., Fowler, A., Ijuo, E., Jones, T., Kantsedikas, I., Lahiri, S., McLean, A.L., Niebrzegowska, E., Phull, M., Wickboldt, N., Baldwin, J., Doyle, D., Mcmullan, S., Oladapo, M., Owen, T., Williams, A., Gregory, P., Husain, T., Kirk-Bayley, J., Mathers, E., Montague, L., Harper, M., Jack, J., Ridley, C., Avis, J., Cook, T., Dali-Kemmery, L., Kerslake, I., Lambourne, V., Pearson, A., Boyd, C., Callaghan, M., Lawson, C., McCrossan, R., Nesbitt, V., O'connor, L., Sinclair, R., Farid, N., Morgese, C., Bhatia, K., Karmarkar, S., Ahmed, J., Branagan, G., Hutton, M., Swain, A., Brookes, J., Cornell, J., Dolan, R., Hulme, J., Jansen van Vuuren, A., Jowitt, T., Kalashetty, G., Lloyd, F., Patel, K., Sherwood, N., Brown, L., Chandler, B., Deighton, K., Emma, T., Haunch, K., Cheeseman, M., Dent, K., Gray, C., Hood, M., Jones, D., Juj, J., Rao, R., Walker, T., Al Anizi, M., Cheah, C., Cheing, Y., Coutinho, F., Gondo, P., Hadebe, B., Hove, M.O., Khader, A., Krishnachetty, B., Rhodes, K., Sokhi, J., Baker, K.A., Bertram, W., Looseley, A., Mouton, R., Hanna, G., Arnold, G., Arya, S., Balfoussia, D., Baxter, L., Harris, J., Jones, C., Knaggs, A., Markar, S., Perera, A., Scott, A., Shida, A., Sirha, R., Wright, S., Frost, V., Andrews, E., Arrandale, L., Barrett, S., Cifra, E., Cooper, M., Dragnea, D., Elna, C., Maclean, J., Meier, S., Milliken, D., Munns, C., Ratanshi, N., Ramessur, S., Salvana, A., Watson, A., Ali, H., Critchley, R., Endersby, S., Hicks, C., Liddle, A., Pass, M., Ritchie, C., Thomas, C., Too, L., Welsh, S., Gill, T., Johnson, J., Reed, J., Davis, E., Papadopoullos, S., Attwood, C., Biffen, A., Boulton, K., Gray, S., Hay, D., Mills, S., Montgomery, J., Riddell, R., Simpson, J., Bhardwaj, N., Paul, E., Uwubamwen, N., Alexander, M., Arrich, J., Arumugam, S., Blackwood, D., Boggiano, V., Chan, Y.L., Chatterjee, D., Chhabra, A., Christian, R., Costelloe, H., Matthewman, M.C., Dalton, E., Darko, J., Davari, M., Dave, T., Deacon, M., Deepak, S., Edmond, H., Ellis, J., El-Sayed, A., Eneje, P., English, R., Ewe, R., Foers, W., Franklin, J., Gallego, L., Garrett, E., Goldberg, O., Goss, H., Greaves, R., Harris, R., Hennings, C., Jones, E., Kamali, N., Kokkinos, N., Lewis, C., Lignos, L., Malgapo, E.V., Malik, R., Milne, A., Mulligan, J.P., Nicklin, P., Palipane, N., Parsons, T., Piper, R., Prakash, R., Ramesh, B., Rasip, S., Reading, J., Rela, M., Reyes, A., Stephens, R., Rooms, M., Shah, K., Simons, H., Solanki, S., Spowart, E., Stevens, A., Waggett, H., Yassaee, A., Kennedy, A., Scott, S., Somanath, S., Berg, A., Hernandez, M., Nanda, R., Tank, G., Wilson, N., Wilson, D., Al-Soudaine, Y., Baldwin, M., Cornish, J., Davies, Z., Davies, L., Edwards, M., Frewer, N., Gallard, S., Glasbey, J., Harries, R., Hopkins, L., Kim, T., Koompirochana, V., Lawson, S., Lewis, M., Makzal, Z., Scourfield, S., Ahmad, Y., Bates, S., Blackwell, C., Bryant, H., Collins, H., Coulter, S., Cruickshank, R., Daniel, S., Daubeny, T., Golder, K., Hawkins, L., Helen, B., Hinxman, H., Levett, D., Salmon, K., Seaward, L., Skinner, B., Tyrell, B., Wadams, B., Walsgrove, J., Dickson, J., Constantin, K., Karen, M., O'Brien, P., O'Donohoe, L., Payne, H., Sundayi, S., Walker, E., Brooke, J., Cardy, J., Humphreys, S., Kessack, L., Kubitzek, C., Kumar, S., Cotterill, D., Hodzovic, E., Hosdurga, G., Miles, E., Saunders, G., Campbell, M., Chan, P., Jemmett, K., Raj, A., Naik, A., Oshowo, A., Ramamoorthy, R., Shah, N., Sylvan, A., Blyth, K., Burtenshaw, A., Freeman, D., Johnson, E., Lo, P., Martin, T., Plunkett, E., Wollaston, J., Allison, J., Carroll, C., Craw, N., Craw, S., Pitt-Kerby, T., Rowland-Axe, R., Spurdle, K., McDonald, A., Simon, D., Sinha, V., Banner-Goodspeed, V., Boone, M., Campbell, K., Lu, F., Scannell, J., Sobol, J., Balajonda, N., Clemmons, K., Conde, C., Elgasim, M., Funk, B., Hopkins, T., Olaleye, O., Omer, O., Pender, M., Porto, A., Waweru, P., Yeh, E., Bodansky, D., Evans, A., Kleopoulos, S., Maril, R., Mathney, E., Sanchez, A., Tinuoye, E., Bateman, B., Eng, K., Jiang, N., Ladha, K., Needleman, J., Chen, L.L., Lane, R., Robinowitz, D., Ghushe, N., Irshad, M., O'Connor, J., Patel, S., Takemoto, S., Wallace, A., Mazzeffi, M., Rock, P., Wallace, K., Chua, P., Mattera, M., Sharar, R., Thilen, S., Treggiari, M., Morgan, A., Sofjan, I., Subramaniam, K., Avidan, M., Maybrier, H., Muench, M., and Wildes, T.
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Male ,Postoperative Complications/epidemiology ,Hospital mortality ,[SDV]Life Sciences [q-bio] ,surgery ,Postoperative Complications ,0302 clinical medicine ,cohort studies ,030202 anesthesiology ,patient safety ,030212 general & internal medicine ,Postoperative Period ,Medicine(all) ,Middle Aged ,Checklist ,3. Good health ,Treatment Outcome ,operative/mortality ,Elective Surgical Procedures ,Surgical Procedures, Operative ,Meta-analysis ,Cohort ,Cohort studies ,Female ,Elective Surgical Procedure ,postoperative care/methods ,postoperative care/statistics and numerical data ,surgical procedures ,Anesthesiology and Pain Medicine ,Cohort study ,Adult ,medicine.medical_specialty ,Evidence-based medicine ,NO ,03 medical and health sciences ,Patient safety ,medicine ,postoperative care/method ,Humans ,Elective Surgical Procedures/standards ,Aged ,Cohort Studies ,Evidence-Based Medicine ,Hospital Mortality ,Patient Safety ,Postoperative Complications/mortality ,Postoperative Complications/prevention & control ,Surgical Procedures, Operative/methods ,business.industry ,Odds ratio ,Surgery ,Observational study ,business ,cohort studie - Abstract
BACKGROUND: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool.METHODS: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals.RESULTS: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32-0.77); PCONCLUSIONS: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.
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- 2018
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33. Reducing Mortality in Acute Kidney Injury Patients: Systematic Review and International Web-Based Survey
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Giovanni, Landoni, Tiziana, Bove, Andrea, Székely, Marco, Comis, Reitze N, Rodseth, Daniela, Pasero, Martin, Ponschab, Marta, Mucchetti, Maria L, Azzolini, Fabio, Caramelli, Gianluca, Paternoster, Giovanni, Pala, Luca, Cabrini, Daniele, Amitrano, Giovanni, Borghi, Antonella, Capasso, Claudia, Cariello, Anna, Carpanese, Paolo, Feltracco, Leonardo, Gottin, Rosetta, Lobreglio, Lorenzo, Mattioli, Fabrizio, Monaco, Francesco, Morgese, Mario, Musu, Laura, Pasin, Antonio, Pisano, Agostino, Roasio, Gianluca, Russo, Giorgio, Slaviero, Nicola, Villari, Annalisa, Vittorio, Mariachiara, Zucchetti, Fabio, Guarracino, Andrea, Morelli, Vincenzo, De Santis, Paolo A, Del Sarto, Antonio, Corcione, Marco, Ranieri, Gabriele, Finco, Alberto, Zangrillo, Rinaldo, Bellomo, Landoni, G., Bove, T., Székely, A., Comis, M., Rodseth, R.N., Pasero, D., Ponschab, M., Mucchetti, M., Azzolini, M.L., Caramelli, F., Paternoster, G., Pala, G., Cabrini, L., Amitrano, D., Borghi, G., Capasso, A., Cariello, C., Carpanese, A., Feltracco, P., Gottin, L., Lobreglio, R., Mattioli, L., Monaco, F., Morgese, F., Musu, M., Pasin, L., Pisano, A., Roasio, A., Russo, G., Slaviero, G., Villari, N., Vittorio, A., Zucchetti, M., Guarracino, F., Morelli, A., De Santis, V., Del Sarto, P.A., Corcione, A., Ranieri, M., Finco, G., Zangrillo, A., Bellomo, R., Landoni, G, Bove, T, Székely, A, Comis, M, Rodseth, Rn, Pasero, D, Ponschab, M, Mucchetti, M, Azzolini, Ml, Caramelli, F, Paternoster, G, Pala, G, Cabrini, L, Amitrano, D, Borghi, G, Capasso, A, Cariello, C, Carpanese, A, Feltracco, P, Gottin, L, Lobreglio, R, Mattioli, L, Monaco, F, Morgese, F, Musu, M, Pasin, L, Pisano, A, Roasio, A, Russo, G, Slaviero, G, Villari, N, Vittorio, A, Zucchetti, M, Guarracino, F, Morelli, A, De Santis, V, Del Sarto, Pa, Corcione, A, Ranieri, M, Finco, G, Zangrillo, A, and Bellomo, R
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renal failure ,short term survival ,patient monitoring ,medicine.medical_treatment ,health care survey ,acute renal injury ,hetastarch ,bacterial peritoniti ,Comorbidity ,hemodynamic monitoring ,health belief ,law.invention ,hemofiltration ,contrast induced nephropathy ,burn patient ,law ,consensu ,burn ,web vote ,angiography ,randomized controlled trial (topic) ,hepatorenal syndrome ,physician ,continuous hemodiafiltration ,article ,Acute kidney injury ,Acute Kidney Injury ,continuous infusion ,Intensive care unit ,human immunoglobulin ,clinical practice ,vasopressin, acute kidney failure ,multiple myeloma ,perioperative hemodynamic optimization ,priority journal ,human albumin ,meta analysis (topic) ,nadroparin ,multicenter study (topic) ,sepsi ,Cardiology and Cardiovascular Medicine ,renal replacement therapy ,Reducing mortality in acute kidney injury patients: systematic review and international web-based surve ,radiation injury ,Human ,medicine.drug ,medicine.medical_specialty ,consensus conference ,Contrast-induced nephropathy ,self report ,anesthesia ,survival ,Perioperative Care ,acute kidney failure, acute renal injury, anesthesia, consensus, consensus conference, critical care, mortality, renal failure, survival, web vote ,terlipressin ,critically ill patient ,acute kidney failure ,Monitoring, Intraoperative ,acetylcysteine ,Hemofiltration ,medicine ,Humans ,systematic review, acute kidney failure ,fenoldopam ,furosemide ,Hemodynamic ,Renal replacement therapy ,Intensive care medicine ,plasmapheresi ,Internet ,continuous hemofiltration ,liver cirrhosi ,Septic shock ,business.industry ,hepatorenal syndrome type 1 ,Hemodynamics ,Perioperative ,citric acid ,bleeding ,medicine.disease ,mortality ,web vote, Acute Kidney Injury ,fluid balance ,heart surgery ,drug efficacy ,critical care ,early intervention ,Anesthesiology and Pain Medicine ,hemodialysi ,consensus ,Health Care Surveys ,septic shock ,Terlipressin ,business ,periangiography hemofiltration - Abstract
"OBJECTIVE: To identify all interventions that increase or reduce mortality in patients with acute kidney injury (AKI) and to establish the agreement between stated beliefs and actual practice in this setting.. . DESIGN AND SETTING: Systematic literature review and international web-based survey.. . PARTICIPANTS: More than 300 physicians from 62 countries.. . INTERVENTIONS: Several databases, including MEDLINE/PubMed, were searched with no time limits (updated February 14, 2012) to identify all the drugs/techniques/strategies that fulfilled all the following criteria: (a) published in a peer-reviewed journal, (b) dealing with critically ill adult patients with or at risk for acute kidney injury, and (c) reporting a statistically significant reduction or increase in mortality.. . MEASUREMENTS AND MAIN RESULTS: Of the 18 identified interventions, 15 reduced mortality and 3 increased mortality. Perioperative hemodynamic optimization, albumin in cirrhotic patients, terlipressin for hepatorenal syndrome type 1, human immunoglobulin, peri-angiography hemofiltration, fenoldopam, plasma exchange in multiple-myeloma-associated AKI, increased intensity of renal replacement therapy (RRT), CVVH in severely burned patients, vasopressin in septic shock, furosemide by continuous infusion, citrate in continuous RRT, N-acetylcysteine, continuous and early RRT might reduce mortality in critically ill patients with or at risk for AKI; positive fluid balance, hydroxyethyl starch and loop diuretics might increase mortality in critically ill patients with or at risk for AKI. Web-based opinion differed from consensus opinion for 30% of interventions and self-reported practice for 3 interventions.. . CONCLUSION: The authors identified all interventions with at least 1 study suggesting a significant effect on mortality in patients with or at risk of AKI and found that there is discordance between participant stated beliefs and actual practice regarding these topics.. . "
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- 2013
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34. Randomized Evidence for Reduction of Perioperative Mortality
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Luciano Clarizia, Fabio Guarracino, Martin Ponschab, Alexandre Slullitel, Demetrio Pittarello, Anna Carpanese, Elena Bignami, John G.T. Augoustides, Ivana Pezzoli, Giovanni Landoni, Marco Comis, Massimiliano Conte, Tiziana Bove, Gianbeppe Giordano, Leonardo Gottin, Laura Ruggeri, Remo Daniel Covello, Rui M.S. Almeida, Mario Musu, Vincenzo De Santis, Daniela Pasero, Yannick Le Manach, Antonio Corcione, Fabio Caramelli, Claudia Cariello, F. Petrini, Andrea Morelli, Marco Ranieri, Giuseppe Biondi-Zoccai, Reitze N. Rodseth, Andrea Székely, Agostino Roasio, Luca Cabrini, Paolo A. Del Sarto, Lukasz J Krzych, Francesco Santini, Rossella Remedi, M. Zucchetti, Gianluca Paternoster, Alberto Zangrillo, Giovanni Pala, Gabriele Finco, Laura Pasin, Paolo Feltracco, Landoni, Giovanni, Rodseth, Rn, Santini, F, Ponschab, M, Ruggeri, L, Székely, A, Pasero, D, Augoustides, Jg, Del Sarto, Pa, Krzych, Lj, Corcione, A, Slullitel, A, Cabrini, L, Le Manach, Y, Almeida, Rm, Bignami, E, Biondi Zoccai, G, Bove, T, Caramelli, F, Cariello, C, Carpanese, A, Clarizia, L, Comis, M, Conte, M, Covello, Rd, De Santis, V, Feltracco, P, Giordano, G, Pittarello, D, Gottin, L, Guarracino, F, Morelli, A, Musu, M, Pala, G, Pasin, L, Pezzoli, I, Paternoster, G, Remedi, R, Roasio, A, Zucchetti, M, Petrini, F, Finco, G, Ranieri, M, Zangrillo, Alberto, Landoni, G., Rodseth, R.N., Santini, F., Ponschab, M., Ruggeri, L., Székely, A., Pasero, D., Augoustides, J.G., Del Sarto, P.A., Krzych, L.J., Corcione, A., Slullitel, A., Cabrini, L., Le Manach, Y., Almeida, R.M.S., Bignami, E., Biondi-Zoccai, G., Bove, T., Caramelli, F., Cariello, C., Carpanese, A., Clarizia, L., Comis, M., Conte, M., Covello, R.D., De Santis, V., Feltracco, P., Giordano, G., Pittarello, D., Gottin, L., Guarracino, F., Morelli, A., Musu, M., Pala, G., Pasin, L., Pezzoli, I., Paternoster, G., Remedi, R., Roasio, A., Zucchetti, M., Petrini, F., Finco, G., Ranieri, M., and Zangrillo, A.
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surgical mortality ,Psychological intervention ,law.invention ,assisted ventilation ,surgery ,atherosclerosi ,systematic review ,Randomized controlled trial ,chlorhexidine gluconate ,cardiovascular disease ,law ,Health care ,anesthesia ,consensus ,mortality ,randomized ,perioperative ,consensu ,randomized controlled trial (topic) ,oxygen, aorta balloon ,physician ,Consensus conference ,Medline ,Surgery ,risk factor ,consensus conference ,continuous infusion ,metoprolol ,priority journal ,hospital infection ,Cardiology and Cardiovascular Medicine ,medicine.drug ,aprotinin ,insulin ,medicine.medical_specialty ,Selective decontamination ,perioperative period ,review ,MEDLINE ,conservative treatment ,levosimendan ,hemodynamic ,medicine ,human ,clonidine ,Intensive care medicine ,Internet ,business.industry ,leukopenia ,Perioperative ,Levosimendan ,bleeding ,heart surgery ,inhalation anesthetic agent ,Anesthesiology and Pain Medicine ,glycemic control ,business - Abstract
"OBJECTIVE: With more than 220 million major surgical procedures performed annually, perioperative interventions leading to even minor mortality reductions would save thousands of lives per year. This international consensus conference aimed to identify all nonsurgical interventions that increase or reduce perioperative mortality as suggested by randomized evidence.. . DESIGN AND SETTING: A web-based international consensus conference.. . PARTICIPANTS: More than 1,000 physicians from 77 countries participated in this web-based consensus conference.. . INTERVENTIONS: Systematic literature searches (MEDLINE\/PubMed, June 8, 2011) were used to identify the papers with a statistically significant effect on mortality together with contacts with experts. Interventions were considered eligible for evaluation if they (1) were published in peer-reviewed journals, (2) dealt with a nonsurgical intervention (drug\/technique\/strategy) in adult patients undergoing surgery, and (3) provided a statistically significant mortality increase or reduction as suggested by a randomized trial or meta-analysis of randomized trials.. . MEASUREMENTS AND MAIN RESULTS: Fourteen interventions that might change perioperative mortality in adult surgery were identified. Interventions that might reduce mortality include chlorhexidine oral rinse, clonidine, insulin, intra-aortic balloon pump, leukodepletion, levosimendan, neuraxial anesthesia, noninvasive respiratory support, hemodynamic optimization, oxygen, selective decontamination of the digestive tract, and volatile anesthetics. In contrast, aprotinin and extended-release metoprolol might increase mortality.. . CONCLUSIONS: Future research and health care funding should be directed toward studying and evaluating these interventions.. . "
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- 2012
35. Mortality reduction in cardiac anesthesia and intensive care: results of the first International Consensus Conference
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Landoni, G., Augoustides, J. G., Guarracino, F., Santini, F., Ponschab, M., Pasero, D., Rodseth, R. N., Biondi-Zoccai, G., Silvay, G., Salvi, L., Camporesi, E., Comis, M., Conte, M., Bevilacqua, S., Cabrini, L., Cariello, C., Caramelli, F., Santis, V., Del Sarto, P., Dini, D., Forti, A., Galdieri, N., Giordano, G., Gottin, L., massimiliano greco, Maglioni, E., Mantovani, L., Manzato, A., Meli, M., Paternoster, G., Pittarello, D., Rana, N. K., Ruggeri, L., Salandin, V., Sangalli, F., Zambon, M., Zucchetti, M., Bignami, E., Alfieri, O., Zangrillo, A., Landoni, G, Augoustides, J G, Guarracino, F, Santini, F, Ponschab, M, Pasero, D, Rodseth, R N, Biondi-Zoccai, G, Silvay, G, Salvi, L, Camporesi, E, Comis, M, Conte, M, Bevilacqua, S, Cabrini, L, Cariello, C, Caramelli, F, De Santis, V, Del Sarto, P, Dini, D, Forti, A, Galdieri, N, Giordano, G, Gottin, L, Greco, M, Maglioni, E, Mantovani, L, Manzato, A, Meli, M, Paternoster, G, Pittarello, D, Rana, N K, Ruggeri, L, Salandin, V, Sangalli, F, Zambon, M, Zucchetti, M, Bignami, E, Alfieri, O, Zangrillo, A, Landoni, Giovanni, Augoustides, Jg, Rodseth, Rn, Biondi Zoccai, G, Rana, Kn, Alfieri, Ottavio, and Zangrillo, Alberto
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Critical Care ,focused update ,Review ,cardiac anesthesia ,intensive care ,Consensus Conference ,anesthesia ,cardiopulmonary bypa ,mortality ,Cardiac surgery ,Cardiac anesthesia ,Mortality ,Consensus conference ,Meeting-Report ,treatment outcome ,Humans ,prevention and control ,Cardiac Surgical Procedures ,consensus development conference ,perioperative outcome ,cardiopulmonary bypass ,cardiac surgery - Abstract
Background There is no consensus on which drugs/techniques/strategies can affect mortality in the perioperative period of cardiac surgery. With the aim of identifying these measures, and suggesting measures for prioritized future investigation we performed the first international consensus conference on this topic. Methods The consensus was a continuous international internet-based process with a final meeting on June 28th 2010 in Milan at the Vita-Salute University. Participants included 340 cardiac anesthesiologists, cardiac surgeons and cardiologists from 65 countries all over the world. A comprehensive literature review was performed to identify topics that subsequently generated position statements for discussion, voting and ranking. Results Of the 17 major topics with a documented mortality effect, seven were subsequently excluded after further evaluation due to concerns about clinical applicability and/or study methodology. The following topics are documented as reducing mortality: administration of insulin, levosimendan, volatile anesthetics, statins, chronic beta-blockade, early aspirin therapy, the use of preoperative intra-aortic balloon counterpulsation and referral to high-volume centers. The following are documented as increasing mortality: administration of aprotinin and aged red blood cell transfusion. These interventions were classified according to the level of evidence and effect on mortality and a position statement was generated. Conclusion This international consensus conference has identified the non-surgical interventions that merit urgent study to achieve further reductions in mortality after cardiac surgery: insulin, intra-aortic balloon counterpulsation, levosimendan, volatile anesthetics, statins, chronic beta-blockade, early aspirin therapy, and referral to high-volume centers. The use of aprotinin and aged red blood cells may result in increased mortality.
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- 2011
36. Changes in patient-reported outcomes during admission to a South African psychiatric facility.
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Motshudi L, Hann CD, Kloppers M, Luhandjula T, Phalatse T, Pretorius D, Smith D, Smith M, van der Westhuizen M, and Rodseth RN
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Background: Patient-reported outcome measures (PROMs) are used as part of clinical practice to determine the impact of the condition and treatment interventions on a patient's health and quality of life. The Patient Health Questionnaire-9 (PHQ-9) is a self-administered diagnostic tool that has been widely adopted for the detection and monitoring of depression., Aim: This analysis reports the change in PHQ-9 scores from admission to discharge in patients admitted for depression to a South African acute psychiatric facility and aims to quantify the treatment effect of the admission using the PHQ-9 as the measurement tool., Setting: South African acute psychiatric facility., Methods: This was a retrospective observational study of all patients admitted to Netcare Akeso acute psychiatric facilities from 01 January 2018 to 31 October 2022. Patients were included if they were ≥ 18 years of age, admitted with a primary International Classification of Disease (ICD)-10 code for depression (i.e. F32-F33) and fully completed both an admission and discharge PHQ-9 questionnaire. We excluded facilities focusing only on the treatment of patients with specialised conditions such as addiction or eating disorders., Results: This analysis included 13 308 patients admitted for depression at 10 different facilities. The median PHQ-9 score on admission was 19 (interquartile range [IQR] 14-23) and 5 (IQR 2-11) on discharge, with a median change of -12 (IQR -5 to -18). A minimal clinically important difference was seen in 87.6% patients ( n = 10 091/11 515); a treatment effect was seen in 74.5% of patients and a clinically significant improvement was seen in 72.1% of patients., Conclusion: With the average patient reporting a four-fold reduction in the severity of their depression scores, PROMs provide a critical patient-centred window into the benefit that an inpatient admission has on those suffering with depression., Contribution: These changes are consistent with those seen internationally and provide a baseline for understanding the treatment efficacy of an inpatient admission for the treatment of depression., Competing Interests: The authors declare that they have no financial or personal relationship(s) that may have inappropriately influenced them in writing this article., (© 2024. The Authors.)
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- 2024
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37. Method of Anesthesia and Perioperative Risk Factors, Maternal Anesthesia Complications, and Neonatal Mortality Following Cesarean Delivery in Africa: A Substudy of a 7-Day Prospective Observational Cohort Study.
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Gerber C, Bishop DG, Dyer RA, Maswime S, Rodseth RN, van Dyk D, Kluyts HL, Mbwele B, Tumukunde JT, Madzimbamuto FD, Elkhogia AM, Ndonga AK, Ngumi ZWW, Omigbodun AO, Amanor-Boadu SD, Zoumenou E, Basenero A, Munlemvo DM, Coulibaly Y, Ndayisaba G, Antwi-Kusi A, Gobin V, Forget P, Rakotoarison S, Samateh AL, Mehyaoui R, Patel-Mujajati U, Sani CM, Madiba TE, Pearse RM, and Biccard BM
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- Humans, Female, Pregnancy, Prospective Studies, Risk Factors, Adult, Infant, Newborn, Africa epidemiology, Maternal Mortality trends, Anesthesia, Spinal adverse effects, Anesthesia, Spinal mortality, Infant, Young Adult, Cohort Studies, Cesarean Section adverse effects, Cesarean Section mortality, Anesthesia, Obstetrical adverse effects, Anesthesia, Obstetrical mortality, Infant Mortality trends, Anesthesia, General adverse effects, Anesthesia, General mortality
- Abstract
Background: The African Surgical Outcomes Study (ASOS) found that maternal mortality following cesarean delivery in Africa is 50 times higher than in high-income countries, and associated with obstetric hemorrhage and anesthesia complications. Mothers who died were more likely to receive general anesthesia (GA). The associations between GA versus spinal anesthesia (SA) and preoperative risk factors, maternal anesthesia complications, and neonatal outcomes following cesarean delivery in Africa are unknown., Methods: This is a secondary explanatory analysis of 3792 patients undergoing cesarean delivery in ASOS, a prospective observational cohort study, across 22 African countries. The primary aim was to estimate the association between preoperative risk factors and the outcome of the method of anesthesia delivered. Secondary aims were to estimate the association between the method of anesthesia and the outcomes (1) maternal intraoperative hypotension, (2) severe maternal anesthesia complications, and (3) neonatal mortality. Generalized linear mixed models adjusting for obstetric gravidity and gestation, American Society of Anesthesiologists (ASA) category, urgency of surgery, maternal comorbidities, fetal distress, and level of anesthesia provider were used., Results: Of 3709 patients, SA was performed in 2968 (80%) and GA in 741 (20%). Preoperative factors independently associated with GA for cesarean delivery were gestational age (adjusted odds ratio [aOR], 1.093; 95% confidence interval [CI], 1.052-1.135), ASA categories III (aOR, 11.84; 95% CI, 2.93-46.31) and IV (aOR, 11.48; 95% CI, 2.93-44.93), eclampsia (aOR, 3.92; 95% CI, 2.18-7.06), placental abruption (aOR, 6.23; 95% CI, 3.36-11.54), and ruptured uterus (aOR, 3.61; 95% CI, 1.36-9.63). SA was administered to 48 of 94 (51.1%) patients with eclampsia, 12 of 28 (42.9%) with cardiac disease, 14 of 19 (73.7%) with preoperative sepsis, 48 of 76 (63.2%) with antepartum hemorrhage, 30 of 55 (54.5%) with placenta previa, 33 of 78 (42.3%) with placental abruption, and 12 of 29 (41.4%) with a ruptured uterus. The composite maternal outcome "all anesthesia complications" was more frequent in GA than SA (9/741 [1.2%] vs 3/2968 [0.1%], P < .001). The unadjusted neonatal mortality was higher with GA than SA (65/662 [9.8%] vs 73/2669 [2.7%], P < .001). The adjusted analyses demonstrated no association between method of anesthesia and (1) intraoperative maternal hypotension and (2) neonatal mortality., Conclusions: Analysis of patients undergoing anesthesia for cesarean delivery in Africa indicated patients more likely to receive GA. Anesthesia complications and neonatal mortality were more frequent following GA. SA was often administered to high-risk patients, including those with eclampsia or obstetric hemorrhage. Training in the principles of selection of method of anesthesia, and the skills of safe GA and neonatal resuscitation, is recommended., Competing Interests: Conflicts of Interest: See Disclosures at the end of the article., (Copyright © 2024 International Anesthesia Research Society.)
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- 2024
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38. A review of the role of testosterone in the care of the critically ill patient.
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Stevenson R, Bishop DG, and Rodseth RN
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Background: Testosterone is an anabolic and androgenic steroid hormone therapeutically used to produce male sex characteristics. It has also been shown to have a modulating effect on proinflammatory biomarkers. Critical illness is characterised by a proinflammatory and catabolic state and is accompanied by altered testosterone production, which may persist into the recovery phase. Testosterone may, therefore be a potential therapeutic option in critical illness. This paper reviews normal testosterone physiology, and the changes seen during critical illness and systematically reviews testosterone therapy during both the acute and chronic phases of critical illness., Contribution of the Study: This article explains the pathophysiology of testosterone during critical illness and explores the therapeutic value of testosterone in the management of critically ill patients., (Copyright © 2024, Author(s).)
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- 2024
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39. A critical analysis of Discovery Health's claims-based risk adjustment of mortality rates in South African private sector hospitals.
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Rodseth RN, Smith D, Maslo C, Laubscher A, and Thabane L
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- Humans, South Africa, Hospital Mortality, Hospitals, Private, Risk Adjustment, Private Sector
- Abstract
In 2019, Discovery Health published a risk adjustment model to determine standardised mortality rates across South African private hospital systems, with the aim of contributing towards quality improvement in the private healthcare sector. However, the model suffers from limitations due to its design and its reliance on administrative data. The publication's aim of facilitating transparency is unfortunately undermined by shortcomings in reporting. When designing a risk prediction model, patient-proximate variables with a sound theoretical or proven association with the outcome of interest should be used. The addition of key condition-specific clinical data points at the time of hospital admission will dramatically improve model performance. Performance could be further improved by using summary risk prediction scores such as the EUROSCORE II for coronary artery bypass graft surgery or the GRACE risk score for acute coronary syndrome. In general, model reporting should conform to published reporting standards, and attempts should be made to test model validity by using sensitivity analyses. In particular, the limitations of machine learning prediction models should be understood, and these models should be appropriately developed, evaluated and reported.
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- 2022
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40. Compatibility and stability of an admixture of multiple anaesthetic drugs for opioid-free anaesthesia.
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Carpenter AM, Rodseth RN, Coetzee E, Roodt F, and Bye S
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- Analgesics, Opioid, Humans, Lidocaine, Magnesium Sulfate chemistry, Anesthesia, Anesthetics, Ketamine
- Abstract
The ability to combine and use drugs in a single infusion device may be useful in resource-limited settings. This study examined the chemical stability of an opioid-sparing mixture of ketamine, lidocaine and magnesium sulphate when combined in a single syringe. High-performance liquid chromatography and atomic absorption spectrophotometry were performed on six syringes containing the three-drug mixture. Since most opioid-sparing techniques typically rely on a 24-hour infusion regime, we tested stability at the initial admixing and 24 hours later. Stability was defined as a measured drug concentration within 10% of expected, with the absence of precipitation or pH alterations. Pharmacokinetic simulations were conducted to further show that the achieved plasma drug concentrations were well within an effective analgesic range. All mixed drug concentration measurements were within the required 10% reference limit. No obvious precipitation or interaction occurred, and pH remained stable. Drug stability was maintained for 24 hours. Pharmacokinetic simulations showed that ketamine and lidocaine were within their minimum analgesic effect concentrations. Our results show that this three-drug mixture is chemically stable for up to 24 hours after mixing, with a pharmacokinetic simulation illustrating safe, clinically useful predicted plasma concentrations when using the described admixture., (© 2022 Association of Anaesthetists.)
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- 2022
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41. An Evaluation of Severe Anesthetic-Related Critical Incidents and Risks From the South African Paediatric Surgical Outcomes Study: A 14-Day Prospective, Observational Cohort Study of Pediatric Surgical Patients.
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Cronjé L, Torborg AM, Meyer HM, Bhettay AZ, Diedericks JBJS, Cilliers C, Kluyts HL, Mrara B, Kalipa MN, Cloete E, Burke A, Mogane PN, Alphonsus CS, Mbeki M, Thomas J, Rodseth RN, and Biccard BM
- Subjects
- Child, Child, Preschool, Humans, Prospective Studies, Retrospective Studies, Risk Factors, South Africa epidemiology, Treatment Outcome, Anesthetics
- Abstract
Background: Severe anesthetic-related critical incident (SARCI) monitoring is an essential component of safe, quality anesthetic care. Predominantly retrospective data from low- and middle-income countries (LMICs) report higher incidence but similar types of SARCI compared to high-income countries (HIC). The aim of our study was to describe the baseline incidence of SARCI in a middle-income country (MIC) and to identify associated risk for SARCI. We hypothesized a higher incidence but similar types of SARCI and risks compared to HICs., Methods: We performed a 14-day, prospective multicenter observational cohort study of pediatric patients (aged <16 years) undergoing surgery in government-funded hospitals in South Africa, a MIC, to determine perioperative outcomes. This analysis described the incidence and types of SARCI and associated perioperative cardiac arrests (POCAs). We used multivariable logistic regression analysis to identify risk factors independently associated with SARCI, including 7 a priori variables and additional candidate variables based on their univariable performance., Results: Two thousand and twenty-four patients were recruited from May 22 to August 22, 2017, at 43 hospitals. The mean age was 5.9 years (±standard deviation 4.2). A majority of patients during this 14-day period were American Society of Anesthesiologists (ASA) physical status I (66.4%) or presenting for minor surgery (54.9%). A specialist anesthesiologist managed 59% of cases. These patients were found to be significantly younger (P < .001) and had higher ASA physical status (P < .001). A total of 426 SARCI was documented in 322 of 2024 patients, an overall incidence of 15.9% (95% confidence interval [CI], 14.4-17.6). The most common event was respiratory (214 of 426; 50.2%) with an incidence of 8.5% (95% CI, 7.4-9.8). Six children (0.3%; 95% CI, 0.1-0.6) had a POCA, of whom 4 died in hospital. Risks independently associated with a SARCI were age (adjusted odds ratio [aOR] = 0.95; CI, 0.92-0.98; P = .004), increasing ASA physical status (aOR = 1.85, 1,74, and 2.73 for ASA II, ASA III, and ASA IV-V physical status, respectively), urgent/emergent surgery (aOR = 1.35, 95% CI, 1.02-1.78; P = .036), preoperative respiratory infection (aOR = 2.47, 95% CI, 1.64-3.73; P < .001), chronic respiratory comorbidity (aOR = 1.75, 95% CI, 1.10-2.79; P = .018), severity of surgery (intermediate surgery aOR = 1.84, 95% CI, 1.39-2.45; P < .001), and level of hospital (first-level hospitals aOR = 2.81, 95% CI, 1.60-4.93; P < .001)., Conclusions: The incidence of SARCI in South Africa was 3 times greater than in HICs, and an associated POCA was 10 times more common. The risk factors associated with SARCI may assist with targeted interventions to improve safety and to triage children to the optimal level of care., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 International Anesthesia Research Society.)
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- 2022
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42. A prospective observational study of preoperative natriuretic peptide testing in adult non-cardiac surgical patients in hospitals in Western Cape Province, South Africa.
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Alphonsus CS, Jagga M, Crowther M, Coetzee E, Davies G, Fullerton Z, Van Zyl HA, Reed A, Cloete E, Roos J, Roodt F, Rodseth RN, and Biccard BM
- Subjects
- Aged, Female, Heart Disease Risk Factors, Humans, Male, Middle Aged, Postoperative Complications etiology, Postoperative Complications prevention & control, Prospective Studies, South Africa, Natriuretic Peptide, Brain blood, Peptide Fragments blood, Preoperative Care methods, Surgical Procedures, Operative adverse effects, Surgical Procedures, Operative methods
- Abstract
Background: International guidelines recommend risk stratification to identify high-risk non-cardiac surgical patients. It is also recommended that all patients aged ≥45 years with significant cardiovascular disease should have preoperative natriuretic peptide (NP) testing. Abnormal preoperative B-type NPs have a strong association with postoperative cardiac complications. In South African hospitals, it is not known how many patients with significant cardiovascular disease scheduled for intermediate- to high-risk surgery will have raised NPs., Objectives: To determine the prevalence of abnormal (raised) NPs in non-cardiac surgical patients with cardiac clinical risk factors. A secondary objective was to develop a model to identify surgical patients who may benefit from preoperative NP screening., Methods: The inclusion criteria were patients aged ≥45 years presenting for elective, non-obstetric, intermediate- to high-risk non-cardiac surgery with at least one of the following cardiovascular risk factors: a history of ischaemic heart disease or peripheral vascular disease (coronary equivalent); a history of stroke or transient ischaemic attack; a history of congestive cardiac failure; diabetes mellitus currently on an oral hypoglycaemic agent or insulin; and serum creatinine level >175 µmol/L (>2.0 mg/dL). Blood samples for N-terminal-prohormone B-type NP (NT-proBNP) were collected before induction of anaesthesia. The preoperative prognostic threshold for abnormal (raised) NT-proBNP was ≥300 pg/mL. A generalised linear mixed model was used to determine the association between the risk factors and an abnormal NT-proBNP level., Results: Of 172 patients, 63 (37%) had an elevated preoperative NT-proBNP level. The comorbidities independently associated with elevated preoperative NT-proBNP were coronary artery disease or peripheral vascular disease, congestive cardiac failure, and a creatinine level >175 µmol/L, Conclusions: We strongly recommend that non-cardiac surgical patients aged ≥45 years undergoing intermediate- or high-risk noncardiac surgery with a history of coronary artery disease/peripheral vascular disease, congestive cardiac failure or elevated creatinine have preoperative NP testing as part of risk stratification.
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- 2021
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43. Hypotension after spinal anaesthesia during caesarean section: a reply.
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Buthelezi AS, Bishop DG, Rodseth RN, and Dyer RA
- Subjects
- Cesarean Section, Female, Humans, Pregnancy, Anesthesia, Obstetrical, Anesthesia, Spinal, Hypotension
- Published
- 2020
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44. Prophylactic phenylephrine and fluid co-administration to reduce spinal hypotension during elective caesarean section in a resource-limited setting: a prospective alternating intervention study.
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Buthelezi AS, Bishop DG, Rodseth RN, and Dyer RA
- Subjects
- Adult, Combined Modality Therapy methods, Developing Countries, Elective Surgical Procedures, Female, Health Resources, Humans, Infusions, Intravenous, Phenylephrine administration & dosage, Prospective Studies, South Africa, Treatment Outcome, Vasoconstrictor Agents administration & dosage, Cesarean Section, Fluid Therapy methods, Hypotension prevention & control, Phenylephrine therapeutic use, Vasoconstrictor Agents therapeutic use
- Abstract
Spinal hypotension is a common and clinically important problem during caesarean section. Current consensus recommendations for resource-rich settings suggest the use of a titrated phenylephrine infusion, in combination with fluid coloading, for prevention of maternal hypotension. In resource-limited settings, where syringe drivers are unavailable, these recommendations advise the addition of 500 μg phenylephrine to the first 1 l of intravenous fluid given after initiation of spinal anaesthesia, with additional vasopressor boluses as required. This prospective, alternating intervention study compared the use of a conventional phenylephrine rescue bolus strategy for prevention of hypotension, defined as systolic arterial pressure < 90 mmHg, with a phenylephrine infusion given according to the consensus recommendation. We studied 300 women having elective caesarean section. There were 77 (51%) women who developed hypotension in the bolus group vs. 55 (37%) in the phenylephrine infusion group (p = 0.011). This represented a 29% reduction in hypotension, with a number needed to treat of 6.8. The six highest systolic arterial pressure readings occurred in the phenylephrine infusion group (range 166-188 mmHg), and there were four instances of bradycardia (heart rate < 50 beats.min
-1 ) with preserved systolic arterial pressure in each group. There were no adverse clinical sequelae, and no differences in neonatal Apgar scores in either group. The consensus recommendation for phenylephrine and fluid co-administration in resource-limited settings appears effective in preventing maternal hypotension, but at the cost of sporadic systolic hypertension., (© 2019 Association of Anaesthetists.)- Published
- 2020
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45. Natriuretic peptide-directed medical therapy: a systematic review.
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Alphonsus CS, Govender P, Rodseth RN, and Biccard BM
- Abstract
Natriuretic peptides (NP) are strongly associated with perioperative cardiovascular events. However, in patients with raised NP, it remains unknown whether treatment to reduce NP levels prior to surgery results in better perioperative outcomes. In this systematic review and meta-analysis, we investigate NP-directed medical therapy in non-surgical patients to provide guidance for NP-directed medical therapy in surgical patients. The protocol was registered with PROSPERO (CRD42017051468). The database search included MEDLINE (PubMed), CINAHL (EBSCO host), EMBASE (EBSCO host), ProQuest, Web of Science, and Cochrane database. The primary outcome was to determine whether NP-directed medical therapy is effective in reducing NP levels within 6 months, compared to standard of care. The secondary outcome was to determine whether reducing NP levels is associated with decreased mortality. Full texts of 18 trials were reviewed. NP-directed medical therapy showed no significant difference compared to standard care in decreasing NP levels (standardized mean difference - 0.04 (- 0.16, 0.07)), but was associated with a 6-month (relative risk (RR) 0.82 (95% confidence interval (CI) 0.68-0.99)) reduction in mortality., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s). 2020.)
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- 2020
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46. Fracture-related infections in HIV infected patients: A systematic review and meta-analysis.
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Nieuwoudt L, Rodseth RN, and Marais LC
- Abstract
Aim: To conduct a systematic review and meta-analysis comparing the incidence of fracture-related infections (FRI) following surgical management of closed and open fractures in HIV-positive and HIV-negative patients., Methods: A systematic literature search was conducted using MEDLINE, ProQuest, Web of Science, The Cochrane Library and Scopus. Our own files and reference lists of identified key articles were also searched. We included studies where the primary outcome was the development of FRI in patients with open and closed fractures., Results: Eleven studies were included for data synthesis. HIV-positive patients had a non-significant increase in FRI when compared to HIV-negative patients (in open and closed fractures combined). Open fractures treated in the pre-antiretroviral era had a 5.6 times greater risk for developing a FRI. In the post-antiretroviral era (1997 onwards) HIV-positive patients did not have a greater risk of FRI than HIV-negative patients for both open and closed fractures. The small retrospective natures of these studies, together with the heterogeneous outcome definitions used, are limitations to this study., Conclusion: While there are few large prospective studies, the available data suggests that before the introduction antiretroviral therapy HIV infection was associated with a greater risk of FRI. In the post-antiretroviral era HIV infected patients did not show an increased risk of FRI., Competing Interests: The authors have no conflicts of interest to disclose., (© 2020 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.)
- Published
- 2020
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47. An audit of paediatric pain prevalence, intensity, and treatment at a South African tertiary hospital.
- Author
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Velazquez Cardona C, Rajah C, Mzoneli YN, Friedrichsdorf SJ, Campbell F, Cairns C, and Rodseth RN
- Abstract
Introduction: Pain in paediatric inpatients is common, underrecognised, and undertreated in resource-rich countries. Little is known about the status of paediatric pain prevention and treatment in low- and middle-income countries., Objectives: This audit aimed to describe the prevalence and severity of pain in paediatric patients at a tertiary hospital in South Africa., Method: A single-day prospective observational cross-sectional survey and medical chart review of paediatric inpatients at Grey's Hospital, Pietermaritzburg, South Africa., Results: Sixty-three children were included, and mean patient age was 9.7 years (SD 6.17). Most patients (87%) had pain during admission, with 29% reporting preexisting (possibly chronic) pain. At the time of the study, 25% had pain (median pain score 6/10). The worst pain reported was from needle procedures, including blood draws, injections, and venous cannulation (34%), followed by surgery (22%), acute illness/infection (18%), and other procedures (14%). Pharmacological treatments included WHO step 1 (paracetamol and ibuprofen) and step 2 (tramadol, tilidine, and morphine) analgesics. The most effective integrative interventions were distraction, swaddling, and caregiver participation. Although a pain narrative was present in the majority of charts, only 16% had documented pain intensity scores., Conclusion: The prevalence of pain in hospitalised children in a large South African Hospital was high and pain assessment inadequately documented. There is an urgent need for pain education and development of guidelines and protocols, to achieve better pain outcomes for children. This audit will be repeated as part of a quality-improvement initiative., Competing Interests: Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.)
- Published
- 2019
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48. The role of cardiac rehabilitation using exercise to decrease natriuretic peptide levels in non-surgical patients: a systematic review.
- Author
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Alphonsus CS, Govender P, Rodseth RN, and Biccard BM
- Abstract
Exercise is recommended in patients with cardiac failure. In the perioperative patient, exercise is also gaining popularity as a form of prehabilitation. In this meta-analysis, we examine if exercise is able to reduce natriuretic peptide levels. Natriuretic peptide (NP) has strong prognostic ability in identifying patients who will develop adverse postoperative cardiovascular outcomes. The protocol was registered with PROSPERO (CRD42017051468). The database search included MEDLINE (PubMed), CINAHL (EBSCO host), EMBASE (EBSCO host), ProQuest, Web of Science, and Cochrane database. The primary outcomes were to determine whether exercise therapy was effective in reducing NP levels as compared to control group, the shortest time period required to reduce NP levels after exercise therapy, and whether reducing NP levels decreased morbidity and mortality. Full texts of 16 trials were retrieved for this review. Exercise therapy showed a significant reduction in natriuretic peptide levels between the intervention and control groups (SMD - 0.45, 95% CI - 0.88 to - 0.03) with significant heterogeneity between the included trials. This was also shown in the within a 12-week period., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s). 2019.)
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- 2019
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49. A prospective observational study testing liquid crystal phase change type thermometer placed on skin against oesophageal/pharyngeal placed thermometers in participants undergoing general anesthesia.
- Author
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Simpson G and Rodseth RN
- Subjects
- Adolescent, Adult, Aged, Anesthesia, General methods, Equipment Design, Esophagus physiology, Female, Humans, Liquid Crystals, Male, Middle Aged, Pharynx physiology, Prospective Studies, Skin Temperature, Young Adult, Body Temperature physiology, Monitoring, Intraoperative methods, Thermometers
- Abstract
Background: Patient outcomes are influenced by intraoperative temperature management. Oesophageal/pharyngeal temperature monitoring is the standard of care at our institute but is not well tolerated in awake patients. Many non-invasive temperature monitors have been studied. Only the TraxIt® Wearable Children's Underarm Thermometer which contains liquid crystals that undergo phase changes according to temperature is available at our institution. We tested these non-invasive monitors against our standard of care which is the oesophageal/pharyngeal temperature monitor., Methods: We conducted a prospective observational study of 100 patients receiving general anaesthesia for elective surgery. Patients were eligible for inclusion if they were ≥ 18 years old, were planned to have a general anaesthetic > 60 min during which no body cavity (chest or abdomen) would be opened. Patient temperature was measured with an oesophageal/pharyngeal thermistor probe and skin surface temperature monitors placed over the forehead, in the axilla, over the sternum, and behind the ear (over major vessels to the brain). Temperatures were recorded and then analysed using Altman-Bland plots. Pre-determined clinically relevant limits of agreement were set at -/+ 0.5 °C., Results: From the 100 patients we collected 500 data points for each monitor with an average monitoring time of 102 min (30-300 min) across a range of surgical procedures. None of the skin surface temperature monitors achieved the pre-determined limits of agreement and results were impacted by the use of a forced air warmer., Conclusion: The TraxIt® Wearable Children's Underarm Thermometers are not suitable for temperature monitoring during general anaesthesia.
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- 2019
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50. Maternal and neonatal outcomes after caesarean delivery in the African Surgical Outcomes Study: a 7-day prospective observational cohort study.
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Bishop D, Dyer RA, Maswime S, Rodseth RN, van Dyk D, Kluyts HL, Tumukunde JT, Madzimbamuto FD, Elkhogia AM, Ndonga AKN, Ngumi ZWW, Omigbodun AO, Amanor-Boadu SD, Zoumenou E, Basenero A, Munlemvo DM, Youssouf C, Ndayisaba G, Antwi-Kusi A, Gobin V, Forget P, Mbwele B, Ndasi H, Rakotoarison SR, Samateh AL, Mehyaoui R, Patel-Mujajati U, Sani CM, Esterhuizen TM, Madiba TE, Pearse RM, and Biccard BM
- Subjects
- Adult, Female, Humans, Infant, Infant, Newborn, Maternal Mortality, Pregnancy, Prospective Studies, Risk Factors, South Africa epidemiology, Cesarean Section adverse effects, Cesarean Section mortality, Infant Mortality, Postoperative Complications epidemiology, Pregnancy Complications, Treatment Outcome
- Abstract
Background: Maternal and neonatal mortality is high in Africa, but few large, prospective studies have been done to investigate the risk factors associated with these poor maternal and neonatal outcomes., Methods: A 7-day, international, prospective, observational cohort study was done in patients having caesarean delivery in 183 hospitals across 22 countries in Africa. The inclusion criteria were all consecutive patients (aged ≥18 years) admitted to participating centres having elective and non-elective caesarean delivery during the 7-day study cohort period. To ensure a representative sample, each hospital had to provide data for 90% of the eligible patients during the recruitment week. The primary outcome was in-hospital maternal mortality and complications, which were assessed by local investigators. The study was registered on the South African National Health Research Database, number KZ_2015RP7_22, and on ClinicalTrials.gov, number NCT03044899., Findings: Between February, 2016, and May, 2016, 3792 patients were recruited from hospitals across Africa. 3685 were included in the postoperative complications analysis (107 missing data) and 3684 were included in the maternal mortality analysis (108 missing data). These hospitals had a combined number of specialist surgeons, obstetricians, and anaesthetists totalling 0·7 per 100 000 population (IQR 0·2-2·0). Maternal mortality was 20 (0·5%) of 3684 patients (95% CI 0·3-0·8). Complications occurred in 633 (17·4%) of 3636 mothers (16·2-18·6), which were predominantly severe intraoperative and postoperative bleeding (136 [3·8%] of 3612 mothers). Maternal mortality was independently associated with a preoperative presentation of placenta praevia, placental abruption, ruptured uterus, antepartum haemorrhage (odds ratio 4·47 [95% CI 1·46-13·65]), and perioperative severe obstetric haemorrhage (5·87 [1·99-17·34]) or anaesthesia complications (11·47 (1·20-109·20]). Neonatal mortality was 153 (4·4%) of 3506 infants (95% CI 3·7-5·0)., Interpretation: Maternal mortality after caesarean delivery in Africa is 50 times higher than that of high-income countries and is driven by peripartum haemorrhage and anaesthesia complications. Neonatal mortality is double the global average. Early identification and appropriate management of mothers at risk of peripartum haemorrhage might improve maternal and neonatal outcomes in Africa., Funding: Medical Research Council of South Africa., (Copyright © 2019 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2019
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