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  • 1
    Online Resource
    Online Resource
    Global variation in anastomosis and end colostomy formation following left‐sided colorectal resection
    Oxford University Press (OUP) ; 2019
    In:  BJS Open Vol. 3, No. 3 ( 2019-06), p. 403-414
    Details
    In: BJS Open, Oxford University Press (OUP), Vol. 3, No. 3 ( 2019-06), p. 403-414
    Type of Medium: Online Resource
    ISSN: 2474-9842 , 2474-9842
    URL: Issue
    URL: Article
    DOI: 10.1002/bjs5.2019.3.issue-3
    DOI: 10.1002/bjs5.50138
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2902033-5
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  • 2
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    Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
    Oxford University Press (OUP) ; 2019
    In:  British Journal of Surgery Vol. 106, No. 2 ( 2019-01-08), p. e103-e112
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 106, No. 2 ( 2019-01-08), p. e103-e112
    Abstract: The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89·6 per cent) compared with that in countries with a middle (753 of 1242, 60·6 per cent; odds ratio (OR) 0·17, 95 per cent c.i. 0·14 to 0·21, P & lt; 0·001) or low (363 of 860, 42·2 per cent; OR 0·08, 0·07 to 0·10, P & lt; 0·001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference −9·4 (95 per cent c.i. −11·9 to −6·9) per cent; P & lt; 0·001), but the relationship was reversed in low-HDI countries (+12·1 (+7·0 to +17·3) per cent; P & lt; 0·001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0·60, 0·50 to 0·73; P & lt; 0·001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1002/bjs.11051
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2006309-X
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  • 3
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    Global economic burden of unmet surgical need for appendicitis
    Oxford University Press (OUP) ; 2022
    In:  British Journal of Surgery Vol. 109, No. 10 ( 2022-09-09), p. 995-1003
    Details
    In: British Journal of Surgery, Oxford University Press (OUP), Vol. 109, No. 10 ( 2022-09-09), p. 995-1003
    Abstract: There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and $73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and $75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially.
    Type of Medium: Online Resource
    ISSN: 0007-1323 , 1365-2168
    URL: Article
    DOI: 10.1093/bjs/znac195
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 2006309-X
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  • 4
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    Heterogeneity in patterns of survival of the invasive species Ipomoea carnea in urban habitats along the Egyptian Nile Delta
    Pensoft Publishers ; 2017
    In:  NeoBiota Vol. 33 ( 2017-01-27), p. 1-17
    Details
    In: NeoBiota, Pensoft Publishers, Vol. 33 ( 2017-01-27), p. 1-17
    Type of Medium: Online Resource
    ISSN: 1314-2488 , 1619-0033
    URL: Article
    DOI: 10.3897/neobiota.33.9968
    Language: Unknown
    Publisher: Pensoft Publishers
    Publication Date: 2017
    detail.hit.zdb_id: 2628537-X
    SSG: 21
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  • 5
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    Richness, phylogenetic diversity, and abundance all have positive effects on invader performance in an arid ecosystem
    Wiley ; 2020
    In:  Ecosphere Vol. 11, No. 2 ( 2020-02)
    Details
    In: Ecosphere, Wiley, Vol. 11, No. 2 ( 2020-02)
    Abstract: In search of generalities in biological invasions, it is sometimes forgotten that invader success can be a function of both the diversity of the invaded community and the relatedness of the invader relative to community residents. Both qualities are likely to be especially important in stressful ecosystems, and identifying the species and community attributes that influence biological invasions can help direct management efforts in a sensitive ecosystem like those in arid regions. Pink Morning Glory, Ipomoea carnea Jaq. (Family: Convolvulaceae), is an annual vine native to Central and South America and is invasive in Egypt. We examined the performance of I. carnea at different densities in assembled communities of Egyptian annual native species. The native plant communities were manipulated to represent gradients of species richness and phylogenetic diversity and relatedness to I. carnea . We quantified the performance of I. carnea in these communities and examined the contribution of resident species richness, phylogenetic diversity, and phylogenetic relatedness to invader resistance. Our findings revealed that there was a positive relationship between invader performance and its mean phylogenetic distance to the resident species. Furthermore, species‐rich communities with more distantly related species positively contributed to invader performance in contrast to the classic biotic resistance hypothesis. Beyond these positive relationships, a positive density‐dependent effect of I. carnea on its performance was observed. We conclude that facilitative interactions are potentially important drivers promoting the successful invasion of the nonnative species I. carnea in water‐limited and harsh ecosystems. These results suggest that perhaps contrary to understanding from temperate systems, communities with a higher diversity of species could be more likely to be invaded by arid‐adapted species that are distantly related to natives. Thus, policy and management in arid regions should carefully consider reviewing the importation of nonnative species that are phylogenetically distinct and adapted to arid conditions and prioritizing their control once they are established.
    Type of Medium: Online Resource
    ISSN: 2150-8925 , 2150-8925
    URL: Issue
    URL: Article
    DOI: 10.1002/ecs2.v11.2
    DOI: 10.1002/ecs2.3045
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2572257-8
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  • 6
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    Enhancing a Specialized Nursing Care Guidelines Improves Acute Lymphoblastic Leukemia Patients' Outcome during Induction Phase; A Developing Country Experience
    American Society of Hematology ; 2018
    In:  Blood Vol. 132, No. Supplement 1 ( 2018-11-29), p. 5850-5850
    Details
    In: Blood, American Society of Hematology, Vol. 132, No. Supplement 1 ( 2018-11-29), p. 5850-5850
    Abstract: Introduction: Pediatric Cancer patients are treated with therapeutic research protocols that detail medical treatment in low- and middle-income countries (LMICs). Unfortunately, there is no precise definition of a structured nursing care plan that is mandatory to enhance the quality of care needed for these patients. Our study aimed to examine the impact of implementing a designed nursing care guidelines (NCG) on acute lymphoblastic leukemia (ALL) patient outcomes during the induction phase concerning; incidence, duration, and intensity of the patient's gastrointestinal tract GIT adverse events. Methods: A Quasi-experimental research design was utilized in this study with posttest only control group conducted at the Hematology Units of Children Cancer Hospital Egypt 57357. Seventy-four oncology nurses received adequate education for the designed nursing care plan. A total of (132) ALL children in induction phase were enrolled in the study and were divided into two groups: group 1 (intervention group) was implemented the nursing care guidelines and group II (control group) who was left to the routine hospital care. Tools: data collection instruments included; "patient outcomes audit chart" to assess the GIT adverse - events data: the incidence, duration, and intensity. The intensity grading of the adverse events Adopted from the NCI (National Cancer Institute) Common Terminology Criteria for Adverse Events v4.0 (CTCAE) Published on May 28, 2009. Results: A significant positive correlation between implementing the NCG and GIT adverse events incidence, duration and severity were observed (Figure 1). Incidence was reported higher in the control group than the study group with a mean score of ±SD (2.48± .949) versus (0.67± 0.751) respectively, and a p-value (P 〈 0.0001). The duration of incidence was (15.32± 5.920) versus (3.70± 5.108) in the intervention group (t =12.074) df (130) and a p-value (P 〈 0.0001). The intensity grading of the adverse events was less in the study group than the control. (figure 2) Mean scores for nurses' post-NCG knowledge in the study group were significantly higher than the nurse's knowledge scores in the control group. The intensity of incidence revealed that a significantly higher on the intervention group. Conclusion: Designing and implementing NCG for all treatment protocols is essential for the enhancement of patients' outcomes. Developing a pediatric oncology nurse residency program for education and teaching of the required practical skills in LMIC is mandatory. Figure 1 Figure 2 Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood-2018-99-119160
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 7
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    Predictors of Mortality in Neutropenic Enterocolitis Among Children and Young Adults with Acute Myeloid Leukemia in Low Middle Income Countries
    American Society of Hematology ; 2018
    In:  Blood Vol. 132, No. Supplement 1 ( 2018-11-29), p. 5174-5174
    Details
    In: Blood, American Society of Hematology, Vol. 132, No. Supplement 1 ( 2018-11-29), p. 5174-5174
    Abstract: Background: Neutropenic enterocolitis (NEC) is a life-threatening disease with substantial morbidity and mortality, seen primarily in patients with hematologic malignancies. The frequency of NEC has increased with the widespread use of chemotherapeutic agents such as the taxanes, which cause severe gastrointestinal mucositis. Methods: This was a retrospective study at the National Cancer Institute, Cairo University. The computerized records were screened for ultrasound or computerized tomographic scan requests for abdominal pain for all Acute myeloid pediatrics inpatients (2012-2016). Retrospective case analysis was used to collect clinical data for patients with features of NEC. D 30 Mortality was reported. Results: The incidence of NEC among our inpatients was 24% (49/203). Forty-Three children had radiologically confirmed Typhlitis, and 6 had clinical features alone. Most (93%) patients were profoundly neutropenic (ANC less than 100). All of the patients received conservative management. All of them needed ICU admission. Eighteen children had a variable period of bowel rest, including 12 patients who were supported with total parenteral nutrition. Three patients had laparotomy that revealed extensive colonic bowel necrosis (1), perforated bowel loop (1), and a perforated appendix (1). Two out of three cases of Laparotomy were diagnosed with Mucormycosis. 30-Days mortality was 44.8% (22/49). Relapsing Typhlitis in subsequent courses was observed in 6/27 (22%) patients. Fulminant gram-negative sepsis without surgical intervention was the leading cause of death in this cohort. NEC related mortality was significantly higher among patients receiving high-risk protocol with more intensive chemotherapy and in patients with other Co-Morbidities [chest infections and/ or Cardiac affection] with a P-value of 0.005 and 0.037 respectively. Also, mortality was increased among patients with more than 2 presenting clinical symptoms with a P-value of 0.01. Conclusion: Although surgical intervention should be reserved for specific complications, its delay increases the incidence of NEC related mortality. Though rare, fungal infection should be suspected especially in cases with worsening signs of typhlitis despite broad antimicrobial coverage. Early management and better supportive care of underlying Co-morbid conditions can decrease NEC related mortality. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    URL: Article
    DOI: 10.1182/blood-2018-99-114970
    RVK:
    XA 33000
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 8
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    Development of the joint Children’s Cancer Hospital Egypt (CCHE-57357) Dana-Farber Boston Children’s Hospital Pediatric Oncology Fellowship Program.
    American Society of Clinical Oncology (ASCO) ; 2017
    In:  Journal of Clinical Oncology Vol. 35, No. 15_suppl ( 2017-05-20), p. e18226-e18226
    Details
    In: Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 35, No. 15_suppl ( 2017-05-20), p. e18226-e18226
    Abstract: e18226 Background: Children diagnosed with cancer in low- and middle-income countries (LMIC) have markedly inferior outcomes compared to those in high income countries. While some of these issues can be resource availability, a major problem is the quality of training and traditional methods of clinical practice where decision making is centered on the most senior person on the team. To ensure real change, highly-trained locally based specialists with a strong emphasis on problem-solving and critical thinking using evidence-based approaches are needed. Methods: The Children’s Cancer Hospital Egypt (CCHE-57357) and Dana-Farber Boston Children’s Hospital (DFBCH) at Harvard Medical School developed a 30 month pediatric oncology fellowship training program following the American Academy of Pediatrics fellowship guidelines. The primary objective of the program was to implement a shared education model to develop highly educated physicians who are able to follow evidence-based approaches and who are committed to sustained practice in LMIC. Results: DFBCH staff provide ongoing education to the fellows through visits to CCHE-57357 every 2-3 months, weekly video sessions with the fellows for case presentation and journal clubs, and weekly conference calls with the fellowship program staff to ensure that the goals and objectives for each fellow and the program are met. Each of the current 15 fellows spend 6 weeks/year in Boston participating in evidence-based multi-disciplinary based rounds; the remainder of the curriculum takes place at CCHE-57357 and incorporates an array of individual, small group and e-learning modules specifically created for the program. Three classes of fellows have been enrolled and the senior class will graduate in the spring of 2017. Conclusions: Training of fellows following the same standards and methods as those applied to North American candidates is feasible and has the potential to advance the quality of education and expertise in LMIC. By focusing on the education of the next generation of clinicians, the opportunity to implement many of the important principles of clinical care can be realized.
    Type of Medium: Online Resource
    ISSN: 0732-183X , 1527-7755
    URL: Article
    DOI: 10.1200/JCO.2017.35.15_suppl.e18226
    RVK:
    XA 52760
    RVK:
    XA 10000
    Language: English
    Publisher: American Society of Clinical Oncology (ASCO)
    Publication Date: 2017
    detail.hit.zdb_id: 2005181-5
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  • 9
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    Growth, photosynthesis and stress-inducible genes of Phragmites australis (Cav.) Trin. ex Steudel from different habitats
    Elsevier BV ; 2015
    In:  Aquatic Botany Vol. 124 ( 2015-07), p. 54-62
    Details
    In: Aquatic Botany, Elsevier BV, Vol. 124 ( 2015-07), p. 54-62
    Type of Medium: Online Resource
    ISSN: 0304-3770
    URL: Article
    DOI: 10.1016/j.aquabot.2015.03.007
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2015
    detail.hit.zdb_id: 390388-6
    detail.hit.zdb_id: 1496041-2
    SSG: 12
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  • 10
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    Predictors of Mortality in Neutropenic Enterocolitis Among Children and Young Adults with Acute Myeloid Leukemia
    Elsevier BV ; 2019
    In:  Clinical Lymphoma Myeloma and Leukemia Vol. 19 ( 2019-09), p. S240-
    Details
    In: Clinical Lymphoma Myeloma and Leukemia, Elsevier BV, Vol. 19 ( 2019-09), p. S240-
    Type of Medium: Online Resource
    ISSN: 2152-2650
    URL: Article
    DOI: 10.1016/j.clml.2019.07.135
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2019
    detail.hit.zdb_id: 2540998-0
    detail.hit.zdb_id: 2193618-3
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