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- Thomas, HS, et al.
(författare)
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- 2019
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swepub:Mat__t
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| 2. |
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| 3. |
- Ademuyiwa, Adesoji O., et al.
(författare)
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Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries
- 2016
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Ingår i: BMJ Global Health. - : BMJ Publishing Group Ltd. - 2059-7908. ; 1:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally.Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged <16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression.Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p<0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed.Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas.
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| 4. |
- Bundschuh, J., et al.
(författare)
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Arsenic in Latin America : New findings on source, mobilization and mobility in human environments in 20 countries based on decadal research 2010-2020
- 2020
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Ingår i: Critical reviews in environmental science and technology. - : Taylor and Francis Inc.. - 1064-3389 .- 1547-6537. ; , s. 1-119
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Forskningsöversikt (refereegranskat)abstract
- Today (year 2020), the globally recognized problem of arsenic (As) contamination of water resources and other environments at toxic levels has been reported in all of the 20 Latin American countries. The present review indicates that As is prevalent in 200 areas across these countries. Arsenic is naturally released into the environment and mobilized from geogenic sources comprising: (i) volcanic rocks and emissions, the latter being transported over thousands of kilometers from the source, (ii) metallic mineral deposits, which get exposed to human beings and livestock through drinking water or food chain, and (iii) As-rich geothermal fluids ascending from deep geothermal reservoirs contaminate freshwater sources. The challenge for mitigation is increased manifold by mining and related activities, as As from mining sites is transported by rivers over long distances and even reaches and contaminates coastal environments. The recognition of the As problem by the authorities in several countries has led to various actions for remediation, but there is a lack of long-term strategies for such interventions. Often only total As concentration is reported, while data on As sources, mobilization, speciation, mobility and pathways are lacking which is imperative for assessing quality of any water source, i.e. public and private.
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