| 1. |
- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 2. |
- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 3. |
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| 4. |
- Hagander, B, et al.
(författare)
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Effect of dietary fibre on blood glucose, plasma immunoreactive insulin, C-peptide and GIP responses in non insulin dependent (type 2) diabetics and controls
- 1984
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Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 215:3, s. 205-213
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Tidskriftsartikel (refereegranskat)abstract
- A high fibre and a low fibre breakfast meal were given to eight non insulin dependent diabetics ( NIDD ), and eight controls. Blood glucose response was monitored continuously for three hours and characterized using a straight line model. After the high fibre meal the rates of increase and decrease in blood glucose concentration were slower both in diabetics and controls than after the low fibre meal. The delay time, however, i.e. the time from meal intake to the start of glucose increase, hypothetically corresponding to gastric emptying time, was the same after both test meals. The postprandial glucose increment calculated as the area under the 0-120 min curve was lower after the high fibre meal in the NIDD , but not in the controls. The two-hour C-peptide and gastric inhibitory polypeptide values were lower for the diabetics after the high fibre breakfast. The results indicate a prolonged carbohydrate digestion and/or absorption after high fibre breakfast.
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| 5. |
- Davies, J. I., et al.
(författare)
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Global surgery, obstetric, and anaesthesia indicator definitions and reporting: An Utstein consensus report
- 2021
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Ingår i: Plos Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 18:8
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Tidskriftsartikel (refereegranskat)abstract
- Background Indicators to evaluate progress towards timely access to safe surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed to capture access to surgery, surgical workforce, surgical volume, perioperative mortality rate, and catastrophic and impoverishing financial consequences of surgery. Despite being rapidly taken up by practitioners, data points from which to derive the indicators were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define-for the first time-the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care globally. Methods and findings The Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a 2-day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. The meeting was held between June 16 to 18, 2019; discussions continued until August 2020. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high-, middle-, and low-income countries. Considering each of the 6 indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2 to 5 (intermediate) and >5 year (full) time frames. We removed one of the original 6 indicators (one of 2 financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. A strength of the process was the number of people from global institutes and multilateral agencies involved in the collection and reporting of global health metrics; a limitation was the limited number of participants from low- or middle-income countries-who only made up 21% of the total attendees. Conclusions To track global progress towards timely access to quality SAO care, these indicators-at the basic level-should be implemented universally as soon as possible. Intermediate and full indicator sets should be achieved by all countries over time. Meanwhile, these evolutions can assist in the short term in developing national surgical plans and collecting more detailed data for research studies.
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| 6. |
- Hagander, B, et al.
(författare)
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Dietary fibre enrichment, blood pressure, lipoprotein profile and gut hormones in NIDDM patients
- 1989
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Ingår i: European Journal of Clinical Nutrition. - 1476-5640. ; 43:1, s. 35-44
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Tidskriftsartikel (refereegranskat)abstract
- The influence of a beet-fibre enriched diet (mean 40 g FibrexR, 27 g dietary fibre per day) on blood pressure, plasma lipoproteins and glycaemic control was studied in 12 non-insulin-dependent diabetic (NIDD) patients. The effect on gastrointestinal hormones was also investigated. Beet-fibre and control diets were given in randomized order for 8 weeks each. During the beet-fibre diet the systolic blood pressure decreased (P less than 0.05) and the HDL-cholesterol levels increased (P less than 0.05) compared to values before the study. There was a tendency for systolic blood pressure to be lower also in the control period, but this was not statistically significant. After both diet periods the total plasma cholesterol and triglyceride levels decreased, as well as the LDL/HDL ratio. Blood glucose levels--fasting or postprandial--and glycosylated haemoglobin were not affected during the two different diet periods. In obese NIDD patients, however, the postprandial insulin levels were lower after the beet-fibre diet compared to the control diet. This subgroup also showed lower fasting values of pancreatic polypeptide and motilin were recorded for the obese patients after the fibre-rich period compared to before the study. Further, increases in postprandial motilin levels, 60-180 min, were found after the fibre-rich period. Investigations with reference to an entero-hormonal mechanism by measuring neurotensin and peptide YY did not show any variations between the diet periods.
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| 7. |
- Søreide, K., et al.
(författare)
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Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services
- 2020
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 0007-1323 .- 1365-2168. ; 107:10, s. 1250-1261
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Forskningsöversikt (refereegranskat)abstract
- Background: The ongoing pandemic is having a collateral health effect on delivery of surgical care to millions of patients. Very little is known about pandemic management and effects on other services, including delivery of surgery. Methods: This was a scoping review of all available literature pertaining to COVID-19 and surgery, using electronic databases, society websites, webinars and preprint repositories. Results: Several perioperative guidelines have been issued within a short time. Many suggestions are contradictory and based on anecdotal data at best. As regions with the highest volume of operations per capita are being hit, an unprecedented number of operations are being cancelled or deferred. No major stakeholder seems to have considered how a pandemic deprives patients with a surgical condition of resources, with patients disproportionally affected owing to the nature of treatment (use of anaesthesia, operating rooms, protective equipment, physical invasion and need for perioperative care). No recommendations exist regarding how to reopen surgical delivery. The postpandemic evaluation and future planning should involve surgical services as an essential part to maintain appropriate surgical care for the population during an outbreak. Surgical delivery, owing to its cross-cutting nature and synergistic effects on health systems at large, needs to be built into the WHO agenda for national health planning. Conclusion: Patients are being deprived of surgical access, with uncertain loss of function and risk of adverse prognosis as a collateral effect of the pandemic. Surgical services need a contingency plan for maintaining surgical care in an ongoing or postpandemic phase.
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| 8. |
- Bolkan, Håkon A, et al.
(författare)
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The Surgical Workforce and Surgical Provider Productivity in Sierra Leone: A Countrywide Inventory.
- 2016
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 40:6, s. 1344-1351
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Tidskriftsartikel (refereegranskat)abstract
- Limited data exist on surgical providers and their scope of practice in low-income countries (LICs). The aim of this study was to assess the distribution and productivity of all surgical providers in an LIC, and to evaluate correlations between the surgical workforce availability, productivity, rates, and volume of surgery at the district and hospital levels.
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| 9. |
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| 10. |
- Chao, T. E., et al.
(författare)
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Surgical Care in Liberia and Implications for Capacity Building
- 2015
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Ingår i: World Journal of Surgery. - : Springer Science and Business Media LLC. - 1432-2323 .- 0364-2313. ; 39:9, s. 2140-2146
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Situational needs of health care facilities inform the optimal allocation of resources and quality improvement efforts. This study examines surgical care delivery metrics at a tertiary care institution in Liberia. METHODS: We retrospectively reviewed operative and ward logbooks from January 1 to December 31, 2012. Data parameters included patients' age, diagnosis, procedure, mortality, and perioperative provider information. RESULTS: In 2012, 1,036 operations were performed. The breakdown of adult surgical cases reveals 452 (45.1 %) general surgery operations, 192 (18.5 %) orthopedic operations, and 180 (17.4 %) ophthalmic operations. Other significant case volume included urologic 53 (5.1 %), ENT 36 (3.5 %), neurosurgical 31 (3.0 %), vascular 24 (2.3 %), and plastic 14 (1.4 %) operations. Pediatric patients accounted for 24.5 % (243) of surgical cases, and 9 % of pediatric surgical cases were for hydrocephalus. General, spinal, and total intravenous anesthesia was provided by non-physician personnel, except when surgeons provided their own anesthesia. Ward logs documented 7.4 % mortality among all patients admitted to the surgical ward, most of which occurred after exploratory laparotomy (44 %), in burn (14 %) patients, and in patients with head/neck emergencies (12 %). CONCLUSIONS: This operative log review can be used to identify surgical practice patterns, needs, and deficits in order to inform the growth of surgical capacity at Liberia's only tertiary medical institution. Using this data to identify critical areas of high-yield operations (e.g., for pediatric hydrocephalus), or excessively high mortality rates (e.g., in burn care), can focus the direction of limited resources toward areas of need. While the heavy reliance on non-consultant surgeons reflects human capacity shortages and a pressing need for postgraduate training programs, identifying the breadth of surgical expertise demonstrated in these operative logs reveals the proficiencies required of surgeons to provide comprehensive surgical care in this setting.
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