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- Glasbey, JC, et al.
(författare)
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- 2021
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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. |
- Sohail, Muhammad, et al.
(författare)
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Persistent organic pollutant emission via dust deposition throughout Pakistan : Spatial patterns, regional cycling and their implication for human health risks
- 2018
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Ingår i: Science of the Total Environment. - : Elsevier BV. - 0048-9697 .- 1879-1026. ; 618, s. 829-837
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Tidskriftsartikel (refereegranskat)abstract
- In the current study, Persistent Organic Pollutants (POPs) in outdoor dustfall was monitored for the first time along the Indus river system of Pakistan. Among the studied OCPs (ng/g, dry weight), DDTs (0.16-62) were the predominant contaminants identified in deposited dust followed by HCHs (0.1-10.2), HCB (0.09-7.4) and chlordanes (0.1-2.8). The indicative diagnostic ratio for DDTs and HCHs suggested recent emission of DDTs as well as historical emission of both chemicals in regions where they were used for crop protection and malarial control. The levels of Sigma(31)PCBs (ng/g, dry weight) in dust ranged from 0.95-125, and compositional profiles suggested arochlor-1248, -1254 commercial mixtures as source. A few exceptions were samples from urban areas that reflected the use of aroclor-1260, and-1262 and/or unintentional leakage from several industrial processes. The WHO05-TEQ values for dioxin-like PCBs (with major contributions of PCB-126) were found to be 0.07-34.5 (median; 1.87) pg TEQ g(-1) dw for all the studied samples. Correlation analysis identified that DDTs, HCHs, HCB and PCBs were significantly associated (r = 90; p < 0.01) with dusts collected in proximity to urban centers with widespread anthropogenic activities in these areas. A few cases where high levels of POPs from remote mountain highlands were detected, point to the potential for long range transport of these chemicals. Human risk assessment analysis of contaminated dust showed that DDTs and PCBs are major constituent chemicals of concern with regard to the development of cancer in children, with ingestion being the main route of exposure of dust-borne DDTs (0.12-1.03 x 10(-6)) and PCBs (0.86-12.43 x 10(-6)).
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