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- 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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| 2. |
- Ali, Moamen, et al.
(författare)
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Geometry and kinematics of the Middle to Late Miocene salt tectonics, central Egyptian Red Sea margin
- 2023
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Ingår i: Journal of Structural Geology. - : Elsevier. - 0191-8141 .- 1873-1201. ; 176
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Tidskriftsartikel (refereegranskat)abstract
- The Red Sea basin includes a thick Middle to Late Miocene evaporitic succession that underwent halokinesis and caused intensive reshaping of the seafloor and the development of salt-tectonic structures. However, the ge-ometry and kinematics of these structures are still poorly understood. This study uses 2D and 3D seismic surveys and well data of the northern Egyptian Red Sea to systematically describe the distribution and morphology of salt structures, discuss their initiation, and construct a kinematic model for their origin. Our results indicate that the massive salt layer developed into five major NW-SE to NNE-SSW trending salt walls, characterized by relatively irregular crests and moderately dipping flanks. In addition, several symmetrical and asymmetrical folds and two categories of normal faults (subsalt and suprasalt) have been recognized. Based on our observations, salt mobilization in the study area started in the Late Miocene, during the precipitation of layered evaporites, and continued until the present day. In the northern Egyptian Red Sea, seismic interpretation indicates that hal-okinesis was triggered by a combination of thin-and thick-skinned systems, where the latter played a major role. The salt layer was welded during the Quaternary as several sags and grabens developed above the salt diapirs. Thick-skinned physical models are compatible with our observations, supporting the impact of basement faulting on Red Sea diapirism.
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