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2. Effect of a multicomponent quality improvement strategy on sustained achievement of diabetes care goals and macrovascular and microvascular complications in South Asia at 6.5 years follow-up: Post hoc analyses of the CARRS randomized clinical trial

Author

Ali, Mohammed K., Singh, Kavita, Kondal, Dimple, Devarajan, Raji, Patel, Shivani A., Menon, V. Usha, Varthakavi, Premlata K., Vishwanathan, Vijay, Dharmalingam, Mala, Bantwal, Ganapati, Sahay, Rakesh Kumar, Masood, Muhammad Qamar, Khadgawat, Rajesh, Desai, Ankush, Prabhakaran, Dorairaj, Narayan, K. M. Venkat, and Tandon, Nikhil

Subjects
South Asia -- Health aspects, Diabetes therapy -- Quality management -- Methods, Diabetic angiopathies -- Care and treatment, Diabetes -- Care and treatment -- Complications and side effects, Biological sciences
Abstract

Background Diabetes control is poor globally and leads to burdensome microvascular and macrovascular complications. We aimed to assess post hoc between-group differences in sustained risk factor control and macrovascular and microvascular endpoints at 6.5 years in the Center for cArdiovascular Risk Reduction in South Asia (CARRS) randomized trial. Methods and findings This parallel group individual randomized clinical trial was performed at 10 outpatient diabetes clinics in India and Pakistan from January 2011 through September 2019. A total of 1,146 patients with poorly controlled type 2 diabetes (HbA1c [greater than or equal to]8% and systolic BP [greater than or equal to]140 mm Hg and/or LDL-cholesterol [greater than or equal to]130 mg/dL) were randomized to a multicomponent quality improvement (QI) strategy (trained nonphysician care coordinator to facilitate care for patients and clinical decision support system for physicians) or usual care. At 2.5 years, compared to usual care, those receiving the QI strategy were significantly more likely to achieve multiple risk factor control. Six clinics continued, while 4 clinics discontinued implementing the QI strategy for an additional 4-year follow-up (overall median 6.5 years follow-up). In this post hoc analysis, using intention-to-treat, we examined between-group differences in multiple risk factor control (HbA1c Conclusions In urban South Asian clinics, a multicomponent QI strategy led to sustained multiple risk factor control and between-group differences in microvascular, but not macrovascular, endpoints. Between-group reductions in vascular outcomes at 6.5 years were observed only at sites that continued the QI intervention, suggesting that practice change needs to be maintained for better population health of people with diabetes. Trial registration ClinicalTrials.gov NCT01212328., Author(s): Mohammed K. Ali 1,2, Kavita Singh 3,4, Dimple Kondal 5, Raji Devarajan 4, Shivani A. Patel 1,2,6, V. Usha Menon 7, Premlata K. Varthakavi 8, Vijay Vishwanathan 9, Mala [...]

Published
2024
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3. Predictors of anastomotic leak and conduit necrosis after oesophagectomy: Results from the oesophago-gastric anastomosis audit (OGAA)

Author

Halle-Smith, J.M., Kamarajah, S.K., Evans, R.P.T., Nepogodiev, D., Hodson, J., Bundred, J.R., Gockel, I., Gossage, J.A., Isik, A., Kauppila, J.H., Kidane, B., Mahendran, H.A., Negoi, I., Okonta, K.E., Sayyed, R., van Hillegersberg, R., Vohra, R.S., Wijnhoven, B.P.L., Singh, P., Griffiths, E.A., Alderson, D., Bundred, J., Gossage, J., Jefferies, B., McKay, S., Mohamed, I., Siaw- Acheampong, K., Vohra, R., Wanigasooriya, K., Whitehouse, T., Gjata, A., Moreno, J.I., Takeda, F.R., Guevara Castro, R., Bekele, A., Harustiak, T., Kechagias, A., Bagajevas, A., Kennedy, A., Da Roit, A., Azagra, J.S., Mejía-Fernández, L., El Kafsi, J., Sayyed, R.H., Sousa, M., Sampaio, A.S., Blanco, R., Wallner, B., Schneider, P.M., Hsu, P.K., Gananadha, S., Wills, V., Devadas, M., Duong, C., Talbot, M., Hii, M.W., Jacobs, R., Andreollo, N.A., Johnston, B., Darling, G., Isaza-Restrepo, A., Rosero, G., Arias- Amézquita, F., Raptis, D., Gaedcke, J., Reim, D., Izbicki, J., Egberts, J.H., Dikinis, S., Kjaer, D.W., Larsen, M.H., Achiam, M.P., Saarnio, J., Theodorou, D., Liakakos, T., Korkolis, D.P., Robb, W.B., Collins, C., Murphy, T., Reynolds, J., Tonini, V., Migliore, M., Bonavina, L., Valmasoni, M., Bardini, R., Weindelmayer, J., Terashima, M., White, R.E., Alghunaim, E., Elhadi, M., Leon-Takahashi, A.M., Medina-Franco, H., Lau, P.C., Heisterkamp, J., Rosman, C., Beban, G., Babor, R., Gordon, A., Rossaak, J.I., Pal, K.M.I., Qureshi, A.U., Naqi, S.A., Syed, A.A., Barbosa, J., Vicente, C.S., Leite, J., Freire, J., Casaca, R., Costa, R.C.T., Scurtu, R.R., Mogoanta, S.S., Bolca, C., Constantinoiu, S., Sekhniaidze, D., Bjelović, M., So, J.B.Y., Gačevski, G., Loureiro, C., Pera, M., Bianchi, A., Moreno Gijón, M., Martín Fernández, J., Trugeda Carrera, M.S., Vallve-Bernal, M., Cítores Pascual, M.A., Elmahi, S., Halldestam, I., Hedberg, J., Mönig, S., Gutknecht, S., Tez, M., Guner, A., Tirnaksiz, M.B., Colak, E., Sevinç, B., Hindmarsh, A., Khan, I., Khoo, D., Byrom, R., Gokhale, J., Wilkerson, P., Jain, P., Chan, D., Robertson, K., Iftikhar, S., Skipworth, R., Forshaw, M., Higgs, S., Nijjar, R., Viswanath, Y.K.S., Turner, P., Dexter, S., Boddy, A., Allum, W.H., Oglesby, S., Cheong, E., Beardsmore, D., Maynard, N., Berrisford, R., Mercer, S., Puig, S., Melhado, R., Kelty, C., Underwood, T., Dawas, K., Lewis, W., Al-Bahrani, A., Bryce, G., Thomas, M., Arndt, A.T., Palazzo, F., Meguid, R.A., Fergusson, J., Beenen, E., Mosse, C., Salim, J., Cheah, S., Wright, T., Cerdeira, M.P., McQuillan, P., Richardson, M., Liem, H., Spillane, J., Yacob, M., Albadawi, F., Thorpe, T., Dingle, A., Cabalag, C., Loi, K., Fisher, O.M., Ward, S., Read, M., Johnson, M., Bassari, R., Bui, H., Cecconello, I., Sallum, R.A.A., da Rocha, J.R.M., Lopes, L.R., Tercioti, V., Coelho, J.D.S., Ferrer, J.A.P., Buduhan, G., Tan, L., Srinathan, S., Shea, P., Yeung, J., Allison, F., Carroll, P., Vargas-Barato, F., Gonzalez, F., Ortega, J., Nino-Torres, L., Beltrán-García, T.C., Castilla, L., Pineda, M., Bastidas, A., Gómez-Mayorga, J., Cortés, N., Cetares, C., Caceres, S., Duarte, S., Pazdro, A., Snajdauf, M., Faltova, H., Sevcikova, M., Mortensen, P.B., Katballe, N., Ingemann, T., Morten, B., Kruhlikava, I., Ainswort, A.P., Stilling, N.M., Eckardt, J., Holm, J., Thorsteinsson, M., Siemsen, M., Brandt, B., Nega, B., Teferra, E., Tizazu, A., Koivukangas, V., Meriläinen, S., Gruetzmann, R., Krautz, C., Weber, G., Golcher, H., Emons, G., Azizian, A., Ebeling, M., Niebisch, S., Kreuser, N., Albanese, G., Hesse, J., Volovnik, L., Boecher, U., Reeh, M., Triantafyllou, S., Schizas, D., Michalinos, A., Balli, E., Mpoura, M., Charalabopoulos, A., Manatakis, D.K., Balalis, D., Bolger, J., Baban, C., Mastrosimone, A., McAnena, O., Quinn, A., Ó Súilleabháin, C.B., Hennessy, M.M., Ivanovski, I., Khizer, H., Ravi, N., Donlon, N., Cervellera, M., Vaccari, S., Bianchini, S., Sartarelli, l, Asti, E., Bernardi, D., Merigliano, S., Provenzano, L., Scarpa, M., Saadeh, L., Salmaso, B., De Manzoni, G., Giacopuzzi, S., La Mendola, R., De Pasqual, C.A., Tsubosa, Y., Niihara, M., Irino, T., Makuuchi, R., Ishii, K., Mwachiro, M., Fekadu, A., Odera, A., Mwachiro, E., AlShehab, D., Ahmed, H.A., Shebani, A.O., Elhadi, A., Elnagar, F.A., Elnagar, H.F., Makkai-Popa, S.T., Wong, L.F., Yr, Tan, S, Thannimalai, Ca, Ho, Ws, Pang, Jh, Tan, Hnl, Basave, Cortés-González, R., Lagarde, S.M., van Lanschot, J.J.B., Cords, C., Jansen, W.A., Martijnse, I., Matthijsen, R., Bouwense, S., Klarenbeek, B., Verstegen, M., van Workum, F., Ruurda, J.P., van der Sluis, P.C., de Maat, M., Evenett, N., Johnston, P., Patel, R., MacCormick, A., Young, M., Smith, B., Ekwunife, C., Memon, A.H., Shaikh, K., Wajid, A., Khalil, N., Haris, M., Mirza, Z.U., Qudus, S.B.A., Sarwar, M.Z., Shehzadi, A., Raza, A., Jhanzaib, M.H., Farmanali, J., Zakir, Z., Shakeel, O., Nasir, I., Khattak, S., Baig, M., Noor, M.A., Ahmed, H.H., Naeem, A., Pinho, A.C., da Silva, R., Bernardes, A., Campos, J.C., Matos, H., Braga, T., Monteiro, C., Ramos, P., Cabral, F., Gomes, M.P., Martins, P.C., Correia, A.M., Videira, J.F., Ciuce, C., Drasovean, R., Apostu, R., Paitici, S., Racu, A.E., Obleaga, C.V., Beuran, M., Stoica, B., Ciubotaru, C., Negoita, V., Cordos, I., Birla, R.D., Predescu, D., Hoara, P.A., Tomsa, R., Shneider, V., Agasiev, M., Ganjara, I., Gunjić, D., Veselinović, M., Babič, T., Chin, T.S., Shabbir, A., Kim, G., Crnjac, A., Samo, H., Díez del Val, I., Leturio, S., Ramón, J.M., Dal Cero, M., Rifá, S., Rico, M., Pagan Pomar, A., Martinez Corcoles, J.A., Rodicio Miravalles, J.L., Pais, S.A., Turienzo, S.A., Alvarez, L.S., Campos, P.V., Rendo, A.G., García, S.S., Santos, E.P.G., Martínez, E.T., Fernández Díaz, M.J., Magadán Álvarez, C., Concepción Martín, V., Díaz López, C., Rosat Rodrigo, A., Pérez Sánchez, L.E., Bailón Cuadrado, M., Tinoco Carrasco, C., Choolani Bhojwani, E., Sánchez, D.P., Ahmed, M.E., Dzhendov, T., Lindberg, F., Rutegård, M., Sundbom, M., Mickael, C., Colucci, N., Schnider, A., Er, S., Kurnaz, E., Turkyilmaz, S., Turkyilmaz, A., Yildirim, R., Baki, B.E., Akkapulu, N., Karahan, O., Damburaci, N., Hardwick, R., Safranek, P., Sujendran, V., Bennett, J., Afzal, Z., Shrotri, M., Chan, B., Exarchou, K., Gilbert, T., Amalesh, T., Mukherjee, D., Mukherjee, S., Wiggins, T.H., Kennedy, R., McCain, S., Harris, A., Dobson, G., Davies, N., Wilson, I., Mayo, D., Bennett, D., Young, R., Manby, P., Blencowe, N., Schiller, M., Byrne, B., Mitton, D., Wong, V., Elshaer, A., Cowen, M., Menon, V., Tan, L.C., McLaughlin, E., Koshy, R., Sharp, C., Brewer, H., Das, N., Cox, M., Al Khyatt, W., Worku, D., Iqbal, R., Walls, L., McGregor, R., Fullarton, G., Macdonald, A., MacKay, C., Craig, C., Dwerryhouse, S., Hornby, S., Jaunoo, S., Wadley, M., Baker, C., Saad, M., Kelly, M., Davies, A., Di Maggio, F., Mistry, P., Singhal, R., Tucker, O., Kapoulas, S., Powell-Brett, S., Davis, P., Bromley, G., Watson, L., Verma, R., Ward, J., Shetty, V., Ball, C., Pursnani, K., Sarela, A., Sue Ling, H., Mehta, S., Hayden, J., To, N., Palser, T., Hunter, D., Supramaniam, K., Butt, Z., Ahmed, A., Kumar, S., Chaudry, A., Moussa, O., Kordzadeh, A., Lorenzi, B., Wilson, M., Patil, P., Noaman, I., Willem, J., Bouras, G., Evans, R., Singh, M., Warrilow, H., Ahmad, A., Tewari, N., Yanni, F., Couch, J., Theophilidou, E., Reilly, J.J., van Boxel, Gijs, Akbari, K., Zanotti, D., Sgromo, B., Sanders, G., Wheatley, T., Ariyarathenam, A., Reece-Smith, A., Humphreys, L., Choh, C., Carter, N., Knight, B., Pucher, P., Athanasiou, A., Tan, B., Abdulrahman, M., Vickers, J., Akhtar, K., Chaparala, R., Brown, R., Alasmar, M.M.A., Ackroyd, R., Patel, K., Tamhankar, A., Wyman, A., Walker, R., Grace, B., Abbassi, N., Slim, N., Ioannidi, L., Blackshaw, G., Havard, T., Escofet, X., Powell, A., Owera, A., Rashid, F., Jambulingam, P., Padickakudi, J., Ben-Younes, H., Mccormack, K., Makey, I.A., Karush, M.K., Seder, C.W., Liptay, M.J., Chmielewski, G., Rosato, E.L., Berger, A.C., Zheng, R., Okolo, E., Singh, A., Scott, C.D., Weyant, M.J., Mitchell, J.D., and Griffiths, Ewen A.

Published
2024
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6. The influence of anastomotic techniques on postoperative anastomotic complications: Results of the Oesophago-Gastric Anastomosis Audit

Author

Kamarajah, S.K., Evans, R.P.T., Nepogodiev, D., Hodson, J., Bundred, J.R., Gockel, I., Gossage, J.A., Isik, A., Kidane, B., Mahendran, H.A., Negoi, I., Okonta, K.E., Sayyed, R., van Hillegersberg, R., Vohra, R.S., Wijnhoven, B.P.L., Singh, P., Griffiths, E.A., Alderson, D., Bundred, J., Gossage, J., Jefferies, B., McKay, S., Mohamed, I., Siaw-Acheampong, K., Vohra, R., Wanigasooriya, K., Whitehouse, T., Gjata, A., Moreno, J.I., Takeda, F.R., Guevara Castro, R., Harustiak, T., Bekele, A., Kechagias, A., Kennedy, A., Da Roit, A., Bagajevas, A., Azagra, J.S., Mejía-Fernández, L., El Kafsi, J., Sayyed, R.H., Sousa, M., Sampaio, A.S., Blanco, R., Wallner, B., Schneider, P.M., Hsu, P.K., Gananadha, S., Wills, V., Devadas, M., Duong, C., Talbot, M., Hii, M.W., Jacobs, R., Andreollo, N.A., Johnston, B., Darling, G., Isaza-Restrepo, A., Rosero, G., Arias-Amézquita, F., Raptis, D., Gaedcke, J., Reim, D., Izbicki, J., Egberts, J.H., Dikinis, S., Kjaer, D.W., Larsen, M.H., Achiam, M.P., Saarnio, J., Theodorou, D., Liakakos, T., Korkolis, D.P., Robb, W.B., Collins, C., Murphy, T., Reynolds, J., Tonini, V., Migliore, M., Bonavina, L., Valmasoni, M., Bardini, R., Weindelmayer, J., Terashima, M., White, R.E., Alghunaim, E., Elhadi, M., Leon-Takahashi, A.M., Medina-Franco, H., Lau, P.C., Heisterkamp, J., Rosman, C., Beban, G., Babor, R., Gordon, A., Rossaak, J.I., Pal, K.M.I., Qureshi, A.U., Naqi, S.A., Syed, A.A., Barbosa, J., Vicente, C.S., Leite, J., Freire, J., Casaca, R., Costa, R.C.T., Scurtu, R.R., Mogoanta, S.S., Bolca, C., Constantinoiu, S., Sekhniaidze, D., Bjelović, M., So, J.B.Y., Gačevski, G., Loureiro, C., Pera, M., Bianchi, A., Moreno Gijón, M., Martín Fernández, J., Trugeda Carrera, M.S., Vallve-Bernal, M., Cítores Pascual, M.A., Elmahi, S., Halldestam, I., Hedberg, J., Mönig, S., Gutknecht, S., Tez, M., Guner, A., Tirnaksiz, M.B., Colak, E., Sevinç, B., Hindmarsh, A., Khan, I., Khoo, D., Byrom, R., Gokhale, J., Wilkerson, P., Jain, P., Chan, D., Robertson, K., Iftikhar, S., Skipworth, R., Forshaw, M., Higgs, S., Nijjar, R., Viswanath, Y.K.S., Turner, P., Dexter, S., Boddy, A., Allum, W.H., Oglesby, S., Cheong, E., Beardsmore, D., Maynard, N., Berrisford, R., Mercer, S., Puig, S., Melhado, R., Kelty, C., Underwood, T., Dawas, K., Lewis, W., Al-Bahrani, A., Bryce, G., Thomas, M., Arndt, A.T., Palazzo, F., Meguid, R.A., Fergusson, J., Beenen, E., Mosse, C., Salim, J., Cheah, S., Wright, T., Cerdeira, M.P., McQuillan, P., Richardson, M., Liem, H., Spillane, J., Yacob, M., Albadawi, F., Thorpe, T., Dingle, A., Cabalag, C., Loi, K., Fisher, O.M., Ward, S., Read, M., Johnson, M., Bassari, R., Bui, H., Cecconello, I., Sallum, R.A.A., da Rocha, J.R.M., Lopes, L.R., Tercioti, V., Jr, Coelho, J.D.S., Ferrer, J.A.P., Buduhan, G., Tan, L., Srinathan, S., Shea, P., Yeung, J., Allison, F., Carroll, P., Vargas-Barato, F., Gonzalez, F., Ortega, J., Nino-Torres, L., Beltrán-García, T.C., Castilla, L., Pineda, M., Bastidas, A., Gómez-Mayorga, J., Cortés, N., Cetares, C., Caceres, S., Duarte, S., Pazdro, A., Snajdauf, M., Faltova, H., Sevcikova, M., Mortensen, P.B., Katballe, N., Ingemann, T., Morten, B., Kruhlikava, I., Ainswort, A.P., Stilling, N.M., Eckardt, J., Holm, J., Thorsteinsson, M., Siemsen, M., Brandt, B., Nega, B., Teferra, E., Tizazu, A., Kauppila, J.H., Koivukangas, V., Meriläinen, S., Gruetzmann, R., Krautz, C., Weber, G., Golcher, H., Emons, G., Azizian, A., Ebeling, M., Niebisch, S., Kreuser, N., Albanese, G., Hesse, J., Volovnik, L., Boecher, U., Reeh, M., Triantafyllou, S., Schizas, D., Michalinos, A., Balli, E., Mpoura, M., Charalabopoulos, A., Manatakis, D.K., Balalis, D., Bolger, J., Baban, C., Mastrosimone, A., McAnena, O., Quinn, A., Ó Súilleabháin, C.B., Hennessy, M.M., Ivanovski, I., Khizer, H., Ravi, N., Donlon, N., Cervellera, M., Vaccari, S., Bianchini, S., Sartarelli, l., Asti, E., Bernardi, D., Merigliano, S., Provenzano, L., Scarpa, M., Saadeh, L., Salmaso, B., De Manzoni, G., Giacopuzzi, S., La Mendola, R., De Pasqual, C.A., Tsubosa, Y., Niihara, M., Irino, T., Makuuchi, R., Ishii, K., Mwachiro, M., Fekadu, A., Odera, A., Mwachiro, E., AlShehab, D., Ahmed, H.A., Shebani, A.O., Elhadi, A., Elnagar, F.A., Elnagar, H.F., Makkai-Popa, S.T., Wong, L.F., Tan, Y.R., Thannimalai, S., Ho, C.A., Pang, W.S., Tan, J.H., Basave, H.N.L., Cortés-González, R., Lagarde, S.M., van Lanschot, J.J.B., Cords, C., Jansen, W.A., Martijnse, I., Matthijsen, R., Bouwense, S., Klarenbeek, B., Verstegen, M., van Workum, F., Ruurda, J.P., van der Sluis, P.C., de Maat, M., Evenett, N., Johnston, P., Patel, R., MacCormick, A., Young, M., Smith, B., Ekwunife, C., Memon, A.H., Shaikh, K., Wajid, A., Khalil, N., Haris, M., Mirza, Z.U., Qudus, S.B.A., Sarwar, M.Z., Shehzadi, A., Raza, A., Jhanzaib, M.H., Farmanali, J., Zakir, Z., Shakeel, O., Nasir, I., Khattak, S., Baig, M., MA, Noor, Ahmed, H.H., Naeem, A., Pinho, A.C., da Silva, R., Bernardes, A., Campos, J.C., Matos, H., Braga, T., Monteiro, C., Ramos, P., Cabral, F., Gomes, M.P., Martins, P.C., Correia, A.M., Videira, J.F., Ciuce, C., Drasovean, R., Apostu, R., Paitici, S., Racu, A.E., Obleaga, C.V., Beuran, M., Stoica, B., Ciubotaru, C., Negoita, V., Cordos, I., Birla, R.D., Predescu, D., Hoara, P.A., Tomsa, R., Shneider, V., Agasiev, M., Ganjara, I., Gunjić, D., Veselinović, M., Babič, T., Chin, T.S., Shabbir, A., Kim, G., Crnjac, A., Samo, H., Díez del Val, I., Leturio, S., Ramón, J.M., Dal Cero, M., Rifá, S., Rico, M., Pagan Pomar, A., Martinez Corcoles, J.A., Rodicio Miravalles, J.L., Pais, S.A., Turienzo, S.A., Alvarez, L.S., Campos, P.V., Rendo, A.G., García, S.S., Santos, E.P.G., Martínez, E.T., Fernández Díaz, M.J., Magadán Álvarez, C., Concepción Martín, V., Díaz López, C., Rosat Rodrigo, A., Pérez Sánchez, L.E., Bailón Cuadrado, M., Tinoco Carrasco, C., Choolani Bhojwani, E., Sánchez, D.P., Ahmed, M.E., Dzhendov, T., Lindberg, F., Rutegård, M., Sundbom, M., Mickael, C., Colucci, N., Schnider, A., Er, S., Kurnaz, E., Turkyilmaz, S., Turkyilmaz, A., Yildirim, R., Baki, B.E., Akkapulu, N., Karahan, O., Damburaci, N., Hardwick, R., Safranek, P., Sujendran, V., Bennett, J., Afzal, Z., Shrotri, M., Chan, B., Exarchou, K., Gilbert, T., Amalesh, T., Mukherjee, D., Mukherjee, S., Wiggins, T.H., Kennedy, R., McCain, S., Harris, A., Dobson, G., Davies, N., Wilson, I., Mayo, D., Bennett, D., Young, R., Manby, P., Blencowe, N., Schiller, M., Byrne, B., Mitton, D., Wong, V., Elshaer, A., Cowen, M., Menon, V., Tan, L.C., McLaughlin, E., Koshy, R., Sharp, C., Brewer, H., Das, N., Cox, M., Al Khyatt, W., Worku, D., Iqbal, R., Walls, L., McGregor, R., Fullarton, G., Macdonald, A., MacKay, C., Craig, C., Dwerryhouse, S., Hornby, S., Jaunoo, S., Wadley, M., Baker, C., Saad, M., Kelly, M., Davies, A., Di Maggio, F., Mistry, P., Singhal, R., Tucker, O., Kapoulas, S., Powell-Brett, S., Davis, P., Bromley, G., Watson, L., Verma, R., Ward, J., Shetty, V., Ball, C., Pursnani, K., Sarela, A., Sue Ling, H., Mehta, S., Hayden, J., To, N., Palser, T., Hunter, D., Supramaniam, K., Butt, Z., Ahmed, A., Kumar, S., Chaudry, A., Moussa, O., Kordzadeh, A., Lorenzi, B., Wilson, M., Patil, P., Noaman, I., Willem, J., Bouras, G., Evans, R., Singh, M., Warrilow, H., Ahmad, A., Tewari, N., Yanni, F., Couch, J., Theophilidou, E., Reilly, J.J., van Boxel Gijs, Akbari, K., Zanotti, D., Sgromo, B., Sanders, G., Wheatley, T., Ariyarathenam, A., Reece-Smith, A., Humphreys, L., Choh, C., Carter, N., Knight, B., Pucher, P., Athanasiou, A., Tan, B., Abdulrahman, M., Vickers, J., Akhtar, K., Chaparala, R., Brown, R., Alasmar, M.M.A., Ackroyd, R., Patel, K., Tamhankar, A., Wyman, A., Walker, R., Grace, B., Abbassi, N., Slim, N., Ioannidi, L., Blackshaw, G., Havard, T., Escofet, X., Powell, A., Owera, A., Rashid, F., Jambulingam, P., Padickakudi, J., Ben-Younes, H., Mccormack, K., Makey, I.A., Karush, M.K., Seder, C.W., Liptay, M.J., Chmielewski, G., Rosato, E.L., Berger, A.C., Zheng, R., Okolo, E., Singh, A., Scott, C.D., Weyant, M.J., and Mitchell, J.D.

Published
2022
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8. Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study

Author

Kamarajah, S.K., Nepogodiev, D., Bekele, A., Cecconello, I., Evans, R.P.T., Guner, A., Gossage, J.A., Harustiak, T., Hodson, J., Isik, A., Kidane, B., Leon-Takahashi, A.M., Mahendran, H.A., Negoi, I., Okonta, K.E., Rosero, G., Sayyed, R.H., Singh, P., Takeda, F.R., van Hillegersberg, R., Vohra, R.S., White, R.E., Griffiths, E.A., Alderson, D., Bundred, J., Gossage, J., Jefferies, B., McKay, S., Mohamed, I., Siaw- Acheampong, K., Vohra, R., Wanigasooriya, K., Whitehouse, T., Gjata, A., Moreno, J.I., Guevara, Castro R., Kechagias, A., Gockel, I., Kennedy, A., Da Roit, A., Bagajevas, A., Azagra, J.S., Mejía-Fernández, L., Wijnhoven, B.P.L., El Kafsi, J., Sousa, M., Sampaio, A.S., Blanco, R., Wallner, B., Schneider, P.M., Hsu, P.K., Gananadha, S., Wills, V., Devadas, M., Duong, C., Talbot, M., Hii, M.W., Jacobs, R., Andreollo, N.A., Johnston, B., Darling, G., Isaza-Restrepo, A., Arias- Amézquita, F., Raptis, D., Gaedcke, J., Reim, D., Izbicki, J., Egberts, J.H., Dikinis, S., Kjaer, D.W., Larsen, M.H., Achiam, M.P., Saarnio, J., Theodorou, D., Liakakos, T., Korkolis, D.P., Robb, W.B., Collins, C., Murphy, T., Reynolds, J., Tonini, V., Migliore, M., Bonavina, L., Valmasoni, M., Bardini, R., Weindelmayer, J., Terashima, M., Alghunaim, E., Elhadi, M., Medina-Franco, H., Lau, P.C., Heisterkamp, J., Rosman, C., Beban, G., Babor, R., Gordon, A., Rossaak, J.I., Pal, K.M.I., Qureshi, A.U., Naqi, S.A., Syed, A.A., Barbosa, J., Vicente, C.S., Leite, J., Freire, J., Casaca, R., Costa, R.C.T., Scurtu, R.R., Mogoanta, S.S., Bolca, C., Constantinoiu, S., Sekhniaidze, D., Bjelović, M., So, J.B.Y., Gačevski, G., Loureiro, C., Pera, M., Bianchi, A., Moreno, Gijón M., Martín Fernández, J., Trugeda Carrera, M.S., Vallve-Bernal, M., Cítores Pascual, M.A., Elmahi, S., Halldestam, I., Hedberg, J., Mönig, S., Gutknecht, S., Tez, M., Tirnaksiz, M.B., Colak, E., Sevinç, B., Hindmarsh, A., Khan, I., Khoo, D., Byrom, R., Gokhale, J., Wilkerson, P., Jain, P., Chan, D., Robertson, K., Iftikhar, S., Skipworth, R., Forshaw, M., Higgs, S., Nijjar, R., Viswanath, Y.K.S., Turner, P., Dexter, S., Boddy, A., Allum, W.H., Oglesby, S., Cheong, E., Beardsmore, D., Maynard, N., Berrisford, R., Mercer, S., Puig, S., Melhado, R., Kelty, C., Underwood, T., Dawas, K., Lewis, W., Al-Bahrani, A., Bryce, G., Thomas, M., Arndt, A.T., Palazzo, F., Meguid, R.A., Fergusson, J., Beenen, E., Mosse, C., Salim, J., Cheah, S., Wright, T., Cerdeira, M.P., McQuillan, P., Richardson, M., Liem, H., Spillane, J., Yacob, M., Albadawi, F., Thorpe, T., Dingle, A., Cabalag, C., Loi, K., Fisher, O.M., Ward, S., Read, M., Johnson, M., Bassari, R., Bui, H., Sallum, R.A.A., da Rocha, J.R.M., Lopes, L.R., Tercioti, V., Jr., Coelho, J.D., Ferrer, J.A.P., Buduhan, G., Tan, L., Srinathan, S., Shea, P., Yeung, J., Allison, F., Carroll, P., Vargas-Barato, F., Gonzalez, F., Ortega, J., Nino-Torres, L., Beltrán-García, T.C., Castilla, L., Pineda, M., Bastidas, A., Gómez-Mayorga, J., Cortés, N., Cetares, C., Caceres, S., Duarte, S., Pazdro, A., Snajdauf, M., Faltova, H., Sevcikova, M., Mortensen, P.B., Katballe, N., Ingemann, T., Morten, B., Kruhlikava, I., Ainswort, A.P., Stilling, N.M., Eckardt, J., Holm, J., Thorsteinsson, M., Siemsen, M., Brandt, B., Nega, B., Teferra, E., Tizazu, A., Kauppila, J.H., Koivukangas, V., Meriläinen, S., Gruetzmann, R., Krautz, C., Weber, G., Golcher, H., Emons, G., Azizian, A., Ebeling, M., Niebisch, S., Kreuser, N., Albanese, G., Hesse, J., Volovnik, L., Boecher, U., Reeh, M., Triantafyllou, S., Schizas, D., Michalinos, A., Mpali, E., Mpoura, M., Charalabopoulos, A., Manatakis, D.K., Balalis, D., Bolger, J., Baban, C., Mastrosimone, A., McAnena, O., Quinn, A., Ó Súilleabháin, C.B., Hennessy, M.M., Ivanovski, I., Khizer, H., Ravi, N., Donlon, N., Cervellera, M., Vaccari, S., Bianchini, S., Sartarelli, l, Asti, E., Bernardi, D., Merigliano, S., Provenzano, L., Scarpa, M., Saadeh, L., Salmaso, B., De Manzoni, G., Giacopuzzi, S., La Mendola, R., De Pasqual, C.A., Tsubosa, Y., Niihara, M., Irino, T., Makuuchi, R., Ishii, K., Mwachiro, M., Fekadu, A., Odera, A., Mwachiro, E., AlShehab, D., Ahmed, H.A., Shebani, A.O., Elhadi, A., Elnagar, F.A., Elnagar, H.F., Makkai-Popa, S.T., Wong, L.F., Tan, Y.R., Thannimalai, S., Ho, C.A., Pang, W.S., Tan, J.H., Basave, H.N.L., Cortés-González, R., Lagarde, S.M., van Lanschot, J.J.B., Cords, C., Jansen, W.A., Martijnse, I., Matthijsen, R., Bouwense, S., Klarenbeek, B., Verstegen, M., van Workum, F., Ruurda, J.P., van der Sluis, P.C., de Maat, M., Evenett, N., Johnston, P., Patel, R., MacCormick, A., Young, M., Smith, B., Ekwunife, C., Memon, A.H., Shaikh, K., Wajid, A., Khalil, N., Haris, M., Mirza, Z.U., Qudus, S.B.A., Sarwar, M.Z., Shehzadi, A., Raza, A., Jhanzaib, M.H., Farmanali, J., Zakir, Z., Shakeel, O., Nasir, I., Khattak, S., Baig, M., Noor, M.A., Ahmed, H.H., Naeem, A., Pinho, A.C., da Silva, R., Bernardes, A., Campos, J.C., Matos, H., Braga, T., Monteiro, C., Ramos, P., Cabral, F., Gomes, M.P., Martins, P.C., Correia, A.M., Videira, J.F., Ciuce, C., Drasovean, R., Apostu, R., Paitici, S., Racu, A.E., Obleaga, C.V., Beuran, M., Stoica, B., Ciubotaru, C., Negoita, V., Cordos, I., Birla, R.D., Predescu, D., Hoara, P.A., Tomsa, R., Shneider, V., Agasiev, M., Ganjara, I., Gunjić, D., Veselinović, M., Babič, T., Chin, T.S., Shabbir, A., Kim, G., Crnjac, A., Samo, H., Díez del Val, I., Leturio, S., Ramón, J.M., Dal Cero, M., Rifá, S., Rico, M., Pagan Pomar, A., Martinez Corcoles, J.A., Rodicio Miravalles, J.L., Pais, S.A., Turienzo, S.A., Alvarez, L.S., Campos, P.V., Rendo, A.G., García, S.S., Santos, E.P.G., Martínez, E.T., Fernández, Díaz MJ., Magadán, Álvarez C., Concepción, Martín V., Díaz, López C., Rosat, Rodrigo A., Pérez, Sánchez LE., Bailón, Cuadrado M., Tinoco, Carrasco C., Choolani Bhojwani, E., Sánchez, D.P., Ahmed, M.E., Dzhendov, T., Lindberg, F., Rutegård, M., Sundbom, M., Mickael, C., Colucci, N., Schnider, A., Er, S., Kurnaz, E., Turkyilmaz, S., Turkyilmaz, A., Yildirim, R., Baki, B.E., Akkapulu, N., Karahan, O., Damburaci, N., Hardwick, R., Safranek, P., Sujendran, V., Bennett, J., Afzal, Z., Shrotri, M., Chan, B., Exarchou, K., Gilbert, T., Amalesh, T., Mukherjee, D., Mukherjee, S., Wiggins, T.H., Kennedy, R., McCain, S., Harris, A., Dobson, G., Davies, N., Wilson, I., Mayo, D., Bennett, D., Young, R., Manby, P., Blencowe, N., Schiller, M., Byrne, B., Mitton, D., Wong, V., Elshaer, A., Cowen, M., Menon, V., Tan, L.C., McLaughlin, E., Koshy, R., Sharp, C., Brewer, H., Das, N., Cox, M., Al Khyatt, W., Worku, D., Iqbal, R., Walls, L., McGregor, R., Fullarton, G., Macdonald, A., MacKay, C., Craig, C., Dwerryhouse, S., Hornby, S., Jaunoo, S., Wadley, M., Baker, C., Saad, M., Kelly, M., Davies, A., Di Maggio, F., Mistry, P., Singhal, R., Tucker, O., Kapoulas, S., Powell-Brett, S., Davis, P., Bromley, G., Watson, L., Verma, R., Ward, J., Shetty, V., Ball, C., Pursnani, K., Sarela, A., Sue, Ling H., Mehta, S., Hayden, J., To, N., Palser, T., Hunter, D., Supramaniam, K., Butt, Z., Ahmed, A., Kumar, S., Chaudry, A., Moussa, O., Kordzadeh, A., Lorenzi, B., Wilson, M., Patil, P., Noaman, I., Willem, J., Bouras, G., Evans, R., Singh, M., Warrilow, H., Ahmad, A., Tewari, N., Yanni, F., Couch, J., Theophilidou, E., Reilly, J.J., van Boxel, Gijs, Akbari, K., Zanotti, D., Sgromo, B., Sanders, G., Wheatley, T., Ariyarathenam, A., Reece-Smith, A., Humphreys, L., Choh, C., Carter, N., Knight, B., Pucher, P., Athanasiou, A., Tan, B., Abdulrahman, M., Vickers, J., Akhtar, K., Chaparala, R., Brown, R., Alasmar, M.M.A., Ackroyd, R., Patel, K., Tamhankar, A., Wyman, A., Walker, R., Grace, B., Abbassi, N., Slim, N., Ioannidi, L., Blackshaw, G., Havard, T., Escofet, X., Powell, A., Owera, A., Rashid, F., Jambulingam, P., Padickakudi, J., Ben-Younes, H., Mccormack, K., Makey, I.A., Karush, M.K., Seder, C.W., Liptay, M.J., Chmielewski, G., Rosato, E.L., Berger, A.C., Zheng, R., Okolo, E., Singh, A., Scott, C.D., Weyant, M.J., and Mitchell, J.D.

Published
2021
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12. Occurrence of Listeria monocytogenes in raw milk and chicken meat in Thrissur, Kerala.

Author

Prasad, M. C. B., Menon, V. K., Milton, A. A. P., Sunil, B., Latha, C., Priya, P. M., and Thomas, Naicy

Subjects
LISTERIA monocytogenes, RAW milk, CHICKEN as food, POLYMERASE chain reaction, MICROBIAL sensitivity tests
Abstract

The present study was carried out with the objective to detect Listeria monocytogenes from raw milk and chicken meat. Two hundred samples of raw milk and chicken meat were obtained from local dairy farms and retail outlets, respectively in Thrissur, Kerala. These samples were enriched primarily in University of Vermont Medium-I (UVM I) broth, followed by further enrichment in UVM II broth. Subsequently, the enriched samples were streaked onto PALCAM agar for further analysis. Simultaneously, the samples were directly screened for presence of L. monocytogenes by PCR and real time PCR. Bacterial cultures that exhibited standard colony features were subsequently identified at the species level through the phenotypic tests. The isolates obtained were subjected to molecular confirmation, specifically targeting hlyA gene using conventional PCR and real time PCR. Additionally, the isolates were subjected to antibiotic sensitivity test. The overall occurrence of L. monocytogenes was 1.5 per cent, with two and one isolate being recovered from milk and meat, respectively. However, the occurrence was determined to be three per cent by PCR and real time PCR respectively. The identification of L. monocytogenes in raw milk and chicken meat highlights the importance to enforce adequate sanitation and hygiene measures in the food chain in order to protect the health of consumers. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients

Author

Nissen, SEE, Lincoff, AM, Brennan, D, Ray, KKK, Mason, D, Kastelein, JJP, Thompson, PDD, Libby, P, Cho, L, Plutzky, J, Bays, HEE, Moriarty, PMM, Menon, V, Grobbee, DEE, Louie, MJJ, Chen, C-F, Li, N, Bloedon, LA, Robinson, P, Horner, M, Sasiela, WJJ, McCluskey, J, Davey, D, Fajardo-Campos, P, Petrovic, P, Fedacko, J, Zmuda, W, Lukyanov, Y, Nicholls, SJJ, CLEAR, OI, Vascular Medicine, ACS - Atherosclerosis & ischemic syndromes, and ACS - Pulmonary hypertension & thrombosis

Subjects
Coronary Disease/Myocardial Infarction, Outpatient-Based Clinical Medicine, Prevention, Cardiology, General Medicine, Clinical Medicine General, Clinical Medicine, Lipids
Abstract

BACKGROUND Bempedoic acid, an ATP citrate lyase inhibitor, reduces low-density lipoprotein (LDL) cholesterol levels and is associated with a low incidence of muscle-related adverse events; its effects on cardiovascular outcomes remain uncertain. METHODS We conducted a double-blind, randomized, placebo-controlled trial involving patients who were unable or unwilling to take statins owing to unacceptable adverse effects (“statin-intolerant” patients) and had, or were at high risk for, cardiovascular disease. The patients were assigned to receive oral bempedoic acid, 180 mg daily, or placebo. The primary end point was a four-component composite of major adverse cardiovascular events, defined as death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization. RESULTS A total of 13,970 patients underwent randomization; 6992 were assigned to the bempedoic acid group and 6978 to the placebo group. The median duration of follow-up was 40.6 months. The mean LDL cholesterol level at baseline was 139.0 mg per deciliter in both groups, and after 6 months, the reduction in the level was greater with bempedoic acid than with placebo by 29.2 mg per deciliter; the observed difference in the percent reductions was 21.1 percentage points in favor of bempedoic acid. The incidence of a primary end-point event was significantly lower with bempedoic acid than with placebo (819 patients [11.7%] vs. 927 [13.3%]; hazard ratio, 0.87; 95% confidence interval [CI], 0.79 to 0.96; P=0.004), as were the incidences of a composite of death from cardiovascular causes, nonfatal stroke, or nonfatal myocardial infarction (575 [8.2%] vs. 663 [9.5%]; hazard ratio, 0.85; 95% CI, 0.76 to 0.96; P=0.006); fatal or nonfatal myocardial infarction (261 [3.7%] vs. 334 [4.8%]; hazard ratio, 0.77; 95% CI, 0.66 to 0.91; P=0.002); and coronary revascularization (435 [6.2%] vs. 529 [7.6%]; hazard ratio, 0.81; 95% CI, 0.72 to 0.92; P=0.001). Bempedoic acid had no significant effects on fatal or nonfatal stroke, death from cardiovascular causes, and death from any cause. The incidences of gout and cholelithiasis were higher with bempedoic acid than with placebo (3.1% vs. 2.1% and 2.2% vs. 1.2%, respectively), as were the incidences of small increases in serum creatinine, uric acid, and hepatic-enzyme levels. CONCLUSIONS Among statin-intolerant patients, treatment with bempedoic acid was associated with a lower risk of major adverse cardiovascular events (death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or coronary revascularization). (Funded by Esperion Therapeutics; CLEAR Outcomes ClinicalTrials.gov number, NCT02993406. opens in new tab.)

Published
2023

17. Tackling NCD in LMIC: Achievements and Lessons Learned From the NHLBI–UnitedHealth Global Health Centers of Excellence Program

Author

Rubinstein, Adolfo, He, Jiang, Alam, Dewan S., Peters, David H., Wu, Yangfeng, Yan, Lijing L., Merson, Michael, Ramirez, Manuel, Caballero, Benjamin, Xavier, Denis, Yusuf, Salim, Prabhakaran, Dorairaj, Narayan, K.M. Venkat, Kimaiyo, Sylvester, Velazquez, Eric, Denman, Catalina A., Cornejo, Elsa, de Zapien, Jill, Rosales, Cecilia, Miranda, J. Jaime, Gilman, Robert H., Levitt, Naomi, Gaziano, Thomas A., Ghannem, Hassen, Laatikainen, Tiina, Rabadan-Diehl, Cristina, Engelgau, Michael M., Belis, Deshiree, Sampson, Uchechukwu, Smith, Richard, Dianis, Nancy L., Wolbach, Tracy L., Matta, Gabriela, Gutierrez, Laura, Elorriaga, Natalia, Poggio, Rosana, Irazola, Vilma, Bazzano, Lydia, Bhuiya, Abbas, Wazed, Abdul, Khan, Alfazal, Siddiquee, Ali T., Islam, Anwar, Khan, Jahangir A.M., Uddin, Jasim, Hasan, Khaled, Khanam, Masuma A., Yunus, Mohammad, Chowdhury, Muhammad A.H., Monalisa, Nazratun N., Alam, Nurul, Streatfield, Peter K., Ahmed, Shyfuddin, Parvin, Sonia, Ali, Taslim, Niessen, Louis W., Hossain, Mohammad D., Koehlmoos, Tracey L.P., Standing, Hilary, Lucas, Henry, Bleich, Sara N., Anderson, Gerard F., Trujillo, Antonio J., Mirelman, Andrew J., Hao, Jesse, Zhang, Jing, Tian, Maoyi, Huang, Polly, Luo, Rong, Fang, Weigang, Li, Xian, Feng, Xiangxian, Li, Zhifang, Deal, Kelly, Peterson, Eric, DeLong, Elizabeth, Zhou, Bo, Shi, Jingpu, Neal, Bruce, Jan, Stephen, Li, Nicole, McMahon, Stephen, Zhang, Jianxin, Sun, Jixin, Elliot, Paul, Zhao, Yi, Zhang, Yuhong, Yao, Chen, Sun, Ningling Huang, Han, Qide, Shen, Ruqun, Niu, Wenyi, Wang, Yanfang, Ke, Yang, Huang, Yining, Leeder, Stephen, Lopez, Alan, Zhang, Ruijuan, Yu, Yan, Roman, Ana V., Mendoza, Carlos, Roche, Dina, Mejicano, Gabriela, Cordova, Maria A., Kroker, Maria F., Fort, Meredith, Letona, Paola, Kanter, Rebecca, Garcia, Regina, Murillo, Sandra, Chacon, Violeta, Montero, Rafael, Lopez, Erika J., Peña, Liz, Castro, Maricruz, Dengo, Ana L., Ulate, Emilce, Alvarado, Nadia, Sibrian, Josefina, Alegria, Astarte, Gutierrez, Ana M., Fontes, Flavia, Sigamani, Alben, Kamath, Deepak, Xavier, Freeda, Deepthi, K.B., Anupama, M., Mathu, Nandini, George, Nisha, Rahul, Pranjali, Pais, Prem, Girish, Preeti, Thomas, Seena, Usha, T., Thomas, Tinku, Joshi, Rajnish, Chidambaram, N., Gupta, Rajeev, Chow, Clara, Pogue, Janice, O'Donnell, Martin, Devereaux, P.J., Misquith, Dominic, Agrawal, Twinkle, Fathima, Farah N., Reddy, Kolli Srinath, Shivashankar, Roopa, Ajay, Vamadevan S., Khan, Hassan M., Kadir, M. Masood, Masood, Muhammad Q., Fatmi, Zafar, Krishnan, Anand, Singh, Kavita, Tandon, Nikhil, Khadgawat, Rajesh, Menon, V. Usha, Sethi, Bipin Kumar, Unnikrishnan, A.G., Hutcheson, Mark L., Ali, Mohammed K., Cunningham, Solveig A., Patel, Shivani A., Gujral, Unjali, Desai, Ankush, Mohan, Deepa, Pradeepa, R. Guha, Mohan, V., Viswanathan, Vijay, Sahay, Rakesh, Shah, Seema, Bantwal, Ganapathi, Varthakavi, Premlata K., Nair, Manisha, Akwanalo, Constantine, Lagat, David, Barasa, Felix, Koech, Myra, Sugut, Wilson, Korir, Belinda, Mosol, Priscah, Ali, Shamim, Sherman, Charles B., Carter, Jane, Bloomfield, Gerald, Binanay, Cynthia, Vedanthan, Rajesh, Bernabé-Ortiz, A., León-Velarde, F., Smith, George D., Málaga, Germán, García, Héctor H., Casas, Juan P., Sacksteder, Katherine, Smeeth, Liam, Huicho, Luis, Rivera, María, Gamboa, Raúl, Ebrahim, Shah, Montori, Víctor M., Wise, Robert A., Checkley, William, Diette, Gregory B., Nojilana, Beatrice, Majikela-Dlangamandla, Buyelwa, Sylvester, Carmelita, Malan, Johanna, Murphy, Katherine, Steyn, Krisela, van Niekerk, Lindi, Mash, Robert, Puoane, Thandi, Kim, Grace, Pandya, Ankur, Abrahams-Gessel, Shafika, Rhode, Hilary, Pather, Michael, Andrade, Alvaro R., Garcia, Beatriz, Velasco, Carlos, Medina, David, Bravo, Delia, Munguia, Diana, Bateman, Eric, Castro, Francisco, Schneider, Helen, Ibarra, Ilse, Zulu, Jabulisiwe, Felix, Joel, Tribe, Karla, Bobrow, Kirsten, Fairall, Lara, Folb, Naomi, Murillo, Norma, Pacheco, Norma, Rodriguez, Paloma, Navarro, Paola, Flores, Reyna, Van Zyl Smit, Richard, Meddoza, Rosario, Surka, Sameer, Van Haght, Serena, Hernandez, Yanira, Tsolekile, Lungiswa, Jeridi, Gouider, Harrabi, Imed, Maatoug, Jihen, Boughammoura, Lamia, Chaieb, Larbi, Mrizek, Nejib, Gaha, Rafika, Limam, Khalifa, Amimi, Souad, Gaha, Karima, Gamra, Habib, Al'Absi, Mustafa, Vartiainen, Erkki, Moore, Cornelius, Spillan, Debi, Cooper, Kristiane, Mitchell, Megan, Kirby, Ruth, Gao, Yunling, Aluko, Emmanuel, Sampson, Uchechukwu K., Miranda, Jaime, and Bloomfield, Gerald S.

Published
2016
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18. Rationale and protocol for estimating the economic value of a multicomponent quality improvement strategy for diabetes care in South Asia

Author

Singh, Kavita, Ali, Mohammed K., Devarajan, Raji, Shivashankar, Roopa, Kondal, Dimple, Ajay, Vamadevan S., Menon, V. Usha, Varthakavi, Premlata K., Viswanathan, Vijay, Dharmalingam, Mala, Bantwal, Ganapati, Sahay, Rakesh Kumar, Masood, Muhammad Qamar, Khadgawat, Rajesh, Desai, Ankush, Prabhakaran, Dorairaj, Narayan, K. M. Venkat, Phillips, Victoria L., Tandon, Nikhil, and On behalf of the CARRS Trial Group

Published
2019
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19. Postoperative outcomes in oesophagectomy with trainee involvement

Author

R P, T Evans, K Kamarajah, S, Bundred, J, Nepogodiev, D, Hodson, J, R van Hillegersberg, Gossage, J, Vohra, R, A Griffiths, E, Singh, P, Alderson, D, Jefferies, B, Mckay, S, Mohamed, I, K Siaw- Acheampong, Wanigasooriya, K, Whitehouse, T, Gjata, A, I Moreno, J, R Takeda, F, Kidane, B, R Guevara Castro, Harustiak, T, Bekele, A, Kechagias, A, Gockel, I, Kennedy, A, A Da Roit, Bagajevas, A, S Azagra, J, A Mahendran, H, Mej??a-Fern??ndez, L, B P, L Wijnhoven, J El Kafsi, H Sayyed, R, Sousa, M, S Sampaio, A, Negoi, I, Blanco, R, Wallner, B, M Schneider, P, K Hsu, P, Isik, A, Gananadha, S, Wills, V, Devadas, M, Duong, C, Talbot, M, W Hii, M, Jacobs, R, A Andreollo, N, Johnston, B, Darling, G, Isaza-Restrepo, A, Rosero, G, Arias-Am??zquita, F, Raptis, D, Gaedcke, J, Reim, D, Izbicki, J, H Egberts, J, Dikinis, S, W Kjaer, D, H Larsen, M, P Achiam, M, Saarnio, J, Theodorou, D, Liakakos, T, P Korkolis, D, B Robb, W, Collins, C, Murphy, T, Reynolds, J, Tonini, V, Migliore, M, Bonavina, L, Valmasoni, M, Bardini, R, Weindelmayer, J, Terashima, M, E White, R, Alghunaim, E, Elhadi, M, M Leon-Takahashi, A, Medina-Franco, H, C Lau, P, E Okonta, K, Heisterkamp, J, Rosman, C, Beban, G, Babor, R, Gordon, A, I Rossaak, J, K M, I Pal, U Qureshi, A, A Naqi, S, A Syed, A, Barbosa, J, S Vicente, C, Leite, J, Freire, J, Casaca, R, R C, T Costa, R Scurtu, R, S Mogoanta, S, Bolca, C, Constantinoiu, S, Sekhniaidze, D, Bjelovi??, M, J B, Y So, Ga??evski, G, Loureiro, C, Pera, M, Bianchi, A, M Moreno Gij??n, J Mart??n Fern??ndez, S Trugeda Carrera, M, Vallve-Bernal, M, A C??tores Pascual, M, Elmahi, S, Hedberg, J, M??nig, S, Gutknecht, S, Tez, M, Guner, A, B Tirnaksiz, T, Colak, E, Sevin??, B, Hindmarsh, A, Khan, I, Khoo, D, Byrom, R, Gokhale, J, Wilkerson, P, Jain, P, Chan, D, Robertson, K, Iftikhar, S, Skipworth, R, Forshaw, M, Higgs, S, Nijjar, R, Y K, S Viswanath, Turner, P, Dexter, S, Boddy, A, H Allum, W, Oglesby, S, Cheong, E, Beardsmore, D, Maynard, N, Berrisford, R, Mercer, S, Puig, S, Melhado, R, Kelty, C, Underwood, T, Dawas, K, Lewis, W, Al-Bahrani, A, Bryce, G, Thomas, M, T Arndt, A, Palazzo, F, A Meguid, R, Fergusson, J, Beenen, E, Mosse, C, Salim, J, Cheah, S, Wright, T, P Cerdeira, M, Mcquillan, P, Richardson, M, Liem, H, Spillane, J, Yacob, M, Albadawi, F, Thorpe, T, Dingle, A, Cabalag, C, Loi, K, M Fisher, O, Ward, S, Read, M, Johnson, M, Bassari, R, Bui, H, Cecconello, I, R A, A Sallum, J R, M da Rocha, R Lopes, L, Tercioti, V, J D, S Coelho, J A, P Ferrer, Buduhan, G, Tan, L, Srinathan, S, Shea, P, Yeung, J, Allison, F, Carroll, P, Vargas-Barato, F, Gonzalez, F, Ortega, J, Nino-Torres, L, C Beltr??n-Garc??a, T, Castilla, L, Pineda, M, Bastidas, A, G??mez-Mayorga, J, Cort??s, N, Cetares, C, Caceres, S, Duarte, S, Pazdro, A, Snajdauf, M, Faltova, H, Sevcikova, M, B Mortensen, P, Katballe, N, Ingemann, T, Morten, B, Kruhlikava, I, P Ainswort, A, M Stilling, N, Eckardt, J, Holm, J, Thorsteinsson, M, Siemsen, M, Brandt, B, Nega, B, Teferra, E, Tizazu, A, S Kauppila, J, Koivukangas, V, Meril??inen, S, Gruetzmann, R, Krautz, C, Weber, G, Golcher, H, Emons, G, Azizian, A, Ebeling, M, Niebisch, S, Kreuser, N, Albanese, G, Hesse, J, Volovnik, L, Boecher, U, Reeh, M, Triantafyllou, S, Schizas, D, Michalinos, A, Baili, E, Mpoura, M, Charalabopoulos, A, K Manatakis, D, Balalis, D, Bolger, J, Baban, C, Mastrosimone, A, Mcanena, O, Quinn, A, B ?? S??illeabh??in, C, M Hennessy, M, Ivanovski, I, Khizer, H, Ravi, N, Donlon, N, Cervellera, M, Vaccari, S, Bianchini, S, Sartarelli, L, Asti, E, Bernardi, D, Merigliano, S, Provenzano, L, Scarpa, M, Saadeh, L, Salmaso, B, DE MANZONI, Giovanni, Giacopuzzi, S, R La Mendola, A De Pasqual, C, Tsubosa, Y, Niihara, M, Irino, T, Makuuchi, R, Ishii, K, Mwachiro, M, Fekadu, A, Odera, A, Mwachiro, E, Alshehab, D, A Ahmed, H, O Shebani, A, Elhadi, A, A Elnagar, F, F Elnagar, H, T Makkai-Popa, S, F Wong, L, Yunrong, T, Thanninalai, S, C Aik, H, W Soon, P, J Huei, T, H N, L Basave, Cort??s-Gonz??lez, R, M Lagarde, S, J J, B van Lanschot, Cords, C, A Jansen, W, Martijnse, I, Matthijsen, R, Bouwense, S, Klarenbeek, B, Verstegen, M, F van Workum, P Ruurda, J, A van der Veen, W van den Berg, J, Evenett, N, Johnston, P, Patel, R, Maccormick, A, Young, M, Smith, B, Ekwunife, C, H Memon, A, Shaikh, K, Wajid, A, Khalil, N, Haris, M, U Mirza, Z, S B, A Qudus, Z Sarwar, M, Shehzadi, A, Raza, A, H Jhanzaib, M, Farmanali, J, Zakir, Z, Shakeel, O, Nasir, I, Khattak, S, Baig, M, A Noor, M, H Ahmed, H, Naeem, A, C Pinho, A, R da Silva, Matos, H, Braga, T, Monteiro, C, Ramos, P, Cabral, F, P Gomes, M, C Martins, P, M Correia, A, F Videira, J, Ciuce, C, Drasovean, R, Apostu, R, Paitici, S, E Racu, A, V Obleaga, C, Beuran, M, Stoica, B, Ciubotaru, C, Negoita, V, Cordos, I, D Birla, R, Predescu, D, A Hoara, P, Tomsa, R, Shneider, V, Agasiev, M, Ganjara, I, Gunji??, D, Veselinovi??, M, Babi??, T, S Chin, T, Shabbir, A, Kim, G, Crnjac, A, Samo, H, I D??ez del Val, Leturio, S, M Ram??n, J, M Dal Cero, Rif??, S, Rico, M, A Pagan Pomar, A Martinez Corcoles, J, L Rodicio Miravalles, J, A Pais, S, A Turienzo, S, S Alvarez, L, V Campos, P, G Rendo, A, S Garc??a, S, E P, G Santos, T Mart??nez, E, J Fern??ndez D??az, M, C Magad??n ??lvarez, V Concepci??n Mart??n, C D??az L??pez, A Rosat Rodrigo, E P??rez S??nchez, L, M Bail??n Cuadrado, C Tinoco Carrasco, E Choolani Bhojwani, P S??nchez, D, E Ahmed, M, Dzhendov, T, Lindberg, F, Ruteg??rd, M, Sundbom, M, Mickael, C, Colucci, N, Schnider, A, S, Er, Kurnaz, E, Turkyilmaz, S, Turkyilmaz, A, Yildirim, R, E Baki, B, Akkapulu, N, Karahan, O, Damburaci, N, Hardwick, R, Safranek, P, Sujendran, V, Bennett, J, Afzal, Z, Shrotri, M, Chan, B, Exarchou, K, Gilbert, T, Amalesh, T, Mukherjee, D, Mukherjee, S, H Wiggins, T, Kennedy, R, Mccain, S, Harris, A, Dobson, G, Davies, N, Wilson, I, Mayo, D, Bennett, D, Young, R, Manby, P, Blencowe, N, Schiller, M, Byrne, B, Mitton, D, Wong, V, Elshaer, A, Cowen, M, Menon, V, C Tan, L, Mclaughlin, E, Koshy, R, Sharp, C, Brewer, H, Das, N, Cox, M, W Al Khyatt, Worku, D, Iqbal, R, Walls, L, Mcgregor, R, Fullarton, G, Macdonald, A, Mackay, C, Craig, C, Dwerryhouse, S, Hornby, S, Jaunoo, S, Wadley, M, Baker, C, Saad, M, Kelly, M, Davies, A, F Di Maggio, Mistry, P, Singhal, R, Tucker, O, Kapoulas, S, Powell-Brett, S, Davis, P, Bromley, G, Watson, L, Verma, R, Ward, J, Shetty, V, Ball, C, Pursnani, K, Sarela, A, H Sue Ling, Mehta, S, Hayden, J, N, To, Palser, T, Hunter, D, Supramaniam, K, Butt, Z, Ahmed, A, Kumar, S, Chaudry, A, Moussa, O, Kordzadeh, A, Lorenzi, B, Wilson, M, Patil, P, Noaman, I, Willem, J, Bouras, G, Evans, R, Singh, M, Warrilow, H, Ahmad, A, Tewari, N, Yanni, F, Couch, J, Theophilidou, E, J Reilly, J, G van Boxel, Akbari, K, Zanotti, D, Sgromo, B, Sanders, G, Wheatley, T, Ariyarathenam, A, Reece-Smith, A, Humphreys, L, Choh, C, Carter, N, Knight, B, Pucher, P, Athanasiou, A, Tan, B, Abdulrahman, M, Vickers, J, Akhtar, K, Chaparala, R, Brown, R, M M, A Alasmar, Ackroyd, R, Patel, K, Tamhankar, A, Wyman, A, Walker, R, Grace, B, Abbassi, N, Slim, N, Ioannidi, L, Blackshaw, G, Havard, T, Escofet, X, Powell, A, Owera, A, Rashid, F, Jambulingam, P, Padickakudi, J, Ben-Younes, H, Mccormack, K, A Makey, I, K Karush, M, W Seder, C, J Liptay, M, Chmielewski, G, L Rosato, E, C Berger, A, Zheng, R, Okolo, E, Singh, A, D Scott, C, J Weyant, M, D Mitchell, J, Surgery, Evans, RPT, Hodson, J, Kamarajah, SK, Griffiths, EA, Singh, P, Alderson, D, Bundred, J, Gossage, J, Jefferies, B, McKay, S, Mohamed, I, Nepogodiev, D, Siaw-Acheampong, K, van Hillegersberg, R, Vohra, R, Wanigasooriya, K, Whitehouse, T, Gjata, A, Moreno, JI, Takeda, FR, Kidane, B, Castro, RG, Harustiak, T, Bekele, A, Kechagias, A, Gockel, I, Kennedy, A, Da Roit, A, Bagajevas, A, Azagra, JS, Mahendran, HA, Mejia-Fernandez, L, Wijnhoven, BPL, El Kafsi, J, Sayyed, RH, Sousa, M, Sampaio, AS, Negoi, I, Blanco, R, Wallner, B, Schneider, PM, Hsu, PK, Isik, A, Gananadha, S, Wills, V, Devadas, M, Duong, C, Talbot, M, Hii, MW, Jacobs, R, Andreollo, NA, Johnston, B, Darling, G, Isaza-Restrepo, A, Rosero, G, Arias-Amezquita, F, Raptis, D, Gaedcke, J, Reim, D, Izbicki, J, Egberts, JH, Dikinis, S, Kjaer, DW, Larsen, MH, Achiam, MP, Saarnio, J, Theodorou, D, Liakakos, T, Korkolis, DP, Robb, WB, Collins, C, Murphy, T, Reynolds, J, Tonini, V, Migliore, M, Bonavina, L, Valmasoni, M, Bardini, R, Weindelmayer, J, Terashima, M, White, RE, Alghunaim, E, Elhadi, M, Leon-Takahashi, AM, Medina-Franco, H, Lau, PC, Okonta, KE, Heisterkamp, J, Rosman, C, Beban, G, Babor, R, Gordon, A, Rossaak, JI, Pal, KMI, Qureshi, AU, Naqi, SA, Syed, AA, Barbosa, J, Vicente, CS, Leite, J, Freire, J, Casaca, R, Costa, RCT, Scurtu, RR, Mogoanta, SS, Bolca, C, Constantinoiu, S, Sekhniaidze, D, So, JBY, Gacvski, G, Loureiro, C, Pera, M, Bianchi, A, Gijon, MM, Fernandez, JM, Carrera, MST, Vallve-Bernal, M, Pascual, MAC, Elmahi, S, Halldestam, I, Hedberg, J, Monig, S, Gutknecht, S, Tez, M, Guner, A, Tirnaksiz, TB, Colak, E, Sevinc, B, Hindmarsh, A, Khan, I, Khoo, D, Byrom, R, Gokhale, J, Wilkerson, P, Jain, P, Chan, D, Robertson, K, Iftikhar, S, Skipworth, R, Forshaw, M, Higgs, S, Nijjar, R, Viswanath, YKS, Turner, P, Dexter, S, Boddy, A, Allum, WH, Oglesby, S, Cheong, E, Beardsmore, D, Maynard, N, Berrisford, R, Mercer, S, Puig, S, Melhado, R, Kelty, C, Underwood, T, Dawas, K, Lewis, W, Al-Bahrani, A, Bryce, G, Thomas, M, Arndt, AT, Palazzo, F, Meguid, RA, Fergusson, J, Beenen, E, Mosse, C, Salim, J, Cheah, S, Wright, T, Cerdeira, MP, McQuillan, P, Richardson, M, Liem, H, Spillane, J, Yacob, M, Albadawi, F, Thorpe, T, Dingle, A, Cabalag, C, Loi, K, Fisher, OM, Ward, S, Read, M, Johnson, M, Bassari, R, Bui, H, Cecconello, I, Sallum, RAA, da Rocha, JRM, Lopes, LR, Tercioti, V, Coelho, JDS, Ferrer, JAP, Buduhan, G, Tan, L, Srinathan, S, Shea, P, Yeung, J, Allison, F, Carroll, P, Vargas-Barato, F, Gonzalez, F, Ortega, J, Nino-Torres, L, Beltran-Garcia, TC, Castilla, L, Pineda, M, Bastidas, A, Gomez-Mayorga, J, Cortes, N, Cetares, C, Caceres, S, Duarte, S, Pazdro, A, Snajdauf, M, Faltova, H, Sevcikova, M, Mortensen, PB, Katballe, N, Ingemann, T, Morten, B, Kruhlikava, I, Ainswort, AP, Stilling, NM, Eckardt, J, Holm, J, Thorsteinsson, M, Siemsen, M, Brandt, B, Nega, B, Teferra, E, Tizazu, A, Kauppila, JS, Koivukangas, V, Merilainen, S, Gruetzmann, R, Krautz, C, Weber, G, Golcher, H, Emons, G, Azizian, A, Ebeling, M, Niebisch, S, Kreuser, N, Albanese, G, Hesse, J, Volovnik, L, Boecher, U, Reeh, M, Triantafyllou, S, Schizas, D, Michalinos, A, Baili, E, Mpoura, M, Charalabopoulos, A, Manatakis, DK, Balalis, D, Bolger, J, Baban, C, Mastrosimone, A, McAnena, O, Quinn, A, Suilleabhain, CBO, Hennessy, MM, Ivanovski, I, Khizer, H, Ravi, N, Donlon, N, Cervellera, M, Vaccari, S, Bianchini, S, Sartarelli, L, Asti, E, Bernardi, D, Merigliano, S, Provenzano, L, Scarpa, M, Saadeh, L, Salmaso, B, De Manzoni, G, Giacopuzzi, S, La Mendola, R, De Pasqual, CA, Tsubosa, Y, Niihara, M, Irino, T, Makuuchi, R, Ishii, K, Mwachiro, M, Fekadu, A, Odera, A, Mwachiro, E, AlShehab, D, Ahmed, HA, Shebani, AO, Elhadi, A, Elnagar, FA, Elnagar, HF, Makkai-Popa, ST, Wong, LF, Yunrong, T, Thanninalai, S, Aik, HC, Soon, PW, Huei, TJ, Basave, HNL, Cortes-Gonzalez, R, Lagarde, SM, van Lanschot, JJB, Cords, C, Jansen, WA, Martijnse, I, Matthijsen, R, Bouwense, S, Klarenbeek, B, Verstegen, M, van Workum, F, Ruurda, JP, van der Veen, A, van den Berg, JW, Evenett, N, Johnston, P, Patel, R, MacCormick, A, Young, M, Smith, B, Ekwunife, C, Memon, AH, Shaikh, K, Wajid, A, Khalil, N, Haris, M, Mirza, ZU, Qudus, SBA, Sarwar, MZ, Shehzadi, A, Raza, A, Jhanzaib, MH, Farmanali, J, Zakir, Z, Shakeel, O, Nasir, I, Khattak, S, Baig, M, Noor, MA, Ahmed, HH, Naeem, A, Pinho, AC, da Silva, R, Bernardes, A, Campos, JC, Matos, H, Braga, T, Monteiro, C, Ramos, P, Cabral, F, Gomes, MP, Martins, PC, Correia, AM, Videira, JF, Ciuce, C, Drasovean, R, Apostu, R, Paitici, S, Racu, AE, Obleaga, CV, Beuran, M, Stoica, B, Ciubotaru, C, Negoita, V, Cordos, I, Birla, RD, Predescu, D, Hoara, PA, Tomsa, R, Shneider, V, Agasiev, M, Ganjara, I, Gunjic, D, Veselinovic, M, Babic, T, Chin, TS, Shabbir, A, Kim, G, Crnjac, A, Samo, H, del Val, ID, Leturio, S, Ramon, JM, Dal Cero, M, Rifa, S, Rico, M, Pomar, AP, Corcoles, JAM, Miravalles, JLR, Pais, SA, Turienzo, SA, Alvarez, LS, Campos, PV, Rendo, AG, Garcia, SS, Santos, EPG, Martinez, ET, Diaz, MJF, Alvarez, CM, Martin, VC, Lopez, CD, Rodrigo, AR, Sanchez, LEP, Cuadrado, MB, Carrasco, CT, Bhojwani, EC, Sanchez, DP, Ahmed, ME, Dzhendov, T, Lindberg, F, Rutegard, M, Sundbom, M, Mickael, C, Colucci, N, Schnider, A, Er, S, Kurnaz, E, Turkyilmaz, S, Turkyilmaz, A, Yildirim, R, Baki, BE, Akkapulu, N, Karahan, O, Damburaci, N, Hardwick, R, Safranek, P, Sujendran, V, Bennett, J, Afzal, Z, Shrotri, M, Chan, B, Exarchou, K, Gilbert, T, Amalesh, T, Mukherjee, D, Mukherjee, S, Wiggins, TH, Kennedy, R, McCain, S, Harris, A, Dobson, G, Davies, N, Wilson, I, Mayo, D, Bennett, D, Young, R, Manby, P, Blencowe, N, Schiller, M, Byrne, B, Mitton, D, Wong, V, Elshaer, A, Cowen, M, Menon, V, Tan, LC, McLaughlin, E, Koshy, R, Sharp, C, Brewer, H, Das, N, Cox, M, Al Khyatt, W, Worku, D, Iqbal, R, Walls, L, McGregor, R, Fullarton, G, Macdonald, A, MacKay, C, Craig, C, Dwerryhouse, S, Hornby, S, Jaunoo, S, Wadley, M, Baker, C, Saad, M, Kelly, M, Davies, A, Di Maggio, F, Mistry, P, Singhal, R, Tucker, O, Kapoulas, S, Powell-Brett, S, Davis, P, Bromley, G, Watson, L, Verma, R, Ward, J, Shetty, V, Ball, C, Pursnani, K, Sarela, A, Ling, HS, Mehta, S, Hayden, J, To, N, Palser, T, Hunter, D, Supramaniam, K, Butt, Z, Ahmed, A, Kumar, S, Chaudry, A, Moussa, O, Kordzadeh, A, Patil, P, Noaman, I, Willem, J, Bouras, G, Evans, R, Singh, M, Warrilow, H, Ahmad, A, Tewari, N, Yanni, F, Couch, J, Theophilidou, E, Reilly, JJ, van Boxel, G, Akbari, K, Zanotti, D, Sgromo, B, Sanders, G, Wheatley, T, Ariyarathenam, A, Reece-Smith, A, Humphreys, L, Choh, C, Carter, N, Knight, B, Pucher, P, Athanasiou, A, Tan, B, Abdulrahman, M, Vickers, J, Akhtar, K, Chaparala, R, Brown, R, Alasmar, MMA, Ackroyd, R, Patel, K, Tamhankar, A, Wyman, A, Walker, R, Grace, B, Abbassi, N, Slim, N, Ioannidi, L, Blackshaw, G, Havard, T, Escofet, X, Powell, A, Owera, A, Rashid, F, Jambulingam, P, Padickakudi, J, Ben-Younes, H, McCormack, K, Makey, IA, Karush, MK, Seder, CW, Liptay, MJ, Chmielewski, G, Rosato, EL, Berger, AC, Zheng, R, Okolo, E, Singh, A, Scott, CD, Weyant, MJ, and Mitchell, JD

Subjects
squamous cell carcinoma, surgical mortality, AcademicSubjects/MED00910, Esophageal Neoplasms, SURGERY, IMPACT, clinical outcome, Anastomotic Leak, Adult, aged, anastomosis leakage, article, cancer staging, cardiovascular disease assessment, Charlson Comorbidity Index, cohort analysis, ECOG Performance Status, esophagectomy, esophagus cancer, female, follow up, histology, human, intensive care unit, length of stay, major clinical study, male, middle aged, mortality, necrosis, neoadjuvant chemoradiotherapy, neoadjuvant chemotherapy, observational study, postoperative complication, postoperative period, reoperation, surgical technique, Cohort Studies, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Surgical, Anastomosis, Surgical, General Medicine, Original Article, AcademicSubjects/MED00010, Life Sciences & Biomedicine, Anastomosis, SOCIETY, Bjs/5, trainee, oesophagectomy, trainee, Humans, Esophagectomy, All institutes and research themes of the Radboud University Medical Center, SDG 3 - Good Health and Well-being, RESIDENT INVOLVEMENT, Science & Technology, SURGICAL OUTCOMES
Abstract

Background The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. Methods Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. Results Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). Conclusion Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery., The aim of this study was to determine the impact of trainee involvement in oesophagectomy on perioperative outcomes in the international multicentre Oesophago-Gastric Anastomosis Audit (OGAA). Analysis of 2232 oesophagectomies has shown that trainee involvement did not negatively impact perioperative outcomes.

Published
2022
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20. Cost‐effectiveness of a multicomponent quality improvement care model for diabetes in South Asia: The CARRS randomized clinical trial.

Author

Singh, Kavita, Kondal, Dimple, Menon, V. Usha, Varthakavi, Premlata K., Viswanathan, Vijay, Dharmalingam, Mala, Bantwal, Ganapati, Sahay, Rakesh Kumar, Masood, Muhammad Qamar, Khadgawat, Rajesh, Desai, Ankush, Prabhakaran, Dorairaj, Narayan, K. M. Venkat, Phillips, Victoria L., Tandon, Nikhil, and Ali, Mohammed K.

Subjects
GLYCOSYLATED hemoglobin, SYSTOLIC blood pressure, MEDICAL care costs, CLINICS, LDL cholesterol, UNCERTAINTY, TYPE 2 diabetes, DECISION support systems, RISK assessment, PATIENTS' attitudes, COST effectiveness, QUALITY assurance, COMBINED modality therapy, METROPOLITAN areas, ELECTRONIC health records, QUALITY-adjusted life years, PROBABILITY theory
Abstract

Objectives: To assess the cost‐effectiveness of a multicomponent strategy versus usual care in people with type 2 diabetes in South Asia. Design: Economic evaluation from healthcare system and societal perspectives. Setting: Ten diverse urban clinics in India and Pakistan. Participants: 1146 people with type 2 diabetes (575 in the intervention group and 571 in the usual care group) with mean age of 54.2 years, median diabetes duration: 7 years and mean HbA1c: 9.9% (85 mmol/mol) at baseline. Intervention: Multicomponent strategy comprising decision‐supported electronic health records and non‐physician care coordinator. Control group received usual care. Outcome Measures: Incremental cost‐effectiveness ratios (ICERs) per unit achievement in multiple risk factor control (HbA1c <7% (53 mmol/mol) and SBP <130/80 mmHg or LDLc <2.58 mmol/L (100 mg/dL)), ICERs per unit reduction in HbA1c, 5‐mmHg unit reductions in systolic BP, 10‐unit reductions in LDLc (mg/dl) (considered as clinically relevant) and ICER per quality‐adjusted life years (QALYs) gained. ICERs were reported in 2020 purchasing power parity–adjusted international dollars (INT$). The probability of ICERs being cost‐effective was considered depending on the willingness to pay (WTP) values as a share of GDP per capita for India (Int$ 7041.4) and Pakistan (Int$ 4847.6). Results: Compared to usual care, the annual incremental costs per person for intervention group were Int$ 1061.9 from a health system perspective and Int$ 1093.6 from a societal perspective. The ICER was Int$ 10,874.6 per increase in multiple risk factor control, $2588.1 per one percentage point reduction in the HbA1c, and $1744.6 per 5 unit reduction in SBP (mmHg), and $1271 per 10 unit reduction in LDLc (mg/dl). The ICER per QALY gained was $33,399.6 from a societal perspective. Conclusions: In a trial setting in South Asia, a multicomponent strategy for diabetes care resulted in better multiple risk factor control at higher costs and may be cost‐effective depending on the willingness to pay threshold with substantial uncertainty around cost‐effectiveness for QALYs gained in the short term (2.5 years). Future research needs to confirm the long‐term cost‐effectiveness of intensive multifactorial intervention for diabetes care in diverse healthcare settings in LMICs. [ABSTRACT FROM AUTHOR]

Published
2023
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22. Should there be greater exposure to interventional radiology in the undergraduate curriculum? Medical students’ perspectives

Author

Nichani S and Menon V

Subjects
interventional radiology, medical school, undergraduate, medical students, curriculum, exposure, Special aspects of education, LC8-6691, Medicine (General), R5-920
Abstract

Sahil Nichani,1 Vishnu Menon2 1Barts and the London School of Medicine and Dentistry, London, UK; 2Bristol Medical School, University of Bristol, Bristol, UK We read with great interest the article by Ojha et al1 highlighting the lack of exposure of medical students to interventional radiology (IR). As senior clinical medical students, we would like to offer our perspective on this issue and propose some additional strategies. View the original paper by Ojha and colleagues.

Published
2018

24. Power of a Finite Speed Carnot Engine

Author

Agrawal, D. C. and Menon, V. J.

Abstract

A model of an endoreversible Carnot engine is considered where the piston moves with a constant speed "u." Expressions for the cycle time [tau] for the four branches, as well as output power, P[subscript W], are derived and the optimized root for maximum power is obtained in closed form. Our results are discussed in terms of the isothermal expansion ratio V[subscript 2]* and temperature ratio "a" in a manner accessible to students. (Contains 4 figures.)

Published
2009
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26. Vitamin D levels as an important predictor for T2DM and weight regain post-sleeve gastrectomy

Author

Aladel, Alanoud, Murphy, A. M., Abraham, J., Shah, N., Barber, Thomas M., Ball, G., Menon, V., Piya, M. K., and McTernan, P. G.

Subjects
RC
Abstract

Weight Loss Surgery (WLS), including sleeve-gastrectomy (SG), results in significant weight loss and improved metabolic health in severe obesity (BMI ≥ 35 kg/m2). Previous studies suggest post-operative health benefits are impacted by nutrient deficiencies, such as Vitamin D (25(OH)D) deficiency, while it is currently unknown whether nutrient levels may actually predict post-surgery outcomes. As such, this study investigated whether 25(OH)D levels could predict metabolic improvements in patients who underwent SG. Patients with severe obesity (n = 309; 75% female) undergoing SG participated in this ethics-approved, non-randomized retrospective cohort study. Anthropometry, clinical data, 25(OH)D levels and serum markers were collected at baseline, 6-, 12- and 18-months post-surgery. SG surgery resulted in significant improvements in metabolic health at 6- and 12-months post-surgery compared with baseline, as expected. Patients with higher baseline 25(OH)D had significantly lower HbA1c levels post-surgery (p < 0.01) and better post-surgical T2DM outcomes, including reduced weight regain (p < 0.05). Further analysis revealed that baseline 25(OH)D could predict HbA1c levels, weight regain and T2DM remission one-year post-surgery, accounting for 7.5% of HbA1c divergence (p < 0.01). These data highlight that higher circulating 25(OH)D levels are associated with significant metabolic health improvements post-surgery, notably, that such baseline levels are able to predict those who attain T2DM remission. This highlights the importance of 25(OH)D as a predictive biomarker of post-surgery benefits.

Published
2022

27. Closing the pandemic-related surgical training gap using cadaveric simulation.

Author

James, HK, Langley, C, Menon, V, Sankar, S, and Robertson, S

Subjects
COVID-19 pandemic, VASCULAR surgery, TEACHING hospitals, OPERATIVE surgery, CRITICAL care medicine
Abstract

Introduction: Surgical training has been greatly hampered by the COVID-19 pandemic. We designed an intensive cadaveric simulation "catch-up" course to be delivered to trainees in several surgical specialties in a single sitting. Our aims were to measure the training gap brought about by the pandemic, and to assess the feasibility and educational impact of a catch-up simulation training course using a single set of cadavers over three days. Methods: Twenty-six trainees (at grades CT1 to ST6 and from 6 surgical specialties as well as anaesthetics/intensive care) in a large teaching hospital were recruited. Bespoke learning objectives were developed before the course. The training gap and educational impact were measured using trainee self-assessment of their procedure-based assessment (PBA) levels in a survey after the course. Results: Twenty-nine different surgical procedures were performed. A mean training gap of 1.36 PBA levels was reported across all specialties (range: 1–3). The gap was greatest for index procedures, vascular surgery trainees and trainees at grade ST3/ST4. The mean PBA level gain (gap closure) after the course was +1.51 (range: 0–5). The gain was highest for index procedures, anaesthetic trainees and ST3/ST4 trainees. Participants were highly satisfied with the course. Conclusions: There is a measurable training gap following COVID-19 disruption to surgical training and intensive cadaveric simulation training with bespoke learning objectives appears to go a long way towards closing this gap. It is feasible to deliver a time and resource efficient cadaveric course for multiple surgical specialties in one sitting. Catch-up simulation is acceptable to trainees, who report that it should be embedded in regular training provision. [ABSTRACT FROM AUTHOR]

Published
2023
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28. Laboratory and Imaging Profile of Primary Hyperparathyroidism: A Record Based Retrospective Study.

Author

MANJUNATH, P. R., NARAYANAN, PREM, PAVITHRAN, PRAVEEN V., BHAVANI, NISHA, KUMAR, HARISH, NAIR, VASANTHA, MENON, V. USHA, and ABRAHAM, NITHYA

Subjects
HYPERPARATHYROIDISM, MEDICAL sciences, HYPOPARATHYROIDISM, WESTERN countries, RETROSPECTIVE studies, HOSPITAL records
Abstract

Introduction: Primary Hyperparathyroidism (PHPT) is an uncommonly diagnosed symptomatic disease that occurs in India. Unlike the Western countries where the disease is asymptomatic, the various manifestations that occur are skeletal, muscular, and renal. Studies on PHPT from developing countries like India, have shown that symptomatic PHPT is still common as compared to developed countries. Data on PHPT from Kerala (a state with health indices comparable to the Western world) are lacking. Aim: To compare the preoperative and postoperative calcium and Parathyroid Hormone (PTH) levels among the participants. Materials and Methods: A record-based retrospective study was conducted at Amrita Institute of Medical Sciences, Cochin, in the Department of Endocrinology. All 116 patients who had PHPT from January 2013 to December 2019 were included in the study. The data available in the hospital records were analysed for various laboratory values and imaging diagnoses. The preoperative and postoperative calcium and PTH levels were compared. Data were analysed by paired sample t-test. (Wilcoxon sign-rank test). The data analysis was done using coGuide. Results: The mean age was 53.42±14.89 years in the study population. Among 116 subjects, (46 (39.66%) were males and 70 (60.34%) were females) eighty-three (71.55%) had the symptomatic disease. The majority, 80 (68.97%) participants underwent single parathyroidectomy. The difference between pre-operative and post-operative calcium and PTH was statistically significant (p-value <0.001). Conclusion: PHPT largely occurs in the fifth decade of life, and the majority were symptomatic. Females were more affected compared to males in the present study. Preoperative imaging is recommended in routine practice. [ABSTRACT FROM AUTHOR]

Published
2023
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30. Textbook outcome following oesophagectomy for cancer: international cohort study

Author

Kamarajah, S. K., Evans, R. P. T., Nepogodiev, D., Hodson, J., Bundred, J. R., Gockel, I., Gossage, J. A., Isik, A., Kidane, B., Mahendran, H. A., Negoi, I., Okonta, K. E., Sayyed, R., van Hillegersberg, R., Vohra, R. S., Wijnhoven, B. P. L., Singh, P., Griffiths, E. A., Alderson, D., Bundred, J., Gossage, J., Jefferies, B., Mckay, S., Mohamed, I., Siaw-Acheampong, K., Vohra, R., Wanigasooriya, K., Whitehouse, T., Gjata, A., Moreno, J. I., Takeda, F. R., Guevara Castro, R., Harustiak, T., Bekele, A., Kechagias, A., Kennedy, A., Da Roit, A., Bagajevas, A., Azagra, J. S., Mej??a-Fern??ndez, L., El Kafsi, J., Sayyed, R. H., Sousa M, M., Sampaio, A. S., Blanco, R., Wallner, B., Schneider, P. M., Hsu, P. K., Gananadha, S., Wills, V., Devadas, M., Duong, C., Talbot, M., Hii, M. W., Jacobs, R., Andreollo, N. A., Johnston, B., Darling, G., Isaza-Restrepo, A., Rosero, G., Arias-Am??zquita, F., Raptis, D., Gaedcke, J., Reim, D., Izbicki, J., Egberts, J. H., Dikinis, S., Kjaer, D. W., Larsen, M. H., Achiam, M. P., Saarnio, J., Theodorou, D., Liakakos, T., Korkolis, D. P., Robb, W. B., Collins, C., Murphy, T., Reynolds, J., Tonini, V., Migliore, M., Bonavina, L., Valmasoni, M., Bardini, R., Weindelmayer, J., Terashima, M., White, R. E., Alghunaim, E., Elhadi, M., Leon-Takahashi, A. M., Medina-Franco, H., Lau, P. C., Heisterkamp, J., Rosman, C., Beban, G., Babor, R., Gordon, A., Rossaak, J. I., Pal, K. M. I., Qureshi, A. U., Naqi, S. A., Syed, A. A., Barbosa, J., Vicente, C. S., Leite, J., Freire, J., Casaca, R., Costa, R. C. T., Scurtu, R. R., Mogoanta, S. S., Bolca, C., Constantinoiu, S., Sekhniaidze, D., Bjelovi??, M., J. B. Y., So, Ga??evski, G., Loureiro, C., Pera, M., Bianchi, A., Moreno Gij??n, M., Fern??ndez, J. Mart??n., Trugeda Carrera, M. S., Vallve-Bernal, M., C??tores Pascual, M. A., Elmahi, S., Halldestam, I., Hedberg, J., M??nig, S., Gutknecht, S., Tez, M., Guner, A., Tirnaksiz, M. B., Colak, E., Sevin??, B., Hindmarsh, A., Khan, I., Khoo, D., Byrom, R., Gokhale, J., Wilkerson, P., Jain, P., Chan, D., Robertson, K., Iftikhar, S., Skipworth, R., Forshaw, M., Higgs, S., Nijjar, R., Viswanath, Y. K. S., Turner, P., Dexter, S., Boddy, A., Allum, W. H., Oglesby, S., Cheong, E., Beardsmore, D., Maynard, N., Berrisford, R., Mercer, S., Puig, S., Melhado, R., Kelty, C., Underwood, T., Dawas, K., Lewis, W., Bryce, G., Thomas, M., Arndt, A. T., Palazzo, F., Meguid, R. A., Fergusson, J., Beenen, E., Mosse, C., Salim, J., Cheah, S., Wright, T., Cerdeira, M. P., Mcquillan, P., Richardson, M., Liem, H., Spillane, J., Yacob, M., Albadawi, F., Thorpe, T., Dingle, A., Cabalag, C., Loi, K., Fisher, O. M., Ward, S., Read, M., Johnson, M., Bassari, R., Bui, H., Cecconello, I., Sallum, R. A. A., da Rocha, J. R. M., Lopes, L. R., Tercioti Jr, V., Coelho, J. D. S., Ferrer, J. A. P., Buduhan, G., Tan, L., Srinathan, S., Shea, P., Yeung, J., Allison, F., Carroll, P., Vargas-Barato, F., Gonzalez, F., Ortega, J., Nino-Torres, L., Beltr??n-Garc??a, T. C., Castilla, L., Pineda, M., Bastidas, A., G??mez-Mayorga, J., Cort??s, N., Cetares, C., Caceres, S., Duarte, S., Pazdro, A., Snajdauf, M., Faltova, H., Sevcikova, M., Mortensen, P. B., Katballe, N., Ingemann, T., Morten, B., Kruhlikava, I., Ainswort, A. P., Stilling, N. M., Eckardt, J., Holm, J., Thorsteinsson, M., Siemsen, M., Brandt, B., Nega, B., Teferra, E., Tizazu, A., Kauppila, J. H., Koivukangas, V., Meril??inen, S., Gruetzmann, R., Krautz, C., Weber, G., Golcher, H., Emons, G., Azizian, A., Ebeling, M., Niebisch, S., Kreuser, N., Albanese, G., Hesse, J., Volovnik, L., Boecher, U., Reeh, M., Triantafyllou, S., Schizas, D., Michalinos, A., Balli, E., Mpoura, M., Charalabopoulos, A., Manatakis, D. K., Balalis, D., Bolger, J., Baban, C., Mastrosimone, A., Mcanena, O., Quinn, A., S??illeabh??in, C. B., Hennessy, M. M., Ivanovski, I., Khizer, H., Ravi, N., Donlon, N., Cervellera, M., Vaccari, S., Bianchini, S., Asti, E., Bernardi, D., Merigliano, S., Provenzano, L., Scarpa, M., Saadeh, L., Salmaso, B., De Manzoni, G., Giacopuzzi, S., La Mendola, R., De Pasqual, C. A., Tsubosa, Y., Niihara, M., Irino, T., Makuuchi, R., Ishii K, K., Mwachiro, M., Fekadu, A., Odera, A., Mwachiro, E., Alshehab, D., Ahmed, H. A., Shebani, A. O., Elhadi, A., Elnagar, F. A., Elnagar, H. F., Makkai-Popa, S. T., Wong, L. F., Tan, Y. R., Thannimalai, S., C. A., Ho, Pang, W. S., Tan, J. H., Basave, H. N. L., Cort??s-Gonz??lez, R., Lagarde, S. M., van Lanschot, J. J. B., Cords, C., Jansen, W. A., Martijnse, I., Matthijsen, R., Bouwense, S., Klarenbeek, B., Verstegen, M., van Workum, F., Ruurda, J. P., van der Sluis, P. C., de Maat, M., Evenett, N., Johnston, P., Patel, R., Maccormick, A., Smith, B., Ekwunife, C., Memon, A. H., Shaikh, K., Wajid, A., Khalil, N., Haris, M., Mirza, Z. U., Qudus, S. B. A., Sarwar, M. Z., Shehzadi, A., Raza, A., Jhanzaib, M. H., Farmanali, J., Zakir, Z., Shakeel, O., Nasir, I., Khattak, S., Baig, M., Noor, M. A., Ahmed, H. H., Naeem, A., Pinho, A. C., da Silva, R., Bernardes, A., Campos, J. C., Matos, H., Braga, T., Monteiro, C., Ramos, P., Cabral, F., Gomes, M. P., Martins, P. C., Correia, A. M., Videira, J. F., Ciuce, C., Drasovean, R., Apostu, R., Paitici, S., Racu, A. E., Obleaga, C. V., Beuran, M., Stoica, B., Ciubotaru, C., Negoita, V., Cordos, I., Birla, R. D., Predescu, D., Hoara, P. A., Tomsa, R., Shneider, V., Agasiev, M., Ganjara, I., Gunji??, D., Veselinovi??, M., Babi??, T., Chin, T. S., Shabbir, A., Kim, G., Crnjac, A., Samo, H., D??ez del Val, I., Leturio, S., Ram??n, J. M., Dal Cero, M., Rif??, S., Rico, M., Pagan Pomar, A., Martinez Corcoles, J. A., Rodicio Miravalles, J. L., Pais, S. A., Turienzo, S. A., Alvarez, L. S., Campos, P. V., Rendo, A. G., Garc??a, S. S., Santos, E. P. G., Mart??nez, E. T., Fern??ndez D??az, M. J., lvarez, C. Magad??n., Mart??n, V. Concepci??n., D??az L??pez, C., Rosat Rodrigo, A., P??rez S??nchez, L. E., Cuadrado, M. Bail??n., Tinoco Carrasco, C., Choolani Bhojwani, E., S??nchez, D. P., Ahmed, M. E., Dzhendov, T., Lindberg, F., Ruteg??rd, M., Sundbom, M., Mickael, C., Colucci, N., Schnider, A., Er, S., Kurnaz, E., Turkyilmaz, S., Turkyilmaz, A., Yildirim, R., Baki, B. E., Akkapulu, N., Karahan, O., Damburaci, N., Hardwick, R., Safranek, P., Sujendran, V., Bennett, J., Afzal, Z., Shrotri, M., Chan, B., Exarchou, K., Gilbert, T., Amalesh, T., Mukherjee, D., Mukherjee, S., Wiggins, T. H., Kennedy, R., Mccain, S., Harris, A., Dobson, G., Davies, N., Wilson, I., Mayo, D., Bennett, D., Young, R., Manby, P., Blencowe, N., Schiller, M., Byrne, B., Mitton, D., Wong, V., Elshaer, A., Cowen, M., Menon, V., Tan, L. C., Mclaughlin, E., Koshy, R., Sharp, C., Brewer, H., Das, N., Cox, M., Al Khyatt, W., Worku, D., Iqbal, R., Walls, L., Mcgregor, R., Fullarton, G., Macdonald, A., Mackay, C., Craig, C., Dwerryhouse, S., Hornby, S., Jaunoo, S., Wadley, M., Baker, C., Saad, M., Kelly, M., Davies, A., Di Maggio, F., Mistry, P., Singhal, R., Tucker, O., Kapoulas, S., Powell-Brett, S., Davis, P., Bromley, G., Watson, L., Verma, R., Ward, J., Shetty, V., Ball, C., Pursnani, K., Sarela, A., Sue Ling, H., Mehta, S., Hayden, J., To, N., Palser, T., Hunter, D., Supramaniam, K., Butt, Z., Ahmed, A., Kumar, S., Chaudry, A., Moussa, O., Kordzadeh, A., Lorenzi, B., Wilson, M., Patil, P., Noaman, I., Bouras, G., Evans, R., Singh, M., Warrilow, H., Ahmad, A., Tewari, N., Yanni, F., Couch, J., Theophilidou, E., Reilly, J. J., van Boxel, G., Akbari, K., Zanotti, D., Sanders, G., Wheatley, T., Ariyarathenam, A., Reece-Smith, A., Humphreys, L., Choh, C., Carter, N., Knight, B., Pucher, P., Athanasiou, A., Tan, B., Abdulrahman, M., Vickers, J., Akhtar, K., Chaparala, R., Brown, R., Alasmar, M. M. A., Ackroyd, R., Patel, K., Tamhankar, A., Wyman, A., Walker, R., Grace, B., Abbassi, N., Slim, N., Ioannidi, L., Blackshaw, G., Havard, T., Escofet, X., Powell, A., Owera, A., Rashid, F., Jambulingam, P., Padickakudi, J., Ben-Younes, H., Mccormack, K., Makey, I. A., Karush, M. K., Seder, C. W., Liptay, M. J., Chmielewski, G., Rosato, E. L., Berger, A. C., Zheng, R., Okolo, E., Singh, A., Scott, C. D., Weyant, M. J., Mitchell, J. D., and Surgery

Subjects
Male, Textbook, MINIMALLY INVASIVE ESOPHAGECTOMY, Minimally Invasive Surgical Procedures/methods, Esophageal Neoplasms, SURGERY, Anastomosis, LYMPH-NODE RETRIEVAL, Anastomosis, Surgical, education, Anastomosis, Surgical/adverse effects, Esophageal Neoplasms/pathology, Esophagectomy/methods, Cohort Studies, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Treatment Outcome, SDG 3 - Good Health and Well-being, Humans, Minimally Invasive Surgical Procedures, Esophagectomy, Surgical, esophagectomy, Surgery, Textbook, esophagectomy, esophageal cancer, esophageal cancer
Abstract

Background Textbook outcome has been proposed as a tool for the assessment of oncological surgical care. However, an international assessment in patients undergoing oesophagectomy for oesophageal cancer has not been reported. This study aimed to assess textbook outcome in an international setting. Methods Patients undergoing curative resection for oesophageal cancer were identified from the international Oesophagogastric Anastomosis Audit (OGAA) from April 2018 to December 2018. Textbook outcome was defined as the percentage of patients who underwent a complete tumour resection with at least 15 lymph nodes in the resected specimen and an uneventful postoperative course, without hospital readmission. A multivariable binary logistic regression model was used to identify factors independently associated with textbook outcome, and results are presented as odds ratio (OR) and 95 per cent confidence intervals (95 per cent c.i.). Results Of 2159 patients with oesophageal cancer, 39.7 per cent achieved a textbook outcome. The outcome parameter ‘no major postoperative complication’ had the greatest negative impact on a textbook outcome for patients with oesophageal cancer, compared to other textbook outcome parameters. Multivariable analysis identified male gender and increasing Charlson comorbidity index with a significantly lower likelihood of textbook outcome. Presence of 24-hour on-call rota for oesophageal surgeons (OR 2.05, 95 per cent c.i. 1.30 to 3.22; P = 0.002) and radiology (OR 1.54, 95 per cent c.i. 1.05 to 2.24; P = 0.027), total minimally invasive oesophagectomies (OR 1.63, 95 per cent c.i. 1.27 to 2.08; P < 0.001), and chest anastomosis above azygous (OR 2.17, 95 per cent c.i. 1.58 to 2.98; P < 0.001) were independently associated with a significantly increased likelihood of textbook outcome. Conclusion Textbook outcome is achieved in less than 40 per cent of patients having oesophagectomy for cancer. Improvements in centralization, hospital resources, access to minimal access surgery, and adoption of newer techniques for improving lymph node yield could improve textbook outcome.

Published
2022
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31. Cell environment shapes TDP-43 function with implications in neuronal and muscle disease

Author

Šušnjar, U. Škrabar, N. Brown, A.-L. Abbassi, Y. Phatnani, H. Phatnani, H. Fratta, P. Kwan, J. Sareen, D. Broach, J.R. Simmons, Z. Arcila-Londono, X. Lee, E.B. Van Deerlin, V.M. Shneider, N.A. Fraenkel, E. Ostrow, L.W. Baas, F. Berry, J.D. Butovsky, O. Baloh, R.H. Shalem, O. Heiman-Patterson, T. Stefanis, L. Chandran, S. Pal, S. Smith, C. Malaspina, A. Hammell, M.G. Patsopoulos, N.A. Dubnau, J. Poss, M. Zhang, B. Zaitlen, N. Hornstein, E. Miller, T.M. Dardiotis, E. Bowser, R. Menon, V. Harms, M. Atassi, N. Lange, D.J. MacGowan, D.J. McMillan, C. Aronica, E. Harris, B. Ravits, J. Crary, J. Thompson, L.M. Raj, T. Paganoni, S. Adams, D.J. Babu, S. Drory, V. Gotkine, M. Broce, I. Phillips-Cremins, J. Nath, A. Finkbeiner, S. Cox, G.A. Cortese, A. Cereda, C. Bugiardini, E. Cardani, R. Meola, G. Ripolone, M. Moggio, M. Romano, M. Secrier, M. Fratta, P. Buratti, E. NYGC ALS Consortium

Subjects
mental disorders, nutritional and metabolic diseases, nervous system diseases
Abstract

TDP-43 (TAR DNA-binding protein 43) aggregation and redistribution are recognised as a hallmark of amyotrophic lateral sclerosis and frontotemporal dementia. As TDP-43 inclusions have recently been described in the muscle of inclusion body myositis patients, this highlights the need to understand the role of TDP-43 beyond the central nervous system. Using RNA-seq, we directly compare TDP-43-mediated RNA processing in muscle (C2C12) and neuronal (NSC34) mouse cells. TDP-43 displays a cell-type-characteristic behaviour targeting unique transcripts in each cell-type, which is due to characteristic expression of RNA-binding proteins, that influence TDP-43’s performance and define cell-type specific splicing. Among splicing events commonly dysregulated in both cell lines, we identify some that are TDP-43-dependent also in human cells. Inclusion levels of these alternative exons are altered in tissues of patients suffering from FTLD and IBM. We therefore propose that TDP-43 dysfunction contributes to disease development either in a common or a tissue-specific manner. © 2022, The Author(s).

Published
2022

32. Lifetime and Temperature of Incandescent Lamps.

Author

Agrawal, Dulli C. and Menon, V. Jayaram

Abstract

Describes a procedure based on the assumption that during the rated lifetime of a light bulb roughly half of the radius of the filament evaporates. Explains how the filament's operating temperature can be deduced. (DDR)

Published
1998

33. The autism brain imaging data exchange: towards a large-scale evaluation of the intrinsic brain architecture in autism

Author

Di Martino, A, Yan, C-G, Li, Q, Denio, E, Castellanos, F X, Alaerts, K, Anderson, J S, Assaf, M, Bookheimer, S Y, Dapretto, M, Deen, B, Delmonte, S, Dinstein, I, Ertl-Wagner, B, Fair, D A, Gallagher, L, Kennedy, D P, Keown, C L, Keysers, C, Lainhart, J E, Lord, C, Luna, B, Menon, V, Minshew, N J, Monk, C S, Mueller, S, Müller, R-A, Nebel, M B, Nigg, J T, O'Hearn, K, Pelphrey, K A, Peltier, S J, Rudie, J D, Sunaert, S, Thioux, M, Tyszka, J M, Uddin, L Q, Verhoeven, J S, Wenderoth, N, Wiggins, J L, Mostofsky, S H, and Milham, M P

Published
2014
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37. Efficacy of vitamin D supplementation in major depression: A meta-analysis of randomized controlled trials

Author

Vellekkatt, F. and Menon, V.

Subjects
Major depressive disorder -- Care and treatment -- Research, Meta-analysis, Vitamin D -- Health aspects -- Usage -- Research, Antidepressants, Databases, Depression (Mood disorder), Tricyclic antidepressants, Online searching, Vitamins, Ethnic, cultural, racial issues/studies, Social sciences, Women's issues/gender studies
Abstract

Byline: F. Vellekkatt, V. Menon Background: There is a need to develop and periodically evaluate new treatment strategies in major depression due to the high burden of nonresponse and inadequate [...]

Published
2019

46. Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study

Author

Kamarajah, S. K. Nepogodiev, D. Bekele, A. Cecconello, I. and Evans, R. P. T. Guner, A. Gossage, J. A. Harustiak, T. and Hodson, J. Isik, A. Kidane, B. Leon-Takahashi, A. M. and Mahendran, H. A. Negoi, I. Okonta, K. E. Rosero, G. and Sayyed, R. H. Singh, P. Takeda, F. R. van Hillegersberg, R. and Vohra, R. S. White, R. E. Griffiths, E. A. Alderson, D. and Bundred, J. Evans, R. P. T. Gossage, J. Griffiths, E. A. and Jefferies, B. Kamarajah, S. K. McKay, S. Mohamed, I. and Nepogodiev, D. Siaw-Acheampong, K. Singh, P. van Hillegersberg, R. Vohra, R. Wanigasooriya, K. Whitehouse, T. and Gjata, A. Moreno, J. I. Takeda, F. R. Kidane, B. and Guevara, Castro R. Harustiak, T. Bekele, A. Kechagias, A. and Gockel, I. Kennedy, A. Da Roit, A. Bagajevas, A. and Azagra, J. S. Mahendran, H. A. Mejia-Fernandez, L. and Wijnhoven, B. P. L. El Kafsi, J. Sayyed, R. H. Sousa, M. and Sampaio, A. S. Negoi, I. Blanco, R. Wallner, B. and Schneider, P. M. Hsu, P. K. Isik, A. Gananadha, S. and Wills, V. Devadas, M. Duong, C. Talbot, M. Hii, M. W. and Jacobs, R. Andreollo, N. A. Johnston, B. Darling, G. and Isaza-Restrepo, A. Rosero, G. Arias-Amezquita, F. Raptis, D. and Gaedcke, J. Reim, D. Izbicki, J. Egberts, J. H. and Dikinis, S. Kjaer, D. W. Larsen, M. H. Achiam, M. P. and Saarnio, J. Theodorou, D. Liakakos, T. Korkolis, D. P. and Robb, W. B. Collins, C. Murphy, T. Reynolds, J. Tonini, V. Migliore, M. Bonavina, L. Valmasoni, M. Bardini, R. and Weindelmayer, J. Terashima, M. White, R. E. Alghunaim, E. Elhadi, M. Leon-Takahashi, A. M. Medina-Franco, H. and Lau, P. C. Okonta, K. E. Heisterkamp, J. Rosman, C. van Hillegersberg, R. Beban, G. Babor, R. Gordon, A. and Rossaak, J. I. Pal, K. M. I. Qureshi, A. U. Naqi, S. A. and Syed, A. A. Barbosa, J. Vicente, C. S. Leite, J. Freire, J. Casaca, R. Costa, R. C. T. Scurtu, R. R. Mogoanta, S. S. Bolca, C. Constantinoiu, S. Sekhniaidze, D. Bjelovic, M. So, J. B. Y. Gacevski, G. Loureiro, C. Pera, M. and Bianchi, A. Moreno, Gijon M. Martin Fernandez, J. Carrera, M. S. Trugeda Vallve-Bernal, M. Pascual, M. A. Citores and Elmahi, S. Halldestam, I. Hedberg, J. Monig, S. and Gutknecht, S. Tez, M. Guner, A. Tirnaksiz, M. B. Colak, E. Sevinc, B. Hindmarsh, A. Khan, I. Khoo, D. Byrom, R. Gokhale, J. Wilkerson, P. Jain, P. Chan, D. and Robertson, K. Iftikhar, S. Skipworth, R. Forshaw, M. and Higgs, S. Gossage, J. Nijjar, R. Viswanath, Y. K. S. and Turner, P. Dexter, S. Boddy, A. Allum, W. H. Oglesby, S. and Cheong, E. Beardsmore, D. Vohra, R. Maynard, N. and Berrisford, R. Mercer, S. Puigt, S. Melhadot, R. Kelty, C. Underwood, T. Dawas, K. Lewis, W. Al-Bahrani, A. and Bryce, G. Thomas, M. Arndt, A. T. Palazzo, F. Meguid, R. A. Fergusson, J. Beenen, E. Mosse, C. Salim, J. and Cheah, S. Wright, T. Cerdeira, M. P. McQuillan, P. and Richardson, M. Liem, H. Spillane, J. Yacob, M. Albadawi, F. Thorpe, T. Dingle, A. Cabalag, C. Loi, K. Fisher, O. M. Ward, S. Read, M. Johnson, M. Bassari, R. Bui, H. Cecconello, I. Sallum, R. A. A. da Rocha, J. R. M. and Lopes, L. R. Tercioti, Jr., V. Coelho, J. D. Ferrer, J. A. P. Buduhan, G. Tan, L. Srinathan, S. Shea, P. Yeung, J. Allison, F. Carroll, P. Vargas-Barato, F. Gonzalez, F. Ortega, J. Nino-Torres, L. Beltran-Garcia, T. C. and Castilla, L. Pineda, M. Bastidas, A. Gomez-Mayorga, J. and Cortes, N. Cetares, C. Caceres, S. Duarte, S. Pazdro, A. and Snajdauf, M. Faltova, H. Sevcikova, M. Mortensen, P. B. and Katballe, N. Ingemann, T. Morten, B. Kruhlikava, I. and Ainswort, A. P. Stilling, N. M. Eckardt, J. Holm, J. and Thorsteinsson, M. Siemsen, M. Brandt, B. Nega, B. and Teferra, E. Tizazu, A. Kauppila, J. H. Koivukangas, V. and Merilainen, S. Gruetzmann, R. Krautz, C. Weber, G. and Golcher, H. Emons, G. Azizian, A. Ebeling, M. Niebisch, S. Kreuser, N. Albanese, G. Hesse, J. Volovnik, L. and Boecher, U. Reeh, M. Triantafyllou, S. Schizas, D. and Michalinos, A. Mpali, E. Mpoura, M. Charalabopoulos, A. and Manatakis, D. K. Balalis, D. Bolger, J. Baban, C. and Mastrosimone, A. McAnena, O. Quinn, A. Suilleabhain, C. B. O. Hennessy, M. M. Ivanovski, I. Khizer, H. Ravi, N. and Donlon, N. Cervellera, M. Vaccari, S. Bianchini, S. and Sartarelli, L. Asti, E. Bernardi, D. Merigliano, S. and Provenzano, L. Scarpa, M. Saadeh, L. Salmaso, B. De Manzoni, G. Giacopuzzi, S. La Mendola, R. De Pasqual, C. A. and Tsubosa, Y. Niihara, M. Irino, T. Makuuchi, R. and Ishii, K. Mwachiro, M. Fekadu, A. Odera, A. Mwachiro, E. and AlShehab, D. Ahmed, H. A. Shebani, A. O. Elhadi, A. and Elnagar, F. A. Elnagar, H. F. Makkai-Popa, S. T. Wong, L. F. and Tan, Y. R. Thannimalai, S. Ho, C. A. Pang, W. S. and Tan, J. H. Basave, H. N. L. Cortes-Gonzalez, R. Lagarde, S. M. van Lanschot, J. J. B. Cords, C. Jansen, W. A. and Martijnse, I. Matthijsen, R. Bouwense, S. Klarenbeek, B. and Verstegen, M. van Workum, F. Ruurda, J. P. van der Sluis, P. C. de Maat, M. Evenett, N. Johnston, P. Patel, R. and MacCormick, A. Young, M. Smith, B. Ekwunife, C. Memon, A. H. Shaikh, K. Wajid, A. Khalil, N. Haris, M. and Mirza, Z. U. Qudus, S. B. A. Sarwar, M. Z. Shehzadi, A. and Raza, A. Jhanzaib, M. H. Farmanali, J. Zakir, Z. and Shakeel, O. Nasir, I. Khattak, S. Baig, M. Noor, M. A. and Ahmed, H. H. Naeem, A. Pinho, A. C. da Silva, R. and Bernardes, A. Campos, J. C. Matos, H. Braga, T. and Monteiro, C. Ramos, P. Cabral, F. Gomes, M. P. Martins, P. C. Correia, A. M. Videira, J. F. Ciuce, C. Drasovean, R. Apostu, R. Ciuce, C. Paitici, S. Racu, A. E. and Obleaga, C. V. Beuran, M. Stoica, B. Ciubotaru, C. and Negoita, V. Cordos, I. Birla, R. D. Predescu, D. Hoara, P. A. Tomsa, R. Shneider, V. Agasiev, M. Ganjara, I. and Gunjic, D. Veselinovic, M. Babic, T. Chin, T. S. and Shabbir, A. Kim, G. Crnjac, A. Samo, H. Del Val, I. Diez and Leturio, S. Ramon, J. M. Dal Cero, M. Rifa, S. Rico, M. Pomar, A. Pagan Corcoles, J. A. Martinez Miravalles, J. L. Rodicio Pais, S. A. Turienzo, S. A. Alvarezt, L. S. and Alvarez, L. S. Campos, P. V. Rendo, A. G. Garcia, S. S. and Santos, E. P. G. Martinez, E. T. Fernandez, Diaz Mj Magadan, Alvarez C. Concepcion, Martin V. Diaz, Lopez C. Rosat, Rodrigo A. Perez, Sanchez L. E. Bailon, Cuadrado M. Tinoco, Carrasco C. Bhojwani, E. Choolani Sanchez, D. P. Ahmed, M. E. Dzhendov, T. Lindberg, F. Rutegard, M. Sundbom, M. and Mickael, C. Colucci, N. Schnider, A. Er, S. Kurnaz, E. Turkyilmaz, S. Turkyilmaz, A. Yildirim, R. Baki, B. E. Akkapulu, N. Karahan, O. Damburaci, N. Hardwickt, R. and Safranek, P. Sujendran, V. Bennett, J. Afzal, Z. and Shrotri, M. Chan, B. Exarchou, K. Gilbert, T. Amalesh, T. Mukherjee, D. Mukherjee, S. Wiggins, T. H. Kennedy, R. McCain, S. Harris, A. Dobson, G. Davies, N. and Wilson, I. Mayo, D. Bennett, D. Young, R. Manby, P. and Blencowe, N. Schiller, M. Byrne, B. Mitton, D. Wong, V. and Elshaer, A. Cowen, M. Menon, V. Tan, L. C. and McLaughlin, E. Koshy, R. Sharp, C. Brewer, H. Das, N. and Cox, M. Al Khyatt, W. Worku, D. Iqbal, R. Walls, L. and McGregor, R. Fullarton, G. Macdonald, A. MacKay, C. and Craig, C. Dwerryhouse, S. Hornby, S. Jaunoo, S. Wadley, M. Baker, C. Saad, M. Kelly, M. Davies, A. Di Maggio, F. McKay, S. Mistry, P. Singhal, R. Tucker, O. and Kapoulas, S. Powell-Brett, S. Davis, P. Bromley, G. and Watson, L. Verma, R. Ward, J. Shetty, V. Ball, C. and Pursnani, K. Sarela, A. Sue, Ling H. Mehta, S. Hayden, J. To, N. Palser, T. Hunter, D. Supramaniam, K. and Butt, Z. Ahmed, A. Kumar, S. Chaudry, A. Moussa, O. and Kordzadeh, A. Lorenzi, B. Wilson, M. Patil, P. Noaman, I. Willem, J. Bouras, G. Evans, R. Singh, M. and Warrilow, H. Ahmad, A. Tewari, N. Yanni, F. Couch, J. and Theophilidou, E. Reilly, J. J. Singh, P. van Boxel, Gijs and Akbari, K. Zanotti, D. Sgromo, B. Sanders, G. and Wheatley, T. Ariyarathenam, A. Reece-Smith, A. Humphreys, L. and Choh, C. Carter, N. Knight, B. Pucher, P. and Athanasiou, A. Mohamed, I. Tan, B. Abdulrahman, M. and Vickers, J. Akhtar, K. Chaparala, R. Brown, R. Alasmar, M. M. A. Ackroyd, R. Patel, K. Tamhankar, A. Wyman, A. and Walker, R. Grace, B. Abbassi, N. Slim, N. Ioannidi, L. Blackshaw, G. Havard, T. Escofet, X. Powell, A. and Owera, A. Rashid, F. Jambulingam, P. Padickakudi, J. and Ben-Younes, H. Mccormack, K. Makey, I. A. Karush, M. K. and Seder, C. W. Liptay, M. J. Chmielewski, G. Rosato, E. L. and Berger, A. C. Zheng, R. Okolo, E. Singh, A. Scott, C. D. and Weyant, M. J. Mitchell, J. D. Oesophago-Gastric Anastomotic

Abstract

Background: No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer. Method: This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III-V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI95%). Results: Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI95%: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI95%: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI95%: 0.54-1.32, p = 0.5), compared to HIC. Conclusion: Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Published
2021

47. Postoperative outcomes in oesophagectomy with trainee involvement

Author

Evans, R. P. T. Hodson, J. Kamarajah, S. K. Griffiths, E. A. and Singh, P. Alderson, D. Bundred, J. Gossage, J. and Jefferies, B. McKay, S. Mohamed, I Nepogodiev, D. and Siaw-Acheampong, K. van Hillegersberg, R. Vohra, R. and Wanigasooriya, K. Whitehouse, T. Gjata, A. Moreno, I, J. and Takeda, F. R. Kidane, B. Castro, R. Guevara Harustiak, T. and Bekele, A. Kechagias, A. Gockel, I Kennedy, A. Da Roit, A. Bagajevas, A. Azagra, J. S. Mahendran, H. A. and Mejia-Fernandez, L. Wijnhoven, B. P. L. El Kafsi, J. Sayyed, R. H. Sousa, M. Sampaio, A. S. Negoi, I Blanco, R. and Wallner, B. Schneider, P. M. Hsu, P. K. Isik, A. and Gananadha, S. Wills, V Devadas, M. Duong, C. Talbot, M. and Hii, M. W. Jacobs, R. Andreollo, N. A. Johnston, B. and Darling, G. Isaza-Restrepo, A. Rosero, G. Arias-Amezquita, F. Raptis, D. Gaedcke, J. Reim, D. Izbicki, J. and Egberts, J. H. Dikinis, S. Kjaer, D. W. Larsen, M. H. and Achiam, M. P. Saarnio, J. Theodorou, D. Liakakos, T. and Korkolis, D. P. Robb, W. B. Collins, C. Murphy, T. and Reynolds, J. Tonini, V Migliore, M. Bonavina, L. and Valmasoni, M. Bardini, R. Weindelmayer, J. Terashima, M. and White, R. E. Alghunaim, E. Elhadi, M. Leon-Takahashi, A. M. and Medina-Franco, H. Lau, P. C. Okonta, K. E. Heisterkamp, J. Rosman, C. Beban, G. Babor, R. Gordon, A. and Rossaak, I, J. Pal, I, K. M. Qureshi, A. U. Naqi, S. A. and Syed, A. A. Barbosa, J. Vicente, C. S. Leite, J. Freire, J. Casaca, R. Costa, R. C. T. Scurtu, R. R. Mogoanta, S. S. Bolca, C. Constantinoiu, S. Sekhniaidze, D. So, J. B. Y. Gacvski, G. Loureiro, C. Pera, M. Bianchi, A. and Gijon, M. Moreno Fernandez, J. Martin Carrera, M. S. Trugeda and Vallve-Bernal, M. Pascual, M. A. Citores Elmahi, S. and Halldestam, I Hedberg, J. Monig, S. Gutknecht, S. Tez, M. Guner, A. Tirnaksiz, T. B. Colak, E. Sevinc, B. and Hindmarsh, A. Khan, I Khoo, D. Byrom, R. Gokhale, J. and Wilkerson, P. Jain, P. Chan, D. Robertson, K. Iftikhar, S. Skipworth, R. Forshaw, M. Higgs, S. Nijjar, R. and Viswanath, Y. K. S. Turner, P. Dexter, S. Boddy, A. and Allum, W. H. Oglesby, S. Cheong, E. Beardsmore, D. and Maynard, N. Berrisford, R. Mercer, S. Puig, S. Melhado, R. Kelty, C. Underwood, T. Dawas, K. Lewis, W. and Al-Bahrani, A. Bryce, G. Thomas, M. Arndt, A. T. and Palazzo, F. Meguid, R. A. Fergusson, J. Beenen, E. and Mosse, C. Salim, J. Cheah, S. Wright, T. Cerdeira, M. P. and McQuillan, P. Richardson, M. Liem, H. Spillane, J. and Yacob, M. Albadawi, F. Thorpe, T. Dingle, A. Cabalag, C. and Loi, K. Fisher, O. M. Ward, S. Read, M. Johnson, M. and Bassari, R. Bui, H. Cecconello, I Sallum, R. A. A. and da Rocha, J. R. M. Lopes, L. R. Tercioti, Jr., V. Coelho, J. D. S. Ferrer, J. A. P. Buduhan, G. Tan, L. Srinathan, S. and Shea, P. Yeung, J. Allison, F. Carroll, P. and Vargas-Barato, F. Gonzalez, F. Ortega, J. Nino-Torres, L. and Beltran-Garcia, T. C. Castilla, L. Pineda, M. Bastidas, A. Gomez-Mayorga, J. Cortes, N. Cetares, C. Caceres, S. and Duarte, S. Pazdro, A. Snajdauf, M. Faltova, H. and Sevcikova, M. Mortensen, P. B. Katballe, N. Ingemann, T. and Morten, B. Kruhlikava, I Ainswort, A. P. Stilling, N. M. and Eckardt, J. Holm, J. Thorsteinsson, M. Siemsen, M. and Brandt, B. Nega, B. Teferra, E. Tizazu, A. Kauppila, J. S. Koivukangas, V Merilainen, S. Gruetzmann, R. Krautz, C. Weber, G. Golcher, H. Emons, G. Azizian, A. and Ebeling, M. Niebisch, S. Kreuser, N. Albanese, G. Hesse, J. Volovnik, L. Boecher, U. Reeh, M. Triantafyllou, S. and Schizas, D. Michalinos, A. Baili, E. Mpoura, M. and Charalabopoulos, A. Manatakis, D. K. Balalis, D. Bolger, J. and Baban, C. Mastrosimone, A. McAnena, O. Quinn, A. and Suilleabhain, C. B. O. Hennessy, M. M. Ivanovski, I. Khizer, H. Ravi, N. Donlon, N. Cervellera, M. Vaccari, S. and Bianchini, S. Sartarelli, L. Asti, E. Bernardi, D. and Merigliano, S. Provenzano, L. Scarpa, M. Saadeh, L. and Salmaso, B. De Manzoni, G. Giacopuzzi, S. La Mendola, R. and De Pasqual, C. A. Tsubosa, Y. Niihara, M. Irino, T. and Makuuchi, R. Ishii, K. Mwachiro, M. Fekadu, A. Odera, A. and Mwachiro, E. AlShehab, D. Ahmed, H. A. Shebani, A. O. and Elhadi, A. Elnagar, F. A. Elnagar, H. F. Makkai-Popa, S. T. Wong, L. F. Yunrong, T. Thanninalai, S. Aik, H. C. and Soon, P. W. Huei, T. J. Basave, H. N. L. and Cortes-Gonzalez, R. Lagarde, S. M. van Lanschot, J. J. B. and Cords, C. Jansen, W. A. Martijnse, I Matthijsen, R. and Bouwense, S. Klarenbeek, B. Verstegen, M. van Workum, F. and Ruurda, J. P. van der Veen, A. van den Berg, J. W. Evenett, N. Johnston, P. Patel, R. MacCormick, A. Young, M. and Smith, B. Ekwunife, C. Memon, A. H. Shaikh, K. Wajid, A. and Khalil, N. Haris, M. Mirza, Z. U. Qudus, S. B. A. and Sarwar, M. Z. Shehzadi, A. Raza, A. Jhanzaib, M. H. and Farmanali, J. Zakir, Z. Shakeel, O. Nasir, I Khattak, S. and Baig, M. Noor, M. A. Ahmed, H. H. Naeem, A. Pinho, A. C. da Silva, R. Bernardes, A. Campos, J. C. Matos, H. and Braga, T. Monteiro, C. Ramos, P. Cabral, F. Gomes, M. P. Martins, P. C. Correia, A. M. Videira, J. F. and Ciuce, C. Drasovean, R. Apostu, R. Paitici, S. Racu, A. E. Obleaga, V, C. Beuran, M. Stoica, B. Ciubotaru, C. and Negoita, V Cordos, I Birla, R. D. Predescu, D. and Hoara, P. A. Tomsa, R. Shneider, V Agasiev, M. Ganjara, I Gunjic, D. Veselinovic, M. Babic, T. Chin, T. S. and Shabbir, A. Kim, G. Crnjac, A. Samo, H. del Val, I. Diez and Leturio, S. Ramon, J. M. Dal Cero, M. Rifa, S. Rico, M. Pomar, A. Pagan Corcoles, J. A. Martinez Miravalles, J. L. Rodicio Pais, S. A. Turienzo, S. A. Alvarez, L. S. and Campos, V, P. Rendo, A. G. Garcia, S. S. Santos, E. P. G. and Martinez, E. T. Diaz, M. J. Fernandez Alvarez, C. Magadan and Martin, V. Concepcion Lopez, C. Diaz Rodrigo, A. Rosat and Sanchez, L. E. Perez Cuadrado, M. Bailon Carrasco, C. Tinoco and Bhojwani, E. Choolani Sanchez, D. P. Ahmed, M. E. Dzhendov, T. Lindberg, F. Rutegard, M. Sundbom, M. Mickael, C. and Colucci, N. Schnider, A. Er, S. Kurnaz, E. Turkyilmaz, S. Turkyilmaz, A. Yildirim, R. Baki, B. E. Akkapulu, N. and Karahan, O. Damburaci, N. Hardwick, R. Safranek, P. and Sujendran, V Bennett, J. Afzal, Z. Shrotri, M. Chan, B. and Exarchou, K. Gilbert, T. Amalesh, T. Mukherjee, D. and Mukherjee, S. Wiggins, T. H. Kennedy, R. McCain, S. and Harris, A. Dobson, G. Davies, N. Wilson, I Mayo, D. and Bennett, D. Young, R. Manby, P. Blencowe, N. Schiller, M. Byrne, B. Mitton, D. Wong, V Elshaer, A. Cowen, M. Menon, V Tan, L. C. McLaughlin, E. Koshy, R. and Sharp, C. Brewer, H. Das, N. Cox, M. Al Khyatt, W. and Worku, D. Iqbal, R. Walls, L. McGregor, R. Fullarton, G. and Macdonald, A. MacKay, C. Craig, C. Dwerryhouse, S. and Hornby, S. Jaunoo, S. Wadley, M. Baker, C. Saad, M. and Kelly, M. Davies, A. Di Maggio, F. Mistry, P. Singhal, R. Tucker, O. Kapoulas, S. Powell-Brett, S. Davis, P. and Bromley, G. Watson, L. Verma, R. Ward, J. Shetty, V and Ball, C. Pursnani, K. Sarela, A. Ling, H. Sue Mehta, S. Hayden, J. To, N. Palser, T. Hunter, D. and Supramaniam, K. Butt, Z. Ahmed, A. Kumar, S. Chaudry, A. and Moussa, O. Kordzadeh, A. Patil, P. Noaman, I Willem, J. Bouras, G. Evans, R. Singh, M. Warrilow, H. and Ahmad, A. Tewari, N. Yanni, F. Couch, J. Theophilidou, E. Reilly, J. J. van Boxel, G. Akbari, K. Zanotti, D. and Sgromo, B. Sanders, G. Wheatley, T. Ariyarathenam, A. and Reece-Smith, A. Humphreys, L. Choh, C. Carter, N. and Knight, B. Pucher, P. Athanasiou, A. Tan, B. and Abdulrahman, M. Vickers, J. Akhtar, K. Chaparala, R. and Brown, R. Alasmar, M. M. A. Ackroyd, R. Patel, K. and Tamhankar, A. Wyman, A. Walker, R. Grace, B. Abbassi, N. and Slim, N. Ioannidi, L. Blackshaw, G. Havard, T. and Escofet, X. Powell, A. Owera, A. Rashid, F. Jambulingam, P. Padickakudi, J. Ben-Younes, H. McCormack, K. Makey, I. A. Karush, M. K. Seder, C. W. Liptay, M. J. and Chmielewski, G. Rosato, E. L. Berger, A. C. Zheng, R. and Okolo, E. Singh, A. Scott, C. D. Weyant, M. J. Mitchell, J. D. West Midlands Res Collaborative

Abstract

Background The complexity of oesophageal surgery and the significant risk of morbidity necessitates that oesophagectomy is predominantly performed by a consultant surgeon, or a senior trainee under their supervision. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on postoperative outcomes in an international multicentre setting. Methods Data from the multicentre Oesophago-Gastric Anastomosis Study Group (OGAA) cohort study were analysed, which comprised prospectively collected data from patients undergoing oesophagectomy for oesophageal cancer between April 2018 and December 2018. Procedures were grouped by the level of trainee involvement, and univariable and multivariable analyses were performed to compare patient outcomes across groups. Results Of 2232 oesophagectomies from 137 centres in 41 countries, trainees were involved in 29.1 per cent of them (n = 650), performing only the abdominal phase in 230, only the chest and/or neck phases in 130, and all phases in 315 procedures. For procedures with a chest anastomosis, those with trainee involvement had similar 90-day mortality, complication and reoperation rates to consultant-performed oesophagectomies (P = 0.451, P = 0.318, and P = 0.382, respectively), while anastomotic leak rates were significantly lower in the trainee groups (P = 0.030). Procedures with a neck anastomosis had equivalent complication, anastomotic leak, and reoperation rates (P = 0.150, P = 0.430, and P = 0.632, respectively) in trainee-involved versus consultant-performed oesophagectomies, with significantly lower 90-day mortality in the trainee groups (P = 0.005). Conclusion Trainee involvement was not found to be associated with significantly inferior postoperative outcomes for selected patients undergoing oesophagectomy. The results support continued supervised trainee involvement in oesophageal cancer surgery. The aim of this study was to determine the impact of trainee involvement in oesophagectomy on perioperative outcomes in the international multicentre Oesophago-Gastric Anastomosis Audit (OGAA). Analysis of 2232 oesophagectomies has shown that trainee involvement did not negatively impact perioperative outcomes.

Published
2021

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