Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study
Thomas M DrakeJulian Camilleri‐BrennanStephen TabiriStuart J FergussonRichard T. SpenceJ.E.F. FitzgeraldAneel BhanguEwen M. HarrisonAdesoji AdemuyiwaStuart J FergussonJames GlasbeyChetan KhatriMidhun MohanDmitri NepogodievKjetil SøreideNeel GobinAna Vega Carreiro De FreitasNigel HallSung‐Hee KimAhmed NegidaZahra JaffryStephen J. ChapmanAlexis ArnaudGustavo RecinosCutting Edge ManipalRadhian AmanditoMarwan ShawkiMichael HanrahanFrancesco PataJustas ŽilinskasApril Camilla RoslaniCheng Chun GohGareth IrwinSebastian ShuLaura LuqueHunain ShiwaniAfnan AltamimiMohammed Ubaid AlsaggafSarah RayneJenifa JeyakumarYücel CengizDmitri RaptisClaudio Gabriel FermaniRubén BalmacedaMaría Marta ModoloEwan MacDermidRoxanne ChennCheryl Ou YongMichael EdyeMartin JarminScott D’AmoursDushyant IyerDaniel YoussefNicholas PhillipsJason BrownRobert C. GeorgeCherry KohOliver WarrenIsaac HanleyMarilla DickfosClemens NawaraDietmar ÖfnerFlorian PrimavesiAshrarur Rahman MitulKhalid MahmudMargub HussainH A Nazmul HakimTapan KumarAntje OosterkampPamphile AssoutoIsmaïl LawaniYacoubou Imorou SouaïbouAung Kyaw TunChean Leung ChongGiridhar H DevadasarMuhammad Rashid Minhas QadirKyaw Phyo AungLee Shi YeoVanessa Dina Palomino CastilloMonique Moron MunhozGisele Monteiro MoreiraLuiz Carlos Barros De Castro SegundoSalim Anderson Khouri FerreiraMaíra Cassa CaretaStella Binna KimAlexandre Venancio De SousaAlyne Daltri Lazzarini CuryGustavo Peixoto Soares MiguelAna Vega Carreiro De FreitasBarbara Pereira SilvestreJulia Guasti Pinto ViannaCarolina Oliveira FelipeLuis Alberto Valente LauferFernanda AltoeLuana Ayres Da SilvaMarina Luiza PimentaThiago Fernandes GiuriatoPaulo Alves Bezerra MoraisJessica Souza LuizRafael AraujoJuliana MenegussiMarisa LealCaio Vinícius Barroso de LimaLuiza Sarmento TatagibaAntônio LealDiogo Vinicius dos SantosGustavo Pereira FragaRomeo Lages SimoesSimon StockSamuel NigoJuana KabbaTagang Ebogo NgwaJulia BrownSebastian KingAugusto ZaniGeorges AzzieMohammed FirdouseSameer KushwahaArnav AgarwalKaren BaileyBrian H. CameronMichael LivingstonAlexandre HorobjowskyDan DeckelbaumTarek RazekBoris MarinkovicEugenio GrassetNicole D’aguzanJulio JiménezRoberto MacchiavelloZhongtao ZhangWei GuoJunyeong OhFei ZhengIrene Moreno MontesSebastián SierraManuela MendezMaría Isabel VillegasMaría Clara Mendoza ArangoIván MendozaFred Alexander Naranjo Aristizã¡balJaime Andres Montoya BoteroVictor Manuel Quintero RiazaJakeline RestrepoCarlos R. MoralesHerman CruzAlejandro MuneraRobert KarloEdgar DominiJakov MihanovićMihael RadicKresimir ZamarinNikica PezeljManuel Hache‐MarliereSylvia Batista LemaireRuben RivasAhmed KhyrallhAhamed HassanGamal ShimyMohamed FahmyAyman NabawiMohamed ElfilMohamed GhoneemMuhammad GoharMohamed AsalMostafa AbdelkaderMahmoud GomahHatem A. 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S. PrasadAnand KirishnanNidhi GyanchandaniBylapudi Seshu KumarMuthukumaran RangarajanSriram BhatAnjana SreedharanS.V. KinneraY. Satish ReddyCaranj VenugopalSunil KumarAbhishek MittalShravan NadkarniHarish Neelamraju LakshmiPuneet MalikNeel LimayeSrinivas PaiPratik JainMonty KhajanchiSavni SatoskarRajeev SatoskarAbid Bin MahamoodEldaa Prisca Refianti SutantoDaniel Ardian SoeseloChintya TedjaatmadjaFitriana Nur RahmawatiMaria MayasariRuqaya Kadhim Mohammed Jawad Al‐HasaniHasan Ismael Ibraheem Al‐HameediHasan Ismael IbraheemIsraa Abdullah Aziz Al‐AzraqiLubna SabeehRahma KamilMuwaffaq Mezeil TelfahAmoudtha RasendranJacqueline SheehanRobert KerleyCaoimhe NormileRichard William GilbertJiheon SongMohamed DabloukLinnea MauroMohammed Osman DabloukPaul KieltyEleanor MarksSimon GoslingMichelle McCarthyDiya MirghaniSyed Altaf NaqviChee Siong WongSiyi ChungReuban D’cruzRonan A. 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ChowdhurySina HossainiNicholas FS WatsonDouglas GJ McKechnieAyaan FarahAnita ChunHoey KohGrace LimGraham SunderlandLaura GouldP C MunipalleH RooneyD R L BrowningBernadette PereiraKristóf NémethEmily DeckerStefano GiulianiAly ShalabyShafaque ShaikhChern Yan TanEbrahim PalkhiA SzczapSwathikan ChidambaramChee Yang ChenK KulasabanathanSrishti ChhabraElisabeth KostovPhilippe HarbordJames BarnacleMadan Mohan PalliyilMina ZikryJohnathan PorterCharef RaslanShazia HafizNiksa SoltaniKatie BailliePriyanka SinghShailee ShethKishen PatelMahry KhaliliJeesoo ChoiMatthew BengerLucy MarplesAlastair MacfarlaneRamesh ThurairajaTamsin BoyceHarriet WhewellElin JonesFrancesca Th’ngNichola RobertsonAhmad A. MirzaHaroon SaeedSimon GallowayGia ElenaMohammad Rauf AfzalMohamed ZakirPeter SoddeCharles HandAiesha SriramTamsyn ClarkPatrick HoltonAmy LiveseyYashashwi SinhaFahad IqbalIndervir Singh BharjAdriana RotundoCara JenveyRobert SladeDavid GoldingSamuel HainesAli Adel Ne’ma AbdullahThomas W TilstonDafydd LoughranDanielle DonoghueLorenzo GiacciMohamed SherifPeter HarrisonA TangDeevia KotechaMohamed ElshaerTomas UrbonasAmjid RiazAnnie ChapmanParisha AcharyaJoseph ShalhoubCathleen GrossartD. McMorranMakhosini MlotshwaWilliam HawkinsSofronis LoizidesKandaswamy KrishnaMelanie OrchardChik Wai HoPeter ThomsonShahab KhanFiona TaylorJalak ShuklaEmma Elizabeth HowieLinda MacDonaldOlusegun KomolafeNeil McIntyreJ. B. CraggJody ParkerDuncan StewartLuke LintinJulia TracyTahir FarooqGeorge MolinaHaytham M.A. KaafaraniRobel BeyeneJack SavaS. Mark ScottMamta SwaroopRaelene KennedyIjeoma A. AzodoDaithi S. HeffernanTristen T. ChunAndrew H. StephenMelanie SionMichael WeinsteinViren PunjaNikolay BugaevMonica GoodsteinShadi RazmdjouEric EtchillJuan Carlos PuyanaMatthew R. KesingerLena M. NapolitanoKathleen ToMark R. HemmilaOliver ToddEdward JennerEllen HoogakkerJacky Hong Chieh ChenIsmaïl LawaniDylan RoiEugenio Grasset Escobar
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Abstract Background Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. Methods This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. Results 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33–4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76–2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42–0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14–0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11–0.44) and SSI (OR 0.21 95% CI 0.09–0.45). Conclusion A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. Trial registration: NCT02179112.Keywords:
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Abstract Dairy product intake was suggested to reduce the risk of gastrointestinal cancers. This study investigated the association between dairy product intake and the risk of pancreatic cancer (PAC) using a prospective cohort study and meta-analysis of prospective cohort studies. First, we included 59 774 people aged 40–79 years from the Japan Collaborative Cohort Study (JACC Study). The Cox regression was used to compute the hazard ratios (HR) and 95 % CI of incident PAC for individuals who reported the highest intakes of milk, cheese and yogurt compared with not consuming the corresponding dairy products. Then, we combined our results with those from other four prospective cohort studies that were eligible after searching several databases, in a meta-analysis, using the fixed-effects model before evaluating publication bias and heterogeneity across studies. In the JACC Study, the highest v . no intakes of milk, cheese and yogurt were not associated with the reduced risk of PAC after a median follow-up of 13·4 years: HR (95 % CI) = 0·93 (0·64, 1·33), 0·91 (0·51, 1·62) and 0·68 (0·38, 1·21), respectively. The results did not significantly change in the meta-analysis: 0·95 (0·82, 1·11) for milk, 1·16 (0·87, 1·55) for cheese and 0·91 (0·79, 1·05) for yogurt. The meta-analysis showed no signs of publication bias or heterogeneity across studies. To conclude, consumption of milk, cheese and yogurt was not associated with the risk of PAC either in the JACC Study or the meta-analysis.
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Background Several case-control studies have suggested that passive smoking may increase the incidence of female breast cancer. However, the results of cohort studies have been inconsistent in establishing an association. The present study evaluated the association between passive smoking and incidence of female breast cancer through a meta-analysis of prospective cohort studies. Methods Relevant articles published before August 2012 were identified by searching the electronic databases PubMed, Embase, and Web of Science. Pooled relative risks (RRs) were determined with either a fixed or random effects model and were used to assess the strength of the association. Sensitivity and subgroup analyses according to ethnicity, menopausal status, and the period and place of exposure to passive smoking were also performed. Results Ten prospective cohort studies involving 782 534 female non-smokers were included in the meta-analysis and 14 831 breast cancer cases were detected. Compared with the women without exposure to passive smoking, the overall combined RR of breast cancer was 1.01 (95% confidence interval: 0.96 to 1.06, P = 0.73) among women with exposure to passive smoking. Similar results were achieved through the subgroup analyses. No evidence of publication bias was observed. Conclusion The results suggest that passive smoking may not be associated with increased incidence of breast cancer. However, the present conclusion should be considered carefully and confirmed with further studies.
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Abstract Objective To evaluate the association between egg intake and cardiovascular disease risk among women and men in the United States, and to conduct a meta-analysis of prospective cohort studies. Design Prospective cohort study, and a systematic review and meta-analysis of prospective cohort studies. Setting Nurses’ Health Study (NHS, 1980-2012), NHS II (1991-2013), Health Professionals’ Follow-Up Study (HPFS, 1986-2012). Participants Cohort analyses included 83 349 women from NHS, 90 214 women from NHS II, and 42 055 men from HPFS who were free of cardiovascular disease, type 2 diabetes, and cancer at baseline. Main outcome measures Incident cardiovascular disease, which included non-fatal myocardial infarction, fatal coronary heart disease, and stroke. Results Over up to 32 years of follow-up (>5.54 million person years), 14 806 participants with incident cardiovascular disease were identified in the three cohorts. Participants with a higher egg intake had a higher body mass index, were less likely to be treated with statins, and consumed more red meats. Most people consumed between one and less than five eggs per week. In the pooled multivariable analysis, consumption of at least one egg per day was not associated with incident cardiovascular disease risk after adjustment for updated lifestyle and dietary factors associated with egg intake (hazard ratio for at least one egg per day v less than one egg per month 0.93, 95% confidence interval 0.82 to 1.05). In the updated meta-analysis of prospective cohort studies (33 risk estimates, 1 720 108 participants, 139 195 cardiovascular disease events), an increase of one egg per day was not associated with cardiovascular disease risk (pooled relative risk 0.98, 95% confidence interval 0.93 to 1.03, I 2 =62.3%). Results were similar for coronary heart disease (21 risk estimates, 1 411 261 participants, 59 713 coronary heart disease events; 0.96, 0.91 to 1.03, I 2 =38.2%), and stroke (22 risk estimates, 1 059 315 participants, 53 617 stroke events; 0.99, 0.91 to 1.07, I 2 =71.5%). In analyses stratified by geographical location (P for interaction=0.07), no association was found between egg consumption and cardiovascular disease risk among US cohorts (1.01, 0.96 to 1.06, I 2 =30.8%) or European cohorts (1.05, 0.92 to 1.19, I 2 =64.7%), but an inverse association was seen in Asian cohorts (0.92, 0.85 to 0.99, I 2 =44.8%). Conclusions Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations. Systematic review registration PROSPERO CRD42019129650.
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Read the full review for this Faculty Opinions recommended article: Fruit and Vegetable Intake and Mortality: Results From 2 Prospective Cohort Studies of US Men and Women and a Meta-Analysis of 26 Cohort Studies.
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Dairy intake was suggested to reduce the risk of gastrointestinal cancers. This study investigated the association between dairy intake and the risk of pancreatic cancer (PAC) using a prospective cohort study and meta-analysis of prospective cohort studies. First, we included 59,774 people aged 40-79 years from the Japan Collaborative Cohort Study (JACC Study). The Cox regression was used to compute the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident PAC for individuals who reported the highest intakes of milk, cheese, and yogurt compared with not consuming the corresponding dairy products. Then, we combined our results with those from other four prospective cohort studies that were eligible after searching several databases, in a meta-analysis, using the fixed-effects model before evaluating publication bias and heterogeneity across studies. In the JACC study, the highest versus no intakes of milk, cheese, and yogurt were not associated with the reduced risk of PAC after a median follow-up of 13.4 years: HRs (95% CIs)= 0.93 (0.64, 1.33), 0.91 (0.51, 1.62), and 0.68 (0.38, 1.21), respectively. The results did not significantly change in the meta-analysis: 0.95 (0.82, 1.11) for milk, 1.16 (0.87, 1.55) for cheese, and 0.91 (0.79, 1.05) for yogurt. The meta-analysis showed no signs of publication bias or heterogeneity across studies. To conclude, consumption of milk, cheese, and yogurt was not associated with the risk of PAC either in the JACC study or the meta-analysis.
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A comprehensive literature search was undertaken to examine the relationship between dairy consumption and overweight/obesity in prospective cohort studies. A literature search from 1980 through to April 2010 was conducted. Nineteen cohort studies met all the inclusion criteria and were included in the systematic review. Of the 19 cohort studies, 10 were among children and adolescents (aged 2 to 14 years, n = 53 to 12,829, follow-up 8 months to 10 years) and nine among adults (aged 18 to 75 years, n = 248 to 42,696, follow-up 2 years to 12 years). A range of dairy food exposure measures were used. Eight studies (three out of 10 studies involving children and five out of nine studies involving adults) showed a protective association against increasing weight gain (measured in various ways); one reported a significant protective association only among men who were initially overweight; seven reported no effect; one reported an increased risk (among children), and two reported both a decreased and increased risk, depending on the dairy food type. The evidence from prospective cohort studies for a protective effect of dairy consumption on risk of overweight and obesity is suggestive but not consistent, making firm conclusions difficult.
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