7 research outputs found
The influence of glyoxalase 1 gene polymorphism on its expression at different stages of breast cancer in Egyptian women
No full textRNA-binding proteins RBM-HuR, RBM3 and PODXL expression in urothelial carcinoma of the urinary bladder. Prognostic and clinical implications
No full textMolecular analysis of sixteen unrelated factor XIIIA deficient families from south-east of Iran
No full textThe Egyptian worker: Work beliefs and attitudes
No full textEarlier investigations have indicated that work beliefs in organization are impacted by different national cultures. In addition, those investigations have sought to understand the meaning of work in such different cultures. This study explores the meaning of work in the Egyptian context through an assessment of work beliefs and work attitudes. The article starts with a presentation of what is meant by the meaning of work and why research into work beliefs is both needed and worthwhile. The article then presents a review of the relevant literature that evaluated the meaning of work in different countries. The review also elucidates recent research efforts that have tried to shed some light on the meaning of work in Middle-Eastern contexts. Data were collected from 201 Egyptian white-collar workers. Work beliefs and some job attitudes were assessed. Results indicate the prevalence of the humanistic work-belief system. Job satisfaction was positively correlated with the humanistic work-belief system and negatively with the Marxist work-belief system. 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Livestock-associated methicillin resistant Staphylococcus aureus in pigs - prevalence, risk factors and transmission dynamics
No full text In 2004, an association between human carriage of methicillin resistant Staphylococcus aureus (MRSA) and contact with pigs was found. To assess the implications of this finding for veterinary and public health more insight into the prevalence, risk factors and transmission dynamics of this so-called livestock-associated (LA-)MRSA was needed. Therefore, field and experimental studies were conducted in pig and human populations of which the results are presented in this thesis. First, observational studies on pig farms were performed to estimate the prevalence of MRSA positive herds, and to identify factors associated with LA-MRSA in pig herds. It was shown that LA-MRSA was present in the majority, i.e. ~70%, of Dutch pig herds and that the prevalence increased over time. Larger herds were more often found LA-MRSA positive than smaller herds, and transmission was shown to occur by animal trade. From all this, it was concluded that LA-MRSA has become endemic in the Dutch pig population. Secondly, studies on LA-MRSA in pigs, the environment and personnel in pig slaughterhouses were performed. In pigs, a clear increase in LA-MRSA positive pigs from 0 to 60% was shown in the time period between loading at the farm and stunning at the slaughterhouse. This indicated a very rapid transmission of LA-MRSA between pigs through direct contact or through contact with a contaminated environment. An increase in LA-MRSA positive environmental samples taken in the slaughterhouse was found during the working day. In personnel, LA-MRSA prevalence was 6% and working with live pigs was the single most important factor for being positive; personnel not working with pigs or working only with dead pigs were all LA-MRSA negative. Thirdly, transmission of LA-MRSA within herds was studied longitudinally both in an experimental setting and also in 6 pig herds. Transmission rates and the factors affecting these rates were determined. The results of both studies indicated that LA-MRSA is able to spread easily and persist in pig populations, resulting in an endemic situation. Use of selective antimicrobials has a positive effect on the transmission rate of LA-MRSA, but transmission occurs even without use of antimicrobials. The key to limiting LA-MRSA transmission from pigs to humans is to eliminate the source, i.e. eradicate LA-MRSA from pig herds, and a combination of different intervention strategies controlling both within- and between-herd transmission will be needed to achieve this. </p
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
No full textBackground
The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy.
Methods
In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation.
Results
Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89·6 per cent) compared with that in countries with a middle (753 of 1242, 60·6 per cent; odds ratio (OR) 0·17, 95 per cent c.i. 0·14 to 0·21, P < 0·001) or low (363 of 860, 42·2 per cent; OR 0·08, 0·07 to 0·10, P < 0·001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high‐HDI countries (risk difference −9·4 (95 per cent c.i. −11·9 to −6·9) per cent; P < 0·001), but the relationship was reversed in low‐HDI countries (+12·1 (+7·0 to +17·3) per cent; P < 0·001). In multivariable models, checklist use was associated with a lower 30‐day perioperative mortality (OR 0·60, 0·50 to 0·73; P < 0·001). The greatest absolute benefit was seen for emergency surgery in low‐ and middle‐HDI countries.
Conclusion
Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low‐HDI countries was half that in high‐HDI countries
Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study
No full textBackground: 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
