Year in review in Intensive Care Medicine 2011: III. ARDS and ECMO, weaning, mechanical ventilation, noninvasive ventilation, pediatrics and miscellanea

SCOPUS: re.jinfo:eu-repo/semantics/publishe

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Purinergic signalling and immune cells

This review article provides a historical perspective on the role of purinergic signalling in the regulation of various subsets of immune cells from early discoveries to current understanding. It is now recognised that adenosine 5'-triphosphate (ATP) and other nucleotides are released from cells following stress or injury. They can act on virtually all subsets of immune cells through a spectrum of P2X ligand-gated ion channels and G protein-coupled P2Y receptors. Furthermore, ATP is rapidly degraded into adenosine by ectonucleotidases such as CD39 and CD73, and adenosine exerts additional regulatory effects through its own receptors. The resulting effect ranges from stimulation to tolerance depending on the amount and time courses of nucleotides released, and the balance between ATP and adenosine. This review identifies the various receptors involved in the different subsets of immune cells and their effects on the function of these cells

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Factores asociados al abandono de la lactancia materna exclusiva en una muestra de madres de Lima, Perú, 2013

Background: Exclusive breastfeeding (EBF) has proven to be highly beneficial for children’s health. Identifying the associated factors with its cessation is useful in order to target specific groups for preventive interventions. Objective: To evaluate the associated factors with EBF cessation before six months of age in women with infants, living in a district in Lima. Methods: A cross-sectional analytic study was performed. It evaluated mothers with infants aged 6-24 months, in a periurban district in Lima, Peru, 2013. The study outcome was cessation in EBF before six months of age. Sociodemographic variables, factors related to gestation and delivery, and factors properly related to breastfeeding were assessed. Crude and adjusted prevalence ratios and their respective 95% confidence intervals (95%CI) were calculated through simple and multiple Poisson regression. Results: From the 109 mothers included in the analysis, 85.3% were 18 years old or more and all of them had a monthly family income under 250 US dollars. Seventy percent of women interrupted EBF before six months of age. Statistically significant association was found between EBF cessation and being primiparous (PR: 1.54; 95%CI: 1.20-1.98), having problems with the nipples (PR: 1.58; 95%CI: 1.07-2.33) and the perception of infant’s persistent hunger with EBF (PR: 1.35; 95%CI: 1.01-1.79). Conclusion: EBF cessation frequency was high in the study sample. Primiparity, having problems with the nipples and the perception of infant’s persistent hunger with EBF were found as associated factors. Preventive strategies might specially focus in mothers with this characteristics.Introducción: La lactancia materna exclusiva (LME) ha probado ser altamente beneficiosa para la salud infantil. Conocer los factores asociados a su abandono es útil para identificar los grupos a los cuales enfocar las intervenciones. Objetivo: Evaluar los factores asociados al abandono de la LME antes de los seis meses en madres de lactantes, residentes en un distrito de Lima. Métodos: Estudio transversal analítico que evaluó, a través de una encuesta, a madres de lactantes entre 6-24 meses de un distrito periférico de Lima, Perú, 2013. Se preguntó por la edad en la que se suspendió la LME y se definió como abandono si esta fue previa a cumplir los seis meses de edad. Se evaluaron variables sociodemográficas, factores relacionados a la gestación y parto, así como factores propiamente relacionados a la lactancia. Se calcularon las razones de prevalencia crudas y ajustadas con sus respectivos intervalos de confianza al 95% (IC95%), a través de regresión de Poisson simple y múltiple, respectivamente. Resultados: De 109 madres incluidas en el análisis, 85,3% eran mayores de 18 años y todas presentaban un ingreso económico familiar menor a 250 dólares americanos. Aproximadamente, 70% abandonó la LME. Se encontró asociación con ser primípara (RP: 1,54; IC95%: 1,20-1,98), presentar problemas con el pezón (RP: 1,58; IC95%: 1,07-2,33) y que perciban que su hijo se encuentra insatisfecho con la LME (RP: 1,35; IC95%: 1,01-1,79). Conclusiones: La frecuencia de abandono de LME en la muestra evaluada fue alta. La primiparidad, los problemas con el pezón y el percibir que su hijo se encuentra insatisfecho con la LME fueron factores asociados. Las estrategias preventivas podrían dirigirse especialmente a mujeres con estas características

Factors associated with exclusive breastfeeding cessation in a sample of mothers from Lima, Peru, 2013

Background: Exclusive breastfeeding (EBF) has proven to be highly beneficial for children’s health. Identifying the associated factors with its cessation is useful in order to target specific groups for preventive interventions. Objective: To evaluate the associated factors with EBF cessation before six months of age in women with infants, living in a district in Lima. Methods: A cross-sectional analytic study was performed. It evaluated mothers with infants aged 6-24 months, in a periurban district in Lima, Peru, 2013. The study outcome was cessation in EBF before six months of age. Sociodemographic variables, factors related to gestation and delivery, and factors properly related to breastfeeding were assessed. Crude and adjusted prevalence ratios and their respective 95% confidence intervals (95%CI) were calculated through simple and multiple Poisson regression. Results: From the 109 mothers included in the analysis, 85.3% were 18 years old or more and all of them had a monthly family income under 250 US dollars. Seventy percent of women interrupted EBF before six months of age. Statistically significant association was found between EBF cessation and being primiparous (PR: 1.54; 95%CI: 1.20-1.98), having problems with the nipples (PR: 1.58; 95%CI: 1.07-2.33) and the perception of infant’s persistent hunger with EBF (PR: 1.35; 95%CI: 1.01-1.79). Conclusion: EBF cessation frequency was high in the study sample. Primiparity, having problems with the nipples and the perception of infant’s persistent hunger with EBF were found as associated factors. Preventive strategies might specially focus in mothers with this characteristics.Revisión por pare