30-day morbidity and mortality of sleeve gastrectomy, Roux-en-Y gastric bypass and one anastomosis gastric bypass: a propensity score-matched analysis of the GENEVA data

Background: There is a paucity of data comparing 30-day morbidity and mortality of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one anastomosis gastric bypass (OAGB). This study aimed to compare the 30-day safety of SG, RYGB, and OAGB in propensity score-matched cohorts. Materials and methods: This analysis utilised data collected from the GENEVA study which was a multicentre observational cohort study of bariatric and metabolic surgery (BMS) in 185 centres across 42 countries between 01/05/2022 and 31/10/2020 during the Coronavirus Disease-2019 (COVID-19) pandemic. 30-day complications were categorised according to the Clavien–Dindo classification. Patients receiving SG, RYGB, or OAGB were propensity-matched according to baseline characteristics and 30-day complications were compared between groups. Results: In total, 6770 patients (SG 3983; OAGB 702; RYGB 2085) were included in this analysis. Prior to matching, RYGB was associated with highest 30-day complication rate (SG 5.8%; OAGB 7.5%; RYGB 8.0% (p = 0.006)). On multivariate regression modelling, Insulin-dependent type 2 diabetes mellitus and hypercholesterolaemia were associated with increased 30-day complications. Being a non-smoker was associated with reduced complication rates. When compared to SG as a reference category, RYGB, but not OAGB, was associated with an increased rate of 30-day complications. A total of 702 pairs of SG and OAGB were propensity score-matched. The complication rate in the SG group was 7.3% (n = 51) as compared to 7.5% (n = 53) in the OAGB group (p = 0.68). Similarly, 2085 pairs of SG and RYGB were propensity score-matched. The complication rate in the SG group was 6.1% (n = 127) as compared to 7.9% (n = 166) in the RYGB group (p = 0.09). And, 702 pairs of OAGB and RYGB were matched. The complication rate in both groups was the same at 7.5 % (n = 53; p = 0.07). Conclusions: This global study found no significant difference in the 30-day morbidity and mortality of SG, RYGB, and OAGB in propensity score-matched cohorts

30-Day morbidity and mortality of bariatric metabolic surgery in adolescence during the COVID-19 pandemic – The GENEVA study

Background: Metabolic and bariatric surgery (MBS) is an effective treatment for adolescents with severe obesity. Objectives: This study examined the safety of MBS in adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This was a global, multicentre and observational cohort study of MBS performed between May 01, 2020, and October 10,2020, in 68 centres from 24 countries. Data collection included in-hospital and 30-day COVID-19 and surgery-specific morbidity/mortality. Results: One hundred and seventy adolescent patients (mean age: 17.75 ± 1.30 years), mostly females (n = 122, 71.8%), underwent MBS during the study period. The mean pre-operative weight and body mass index were 122.16 ± 15.92 kg and 43.7 ± 7.11 kg/m2, respectively. Although majority of patients had pre-operative testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (n = 146; 85.9%), only 42.4% (n = 72) of the patients were asked to self-isolate pre-operatively. Two patients developed symptomatic SARS-CoV-2 infection post-operatively (1.2%). The overall complication rate was 5.3% (n = 9). There was no mortality in this cohort. Conclusions: MBS in adolescents with obesity is safe during the COVID-19 pandemic when performed within the context of local precautionary procedures (such as pre-operative testing). The 30-day morbidity rates were similar to those reported pre-pandemic. These data will help facilitate the safe re-introduction of MBS services for this group of patients

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Porównanie zawartości pierwiastków w roślinach fasoli szparagowej uprawianych w systemie organicznym i konwencjonalnym w celach spożywczych i leczniczych

Today, sustainable agriculture and food content is a very important issue in the world. Organic farming practices are very important in this respect.This study was made to observe the impact of organic agricultural regime on the products in case of haricot beans (Phaseolus vulgaris L.). A comparative study on elemental composition of various haricot beans (Phaseolus vulgaris L.) samples was conducted by using a sensitive method, wavelength dispersive X-ray fluorescence (WDXRF). 26 elements such as Al, Ca, Cu, Fe, As, Hg, Pb, Cd, Bi, Mn, Ni, P, S, Sr, Zn, Zr, La, Ti, Sn, Cl, K, Mg, Na, Ba, Rb and Si were determined in haricot beans samples (n=10) grown under organic and conventional farming regimes. The obtained results from each group were analyzed statistically by using SPSS statistic program. It was observed that the concentration and peak intensity values of Ca, Fe, Mn, P, Zn, Cl, K, Na, Mg and Si elements were higher in the haricot beans samples grown under organic farming regime. Likewise, Al and Sr levels were found in higher levels in the samples grown under conventional farming regime. Our findings clearly revealed that organic haricot beans are likely to have higher nutritional mineral content. And the haricot beans samples grown under conventional farming regime could contain harmful metals like Al and Sr that might damage the various systems and/or organs of humans and animals.Obecnie rolnictwo nienaruszające równowagi ekologicznej oraz wartość żywności stanowią sprawę istotną dla całego świata. Praktyki uprawy ekologicznej mają w tej kwestii duże znaczenie. Celem niniejszej pracy jest obserwacja wpływu systemu rolnictwa organicznego na produkty, na przykładzie fasoli szparagowej (Phaseolus vulgaris L.). Przeprowadzono badanie porównawcze składu pierwiastkowego (chemicznego) różnych próbek fasoli szparagowej (Phaseolus vulgaris L.) czułą metodą fluorescencji rozpraszającej długość fali promieniami Roentgena (WDXRF). 26 pierwiastków, takich jak: Al, Ca, Cu, Fe, As, Hg, Pb, Cd, Bi, Mn, Ni, P, S, Sr, Zn, Zr, La, Ti, Sn, Cl, K, Mg, Na, Ba, Rb oraz Si oznaczono w próbkach fasoli szparagowej (n = 10) uprawianej systemem organicznym i tradycyjnym. Otrzymane wyniki z każdej grupy poddano analizie statystycznej z wykorzystaniem programu statystycznego SPSS. Zaobserwowano, że wartości stężenia I szczytowej intensywności pierwiastków Ca, Fe, Mn, P, Zn, Cl, K, Na, Mg oraz Si były wyższe w próbkach fasoli szparagowej uprawianej systemem organicznym. Stwierdzono także wyższy poziom Al i Sr w próbkach uprawianych zgodnie z systemem konwencjonalnym. Nasze wyniki wyraźnie wykazały, że uprawiana organicznie fasola szparagowa prawdopodobnie zawiera więcej mineralnych składników odżywczych, zaś uprawiana zgodnie z systemem konwencjonalnym może zawierać szkodliwe metale, takie jak Al i Sr, mogące uszkadzać różne narządy i/lub układy w organizmach ludzi i zwierząt

Residual efficacy of pirimiphos methyl (Actellic) on Anopheles sacharovi in Cukurova, Turkey.

PubMedID: 1583488Village-scale trials of 50% emulsifiable concentrate (EC) and 40% wettable powder (WP) formulations of pirimiphos methyl (Actellic) were carried out against Anopheles sacharovi in Cukurova, Turkey. Susceptibility tests with wild caught, gonoactive and composite aged An. sacharovi over a range of chemical concentrations resulted in 100% mortality after exposure for 60 min to a 0.5% active ingredient concentration. Surface treatments of Actellic 50% EC at 0.9 g/m2 caused a significant decrease in parous rate and a 96.9% reduction in resting density. Persistence on concrete, wood, zinc and plywood was still high at the time of the second spray round, more than 7 wk postspray and ranged from 73% (zinc) to 98% (plywood). More than 50% mortality was still recorded 8 wk postspray using 1.6 g/m2 WP on wood, plywood, zinc and thatch substrates

Microsporum audouinii tinea capitis in a Swiss school: assessment and management of patients and asymptomatic carriers

We report three cases involving 7- to 8-year-old children from a Swiss school who had refractory tinea capitis due to an unusual strain of Microsporum audouinii which perforates hair in vitro. The patients showed no response to modern oral antifungal drugs like terbinafine and fluconazole. After switching to oral griseofulvin, two of the patients had a complete recovery, while the third was cured after the introduction of oral itraconazole. Given the high potential for contagion of this anthropophilic dermatophyte, all family members and three entire school classes were screened using the 'toothbrush technique'. Three family members and five class-mates were found to be asymptomatic carriers of M. audouinii and were consequently treated to avoid further transmission or reinfection of the treated patients. This is the first report of an outbreak of M. audouinii in Switzerland and underlines the importance of screening all contacts of patients with M. audouinii tinea capitis. Further, the effectiveness of griseofulvin in Microsporum tinea capitis has been corroborated, while newer antimycotic drugs like fluconazole or terbinafine failed