27 research outputs found
Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)
Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic
Cristobalite in the 2011–2012 Cordón Caulle eruption (Chile)
Cristobalite is a low-pressure high-temperature polymorph of SiO2 found in many volcanic rocks. Its volcanogenic formation has received attention because (1) pure particulate cristobalite can be toxic when inhaled, and its dispersal in volcanic ash is therefore a potential hazard; and (2) its nominal stability field is at temperatures higher than those of magmatic systems, making it an interesting example of metastable crystallization. We present analyses (by XRD, SEM, EPMA, Laser Raman, and synchrotron μ-cT) of representative rhyolitic pyroclasts and of samples from different facies of the compound lava flow from the 2011–2012 eruption of Cordón Caulle (Chile). Cristobalite was not detected in pyroclasts, negating any concern for respiratory hazards, but it makes up 0–23 wt% of lava samples, occurring as prismatic vapour-deposited crystals in vesicles and/or as a groundmass phase in microcrystalline samples. Textures of lava collected near the vent, which best represent those generated in the conduit, indicate that pore isolation promotes vapour deposition of cristobalite. Mass balance shows that the SiO2 deposited in isolated pore space can have originated from corrosion of the adjacent groundmass. Textures of lava collected down-flow were modified during transport in the insulated interior of the flow, where protracted cooling, additional vesiculation events, and shearing overprint original textures. In the most slowly cooled and intensely sheared samples from the core of the flow, nearly all original pore space is lost, and vapour-deposited cristobalite crystals are crushed and incorporated into the groundmass as the vesicles in which they formed collapse by strain and compaction of the surrounding matrix. Holocrystalline lava from the core of the flow achieves high mass concentrations of cristobalite as slow cooling allows extensive microlite crystallization and devitrification to form groundmass cristobalite. Vapour deposition and devitrification act concurrently but semi-independently. Both are promoted by slow cooling, and it is ultimately devitrification that most strongly contributes to total cristobalite content in a given flow facies. Our findings provide a new field context in which to address questions that have arisen from the study of cristobalite in dome eruptions, with insight afforded by the fundamentally different emplacement geometries of flows and domes
Avance del proceso de evaluación de riesgo de extinción de los mamÃferos en Colombia
The extinction risk assessment of mammals in Colombia has been carried out heterogeneously in the last 16 years. However, assessments of Colombian mammals are outdated. For this reason, it is necessary to renew the assessment of the risk of extinction of mammals in Colombia. This process is carried out in an articulated manner and with the support of experts and entities according to the criteria of the International Union for Conservation of Nature (IUCN). This work has also served to consolidate information on poorly documented species with information from biological collections or photo-trapping. The evaluation process will end in 2022 with the efforts of the Colombian Society of Mammalogy, the Alexander von Humboldt Biological Resources Research Institute, the Colombian Association of Zoology, and the support of other organizations.La evaluación de riesgo de extinción de los mamÃferos de Colombia se ha realizado heterogéneamente en los últimos 16 años. Sin embargo, las evaluaciones de los mamÃferos de Colombia están desactualizadas. Por esta razón, se hace necesario renovar la evaluación del riesgo de extinción de los de mamÃferos de Colombia. Este proceso se realiza de manera articulada y con el apoyo de expertos y entidades según los criterios de la Unión Internacional para la Conservación de la Naturaleza (IUCN). Esta labor ha servido además, para consolidar información de especies pobremente documentadas con información de colecciones biológicas o con fototrampeo. El proceso de evaluación terminará en 2022 con los esfuerzos de la Sociedad Colombiana de MastozoologÃa, el Instituto de Investigación de Recursos Biológicos Alexander von Humboldt, la Asociación Colombiana de ZoologÃa y el apoyo de otras organizaciones