9 research outputs found
Phthalocyanines and porphyrins linked to gold adatoms and their catalytic property towards hydroxide oxidation
An evaluation of severe anesthetic-related critical incidents and risks from the South African paediatric surgical outcomes study : a 14-day prospective, observational cohort study of pediatric surgical patients
SUPPLEMENTARY MATERIAL 1 : The South African Paediatric Surgical Outcomes Study (SAPSOS): A 14-day
prospective, observational cohort study of paediatric surgical patients.SUPPLEMENTARY MATERIAL 2 : South African Paediatric Surgical Outcomes Study (SAPSOS) : Operating Room case record form.SUPPLEMENTARY MATERIAL 3 : Supplemental Tables and Figures.BACKGROUND :
Severe anesthetic-related critical incident (SARCI) monitoring is an essential component of safe, quality anesthetic care. Predominantly retrospective data from low- and middle-income countries (LMICs) report higher incidence but similar types of SARCI compared to high-income countries (HIC). The aim of our study was to describe the baseline incidence of SARCI in a middle-income country (MIC) and to identify associated risk for SARCI. We hypothesized a higher incidence but similar types of SARCI and risks compared to HICs.
METHODS :
We performed a 14-day, prospective multicenter observational cohort study of pediatric patients (aged <16 years) undergoing surgery in government-funded hospitals in South Africa, a MIC, to determine perioperative outcomes. This analysis described the incidence and types of SARCI and associated perioperative cardiac arrests (POCAs). We used multivariable logistic regression analysis to identify risk factors independently associated with SARCI, including 7 a priori variables and additional candidate variables based on their univariable performance.
RESULTS :
Two thousand and twenty-four patients were recruited from May 22 to August 22, 2017, at 43 hospitals. The mean age was 5.9 years (±standard deviation 4.2). A majority of patients during this 14-day period were American Society of Anesthesiologists (ASA) physical status I (66.4%) or presenting for minor surgery (54.9%). A specialist anesthesiologist managed 59% of cases. These patients were found to be significantly younger (P < .001) and had higher ASA physical status (P < .001). A total of 426 SARCI was documented in 322 of 2024 patients, an overall incidence of 15.9% (95% confidence interval [CI], 14.4â17.6). The most common event was respiratory (214 of 426; 50.2%) with an incidence of 8.5% (95% CI, 7.4â9.8). Six children (0.3%; 95% CI, 0.1â0.6) had a POCA, of whom 4 died in hospital. Risks independently associated with a SARCI were age (adjusted odds ratio [aOR] = 0.95; CI, 0.92â0.98; P = .004), increasing ASA physical status (aOR = 1.85, 1,74, and 2.73 for ASA II, ASA III, and ASA IVâV physical status, respectively), urgent/emergent surgery (aOR = 1.35, 95% CI, 1.02â1.78; P = .036), preoperative respiratory infection (aOR = 2.47, 95% CI, 1.64â3.73; P < .001), chronic respiratory comorbidity (aOR = 1.75, 95% CI, 1.10â2.79; P = .018), severity of surgery (intermediate surgery aOR = 1.84, 95% CI, 1.39â2.45; P < .001), and level of hospital (first-level hospitals aOR = 2.81, 95% CI, 1.60â4.93; P < .001).
CONCLUSIONS :
The incidence of SARCI in South Africa was 3 times greater than in HICs, and an associated POCA was 10 times more common. The risk factors associated with SARCI may assist with targeted interventions to improve safety and to triage children to the optimal level of care.The Jan Pretorius Research Fund, South African
Society of Anaesthesiologists; Discipline of Anaesthesiology and Critical Care, Nelson R.
Mandela School of Medicine, University of KwaZulu-Natal; Department of Anaesthesia and
Perioperative Medicine, Groote Schuur Hospital and University of Cape Town; Department
of Anaesthesia, University of the Witwatersrand; and Paediatric Anaesthesia Community of
South Africa.https://journals.lww.com/anesthesia-analgesia/pages/default.aspxhj2023Anaesthesiolog
Open Data for Global Science
The global science system stands at a critical juncture. On the one hand, it is overwhelmed by a hidden avalanche of ephemeral bits that are central components of modern research and of the emerging âcyberinfrastructureâ4 for e-Science.5 The rational management and exploitation of this cascade of digital assets offers boundless opportunities for research and applications. On the other hand, the ability to access and use this rising flood of data seems to lag behind, despite the rapidly growing capabilities of information and communication technologies (ICTs) to make much more effective use of those data. As long as the attention for data policies and data management by researchers, their organisations and their funders does not catch up with the rapidly changing research environment, the research policy and funding entities in many cases will perpetuate the systemic inefficiencies, and the resulting loss or underutilisation of valuable data resources derived from public investments. There is thus an urgent need for rationalised national strategies and more coherent international arrangements for sustainable access to public research data, both to data produced directly by government entities and to data generated in academic and not-for-profit institutions with public funding. In this chapter, we examine some of the implications of the âdata drivenâ research and possible ways to overcome existing barriers to accessibility of public research data. Our perspective is framed in the context of the predominantly publicly funded global science system. We begin by reviewing the growing role of digital data in research and outlining the roles of stakeholders in the research community in developing data access regimes. We then discuss the hidden costs of closed data systems, the benefits and limitations of openness as the default principle for data access, and the emerging open access models that are beginning to form digitally networked commons. We conclude by examining the rationale and requirements for developing overarching international principles from the top down, as well as flexible, common-use contractual templates from the bottom up, to establish data access regimes founded on a presumption of openness, with the goal of better capturing the benefits from the existing and future scientific data assets. The âPrinciples and Guidelines for Access to Research Data from Public Fundingâ from the Organisation for Economic Cooperation and Development (OECD), reported on in another article by Pilat and Fukasaku,6 are the most important recent example of the high-level (inter)governmental approach. The common-use licenses promoted by the Science Commons are a leading example of flexible arrangements originating within the community. Finally, we should emphasise that we focus almost exclusively on the policyâthe institutional, socioeconomic, and legal aspects of data accessârather than on the technical and management practicalities that are also important, but beyond the scope of this article
EFFECT OF A CARBOHYDRATE LOLLIPOP ON THE GASTRIC VOLUME OF FASTED PEDIATRIC PATIENTS
Background
Preoperative fasting is part of routine practice. Children subjected to prolonged preoperative fasting often suffer adverse effects. Consuming a preoperative lollipop may lessen their anxiety and have clinical benefits.
Aims:
To assess the effect of consuming a lollipop on gastric volume and the feasibility of administering a lollipop to a child preoperatively.
Methods:
In this prospective, repeated measures interventional study, we measured gastric antrum volume using ultrasound in children aged 2-18 years. We measured antrum volumes after participants had fasted for a minimum of six hours for solids and two hours for clear fluids. They then consumed a standard carbohydrate lollipop, and we repeated the antrum volume measurements after one hour.
Results:
Of the 38 patients enrolled, 32 completed the study; four had ingested additional food or liquid, and two were diagnosed with systemic disease the day after data collection. The gastric volume data were normally distributed. The mean volume change was 0.01 ml.kg-1 (95% CI -0.02 to 0.05; p = 0.460). The mean post-lollipop volume was 0.51 ml/kg (95% CI 0.43 to 0.58).
Conclusions:
Consuming a standard lollipop did not affect the gastric volume of fasted pediatric patients
Electrochemical deposition of 5,10,15,20-tetrakis-(4-sulphonatophenyl) porphyrin and its Co(II) derivative at a gold microelectrode array
Bronchoscopy in children with COVIDâ19 : a case series
CITATION: Goussard, P. et al. 2020. Bronchoscopy in children with COVIDâ19 : a case series. Pediatric Pulmonology, 55:2816â2822, doi:10.1002/ppul.25015.The original publication is available at https://onlinelibrary.wiley.comIntroduction: The coronavirus diseaseâ2019 (COVIDâ19) era is a challenging time
for respiratory teams to protect their patients and staff. COVIDâ19 is predominantly
transmitted by respiratory droplets; in the clinical setting, aerosol generating procedures pose the greatest risk for COVIDâ19 transmission. Bronchoscopy is associated with increased risk of patientâtoâhealth care worker transmission, owing to
aerosolized viral particles which may be inhaled and also result in environmental
contamination of surfaces.
Methods: We describe our experience with the use of modified fullâface snorkeling
masks for pediatric bronchoscopy procedures in four COVIDâ19 infected children
when filtering facepieces/respirators were in limited supply.
Results: Bronchoscopy was urgently required in four children, and could not be
delayed until COVIDâ19 test results were available. During the pandemic peak,
when respirators were in short supply, modified fullâface snorkel masks (SEAC
Libera, SEAC, Italy) were worn by the bronchoscopy team. Each mask was fitted with
an Oâring, adapter, and heat and moisture exchanger filter. To date, there have been
no COVIDâ19 infections among the bronchoscopy team staff, whereas the overall
Hospital staff COVIDâ19 prevalence rate has exceeded 13.5% (667/4949).
Conclusion: Emergency bronchoscopy procedures on COVIDâ19 infected patients or
patients with unknown infection status can be safely performed using modified fullâ
face snorkel masks.https://onlinelibrary.wiley.com/doi/full/10.1002/ppul.25015Publisher's versio