South African Paediatric Surgical Outcomes Study : a 14-day prospective, observational cohort study of paediatric surgical patients

BACKGROUND : Children comprise a large proportion of the population in sub-Saharan Africa. The burden of paediatric surgical disease exceeds available resources in Africa, potentially increasing morbidity and mortality. There are few prospective paediatric perioperative outcomes studies, especially in low- and middle-income countries (LMICs). METHODS : We conducted a 14-day multicentre, prospective, observational cohort study of paediatric patients (aged <16 yrs) undergoing surgery in 43 government-funded hospitals in South Africa. The primary outcome was the incidence of in-hospital postoperative complications. RESULTS : We recruited 2024 patients at 43 hospitals. The overall incidence of postoperative complications was 9.7% [95% confidence interval (CI): 8.4–11.0]. The most common postoperative complications were infective (7.3%; 95% CI: 6.2–8.4%). In-hospital mortality rate was 1.1% (95% CI: 0.6–1.5), of which nine of the deaths (41%) were in ASA physical status 1 and 2 patients. The preoperative risk factors independently associated with postoperative complications were ASA physcial status, urgency of surgery, severity of surgery, and an infective indication for surgery. CONCLUSIONS : The risk factors, frequency, and type of complications after paediatric surgery differ between LMICs and high-income countries. The in-hospital mortality is 10 times greater than in high-income countries. These findings should be used to develop strategies to improve paediatric surgical outcomes in LMICs, and support the need for larger prospective, observational paediatric surgical outcomes research in LMICs. CLINICAL TRIAL REGISTRATION : NCT03367832.Jan Pretorius Research Fund; 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 the Paediatric Anaesthesia Community of South Africa (PACSA).https://bjanaesthesia.org2020-02-01gl2019Anaesthesiolog

Structural characteristics of some mercaptoacetic acid hydrazides

NMR and molecular modeling were used to analyze the conformational states of a series of mercaptoacetic acid hydrazides. A chemical exchange phenomenon was observed in the phase-sensitive NOESY spectrum of all derivatives in both CDCl3 and DMSO-d6 solvents. Chemical shifts, temperature and solvent dependence as well as MonteCarlo conformational search suggest that two rotamers exist around the amide bond in solution in a slow, for the NMR time scale, interconversion at room temperature. The trans conformer is predominant in CDCl3 and seems to be stabilized by the presence of hydrophobic interactions between the two aliphatic ends of the molecule. The relative population of the cis conformer increases tenfold in DMSO-d6 stabilized through the formation of hydrogen bonds. © 2003 Elsevier Science B.V. All rights reserved

Synthesis and antifungal and antioxidant properties of some new 5-substituted-4-amino(or aryl)-3-mercapto-4(H)-1,2,4-triazoles

The synthesis and antifungal and antimicrobial evaluation of some new 5-substituted-4-amino(or aryl)-3-mercapto-4(H)-1,2,4-triazoles is reported. The involvement of the new compounds in free radical processes is also investigated and their lipophilicity is calculated and related to the determined antioxidant activity. Compounds 7a, 7b and 7c exhibited interesting antioxidant properties at concentration 0.01 mmol/l, expressed by their capacity to inhibit Fe2+/ascorbate induced hepatic microsomal lipid peroxidation, to scavenge OH·and to interact with nitrogen centered radicals such as 1,1-diphenyl-2-picrylhydrazyl stable free radical (DPPH). Moreover, compound 6a showed activity against Aspergillus versicolor, possessing a MIC of 82 μg/ml

Synthesis and antiviral activity evaluation of some new 6-substituted 3-(1-adamantyl)-1,2,4-triazolo[3,4-b][1,3,4]thiadiazoles

A number of novel 3,6-disubstituted 1,2,4-triazolo[3,4-b][1,3,4] thiadiazole derivatives, containing the adamantyl moiety, were synthesized and examined in various viral test systems. No antiviral effects were noted with any of the compounds at subtoxic concentrations in cell culture. © 2002 Published by Éditions scientifiques et médicales Elsevier SAS