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

ETUDE RETROSPECTIVE D'UNE SERIE DE 260 PATIENTS OPERES SOUS COELIOSCOPIE D'UN REFLUX GASTRO-OESOPHAGIEN (RESULTATS FONCTIONNELS)

TOURS-BU Médecine (372612103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Development of a Potentiometric Biosensor Based on Nanostructured Surface for Lactate Determination

Nanostructuring surfaces in order to improve the quality of determinations, in terms of detection limit and signal-to-noise ratio, had received a great attention in the last years. At this effect, a potentiometric for the determination of lactate, based on a nanostructured (ND) Si4N3 surface, is presented here. The potentiometric sensor developed is an electrolyte¿membrane¿insulator¿semiconductor (EMIS). The surface was first modified by a polyacrylic acid (PAA) layer, deposited by plasma enhanced chemical vapor deposition (PECVD), that can covalently link to the NH2 groups of the lactate dehydrogenase. Secondly, the nanostructures were formed on the surface by colloidal lithography. The obtained nanostructured surface was characterized. The stability of the biosensor in aqueous media was investigated obtaining a sensitivity of 49.7mV per decade. The detection limit for the determination of lactate was 2×10-7 M, with a linear range up to 10-5 M. The intra- and inter-electrode standard deviation were about 2.4% and 11%, respectively. Nanostructuring leads to a signal amplification of one order of magnitude when compared to the values obtained with the same device based on flat surface.JRC.I.4-Nanotechnology and Molecular Imagin

Protein Nanopatterns for Improved Immunodetection Sensitivity

In this work, we clearly demonstrate the capability of protein nanopatterns of improving the quality factors of immunosensing devices, such as lowering of the limit of detection and increase of sensitivity. This beneficial effect is obtained by the formation on the sensor's surface of bioadhesive domains of nanometric dimensions in a nonadhesive matrix by means of colloidal lithography.JRC.I.4-Nanotechnology and Molecular Imagin

Microstructural Evolution of Allylamine Polymerized Plasma Films

The present paper deals with the characterization of plasma polymerized allylamine films. The films were characterized using a large panel of techniques such as Fourier transformation infrared spectroscopy, X-ray photoemission spectroscopy and ellipsometry. The film microstructure was investigated as a function of the deposition power while other process parameters (gas mixture flow, pressure) were kept constant. The microstructure shows a strong dependence on the deposition power. A power transition has been identified outlining two deposition modes in agreement with a growth model developed for carbon nitride thin films. Conditions of deposition closed to this transition provide a film microstructure interesting for absorption and adhesion of biomolecules i.e. high NH2 content, high porosity and high deposition rate.JRC.I.4-Nanotechnology and Molecular Imagin

Large-Area Protein Nano-Arrays Patterned by Soft Lithography

Nanostructured polydimethylsiloxane stamps have been used to pattern regular nano-arrays of proteins on polyethylene glycol surfaces by microcontact printing. The master was fabricated by using colloidal lithography. In this technique polystyrene nanobeads were used as nanomasks during subsequent oxygen etching and silica deposition. The elastomeric stamps, fabricated by classical replica moulding, reproduced accurately the nanosized features of the moulds. Printing of the proteins was performed by controlling the pressure, enabling the creation of an ordered arrangement of fouling domains (protein) on a non-fouling background (polyethylene glycol). 300 nm diameter poly-L-lysine spots spaced 100 nm were patterned. Such nanofabricated biofunctional surfaces offer promising capabilities for the development of highly compacted, ultra-sensitive biosensing devices.JRC.I.4-Nanotechnology and Molecular Imagin

Large-Area Protein Nano-Arrays Patterned by Soft Lithography

Nanostructured polydimethylsiloxane stamps have been used to pattern regular nano-arrays of proteins on polyethylene glycol surfaces by microcontact printing. The master was fabricated by using colloidal lithography. In this technique polystyrene nanobeads were used as nanomasks during subsequent oxygen etching and silica deposition. The elastomeric stamps, fabricated by classical replica moulding, reproduced accurately the nanosized features of the moulds. Printing of the proteins was performed by controlling the pressure, enabling the creation of an ordered arrangement of fouling domains (protein) on a non-fouling background (polyethylene glycol). 300 nm diameter poly-L-lysine spots spaced 100 nm were patterned. Such nanofabricated biofunctional surfaces offer promising capabilities for the development of highly compacted, ultra-sensitive biosensing devices.JRC.I.4-Nanotechnology and Molecular Imagin

Plasma Assisted Production of Chemical Nano-Patterns by Nano-Sphere Lithography: Application to Bio-Interfaces

In this work a low-cost parallel technique for creating chemical nano-patterned surfaces using nano-spheres as masks is presented. This technique, called nano-sphere lithography, makes use of different steps of plasma etching and deposition processes, for the creation of polymeric nano-structures of different chemical functionalities with relevant applications to bio-interfaces. In this study, the attention is focused on the plasma processing aspects for the etching of the polymeric masks (colloidal masks) in order to control the shape and the size of the etched nano-structures. The bio-functionality of the nano-patterned surfaces has been proved with a selective immobilization of proteins on the bioactive spots.JRC.I.4-Nanotechnology and Molecular Imagin

Phase Transition of pNIPAM Grafted on Plasma-Activated PEO Monitored in-Situ by Quartz Crystal Microbalance

Thermoresponsive poly(N-isopropylacrylamide) layers were grafted on plasmaactivated poly(ethylene oxide)-like substrate. Analysis by ToF-SIMS confirmed the presence of a pNIPAM film, which shows a phase transition temperature at 28 - 32 °C with hysteresis, as determined in-situ by quartz crystal microbalance. During the transition, the frequency of the pNIPAM coated quartz sensor exhibits a pronounced and unexpected minimum while the dissipation changes monotonously. This peculiar behaviour is explained by temporary formation of water-rich regions, which may cause delayed release and uptake of water during the collapse and re-swelling of the layer.JRC.I.4-Nanotechnology and Molecular Imagin