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

Experimental validation of a high-gain observer for composition estimation in an ethanol-water distillation column

International audienceIn this paper a high-gain observer used to estimate the product compositions in a distillation column for a non-ideal mixture (ethanol-water) through the tray temperature measurements is presented. The design of this observer is based on a simplified mathematical model. One of the main advantages of this observer is its constant gain, therefore its tuning depends only on choosing a few constant parameters satisfying some simple algebraic inequalities. The effectiveness of the proposed method is demonstrated through on-line experiments in a distillation pilot plant

SEOM clinical guideline in nasopharynx cancer (2017).

Nasopharyngeal carcinoma (NPC) is distinct from other cancers of the head and neck in biology, epidemiology, histology, natural history, and response to treatment. Radiation therapy is an essential component of curative-intent of non-disseminated disease and the association of chemotherapy improves the rates of survival. In the case of metastatic disease stages, treatment requires platinum/gemcitabine-based chemotherapy and patients may achieve a long survival time

Biochemical Markers in Osteoarthritis

Osteoarthritis (OA) is a chronic disease with a long silent period. The hallmarks of osteoarthritis (OA) include cartilage loss that leads to joint destruction and severe impairment of mobility. Involvement of subchondral bone and synovial tissue is well documentated. OA is the most prevalent cause of disability in the aging population of developing countries.The diagnosis is generally based on clinical symptoms and radiographic changes. However, X-ray has a poor sensitivity that does not allow an early detection of OA or the monitoring of joint damage progression. Another imaging technique is the magnetic resonance imaging (MRI). Although this medical test is more sensitive than plain radiography, it is more expensive and can´t be routinely applied to many patients. The limitations offered by such tools have cleared the need to identify more specific biological markers, which evaluate quantitative variations in joint remodeling, diagnostic, prognostic and efficacy of intervention. OA affects cartilage, subchondral bone, and synovium. Thus, molecules derived from these tissues could be considered as candidates for biological markers in OA, as these molecules have a role in metabolic processes in the joints. Recent data indicates that some markers could be valuable to diagnose, predict OA progression and assess therapeutic response; however, the interpretation of results should be careful because tissue specificity, clearance rates and circadian variations are still under investigation in most of biomarkers. Although biomarkers could be considered valuable tools, they still have some limitations in clinical practice and it is necessary to develop and validate specific and sensitive biomarkers