42 research outputs found

    Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

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    PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

    Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

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    PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

    Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

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    This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

    The anthropogenic impact on water quality of the river Danube in Serbia: Microbiological analysis and genotoxicity monitoring

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    The aim of this work was to examine the impact of urban wastewaters on the water quality of the Danube River in Serbia. Samples of water and sediments for microbiological analysis and genotoxicity monitoring were collected from 6 sites during spring and/or autumn 2010. Sanitary analysis, i.e. enumeration of total and fecal coliforms and intestinal enterococci, indicated moderate to critical fecal contamination, while organic load assessment (oligotroph to heterotroph ratio, index of phosphatase activity) revealed the category of moderately polluted water. Mercury-resistant bacteria were detected in all water samples, with high numbers at locations positioned downstream of Belgrade. There was no correlation of the microbiological parameters of the sediment and water samples. Genotoxicity monitoring, performed by the comet assay on hemocytes of mussels Sinanodonta woodiana, indicated a significant increase of DNA damage in mussels collected from the studied sites compared with the control group

    Variability in DNA damage of chub (Squalius cephalus L.) blood, gill and liver cells during the annual cycle

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    In this work the genotoxic potential of water in three localities in Serbia, which differ by the nature and degree of pollution, was determined in tissues of European chub (Squalius cephalus L.) on monthly basis over the 2011/2012 year season using the alkaline comet assay. Specimen samples of chub were taken from Special Nature Reserve ``Uvac{''}, as control site, and Pestan and Beljanica Rivers, as polluted sites at Kolubara basin, surrounded with coal mines. Three tissues, blood, gills and liver were used for assessing the level of DNA damage. Analysis was done by software (Comet Assay IV). The control site at Reserve ``Uvac{''} showed the lowest DNA damage values for all three tissues compared to Pestan and Beljanica. Blood has the lowest level of DNA damage in comparison with liver and gills. Decreased damage for all three tissues was observed at summer, while during the spring and autumn damage increased. (C) 2014 Elsevier B.V. All rights reserved.Ministry of Education, Science and Technological Development of the Republic of Serbia {[}173045

    Spectral sensitivity of the perch (Perca fluviatilis) from the Danube

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    In spectral sensitivity studies, electroretinograms (ERG) were recorded from the in situ eyecup of immobilized perch (Perca fluviatilis) electrofished in the floodplain zone of the Danube River. It is shown that the ERG b-wave is a good indicator of spectral sensitivity, although it reflects the activity of photoreceptors indirectly. With a maximum around 542 mm, the scotopic spectral sensitivity of perch obtained using fitted amplitude-log intensity functions for threshold calculation and two models developed in our laboratory for computer-assisted fitting of spectral sensitivity curves did not differ from the sensitivity determined using the microspectrophotometric and isolated pigment methods (maximum around 541 nm)

    VARIABILITY OF MESOSCALE FEATURES IN THE MEDITERRANEAN SEA FROM XBT DATA ANALYSIS

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    During the period 1998–2000, the Mediterranean Forecasting System Pilot Project, aiming to build a forecasting system for the physical state of the sea, has been carried out. A ship-of-opportunity programme sampled the Mediterranean upper ocean thermal structure by means of eXpendable Bathy-Thermographs (XBTs), along seven tracks, from September 1999 to May 2000. The tracks were designed to detect some of the main circulation features, such as the stream of surface Atlantic water flowing from the Alboran Sea to the Eastern Levantine Basin. The cyclonic gyres in the Liguro-Provenal Basin, the southern Adriatic and Ionian Seas and the anticyclonic gyres in the Levantine Basin were also features to be detected. The monitoring system confirmed a long-term persistence of structures (at least during the entire observing period), which were previously thought to be transient features. In particular, in the Levantine Basin anticyclonic Shikmona and Ierapetra Gyres have been observed during the monitoring period. In order to identify the major changes in the thermal structures and the dynamical implications, the XBT data are compared with historical measurements collected in the 1980s and 1990s. The results indicate that some thermal features are being restored to the situation that existed in the 1980s, after the changes induced by the so-called “Eastern Mediterranean Transient”
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