Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Impacts of the Tropical Pacific/Indian Oceans on the Seasonal Cycle of the West African Monsoon

The current consensus is that drought has developed in the Sahel during the second half of the twentieth century as a result of remote effects of oceanic anomalies amplified by local land–atmosphere interactions. This paper focuses on the impacts of oceanic anomalies upon West African climate and specifically aims to identify those from SST anomalies in the Pacific/Indian Oceans during spring and summer seasons, when they were significant. Idealized sensitivity experiments are performed with four atmospheric general circulation models (AGCMs). The prescribed SST patterns used in the AGCMs are based on the leading mode of covariability between SST anomalies over the Pacific/Indian Oceans and summer rainfall over West Africa. The results show that such oceanic anomalies in the Pacific/Indian Ocean lead to a northward shift of an anomalous dry belt from the Gulf of Guinea to the Sahel as the season advances. In the Sahel, the magnitude of rainfall anomalies is comparable to that obtained by other authors using SST anomalies confined to the proximity of the Atlantic Ocean. The mechanism connecting the Pacific/Indian SST anomalies with West African rainfall has a strong seasonal cycle. In spring (May and June), anomalous subsidence develops over both the Maritime Continent and the equatorial Atlantic in response to the enhanced equatorial heating. Precipitation increases over continental West Africa in association with stronger zonal convergence of moisture. In addition, precipitation decreases over the Gulf of Guinea. During the monsoon peak (July and August), the SST anomalies move westward over the equatorial Pacific and the two regions where subsidence occurred earlier in the seasons merge over West Africa. The monsoon weakens and rainfall decreases over the Sahel, especially in August.Peer reviewe

Documentos de Trabajo, no.31

El presente trabajo, es el segundo de la Serie Estudios de Trayectorias Sociolaborales, en el marco del proyecto UBACyT “El núcleo duro de la desocupación en los ’90. Los diferentes trabajos, que se exponen a continuación nos muestran analíticamente el segmento de los varones adultos, en particular los jefes de familia, que han constituido y siguen constituyendo –aunque cada vez menos- el núcleo central del mundo del trabajo, especialmente si se trata de trabajo asalariado registrado. De hecho, gran parte de la literatura occidental que ha abordado la dimensión social del problema del desempleo -durante el siglo XX- ha tenido a esta población como su principal objeto implícito o explícito de estudio y de propuestas de políticas.UT Librarie

Trayectorias laborales masculinas : estudios diacrónicos de varones beneficiarios del Seguro de Desempleo y del Pago Único. Trayectorias laborales No. 2

Resumen: El presente trabajo, es el segundo de la Serie Estudios de Trayectorias Sociolaborales, en el marco del proyecto UBACyT El núcleo duro de la desocupación en los 90. Los diferentes trabajos, que se exponen a continuación nos muestran analíticamente el segmento de los varones adultos, en particular los jefes de familia, que han constituido y siguen constituyendo -aunque cada vez menos- el núcleo central del mundo del trabajo, especialmente si se trata de trabajo asalariado registrado. De hecho, gran parte de la literatura occidental que ha abordado la dimensión social del problema del desempleo -durante el siglo XX- ha tenido a esta población como su principal objeto implícito o explícito de estudio y de propuestas de políticas.\nAl respecto, creemos que del mismo modo en que los estudios de género, juventud o gerontología se han difundido a partir de desarrollar modelos, categorías e indicadores específicos, acordes con los nuevos procesos sociales de exclusión o discriminación que afectan a esos sectores, es fundamental abordar el desempleo en los hombres adultos y su relación con el mundo laboral, familiar y socio-institucional, redescubriendo su especificidad en cuanto a su relevancia económica, social y política.Fil: Chávez Molina, Eduardo. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones Gino Germani; Argentina.Fil: Salvia, Agustín. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones Gino Germani; Argentina.Fil: Gómez, Florencia. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones Gino Germani; Argentina.Fil: De Gainza, Mariana. Universidad de Buenos Aires. Facultad de Ciencias Sociales. Instituto de Investigaciones Gino Germani; Argentina.Fil: Salvia, Victoria. Universidad de Buenos Aires. Facultad de Filosofía y Letras; Argentina.Fil: Persia, Juliana. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina.Fil: Ferro, Mariano. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina.Fil: Austral, Rosario. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina.Fil: Herrera Gallo, Gonzalo. Universidad de Buenos Aires. Facultad de Ciencias Sociales; Argentina

Trayectorias laborales masculinas: Estudios diacrónicos de varones beneficiarios del Seguro de Desempleo y del Pago Único

El presente trabajo, es el segundo de la Serie Estudios de Trayectorias Sociolaborales, en el marco del proyecto UBACyT “El núcleo duro de la desocupación en los ’90. Los diferentes trabajos, que se exponen a continuación nos muestran analíticamente el segmento de los varones adultos, en particular los jefes de familia, que han constituido y siguen constituyendo –aunque cada vez menos- el núcleo central del mundo del trabajo, especialmente si se trata de trabajo asalariado registrado. De hecho, gran parte de la literatura occidental que ha abordado la dimensión social del problema del desempleo -durante el siglo XX- ha tenido a esta población como su principal objeto implícito o explícito de estudio y de propuestas de políticas. Al respecto, creemos que del mismo modo en que los estudios de género, juventud o gerontología se han difundido a partir de desarrollar modelos, categorías e indicadores específicos, acordes con los nuevos procesos sociales de exclusión o discriminación que afectan a esos sectores, es fundamental abordar el desempleo en los hombres adultos y su relación con el mundo laboral, familiar y socio-institucional, redescubriendo su especificidad en cuanto a su relevancia económica, social y política

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study (vol 46, pg 2021, 2022)

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Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2