36 research outputs found

    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

    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

    Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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    Contains fulltext : 172380.pdf (publisher's version ) (Open Access

    Pegylated Interferons and Their Use in Clinical Practice

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    The Alphabet of the Hepatitis Viruses has been Increasing: Hepatitis G Virus and GB Viruses

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    In the last year (1995), a new hepatitis agent that transmissible via blood has been found out by the Genelabs laboratories and it has been named as hepatitis G virus (HGV). In the same year, the Abbott laboratories have presented three new viral agents named with GB prefix and have defined them as GBV-A, GBVB and GBV-C. The hepatitis G virus as a member of the Flaviviridae is a RNA virus and closely related with HCV. It has been shown that it is an agent of both acute and chronic hepatitis. According to the results of the studies limited number, statistically important HGV-RNA positivity has been found among the multiple transfused patients, iv. drug addicts, haemophilic patients. In healthy blood donor population, the HGV-RNA positivity ranges from 0.5% to 1.7%. Besides the GBV-A one of the GB agents has not the replication state on the liver of the tamarin, it has been shown that GBV-B causes hepatit disease in the tamarins. It has not been provided yet whether or not the GBV-B causes a disease in man. However, GBV-C is a hepatitis agent of human being and there are strong evidence that the disease would end to be chronic. According to the present data, there is a close similarity between the GBV-C and HGV and the mentioned two viruses may be the same virus. Next studies will clearly demonstrate the relationship between the GBV-C and HGV. In the paper, the information related to HGV and GB agents to be the new agents of hepatitis has been reviewed in the light of the literature

    Antimicrobial Susceptibility of Enterococcus Species Collected from Clinical Specimens

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    Seventy isolates of enterococci with species identification were collected from clinical specimens between August 1996-June 1997 and antimicrobial susceptibility tests were performed. Using conventional tests, 67.2% of the isolates were identified as Enterococcus faecalis, 28.6% of the isolates as E. faecium and 2.8% of the isolates as E. gallinarum. Penicillin and ampicillin resistance were present in 21.4% of the isolates and there was no β-lactamase producer. High-level resistance to gentamicin and streptomycin were detected in 31.4% and 22.8% of the isolates, respectively. While there was no vancomycin and teicoplanin resistance in E. faecalis and E. faecium strains, E. gallinarum strains were moderately susceptible to vancomycin but susceptible to teicoplanin. Ciprofloxacin resistance was present in 20% of the isolates. Penicillin, ampicillin, ciprofloxacin and gentamicin resistance were significantly higher in E. faecium strains than that in E. faecalis strains (p 0.05)

    Chronic Hepatitis C and Diabetes Mellitus

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    We often see type-2 diabetes mellitus (DM) in the patients admitted to our clinics for chronic hepatitis C. Thereforey, we decide to examine the patients with chronic viral hepatitis (B and C) for DM and the patients with type-2 DM for HBsAg and anti-HCV antibodies. Group-1 was consisted of 72 patients with chronic hepatitis B and 38 patients with chronic hepatitis C between 1990 and 1995 (n=110). The patients who admitted to hospital for type-2 DM second half of 1995 consisted of group-2. In these two group, we searched the transaminases, other biochemical tests and viral hepatitis markers with ELISA method. We found type-2 DM in 34.2% of patients with chronic hepatitis C and 2.7% of chronic B hepatitis group (p<0.001). All of type-2 DM with chronic hepatitis had not any genetic predisposition for DM. Type-2 DM was diagnosed in 2/3 of the patients after chronic hepatitis C was diagnosed. In the patients with type-2 DM, rates of HBsAg and anti-HCV positivity were found 5% and 6% respectively. The prevalence of HBsAg positiveness is the same as general population value of 5 (4-11)%. Percentage (6%) of anti HCV positiveness in diabetics is significantly higher than normal population value of 0.6 (0.2-1)% (p<0,05). As a result, we think that chronic hepatitis C infection might be a risk factor for type-2 DM
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