Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Facile Method for Obtaining Gold-Coated Polyester Surfaces with Antimicrobial Properties

The antimicrobial and antifungal activity of polymers used in medical devices has been extensively studied due to the growing impact of hospital-related infections in patients. The ideal biocidal polymeric materials should be very effective in the microorganism’s inhibition, not toxic to the human body, and environmentally friendly. In this context, this work is aimed at obtaining antimicrobial and antifungal properties at the polyester film surfaces without introducing toxic effects. Poly (ethylene terephthalate) (PET) films were functionalized with Ar plasma and then immersed in a solution containing gold nanoparticles (AuNps). The results demonstrated the appearance of the hydrophilic groups on the film surface after modification of PET film by plasma Ar treatment and the formation of the polar groups such as C=O, COO-, and OH, which then reacted with AuNps. The changes induced in the treated polymer samples were investigated in terms of AuNp adsorption efficiency on polyester film by contact angle, profilometry, Scanning Electron Microscopy (SEM), Attenuated Total Reflectance Spectroscopy-Fourier Transform Infrared (ATR-FTIR), and X-ray Photoelectron Spectroscopy (XPS) measurements. The morphological and structural analyses have shown a good adhesion of AuNps at treated film surfaces. The results of biocompatibility antimicrobial and antifungal tests proved the nontoxic behavior of the sample and its good antimicrobial and antifungal activity

Temperature influence on the dipalmitoylphosphatidylcholyne - Model membranes studied by FTIR

Lyotropic liquid crystals are realized from certain concentration of amphiphilic molecules, such as phospholipids, in water. The specific interactions in which water is involved are very important for model-membrane stability. Dipalmitoylphosphatidylcholyne (DPPC) model membranes have been studied by FTIR technique at different temperatures in the spectral range {2500 - 4000} cm(-1). A Gaussian deconvolution has been performed in order to study the water behaviour from the point of view of hydrogen-bond formation between water molecules and both the hydrophilic heads of phospholipids and the components of buffer solution. This study contributes to the understanding the mechanisms which assure the model membrane stability