How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Contribución a los sistemas mixtos del centro oeste bonaerense : resultados de la campaña 2019/2020

El equipo de trabajo responsable de esta publicación se enorgullece de presentar la segunda edición de “Contribución a los sistemas mixtos del centro-oeste bonaerense”. El contexto mundial y, en particular de nuestra región, presenta condiciones diferentes a partir de la presencia del Covid-19. Si bien se han continuado realizando los ensayos a campo y la posterior redacción de informes técnicos, esta situación ha obligado a replantear y reprogramar el trabajo de extensión, ya que no han sido posibles las actividades presenciales, siendo reemplazadas por la vía virtual. De modo tal, que cobra aún más relevancia la generación de información y su difusión para estar cerca de la comunidad agropecuaria en general. La contribución del estado provincial y nacional en la generación de información técnica, ha sido fundamental en el desarrollo agropecuario del país. El Ministerio de Desarrollo Agrario de la provincia de Buenos Aires, a través de la Chacra Experimental de Bellocq y el INTA representado por las Agencias de Extensión Rural Bolívar, Pehuajó y Carlos Casares, trabajan de manera conjunta aunando recursos humanos y económicos en pos de aportar soluciones y alternativas a los sistemas de producción de la región. El contenido de esta publicación pretende contribuir a las principales actividades productivas de la zona, mediante artículos referidos a ganadería, agricultura, extensión y reportes integradores donde se pretende evaluar el sistema productivo en su conjunto y no un cultivo o una secuencia productiva en particular en la que sólo se tiene en cuenta la productividad. Se trata de caracterizar el comportamiento de los factores productivos, económicos y ambientales en su conjunto y no como compartimentos estancos. Como en la edición anterior, la metodología de trabajo depende fuertemente de la interacción con diferentes instituciones como universidades, escuelas agrotécnicas, centros educativos para la producción total, grupos CREA, Aapresid, Cambio Rural y empresas del sector, a quienes se agradece la colaboración. Se pone de manifiesto que la mención de productos y marcas comerciales en esta publicación no significa la recomendación, garantía o certificación por parte de los autores, ni implica que haya otros similares de igual funcionamiento no mencionados en los trabajos publicados.EEA PergaminoFil: Estelrrich, Carolina. Ministerio de Desarrollo Agrario. Chacra Experimental Bellocq; ArgentinaFil: Pérez, Gonzalo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Pergamino. Agencia de Extensión Rural Bolívar; ArgentinaFil: Pereyro, Alvaro. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria General Villegas. Agencia de Extensión Rural Pehuajó; ArgentinaFil: Lacentre, Eduardo. Ministerio de Desarrollo Agrario. Chacra Experimental Bellocq; ArgentinaFil: Sciarretta, Federico. Gentos. Equipo de desarrollo; ArgentinaFil: Buffarini, Miguel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria General Villegas; ArgentinaFil: Pagani, Agustín. CLARION; ArgentinaFil: Gomez, Gastón. Kikel. Establecimiento Nueva Bélgica; ArgentinaFil: Mazzola, Leandro. Kikel. Establecimiento Nueva Bélgica; ArgentinaFil: Sticconi, María Eugenia. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Pergamino. Desarrollo Rural; ArgentinaFil: Bailleres, Matias Andres. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Cuenca del Salado. Agencia De Extensión Rural Chascomus; ArgentinaFil: Bailleres, Matias Andres. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Cuenca del Salado. Agencia De Extensión Rural Chascomus; ArgentinaFil: González Maddaloni, Magdalena. Actividad Privada. Diseño y Diagramación; ArgentinaFil: Gonzalez, Pablo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Pergamino. Sección Comunicaciones; Argentin

Effects of pre‐operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or >= 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care