Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p<00001), age 70 years or older versus younger than 70 years (230 [165-322], p<00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p<00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

NEUROMYOPATHIES IN THE CORRECTION OF ATTENTION DEFICIT DISORDER AND HYPERACTIVITY IN SCHOOLCHILDREN

The proposed correction procedure in educational technology for children suffering from attention deficit disorder with hyperactivity. The analysis of the correlation of the results of psychological testing of the properties of attention and the dynamics of EEG with the efficiency of the educational process

THE POSSIBILITY OF BIOFEEDBACK IN EDUCATIONAL ADAPTATION OF JUNIOR SCHOOLCHILDREN

In order to develop an effective self-regulation skills in younger students the technology of computer games biofeedback psychological state of the child. Using the virtual simulation of situations and conditions it is shown that as a result of conscious control over one’s own state, the student can develop skills of self-regulation. Described stories of gaming training, which is controlled by the heart rate of the playe

Development of A Method for the Combined Control of the Hardness of Winding Textile Package

Analysis of methods for determining the hardness of the winding shows that all existing methods require a lot of labor and time. When measuring the layer-by-layer hardness, the known methods do not allow obtaining continuous values, and in the case of measuring the hardness of packages of complex shape (conical bobbins, cops, spinning cobs, etc.), it requires a calculation using cumbersome formulas. In this case, the main difficulties arise in determining the volume of the layers of the winding, which in the general case have a complex configuration, and due to defects in the winding may have an irregular shape. Obviously, the described technique is rather cumbersome, and a lot of measurements and calculations are required to obtain a graph of the change in the winding hardness along the package radius. The construction of a graph of the change in hardness along the generatrix using a special device is generally problematic, since placement of more than three sources on the device is impossible due to the size of the meters, and the construction of the curve by three points cannot be considered satisfactory. Winding hardness is one of the most important parameters, on which many technological properties of the package depend. Indeed, with an increase in the hardness of the winding, the amount of material in the same volume increases, which makes it possible to replace packages less often, both on the machine that forms them, and at the subsequent transition. As a result, the equipment useful time increases. It was found that the hardness of the winding is closely related to its rigidity, and hence to the stability during transportation. The hardness of the winding affects the permeability of the package when it is treated with solutions. In this case, a huge role is played not only by the average value of the hardness, but also by its distribution over the layer

ASSESSMENT OF THE ADAPTIVE ABILITIES IN JUNIOR SCHOOL STUDENTS USING GAME BIOFEEDBACK TECHNOLOGY

In this study we selected 3 basic types of the adaptive behavior of the junior school students (n = 80) using a comparative analysis of the psychological and psycho-physiological characteristics in the course of game biofeedback. As a result of training the emotional state of the students normalized and psycho   physiological tension decreased. The ADHD and frequently ill students also got a positive outcome after training

Game-based biofeedback in the adaptation of junior schoolchildren

The paper presents the results of the use of the computer game-based biofeedback in the process of adaptation to the school learning. We conducted health-improving development lessons in several groups of junior schoolchildren. Analysis of the results showed high efficiency of the use of computer biofeedback at school. 3 types of children’s behavior during the lessons were described; one of them might be related to the risk group of ADHD syndrome