Role of surgical setting and patients-related factors in predicting the occurrence of postoperative pulmonary complications after abdominal surgery

OBJECTIVE: The aim of this retrospective study was to evaluate the role of surgical setting (urgent vs. elective) and approach (open vs. laparoscopic) in affecting postoperative pulmonary complications (PPCs) prevalence in patients undergoing abdominal surgery. PATIENTS AND METHODS: After local Ethical Committee approval, 409 patients who had undergone abdominal surgery between January and December 2014 were included in the final analysis. PPCs were defined as the development of one of the following new findings: respiratory failure, pulmonary infection, aspiration pneumonia, pleural effusion, pneumothorax, atelectasis on chest X-ray, bronchospasm or un-planned urgent re-intubation. RESULTS: PPCs prevalence was greater in urgent (33%) vs. elective setting (7%) (chi(2) with Yates correction: 44; p=0.0001) and in open (6%) vs. laparoscopic approach (1.9%) (chi(2) with Yates correction: 12; p=0.0006). PPCs occurrence was positively correlated with in-hospital mortality (Biserial Correlation r=0.37; p=0.0001). Logistic regression showed that urgent setting (p=0.000), Ariscat (Assess Respiratory Risk in Surgical Patients in Catalonia) score (p=0.004), and age (p=0.01) were predictors of PPCs. A cutoff of 23 for Ariscat score was also identified as determining factor for PPCs occurrence with 94% sensitivity and 29% specificity. CONCLUSIONS: Patients undergoing abdominal surgery in an urgent setting were exposed to a higher risk of PPCs compared to patients scheduled for elective procedures. Ariscat score fitted with PPCs prevalence and older patients were exposed to a higher risk of PPCs. Prospective studies are needed to confirm these result

Detection of receptors for polymerised human albumin by immunoperoxidase and immunoadherence in liver tissue of HBsAg chronic carriers.

Receptors for polymerised human albumin (pHSA-Rs) were detected in unfixed cryostat sections from HBsAg chronic carriers using direct immunoperoxidase and immunoadherence methods. Although pHSA-Rs were detected by both methods, the receptors detected by immunoperoxidase were associated with HBV and showed properties different from the receptors detected by immunoadherence. The double immunocytochemical staining which detected contemporaneously pHSA-Rs and HBsAg in the same cell showed that there are two types of infected hepatocytes: one capable of synthesizing pHSA-Rs and HBsAg and the other capable of synthesizing only HBsAg. The intrahepatocyte synthesis of pHSA-Rs does not correlate with the severity of chronic liver disease or with the presence of tissue HB core antigen

Correlation between hepatitis B virus deoxyribonucleic acid and receptors for polymerized human albumin in HBV chronic infection.

This study indicates that hepatitis B virus deoxyribonucleic acid (HBV DNA) is actually the most sensitive marker for the identification of HBV-related pathologies in active replication phase and does not correlate with serum receptor activity for polymerized human serum albumin which can be found in absence of either HBV DNA or HBeAg in HBV chronic infection

Serum binding activity for human albumin polymers in acute and chronic virus hepatitis.

We considered the serum binding activity for human albumin polymerized with glutaraldehyde in 346 serum samples of 205 subjects with acute and chronic type A, B and non-A, non-B virus hepatitis. We showed that the binding activity for pHSA in the control groups did not have a titer higher than 2(-6). All sera from patients with HAV and HBV acute infection showed a high binding titer that returned to below the threshold in the former after the peak of hepatocytolysis, and in the latter after the seroconversion of HBsAg to anti-HBs. In the subjects who became HBsAg chronic carriers after the acute episode of HBV infection, the pHSA binding activity showed a decrement of the titer in relation to the seroconversion of HBeAg to anti-HBe. Furthermore, 92% of HBsAg chronic carriers who were HBeAg positive had a high titer of pHSA binding, while only 14.3% of the anti-HBe positives showed a high titer. Acute and chronic hepatitis non-A, non-B virus showed a pHSA binding titer similar to that of the control group. The results indicate that the non-A, non-B virus does not seem to be correlated to pHSA or related factors

Indagine sulla eco-epidemiologia di virus delle ortive in Provincia di Brindisi

Eco-epidemiological research of vegetables viruses in Brindisi Province Nearly 45% of Italy’s tomato production is fieldgrown in Apulia, Southern Italy and in this Region, the Brindisi Province is the second largest producer with an acreage of about 3500 ha. The crop is directed mostly to canning industry and has a high economic value. In 1997 and 1998 about 30% of the total tomato acreage in the Brindisi Province was stricken by massive outbreaks of virus diseases involving mainly Tomato spotted wilt virus (TSWV), Cucumber mosaic virus (CMV), Alfalfamosaic virus (AMV) and Potato virus Y (PVY). All these viruses caused appreciable economic that caused relinquishment of traditional tomato-growing areas, low quality of the commodities and a huge increase and often indiscriminate use of insecticides. TSWV epiphytotics were the most devastating with nearly 95% crop losses. This paper reports the results of a systematic survey whereby, over a 12-month period, the occurrence of TSWV, CMV, AMV and PVY was monitored in weeds that usually colonise tomatogrowing areas. More than 4800 plants belonging to 31 species and about 8000 thrips, including adults and larvae, were collected and analysed by Digoxigenin-labeled riboprobes. TSWV was the virus more frequently detected (percent of infection in parentheses) (3.5%), followed by PVY (1%), CMV (0,7%), AMV (0,7%) and INSV (0.2%). In tomato, INSV was found in mixed infection with TSWV. TSWV was also recorded in the adults of Frankliniella occidentalis (28%), Thrips tabaci (29%), and in other undetermined thrips species (31%) and larvae (14,5%). Diplotaxis erucoides, Fumaria officinalis, Oxalis acetosella, Sinapis spp, and Veronica spp were identified as new hosts for TSWV in Ital