Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

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.

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

The evaluation of the effects of age, carbon dioxide concentration and cracks to the carbonation of concrete: A case of selected public schools in Bulacan and Manila

Infrastructure development is a vital component in encouraging a country\u27s economic growth and in these infrastructures, concrete is the most widely used material because of its high compressive strength. Although concrete has high compressive strength, it is very weak when it comes to tensile strength which is solved by the introduction of steel reinforcement. Steel reinforcement improves the tensile strength of concrete but it is susceptible to problem like corrosion, specifically carbonation-induced corrosion. Carbonation is the process of carbon dioxide reacting with hydrated cement paste in pore water to reduce the natural alkalinity of concrete which results into corroding the steel reinforcement thus inducing cracks in the concrete. Carbonation is controlled by several factors but only some are significantly influential. Therefore, there is a need to determine the relationship of these factors to carbonation since structural integrity is important when it comes to infrastructures as safety and welfare of the people using it is the primary concern. In line with the foreseen problem, the objective of the study is to determine the relationship of each factor that affect the carbonation of concrete to its carbonation depth. The data that were obtained for the study came from different public schools in Manila and Bulacan. Using simple linear regression and multi linear regression, the relationship of each factor to the carbonation depth and how these factors contribute collectively to it was established. After considering the factors that may affect the carbonation of concrete which is age, width of cracks and carbon dioxide concentration, it is concluded from made linear regressions that age is the most dominant factor when it comes to determining the carbonation depth of a certain structure. Other factors such s width of cracks and carbon dioxide concentration doesn\u27t have such significant effect compared to age

Aplicación de la metodología Gemas Malitas para asignar las causas básicas de muerte feto infantil, Cali 1999

Se revisaron los certificados de defunciones fetales e infantiles ocurridas en Cali de julio 1 a diciembre 31, 1999, para asignarles la causa básica de muerte, con la metodología GEMAS MALITAS. Se analizaron 465 certificados; 45.6% corresponden a defunciones fetales y 25% a muertes post-neonatales. Las muertes perinatales representaron 67.8%; 52.6% ocurrieron en niños menores de 2,500 g de peso al nacer. Las malformaciones congénitas se presentan como la primera causa de muerte con 22.1%. Las infecciones fueron la segunda causa con 17.3%. Los problemas de placenta y cordón representan 12.5%. En 24.6% de los certificados analizados no se pudo establecer la causa de muerte. La aplicación de la metodología GEMAS MALITAS para asignar las causas básicas de muerte feto-infantil permite disminuir la causa indeterminada de muerte, sobre todo en los casos donde no se puede hacer autopsia anatomopatológica de los fetos recién nacidos e infantes. A review of death certificates was made between the 1st of July and the 31st of December of 1999 to assign the basic cause of death using the methodology developed by our Research Center (CEMIYA); 465 death certificates were analyzed; 45.6% were fetal deaths and 25% were post-neonatal deaths. Perinatal deaths were 67.8%. Low birth weight babies less than 2,500 were 52.6%. Congenital malformations were the leading cause of death with 22.1%. Infections were the second cause with 17.3%. Cord and placenta problems accounted for 12.5%. In 24.6% of the certificates it was impossible to establish the cause of death. The application of the methodology GEMAS MALITAS to assign basic causes in fetal infantile deaths is useful to avoid the term “indeterminate,” as a cause of death when the autopsy of the fetus or infant cannot be made

Aplicación de la metodologí Gemas Malitas para asignar las causas básicas de muerte feto infantil, Cali 1999

A review of death certificates was made between the 1st of July and the 31st of December of 1999 to assign the basic cause of death using the methodology developed by our Research Center (CEMIYA); 465 death certificates were analyzed; 45.6% were fetal deaths and 25% were post-neonatal deaths. Perinatal deaths were 67.8%. Low birth weight babies less than 2,500 were 52.6%. Congenital malformations were the leading cause of death with 22.1%. Infections were the second cause with 17.3%. Cord and placenta problems accounted for 12.5%. In 24.6% of the certificates it was impossible to establish the cause of death. The application of the methodology GEMAS MALITAS to assign basic causes in fetal infantile deaths is useful to avoid the term "indeterminate," as a cause of death when the autopsy of the fetus or infant cannot be made

Metodología para asignar causas básicas y directas en muertes fetoinfantiles

A methodology to assign underlying causes and direct causes in death certificates for fetal and infants deaths in under 1 year is proposed. A bibliographic review was made considering the different classifications proposed for the 2000 year. This metodology try to identify the leading causes of perinatal and infant deaths in order to propose preventive projects with risk approach at the different levels of maternal and infant care

Hepatitis B virus drug resistance mutations in HIV/HBV co-infected children in Windhoek, Namibia

CITATION: Tchuem, C. R. T., et al. 2020. Hepatitis B virus drug resistance mutations in HIV/HBV co-infected children in Windhoek, Namibia. PLoS ONE, 15(9):e0238839, doi:10.1371/journal.pone.0238839.The original publication is available at https://journals.plos.org/plosone/Publication of this article was funded by the Stellenbosch University Open Access FundENGLISH ABSTRACT: In patients who are HIV infected, hepatitis B virus (HBV) infection is an important co-morbidity. However, antiretroviral options for HIV/HBV co-infected children are limited and, at the time of this study, only included lamivudine. These children may remain on this regimen for many years until late adolescence. They are at high risk of developing HBV drug resistance and uncontrolled HBV disease. The aim of this study was to characterize HBV infection in HIV/HBV co-infected children. Known HIV-infected/HBsAg-positive children, previously exposed to lamivudine monotherapy against HBV, and their mothers were recruited at the Katutura Hospital paediatric HIV clinic in Windhoek, Namibia. Dried blood spot and serum samples were collected for HBV characterization and serological testing, respectively. Fifteen children and six mothers participated in the study. Eight of the 15 children (53.3%) tested HBV DNA positive; all eight children were on lamivudine-based ART. Lamivudine-associated resistance variants, together with immune escape mutants in the surface gene, were identified in all eight children. Resistance mutations included rtL80I, rtV173L, rtL180M, rtM204I/V and the overlapping sE164D, sW182*, sI195M and sW196LS variants. HBV strains belonged to genotypes E (6/8, 75%) and D3 (2/8, 25%). Further analysis of the HBV core promoter region revealed mutations associated with reduced expression of HBeAg protein and hepatocarcinogenesis. All six mothers, on HBV-active ART containing tenofovir and lamivudine, tested HBV DNA negative. This study confirms the importance of screening HIV-infected children for HBV and ensuring equity of drug access to effective HBV treatment if co-infected.https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238839Publisher's versio