13 research outputs found

    Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

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    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

    Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

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    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

    Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

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    The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

    Synthesis and pharmacological evaluation of several ring-contracted amantadine analogs.

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    The synthesis of several (3-noradamantyl)amines, [(3-noradamantyl)methyl]amines, (3,7-dimethyl-1-bisnoradamantyl)amines, and [(3,7-dimethyl-1-bisnoradamantyl)methyl]amines is reported. They were evaluated against a wide range of viruses and one of them inhibited the cytopathicity of influenza A virus at a concentration similar to that of amantadine. Several of the new polycyclic amines show an interesting activity as NMDA receptor antagonists. A rimantadine analogue displayed significant trypanocidal activity. Moreover, to further characterize the pharmacology of these compounds, their effects on dopamine uptake were also assessed

    Publicaciones del Instituto de Biología Aplicada. Tomos 52-53

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    [Tomo 52] María del Pilar Gracia. — Contribución al estudio de las tecamebas amebas (Protozoa, Thecamoeboidea). Tecamebas esfagnícolas de la Península Ibérica. Enrique Gadea. — Algunas consideraciones sobre el poblamiento nematódico muscícola de Menorca. F. Español.—Notas sobre anóbidos (col.). Manuel González. — Contribución al conocimiento de los curculiónidos del Mediterráneo occidental. - XII. Los Barynotus ibéricos. María Concepción Rigau y Miguel Berbel. — Correlaciones de los pigmentos foliares con el crecimiento y la producción. - II. Estudio de las correlaciones existentes entre los pigmentos clorofila a y carotinoide y la producción en Lolium perenne L. Alejandro Palomo González. — Sobre alguno-; nematodos muscícolas de la zona de Ledesma (prov. Salamanca). Javier Fernández Casas. — Gypsophila niontserratii, nueva especie del Sur de España. Linnavuori. — A new species of the genus CompsidoIon Rt. (Het. Miridae) from Spain. Carmen Bach-Piella. — Tisanuros de la fauna española. Nota sobre Machilidae de Marchagaz (Cáceres).[Tomo 53] María del Pilar Gracia. — Tecamebas muscícolas de la Península Ibérica. A. Casinos. — Algunas consideraciones sobre la anatomía funcional del cráneo de los teleósteos. M. Dolores Romero Duque. — Algunos focos de infección de Heterodera schachtii Schmidt (Nematoda) en remolacha, en la región española de Levante. Enrique Gadea. — Algunas consideraciones en torno a la nematofauna muscícola de la isla de Zákynthos (Grecia). C. Altimira. — Notas malacológicas. J. Nadal. — Efecto del tiofosfato de 0-0 dimetilo y 0-(metilo-3 metil tio-4 fenilo) sobre una población Chlidonias hybrida (Pall) en La Encañizada (provincia de Tarragona). J. Gosálbez. — Primer coloquio sobre Mastozoología Ibérica. F. Español. — Notas sobre anóbidos (Col.). Carmen Bach Piella. — Sobre algunos caracteres faunísticos y ecológicos de los Machiladae de la Cordillera Central y provincia de Salamanca. J. Andrés. — Variaciones cronológicas de la intensidad del crecimiento longitudinal en plantas de maíz y avena.Peer reviewe

    Publicaciones del Instituto de Biología Aplicada. Tomos 48-49

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    [Tomo 48] E. Petitpiebre.—Variaciones morfológicas y de la genitalia en las Timarcha Lat. (Col. Chrysomelidae). Jorge Sabateb-Pí. —Aportación a la ecología de los Colobus polykomos satanas, Waterhouse 1838, de Río Muni (República de Guinea Ecuatorial). F. Español. — Notas sobre anóbidos (Col.). Manuel González. — El género Desbrochersella Reitter (Col. Curculionidae). Francisco Castelló. — Sobre la presencia del género Achanthochiton (Mol. Poliplaeophora) en las costas de la isla de Ibiza (Baleares). Mabía Rambla. — La especie Cosmobunus granarius (Lucas 1847) en la Península Ibérica y Norte de Africa. Jaime Isern.—Sobre Aspidosiphon clavatus (Sipunculoidea) del litoral de Blanes. Enrique Gadea. — Sobre la nematofauna muscícola de los Andes venezolanos. J. Mª Losa. — El Geaster triplex Juneh, característica de la asociación Buxo-Juniperetum phoeniceae Riv. Mart. Valentín Sans Coma. — Sobre la distribución de micromíferos del N. E. de la península ibérica, con algunasconsideraciones metodológicas.[Tomo 49] Benigno Román. — Nuevas especies de peces de Río Muni (Guinea Ecuatorial). Francisco Castelló. — Nota sobre la presencia de Chiton olivaceus en las islas Baleares. Esther Simón-Martínez. — Variación del nitrógeno mine ral en praderas experimentales. F. Español. — Notas sobre anóbidos (Col.). Enrique Gadea. — Algunas consideraciones sobre las nematocenosis de suelos primordiales. Giorgio Marcuzzi, Paola Pelusio e Silio Rigatti Luchini. — Osservazioni sulla variabilitá di due specie di Glomeris (Myriapoda, Diplopoda) nella regione di Asiago (Veneto). Mª Dolores Romero, F. Jiménez Millán y María Arias. — Interrelación de nematodos fitoparAsitos de algunos cultivos de solanáceas. F. J. Fernández Casas. — Notas sobre vegetación . Valentín Sans-Coma. — Algunos datos sobre los roedores de los Picos de Europa . V. Sans-Coma y J. Nadal-Puigdefábregas. — Sobre la distribución de Clethrionomys glareolus (Schreber, 1780) y Pitymys duodecimcostatus (de Sélys-Longchamps, 1839) en la Península ibérica.Peer reviewe

    Assessment of plasma chitotriosidase activity, CCL18/PARC concentration and NP-C suspicion index in the diagnosis of Niemann-Pick disease type C : A prospective observational study

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    Niemann-Pick disease type C (NP-C) is a rare, autosomal recessive neurodegenerative disease caused by mutations in either the NPC1 or NPC2 genes. The diagnosis of NP-C remains challenging due to the non-specific, heterogeneous nature of signs/symptoms. This study assessed the utility of plasma chitotriosidase (ChT) and Chemokine (C-C motif) ligand 18 (CCL18)/pulmonary and activation-regulated chemokine (PARC) in conjunction with the NP-C suspicion index (NP-C SI) for guiding confirmatory laboratory testing in patients with suspected NP-C. In a prospective observational cohort study, incorporating a retrospective determination of NP-C SI scores, two different diagnostic approaches were applied in two separate groups of unrelated patients from 51 Spanish medical centers (n = 118 in both groups). From Jan 2010 to Apr 2012 (Period 1), patients with ≥2 clinical signs/symptoms of NP-C were considered 'suspected NP-C' cases, and NPC1/NPC2 sequencing, plasma chitotriosidase (ChT), CCL18/PARC and sphingomyelinase levels were assessed. Based on findings in Period 1, plasma ChT and CCL18/PARC, and NP-C SI prediction scores were determined in a second group of patients between May 2012 and Apr 2014 (Period 2), and NPC1 and NPC2 were sequenced only in those with elevated ChT and/or elevated CCL18/PARC and/or NP-C SI ≥70. Filipin staining and 7-ketocholesterol (7-KC) measurements were performed in all patients with NP-C gene mutations, where possible. In total across Periods 1 and 2, 10/236 (4%) patients had a confirmed diagnosis o NP-C based on gene sequencing (5/118 [4.2%] in each Period): all of these patients had two causal NPC1 mutations. Single mutant NPC1 alleles were detected in 8/236 (3%) patients, overall. Positive filipin staining results comprised three classical and five variant biochemical phenotypes. No NPC2 mutations were detected. All patients with NPC1 mutations had high ChT activity, high CCL18/PARC concentrations and/or NP-C SI scores ≥70. Plasma 7-KC was higher than control cut-off values in all patients with two NPC1 mutations, and in the majority of patients with single mutations. Family studies identified three further NP-C patients. This approach may be very useful for laboratories that do not have mass spectrometry facilities and therefore, they cannot use other NP-C biomarkers for diagnosis

    Simplificación de la escala de Barthel para el cribado de fragilidad y dependencia severa en pacientes pluripatológicos

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    Delaying surgery for patients with a previous SARS-CoV-2 infection

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    Preoperative nasopharyngeal swab testing and postoperative pulmonary complications in patients undergoing elective surgery during the SARS-CoV-2 pandemic.

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    BACKGROUND: Surgical services are preparing to scale up in areas affected by COVID-19. This study aimed to evaluate the association between preoperative SARS-CoV-2 testing and postoperative pulmonary complications in patients undergoing elective cancer surgery. METHODS: This international cohort study included adult patients undergoing elective surgery for cancer in areas affected by SARS-CoV-2 up to 19 April 2020. Patients suspected of SARS-CoV-2 infection before operation were excluded. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery. Preoperative testing strategies were adjusted for confounding using mixed-effects models. RESULTS: Of 8784 patients (432 hospitals, 53 countries), 2303 patients (26.2 per cent) underwent preoperative testing: 1458 (16.6 per cent) had a swab test, 521 (5.9 per cent) CT only, and 324 (3.7 per cent) swab and CT. Pulmonary complications occurred in 3.9 per cent, whereas SARS-CoV-2 infection was confirmed in 2.6 per cent. After risk adjustment, having at least one negative preoperative nasopharyngeal swab test (adjusted odds ratio 0.68, 95 per cent confidence interval 0.68 to 0.98; P = 0.040) was associated with a lower rate of pulmonary complications. Swab testing was beneficial before major surgery and in areas with a high 14-day SARS-CoV-2 case notification rate, but not before minor surgery or in low-risk areas. To prevent one pulmonary complication, the number needed to swab test before major or minor surgery was 18 and 48 respectively in high-risk areas, and 73 and 387 in low-risk areas. CONCLUSION: Preoperative nasopharyngeal swab testing was beneficial before major surgery and in high SARS-CoV-2 risk areas. There was no proven benefit of swab testing before minor surgery in low-risk areas
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