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

Approaches in biotechnological applications of natural polymers

Natural polymers, such as gums and mucilage, are biocompatible, cheap, easily available and non-toxic materials of native origin. These polymers are increasingly preferred over synthetic materials for industrial applications due to their intrinsic properties, as well as they are considered alternative sources of raw materials since they present characteristics of sustainability, biodegradability and biosafety. As definition, gums and mucilages are polysaccharides or complex carbohydrates consisting of one or more monosaccharides or their derivatives linked in bewildering variety of linkages and structures. Natural gums are considered polysaccharides naturally occurring in varieties of plant seeds and exudates, tree or shrub exudates, seaweed extracts, fungi, bacteria, and animal sources. Water-soluble gums, also known as hydrocolloids, are considered exudates and are pathological products; therefore, they do not form a part of cell wall. On the other hand, mucilages are part of cell and physiological products. It is important to highlight that gums represent the largest amounts of polymer materials derived from plants. Gums have enormously large and broad applications in both food and non-food industries, being commonly used as thickening, binding, emulsifying, suspending, stabilizing agents and matrices for drug release in pharmaceutical and cosmetic industries. In the food industry, their gelling properties and the ability to mold edible films and coatings are extensively studied. The use of gums depends on the intrinsic properties that they provide, often at costs below those of synthetic polymers. For upgrading the value of gums, they are being processed into various forms, including the most recent nanomaterials, for various biotechnological applications. Thus, the main natural polymers including galactomannans, cellulose, chitin, agar, carrageenan, alginate, cashew gum, pectin and starch, in addition to the current researches about them are reviewed in this article.. }To the Conselho Nacional de Desenvolvimento Cientfíico e Tecnológico (CNPq) for fellowships (LCBBC and MGCC) and the Coordenação de Aperfeiçoamento de Pessoal de Nvíel Superior (CAPES) (PBSA). This study was supported by the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UID/BIO/04469/2013 unit, the Project RECI/BBB-EBI/0179/2012 (FCOMP-01-0124-FEDER-027462) and COMPETE 2020 (POCI-01-0145-FEDER-006684) (JAT)

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

Inhibitory and synergistic effects of natural olive phenols on human platelet aggregation and lipid peroxidation of microsomes from vitamin E-deficient rats

20 Páginas; 3 Tablas; 3 FigurasPurpose This study explored the in vitro antioxidant and anti-platelet activities of hydroxytyrosol, hydroxytyrosol acetate, 3,4-dihydroxyphenylglycol and two phenolic olive extracts. These compounds and extracts were obtained from a new industrial process to hydrothermally treat the alperujo (160 °C/60 min), a by-product of olive oil extraction. Methods The extracts and the purified compounds were obtained chromatographically using both ionic and adsorbent resins. The antioxidant activity was determined by measuring inhibition of human platelet aggregation and inhibition of lipid peroxidation in liver microsomes of vitamin E-deficient rats. Results The positive effect of the extracts on the inhibition of platelet aggregation is showed, being higher in the case of hydroxytyrosol acetate up to 38 %, and for the first time, its synergist effect with hydroxytyrosol has been proved, obtaining more than double of inhibition. The phenolic extracts and the isolated phenols showed good results for inhibiting the lipid oxidation, up to 62 and 25 %, respectively. A synergistic effect occurred when the hydroxytyrosol acetate and the 3,4-dihydroxyphenylglycol were supplemented by hydroxytyrosol. Conclusion These results suggest the extract and these compounds obtained from a novel industrial process could be natural alternatives for the prevention of diseases related to cardiovascular disorder or oxidative damage.The authors wish to express their gratitude to the Ministerio de Economía y Competitividad of Spain and co-funded by European Social Fund (ESF) (Project AGL2013-48291-R) for providing financial support. Dr. Rodríguez-Gutiérrez (RYC-2012-10456 contract) wishes to thank to the “Ramón y Cajal” Program from the Spanish Ministry of Economy and Competitiveness, and Ms Rubio-Senent (JAE-Pre104) to the Spanish National Research Council and co-funded by European Social Fund (CSIC-ESF) for providing financial support.Peer reviewe

New phenolic compounds hydrothermally extracted from the olive oil byproduct alperujo and their antioxidative activities

The application of a novel process based on the hydrothermal treatment of olive oil waste (alperujo) led to a final liquid phase that contained a high concentration of simple phenolic compounds. This study evaluated the effects of time (15-90 min) on the composition of the phenolic compounds isolated at a fixed temperature of 160 °C. Phenolic compounds were extracted with ethyl acetate. Both qualitative and quantitative HPLC analyses of the extracts showed variation of the concentrations of phenolic compounds with time. In addition, new phenols that were not present in the untreated control have been characterized. The antioxidant activities of different phenolic extracts was measured by various assays conducted in vitro: antiradical capacity (using DPPH and ABTS radicals), ferric reducing power (P R), inhibition of primary and secondary oxidation in lipid systems, and other tests, such as inhibition of tyrosinase activity. The results show that the phenolic extracts inhibited oxidation in aqueous and lipid systems to a significantly greater extent than the untreated control, and they performed as well as or better than vitamin E in this capacity. © 2012 American Chemical Society.F.R.-S. and G.R.-G. thank the Consejo Superior de Investigaciones Científicas (CSIC) of Spain for their research contracts (JAE Pre_2010_00425 and JAE Doc_2009_00666). This work was partially financed by Ministerio de Ciencia e Innovación of Spain (Grant AGL2009-12352) and Consejería de Innovación, Ciencia y Empresa de la Junta de Andalucía (Proyecto de Excelencia P08-AGR-03751).Peer Reviewe

Production, characterization and isolation of neutral and pectic oligosaccharides with low molecular weights from olive by-products thermally treated

Alperujo was pre-treated in a hydrothermal reactor to solubilize the oligosaccharides. The liquid was extracted with ethyl acetate to remove the phenols, and then its sugar content was sequentially precipitated with ethanol:water solutions and ultrafiltered, obtaining oligosaccharide fractions in the range of 3000 to 1000Da that represent 23% of the total. One of the two major fractions was rich in pectic polymers, and the composition of the other fraction indicated the possible presence of xyloglucans and xylo-oligosaccharides. Hydrolysis was used to decrease the molecular weight of oligosaccharides by means of TFA or HCl for the neutral or enzymes for the pectic oligosaccharides. They were isolated by adsorption and size exclusion chromatography and identified by HPLC, GC, ESI-MS and MS/MS. The presence of tetra-, tri- and di-galacturonic acids was confirmed, and different structures for neutral and acidic xylo-oligosaccharides and oligosaccharides of xyloglucan with low molecular weight have been proposed. © 2011 Elsevier Ltd.We thank the Ministerio de Ciencia e Innovación of Spain for financial support (grant no. AGL2009-12352) and the Consejería de Innovación, Ciencia y Empresa de la Junta de Andalucía (Proyecto de Excelencia P08-AGR-03751).Peer Reviewe

New hydrothermal treatment of alperujo enhances the content of bioactive minor components in crude pomace olive oil

The application of a new process based on the hydrothermal treatment of olive oil waste (alperujo) led to a final solid rich in pomace olive oil (POO) enriched in minor components with functional activities. The effects of the time (15-90 min) and the temperature (150, 160, and 170 °C) of the thermal processing of alperujo on the yield, quality, and enrichment of minor components of crude POO were evaluated. The final treated solid had an increase in oil yield up to 97%, with a reduction in solids up to 35.6-47.6% by solubilization. Sterols increased up to 33%, aliphatic alcohols increased up to 92%, triterpenic alcohols increased up to 31%, squalene increased up to 43%, tocopherols increased up to 57%, and oleanolic acid increased up to 16% by the new treatment. The increase maintains a high concentration of functional substances probably even in the refining POO. © 2011 American Chemical Society.We thank the Ministerio de Ciencia e Innovación of Spain for financial support (Grant AGL2009-12352).Peer Reviewe