29 research outputs found

    The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

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    Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

    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

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

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    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

    Growth, mortality and migratory pattern of white shrimp (Litopenaeus vannamei, Crustacea, Penaeidae) in the Carretas-Pereyra coastal lagoon system, Mexico

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    The growth, mortality and migration pattern of the population of Litopenaeus vannamei Boone 1931 in the Carretas-Pereyra coastal lagoon system, Mexico, were studied. The shrimp spatial distribution and abundance were analyzed in relation to salinity, water temperature, and substrate. A total of 2 669 shrimps was collected at 22 sites sampled monthly from March 2004 to August 2005. Juvenile shrimps of L. vannamei were present in the coastal lagoon system throughout the year, reaching densities from 0.001 to 0.302 ind/m2. The estimated daily growth rate was 0.06 to 0.27 mm carapace length (CL). No significant seasonal differences were appreciated. Weekly total mortality (Z) was between 0.04 and 0.34. Recruits, juveniles and sub-adults displayed a bimodal distributional pattern regulated by the prevailing conditions during the dry season. The peak abundance of juvenile stages occurred in December-January and March-May. The abundance presented an inverse correlation with salinity (r=-0.42; p < 0.05) and a positive correlation (r=0.44; p < 0.05) with silt content. No clear correlation was distinguished for emigration size with season of the year or water temperature

    Reproductive biology of Oreochromis niloticus (Perciformes: Cichlidae) at Emiliano Zapata dam, Morelos, Mexico

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    The reproductive season of tilapia was studied by monthly samplings at Emiliano Zapata dam, Morelos State, Mexico. From February 1999 through February 2000 a sample of 50 fish was taken from the commercial catch (castnet, 6.5 cm of mesh size). The observed sex ratio was 1:1.29 (females:males) (χÂČ=10.26; p&lt;0.05). The tilapia reached maturity at 151.3 mm (females) and 152.0 mm (males) of total length. Rainy (August) and dry (February) seasons were determined as the breeding period. Fecundity variation was better correlated with length (r=0.7473; p&lt;0.002) than with weight (r=0.7395; p&lt;0.002). The fecundity ranged between 243 and 847 oocytes per fish, with egg diameter from 300 to 3 700 ÎŒm. Intensive breeding activity in August and February coincide with phytoplankton biomass increase.Se analizĂł la biologĂ­a reproductiva de la tilapia en la presa Emiliano Zapata, Morelos, MĂ©xico. Para esto se realizaron muestreos de febrero 1999 a febrero 2000. Se tomaron 50 organismos mensuales de la captura comercial obtenidos con una atarraya de 6.5 cm de luz de malla. La proporciĂłn sexual fue de1:1.29 hembras:machos (χÂČ=10.26; p&lt;0.05). La madurez sexual se alcanza a los 151.3 mm (hembras) y a los 152.0 mm (machos) de longitud total. Se detectaron dos Ă©pocas de reproducciĂłn para la especie: durante la estaciĂłn lluviosa (agosto) y durante la estaciĂłn de secas (febrero). La fecundidad relativa presentĂł mayor correlaciĂłn con la longitud (r=0.7473; p&lt;0.002) que con el peso (r=0.7395; p&lt;0.002). Por otra parte, el intervalo para la fecundidad oscilĂł entre 243 y 847 ovocitos por pez, con diĂĄmetros de 300 a 3 700 ÎŒm. Asimismo, la actividad reproductiva de la especie en Agosto y Febrero, coincide con el incremento de biomasa fitoplanctĂłnic

    Reproductive aspects of Oreochromis niloticus (Perciformes: Cichlidae) at Coatetelco lake, Morelos, Mexico

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    Sex ratio, size at maturity, maturity stages, fecundity and egg diameter of Oreochromis niloticus from Coatetelco Lake, Morelos State, Mexico, were studied from January to December 1993. Sex ratio (male:female) was approximately 1:1.02. Length at maturity was 117 mm (males) and 120 mm (females). The fecundity ranged between 104 and 709 eggs, with egg diameter from 1 000 to 3 000 ÎŒm. The gonadosomatic and hepatosomatic index indicate that the species breeds during summer and winter.En este estudio se analizaron algunos aspectos reproductivos de la mojarra-tilapia Oreochromis niloticus L. en el lago de Coatetelco, Morelos. La informaciĂłn esta basada en los datos biolĂłgicos de 319 organismos obtenidos de enero a diciembre de 1993 de la captura comercial. Las hembras (161) representaron el 51% y los machos (158) el 49 % del total de la poblaciĂłn. La proporciĂłn de sexo fue de 1:1.02 (χ_ = 0.02; p=0.05). Los peces alcanzan la primera madurez sexual a los 117 mm y 120 mm de longitud total (hembras y machos respectivamente). El nĂșmero de Ăłvulos presentes en las gĂłnadas oscilĂł entre 104 y 709 con diĂĄmetro de 1 000 a 3 000 ÎŒm, lo cual hace que esta especie tenga baja fecundidad pero alta fertilidad por los hĂĄbitos de reproducciĂłn que presenta la especie. Se aplicĂł el indice gonadosomĂĄtico y hepatosomĂĄtico con los cuales se detectaron dos perĂ­odos (verano e invierno) de mĂĄxima actividad reproductiva
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