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

Demand for lamps in the local luminaire manufacturers\u27 market

The study was conducted in order to find out more about an untapped market known as the local luminaire manufacturers market. Philips Electronics and Lighting Incorporated needs to know how they can penetrate this market with their lamp products. This market manufactures luminaires and assembles these with lamps before selling these to final customers. In order to study how Philips can become suppliers for this market, the researchers came up this problem: to determine the size of the demand for lamps in the local luminaire manufacturer market. The study also focuses on the number and types of luminaires produced by each LLM, the types of lamps needed for each type of luminaire, the supply source of lamps for these LLMS, and the basis and requirements of these LLMs for supplier selection. The researchers conducted interviews with all known local luminaire manufacturers in order to determine the information needed. The interviews were done with the help of an interview guide. Out of the nine possible respondents, only seven granted interviews, and the analysis of the study\u27s findings were based on the results of these interviews. The findings revealed that there is a large demand for fluorescent lamps in the local luminaire manufacturer market, as compared to other lamps such as incandescents, halogens, and compact fluorescents. This is due to the fact that most of these manufacturers produce only fluorescent-based luminaires, and the other types of luminaires such as downlights, pinlights, and wallwashers are usually imported

Factores ambientales naturales que determinan la produccion furticola de las especies manzana, pera, uva de mesa en la Comuna de San Javier.

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Efeito mutagênico da água natural (poço, rios Ficha e Minas Gerais, próximos à cidade de Ubiratã, Estado do Paraná, Brasil) em sistema teste animal - DOI: 10.4025/actascibiolsci.v26i1.1665

Intense industrial development and population growth have been altering the quality of water and innumerous studies have been undertaken to analyze their effects on humans. Due to rivers contamination with agrotoxics, herbicides, pesticides, excess of farming chemical additives and through sewers spilling not properly treated industrial waste, investigating cytotoxic and mutagenic activity of river water becomes all-important. Bone marrow cells of Wistar rats (Rattus norvegicus), treated in vivo, through gavage, in subchronic treatment (7 days), were used as experimental animal test system to investigate the effects of well water and water from the rivers Ficha and Minas Gerais, close to the municipality of Ubiratã, State of Paraná, southern Brazil. Cell division index and metaphase chromosomes were analyzed. The statistical analysis showed that the experiment's water failed to alter cell division cycle of Wistar rats and did not increase number of chromosome aberrations. No cytotoxic and clastogenic effects ensued from this treatmentO intenso desenvolvimento industrial e crescimento populacional têm promovido alterações na qualidade da água, sendo esta fonte de muitos estudos para análise desses efeitos no ser humano. Devido a contaminação dos rios por agrotóxicos, herbicidas, pesticidas e demais aditivos químicos utilizados nas lavouras, e pelas indústrias que despejam através de esgotos, resíduos de sua produção, que não são devidamente tratados, torna-se importante a investigação da atividade citotóxica e mutagênica da água dos rios. Neste estudo foi utilizado como sistema teste animal as células da medula óssea de ratos Wistar (,em>Rattus norvegicus), tratados in vivo, via gavagem, de forma subcrônica (7 dias), para investigação dos efeitos das águas do poço, e dos rios Ficha e Minas Gerais, próximos à Ubiratã, Estado do Paraná, Brasil, analisando-se o ciclo de divisão celular e os cromossomos metafásicos. A análise estatística demonstrou que as águas não alteraram o ciclo de divisão celular dos ratos Wistar e também não provocaram aumento no número de aberrações cromossômicas, mostrando não terem neste tratamento, efeito citotóxico e nem clastogênic

Lipid nutrition studies on grouper (Epinephelus coioides) larvae

The main objectives of this project were to study the lipid chain transfer from the egg stage through hatching and the patterns of lipid conservation or loss during starvation and feeding of larvae in order to elucidate the lipid metabolism of grouper (Phase 1); to determine the fatty acid composition of highly unsaturated fatty acid (HUFA) boosters and enriched live food organisms to enable the possibility of choosing food organisms that provide various dietary levels and ratios of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and arachidonic acid (ARA, Phase 2); and to determine the effect of Brachionus and Artemia, containing different levels and ratios of DHA:EPA:ARA, on the growth and survival of grouper larvae (Phase 3). Total lipids (TL) of samples were extracted and separated into neutral (NL) and polar lipids (PL). The samples collected in Phase 1 were floating neurula eggs, newly hatched (NHL) and unfed 4-day larvae; larvae fed with live food organisms for 25 and 35 days or starved for 3 days; and wild-sourced larvae starved for a week. In Phase 2, the samples collected were phytoplanktons, Brachionus cultured in phytoplankton for 4 days, Diaphanosoma celebensis and Pseudodiaptomus annandalei. In phase 3, larvae were fed Brachionus until day 14 and at day 25 with Artemia. E. coioides eggs contained high DHA, EPA and ARA, demonstrating their importance in larval development. Larvae primarily spent NL as energy, whereas PL was generally conserved. Wild grouper larvae had higher levels of PL than NL, whereas hatchery-sourced eggs and larvae contained higher levels of NL than PL. Based on the lipid content of wild larvae, high phospholipid diets were essential for larvae survival and normal development. A variety of products were effective in enriching the HUFA content (particularly ratios of DHA, EPA and ARA) of live food organisms. HUFA-enriched live food organisms enhanced the growth, survival and pigmentation in grouper larvae

Amino and fatty acid profiles of wild-sourced grouper (Epinephelus coioides) broodstock and larvae

This study was undertaken to provide information on the levels of amino acids in the muscle, liver and gonad of wild-sourced broodstock and larvae, as well as in neurula eggs and day 35 larvae from a hatchery. The fatty acid composition of grouper broodstock tissues was also determined. Samples were analysed for crude protein, amino acids, total lipids and fatty acid contents. Muscle contained higher levels of crude protein and amino acids than the ovary and liver. At the early maturing stage, the grouper ovarian protein was 73.3% and lipid was 19.3%, indicating the high dietary requirements of these nutrients for ovarian development. The crude protein and amino acid contents in wild-sourced larvae were higher than that in eggs and larvae from the hatchery

Low-sodium diet induces atherogenesis regardless of lowering blood pressure in hypertensive hyperlipidemic mice.

This study investigated the influence of sodium restriction and antihypertensive drugs on atherogenesis utilizing hypertensive (H) low-density lipoprotein-receptor knockout mice treated or not with losartan (Los) or hydralazine (Hyd) and fed low-sodium (LS) or normal-sodium (NS) chow. Despite reducing the blood pressure (BP) of H-LS mice, the LS diet caused arterial lipid infiltration due to increased plasma total cholesterol (TC) and triglycerides (TG). Los and Hyd reduced the BP of H-LS mice, and Los effectively prevented arterial injury, likely by reducing plasma TG and nonesterified fatty acids. Aortic lipid infiltration was lower in Los-treated H-LS mice (H-LS+Los) than in normotensive (N)-LS and H-LS mice. Aortic angiotensin II type 1 (AT1) receptor content was greater in H-NS than H-LS mice and in H-LS+Hyd than H-LS+Los mice. Carboxymethyl-lysine (CML) and receptor for advanced glycation end products (RAGE) immunostaining was greater in H-LS than H-NS mice. CML and RAGE levels were lower in LS animals treated with antihypertensive drugs, and Hyd enhanced the AT1 receptor level. Hyd also increased the gene expression of F4/80 but not tumor necrosis factor-α, interleukin (IL)-1β, IL-6, IL-10, intercellular adhesion molecule-1 or cluster of differentiation 66. The novelty of the current study is that in a murine model of simultaneous hypertension and hyperlipidemia, the pleiotropic effect of chronic, severe sodium restriction elicited aortic damage even with reduced BP. These negative effects on the arterial wall were reduced by AT1 receptor antagonism, demonstrating the influence of angiotensin II in atherogenesis induced by a severely LS diet

Low-sodium diet induces atherogenesis regardless of lowering blood pressure in hypertensive hyperlipidemic mice - Fig 5

<p>Histomorphometric analysis of immunofluorescence-stained AT1 receptor (<b>A</b> segments I and II; <b>B</b> segments III and IV), and vascular injury quantified by a histomorphometric analysis of immunofluorescence-stained CML (<b>C</b> segments I and II; <b>D</b> segments III and IV) and RAGE (<b>E</b> segments I and II; <b>F</b> segments III and IV); data are represented as the mean percentage of the total positively stained area of the aortic arch cross-sections; n = 4 mice per group. ^a <i>P</i> < 0.05, hypertensive mice fed a normal-sodium diet (H-NS) <i>vs</i> hypertensive mice fed a low-sodium diet (H-LS), Mann Whitney test. ^b <i>P</i> < 0.05, Kruskal Wallis with Dunn’s post hoc test applied for comparisons among LS groups.</p