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

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

Middle Ordovician acritarchs and problematic organic-walled microfossils from the Saq-Hanadir transitional beds in the QSIM-801 well, Saudi Arabia

Core samples from the QSIM-801 water well, drilled in central Saudi Arabia, cover a 93-foot interval spanning the transition between the Sajir Member of the Saq Formation, that consists mainly of sandstones of tidal sand flat environments, and the Hanadir Member of the Qasim Formation, characterized by argillaceous graptolitic mudstones, corresponding to a tidal delta front. The samples contain abundant, exceptionally well-preserved and diverse palynomorphs, which include cryptospores, acritarchs and chitinozoans, other problematic organic-walled microfossils as well as other organic particles such as cuticle-like fragments. The studied interval is biostratigraphically well constrained by the presence of chitinozoans of the formosa and pissotensis Zones of late-early to late Darriwilian age (Middle Ordovician) in the uppermost Saq Formation and Hanadir Member. The biostratigraphic age of the Sajir Member considered to span the Dapingian–Darriwilian boundary, is re-discussed based on the results herein. The uppermost part of the Sajir Member yielded the ichnofossil, Phycodes fusiforme. Acritarch assemblages from the Sajir Member of the Saq Formation are poorly diversified and dominated by sphaeromorphs. More diverse assemblages of acritarchs, associated with enigmatic forms, occur in the Hanadir Member of the Qasim Formation. The contact between the two formations and the transition between the palynomorph assemblages are sharp, suggesting a stratigraphic hiatus. A quantitative analysis allows us to discuss the paleoenvironmental changes and possibly climatic changes associated with an hypothesis of ice house conditions during this period. Among the diagnostic acritarch taxa observed are Frankea breviuscula, F. longiuscula, Baltisphaeridium ternatum, Dasydorus cirritus, Dicrodiacrodium ancoriforme, Poikilofusa ciliaris, Pterospermopsis colbathii and Uncinisphaera fusticula. These are associated with other typical forms known to range across the Lower–Middle Ordovician boundary, such as Aremoricanium rigaudae, Aureotesta clathrata, Barakella fortunata, B. rara, Baltisphaeridium klabavense, Glaucotesta latiramosa and Striatotheca spp. Galeate and peteinoid acritarchs are also well represented, as well as tiny forms of ultraplanctonic size. Three new species of acritarchs are proposed: Frankea longiuscula var. darriwilense var. nov, Micrhystridium regulum sp. nov, and Tyrannus proteus sp. nov. Repeated occurrences throughout the section of cryptospores, problematic microfossils such as organic filaments, cuticle-like tissues, striated and pigmented leiospheres frequently in clusters, are interpreted to reflect recurrent terrestrial and freshwater inputs in the depositional environment. Single-specimen, high-resolution analyses using Confocal Laser Scanning Microscopy on the enigmatic form Tyrannus proteus sp. nov. show fluorescence emission spectra and microstructural properties significantly different from those of typical marine acritarchs from the same levels

Lower Ordovician trilobites from the Hanadir Shale of Saudi Arabia

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