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

Trabalhos finais - Banca

Apenas foram migradas as páginas e/ou folhas que evidenciam a participação e/ou citação ao Dr. José Maria de Souza.BR IEC JMS AP UFPA AE PBAN 002itemItensTrabalho final o qual contou com a participação do Dr. José M. Souza como integrante da banca examinadora. Trabalho de Jane Amaral intitulado "Avaliação longitudinal da infecção causada por Plasmodium Falciparum e/ou Plasmodium Vivax na população de duas localidades de Icoaraci, distrito de Belém, Pará

Escolha de veias periféricas para terapia intravenosa em recém-nascidos pela equipe de enfermagem

Implementar la terapia intravenosa en el recién nacido es compleja y desafiadora. Se planteó identificar la eleccíón de venas periféricas para la punción venosa en el recién nacido y describir los criterios adoptados por el equipo de enfermería al elegir esos vasos, en una Unidad de Cuidado Intensivo Neonatal de Río de [aneiro, Brasil. Fueron entrevistados 10 profesionales de enfermería, de mayo a junio de 2007. El análisis temático originó las categorías: Elección de la vena periférica en RJ.\J; Prioridades del equipo de enfermería; Criterios adoptados y dificultades enfrentadas al elegir las venas para punción venosa periférica. Las venas del arco dorsal de la mano fueron las primeras elegidas y las epícraneales las de última elección. Los criterios de elección fueron visualización, facilidad, durabilidad y fármaco infundido. Las dificultades enfrentadas para realizar terapia intravenosa en RJ.'\J fueron: el desgaste de la red venosa y el dolor advenido de las múltiples punciones

Fauna anofélica da cidade de Belém, Pará, Brasil: dados atuais e retrospectivos Anophelines in Belém, Pará, Brazil: current and retrospective data

Relato de coletas de anofelinos realizadas em Belém, Pará, Brasil, de 1995 a 2004, comparando os dados obtidos com os de levantamentos anteriores, feitos a partir da década de 1930. Nesses, vinte espécies haviam sido identificadas: Anopheles albitarsis s.l., An. aquasalis, An. argyritarsis, An. braziliensis, An. darlingi, An. eiseni, An. evansae, An. galvaoi, An. intermedius, An. kompi, An. mediopunctatus, An. nimbus, An. nuneztovari, An. oswaldoi, An. peryassui, An. punctimacula, An. shannoni, An. strodei, An. thomasi e An. triannulatus. Sete (An. argyritarsis, An. eiseni, An. galvaoi, An. kompi, An. nimbus, An. punctimacula e An. thomasi) não são agora registradas. A permanência de tantas outras espécies provavelmente decorre da preservação de áreas de mata no âmbito urbano. Duas delas são consideradas de importância vetorial (An. darlingi e An. aquasalis). Esta última continua sendo a de maior densidade nas coletas (46,26% dos adultos e 99,21% das larvas) e é a única registrada em todos os distritos administrativos. Existe, portanto, risco potencial de transmissão de malária em todo o município.<br>We present the results of anopheline captures in Belém, Pará, Brazil, from 1995-2004, and a comparison with captures from 1930-1999. In the earlier period, 20 species were identified: Anopheles albitarsis s.l., An. aquasalis, An. argyritarsis, An. braziliensis, An. darlingi, An. eiseni, An. evansae, An. galvaoi, An. intermedius, An. kompi, An. mediopunctatus, An. nimbus, An. nuneztovari, An. oswaldoi, An. peryassui, An. punctimacula, An. shannoni, An. strodei, An. thomasi, and An. triannulatus. Seven of these species were not found in 1995-2004 (An. argyritarsis, An. eiseni, An. galvaoi, An. kompi, An. nimbus, An. punctimacula, and An. thomasi). The persistence of so many species is probably due to the local preservation of forest areas. Two species are of vectorial importance (An. darlingi and An. aquasalis). An. aquasalis is still the most abundant species (46.26% of adults, 99.21% of larvae) and the only one detected in all capture sites. There is thus a potential risk of malaria transmission in the entire municipality of Belém

A experiência de cinco anos do projeto de extensão Atendimento aos pacientes do Centro de Oncologia Bucal da Faculdade de Odontologia de Araçatuba – UNESP

The Oral Oncology Center is a unit Simple Structure of Auxiliary of the Universidade Estadual Paulista "Julio de Mesquita Filho" - UNESP installed at the Faculty of Dentistry of Araçatuba Campus. The main activity carried out in this center is the interdisciplinary treatment of patients with malignant tumors of the head and neck. Develops activities in education, such as the Discipline of Oncology, which involves undergraduate and graduate; research activities with the development of scientific papers by graduate students, and especially the extension, through the care of patients with oral pathologies, including head and neck cancer. Among the registered extension projects in Oral Oncology Center, stands out the "Assistance to patients of Oral Oncology Center, Faculty of Dentistry of Araçatuba-UNESP," registered with the Dean of UNESP University Extension in 2010. The objective of this study is to present the activities and results of this 2010-2014 project.O Centro de Oncologia Bucal é uma Unidade Auxiliar de Estrutura Simples da Universidade Estadual Paulista “Júlio de Mesquita Filho”- UNESP instalado na Faculdade de Odontologia do Campus de Araçatuba. A principal atividade realizada nesse centro é o tratamento interdisciplinar de pacientes com tumores malignos de cabeça e pescoço. Desenvolve atividades na área do ensino, a exemplo da Disciplina de Oncologia, que envolve alunos de graduação e pós-graduação; atividades de pesquisa com o desenvolvimento de trabalhos científicos pelos alunos de pós-graduação e, principalmente, a extensão, por meio do atendimento de pacientes com patologias bucais, incluindo o câncer de cabeça e pescoço. Dentre os projetos de extensão cadastrados no Centro de Oncologia Bucal, destaca-se o “Atendimento aos pacientes do Centro de Oncologia Bucal da Faculdade de Odontologia de Araçatuba-UNESP,” registrado junto à Pró-Reitoria de Extensão Universitária da UNESP em 2010. O objetivo desse trabalho é apresentar as atividades realizadas e os resultados desse projeto de 2010 a 2014

Transverse polarisation measurement of Λ\Lambda hyperons in ppNe collisions at sNN\sqrt{s_{NN}}=68.4 GeV with the LHCb detector

A measurement of the transverse polarization of the $\Lambda$ and $\bar{\Lambda}$hyperons in $p$Ne fixed-target collisions at $\sqrt{s_{NN}}$=68.4 GeV is presented using data collected by the LHCb detector. The polarization is studied using the decay $\Lambda \rightarrow p \pi^-$ together with its charge conjugated process, the integrated values measured are $$P_{\Lambda} = 0.029 \pm 0.019 \, (\rm{stat}) \pm 0.012 \, (\rm{syst}) \, ,$$ $$P_{\bar{\Lambda}} = 0.003 \pm 0.023 \, (\rm{stat}) \pm 0.014 \,(\rm{syst}) \,$$ Furthermore, the results are shown as a function of the Feynman $x$ variable, transverse momentum, pseudorapidity and rapidity of the hyperons, and are compared with previous measurements.A measurement of the transverse polarization of the $\Lambda$ and $\bar{\Lambda}$ hyperons in $p$Ne fixed-target collisions at $\sqrt{s_{NN}}$ = 68.4 GeV is presented using data collected by the LHCb detector. The polarization is studied using the decay $\Lambda \rightarrow p \pi^-$ together with its charge conjugated process, the integrated values measured are $$P_{\Lambda} = 0.029 \pm 0.019 \, (\rm{stat}) \pm 0.012 \, (\rm{syst}) \, ,$$ $$P_{\bar{\Lambda}} = 0.003 \pm 0.023 \, (\rm{stat}) \pm 0.014 \,(\rm{syst}) \,.$$ Furthermore, the results are shown as a function of the Feynman~$x$~variable, transverse momentum, pseudorapidity and rapidity of the hyperons, and are compared with previous measurements

Measurement of the branching fraction ratios R(D+)R(D^+) and R(D∗+)R(D^{*+}) using muonic τ\tau decays

The branching fraction ratios of $\kern 0.18em \overline{\kern -0.18em B}{}^0\to D^+\tau^-\overline{\nu}_{\tau}$ and $\kern 0.18em \overline{\kern -0.18em B}{}^0\to D^{*+}\tau^-\overline{\nu}_{\tau}$ decays are measured with respect to their muonic counterparts, using a data sample corresponding to an integrated luminosity of 2.0 fb$^{-1}$ collected by the LHCb experiment in proton-proton collisions at $\sqrt{s} = 13\,\text{TeV}$. The reconstructed final states are formed by combining $D^+$ mesons with $\tau^-\to\mu^-\overline{\nu}_{\mu}\nu_{\tau}$ candidates, where the $D^+$ is reconstructed via the $D^+\to K^-\pi^+\pi^+$ decay. The results are \begin{align*} R(D^{+}) &= 0.249 \pm 0.043 \pm 0.047, \\ R(D^{*+}) &= 0.402 \pm 0.081\pm 0.085, \end{align*} where the first uncertainties are statistical and the second systematic. The two measurements have a correlation coefficient of $-0.39$ and are compatible with the Standard Model.The branching fraction ratios of $\overline{B}^0\to D^+\tau^-\overline{\nu}_{\tau}$ and $\overline{B}^0\to D^{*+}\tau^-\overline{\nu}_{\tau}$ decays are measured with respect to their muonic counterparts, using a data sample corresponding to an integrated luminosity of 2.0 fb$^{-1}$ collected by the LHCb experiment in proton-proton collisions at $\sqrt{s} = 13$ TeV. The reconstructed final states are formed by combining $D^+$ mesons with $\tau^-\to\mu^-\overline{\nu}_{\mu}\nu_{\tau}$ candidates, where the $D^+$ is reconstructed via the $D^+\to K^-\pi^+\pi^+$ decay. The results are \begin{align*} R(D^{+}) &= 0.249 \pm 0.043 \pm 0.047, R(D^{*+}) &= 0.402 \pm 0.081\pm 0.085, \end{align*} where the first uncertainties are statistical and the second systematic. The two measurements have a correlation coefficient of $-0.39$ and are compatible with the Standard Model