SAN FELIÚ DE GUIXOLS (Gerona) (Fondeadero). Cartas náuticas. 1889 (1885). 1:5.000

Escala también dada de forma gráfica en 2 millas y 400 metros. Coordenadas de la ermita de S. Telmo referidas al meridiano de S. Fernando (E 9°13'55''/ N 4°46'24''). Orientado con estrella en gráfico de declinación magnéticaOrografía por normales; puntos acotados expresados en metrosIndica sondas batimetrícas y de isolíneas expresadas en metros, veriles, bajos, fondeaderos y bancos de arenaClave hidrográfica para determinar la calidad del fondoDestacan los caminos y núcleos de poblaciónConsta el sello en seco de la Dirección de Hidrografí

MEDAS (Gerona) (Islas) (Fondeadero). Cartas náuticas. 1889 (1886). 1:10.000

Escala también dada de forma gráfica en media milla y 1000 metros. Coordenadas del faro de las islas Medas referidas al meridiano de San Fernando (E9°25'35''/N 42°02'47''). Orientado con estrella en gráfico de declinación magnéticaOrografía por normales y puntos acotados expresados en metrosIndica sondas e isolíneas batimétricas, en metros y enfilacionesClave hidrográfica para determinar la calidad del fondo.Destacan caminos y núcleos de poblaciónConsta el sello en seco de la Dirección de Hidrografí

Barcelona (Puerto). Cartas náuticas. 1942 (1883). 1:5.000

Comprende el puerto de Barcelona, y la parte de la ciudad cercana al mismoFecha de publicación más antigua de las que aparecen en el documento: 1913Escala también dada de forma gráfica en 600 metros y 0,3 millas náuticasCoordenadas del reloj actual del puerto referidas al meridiano de Greenwich (E 2°11'06''/N 41°22'25''). Orientado con gráfico de declinación magnética, siendo ésta de 12°15' O en 1918 y el decrecimiento anual de la aguja de 5' aproximadamenteOrografía por curvas de nivelIndica sondas batimétricas en metros, boyas y faros, estos últimos iluminados en rojo y amarilloClave hidrográfica para determinar la calidad del fondoSeñala las principales instalaciones del puerto de Barcelona (diques, muelles, dársenas, etc.), así como los paseos, calles, plazas y edificios de la ciudadEn el verso figura el sello estampado del Instituto Hidrográfico de la Marin

Gerona (Provincia). Cartas náuticas. 1890 (1886). 1:10.000

Coordenadas del faro del Cabo de San Sebastian referidas al meridiano de San Fernando. Figura gráfico de declinación magnéticaRelieve representado por normales, sondas batimétricas y puntos acotadosClave hidrográfica para determinar la calidad del fond

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care