104 research outputs found
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Determination of four arsenic species in soil by sequential extraction and high performance liquid chromatography with post-column hydride generation and inductively coupled plasma optical emission spectrometry detection
376-38
Discriminant validity and test re-test reproducibility of a gait assessment in patients with vestibular dysfunction
Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study
Background
Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.
Methods
We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).
Findings
In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683–0·717]).
Interpretation
In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.
Funding
British Journal of Surgery Society
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Determination of selenium by flow injection hydride generation inductively coupled plasma optical emission spectrometry
298-30
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Simultaneous speciation of arsenic and selenium in human urine by high-performance liquid chromatography inductively coupled plasma mass spectrometry
931-93
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Selective detection and identification of Se containing compounds - review and recent developments
The complexity of selenium (Se) chemistry in the environment and in living organisms presents broad analytical challenges. The selectivequalitative and quantitative determination of particular species of this element is vital in order to understand selenium’s metabolism andsignificance in biology, toxicology, clinical chemistry and nutrition. This calls for state-of-the-art analytical techniques such as hyphenatedmethods that are reviewed with particular emphasis on interfaced separation with element-selective detection and identification of the detectedselenium compounds. Atomic spectral element specific detection for monitoring chromatographic eluent enabled quantitative determinationof selenium species in selenized yeast and qualitative measurement for breath samples. Gas chromatography with atomic emission detection(AED) of ethylated species and fluoroacid ion pair HPLC applied to the analysis of currently produced or archived selenized yeast and Brassicajuncea have revealed the presence of a previously unrecognised Se–S amino acid, S-(methylseleno)cysteine
Microwave-assisted extraction of monomethyl arsonic acid from soil and sediment standard reference materials
1511-151
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Identification of the principal selenium compounds in selenium-enriched natural sample extracts by ion-pair liquid chromatography with inductively coupled plasma- and electrospray ionization-mass spectrometric detection
249-25
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