Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: 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

Desempenho de cultivares de cebola em cultivo orgânico e tipos de solo no Vale do São Francisco Evaluation of onion cultivars under organic cultivation in two soil types in the São Francisco Valley, Brazil

Com o objetivo de avaliar a produtividade de cultivares de cebola em cultivo orgânico no Vale do São Francisco, conduziram-se dois experimentos, de maio a outubro de 2005, nos Campos Experimentais de Bebedouro, Petrolina-PE, e Mandacaru, Juazeiro-BA, em ARGISSOLO e VERTISSOLO respectivamente. O delineamento experimental utilizado foi em blocos ao acaso, utilizando-se dezoito e quatorze cultivares de cebola, respectivamente e quatro repetições. Em ARGISSOLO a produtividade total de bulbos variou de 13,52 a 39,52 t/ha. A produtividade comercial oscilou de 7,45 a 38,32 t/ha, sobressaindo-se como mais produtivas as cultivares Brisa IPA-12 (38,32 t/ha) e São Paulo (35,86 t/ha) que não evidenciaram diferenças significativas entre si, assim como as cultivares Botucatu-150 (26,41 t/ha) e Pira Ouro (26,37 t/ha), e menos produtivas as cultivares Conquista (7,45 t/ha) e Crioula Alto Vale (7,81 t/ha). Em VERTISSOLO a produtividade total de bulbos variou de 6,87 a 24,68 t/ha. Sobressairam-se com produtividade comercial as cultivares Texas Grano PRR (21,56 t/ha) e IPA-10 (17,50 t/ha), que não diferiram entre si. As cultivares Crioula Alto Vale, CNPH-6348, CNPH- 6436 e CNPH-6206 não tiveram produção comercial de bulbos.<br>In this research were evaluated the yield of onion cultivars under organic growth in the São Francisco Valley. Two field trials were evaluated, one at the Experimental Farm Station of Embrapa Tropical Semi-Arid, in Petrolina, in an ultisol type and the other at the Experimental Farm Station of Mandacaru, in Juazeiro, in a vertisol type, from February to October of 2005. The experimental design was of randomized complete blocks, with 18 and 14 cultivars, respectively, and four replications. In the ultisol, the total yield of bulbs ranged from 13.52 to 39.52 t/ha. The commercial yield ranged from 7.45 to 38.32 t/ha where the cultivars Brisa (38.32 t/ha) and São Paulo (35.86 t/ha) showed the highest yield without statistical difference; Cultivars Botucatu-150 (26.41 t/ha) and Pira Ouro (26.37 t/ha) also stood out with high yield without statistical difference. The cultivars Conquista (7.45 t/ha) and Crioula Alto Vale (7.81 t/ha) presented the worst performance. In the vertisol the total yield of bulbs ranged from 6.87 to 24.68 t/ha. The cultivars Texas Grano PRR (21.56 t/ha) and IPA-10 (17.50 t/ha) presented the highest yield, without statistical differences. The cultivars Crioula Alto Vale, CNPH-6348, CNPH-6436 and CNPH- 6206 presented no commercial yield

Cardiovascular risk assessment in patients with a severe mental illness: a systematic review and meta-analysis.

BACKGROUND: Cardiovascular risk (CVR) has been observed to be higher in patients with severe mental illness (SMI) than in the general population. However, some studies suggest that CVR is not equally increased in different subgroups of SMI. The purposes of this review are to summarise CVR scores of SMI patients and to determine the differences in CVR between patients with different SMIs and between SMI patients and the control-population. METHODS: MEDLINE (via PubMed) was searched for literature published through August 28, 2014, followed by a snowball search in the Web of Science. Observational and experimental studies that reported CVR assessments in SMI patients using validated tools were included. The risk of bias was reported using STROBE and CONSORT criteria. Pooled continuous data were expressed as standardized mean differences (SMD) with 95 % confidence intervals (CI). Two reviewers independently selected studies, extracted data and assessed methodological quality. RESULTS: A total of 3,608 articles were identified, of which 67 full text papers were assessed for eligibility and 35 were finally included in our review, in which 12,179 psychiatric patients and 225,951 comparative patients had been assessed. The most frequent diagnoses were schizophrenia and related diagnoses (45.7 %), depressive disorders (14.7 %), SMI (11.4 %) and bipolar disorders (8.6 %). The most frequent CVR assessment tool used was the Framingham risk score. Subgroups analysis showed a higher CVR in schizophrenia than in depressive disorder or in studies that included patients with multiple psychiatric diagnoses (SMD: 0.63, 0.03, and 0.02, respectively). Six studies were included in the meta-analysis. Total overall CVR did not differ between SMI patients and controls (SMD: 0.35 [95 % CI:-0.02 to 0.71], p = 0.06); high heterogeneity was observed (I (2) = 93 %; p < 0.001). CONCLUSIONS: The summary of results from studies that assessed CVR using validated tools in SMI patients did not find sufficient data (except for limited evidence associated with schizophrenia) to permit any clear conclusions about increased CVR in this group of patients compared to the general population. The systematic review is registered inThis research has been funded by the Ministry of Science and Innovation through the Instituto Carlos III (PI12/00427). This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. LA is funded by the National Institute of Health Research (NIHR) U