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Article ; Online: Linearized Siderophore Products Secreted via MacAB Efflux Pump Protect Salmonella enterica Serovar Typhimurium from Oxidative Stress.

Bogomolnaya, L M / Tilvawala, R / Elfenbein, J R / Cirillo, J D / Andrews-Polymenis, H L

2020 Volume 11, Issue 3

Abstract: Nontyphoidal salmonellae (NTS) are exposed to reactive oxygen species (ROS) during their residency in the gut. To survive oxidative stress encountered during infection, salmonellae employ several mechanisms. One of these mechanisms involves the multidrug ...

Abstract	Nontyphoidal salmonellae (NTS) are exposed to reactive oxygen species (ROS) during their residency in the gut. To survive oxidative stress encountered during infection, salmonellae employ several mechanisms. One of these mechanisms involves the multidrug efflux pump MacAB, although the natural substrate of this pump has not been identified. MacAB homologs in pseudomonads secrete products of nonribosomal peptide synthesis (NRPS). In
MeSH term(s)	ATP-Binding Cassette Transporters/genetics ; ATP-Binding Cassette Transporters/metabolism ; Animals ; Bacterial Proteins/genetics ; Bacterial Proteins/metabolism ; Biological Transport ; Cattle ; Enterobactin/analogs & derivatives ; Enterobactin/metabolism ; Female ; Hydrogen Peroxide/pharmacology ; Iron/metabolism ; Mice ; Mice, Inbred C57BL ; Oxidative Stress ; Peptide Biosynthesis, Nucleic Acid-Independent ; Peptide Synthases/genetics ; Reactive Oxygen Species/metabolism ; Salmonella typhimurium/genetics ; Salmonella typhimurium/metabolism ; Siderophores/metabolism
Chemical Substances	ATP-Binding Cassette Transporters ; Bacterial Proteins ; Reactive Oxygen Species ; Siderophores ; salmochelin ; Enterobactin (28384-96-5) ; Hydrogen Peroxide (BBX060AN9V) ; Iron (E1UOL152H7) ; Peptide Synthases (EC 6.3.2.-)
Language	English
Publishing date	2020-05-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	2557172-2
ISSN	2150-7511 ; 2161-2129
ISSN (online)	2150-7511
ISSN	2161-2129
DOI	10.1128/mBio.00528-20
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Article ; Online: Impact of emergency short-stay unit opening on in-hospital global and cardiology indicators.

Cirillo, Willian / Freitas, Lidia R C / Kitaka, Edson L / Matos-Souza, José R / Silva, Marcos R / Coelho, Otávio R / Coelho-Filho, Otávio R / Sposito, Andrei C / Nadruz, Wilson

Journal of evaluation in clinical practice

2021 Volume 27, Issue 6, Page(s) 1262–1270

Abstract: Rationale, aims and objectives: Emergency short-stay unit (SSU) alleviates emergency department (ED) overcrowding, but may affect in-hospital indicators. Cardiology patients comprise a substantial part of patients admitted at SSU. This study evaluated ... ...

Abstract	Rationale, aims and objectives: Emergency short-stay unit (SSU) alleviates emergency department (ED) overcrowding, but may affect in-hospital indicators. Cardiology patients comprise a substantial part of patients admitted at SSU. This study evaluated whether SSU opening differentially modified in-hospital indicators at a whole general hospital and at its cardiology division (CARD). Methods: We retrospectively analysed indicators based on 859 686 ED visits, and 171 547 hospital admissions, including 12 110 CARD admissions, from 2007 to 2018 at a general tertiary hospital, and compared global ED indicators and in-hospital indicators at the hospital and CARD before (2007-2011) and after (2011-2018) SSU opening. Results: After SSU opening, monthly ED bed occupancy rate decreased (mean ± SD 200 ± 18% vs 187 ± 22%; P < .001) and in-hospital admissions from ED increased at the hospital (median [interquartile range] 460 [81] vs 524 [41], P < .001) and CARD (50 [12] vs 54 [12], P = .004). In parallel, monthly in-hospital elective admissions decreased at CARD (34 [18] vs 28 [17], P = .019), but not at the hospital (712 [73] vs 700 [104], P = .54). Average length of stay (LOS) increased at both hospital (8.5 ± 0.3 vs 8.7 ± 0.4 days, P < .001) and CARD (9.2 ± 1.5 vs 10.3 ± 2.3 days, P = .002) after SSU opening, but percent admissions at SSU showed a direct relationship with LOS solely at CARD. Furthermore, cardiology patients admitted at SSU had greater LOS, prevalence of coronary heart disease and age than those admitted at the conventional cardiology ward. Conclusions: SSU opening improved ED crowding, but was associated with changes in in-hospital indicators, particularly at CARD, and in the characteristics of hospitalized cardiology patients. These findings suggest that in-hospital cardiology services may need re-evaluation following SSU opening at a general hospital.
MeSH term(s)	Cardiology ; Emergency Service, Hospital ; Humans ; Length of Stay ; Patient Admission ; Retrospective Studies ; Tertiary Care Centers
Language	English
Publishing date	2021-01-09
Publishing country	England
Document type	Journal Article
ZDB-ID	1327355-3
ISSN	1365-2753 ; 1356-1294
ISSN (online)	1365-2753
ISSN	1356-1294
DOI	10.1111/jep.13534
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Article: Protection of Mycobacterium tuberculosis from Reactive Oxygen Species Conferred by the mel2 Locus Impacts Persistence and Dissemination

Cirillo, Suat L.G / Subbian, Selvakumar / Chen, Bing / Weisbrod, Torin R / Jacobs, William R. Jr / Cirillo, Jeffrey D

Infection and immunity. 2009 June, v. 77, no. 6

2009

Abstract: Persistence of Mycobacterium tuberculosis in humans represents a major roadblock to elimination of tuberculosis. We describe identification of a locus in M. tuberculosis, mel2, that displays similarity to bacterial bioluminescent loci and plays an ... ...

Abstract	Persistence of Mycobacterium tuberculosis in humans represents a major roadblock to elimination of tuberculosis. We describe identification of a locus in M. tuberculosis, mel2, that displays similarity to bacterial bioluminescent loci and plays an important role during persistence in mice. We constructed a deletion of the mel2 locus and found that the mutant displays increased susceptibility to reactive oxygen species (ROS). Upon infection of mice by aerosol the mutant grows normally until the persistent stage, where it does not persist as well as wild type. Histopathological analyses show that infection with the mel2 mutant results in reduced pathology and both CFU and histopathology indicate that dissemination of the mel2 mutant to the spleen is delayed. These data along with growth in activated macrophages and infection of Phox⁻/⁻ and iNOS⁻/⁻ mice and bone marrow-derived macrophages suggest that the primary mechanism by which mel2 affects pathogenesis is through its ability to confer resistance to ROS. These studies provide the first insight into the mechanism of action for this novel class of genes that are related to bioluminescence genes. The role of mel2 in resistance to ROS is important for persistence and dissemination of M. tuberculosis and suggests that homologues in other bacterial species are likely to play a role in pathogenesis.
Keywords	Mycobacterium tuberculosis ; aerosols ; bioluminescence ; genes ; histopathology ; humans ; loci ; macrophages ; mechanism of action ; mice ; mutants ; pathogenesis ; reactive oxygen species ; spleen ; tuberculosis
Language	English
Size	p. 2557-2567.
Publishing place	American Society for Microbiology
Document type	Article
ZDB-ID	218698-6
ISSN	1098-5522 ; 0019-9567
ISSN (online)	1098-5522
ISSN	0019-9567
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Article ; Online: Benefits of global mutant huntingtin lowering diminish over time in a Huntington's disease mouse model.

Marchionini, Deanna M / Liu, Jeh-Ping / Ambesi-Impiombato, Alberto / Kerker, Kimberly / Cirillo, Kim / Bansal, Mukesh / Mushlin, Rich / Brunner, Daniela / Ramboz, Sylvie / Kwan, Mei / Kuhlbrodt, Kirsten / Tillack, Karsten / Peters, Finn / Rauhala, Leena / Obenauer, John / Greene, Jonathan R / Hartl, Christopher / Khetarpal, Vinod / Lager, Brenda /

Rosinski, Jim / Aaronson, Jeff / Alam, Morshed / Signer, Ethan / Muñoz-Sanjuán, Ignacio / Howland, David / Zeitlin, Scott O

JCI insight

2022 Volume 7, Issue 20

Abstract: We have developed an inducible Huntington's disease (HD) mouse model that allows temporal control of whole-body allele-specific mutant huntingtin (mHtt) expression. We asked whether moderate global lowering of mHtt (~50%) was sufficient for long-term ... ...

Abstract	We have developed an inducible Huntington's disease (HD) mouse model that allows temporal control of whole-body allele-specific mutant huntingtin (mHtt) expression. We asked whether moderate global lowering of mHtt (~50%) was sufficient for long-term amelioration of HD-related deficits and, if so, whether early mHtt lowering (before measurable deficits) was required. Both early and late mHtt lowering delayed behavioral dysfunction and mHTT protein aggregation, as measured biochemically. However, long-term follow-up revealed that the benefits, in all mHtt-lowering groups, attenuated by 12 months of age. While early mHtt lowering attenuated cortical and striatal transcriptional dysregulation evaluated at 6 months of age, the benefits diminished by 12 months of age, and late mHtt lowering did not ameliorate striatal transcriptional dysregulation at 12 months of age. Only early mHtt lowering delayed the elevation in cerebrospinal fluid neurofilament light chain that we observed in our model starting at 9 months of age. As small-molecule HTT-lowering therapeutics progress to the clinic, our findings suggest that moderate mHtt lowering allows disease progression to continue, albeit at a slower rate, and could be relevant to the degree of mHTT lowering required to sustain long-term benefits in humans.
MeSH term(s)	Mice ; Humans ; Animals ; Infant ; Huntington Disease/drug therapy ; Huntington Disease/genetics ; Protein Aggregates ; Huntingtin Protein/genetics ; Huntingtin Protein/cerebrospinal fluid ; Disease Models, Animal ; Corpus Striatum/metabolism ; Disease Progression
Chemical Substances	Protein Aggregates ; Huntingtin Protein
Language	English
Publishing date	2022-10-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ISSN	2379-3708
ISSN (online)	2379-3708
DOI	10.1172/jci.insight.161769
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Article ; Online: Platelet participation in the pathogenesis of dermonecrosis induced by Loxosceles gaucho venom.

Tavares, F L / Peichoto, M E / Marcelino, J R / Barbaro, K C / Cirillo, M C / Santoro, M L / Sano-Martins, I S

Human & experimental toxicology

2016 Volume 35, Issue 6, Page(s) 666–676

Abstract: ... induced by L. gaucho venom, using thrombocytopenic rabbits as a model. L. gaucho venom evoked a drop ...

Abstract	Loxosceles gaucho spider venom induces in vitro platelet activation and marked thrombocytopenia in rabbits. Herein, we investigated the involvement of platelets in the development of the dermonecrosis induced by L. gaucho venom, using thrombocytopenic rabbits as a model. L. gaucho venom evoked a drop in platelet and neutrophil counts 4 h after venom injection. Ecchymotic areas at the site of venom inoculation were noticed as soon as 4 h in thrombocytopenic animals but not in animals with initial normal platelet counts. After 5 days, areas of scars in thrombocytopenic animals were also larger, evidencing the marked development of lesions in the condition of thrombocytopenia. Histologically, local hemorrhage, collagen fiber disorganization, and edema were more severe in thrombocytopenic animals. Leukocyte infiltration, predominantly due to polymorphonuclears, was observed in the presence or not of thrombocytopenia. Thrombus formation was demonstrated by immunohistochemistry at the microvasculature, and it occurred even under marked thrombocytopenia. Taken together, platelets have an important role in minimizing not only the hemorrhagic phenomena but also the inflammatory and wound-healing processes, suggesting that cutaneous loxoscelism may be aggravated under thrombocytopenic conditions.
MeSH term(s)	Animals ; Blood Cell Count ; Blood Platelets/physiology ; Disease Models, Animal ; Endothelium, Vascular/drug effects ; Endothelium, Vascular/metabolism ; Necrosis ; Neutrophils/drug effects ; Phagocytosis/drug effects ; Phosphoric Diester Hydrolases/toxicity ; Prothrombin Time ; Rabbits ; Skin/blood supply ; Skin/drug effects ; Skin/pathology ; Skin Diseases/blood ; Skin Diseases/chemically induced ; Skin Diseases/pathology ; Spider Venoms/toxicity ; Thrombocytopenia/blood ; von Willebrand Factor/analysis
Chemical Substances	Spider Venoms ; loxosceles venom ; von Willebrand Factor ; Phosphoric Diester Hydrolases (EC 3.1.4.-)
Language	English
Publishing date	2016-06
Publishing country	England
Document type	Journal Article
ZDB-ID	1027454-6
ISSN	1477-0903 ; 0144-5952 ; 0960-3271
ISSN (online)	1477-0903
ISSN	0144-5952 ; 0960-3271
DOI	10.1177/0960327115597983
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Article: Regulation of Ca2+ transport by platelet-derived growth factor-BB in rat vascular smooth muscle cells.

Cirillo, M / Quinn, S J / Romero, J R / Canessa, M L

Circulation research

1993 Volume 72, Issue 4, Page(s) 847–856

Abstract: The present study investigates the effects of platelet-derived growth factor (PDGF) isoform BB (PDGF-BB) on cytosolic Ca2+ concentration ([Ca2+]i), Ca2+ transport, and Ca2+ pools in rat vascular smooth muscle (VSM) cells. VSM cells from thoracic aorta of ...

Abstract	The present study investigates the effects of platelet-derived growth factor (PDGF) isoform BB (PDGF-BB) on cytosolic Ca2+ concentration ([Ca2+]i), Ca2+ transport, and Ca2+ pools in rat vascular smooth muscle (VSM) cells. VSM cells from thoracic aorta of Milan normotensive rats were enzymatically dispersed, cultured in 10% serum medium, and made quiescent by 72 hours in 0.3% serum medium. [Ca2+]i, Ca2+ influx, Ca2+ efflux, and exchangeable cell Ca2+ pool were evaluated by ratiometric fluorescent and radioisotope techniques. Ca2+ transport showed time-dependent changes during stimulation with PDGF-BB. The initial early responses to this peptide were transient rise in [Ca2+]i, a 30% decrease in Ca2+ influx, and a 3.6-fold increase in the rate constant for active Ca2+ efflux. Stimulation of Ca2+ efflux and inhibition of Ca2+ influx were associated with a substantial 30% reduction in the cell Ca2+ pool. This initial stimulation of Ca2+ efflux is concomitant with Ca2+ mobilization into the cytosol and is due to activation of Na(+)-independent Ca2+ efflux via the Ca2+ pump. After a 10-minute stimulation, Ca2+ influx returned to the basal value, whereas Ca2+ efflux remained 2.2-fold above control values, leading to a decline in [Ca2+]i below basal levels and a further decrease in the cell Ca2+ pool. Nearly half of this late Ca2+ efflux appears to be driven by Na(+)-Ca2+ exchange, as evidenced by its external Na+ dependence. After a 120-minute stimulation with PDGF-BB, nifedipine-sensitive Ca2+ influx is increased 37% above basal levels, and Ca2+ efflux remains elevated. During prolonged stimulation by PDGF-BB, both Ca2+ influx and efflux are stimulated, resulting in a new intracellular Ca2+ homeostasis marked by the recovery of the cell Ca2+ pool but a lowered [Ca2+]i. These final events coincide with the initiation of cell proliferation in VSM cells by PDGF-BB.
MeSH term(s)	Animals ; Becaplermin ; Biological Transport/drug effects ; Calcium/metabolism ; Cytosol/metabolism ; Muscle, Smooth, Vascular/cytology ; Muscle, Smooth, Vascular/metabolism ; Platelet-Derived Growth Factor/pharmacology ; Proto-Oncogene Proteins c-sis ; Rats ; Recombinant Proteins/pharmacology ; Time Factors
Chemical Substances	Platelet-Derived Growth Factor ; Proto-Oncogene Proteins c-sis ; Recombinant Proteins ; Becaplermin (1B56C968OA) ; Calcium (SY7Q814VUP)
Language	English
Publishing date	1993-04
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	80100-8
ISSN	1524-4571 ; 0009-7330 ; 0931-6876
ISSN (online)	1524-4571
ISSN	0009-7330 ; 0931-6876
DOI	10.1161/01.res.72.4.847
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Article: Light effects in yeast: inhibition by visible light of growth and transport in Saccharomyces cerevisiae grown at low temperatures

Woodward, J.R / Cirillo, V.P / Edmunds, L.N. Jr

Journal of bacteriology. Feb 1978, 133 (2)

1978

Keywords	plant physiology ; plant biochemistry
Language	English
Size	p. 692-698.
Document type	Article
ZDB-ID	2968-3
ISSN	1098-5530 ; 0021-9193
ISSN (online)	1098-5530
ISSN	0021-9193
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Article: Genetic systems for Mycobacteria

Jacobs, W.R. Jr / Kalpana, G.V / Cirillo, J.D / Pascopella, L / Snapper, S.B / Udani, R.A / Jones, W / Barletta, R.G / Bloom, B.R

Methods in enzymology. 1991. v. 204

1991

Keywords	Mycobacterium ; virulence ; genetic engineering ; genetic techniques and protocols
Language	English
Size	p. 537-555.
Document type	Article
Note	In the series analytic: Bacterial genetic systems / edited by J. H. Miller.
ISSN	0076-6879
ISSN	0076-6879
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Article ; Online: A cluster of multidrug-resistant Mycobacterium tuberculosis among patients arriving in Europe from the Horn of Africa

Walker, Timothy M. / Merker, Matthias / Knoblauch, Astrid M. / Helbling, Peter / Schoch, Otto D. / van der Werf, Marieke J. / Kranzer, Katharina / Fiebig, Lena / Kröger, Stefan / Haas, Walter / Hoffmann, Harald / Indra, Alexander / Egli, Adrian / Cirillo, Daniela M. / Robert, Jérôme / Rogers, Thomas R. / Groenheit, Ramona / Mengshoel, Anne T. / Mathys, Vanessa /

Haanperä, Marjo / van Soolingen, Dick / Niemann, Stefan / Böttger, Erik C. / Keller, Peter M. / MDR-TB Cluster Consortium

a molecular epidemiological study

2018

Abstract: Background The risk of tuberculosis outbreaks among people fleeing hardship for refuge in Europe is heightened. We describe the cross-border European response to an outbreak of multidrug-resistant tuberculosis among patients from the Horn of Africa and ... ...

Abstract	Background The risk of tuberculosis outbreaks among people fleeing hardship for refuge in Europe is heightened. We describe the cross-border European response to an outbreak of multidrug-resistant tuberculosis among patients from the Horn of Africa and Sudan. Methods On April 29 and May 30, 2016, the Swiss and German National Mycobacterial Reference Laboratories independently triggered an outbreak investigation after four patients were diagnosed with multidrug-resistant tuberculosis. In this molecular epidemiological study, we prospectively defined outbreak cases with 24-locus mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) profiles; phenotypic resistance to isoniazid, rifampicin, ethambutol, pyrazinamide, and capreomycin; and corresponding drug resistance mutations. We whole-genome sequenced all Mycobacterium tuberculosis isolates and clustered them using a threshold of five single nucleotide polymorphisms (SNPs). We collated epidemiological data from host countries from the European Centre for Disease Prevention and Control. Findings Between Feb 12, 2016, and April 19, 2017, 29 patients were diagnosed with multidrug-resistant tuberculosis in seven European countries. All originated from the Horn of Africa or Sudan, with all isolates two SNPs or fewer apart. 22 (76%) patients reported their travel routes, with clear spatiotemporal overlap between routes. We identified a further 29 MIRU-VNTR-linked cases from the Horn of Africa that predated the outbreak, but all were more than five SNPs from the outbreak. However all 58 isolates shared a capreomycin resistance-associated tlyA mutation. Interpretation Our data suggest that source cases are linked to an M tuberculosis clone circulating in northern Somalia or Djibouti and that transmission probably occurred en route before arrival in Europe. We hypothesise that the shared mutation of tlyA is a drug resistance mutation and phylogenetic marker, the first of its kind in M tuberculosis sensu stricto. Peer Reviewed
Keywords	610 Medizin und Gesundheit ; ddc:610
Subject code	572
Language	English
Publishing date	2018-01-08
Publisher	Robert Koch-Institut
Publishing country	de
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection

Nepogodiev, D / Bhangu, A / Glasbey, JC / Li, E / Omar, OM / Simoes, JFF / Abbott, TEF / Alser, O / Arnaud, AP / Bankhead-Kendall, BK / Breen, KA / Cunha, MF / Davidson, GH / Di Saverio, S / Gallo, G / Griffiths, EA / Gujjuri, RR / Hutchinson, PJ / Kaafarani, HMA /

Lederhuber, H / Löffler, MW / Mashbari, HN / Minaya-Bravo, A / Morton, DG / Moszkowicz, D / Pata, F / Tsoulfas, G / Venn, ML / Cox, D / Roslani, AC / Alakaloko, F / de Vries, JPPM / Aaraj, MA / Abbott, SJ / Abdalla, MOM / Abdelaal, AS / Ademuyiwa, AO / Aherne, TM / Ali, OM / Alkadeeki, GZ / Almeida, AC / Alrahawy, MM / Ambler, GK / Alameer, E / Andreani, SM / De Andrés-Asenjo, B / Antonanzas, LL / Aoun, SG / Ashoush, FM / Augestad, KM / Avellana, RB / Ayeni, FA / Ayorinde, JOO / Babu, BH / Baig, MMAS / Bajomo, OM / Baker, OJ / Baker, MP / Baldwin, AJ / Ban, VS / Baron, RD / Barranquero, AG / Barry, CP / DI Bartolomeo, A / Bass, GA / Bath, MF / Batjer, HH / Beamish, AJ / Belgaumkar, AP / Bence, MN / Benson, RA / Bernal-Sprekelsen, JC / Bhama, AR / Bhavaraju, AV / Biffl, WL / Blundell, CM / Boddy, AP / Borgstein, ABJ / Bosanquet, DC / Bosch, KD / Bouhuwaish, AEM / Bozkurt, MA / Brathwaite, CEM / Brown, BC / Brown, OD / Brown, AK / Buarque, IL / Bueno-Ca nones, AD / Bulugma, MR / Burke, JR / Byrne, MHV / Cagigal-Ortega, EP / Callcut, RA / DI Candido, F / Canova, ME / Carlos, WJ / Caruana, EJ / Cato, LD / Catton, AB / Ceretti, AP / Chase, TJG / Chiara, FD / Chowdhury, AH / Chung, EA / Cicerchia, PM / Clough, ECS / Coleman, NL / Collins, CG / Collins, ML / Colonna, ET / Comini, LV / Coughlin, PA / Cruzado, LFG / Davidson, BR / Davies, RJ / Davies, EJ / Davis, NF / Dawson, BE / Dean, BJF / Delgado, MGC / Diaz, JJ / Dickson, KE / Diez-Alonso, MM / Dixon, JR / Doe, MJ / Drake, TD / Drake, FT / Duffy, JP / Dunne, DFJ / Dunne, NJM / Durán-Mu noz-Cruzado, VM / Durst, AZE / Eardley, NJ / Edwards, JG / Elfallal, AH / Elfiky, MMA / Elliott, JA / Emile, SH / Emslie, KM / Endorf, FW / Engel, JL / Enjuto, DT / Etchill, EW / Evans, JP / Fahey, BA / Faria, CS / Feo, CV / Ferguson, HJM / Fernandez, BD / Fernandez, AG / Fernández, AJ / Fernández-Pacheco, BC / Fitzgerald, JE / Fonsi, GB / Font, RF / Fowler, AL / Fretwell, KR / Fructuoso, LS / Fusai, GK / Garcia, MH / Garcia-Ure na, MA / Gill, CK / Gisbertz, SS / Del Giudice, R / Giuffrida, MC / Di Giuseppe, M / Gómez, MF / Guariglia, CA / Hainsworth, AJ / Hall, BJ / Hall, JRW / Hammond, JS / Haqqani, MH / Harrison, EM / Hazelton, JP / van Heinsbergen, M / Hill, ADK / Hing, CB / Hirji, SA / Ho, MWS / Holbrook, CM / Holme, TJ / Hopkins, JC / Hopkinson, DN / Hossain, FS / Hudson, VE / Hughes, JL / Hwang, ES / Ibrahim, MAH / Isolani, SM / Jenkinson, MD / Jenny, HE / Jeyaretna, DS / Jones, RP / Jones, AP / Jonker, PKC / Jönsson, ML / Joyce, DP / Kalkwarf, KJ / Kamarajah, SK / El Kassas, M / Kavanagh, DO / Keatley, JM / Khalefa, MA / Khan, JS / Kirmani, BH / Kisiel, AP / Kouris, SM / Kowal, MR / Labib, PL / Larkin, JO / Lauscher, JC / Leclercq, WKG / Ledesma, FSJ / Leite-Moreira, AM / Leung, EYL / Lewis, SE / Lima, MJA / Lin, DJ / Liu, HH / Lowery, AJ / Lozano, SM / Luney, CR / Maia, MMA / Mariani, NM / Marino, MV / Marra, AA / Marsh, CL / Martin, RCG / McCluney, SJ / McIntyre, RC / Mckay, SC / McKevitt, KL / Meagher, AD / 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an international cohort study

2020

Abstract: 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 ... ...

Abstract	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.
Keywords	covid19
Language	English
Publisher	Elsevier
Publishing country	uk
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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