Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.

No abstract

SARS-CoV-2 has been associated with an increased rate of venous thromboembolism in critically ill patients. Since surgical patients are already at higher risk of venous thromboembolism than general populations, this study aimed to determine if patients with peri-operative or prior SARS-CoV-2 were at further increased risk of venous thromboembolism. We conducted a planned sub-study and analysis from an international, multicentre, prospective cohort study of elective and emergency patients undergoing surgery during October 2020. Patients from all surgical specialties were included. The primary outcome measure was venous thromboembolism (pulmonary embolism or deep vein thrombosis) within 30 days of surgery. SARS-CoV-2 diagnosis was defined as peri-operative (7 days before to 30 days after surgery); recent (1-6 weeks before surgery); previous (≥7 weeks before surgery); or none. Information on prophylaxis regimens or pre-operative anti-coagulation for baseline comorbidities was not available. Postoperative venous thromboembolism rate was 0.5% (666/123,591) in patients without SARS-CoV-2; 2.2% (50/2317) in patients with peri-operative SARS-CoV-2; 1.6% (15/953) in patients with recent SARS-CoV-2; and 1.0% (11/1148) in patients with previous SARS-CoV-2. After adjustment for confounding factors, patients with peri-operative (adjusted odds ratio 1.5 (95%CI 1.1-2.0)) and recent SARS-CoV-2 (1.9 (95%CI 1.2-3.3)) remained at higher risk of venous thromboembolism, with a borderline finding in previous SARS-CoV-2 (1.7 (95%CI 0.9-3.0)). Overall, venous thromboembolism was independently associated with 30-day mortality ). In patients with SARS-CoV-2, mortality without venous thromboembolism was 7.4% (319/4342) and with venous thromboembolism was 40.8% (31/76). Patients undergoing surgery with peri-operative or recent SARS-CoV-2 appear to be at increased risk of postoperative venous thromboembolism compared with patients with no history of SARS-CoV-2 infection. Optimal venous thromboembolism prophylaxis and treatment are unknown in this cohort of patients, and these data should be interpreted accordingly.

O presente trabalho descreve a anatomia da madeira de Heterothalamus alienus e Heterothalamus rupestris (Astereae - Asteraceae), como parte do estudo do xilema secundário do referido gênero. Para ambas as espécies, foram confirmados detalhes anatômicos mencionados na literatura para a família Asteraceae, como vasos tipicamente pequenos e agrupados em padrão dendrítico, placas de perfuração invariavelmente simples e parênquima paratraqueal. Heterothalamus alienus possui espessamentos espiralados nos vasos lenhosos e parênquima axial vasicêntrico estratificado. Heterothalamus rupestris distingue-se pela ausência de espessamentos espiralados nos vasos e pelo parênquima paratraqueal vasicêntrico a unilateral. São fornecidas fotomicrografias, dados quantitativos de características anatômicas e uma comparação entre a madeira das duas espécies.

ANATOMIA DA MADEIRA DE TRÊS ESPÉCIES BRASILEIRAS DE BACCHARIS L. (ASTERACEAE -ASTEREAE) 1 JOSÉ NEWTON CARDOSO MARCHIORI 2 ANABELASILVEIRADE OLIVEIRA 3 RESUMO São anatomicamente descritas as madeiras de Baccharis dracunculifolia De., B. patens Baker e B. tridentata Vahl. As três espécies reúnem as seguintes características: porosidade difusa; vasos numerosos, de pequeno diâmetro; elementos vasculares com placas de perfuração simples e espessamentos espiralados; pontoações intervasculares alternas, diminutas a pequenas; pontoações raio-vasculares similares; parênquima paratraqueal; e fibras não septadas, com ponto ações simples. O arranjo de poros é nitidamente dendrítico em Baccharis dracunculifolia e B. patens, espécies que também apresentam cristais em raios. Baccharis patens distinguese pelos raios compostos inteiramente de células quadradas.

JOSÉ NEWTON CARDOSO MARCHIORJ4 RESUMO O gênero Heterothalamus Lessing e táxones afms são estudados com o objetivo de contribuir para o conhecimento da flora sul-americana, em especial do Brasil, Argentina e Uruguai. O gênero Heterothalamulopsis constitui novidade taxonôrnica. Heterothalamulopsis wagenitzii, única espécie do gênero até o momento, compreende subarbustos dióicos, glandulosos e rarnificados, providos de pápus com cerdas persistentes e ápice dilatado nas flores masculinas, e de flores femininas carnosas, de ápice ligulado, protegidas por 'páleas persistentes; endêmica do sul do Brasil, a espécie tem ocorrência restrita à borda dos "Aparados da Serra Geral", nos estados de Santa Catarina e Rio Grande do Sul. O gênero Heterothalamus compreende três espécies polígamo-dióicas ou imperfeitamente dióicas de subarbustos e arbustos rarnificados, glandulosos, que se caracterizam pela presença de 1-2-séries de flores radiais, femininas ou neutras, nos capítulos funcionalmente masculinos, e pela presença de flores carnosas de ápice ligulado nos capítulos femininos, protegidas por páleas persistentes. A distribuição geográfica do gênero inclui o centro da Argentina (províncias de Córdoba, San Luis, La Rioja e Santiago deI Estero), o Uruguai e o sul do Brasil (estados do Rio Grande do Sul e Santa Catarina). Foi elaborada uma chave dicotômica para a separação dos gêneros da subtribo Baccharinae Less., incluídos nas floras da Argentina, Uruguai e Brasil. Outra chave é apresentada para a separação das três espécies de Heterothalamus. Baccharis czermakii Hochreutiner foi presentemente reduzido à sinonímia de Heterothalamus psiadioides Lessing.

RESUMO No presente trabalho é comprovada a presença de Tagetes osteni Hicken para a flora sul-brasileira. A espécie é descrita, ilustrada e separada de Tagetes minuta, mediante chave dicotômica.

The paper presents a checklist to the 146 species of the genus Baccharis, native in Brazil. Aster pohlii Bak:er is changed to Baccharis, and a new combination is proposed: Baccharis pohlii (Bak:er) Deble & An. S. de Oliveira. A new name is created-Baccharis hyemalis Deble-to replace Heterothalamus rupestris Deble, An. S. de Oliveira & Marchiori (non B. rupestris Heering). Twenty one new synonymities are proposed, being seven to B.