No abstract

To support the global restart of elective surgery, data from an international prospective cohort study of 8492 patients (69 countries) was analysed using artificial intelligence (machine learning techniques) to develop a predictive score for mortality in surgical patients with SARS-CoV-2. We found that patient rather than operation factors were the best predictors and used these to create the COVIDsurg Mortality Score (https://covidsurgrisk.app). Our data demonstrates that it is safe to restart a wide range of surgical services for selected patients.

Volvulus is the torsion of an organ over its ligaments, which compromises vascularization and produces ischemia. Intestinal volvulus, then, consists in the twisting of the intestine around the mesentery that supports it, which often results in an obstructive pathophysiology and may evolve to ischemia. [1][2][3][4][5] This article is focused on neonatal intestinal volvulus. There are two main types of intestinal volvulus: midgut volvulus (MGV) and segmental volvulus (SV). MGV occurs in malrotated patients when all the small bowel and part of the large intestine twist around the superior mesenteric artery and a narrow mesentery. SV occurs when an intestinal loop twists around itself. Quite often in articles focused in prenatal diagnosis the literature does not distinguish between these two entities, therefore leading to both being included in the same case series. 2,6,7 MGV is almost always related to anomalies of gut development, such as

Background:In animal models of congenital diaphragmatic hernia (CDH), tracheal occlusion (TO) has induced maturation of both airway spaces and vascular structures. Airway and vascular response to TO are assumed to occur in parallel. This study aims to describe and measure the relationship between airway and vascular maturation induced by TO. Methods: A rabbit model of CDH on gestational day (GD) 23 and TO on GD 28 (term = GD 31) has been used. Two study groups have been defined: DH (diaphragmatic hernia) and TO (DH treated with TO). Animals were collected on GD 30 and blood flow data of the pulmonary artery (pulsatility index (PI) and fractional moving blood volume) were ultrasonographically measured. Lung morphometry consisted of measurements of radial alveolar count (RAC) and arterial muscular thickness. results: Animals in the DH group (n = 9) had the worst hemodynamic parameters; their lungs were hypoplastic and had the thickest arterial muscular layer. Animals in the TO group (n = 10) had all these effects reversed. There were no correlations among hemodynamic, airway, and vascular parameters, except for RAC and PI (r = −0.528, P = 0.043). conclusion: Airway and vascular maturation after TO appear to be uncorrelated effects. TO could trigger several pathways that separately regulate airway and vascular responses.