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- Bravo, L, et al.
(författare)
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- 2021
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swepub:Mat__t
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- Tabiri, S, et al.
(författare)
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- 2021
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swepub:Mat__t
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- Khatri, C, et al.
(författare)
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Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study
- 2021
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 11:11, s. e050830-
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Tidskriftsartikel (refereegranskat)abstract
- Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis.SettingProspective, international, multicentre, observational cohort study.ParticipantsPatients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative).Primary outcome30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality.ResultsThis study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p<0.001), age >80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787).ConclusionsPatients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups.Trial registration numberNCT04323644
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| 9. |
- Fayad, W., et al.
(författare)
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A systematic multicellular spheroids screening approach lead to the identification of antineoplastic activity in three different plant extracts from the Egyptian flora
- 2017
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Ingår i: Journal of Applied Pharmaceutical Science. - : Medipoeia Publication. - 2231-3354. ; 7:6, s. 13-22
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Tidskriftsartikel (refereegranskat)abstract
- Developing natural products as potential antineoplastic drugs is a meticulous process involving both compound isolation and biological testing. Many studies are based on primary screening using tumor cell viability as the readout followed by compound isolation. We here present an approach which utilizes both 2-D and 3-D cultured of tumor cells for screening and immortalized human non-transformed cells for counter screening. This procedure increases the precision of identifying tumor-specific cytotoxic compounds with interesting pharmacological properties. Using this straight-forward approach, we screened 500 plant extracts from the Egyptian flora for anticancer activity. The primary screen on 2-D cultured cells yielded 41 hits, 12 of which showed significant cytotoxicity on 3-D cultured cells. Of these, 4 extracts showed limited cytoxicity to normal cells. We conclude that only ~10% of the cytotoxic extracts showed desired properties with regard to tumor parenchyme penetration and tumor-specific activity. Extracts from Euphorbia dendroides L. herb, Ononis vaginalis Vahl. herb and Quercus robur L. branches were found to induce tumor apoptosis and were considered the most promising. These three extracts showed significant inhibition in the Ehrlich ascites carcinoma in vivo model and did not show severe toxicity on healthy animals.
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