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Negreskul Y, Wingfield L, Mandal I, Gilmour J. 1451 Early Experiences with Covid-19 In Surgical Patients at The Start of The Global Pandemic. Br J Surg 2021. [PMCID: PMC8524573 DOI: 10.1093/bjs/znab259.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Covid-19 is a global threat which had emerged rapidly over the course of last year and is particularly deleterious to those with multiple co-morbidities. While limited data is available on the outcomes of emergency surgical patients infected with SARS-CoV-2, initial reports suggest prolonged post-operative course. Early Covid-19 diagnosis and understanding its impact on outcomes are essential for appropriate management of emergency surgical patients. We aim to report a tertiary hospital’s experiences with the first UK patients infected with Covid-19 at the time of surgery.
Method
A limited consecutive, case series (n = 4) was completed in March-April 2020 in a single tertiary centre with a review of case notes, image, and laboratory results.
Results
All patients presented with acute abdominal pathology (appendicitis, incarcerated umbilical hernia and small bowel obstruction). One patient had a laparoscopy whilst the rest underwent open procedures. All patients suffered from multiple co-morbidities and were on average 71 years-old (57-87). Initial SARS-CoV-2 PCR was negative in 3 patients. However, their clinical features, imaging findings and haematological profiles (raised inflammatory markers with lymphopenia) were in keeping with a diagnosis of Covid-19. All patients had a protracted hospital course with an average hospital stay of 22 days (15-30). 3 patients required unplanned ITU (ITU stay: 4-30 days). The length of ITU stay did not correlate with the procedure complexity.
Conclusions
These initial cases suggest that Covid-19 complicates post-operative recovery. Multimodal approach including PCR testing, imaging and haematological profiles is essential to identify patients at risk of post-operative deterioration and thus plan care accordingly.
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Affiliation(s)
- Y Negreskul
- John Radcliffe Hospital, Oxford, United Kingdom
| | - L Wingfield
- University of Oxford, Oxford, United Kingdom
| | - I Mandal
- John Radcliffe Hospital, Oxford, United Kingdom
| | - J Gilmour
- John Radcliffe Hospital, Oxford, United Kingdom
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Xu Y, Mandal I, Lam S, Troumpoukis N, Uberoi R, Sabharwal T, Makris GC. Impact of the COVID-19 pandemic on interventional radiology services across the world. Clin Radiol 2021; 76:621-625. [PMID: 34090708 PMCID: PMC8133525 DOI: 10.1016/j.crad.2021.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/05/2021] [Indexed: 12/14/2022]
Abstract
AIM To review data on the impact of the COVID-19 pandemic on interventional radiology (IR) services. MATERIALS AND METHODS A systematic review of the available studies was performed according to the PRISMA guidelines. RESULTS A total of 14 studies met the inclusion criteria. IR caseload reduced between 16.8-80%, with elective activity affected more than emergency work. Trainees also experienced a 11-51.9% reduction in case volumes and many were redeployed to critical care. IR departments re-organised operations and personnel, and many continued to offer 24/7 services and support critical care areas through redeployment of staff. The majority of studies report no significant issues with the availability of personal protective equipment and that local or national governing body or radiology society guidelines were followed. CONCLUSION The COVID-19 pandemic reduced case volumes and training opportunities. IR departments showed flexibility in service delivery. The lessons learned offer novel insights into how services and training can be reorganised to ensure that IR continues to thrive.
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Affiliation(s)
- Y Xu
- Department of Radiology, Imperial College Healthcare NHS Trust, Paddington, London, W2 1NY, UK
| | - I Mandal
- Department of Radiology, Royal Berkshire Hospital, Reading, RG1 5AN, UK; UK National Interventional Radiology Trainee Research (UNITE) Collaborative, St Thomas Hospital, SE1 7EH, UK
| | - S Lam
- UK National Interventional Radiology Trainee Research (UNITE) Collaborative, St Thomas Hospital, SE1 7EH, UK; Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, E1 2AD, UK
| | - N Troumpoukis
- Alfa Institute of Biomedical Sciences, Neapoleos 9, Marousi, Athens, Greece; Radiology Department, University Hospital of Lewisham, London, SE13 6LH, UK
| | - R Uberoi
- Department of Interventional Radiology, Oxford University Hospitals, NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - T Sabharwal
- Department of Interventional Radiology, Guys & St Thomas NHS Foundation Trust, London, SE1 9RS, UK
| | - G C Makris
- UK National Interventional Radiology Trainee Research (UNITE) Collaborative, St Thomas Hospital, SE1 7EH, UK; Alfa Institute of Biomedical Sciences, Neapoleos 9, Marousi, Athens, Greece; Radiology Department, University Hospital of Lewisham, London, SE13 6LH, UK; Department of Interventional Radiology, Guys & St Thomas NHS Foundation Trust, London, SE1 9RS, UK.
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Mandal I, Basak J, Mukhopadhyay A, Bose C. Screening program for cervical cancer among rural women by visual inspection with acetic acid (VIA): A camp approach in Eastern India. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy436.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mandal I, Paul S, Venkatramani R. Optical backbone-sidechain charge transfer transitions in proteins sensitive to secondary structure and modifications. Faraday Discuss 2018; 207:115-135. [DOI: 10.1039/c7fd00203c] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We report the UV-vis absorption originating from protein backbone-sidechain charge transfer transitions in charged amino acids with anionic and cationic sidechains.
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Affiliation(s)
- I. Mandal
- Department of Chemical Sciences
- Tata Institute of Fundamental Research
- Mumbai 400005
- India
| | - S. Paul
- Department of Chemical Sciences
- Tata Institute of Fundamental Research
- Mumbai 400005
- India
| | - R. Venkatramani
- Department of Chemical Sciences
- Tata Institute of Fundamental Research
- Mumbai 400005
- India
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Lazar R, Mandal I, Slater N. Effect of bore fluid composition on microstructure and performance of a microporous hollow fibre membrane as a cation-exchange substrate. J Chromatogr A 2015; 1394:148-53. [DOI: 10.1016/j.chroma.2015.03.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 02/23/2015] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
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Mandal I, Townsend M, Darton N, Bonyadi S, Slater N. A microporous walled micro-capillary film module for cation-exchange protein chromatography. J Memb Sci 2014. [DOI: 10.1016/j.memsci.2014.04.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bhattacharyya R, Das AK, Moitra PK, Pal B, Mandal I, Basu J. Mapping of a palmitoylatable band 3-binding domain of human erythrocyte membrane protein 4.2. Biochem J 1999; 340 ( Pt 2):505-12. [PMID: 10333496 PMCID: PMC1220278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Evidence accumulated over the years suggests that human erythrocyte membrane protein 4.2 is one of the proteins involved in strengthening the cytoskeleton-membrane interactions in the red blood cell. Deficiency of protein 4.2 is linked with a variety of hereditary haemolytic anaemia. However, the interactions of protein 4.2 with other proteins of the erythrocyte membrane remain poorly understood. The major membrane-binding site for protein 4.2 resides on the cytoplasmic domain of band 3 (CDB3). In order to carry out an initial characterization of its interaction with the CDB3, protein 4. 2 was subjected to proteolytic cleavage and gel renaturation assay, and the 23-kDa N-terminal domain was found to interact with band 3. This domain contained two putative palmitoylatable cysteine residues, of which cysteine 203 was identified as the palmitoylatable cysteine. Recombinant glutathione S-transferase-fusion peptides derived from this domain were characterized with respect to their ability to interact with the CDB3. Whereas these studies do not rule out the involvement of other subsites on protein 4.2 in interaction with the CDB3, the evidence suggests that the region encompassing amino acid residues 187-211 is one of the domains critical for the protein 4.2-CDB3 interaction. This is also the first demonstration that palmitoylation serves as a positive modulator of this interaction.
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Affiliation(s)
- R Bhattacharyya
- Department of Chemistry, Bose Institute, 93/1 Acharya Prafulla Chandra Road, Calcutta 700 009, India
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