[Outcomes following the triage of patients for urological cancer and non-cancer surgery during Covid-19 pandemic peak]

Introduction

Lors de la première vague épidémique Covid-19, des mesures de triage, sans PCR systématique, étaient mises en place pour sélectionner les patients à opérer. Notre étude a comparé leurs résultats chirurgicaux après triage à ceux d’un groupe contrôle.

Matériel

L’analyse portait sur l’ensemble des patients initialement programmés dans un centre Covid de référence et inclus consécutivement, du 15 mars au 1^er mai 2020 (NCT04352699). Leurs données étaient recueillies prospectivement et ultérieurement comparées à celles des patients opérés 1 an auparavant sur la même période dans ce centre. Le critère d’évaluation principal était l’admission post-opératoire en unité de soins intensifs (USI). La morbidité, la mortalité postopératoire, le report d’interventions, les tests PCR étaient évalués. Des analyses de sous-groupes étaient réalisés pour les patients opérés de cancer.

Résultats

Après triage, 96 des 142 interventions programmées ont dû être reportées. Sur les opérés, 48 (68 %) l’étaient pour cancer. Au total, aucun cas de pneumonie Covid-19 post-opératoire n’a été identifié. Trois patients (4 %) ont été admis en USI, dont un finalement décédé pour sepsis urinaire. Chez ces patients, les RT-PCR étaient négatives. Globalement, comparativement au groupe contrôle, aucune différence d’admission en USI, ni de taux de mortalité post-opératoire n’ont été rapportées.

Conclusions

Le triage de la première vague n’a pas surexposé les patients sélectionnés à un risque de complication ou de décès post-opératoire, particulièrement pas pour ceux opérés pour cancer. En revanche, 67 % des patients ont été reportés, avec un risque associé à des retard de soins pouvant conduire au décès.

Niveau de preuve

3.

Photocatalytic abatement results from a model street canyon

During the European Life+ project PhotoPAQ (Demonstration of Photocatalytic remediation Processes on Air Quality), photocatalytic remediation of nitrogen oxides (NOx), ozone (O3), volatile organic compounds (VOCs), and airborne particles on photocatalytic cementitious coating materials was studied in an artificial street canyon setup by comparing with a colocated nonactive reference canyon of the same dimension (5 × 5 × 53 m). Although the photocatalytic material showed reasonably high activity in laboratory studies, no significant reduction of NOx, O3, and VOCs and no impact on particle mass, size distribution, and chemical composition were observed in the field campaign. When comparing nighttime and daytime correlation plots of the two canyons, an average upper limit NOx remediation of ≤2% was derived. This result is consistent only with three recent field studies on photocatalytic NOx remediation in the urban atmosphere, whereas much higher reductions were obtained in most other field investigations. Reasons for the controversial results are discussed, and a more consistent picture of the quantitative remediation is obtained after extrapolation of the results from the various field campaigns to realistic main urban street canyon conditions.

Construction of a photocatalytic de-polluting field site in the Leopold II tunnel in Brussels

Within the framework of the European Life+-funded project PhotoPAQ (Demonstration of Photocatalytic remediation Processes on Air Quality), which was aimed at demonstrating the effectiveness of photocatalytic coating materials on a realistic scale, a photocatalytic de-polluting field site was set up in the Leopold II tunnel in Brussels, Belgium. For that purpose, photocatalytic cementitious materials were applied on the side walls and ceiling of selected test sections inside a one-way tunnel tube. This article presents the configuration of the test sections used and the preparation and implementation of the measuring campaigns inside the Leopold II tunnel. While emphasizing on how to implement measuring campaigns under such conditions, difficulties encountered during these extensive field campaigns are presented and discussed. This included the severe de-activation observed for the investigated material under the polluted tunnel conditions, which was revealed by additional laboratory experiments on photocatalytic samples that were exposed to tunnel air. Finally, recommendations for future applications of photocatalytic building materials inside tunnels are given.

A tunable diode laser absorption spectrometer for formaldehyde atmospheric measurements validated by simulation chamber instrumentation

A tunable diode laser absorption spectrometer (TDLAS) for formaldehyde atmospheric measurements has been set up and validated through comparison experiments with a Fourier transform infrared spectrometer (FT-IR) in a simulation chamber. Formaldehyde was generated in situ in the chamber from reaction of ethene with ozone. Three HCHO ro-vibrational line intensities (at 2909.71, 2912.09 and 2914.46 cm(-1)) possibly used by TDLAS were calibrated by FT-IR spectra simultaneously recorded in the 1600-3200 cm(-1) domain during ethene ozonolysis, enabling the on-line deduction of the varying concentration for HCHO in formation. The experimental line intensities values inferred confirmed the calculated ones from the updated HITRAN database. In addition, the feasibility of stratospheric in situ HCHO measurements using the 2912.09 cm(-1) line was demonstrated. The TDLAS performances were also assessed, leading to a 2sigma detection limit of 88 ppt in volume mixing ratio with a response time of 60 sec at 30 Torr and 294 K for 112 m optical path. As part of this work, the room-temperature rate constant of this reaction and the HCHO formation yield were found to be in excellent agreement with the compiled literature data.

Calculation of the vibrational properties of LiMgAs

We have studied the vibrational properties of the filled tetrahedral semiconductor LiMgAs and its binary analog AlAs by using the plane-wave pseudopotential method within density functional theory. The calculated lattice constants for the studied compounds are in good agreement with previous theoretical and experimental results. The phonon dispersion curves and phonon density of states are calculated by using density functional perturbation theory. The sound speeds in different directions are quantitatively similar in LiMgAs and AlAs. The assignment of the zone center modes to the relative motion of the atoms shows that the lower optic modes are due to the Mg-As pair vibrations, while for the upper ones the Li-Mg pair dominates, which is attributed to the smaller Mg atom mass. The longitudinal interatomic force constant of Mg-As is about 66% higher than that of Li-As, showing the relatively high covalency of the former bond.

UV absorption cross-sections of a series of dimethylbenzaldehydes

The ultraviolet absorption cross-sections of 2,4-, 2,5-, 2,6-, 3,4- and 3,5- dimethylbenzaldehydes are reported in the wavelength range 240-320 nm. The measurements were carried out in the temperature range 318-363 K using two different experimental systems (D 2 lamp-monochromator and D 2 lamp-diode array). The absorption spectra of the five aldehydes have been found to exhibit relatively high absorption cross-sections in the region of the tropospheric interest with maxima around 290 nm. This work provides the first UV cross-section measurements for these aromatic aldehydes. The obtained cross-section values enable us to estimate the tropospheric photolysis lifetimes of these compounds. The results suggest that photolysis could be an important removal process for these species in the troposphere.

Trifluralin: photolysis under sunlight conditions and reaction with HO* radicals

The gas phase atmospheric degradation of trifluralin (a widely used herbicide) has been investigated at the EUPHORE facility. Its photolysis has been studied under sunlight conditions and its reaction rate constant with HO() radicals was measured using the relative rate method. Using 1,3,5-trimethylbenzene as reference compound, the rate constant of HO() reaction with trifluralin was obtained to be [formula: see text] The mean photolysis rate measured under solar radiation was [formula: see text] . The photolysis of trifluralin was found to generate organic aerosols with a yield of (20 +/-10)%. The data obtained enabled us to discuss the atmospheric fate of trifluralin in the gas phase.

The gas phase tropospheric removal of fluoroaldehydes (CxF2x+1CHO, x = 3, 4, 6)

The rate coefficient of the OH reaction with the perfluoroaldehydes C(3)F(7)CHO and C(4)F(9)CHO have been determined in the temperature range 252-373 K using the pulsed laser photolysis-laser induced fluorescence (PLP-LIF) method: k(C(3)F(7)CHO+OH) = (2.0 +/- 0.6) x 10(-12) exp[-(369 +/- 90)/T] and k(C(4)F(9)CHO+OH) = (2.0 +/- 0.5) x 10(-12) exp[-(356 +/- 70)/T] cm(3) molecule(-1) s(-1), corresponding to (5.8 +/- 0.6) x 10(-13) and (6.1 +/- 0.5) x 10(-13) cm(3) molecule(-1) s(-1), respectively, at 298 K. The UV absorption cross sections of these two aldehydes and CF(3)(CF(2))(5)CH(2)CHO have been measured over the range 230-390 nm at 298 K and also at 328 K for CF(3)(CF(2))(5)CH(2)CHO. The obtained results for C(3)F(7)CHO and C(4)F(9)CHO are in good agreement with two recent determinations but the maximum value of the absorption cross section for CF(3)(CF(2))(5)CH(2)CHO is over a factor of two lower than the single one recently published. The photolysis rates of C(3)F(7)CHO, C(4)F(9)CHO and CF(3)(CF(2))(5)CHO have been measured under sunlight conditions in the EUPHORE simulation chamber in Valencia (Spain) at the beginning of June. The photolysis rates were, respectively, J(obs) = (1.3 +/- 0.6) x 10(-5), (1.9 +/- 0.8) x 10(-5) and (0.6 +/- 0.3) x 10(-5) s(-1). From the J(obs) measurements and calculated photolysis rate J(calc), assuming a quantum yield of unity across the atmospheric range of absorption of the aldehydes, quantum yields J(obs)/J(calc) = (0.023 +/- 0.012), (0.029 +/- 0.015) and (0.046 +/- 0.028) were derived for the photodissociation of C(3)F(7)CHO, C(4)F(9)CHO and CF(3)(CF(2))(5)CHO, respectively. The atmospheric implication of the data obtained in this work is discussed. The main conclusion is that the major atmospheric removal pathway for fluoroaldehydes will be photolysis, which under low NO(x) conditions, may be a source of fluorinated carboxylic acids in the troposphere.

Reaction of Cl Atoms with C6F13CH2OH, C6F13CHO, and C3F7CHO

The Cl atom initiated oxidation of C(6)F(13)CH(2)OH, C(6)F(13)CHO, and C(3)F(7)CHO was investigated at 298 K and 1000 mbar pressure of air in a photoreactor using in situ Fourier transform infrared (FTIR) analysis. The rate coefficient for the reaction Cl + C(6)F(13)CH(2)OH (reaction 2) was measured using a relative method: k(2) = (6.5 +/- 0.8) x 10(-13) cm(3) molecule(-1) s(-1). C(6)F(13)CHO was detected as the major primary product, while CO and CF(2)O were found to be the major secondary products. A fitting procedure applied to the concentration-time profiles of C(6)F(13)CHO provided a production yield of (1.0 +/- 0.2) for this aldehyde in reaction 2, and the rate coefficient for the reaction Cl + C(6)F(13)CHO (reaction 4) was k(4) = (2.8 +/- 0.7) x 10(-12) cm(3) molecule(-1) s(-1). A high CO yield observed in the oxidation of C(6)F(13)CH(2)OH, (52 +/- 1)%, is attributed to the Cl atom initiated oxidation of C(6)F(13)CHO. High CO yields, (61 +/- 2)% and (85 +/- 5)%, were also measured in the Cl atom initiated oxidation of C(3)F(7)CHO in air and nitrogen, respectively. These high CO yields suggest the occurrence of a decomposition reaction of the perfluoroacyl, C(6)F(13)CO, and C(3)F(7)CO radicals to form CO which will compete with the combination reaction of these radicals with oxygen to form perfluoroacyl peroxy radicals in the presence of air. The latter radicals C(n)F(2)(n)(+1)CO(O)(2) (n = 6-12), through their reaction with HO(2) radicals, are currently considered as a possible source of persistent perfluorocarboxylic acids which have been detected in the environment. The consequences of the present results would be a reduction of the strength of this potential source of carboxylic acids in the atmosphere.

Atmospheric fate of dichlorvos: photolysis and OH-initiated oxidation studies

The OH-initiated oxidation of dichlorvos (a widely used insecticide) has been investigated under atmospheric conditions at the large outdoor European photoreactor (EUPHORE) in Valencia, Spain. The rate constant of OH reaction with dichlorvos, k, was measured by using a conventional relative rate technique where 1,3,5-trimethylbenzene (TMB) and cyclohexane were taken as references. With the use of the rate constants of 5.67 x 10(-11) and of 6.97 x 10(-12) cm3 molecule(-1) s(-1) for the reactions OH + TMB and OH + cyclohexane, respectively, the resulting value of the OH reaction rate constant with dichlorvos was derived to be k = (2.6 +/- 0.3) x 10(-11) cm3 molecule(-1) s(-1). The tropospheric lifetime of dichlorvos with respect to reaction with OH radical has been estimated to be around 11 h. The major carbon-containing products observed for the OH reaction with dichlorvos in air under sunlight condition were phosgene and carbon monoxide. The formation of a very stable toxic primary product such as phosgene associated with the relatively short lifetime of dichlorvos may make the use of this pesticide even more toxic for humans when released into the atmosphere.

Photolysis and OH-Initiated Oxidation of Glycolaldehyde under Atmospheric Conditions

The photolysis and OH-initiated oxidation of glycolaldehyde (HOCH(2)CHO), which are relevant atmospheric processes, have been investigated under different conditions using complementary methods in three different laboratories. The UV absorption cross sections of glycolaldehyde determined in two of the laboratories are in excellent agreement. The photolysis of glycolaldehyde in air has been investigated in a quartz cell with sunlamps and in the EUPHORE chamber irradiated by sunlight. The mean photolysis rate measured under solar radiation was (1.1 +/- 0.3) x 10(-5) s(-1) corresponding to a mean effective photolysis quantum yield of (1.3 +/- 0.3). The major products detected were HCHO and CO, whereas CH(3)OH was also observed with an initial yield around 10%. Evidence for OH production was found in both experiments using either OH scavenger or OH tracer species. Photolysis of glycolaldehyde was used as the OH source to measure the reaction rate constants of OH with a series of dienes by the relative method and to identify and quantify the oxidation products of the OH-initiated oxidation of 2-propanol. The different experiments suggest that OH is produced by the primary channel: HOCH(2)CHO + hnu --> OH + CH(2)CHO (1). The rate constant of the OH reaction with glycolaldehyde has been measured at 298 K using the relative method: k(glyc) = (1.2 +/- 0.3) x 10(-11) cm(3) molecule(-1) s(-1). The product study of the OH-initiated oxidation of glycolaldehyde in air has been performed using both a FEP bag and the EUPHORE chamber. HCHO was observed to be the major product with a primary yield of around 65%. Glyoxal (CHOCHO) was also observed in EUPHORE with a primary yield of (22 +/- 6)%. This yield corresponds to the branching ratio ( approximately 20%) of the H-atom abstraction channel from the CH(2) group in the OH + HOCH(2)CHO reaction, the major channel ( approximately 80%) being the H-atom abstraction from the carbonyl group. The data obtained in this work, especially the first determination of the photolysis rate of glycolaldehyde under atmospheric conditions, indicate that the OH reaction and photolysis can compete as tropospheric sinks for glycolaldehyde. Since glycolaldehyde is a significant oxidation product of isoprene whereas the photolysis of glycolaldehyde is a significant source of methanol, isoprene might contribute a few percent of the global budget of methanol.

The OH-initiated oxidation of hexylene glycol and diacetone alcohol

The OH-initiated oxidation of two VOCs directly emitted to the atmosphere through their use as industrial solvents, hexylene glycol (HG, (CH3)2C(OH)CH2CH(OH)CH3) and diacetone alcohol (DA, (CH3)2C(OH)CH2C(O)CH3), has been studied in two photoreactors: a 140 L Teflon bag irradiated by lamps at CNRS-Orleans and the 200 m3 European photoreactor, EUPHORE, irradiated by sunlight. The rate constants for the reactions of HG and DA with OH radicals have been determined at (298 +/- 3) K using a relative rate method: k(HG) = (1.5 +/- 0.4) x 10(-11) and k(DA) = (3.6 +/- 0.6) x 10(-12) cm(3) molecule(-1) s(-1) and have been found in good agreement with estimations from structure-reactivity relationships. The study at Orleans and EUPHORE of the OH-initiated oxidation of hexylene glycol showed the formation of diacetone alcohol, acetone, and PAN as the principal products. The branching ratio of the H-atom abstraction from the > CH- group of HG has been estimated to be (47 +/- 4)% corresponding to the measured formation yield of DA. The formation yields of acetone and PAN lead to the determination of a lower limit of (33 +/- 7)% for the branching ratio of the H-atom abstraction of the -CH2- group of HG. For diacetone alcohol, studies at EUPHORE have shown negligible photolysis under atmospheric conditions (J < 5 x 10(-6) s(-1)) and the formation of acetone, PAN, HCHO, and CO in the OH-initiated oxidation experiments. The molar yield of acetone, close to 100%, corresponds to the branching ratio of the H-atom abstraction from the -CH2- group of DA. The present study has allowed the identification of the nature and the fate of the oxy radicals as intermediates in the oxidation mechanism of both HG and DA. The atmospheric implication of these results, especially the ozone formation potential of HG and DA, is discussed.