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The conformational space of cis-1,2-cyclohexanediol, a model molecule for cyclic vicinal diols, was investigated using rotational spectroscopy and density functional theory calculations. Four low energy conformers within an energy window of 5 kJ mol-1 were identified computationally. A rotational spectrum of jet-cooled cis-1,2-cyclohexanediol was recorded with a chirped pulse Fourier transform microwave spectrometer. Two sets of rotational transitions were observed and could be assigned to conformers of cis-1,2-cyclohexanediol. The non-observation of other low energy conformers was explained by conformational conversion barrier height calculations and results from experimental spectra recorded with different carrier gases. Eight isotopologues, including those with 13C and 18O, of the lowest energy conformer were observed, allowing the determination of the semi-experimental equilibrium structure, reSE. Interestingly, the structural analysis revealed that the C-O bond length of the intramolecular hydrogen-bond donor is shorter than that of the acceptor. This appears to be a general characteristic of vicinal diols and can be used as a novel hydrogen-bond marker in such compounds.
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The complex conformational panorama of binary 4,4,4-trifluoro-1-butanol (TFB) aggregates was investigated using chirped-pulse Fourier transform microwave spectroscopy, aided by conformational searches using CREST (Conformer-Rotamer Ensemble Sampling Tool) and quantum chemistry calculations. From nearly 1500 initial dimer geometries, 16 most stable binary candidates were obtained within a relative energy window of â¼4 kJ mol-1. Rotational spectra of five binary conformers were experimentally observed in supersonic expansion and assigned. Interestingly, three out of the five observed binary conformers are composed solely of monomer conformers, which were not observed in their isolated gas phase forms in jet expansion. In addition, an observed dimer that is made exclusively of the most stable TFB monomer subunits does not correspond to the global minimum. The intricate kinetically and thermodynamically controlled dimer formation mechanisms are discussed, and a modified kinetic-thermodynamic model was developed, providing conformational abundances that are in good agreement with the experiment. Subsequent non-covalent interaction analyses reveal that the observed conformers are held together by one primary O-Hâ¯O hydrogen bond and secondary intermolecular C-Hâ¯O, C-Hâ¯F, and/or O-Hâ¯F interactions, as well as C-Hâ¯H-C London dispersion interactions between the methylene groups. Further symmetry-adapted perturbation theory analyses of the TFB dimer conformers and related alcohol dimers reveal a considerable rise in dispersion contributions with increasing n-alkyl carbon chain length and highlight the role of dispersion interactions in preferentially stabilizing the global minimum of the TFB dimer.
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Two competing solvation pathways of 3-methylcatechol (MC), an atmospherically relevant aromatic molecule, with up to five water molecules were explored in detail by using a combination of broadband rotational spectroscopy and computational chemistry. Theoretically, two different pathways of solvation emerge: the commonly observed droplet pathway which involves preferential binding among the water molecules while the solute serves as an anchor point for the formation of a water cluster, and an unexpected wetting pathway which involves interactions between the water molecules and the aromatic face of MC, i.e., a wetting of the π-surface. Conclusive identification of the MC hydrate structures, and therefore the wetting pathway, was facilitated by rotational spectra of the parent MC hydrates and several H2 18 O and 13 C isotopologues which exhibit splittings associated with methyl internal rotation and/or water tunneling motions. Theoretical modelling and analyses offer insights into the tunneling and conversion barriers associated with the observed hydrate conformers and the nature of the non-covalent interactions involved in choosing the unusual wetting pathway.
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Gas phase homodimers of 3,3,3-trifluoro-1,2-epoxypropane (TFO), a molecule which has shown promise as an effective chiral tag for determining the absolute stereochemistry and the enantiomeric composition of chiral analytes, are explored using a variety of quantum chemistry models and rotational spectroscopy. The potential surface governing the interaction of the two molecules is rapidly explored using the artificial bee colony algorithm for homodimer candidates that are subsequently optimized by quantum chemistry methods. Although all model chemistries employed agree that the lowest energy form of the heterochiral homodimer of TFO (RS or SR) is lower in energy than that of the homochiral dimer (RR or SS), the energy spacings among the lower energy isomers of each and indeed the absolute energy ordering of the isomers of each are very model dependent. The experimental results suggest that the B3LYP-D3BJ/def2-TZVP model chemistry is the most reliable and provides excellent estimates of spectroscopic constants. In accord with theoretical predictions the non-polar lowest energy form of the heterochiral homodimer is not observed, while two isomers of the homochiral dimer are observed and spectroscopically characterized. Observation and assignment of the spectra for all three unique singly-substituted 13C isotopologues, in addition to that of the most abundant isotopologue for the lowest energy isomer of the homochiral homodimer of TFO, provide structural information that compares very favorably with theoretical predictions, most notably that the presence of three fluorine atoms on the trifluoromethyl group removes their direct participation in the intermolecular interactions, which instead comprise two equivalent pairs of CHâ¯O hydrogen bonds between the two epoxide rings augmented by favorable dispersion interactions between the rings themselves.
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Organic acids are released during wildfire combustion and can influence aerosol formation and growth. Conformational flexibility is thought to be advantageous in stabilizing the precritical nucleus in the process of aerosol particle formation and allowing for further complexation with other atmospheric constituents. We describe here a study of the conformational flexibility of vanillic acid and its monohydrate using electronic structure calculations and Fourier transform microwave spectroscopy. Computationally, 12 and 28 conformers were found for the monomer and monohydrate, respectively. The two lowest energy conformers of both the vanillic acid monomer and the vanillic acid-water complex could be experimentally identified. The deviation between experimental and theoretical rotational constants determined at the MP2/aug-cc-pVTZ and DFT B3LYP-D3(BJ)/def2-TZVP levels of theory is less than 1%. No tunneling splittings were observed, which suggests a relatively high barrier to methyl internal rotation, in agreement with other, previously studied vanillin derivatives. Furthermore, no c-type transitions could be observed for the vanillic acid monomer, in agreement with the computed zero c-dipole moment component of the two lowest energy structures. For the monohydrate the absence of c-type transitions is rationalized by averaging over a large amplitude motion involving the free H atom of the water unit. From the theoretical structures, it is apparent that intramolecular hydrogen bonds play a significant role in stabilizing the lowest energy conformers. To further characterize the intramolecular interactions in the monomer and intra- and intermolecular interactions in the monohydrate, quantum theory of atoms-in-molecules (QTAIM), noncovalent interactions (NCI), and intrinsic bond strength index (IBSI) analyses were performed. The atmospheric abundance of the vanillic acid monohydrate relative to the monomer was evaluated to assess its atmospheric significance.
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Ácido Vanílico , Água , Modelos Moleculares , Conformação Molecular , Análise EspectralRESUMO
Rotational dynamics of D_{2} molecules inside helium nanodroplets is induced by a moderately intense femtosecond pump pulse and measured as a function of time by recording the yield of HeD^{+} ions, created through strong-field dissociative ionization with a delayed femtosecond probe pulse. The yield oscillates with a period of 185 fs, reflecting field-free rotational wave packet dynamics, and the oscillation persists for more than 500 periods. Within the experimental uncertainty, the rotational constant B_{He} of the in-droplet D_{2} molecule, determined by Fourier analysis, is the same as B_{gas} for an isolated D_{2} molecule. Our observations show that the D_{2} molecules inside helium nanodroplets essentially rotate as free D_{2} molecules.
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Rotational spectra of 2,2,3,3,3-pentafluoro-1-propanol (PFP) were measured using cavity and chirped pulse Fourier transform microwave spectrometers. Of the nine possible PFP configurations which include four mirror-imaged pairs and an achiral conformer, the two most stable monomeric PFP imaged pairs, i.e., PFPG+g+/G-g- and PFPTg+/Tg- were observed and assigned, along with the 13C, 18O and deuterated isotopologues of PFPG+g+/G-g-. The rotational transitions of PFPTg+/Tg- exhibit large tunnelling splittings and were analyzed in detail. CREST, a recently developed conformational search tool that was used for systematic conformational searches of possible binary PFP conformers and the subsequent DFT calculations at the B3LYP-D3(BJ)/def2-QZVP level produced nearly 80 stable, binary PFP geometries, where ten of them are within a narrow energy window of â¼1 kJ mol-1, highlighting the structural diversity of the system. Rotational spectra of five (PFP)2 conformers were assigned and were identified as the five most stable binary conformers predicted. A closer examination reveals that the assigned binary conformers are made exclusively of the two most stable PFP monomeric subunits observed experimentally. A combined kinetic and thermodynamic model was proposed to explain the observation or non-observation of low energy conformers, and the analysis was further verified by the 'argon test'. The non-covalent intermolecular interactions of PFP and its binary conformers are also discussed with the aid of quantum theory of atoms in molecules (QTAIM) and non-covalent interaction (NCI) analyses, as well as the effects of fluorination by comparing with 1-propanol and its dimers.
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The 2,2,3,3,3-pentafluoropropanol (PFP) monomer can exist in five conformations defined by the CCCO and CCOH dihedral angles: four mirror-imaged pairs (G+g+/G-g-, G+g-/G-g+, G+t/G-t, Tg+/Tg-) and an achiral Tt form. We examined the conformational landscape of the PFPâ â â water complex using chirped pulsed Fourier transform microwave spectroscopy and theoretical calculations. Rotational spectra of two PFPâ â â water conformers, PFPG+g+â â â WH and PFPTg+â â â WH , and seven deuterated isotopologues of each, were assigned. Tunneling splittings were observed for both conformers and are attributed to the exchange of the bonded and non-bonded hydrogen atoms of water. On the other hand, the tunneling splitting associated with the OH flipping motion in PFPTg+/Tg- appears to be quenched upon hydrogen bonding with water. The large amplitude motions associated with the water subunits were examined in detail to explain the very different magnitudes of the experimental and theoretical permanent electric dipole moment components. The study highlights the challenge in correctly identifying the conformers observed when large amplitude motions are involved. Quantum theory of atoms in molecules (QTAIM) and non-covalent interaction (NCI) analyses, as well as electrostatic potential (ESP) calculations were carried out to explore the nature of the non-covalent interactions and to appreciate the effects of fluorination.
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Hidrogênio , Água , Água/química , Conformação Molecular , Análise Espectral , RotaçãoRESUMO
A rotational spectrum of the hydrogen-bonded complex between 1-phenyl-2,2,2-trilfuoroethanol (PhTFE), a chiral fluoroalcohol, and 1,4-dioxane, a common solvent for organic reactions, was measured using a chirped pulse Fourier transform microwave spectrometer. Initial theoretical conformational searches were carried out using CREST, a recently developed conformational searching tool. Subsequent geometry optimization and harmonic frequency calculations at the B3LYP-D3(BJ)/def2-TZVP level of theory yielded nearly 30 binary conformers of which 13 are within an energy window of â¼5 kJ mol-1. Interestingly, while the O-H···O hydrogen bond dominates the attractive binary interactions, the complex conformational landscape is mainly controlled by subtle dispersion interactions between the phenyl and 1,4-dioxane rings. Two sets of rotational transitions were assigned in the experimental spectrum and attributed to the two most stable conformers of PhTFE···1,4-dioxane. The quantum theory of atoms in molecules (QTAIM), noncovalent interactions (NCI), and symmetry-adapted perturbation theory (SAPT) analyses were employed in order to appreciate how the phenyl ring and O-H functional groups influence the intermolecular interaction and conformational distribution of the binary complex. The main PhTFE conformation within the complex, identified experimentally, is different from that of the isolated PhTFE monomer reported previously.
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BACKGROUND: Radical cystectomy has high complication rates and, consequently, a high socioeconomic burden. The association between preoperative electrolyte levels and postoperative outcomes after radical cystectomy has not been investigated. Therefore, we aimed to investigate the association between preoperative potassium level and clinical (30-day morbidity) and economical (length of hospital stay) postoperative outcomes of patients undergoing radical cystectomy. MATERIALS AND METHODS: We retrospectively evaluated clinical data of 317 patients who had undergone radical cystectomy for bladder cancer. Univariate and multivariate logistic regression analyses were performed to determine whether preoperative patient clinical factors influence clinical (30-day morbidity according to the Clavien-Dindo classification) and economical (length of hospital stay) postoperative outcomes. RESULTS: In univariate analysis, low Charlson comorbidity score (p = 0.011), low ASA score (p = 0.015), no aspirin intake (p = 0.048) and high-normal preoperative potassium level (p = 0.034) were associated with reduced 30-day morbidity. In multivariate analysis, only high preoperative potassium remained an independent predictive factor for a reduced risk of postoperative complications (odds ratio 0.67, 95% confidence interval (0.48, 0.92), p = 0.014). Furthermore, high-normal preoperative potassium was the only preoperative factor associated with a shorter hospital stay ≤21 days (p = 0.007). CONCLUSIONS: High-normal preoperative potassium level was associated with better clinical (lower 30-day morbidity) and economical (shorter hospital stay) outcomes in patients undergoing radical cystectomy. We recommend that a randomized controlled trial be performed to investigate whether there is a causal relationship between preoperative potassium supplementation and postoperative complications and length of hospital stay.
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Previous microwave studies of naphthol monomers were supplemented by measuring spectra of all 13C mono-substituted isotopologues of the cis- and trans-conformers of 1-naphthol and 2-naphthol in their natural abundances. The resulting data were utilized to determine substitution structures and so-called semi-experimental effective structures. Results from electronic structure calculations show that the OH group of cis-1-naphthol points ≈6° out of plane, which is consistent with the inertial defect data of cis- and trans-1-naphthol. The non-planarity of cis-1-naphthol is a result of a close-contact H-atom-H-atom interaction. This type of H-H interaction has been the subject of much controversy in the past and we provide here an in-depth theoretical analysis of it. The naphthol system is particularly well-suited for such analysis as it provides internal standards with its four different isomers. The methods used include quantum theory of atoms in molecules, non-covalent interactions, independent gradient model, local vibrational mode, charge model 5, and natural bond orbital analyses. We demonstrate that the close-contact H-H interaction is neither a purely attractive nor repulsive interaction, but rather a mixture of the two.
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Naftóis , Teoria Quântica , IsomerismoRESUMO
BACKGROUND: In testicular cancer determination of clinical stage and recommendation of therapeutic strategy after inguinal orchiectomy are based on primary imaging by CT-scan of the chest and CT- or MRI-abdomen. It has not been investigated so far whether the imaging should be performed before or after primary testicular surgery. Staging before surgery means exposing all patients to CT radiation irrespective of ensured histologic malignancy while postoperative staging could pose a risk in biased clinical decision making by increased presence of unspecific lymph node enlargement caused by postsurgical effects. Therefore, we aimed to investigate the association between the timing of initial staging and occurrence of unspecific lymph node enlargement and adjuvant therapies after inguinal orchiectomy. METHODS: We retrospectively evaluated clinical and radiological data from 236 patients who had undergone inguinal orchiectomy for testicular cancer at our department. Statistical analysis was performed to determine whether the occurrence of unspecific lymph node enlargement or the rate of adjuvant therapies were influenced by timing of initial staging (preoperative vs. postoperative). RESULTS: The postoperative imaging cohort showed significant more inguinal, pelvic and retroperitoneal unspecific lymph node enlargement than the preoperative imaging cohort. Simultaneous occurrence of inguinal or pelvic lymph node enlargement together with retroperitoneal enlargements could only be found in the postoperative imaging cohort. No difference regarding adjuvant therapies could be found. CONCLUSIONS: Timing of imaging affects the detection rate of unspecific lymph node enlargements but does not show a significant effect on the rate of adjuvant therapies.
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Neoplasias Testiculares , Tomada de Decisão Clínica , Humanos , Metástase Linfática/diagnóstico por imagem , Masculino , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias Testiculares/diagnóstico por imagem , Neoplasias Testiculares/cirurgiaRESUMO
Quantum fluid droplets made of helium-3 (3He) or helium-4 (4He) isotopes have long been considered as ideal cryogenic nanolabs, enabling unique ultracold chemistry and spectroscopy applications. The droplets were believed to provide a homogeneous environment in which dopant atoms and molecules could move and react almost as in free space but at temperatures close to absolute zero. Here, we report ultrafast x-ray diffraction experiments on xenon-doped 3He and 4He nanodroplets, demonstrating that the unavoidable rotational excitation of isolated droplets leads to highly anisotropic and inhomogeneous interactions between the host matrix and enclosed dopants. Superfluid 4He droplets are laced with quantum vortices that trap the embedded particles, leading to the formation of filament-shaped clusters. In comparison, dopants in 3He droplets gather in diffuse, ring-shaped structures along the equator. The shapes of droplets carrying filaments or rings are direct evidence that rotational excitation is the root cause for the inhomogeneous dopant distributions.
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Rotational spectra of the 1,1,1,3,3,3-hexafluoro-2-propanol (HFIP)···water complex were measured using a chirped pulse Fourier-transform microwave spectrometer. The spectral analyses, aided by density functional theory calculations, reveal two HFIP···water isomers: one previously reported, trans HFIP (HFIPt)···water (Phys. Chem. Chem. Phys. 2015, 119, 5650-5657), and a new isomer, gauche HFIP (HFIPg)···water. To confirm the identity of the new isomer, rotational spectra of seven of its deuterated species were also measured and analyzed. Both the experimental and theoretical pieces of evidence indicate that the intermolecular interaction with water preferentially stabilizes the HFIPg monomer configuration over the global minimum configuration, HFIPt. The relative energy difference between these monomeric forms is 4.1 kJ mol-1 and decreases to 2.5 kJ mol-1 in the respective monohydrates at the B3LYP-D3(BJ)/def2-QZVP level of theory. Both rigid and relaxed potential energy surface scans were carried out to gain insights into the large-amplitude water motions in HFIPg···water. The nonobservation of a water tunneling splitting in HFIPt···water has been explained to be a result of a barrier-less (after zero-point-energy correction) pathway for the water motion, whereas in HFIPg···water, a relatively large water tunneling barrier was identified as the cause of barely resolved water tunneling splittings. Noncovalent interaction and quantum theory of atoms and molecule analyses were used to evaluate the changes in HFIPg···water when going from the minimum to the transition state in terms of attractive interactions such as the OH···H and OH···F contacts. The effect of fluorination is discussed by comparing the vastly different binding topologies of isopropanol···water and HFIP···water.
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INTRODUCTION: After radical cystectomy, orthotopic neobladder is one surgical strategy for urinary diversion. To assess the usefulness of an operation, long-term data are essential. We examined long-term complications and continence rates of orthotopic ileocecal (MAINZ pouch) bladder substitution. MATERIAL AND METHODS: Between 1986 and 2011, 193 patients underwent orthotopic MAINZ pouch bladder substitution. Until July 2000, ureter implantation was performed into the ascending colon through a submucosal tunnel technique (Goodwin-Hohenfellner). After July 2000, ureters were implanted into the terminal Ileum using the ileocecal valve to prevent reflux: the left spatulated ureter by an end-to-end (Wallace) and the right ureter by an end-to side technique (Nesbit). Surgical and medical follow-up reports were evaluated and a recent follow-up was obtained by a questionnaire. RESULTS: Median follow-up in 183 patients was 72 months (1-336). A total of 74 patients (38%) died during the follow-up. A surgical intervention was required in 26 out of 193 patients with early complications while 45 out of 183 patients had late and 17 patients had both, early and late complications. Ureteral stenosis was found in 13% of submucosal implanted ureters, 13% with the Wallace technique, and 3.6% with the Nesbit technique. In total, 66 patients responded to the questions concerning long-term continence (minimal follow-up >2 years). Overall, 84.8% were completely continent, 1.6%, reported grade I and 9.8% grade II stress incontinence. CONCLUSIONS: The long-term continence and complication rates are comparable to those of other types of orthotopic bladder substitution. Orthotopic MAINZ pouch procedure can be considered as one of the options for orthoptic diversion, which stands the test of time.
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Broadband rotational spectra of cis- and trans-(-)-carveol were recorded using a chirped pulse Fourier transform microwave spectrometer in the 2-6 GHz region. To aid in spectroscopic assignments a theoretical conformational search was carried out using a combination of a two dimensional potential energy scan, scanning over the isopropenyl and hydroxyl groups torsional angles, and the Conformer-Rotamer Ensemble Sampling Tool. The theoretical results yielded a total of 23 conformers for the trans- and 19 for the cis-conformer. Utilizing these results, a total of five conformers could be assigned in the spectra, two for trans- and three for cis-(-)-carveol. In both conformers of trans-carveol, the isopropenyl group is in an equatorial position and adopts the gauche- conformation in one and the the antiperiplanar conformation in the other, with the hydroxyl group in the axial position and adopting the antiperiplanar conformation in both. For cis-carveol the analogous conformers were found but with the hydroxyl in a equatorial position, in addition to an axial isopropenyl conformer. To interpret the experimental intensity patterns and examine conformational cooling effects, transition states were identified using the Synchronous Transit Quasi-Newton method. We found that most of the higher energy conformers cool out to the five experimentally observed ones and the others are too high in energy to be sufficiently populated in the molecular expansion for an experimental observation. To investigate the interesting preference for the axial position of the isopropenyl group in cis-(-)-carveol, which has not been seen before in monoterpenoids, non-covalent interactions and quantum theory of atoms-in-molecules analyses were carried out. These analyses reveal a hydrogen bonding interaction between the hydroxyl group and the isopropenyl π-system. A natural bond orbital analysis of the hydrogen bond allowed us to decompose the interaction into its constituent natural bond orbitals, and to quantify its strength. Although relatively weak, the hydrogen bond tips the balance towards the axial position of the isopropenyl group.
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The structures and binding topologies of two binary van der Waals complexes 1,1,1,3,3,3-hexafluoro-2-propanol (HFIP)···Ne and ···Ar were investigated. The rotational spectra of these two complexes including several isotopic species containing 20Ne, 22Ne, 40Ar, 13C, and hydroxyl D were measured using a chirped pulse Fourier transform microwave spectrometer and a cavity-based Fourier transform microwave spectrometer. While HFIP was shown to exist in both the gauche and trans configurations based on previous reports, the rare gas atom is predicted to attach to HFIP in several different binding topologies, leading to a total of nine possible structural isomers for each complex. Only one isomer was detected for each species, and it corresponds to the most stable one predicted, based on the comparison of the experimental rotational constants and electric dipole moment components with the theoretical predictions and on the isotopic data. We applied quantum theory of atoms in molecules (QTAIM) and electrostatic potential calculations to examine the different rare gas binding sites and to explore the nature of the interactions in these two complexes and several previously reported alcohol···Ar complexes. The effects of fluorination are also discussed by comparison with the binary complexes of isopropanol···Ne and ···Ar.
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The S1 â S0 electronic transition of perylene bisimide (PBI) and its binary aggregates were investigated using a combination of helium nanodroplet isolation spectroscopy and computational methods. First, well-resolved vibronic bands of the PBI monomer obtained under the superfluid helium nanodroplet environment were compared to simulated vibronic spectra with anharmonic corrections of the band positions. Second, about ten sets of weaker vibronic bands were observed, which show similar vibronic patterns as that of the PBI monomer and have their band origins red-shifted by about 8 to 218 cm-1. Experimental Poisson curve analyses, performed at the origins of these new sets of bands and the PBI monomer, indicate that the carriers of these weaker red-shifted vibronic bands are binary adducts of PBI. Three types of PBI dimer structures where the electronic transition dipole moments of the two subunits are perpendicular to each other were proposed as possible carriers of these red-shifted vibronic patterns. Extensive vibronic simulations were carried out in a multi-step procedure with TD-DFT, vertical Hessian, and finally adiabatic Hessian approaches. Small red-shifted band origins and very similar vibronic patterns to that of the monomer were predicted for unusual, T-shaped, type I dimer structures and are in close agreement with the experimental data. The combined experimental and theoretical results indicate that the helium nanodroplet environment enables the formation of these unusual T-shaped dimers and stabilizes them.
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OBJECTIVES: To investigate the safety of robotic surgery during COVID-19 pandemic concerning new-acquired COVID-19 infections for patients and healthcare workers. PATIENTS: We performed a retrospective single-centre cohort study of patients undergoing robotic surgery in initial period of COVID-19 pandemic. Patients and healthcare workers COVID-19 infection status was assessed by structured telephone follow-up and/or repeated nasopharyngeal swabs. RESULTS: After 61 robotic surgeries (93,5% cancer surgery), one patient (1.6%) had COVID-19 infection. Sixty healthcare workers cumulatively exposed to 1187 h of robotic surgery had no infection. One patient with postoperative proof of SARS-CoV-2 had complete recovery. After this potentially contagious robotic surgery, eight healthcare workers had no COVID-19 infection after follow-up with each three nasopharyngeal swabs. CONCLUSIONS: Early clinical experience of robotic surgery during COVID-19 pandemic shows that robotic surgery can be safely performed for patients and healthcare workers. Despite our results we recommend elective surgery only for verified COVID-19 negative patients.
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COVID-19 , Procedimentos Cirúrgicos Robóticos , Idoso , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos , SARS-CoV-2RESUMO
BACKGROUND: The SARS-CoV-2 pandemic presents an unprecedented challenge to health care systems worldwide. Data on SARS-CoV-2 transmission in a hospital is rare and outbreaks among health care professionals are complex to control. MATERIAL AND METHODS: Over the course of 6 consecutive weeks we recorded data on an exponential outbreak of SARS-CoV-2 within our department. We reconstructed the assumed route of the spread of infection, and the employees' acute and late symptoms. Increasing preventive measures (mandatory face masks, intense training in hygiene, physical distancing whenever possible, and termination of visits from outside the hospital) were implemented. RESULTS: Within 6 weeks, 13 employees were tested positive for SARS-CoV-2. All individuals had a moderate course, not resulting in hospitalization. The majority of infections was discovered after testing contacts of known cases, prior to their onset of symptoms and was predominantly related to removal of face masks during breaks. Increasing preventive measures resulted in a decline and finally containment of transmission rates amongst the staff, confirmed by mass testing at week 6, with no further SARS-CoV-2 infection. Three individuals, all in their late 40s or older, have lasting or newly onset neurological symptoms 8 months after their infection. CONCLUSIONS: Outbreaks of SARS-CoV-2 are particularly difficult to contain in a medical setting, where employees work in close physical proximity. Adherence to preventive measures, particularly face masks, seem to be effective.