Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during 'daytime' when induction of anaesthesia was between 8:00 AM and 7:59 PM, and as 'night-time' when induction was between 8:00 PM and 7:59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P<0.001) and propensity-matched analyses (43.7% vs 36.8%; P¼0.029). PPCs also occurred more often in patients who underwent night-time surgery (14% vs 10%; P¼0.004) in an unmatched cohort analysis, although not in a propensity-matched analysis (13.8% vs 11.8%; P¼0.39). In a multivariable regression model, including patient characteristics and types of surgery and anaesthesia, night-time surgery was independently associated with a higher incidence of intraoperative AEs (odds ratio: 1.44; 95% confidence interval: 1.09e1.90; P¼0.01), but not with a higher incidence of PPCs (odds ratio: 1.32; 95% confidence interval: 0.89e1.90; P¼0.15). Conclusions: Intraoperative adverse events and postoperative pulmonary complications occurred more often in patients undergoing night-time surgery. Imbalances in patients' clinical characteristics, types of surgery, and intraoperative management at night-time partially explained the higher incidence of postoperative pulmonary complications, but not the higher incidence of adverse events. Clinical trial registration: NCT01601223.

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In southern Brazil, the Florianopolis Batholith results from prolonged, mainly granitic magmatism, as part of the Neoproterozoic Dom Feliciano Belt. Plutonic associations in this belt are related to transpressive tectonism (650-580 Ma) in post-collisional setting, where the translithospheric discontinuities of the Southern Brazilian Shear Belt have triggered magmatism, acting as channels for melts originated in deep crustal or mantle sources. In the region of Garopaba-Paulo Lopes, a fraction of this magmatism was studied, resulting in a formal proposition for its stratigraphic organization in igneous suites. A small volume of gneissic host rocks is found as roof pendants. The Paulo Lopes Suite comprises the foliated Paulo Lopes Granite, Garopaba Granitoids and Silveira Gabbro. It is characterized as porphyritic granitoids of high-K tholeiitic affinity, coeval with mafic, tholeiitic magmatism. It is followed by metaluminous, alkaline series granitoids of the Pedras Grandes Suite, namely the Vila da Penha Granite, comprising heterogranular and porphyritic facies, and the Serra do Tabuleiro Granite, comprising heterogranular, equigranular and porphyritic facies. The Cambirela Suite, last magmatic episode in the study area, encompasses alkaline plutonic, volcanic and subvolcanic rock types, as the Ilha Granite, the Cambirela Rhyolite and the Itacorumbi Granite. Hypabissal rocks are also part of this suite, and result from recurrent acid and basic magma pulses emplaced either as idividual dykes or composite ones. The magmatic associations described in this region attest to magma emplacement under a moderate to low stress field, possibly extinguished by the time the Cambirela Suite crystallized. Their age values indicate that they are mostly contemporaneous to the post-collisional, syntectonic magmatism of the Southern Brazilian Shear Belt, and the preservation of magmatic structures such as modal layering, relatively uncomon in granitoids, may also be attributed to their emplacement far from the main deformation sites. Features indicative of coeval mafic and felsic magmas are described in all three magmatic associations, and are especially significant in the Paulo Lopes and Cambirela suites. They attest to continuous mantle participation in the batholith construction.

This study aimed to investigate the clinical predictors of post-ictal headache (PIH) in patients with epilepsy in a tertiary center in Brazil. Methods: 302 individuals with adult-onset epilepsy were followed for 9.8 years in our Hospital. Structured questionnaires about headaches were applied. The presence of PIH was the primary outcome. We used multilevel linear modeling in our data analysis. Results: From the total, 46.3% had post-ictal headaches. Tension-type post-ictal headache was present in 55% (N = 77) of the subjects, migrainous in 32.1% (N = 45), and both types in 12.8% (N = 18). Family history of migraine (Odds ratio: 1.696; 95% CI: 1.372 to 2.096), diagnosis of drug-resistant epilepsy (Odds ratio: 1.169; 95% CI: 1.135 to 2.146), months since last visit (Odds ratio: 1.464; 95% CI: 1.243 to 2.888), and generalized seizure onset type of epilepsy (Odds ratio: 1.527; 95% CI: 1.114 to 1.668), were significant determinants of PIH on multilevel linear modeling. Discussion: PIH are associated with drug-resistant epilepsy, generalized seizures, and family history of migraine. The rates of pos-ictal headaches could be influenced by the use of antiepileptic drugs.