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Background: Postoperative pain is common at the global level, despite considerable attempts for improvement, reflecting the complexity of offering effective pain relief. In this study, clinicians from Mexico, China, and eight European countries evaluated perioperative pain practices and patient-reported outcomes (PROs) in their hospitals as a basis for carrying out quality improvement (QI) projects in each country.Methods: PAIN OUT, an international perioperative pain registry, provided standardized methodology for assessing management and multi-dimensional PROs on the first postoperative day, in patients undergoing orthopaedic, general surgery, obstetric & gynaecology or urological procedures.Results: Between 2017 and 2019, data obtained from 10,415 adult patients in 105 wards, qualified for analysis. At the ward level: 50% (median) of patients reported worst pain intensities ≥7/10 NRS, 25% spent ≥50% of the time in severe pain and 20-34% reported severe ratings for pain-related functional and emotional interference. Demographic variables, country and surgical discipline explained a small proportion of the variation in the PROs, leaving about 88% unexplained. Most treatment processes varied considerably between wards. Ward effects accounted for about 7% and 32% of variation in PROs and treatment processes, respectively. Conclusions:This comprehensive evaluation demonstrates that many patients in this international cohort reported poor pain-related PROs on the first postoperative day. PROs and treatments varied greatly. Most of the variance of the PROs could not be explained. The findings served as a basis for devising and implementing QI programmes in participating hospitals.Author names are listed in the acknowledgement section.

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The pandemic of COVID-19 requires rapid and easy access to reliable imaging modalities for diagnosis and follow up. Considering the cost-effectiveness of the imaging used, ultrasound is a non-ionizing, portable and bedside imaging modality with a high diagnostic impact in emergencies and intensive care units in pandemics, but it is operator dependent. In our article, we provide a comprehensive review of the role of point-of-care ultrasound in the diagnosis of COVID-19 infection and its impact on the lungs, cardiovascular system, eyes and abdominal organs. Moreover, ultrasound can provide real-time diagnostic and therapeutic interventions, such as the placement of a central catheter and aspiration of pericardial effusion. Awareness of health care professionals in the front-line fighting COVID-19 infection in emergency rooms, clinics, and in intensive care units is important and will help rapid and targeted management decisions.