Busqueda De Un Patron Clinico Para La Prediccion De Colonoscopia Patologica En Los Pacientes Participantes De Las 2 Primeras Rondas Del Programa De Deteccion Precoz De Cancer Colorrectal Del Hospital Comarcal De Inca

Introduccion: En el desarrollo de los Programas de Deteccion Precoz de Cancer Colorrectal (PDPCCR), la colonoscopia es la prueba diagnostica final, asi como el principal factor l imitante, este hecho sumado a situaciones como la reciente pandemia por COVID, que puso en minimos el funcionamiento de varios servicios de endoscopia a nivel nacional, hace que nos plantearamos intentar buscar patrones predictivos que a futuro permitan la priorizacion de aquellos pacientes con mayor riesgo de endoscopia patologica dentro del programa de cribado, a fin de agilizar el desarrollo de los mismos. Metodos: Estudio retrospectivo basado en una muestra de datos clinicos y endoscopicos recopilados de las 2 primeras rondas del PDPCCR del Area de la Tramuntana-Hospital Comarcal de Inca (Mallorca). Resultados: Se encontro asociacion entre la variabilidad de la edad, el sexo y los valores cuantitativos de la sangre oculta en heces inmunoquimica (SOHi) con el riesgo de hallazgos endoscopicos, asi como la toma de antiinflamatorios no esteroideos (AINES) y acido acetilsalicilico (AAS) como factores protectores. Conclusiones: Hemos podido replicar los resultados de otros estudios, lo que fortalece nuestro programa de cribado, y nos sirve de base para obtener prospectivamente modelos de riesgo mas precisos.Copyright © 2023 Elsevier Espana, S.L.U. Todos los derechos reservados.

Continuous Glucose Monitoring in the Intensive Care Unit.

Traditionally, the care of critically ill patients with diabetes or stress hyperglycemia in the intensive care unit (ICU) demands the use of continuous intravenous insulin (CII) therapy to achieve narrow glycemic targets. To reduce the risk of iatrogenic hypoglycemia and to achieve glycemic targets during CII, healthcare providers (HCP) rely on hourly point-of-care (POC) arterial or capillary glucose tests obtained with glucose monitors. The burden of this approach, however, was evident during the beginning of the pandemic when the immediate reduction in close contact interactions between HCP and patients with COVID-19 was necessary to avoid potentially life-threatening exposures. Taking advantage of the advancements in current diabetes technologies, including continuous glucose monitoring (CGM) devices integrated with digital health tools for remote monitoring, HCP implemented novel protocols in the ICU to care for patients with COVID-19 and hyperglycemia. We provide an overview of research conducted in the ICU setting with the use of initial CGM technology to current devices and summarize our recent experience in the ICU.

Study of PM2.5-bound polycyclic aromatic hydrocarbons and anhydro-sugars in ambient air near two Spanish oil refineries: Covid-19 effects

We report the results from a 12 month-long study of the organic compounds associated to PM2.5 samples collected around two petroleum refineries (4 samples/month/site) in two complex industrial zones reporting atmospheric pollution issues in the past (Estuary of Huelva and Bay of Algeciras, Spain). Sampling campaign was done from March 2020 when a Covid-19 lockdown was established at Spain to March 2021. Concentrations of fine particulate polycyclic aromatic hydrocarbons (PAHs) and anhydrosugars were separately measured using gas chromatography-mass spectrometry (GC-MS) and ion chromatography-amperometric detection (IC-PAD). The annual average abundances of PM2.5-bound benzo[a]pyrene (BaP) are 0.024 and 0.013 ng˖m−3 at La Rábida and Puente Mayorga monitoring stations, while both sites have annual average concentrations of levoglucosan in PM2.5 of 14.98 and 9.78 ng˖m−3, respectively. Seasonal variations are observed for concentrations of ƩPAHs and total anhydrosugars in both sampling sites. For PAHs, the highest concentrations averaging c. a. 0.400 (La Rábida) and 0.350 ng m−3 (Puente Mayorga) are reported in cold months during December 2020-Febraury 2021 (post-lockdown period), compared to the lowest levels averaging 0.111 and 0.211 ng˖m−3, respectively, in temperate months from mid-March 2020 to early June 2020 (0.284 and 0.321 ng m−3 on average annually), coinciding with the confinement and relaxation periods in Spain. Similarly, total anhydrosugars show the highest values of 81.80 ng˖m−3 (La Rábida) and 53.52 ng˖m−3 (Puente Mayorga) in winter and lowest values of 2.71 ng˖m−3 and 3.30 ng˖m−3 into the lockdown period (22.51 and 14.09 ng˖m−3 on average annually). Except phenanthrene, PAHs are present in PM2.5 principally as result of motor vehicle exhausts. Levoglucosan, a tracer for biomass burning, peaked in December 2020 and January 2021, during the high residential wood-burning season. In addition, multivariate analysis was used to assess the origin of organic components of PM2.5 samples. The two principal components are characterized by the grouping of heavy PAHs associated to vehicular traffic, and anhydrosugars indicating biomass burning emissions, respectively.

Increasing Bioburden of Candida auris Body Site Colonization is Associated with Environmental Contamination

Background: Environmental contamination is suspected to play a key role in transmission of Candida auris in healthcare facilities. We recently showed that environmental surfaces near C. auris-colonized patients are commonly recontaminated within hours after disinfection. Clinical factors contributing to environmental contamination are not well characterized. Methods: We conducted a multi-regional (Chicago, IL;Irvine, CA) prospective study of environmental contamination associated with C. auris colonization at six long-term care facilities (LTCF) and 1 acute-care hospital (ACH). On day of sampling, 5 participant body sites were cultured once, followed by routine daily room cleaning by facility staff, then targeted disinfection of high-touch surfaces with hydrogen peroxide wipes by research staff. Surfaces were cultured for C. auris using pre-moistened sponge-sticks and neutralizer immediately pre- and post-disinfection, and 4, 8, and 12 hours post-disinfection. We calculated the odds of surface recontamination after disinfection as a function of body site colonization with C. auris using generalized estimating equations to account for clustering among multiple surfaces within timepoints, patients, and facilities. Models included an interaction between facility type and colonization. Results: C. auris was cultured from ≥1 body site in 41 participants (12 ACH and 29 LTCF patients, 205 body sites) on day of sampling. Proportion of body sites colonized did not vary by facility type (Table). Although environmental contamination rates were similar prior to disinfection [ACH 38% (n=60 samples) vs LTCF 29%, (n=145 samples), p=0.209)], the proportion of surfaces recontaminated between 4–12 hours after disinfection was higher in ACH vs LTCF (n=574 samples) (Figure). Number of body sites colonized with C. auris was associated with higher odds of environmental recontamination [ACH: OR 2.16 (95% CI 1.63–2.88), p< 0.001;LTCF: OR 1.40 (95% CI 1.07–1.84), p=0.015;Interaction ACH vs LTCF p< 0.001].Figure.Percent of Environmental Surfaces Recontaminated with C. auris within 12 hours of Cleaning by Facility Type Conclusion: The number of body sites colonized was associated with odds of C. auris environmental contamination. Differences in environmental recontamination by facility type may be related to greater provider-patient interactions in ACH as a driving factor. Disclosures: Gabrielle M. Gussin, MS, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products Raveena D. Singh, MA, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products Raheeb Saavedra, AS, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttrium Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products Nicholas M. Moore, PhD, D(ABMM), Abbott Molecular: Grant/Research Support;Cepheid: Grant/Research Support Susan S. Huang, MD, MPH, Medline: Conducted studies in which hospitals and nursing homes received contributed antiseptic and/or environmental cleaning products;Molnlyke: Conducted clinical studies in which hospitals received contributed antiseptic product;Stryker: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic products;Xttri m Laboratories: Conducted clinical studies in which hospitals and nursing homes received contributed antiseptic product Mary K. Hayden, MD, Sanofi: Member, clinical adjudication panel for an investigational SARS-CoV-2 vaccine.

Evaluation of ultramicroanalytic assays to detect antibodies against SARS-CoV-2

Introduction: This paper shows the results obtained in the validation of in vitro serological assays to detect IgM, IgG antibodies, and total antibodies against SARS-CoV-2 UMELISA SARS-CoV-2 IgM, UMELISA ANTI-SARS-CoV-2 and UMELISA SARS-CoV-2 IgG developed by the Immunoassay Center.

Evaluation of ultramicroanalytic assays to detect antibodies against SARS-CoV-2

Introduction: This paper shows the results obtained in the validation of in vitro serological assays to detect IgM, IgG antibodies, and total antibodies against SARS-CoV-2 UMELISA SARS-CoV-2 IgM, UMELISA ANTI-SARS-CoV-2 and UMELISA SARS-CoV-2 IgG developed by the Immunoassay Center. Methods: Panels of serum samples from negative and COVID-19 confirmed patients were used to determine the analytical performance of each assay. Results: UMELISA SARS-CoV-2 IgM, UMELISA ANTI-SARS-CoV-2 and UMELISA SARS-CoV-2 IgG assays demonstrated 100% clinical specificity for all assays;and 100% analytical specificity for the first two assays, and 93.1% for the last one. Clinical sensitivity was 64.3%, 80.8% and 97.5%, respectively. The positive predictive value was 100% in all assays, while the negative predictive value ranged from 83.3% to 95.2%. Concordance varied from 92.4% to 96.9%, and kappa index in every assay was very good. Assays sensitivity increased to 82.7%, 96.5% and 100 %, respectively for serum samples collected more than 14 days after onset of the symptoms. Conclusions: The assays demonstrated high sensitivity and specificity, which allows us to have Cuban technology-based tools for serological, epidemiological surveillance, and other types of studies, including those related to vaccines on a platform with wide national distribution. © 2022, Editorial Ciencias Medicas. All rights reserved.

Evaluating the Endothelial Impairments in COVID-19 Patients Using Near-Infrared Spectroscopy: the HEMOCOVID-19 trial

HEMOCOVID-19 is a multi-center trial aiming to assess the microvascular and endothelial health of severe COVID-19 patients in the intensive care using near-infrared spectroscopy. Here, we present the preliminary results, showing that peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome. © 2022 The Author(s).

Combining hands-on and virtual experiments for enhancing fluid mechanics teaching: A design-based research study

Fluid Mechanics courses comprise both theoretical and laboratory modules. In developing nations, computer-assisted techniques are not commonly applied in Fluid Mechanics instruction. Forced by the COVID-19 pandemic, South American universities are, however, using them for online teaching. This contribution presents an 8-semester (2016–2019) educational intervention over an undergraduate Fluid Mechanics course. It mainly blends physical (hands-on) and virtual experiments (computer fluid dynamics-based simulations) for the laboratory module, which are complemented by flipped classroom-based prompts for the theoretical module. The intervention follows design-based research as a research method and is guided via conjecture mapping and fidelity of implementation standards. Our results suggest that the intervention improves fluid mechanics laboratory instruction, although improvements depend upon the participation of other educational actors such as teaching assistants and laboratory technicians to some extent. Laboratory report grades (the assessment instrument) follow the Gompertz probability distribution. Following UNESCO standards, a portion of the intervention output is shared as open educational resources. This contribution encourages upscaling the educational intervention through the formation of cooperative clusters to build common-pool Fluid Mechanics resources. Learning scientists have underlined the need to better understand laboratory instruction processes. They have been addressed in very few instances in developing countries. We believe that this study has the potential to provide valuable insights on the matter. © 2022 Wiley Periodicals LLC.

Impact of the COVID-19 pandemic on a notification and learning system for patient safety in a psychiatric hospital

Background and importanceThe incident notification system is a tool that complements others for promoting a patient safety culture and defining the risk profile of a health organisation.Aim and objectivesThis study was carried out to find out how the COVID-19 pandemic has influenced the number of notifications of incidents related to patient safety through the evolution of a notification and learning system for patient safety (SiNASP) since its implementation.Material and methodsThe classification of reported incidents was done with the matrix of the ‘Severity Assessment Code’ (SAC);SAC=1 extreme risk, SAC=2 high risk, SAC=3, medium risk, SAC=4, low risk, No-SAC=does not reach the patient.Descriptive study of the results obtained from the analysis of the notifications received from its implementation 2011–2020.SPSS program (p≤0.05).Results295 incidents related to the safety of patients at the psychiatric hospital or one of its resources were reported.%SAC=2 was 11.9%,%SAC=3 of 24.1%,%SAC=4 of 24.8% and without-SAC 39.3% of the incidents.94.6% (n=199) of notifications occurred in hospitalisation, with nursing being the professional group that made the most notifications (53.2%).27.5% were situations with the capacity to cause an incident, 11.9% incidents that did not reach the patient and 60.7% (179) reached the patient;of the latter, 39.3% (116) did not cause damage, 21.0% (62) caused temporary damage and required intervention or prolonged hospitalisation, and 0.3% (1) compromised the patient’s life.Most frequently recorded incident is related to medication (17.8%), followed by infrastructure problems (13.4%) and altered/aggressive behaviour (12.6%).By year, a statistically significant decrease (p<0.05) is observed in the number of notifications in 2020 (13) and the increasing annual average of the previous years (34.3).Average number of reports disseminated/case presentation sessions was 7.1 until 2019 and only 2 in 2020.Conclusion and relevanceNursing is the group that reports the most, and the notification of incidents should be promoted to the rest of the healthcare personnel.During the pandemic, a significant reduction in the reporting of incidents was observed, possibly due to the increased workload and attention to other priority activities of healthcare professionals associated with COVID.The development of newsletters to disseminate the results of the SiNASP among healthcare providers and the holding of training sessions for new staff have also been negatively affected by the pandemic, having previously proven to be a useful tool for promoting a culture of safety among sanitary professionals.References and/or acknowledgementsConflict of interestNo conflict of interest

Illness attitudes, mood, and dreams during the second wave of the COVID-19 pandemic: An international study

The Coronavirus Disease 2019 (COVID-19) has strongly impacted the world. Recent research on the pandemic has found a significant impact on sleep habits, dreaming, and psychological well-being. We investigated sociodemographic and COVID-19 related variables, attitudes toward illness (using the Illness Attitude Scale, or IAS), mood (using the Depression, Anxiety, and Stress Scale, or DASS-21), and oneiric activity (using participant's Most Recent Dream) during the second wave of the COVID-19 pandemic in a sample of 620 Italian, Canadian and Mexican adult subjects (79.9% women;ages 18-73 years, M = 27, SD = 11.5). Results indicated that: a) participants presented problematic scores of worries about illness and health habits, as well as moderate levels of depression, anxiety, and stress;b) female participants reported higher levels of negative illness attitudes, as well as higher levels of depression, anxiety, and stress;c) participants knowing a person who had the COVID-19 disease reported higher levels of stress, while participants knowing a COVID-19-related death reported higher levels of negative illness attitudes and higher levels of anxiety;d) participants reporting negative emotional tone in their dreams also reported higher levels of depression, anxiety, and stress;finally, e) the most represented emotional dream tone was negative, the most represented emotions in participants' dreams were anxiety and being scared, while the most represented actions were life or death situations. In sum, the findings of this study indicate that the COVID-19 lockdown measures, categorized as a catastrophic and traumatic event, significantly affected people's oneiric imagery in the three countries, in relation to some differences related to specific public health policies and different socioeconomic conditions, and that an integrative experimental and clinical perspective, including qualitative and quantitative analysis, as well as different theoretical approaches, could contribute to a more comprehensive analysis of dreaming. © 2022. All Rights Reserved.

HEMOCOVID-19 Study: An International Clinical Study to Evaluate Microvascular and Endothelial Impairments in Severe COVID-19 Patients Using Near-Infrared Spectroscopy

We present the HEMOCOVID-19 study spanning four countries and eight hospitals where near-infrared spectroscopy is utilized to evaluate microvascular and endothelial health of severe COVID-19 patients at the intensive care. © 2021 SPIE. All rights reserved.

Tomographic characteristics of lung lesions in hospitalized patients with COVID-19 and its prognostic value

The severity of lung involvement on chest tomography (CT) images in COVID-19 patients may have a prognostic value. This study assesses the type, severity and frequency of the different images of lung CT in hospitalized patients with COVID-19, and the differences in clinical characteristics and in-hospital outcomes, according to the CT severity score. This represents an observational study (retrospective cohort) of hospitalized patients with COVID-19. The ISARIC-WHO form was used to collect data. The type of lung lesions, affected lobes, and total CT severity score were determined at hospital admission. The first, second and third quartiles of the total CT score were calculated to divide the sample into four equal parts (Q1, Q2, Q3 and Q4). A total of 556 patients were included, 336 men (60.4%) and 220 women (39.6%), with a mean age of 61.9 +/- 15.8 years;and 532 of them had CT scan at admission. Patients in the more severe quartiles had more days of symptoms evolution (Q1 6.4 +/- 3.5, Q2 7.9 +/- 4.1, Q3 8.2 +/- 4.1, Q4 8.1 +/- 4.4), desaturation (Q1 95.3 +/- 3.7, Q2 94.4 +/- 3.1%, Q3 91.7 +/- 4.8%, Q4 86.5 +/- 9.1%), alterations of inflammatory markers, hospital stay (Q1 6.4 +/- 2.9, Q2 7.4 +/- 4.1, Q3 9.6 +/- 5.8, Q4 13.1 +/- 10.4 days), admission to ICU (Q1-2.5%, Q2-5.8%, Q3-12.5%, Q4-49.1%), mortality (Q1-3.8%, Q2-4.5%, Q3-9.4%, Q4-33.3%), mixed CT lesions (ground glass opacity-consolidation), linear opacities, crazy-paving pattern, reverse halo sign, and bronchiectasis. The total CT score significantly correlated with leukocyte, neutrophil and lymphocyte counts, and with other inflammatory markers. Semi-quantitative evaluation of pulmonary involvement in the initial chest CT can help to establish the severity of the case and predict relevant clinical outcomes in COVID-19 patients.

Digital Tool to Detect the State of Languishing of Students During the Covid-19 Pandemic

This paper presents a mobile application prototype that pretends to identify the state of languishing in postgraduate students, who have been dealing with social distancing due COVID-19 pandemic. In order to make visible the social significance of tools that encourage students and other users to understand their emotions and to look for a good mental health accompanied by specialists, with the knowledge that no one is spare of suffering from an emotional problem. In addition, the data obtained may be used to take appropriate measures by the corresponding authorities by the hand of mental health specialized. The presented prototype development process in this paper responds to an interface design based on human-computer interaction methods and tools and shows some suggested improvements after the evaluating phase. © 2021, Springer Nature Switzerland AG.

The pandemic economic crisis, precautionary behavior, and mobility constraints: An application of the dynamic disequilibrium model with randomness†

This article analyzes the economic impact of the pandemic, providing insights into the consequences of alternative policies. Our framework focuses on three key features: (i) The coronavirus disease (COVID-19) is a sectoral shock of unknown depth and duration affecting some sectors and technologies more than others;(ii) there are constraints in shifting resources across sectors;and (iii) there is a high level of uncertainty about the disease and its economic aftermath, inducing a high level of precautionary behavior by some agents and leading to others facing more severe credit constraints. Because of macroeconomic externalities, precautionary behavior exacerbates the downturn, and even sectors where COVID-19 does not directly affect consumption or production may face unemployment. Multipliers associated with different government expenditure programs differ markedly. The article describes policies that can mitigate precautionary behavior, leading to reduced unemployment. Greater wage flexibility may lead to increased unemployment. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of Associazione ICC. All rights reserved.

Antibiotic prescription in hospitalized patients with covid-19 in a private hospital in caracas: Retrospective study

Background: There is little information on the prevalence of bacterial coinfection and use of antibiotics in hospitalized CO-VID-19 patients. The present study assesses the frequency of in-hospital antibiotic prescription, the bacterial cultures im-plementation and the clinical characteristics of patients with COVID-19 according to the use of antibiotics. Methods: Ret-rospective, observational study of hospitalized patients with COVID-19. The ISARIC-WHO form was used for data col-lection. Results: 145 patients were included, 95 men and 50 women, with a mean age 63.8±16.0 years. 79/145 (54.5%) patients received antibiotics, 52/145 (35%) had samples for culture and 49/145 (33.8%) were blood cultures. Pathogenic bacteria were isolated only in 7% of the patients. The patients with antibiotics had worse oxygenation, chest tomography and inflammatory markers, more admission to ICU, deaths, and prolonged hospital stay. Conclusion: Our results do not support the initial widespread use of antibiotics in hospitalized COVID-19 patients without knowing the pathogen and its susceptibility.