Factores de riesgo de fracaso de ventilación no invasiva en neumonía primaria por influenza A en pacientes críticos / Risk factors associated to noninvasive ventilation failure in primary influenza A pneumonia in the critical care setting

Objetivo Analizar factores de riesgo de fracaso de la ventilación no invasiva (VNI) en pacientes que ingresan en una unidad de cuidados intensivos (UCI) por neumonía primaria por virus influenza A (H1N1)pdm09. Demostrar que los pacientes que fracasan con la VNI tienen mayor mortalidad y estancias más largas. Diseño Estudio de cohorte. Ámbito UCI polivalente de un hospital universitario de 16 camas. Pacientes Pacientes adultos que ingresaron en la UCI en los que se confirmó el diagnóstico de neumonía por influenza A (H1N1)pdm09 y que recibieron ventilación mecánica. Variables Edad, sexo, puntuaciones de gravedad, administración de corticoides, oseltamivir dentro de las 72h de la sintomatología, días de sintomatología previos al ingreso, cuadrantes afectados, fracaso hemodinámico, renal y datos analíticos al ingreso, mortalidad y estancia en UCI y hospitalaria. Resultados Ingresaron 54 pacientes y 49 fueron ventilados. Sexo femenino, 29 (59,2%) y una edad media±desviación estándar de 66,77±14,77 años. Fueron ventilados con VNI 43 (87,75%), de los que fracasaron 18 (41,9%). Los pacientes que fracasaron presentaron menor edad (63 vs. 74 años; p=0,04), mayor puntuación SOFA (7 vs. 4; p=0,01) y mayor fracaso hemodinámico (61,1 vs. 8%; p=0,01). Además, presentaron estancias más largas tanto en UCI (26,28 vs. 6,88 días; p=0,01) como hospitalarias (32,78 vs. 18,8 días; p=0,01), y mayor mortalidad en UCI (38,9 vs. 0%; p=0,02). Se identificaron como factores de riesgo de fracaso a VNI recibir corticoides (OR 7,08; IC 95% 1,23-40,50) y el fallo hemodinámico precoz (OR 14,77; IC 95% 2,34-92,97). Conclusiones El tratamiento con corticoides y el fracaso hemodinámico precoz se asociaron con el fracaso de la VNI en pacientes con neumonía primaria por virus influenza A (H1N1)pdm09. Estos tienen una mortalidad superior. (AU)

Objective To evaluate the risk factors associated to noninvasive mechanical ventilation (NIV) failure in patients with primary pneumonia due to influenza A (H1N1)pdm09 virus admitted to the intensive care unit (ICU), and to demonstrate the association of NIV failure to increased mortality and longer stays. Design A cohort study was carried out. Scope A mixed ICU (16 beds) in a teaching hospital. Patients Adult patients admitted to the ICU with a diagnosis of pneumonia due to influenza A (H1N1)pdm09 virus requiring mechanical ventilation. Measurements Age, sex, severity scores, administration of corticosteroids, oseltamivir within 72h of symptoms onset, days of symptoms prior to admission, affected quadrants, hemodynamic parameters, renal failure, laboratory test data on admission, mortality and stay in ICU and in hospital. Results A total of 54 patients were admitted to the ICU and 49 were ventilated; 29 were females (59.2%), and the mean age±standard deviation was 66.77±14.77 years. Forty-three patients (87.75%) were ventilated with NIV, and 18 (41.9%) of them failed. Patients with NIV failure were younger (63 vs. 74 years; P=.04), with a higher SOFA score (7 vs. 4; P=.01) and greater early hemodynamic failure (61.1 vs. 8%; P=.01). In addition, they presented longer ICU (26.28 vs. 6.88 days; P=.01) and hospital stay (32.78 vs. 18.8 days; P=.01). The ICU mortality rate was also higher in the NIV failure group (38.9 vs. 0%; P=.02). In the multivariate analysis, corticosteroid therapy (OR 7.08; 95% CI 1.23-40.50) and early hemodynamic failure (OR 14.77; 95% CI 2.34-92.97) were identified as independent risk factors for NIV failure. Conclusions Treatment with corticosteroids and early hemodynamic failure were associated to NIV failure in patients with primary pneumonia due to influenza A (H1N1)pdm09 virus infection admitted to the ICU. The failure of NIV was associated to increased mortality. (AU)

Risk factors associated to noninvasive ventilation failure in primary influenza A pneumonia in the critical care setting.

OBJECTIVE: To evaluate the risk factors associated to noninvasive mechanical ventilation (NIV) failure in patients with primary pneumonia due to influenza A (H1N1)pdm09 virus admitted to the intensive care unit (ICU), and to demonstrate the association of NIV failure to increased mortality and longer stays. DESIGN: A cohort study was carried out. SCOPE: A mixed ICU (16 beds) in a teaching hospital. PATIENTS: Adult patients admitted to the ICU with a diagnosis of pneumonia due to influenza A (H1N1)pdm09 virus requiring mechanical ventilation. MEASUREMENTS: Age, sex, severity scores, administration of corticosteroids, oseltamivir within 72h of symptoms onset, days of symptoms prior to admission, affected quadrants, hemodynamic parameters, renal failure, laboratory test data on admission, mortality and stay in ICU and in hospital. RESULTS: A total of 54 patients were admitted to the ICU and 49 were ventilated; 29 were females (59.2%), and the mean age±standard deviation was 66.77±14.77 years. Forty-three patients (87.75%) were ventilated with NIV, and 18 (41.9%) of them failed. Patients with NIV failure were younger (63 vs. 74 years; p=0.04), with a higher SOFA score (7 vs. 4; p=0.01) and greater early hemodynamic failure (61.1 vs. 8%; p=0.01). In addition, they presented longer ICU (26.28 vs. 6.88 days; p=0.01) and hospital stay (32.78 vs. 18.8 days; p=0.01). The ICU mortality rate was also higher in the NIV failure group (38.9 vs. 0%; p=0.02). In the multivariate analysis, corticosteroid therapy (OR 7.08; 95% CI 1.23-40.50) and early hemodynamic failure (OR 14.77; 95% CI 2.34-92.97) were identified as independent risk factors for NIV failure. CONCLUSIONS: Treatment with corticosteroids and early hemodynamic failure were associated to NIV failure in patients with primary pneumonia due to influenza A (H1N1)pdm09 virus infection admitted to the ICU. The failure of NIV was associated to increased mortality.

Ventilacion mecanica no invasiva y covid-19. Minimizando la dispersion / Non invasive mechanical ventilation and covid-19. minimizing dispersión

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Schinus molle essential oil as a potential source of bioactive compounds: antifungal and antibacterial properties.

AIMS: The study was focused on the evaluation of antimicrobial activity in vitro of the essential oil (EO) of leaves from Schinus molle against bacteria and fungi of clinical importance in the search for the discovery of new active compounds. METHODS AND RESULTS: The chemical composition of the S. molle EO was determined by gas chromatography/mass spectrometry and its antimicrobial effect was verified by broth microdilution method. The major compounds found were ß-pinene (25·23%), epi-α-cadinol (21·29%), α-pinene (18·72%), myrcene (11·54%) and sabinene (5·02%). The EO showed significant antifungal activity against Paracoccidioides brasiliensis (39·06 µg ml-1 ), weak action against Cryptococcus neoformans (625 µg ml-1 ) and Trichophyton quinckeanum (625 µg ml-1 ) and was inactive against Candida sp. In the analysis of the antibacterial action, the micro-organisms tested did not show sensitivity. CONCLUSIONS: This study showed a promising result of S. molle volatiles against the fungus P. brasiliensis, which causes paracoccidioidomycosis (PCM), a systemic mycosis of great clinical importance in Latin America. SIGNIFICANCE AND IMPACT OF THE STUDY: The results found here are novel and encourage investigations of the compounds present in this EO, which represents a source of molecules with potential use in the treatment of PCM.

[Tobacco consumption in the population insured by Mexican Institute of Social Security]. / Consumo de tabaco en la población derechohabiente del Instituto Mexicano del Seguro Social.

OBJECTIVE: To determine the prevalence of tobacco consumption among the active insured population of the Mexican Social Security Institute. MATERIAL AND METHODS: A cross-sectional study in which the active insured population from the 36 political delegations was interviewed by means of a structured and self-applicable questionnaire on tobacco consumption, age of initiation, amount of cigarettes consumed and suspension. RESULTS: The sample consisted of 45 117 subjects, of which approximately half were men and half women. Smoking prevalence in men was 40% and in women, 17.6%. Prevalence was highest in the north of the country. There is an effect of age on tobacco consumption and more than half started smoking during adolescence. CONCLUSIONS: Smoking prevalence was found to be high, however, the average number of cigarettes is low. Suspension index is low. Public health measures are necessary to diminish this addiction.

[First report in Panama on Nerocila californica Schioedte and Meinert 1881 (Isopoda: Cymothoidea) in Sciaenops ocellatus (L) (Pisces: Sciaenidae)]. / Primer informe en Panamá de Nerocila californica Schioedte y Meinert 1881 (Isopoda: Cymothoidea) en Sciaenops ocellatus (L) (Pisces: Sciaenidae).

One juvenile specimen of the isopod Nerocila californica (acuminata form) was found on the skin of a cage-raised red drum, Sciaenops ocellatus, in Aguadulce, Cocle Province. This finding is the first report of the occurrence of Nerocila californica as ectoparasitic of fishes on the Pacific side of the Republic of Panama.

Primer informe en Panamá de Nerocila californica Schioedte y Meinert 1881 (Isopoda: Cymothoidea) en Sciaenops ocellatus (L) (Pisces: Sciaenidae) / First report in Panama on Nerocila californica Schioedte and Meinert 1881 (Isopoda: Cymothoidea) in Sciaenops ocellatus (L) (Pisces: Sciaenidae)

One juvenile specimen of the isopod Nerocila californica (acuminata form) was found on the skin of a cage-raised red drum, Sciaenops ocellatus, in Aguadulce, Cocle Province. This finding is the first report of the occurrence of Nerocila californica as ectoparasitic of fishes on the Pacific side of the Republic of Panama