Preventive Strategies In Paediatric Cardiovascular Surgery: Impact On Surgical Site Infections And Beyond.

BACKGROUND: Surgical management of congenital heart disease (CHD) has increased worldwide, but healthcare-associated infections (HAI) can impede these efforts. This study analysed the incidence of HAI, the impact of preventive interventions, and microbiological profiles in a paediatric cardiovascular surgery program. METHODS: Cohort study including children under 12 years of age with CHD who underwent cardiovascular surgery between 2010-2021 in Medellín, Colombia (a middle-income setting). Data were collected from medical and laboratory records and infection control program databases. Impact of various preventive interventions was assessed using a Poisson model. A p-value less than 0.05 was considered statistically significant. RESULTS: 2512 surgeries were analysed. Incidence of surgical site infection (SSI) was 5.9%, followed by central line-associated bloodstream infection (CLABSI; 4.7%), catheter-associated urinary tract infection (CAUTI; 2.2%) and ventilator-associated pneumonia (VAP; 1.4%). Most of the strategies focused on preventing SSI, resulting in a reduction from 9.5% in 2010 to 3.0% in 2021 (p=0.030). Antibiotic prophylaxis based on patient weight and continuous infusion had an impact on reducing SSI (RR:0.56; 95%CI:0.32-0.99). Vacuum-assisted closure (VAC) in clean wounds reduced 100% infections. No significant risk reduction was observed for other HAI with the implemented interventions. CONCLUSION: Preventive strategies effectively reduced SSI but no other infections, emphasizing the need for targeted approaches to address a broader spectrum of HAI successfully.

Dengue Cases in Colombia: Mathematical Forecasts for 2018-2022.

INTRODUCTION Dengue is a disease caused by any one of five virus serotypes and transmitted to humans by the Aedes aegypti mosquito. Climate change and health conditions have combined to make dengue a global public health problem. The situation is especially serious in Colombia, where by week 36 of 2018, dengue incidence was 96 cases per 100,000 population, with a total of 111 deaths. Different mathematical and statistical models have been proposed to understand the dynamics of transmission and consequently to apply control strategies to reduce the number of dengue cases. OBJECTIVE Forecast the number of dengue cases expected in Colombia from 2018 through 2022 with the stochastic Auto-Regressive Integrated Moving Average (ARIMA) model and use the results to adjust the parameters of an ordinary differential equations model in order to determine the disease's basic reproduction number in the year presenting the highest number of dengue cases. METHODS An ecological time series study was conducted to forecast dengue incidence in Colombia from 2018 through 2022. The data were compiled from Colombia's National Health Institute series on dengue cases reported by epidemiological week from 2009 to 2017. The stochastic ARIMA time series model was applied. Forecasts were then analyzed, and the year with the highest number of predicted cases was used to adjust the parameters of an ordinary differential equations model (ODE) through nonlinear least squares regression to calculate the vectorial capacity of the transmitting mosquito. RESULTS Forecasts of the total number of dengue cases per year in Colombia for the following five years were: 32,411 (2018); 88,221 (2019); 56,392 (2020); 47,940 (2021); and 77,344 (2022). The highest number of cases was forecast for 2019. Values for the parameters affecting dengue transmission that year (by the year's four quarters), such as recovery rate (0.0992, 0.0838, 0.1177, and 0.1535, respectively), vectorial capacity of the transmitting mosquito (0.1720, 0.1705, 0.1204, and 0.2147, respectively) and the basic dengue reproduction number (1.73, 2.03, 1.02, and 1.40, respectively) were estimated, indicating that most cases would occur in the second quarter and, since the basic reproduction number values were >1, the disease would persist in the country throughout the entire year. CONCLUSIONS ARIMA model forecasts for 2018 through 2022 predicted the highest incidence of dengue cases in Colombia would occur in 2019. Comparison of ARIMA model forecasts and the ODE model allowed projections of possible variations in dengue cases reported, and the basic reproduction number predicted that dengue would persist throughout 2019. KEYWORDS Arboviruses, climate, dengue, models, theoretical, basic reproduction number, prognosis, Colombia.

Paradox of plant growth promotion potential of rhizobacteria and their actual promotion effect on growth of barley (Hordeum vulgare L.) under salt stress.

From the rhizosphere of two salt tolerant plant species, Hordeum secalinum and Plantago winteri growing in a naturally salt meadow, 100 strains were isolation on enrichment media for various plant growth-promoting (PGP) functions (ACC deaminase activity, auxin synthesis, calcium phosphate mobilization and nitrogen fixation). Based on the taxonomic affiliation of the isolated bacteria and their enrichment medium 22 isolates were selected to test their growth promotion effect on the crop barley (Hordeum vulgare) under salt stress in pot experiment. In parallel the isolates were characterized in pure culture for their plant growth-promoting activities. Surprisingly the best promotors did not display a promising set of PGP activities. Isolates with multiple PGP-activities in pure culture like Microbacterium natoriense strain E38 and Pseudomonas brassicacearum strain E8 did not promote plant growth. The most effective isolate was strain E108 identified as Curtobacterium flaccumfaciens, which increased barley growth up to 300%. In pure culture strain E108 showed only two out of six plant growth promoting activities and would have been neglected. Our results highlight that screening based on pure culture assays may not be suitable for recognition of best plant growth promotion candidates and could preclude the detection of both new PGPR and new plant promotion mechanisms.

Estado nutricional preoperatorio y estancia hospitalaria postoperatoria del paciente de cirugía mayor del tracto gastrointestinal. Hospital Nacional Hipólito Unanue. Lima 2010 / Nutritional status preoperative and postoperative hospital stay of the patient of major surgery of the gastrointestinal tract. National Hospital Hipolito Unanue. Lima 2010

Objetivos: Determinar la relación entre el estado nutricional en el preoperatorio y la estancia hospitalaria posoperatoria del paciente de cirugía mayor del tracto gastrointestinal del Hospital Nacional Hipólito Unanue. Diseño: Descriptivo de asociación cruzada, Observacional, Prospectivo. Lugar: Servicio de Cirugía General del HNHU. Población: Pacientes adultos que ingresaron al Servicio de Cirugía General del HNHU. Procedimientos: Valoración del estado nutricional preoperatorio mediante el pliegue cutáneo tricipital, circunferencia muscular del brazo, albumina sérica y recuento total de linfocitos y se relacionó cada uno con la estancia hospitalaria posoperatoria mediante las pruebas estadística de coeficiente de correlación de Spearman y Chi cuadrado. Resultados: Se estudiaron un total de 38 pacientes, de los cuales 4 fallecieron durante su estancia hospitalaria. Los 34 pacientes restantes tenían entre 20 y 75 años y los diagnósticos más frecuentes que presentaron fueron: Nm gástrico, obstrucción intestinal, traumatismo abdominal abierto, pseudoquiste pancreático, entre otros. Según el coeficiente de correlación de Spearman la relación entre las variables no fue estadísticamente significativa, además se realizó la prueba de Chi-cuadrado para comparar los valores obtenidos de los diferentes indicadores nutricionales con la estancia hospitalaria posoperatoria, ésta última de acuerdo a la categoría: estancia corta: 14 días; el 55 por ciento de los pacientes que estuvieron malnutridos según reserva energética comprometida tuvieron una estancia hospitalaria posoperatoria larga, el 64 por ciento y 67 por ciento de pacientes que tuvieron desnutrición según reserva proteica comprometida y compromiso de los niveles de albúmina respectivamente presentaron una estancia hospitalaria posoperatoria larga, pero solo fue significativa para el recuento total de linfocitos con un valor-p < 0.05 (0.002) indicando asociación entre este...

To determine the relationship between nutritional status in the preoperative and postoperative hospital stay for major surgery the patient's gastrointestinal tract National Hospital Hipolito Unanue. Design: Descriptive cross-association, observational, prospective. Location: Department of General Surgery of HNHU. Population: Adult patients of both genders who enter the General Surgery Service HNHU. Procedures: Nutritional status was assessed preoperatively by triceps skin fold; arm muscle circumference, serum albumin and total Iymphocyte count and associated each one with postoperative hospital stay by statistical tests of Spearman correlation coefficient and Chi square. Results: We studied a total of 38 patients, of whom 4 died during their hospital stay. The remaining 34 patients were between 20 and 75 years and the most common diagnoses were presented: Nm gastric, intestinal obstruction, open abdominal trauma, pancreatic pseudocyst, among others. According to the Spearman correlation coefficient of the relationship between the variables was not statistically significant, was also performed chi-square test to compare the values obtained from the different nutritional indicators postoperative hospital stay, according to the latter category: short stay: 14 days, 55 per cent of patients were malnourished before undergoing major surgery as energy reserve as measured by triceps skin fold had a longer postoperative hospital stay, 64 per cent and 67 per cent of patients who had malnutrition before surgery, as measured by arm muscle circumference and albumin respectively had a longer postoperative hospital stay, but was only significant for the total Iymphocyte count with a p-value < 0.05 (0.002) indicating association between this indicator in the preoperative to the postoperative hospital stay, in this case 77 per cent of patients diagnosed with malnutrition before surgery had a longer postoperative hospital stay...

Prevalencia de trombosis venosa profunda en pacientes hospitalizados en la unidad de cuidados intensivos de la Clínica Medellín, Octubre de 1997 a Julio de 1998 / Prevalence of deep venous thrombosis in hospitalized patients in Intensive Care Unit at Medellín Clinic. October 1997 to July 1998

El objetivo fue determinar la prevalencia de trombosis venosa profunda (TVP) por medio de ultrasonografía (US) a color en los pacientes hospitalizados en la unidad de cuidados intensivos (UCI) de la Clínica Medellín, entre octubre de 1997 y julio de 1998. Estudio observacional, descriptivo, prospectivo, cuya población fue hombres y mujeres de cualquier edad admitidos en este servicio, exceptuando aquellos que ingresaron con diagnostico de TVP o tromboembilismo pulmonar (TEP). El US a color se realizó una solo vez por paciente con diagnóstico de TVP fue de 16.1 por ciento, 10 pacientes de 62 escogidos durante un periodo de 10 meses. El 80 por ciento tuvieron TVP distal, la cual no tenía profilaxis, ni anticoagulación, que posteriormente falleció con diagnóstico de TEP. No se encontró relación entre los factores de riesgo o profilácticos y la prevalencia de TVP.