Acute Myocardial Injury Assessed by High-Sensitivity Cardiac Troponin I Levels in Adult Patients with Early Sepsis at a Tertiary Referral Center in Mexico: An Exploratory Study.

The objective of the study was to describe the frequency of acute myocardial injury (AMI) assessed by high-sensitivity cardiac troponin I (hs-cTnI) levels and to determine the possible initial risk factors (related to the characteristics of the patient, the disease, and the initial management) in a population of adult patients with early sepsis (within the first 72 h of diagnosis) in a single tertiary hospital center in western Mexico. For the inferential statistics, the proportions of the categorical dichotomous variables were compared using the chi-square test. In all analyses, p values less than 0.05 with a 95% confidence interval were considered significant. We included a total of 64 patients diagnosed with early sepsis, of whom 46 presented elevated hs-cTnI and were classified as having AMI. In our study, the frequency of AMI in patients with early sepsis was 71.87%, and no significant differences were found in all of the characteristics of patients with early sepsis with and without AMI, nor was any significant association found with any of the variables analyzed. In the population of western Mexico, the frequency of AMI in patients with early sepsis, assessed by hs-cTnI levels, is high and similar to that reported in other populations worldwide.

A global comparison of building decarbonization scenarios by 2050 towards 1.5-2 °C targets.

Buildings play a key role in the transition to a low-carbon-energy system and in achieving Paris Agreement climate targets. Analyzing potential scenarios for building decarbonization in different socioeconomic contexts is a crucial step to develop national and transnational roadmaps to achieve global emission reduction targets. This study integrates building stock energy models for 32 countries across four continents to create carbon emission mitigation reference scenarios and decarbonization scenarios by 2050, covering 60% of today's global building emissions. These decarbonization pathways are compared to those from global models. Results demonstrate that reference scenarios are in all countries insufficient to achieve substantial decarbonization and lead, in some regions, to significant increases, i.e., China and South America. Decarbonization scenarios lead to substantial carbon reductions within the range projected in the 2 °C scenario but are still insufficient to achieve the decarbonization goals under the 1.5 °C scenario.

Clinical features associated with neurosyphilis in people living with HIV and late latent syphilis.

BACKGROUND: The diagnosis of neurosyphilis is a challenge, and the criteria for deciding when to perform a lumbar puncture are still controversial, especially in people living with HIV with a late latent syphilis diagnosis. METHODS: Retrospective analysis of demographic, clinical, and laboratory data of people with HIV and documented late latent syphilis or syphilis of unknown duration with a cerebrospinal fluid VDRL test. RESULTS: 122 patients were evaluated, of whom 52 had the diagnosis of neurosyphilis. Patients with and without neurosyphilis presented a similar viral load and lymphocyte CD4+ T-cell count. Neurological symptoms (OR 6.4, 95% CI 2.1-22.4; p < 0.01), serum VDRL titers of 1:32 (p<0.01), 1:64 (p = 0.055), and ≥1:128 (p < 0.001) were associated with neurosyphilis. Furthermore, serum VDRL ≥1:32 were associated with (OR 24.9, 95% CI 5.45-154.9; p < 0.001) or without (OR 6.5, 95% CI 2.0-29.2; p = 0.004) neurological symptoms with neurosyphilis; however, VDRL ≤1:16 with neurological symptoms can be associated with neurosyphilis (OR 7.6, 95% CI 1.03-64.3; p = 0.046). CONCLUSION: Neurological symptoms, particularly headache, were predictors of neurosyphilis in people with HIV irrespective of their viral load and lymphocyte CD4+ T-cell count in late latent syphilis. A serum VDRL ≥1:32 increased the risk of neurosyphilis in patients with or without any symptoms.

Potenciales evocados miogénicos vestibulares: estado del arte / Myogenic vestibular evoked potencials: state of art

El ser humano logra la estabilidad necesaria para poder desempeñar eficientemente las actividades comunes de la vida diaria mediante el sistema vestibular y su constante comunicación con múltiples sistemas, principalmente con el sistema óculo-motor y el sistema propioceptivo. Actualmente y con aumento en su incidencia las consultas por síntomas vestibulares juegan un papel importante en la actividad laboral del otorrinolaringólogo, sumándole a esto la dificultad que existe para corroborar el diagnóstico de una manera objetiva. Se han descrito históricamente múltiples técnicas para evaluar el sistema vestibular en respuesta a un esfuerzo por hacer un mejor diagnóstico y tratamiento de estas lesiones entre las que se encuentra el estudio del Potencial Evocado Miogénico Vestibular (VEMP). El VEMP es una metodología de estudio relativamente nueva, descrita por primera vez como método de evaluación de la función vestibular en la década de los noventa por Colebatch y cols. Es una prueba no invasiva, de bajo costo, fácil y rápido de realizar, transformándose en una herramienta clínica muy útil en la verificación de patologías del laberinto posterior, complementando la exploración otoneurológica tradicional. En el presente trabajo de revisión se exponen generalidades, definición, historia, fundamento fisiológico, métodos y aplicaciones clínicas de los VEMP...

The human being attains the stability required to efficiently perform common activities of daily living by the vestibular system and includes communication with multiple systems, mainly with the oculo-motor system and the proprioceptive system. Currently, and with increased incidence of vestibular symptoms consultations play an important role in the work activity of the otolaryngologist, adding to that the difficulty to confirm the diagnosis in an objective manner. Historically have been reported multiple techniques to evaluate the vestibular system in response to an effort to better diagnosis and treatment of these pathologies among which is the study of Vestibular Evoked Myogenic Potentials (VEMP). The VEMP is a relatively new research methodology, first described as a method of evaluating vestibular function in the early 90’s by Colebatch et al. It is a noninvasive test, low cost, easy and quick to perform, making it a useful clinical tool in the verification of pathologies of the posterior labyrinth, complementing the traditional neuro-otological examination. The present review presents an overview, definition, history, physiological basis, methods and clinical applications of VEMP...