Outcomes of ECMO support with polypropylene membrane during pandemic times: a retrospective cohort study.

BACKGROUND: The SARS-CoV-2 pandemic resulted in shortages of supplies, which limited the use of extracorporeal membrane oxygenation (ECMO) support. As a contingency strategy, polypropylene (PP) oxygenation membranes were used. This study describes the clinical outcomes in patients on ECMO with PP compared to poly-methylpentene (PMP) oxygenation membranes. METHODS: Retrospective cohort of patients in ECMO support admitted between 2020 and 2021. RESULTS: A total of 152 patients with ECMO support were included, 71.05% were men with an average age of 42 (SD 9.91) years. Veno-venous configuration was performed in 75.6% of cases. The PP oxygenation membranes required more changes 22 (63.1%), than the PMP Sorin® 24 (32,8%) and Euroset® 15 (31,9%) (p.0.022). The main indication for membrane change was low oxygen transfer for PP at 56.2%, Sorin® at 50%, and Euroset® at 14.8%. Renal replacement therapy was the most frequent complication with PP membrane in 22 patients (68.7%) Sorin® 25 patients (34.2%), and Euroset® 15 patients (31.9%) (p 0.001) without statistically significant differences in mortality. CONCLUSION: PP oxygenation membranes was a useful and feasible strategy. It allowed a greater disponibility of ECMO support for critically ill in a situation of great adversity during the SARS-CoV-2 pandemic.

Invasive scedosporiosis in lung transplant recipients: A nine-year retrospective study in a tertiary care hospital.

BACKGROUND: Scedosporium species and Lomentospora prolificans (Sc/Lp) are emerging molds that cause invasive disease associated with a high mortality rate. After Aspergillus, these molds are the second filamentous fungi recovered in lung transplant (LT) recipients. AIMS: Our objective was to evaluate the incidence, risk factors and outcome of Sc/Lp infections in LT recipients at a tertiary care hospital with a national reference LT program. METHODS: A nine-year retrospective study was conducted. RESULTS: During this period, 395 LT were performed. Positive cultures for Sc/Lp were obtained from twenty-one LT recipients. Twelve patients (incidence 3.04%) developed invasive scedosporiosis (IS). In 66.7% of the patients with IS the invasive infection was defined as a breakthrough one. The main sites of infection were lungs and paranasal sinuses. Most of the patients received combination antifungal therapy. The IS crude mortality rate after 30 days was 16.7%, and 33.3% after a year. CONCLUSIONS: Our study highlights improved survival rates associated with combination antifungal therapy in LT recipients and underlines the risk of breakthrough infections in patients with allograft dysfunction on nebulized lipidic amphotericin B prophylaxis. In addition to pretransplant colonization, acute or chronic organ dysfunctions seem to be the main risk factors for IS.

Influence of environmental conditions and pollution on the incidence of Streptococcus pneumoniae infections.

Fossil fuel derived pollutants (SO2, NO), dry air and cold increase the incidence of S. pneumoniae infections http://ow.ly/RnLW30gogb1.

Caracterización de los pacientes en una consulta de hipertensión arterial de Dosquebradas: Risaralda-Colombia: 2008-2012 / Patients characterization in one high blood pressure consultation from Dosquebradas: Risaralda-Colombia: 2008-2012

El objetivo fue describir las características de los pacientes evaluados en la consulta de hipertensión arterial del Hospital Santa Mónica de Dosquebradas, Risaralda, Colombia, atendidos en el período 2008-2012. Estudio observacional descriptivo realizado en el Hospital Santa Mónica de Dosquebradas, Risaralda, Colombia. Los pacientes corresponden a la población atendida en el programa de detección de hipertensión arterial con sospecha de la enfermedad que fueron ingresados a la consulta de hipertensión arterial del Hospital. Se evaluaron variables demográficas y clínicas, incluyendo presión arterial sistólica y diastólica, entre otras. De un total de 8900 pacientes con evaluación de la presión arterial en el período, se atendieron en promedio 1780 por año (±934), el promedio por mes durante el período fue de 148 pacientes (intervalo 93-286). De los pacientes 73,3% correspondió al sexo femenino y 26,7% al masculino. La edad promedio de los mismos fue de 62,91 años (±13,09). Del total de pacientes, 92,57% (IC95% 92,02-93,12) presentaban valores de prehipertensión/hipertensión arterial, siendo mayor en las mujeres de > igual 70 años (93,7%) que en las mujeres < 70 años (92,1%) (OR=1,269; IC95% 1,026-1,569). No se observaron diferencias significativas por edad en los pacientes del sexo masculino. El presente estudio permitió caracterizar una población de casi 9000 pacientes que acudieron a la consulta de hipertensión arterial del hospital de referencia del municipio durante 5 años, del cual no existen estudios previos y que muestra una considerable proporción de población con alteraciones de la presión arterial, especialmente en mujeres de más de 70 años.

The objetive was to describe the characteristics of patients evaluated at the high blood pressure consultation of the Hospital Santa Monica, Dosquebradas, Risaralda, Colombia, attended between 2008-2012. Observational, descriptive study realized in the Hospital Santa Monica,Dosquebradas, Risaralda, Colombia. The patients comes from the population attended at the hypertension screening program with disease who were admitted to the Hospital with high blood pressure diagnosis. We evaluated demographic and clinical variables, including systolic and diastolic blood pressure, among others. Results: from a total of 8900 patients with blood pressure assessment in the period, were attended on average 1780 per year(±934), the average per month during the period was 148 patients (range 93-286). Of the patients 73.3% were female and 26.7% male. The average age of them was 62.91 years (±13.09). Of the patients, 92.57% (95%CI 92.02-93.12) had values of prehypertension/hypertension, being higher in women < igual 70 years (93.7%) that in woman < 70 years (92.1%) (OR=1.269;95% CI 1.026-1.569). There were no significant differences by age in male patients. This study allowed us to characterize a population of nearly 9000 patients who were attended at the reference hospital of municipality for five years, of which there are no previous studies that show a considerable proportion of the population with blood pressure changes, especially in women over 70 years.