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The introduction of exotic species constitutes one of the main threats to biodiversity around the world. Spathodea campanulata is a tree species cultivated for its ornamental value, having toxic nectar with insecticidal properties, particularly against bees. In Argentina, its effects on the native entomofauna are unknown. This study explores the mortality effects of S. campanulata on the native entomofauna in a green area of Corrientes city. From the study of three trees, the percentage of flowers with dead entomofauna specimens inside was analyzed and the abundance of the taxa represented was determined. Diversity indices, species richness, inventory completeness and range-abundance curve were calculated. The results revealed the native bee Scaptotrigona jujuyensis was the most abundant, with a total of 46 specimens out of a total of 151 specimens, among which were founded representatives of the orders Himenoptera, Diptera, Coleoptera, Hemiptera, and Araneae. This exploratory study warns that S. campanulata is a potential threat to native entomofauna in urban areas. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Factors associated with mortality among mechanically ventilated COVID-19 patients have been scarcely studied in Latin America. Objective: To identify factors associated with mortality in mechanically ventilated COVID-19 patients. Methods: This prospective study was undertaken in a single center between April and October 2020, recruiting COVID-19 patients managed with mechanical ventilation. We excluded patients who died within the first 24 hours after endotracheal intubation. Clinical characteristics, laboratory results, ventilation interventions, and outcomes were collected and compared between the deceased and surviving groups. The association between these factors and hospital death was examined, and relevant covariates were included in a multivariate logistic regression model. Results: A total of 273 patients were included (72.5% male), the mortality rate was 37% (95% CI 31% - 43%), and the median age was 63 years (IQR 52-72). The most frequent comorbidity was hypertension (45%). Factors associated with mortality were: older age (OR 1.08; 95% CI 1.05- 1.11), male gender (OR 2.79; 95% CI 1.30-6.01), immunosuppression (OR 3.98; 95% CI 1.57-10.06), thrombocytopenia (OR 3.84; CI 95% 1.47-10.01), driving pressure (OR 1.20; 95% CI 1.07-1.34) and the use of dialysis (OR 4.94; 95% CI 2.56-9.51). Chronic hypertension (OR 0.35; 95% CI 0.17-0.71) and fever on admission (OR 0.51; 95% CI 0.27-0.98) were found to have a protective effect. Conclusions: Older age, male sex, immunosuppression, thrombocytopenia, increased driving pressure, use of dialysis, absence of fever, or arterial hypertension were associated with an increased risk of mortality among mechanically ventilated COVID-19 patients. [ABSTRACT FROM AUTHOR]

Introduction: The presence of secondary infections in critically ill patients and antibiotic resistance are often determining factors in the clinical evolution of these patients. Objective: To describe the pathogens isolated in blood cultures and tracheal secretion cultures in ICU patients with COVID-19 and to evaluate the association between the presence of secondary infections and 60-day mortality. Methods: Retrospective analytical cohort study conducted in 273 adults admitted to the ICU with COVID-19 at the Subred Integrada de Servicios de Salud del Sur - Hospital El Tunal, Bogotá, Colombia between April and December 2020. Data from records of blood or tracheal secretion cultures were collected . A bivariate analysis was performed using a Cox proportional-hazards regression model to assess the association between the development of secondary infections and 60-day mortality. Results: At least one positive blood culture was reported in 96/511 patients (18.8%). Of the 214 blood cultures performed within 48 hours after ICU admission, 7.7% were positive. A total of 127 germs were isolated from blood cultures - mostly gram-negative bacteria (61.4%) - followed by fungi (25.2%). Additionally, 39.5% were multidrug-resistant, and carbapenem resistance was the most common antibiotic resistance pattern (33.3% of all gram-negative bacteria isolates). Finally, in this cohort, the presence of secondary infections was not associated with 60-day mortality (HR: 1.012, 95%CI: 0.721- 1.420; p= 0.946). Conclusions: Although the prevalence of superinfection was moderately high, the prevalence of coinfection was low. Gram-negative bacteria were predominant, and almost one third of the germs were multidrug-resistant. [ABSTRACT FROM AUTHOR]

Introduction: Septic shock is a potentially life-threatening condition. The aim of this study was to identify clinical and epidemiological factors associated with mortality in pediatric patients admitted to a pediatric intensive care unit (PICU) with septic shock. Materials and methods: A retrospective comparative case series study was conducted with children aged 1 month to 14 years with septic shock from 2018 to 2020 in a PICU in Lima, Peru. Patients were divided into deceased and survivor groups based on their condition at discharge from the PICU. The influence of each variable on mortality was assessed using a logistic regression model. Results: A total of 174 patients were included in the study, with 51 (29.3%) fatalities. Deceased patients, compared to survivors, were older, had a higher incidence of oncological disease (31.4% vs. 14.6%; p = 0.011), more frequently presented with hemoglobin = 9 g/dL (44% vs. 28%; p = 0.043), lactate > 2 mmol/L (70% vs. 44%; p = 0.002), platelets = 150 (×103)/µL (77% vs. 42%; p < 0.001), and pH = 7.1 (31% vs. 6%; p < 0.001). In the logistic regression model, factors related to mortality were having a pH = 7.1 (odds ratio [OR] = 8.95; 95% confidence interval [CI]: 2.52-31.75) and platelets = 150 (×103)/µL (OR = 3.89; 95% CI: 1.40-10.84). Conclusions: Factors associated with mortality in pediatric patients with septic shock were a pH = 7.1 and platelets = 150 (×103)/µL in the assessments conducted upon admission to the PICU. [ABSTRACT FROM AUTHOR]

This study aimed at studying the clinical and anatomopathological characteristics, treatment and survival of patients with differentiated thyroid cancer. A retrospective cohort study was conducted with data from 150 patients from a Peruvian hospital between the years 2010 to 2020. Characteristics and survival (Kaplan-Meier method) were described. The mean age was 48.3 years, 130 participants (86.7%) were women and the most frequent histologic type was papillary 94.6%. Of the participants, 74.2% had TNM stage I, 70.7% had total thyroidectomy and 68.7% received radioactive iodine. Overall survival at 5 years was 89.3%, being lower in those with TNM stage IV and higher in those who used radioactive iodine. In conclusion, in a hospital in Cusco, differentiated thyroid cancer was more frequent in women and survival was lower compared to reports from other countries. [ABSTRACT FROM AUTHOR]

Objectives. To determine the requirement and time to mechanical ventilation and Intensive Care Unit (ICU), hospitalization and hospitalization time, death and disability of the axonal variants of Guillain-Barré Syndrome (GBS) in comparison with the acute demyelinating variant in patients of all the ages. Materials and methods. The systematic review that included patients with GBS. The exposure variable was the axonal variants and the comparator was acute inflammatory demyelinating polyneuropathy (AIDP). The outcomes were the requirement and time on mechanical ventilation (MV), requirement and time in the ICU, hospitalization time, disability and death. The NewCasttle-Ottawa Scale (NOS) was used to assess risk of bias. A meta-analysis was conducted to calculate mean differences and relative risks (RR) with their 95% confidence intervals (CI) using inverse variances and random effects models. Results. Of the 3116 articles found, 46 met the selection criteria. The time on MV was 7.42 days (95% CI: 0.36 to 1.48) and the hospitalization time was 3.11 (95% CI: 0.73 to 5.49) days for the axonal variants. The axonal variants had a RR of 0.47 (95% CI: 0.24 to 0.92) for the requirement of MV in adults, but it was 1.68 (95% CI: 1.25 to 2.25) in children. There was a high statistical heterogeneity. Conclusions. Axonal variants showed, on average, longer MV and hospitalization time, overall and by subgroups. A high MV requirement was found for axonal variants in children; it was lower for adults. [ABSTRACT FROM AUTHOR]

Objectives. To analyze the evolution of COVID-19 in rural populations of Loreto and Ucayali in the early stage of the pandemic. Materials and methods. A community-level longitudinal observational study was conducted and based on two rounds of telephone surveys with local authorities of more than 400 indigenous and non-indigenous rural communities in Loreto and Ucayali, in July and August 2020. We collected information on cases and deaths by COVID-19 in their communities, protective measures adopted and if state assistance was received in the early stage of the pandemic. Descriptive statistics allowed us to evaluate the evolution of the pandemic after the initial outbreak and compare the trends of the two regions, as well as between indigenous and non-indigenous populations. Results. In July 2020, COVID-19 had reached 91.5% of the communities, although deaths from COVID-19 were reported in 13.0% of the communities, with rural mortality being higher in Ucayali (0.111%) than in Loreto (0.047%) and in non-indigenous communities. By August, prevalence decreased from 44.0% to 32.0% of communities, but became more frequent in indigenous communities, and those in Ucayali. Traveling to the city to receive state bonuses and difficulties maintaining social distancing contributed to the spread. Conclusions. Our findings show the evolution of COVID-19 in rural communities and point to important areas of attention in future public policies, for the adoption of protective measures and reconsidering strategies for the distribution of assistance in the face of future pandemics. [ABSTRACT FROM AUTHOR]

Abdominal trauma is an important cause of mortality in young people. The objectives of the review were to identify risk factors associated with mortality in abdominal trauma and to determine the incidence of mortality. A systematic review and meta-analysis was performed including ten observational studies that provided information on 188,400 participants. The risk factors were as follows: advanced age SMD 0.27 [95% CI: 0.15; 0.38], firearm injury OR 1.71 [95% CI: 1.52; 1.93], associated injuries OR 2.94 [95% CI: 1.98; 4.37], vascular injury OR 4.83 [95% CI: 3.09; 7.55]), increased number of red blood cell transfusions SMD 1.07 [95% CI: 0.96; 1.19], and solid organ injury OR 2.13 [95% CI: 1.51; 3.00]. The mortality ranged between 5 and 25.8% and the risk factors described were predictors of mortality in abdominal trauma. [ABSTRACT FROM AUTHOR]

Objective: The treatment with phosphodiesterase-5 (PDE-5) inhibitors was postulated in heart failure (HF). We conducted a systematic review and a meta-analysis on their beneficial and adverse effects in patients with HF. Method: A meta-analysis of randomized trials evaluating the chronic use of PDE-5 inhibitors in patients with HF was conducted. Endpoints included death, HF hospitalizations, functional capacity, pulmonary pressures, quality of life, and adverse effects. Random-effects models were used to pool outcomes. Categorical data were summarized with relative risks (RR) and 95% confidence intervals (95%CI), and continuous data with weighted mean differences and standardized mean differences. Results: Sixteen studies (1119 participants) were included. No effect was observed on mortality (RR: 1.16; 95%CI: 0.50-2.66; I2: 0.0%) or HF hospitalizations (RR: 0.75; 95%CI: 0.41-1.37; I2: 38.7%). Treatment significantly reduced pulmonary systolic pressure (-10.64 mmHg; 95%CI: -5.14 to -16.15 mmHg; I2: 96.0%), and increased peak oxygen consumption (2.06 ml/kg/min; 95%CI: 0.40-3.72; I2: 89.6%), although with high inconsistency. There were no significant effects on quality of life (-0.15; 95%CI: -0.48-0.18; I2: 0.0%). On the other hand, the risk of headaches was increased (RR: 1.63; 95%CI: 1.11-2.39; I2: 0.0%). Publication bias was identified for HF hospitalizations. Conclusions: Current data suggest that PDE-5 inhibitors therapy does not improve prognosis or quality of life among HF patients. Hemodynamic and functional effects could be relevant, and more studies are necessary to define its role. [ABSTRACT FROM AUTHOR]

Objective: this study aimed to assess the effects of two isocaloric parenteral nutrition (PN) regimens with different protein content and non-protein calorie to nitrogen ratio (NPCNR) on the evolution of nutritional parameters and outcomes in adult inpatients. Methods: this was a retrospective quasi-experimental study performed in a 400-bed tertiary hospital. Adult inpatients were initially eligible if they had received ≥ 4 days of PN with NPCNR ≥ 100 or ≤ 90 in a period of three years. Patients were propensity-score matched to adjust for differences, resulting in two final cohorts: Cohort "Medium-P" included patients receiving PN with NCPCNR ≥ 100 and cohort "High-P", receiving PN with NCPCNR ≤ 90. The main variables were differences in plasma albumin, prealbumin, cholesterol, and lymphocyte count, days requiring PN, length of stay, and mortality at 90 days. Results: 202 patients were finally recruited and divided into the two equal cohorts. Patients were mainly male (122; 60.4 %), surgical (149; 73.8 %), critically ill (100; 49.5 %), with high nutritional risk (141; 69.8 %) and with a neoplasm (145; 71.8 %). PN provided 25 kcal/kg/day, but protein intake was 0.25 g/kg/day higher in the "High-P" cohort. Baseline characteristics and biochemistry were not different between the two cohorts. The "High-P" cohort presented a smaller difference at the end of PN for lymphocytes, more days with hyperglycaemia, and more days requiring PN. The rest of variables did not differ. Conclusions: high doses of protein (lower NPCNR) did not present advantages compared to medium doses of protein (higher NPCNR) when providing isocaloric PN in adult inpatients. [ABSTRACT FROM AUTHOR]

Copyright of Nefrologia is the property of Revista Nefrologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cirugía y Cirujanos is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducción. En los países de medianos y bajos ingresos, los datos sobre la mortalidad y los factores de riesgo en pacientes con enfermedad pulmonar obstructiva crónica son limitados. Objetivo. Identificar la incidencia de muerte y sus variables relacionadas en una población colombiana durante 12 meses de seguimiento. Materiales y métodos. Se llevó a cabo un estudio retrospectivo de sujetos con diagnóstico de enfermedad pulmonar obstructiva crónica en una clínica de tercer nivel en Colombia. Los cocientes de probabilidades se calcularon mediante un análisis de regresión logística multivariable con la variable de resultado “mortalidad a los 12 meses”. Resultados. Ingresaron 524 pacientes, de los cuales el 18,1 % (95 / 524) murió. La edad promedio fue de 69,7 (DE = 8,92) y el 59,2 % (310 / 524) eran mujeres. Las variables asociadas con la mortalidad fueron la edad (OR = 6,54; IC95%: 3,65-11,36; p < 0,001), años de exposición al humo de leña (OR = 4,59; IC95%: 1,64-12,82; p = 0,002), insuficiencia cardiaca crónica (OR = 1,81; IC95%: 1,13-2,91; p = 0,014), enfermedad cerebrovascular (OR = 3,35; IC95%: 1,04-10,75; p = 0,032) y enfermedad renal crónica (OR=6,96; IC 95%:1,15-41,67; p = 0,015). Al ajustar las variables en el análisis multivariado únicamente se mostró asociación entre el sexo (OR = 1,55; IC95%: 0,95-2,54; p = 0,008) y la edad (OR = 5,94; IC95%: 3,3-10,69; p < 0,001). Conclusión. La edad, los años de exposición al humo de leña, la insuficiencia cardiaca crónica, la enfermedad cerebrovascular y la renal crónica fueron variables clínicas asociadas a un desenlace fatal. Sin embargo, la edad y el sexo fueron las únicas relacionadas con la mortalidad al ajustarlas por factores de confusión.

Introducción. Algunos estudios han señalado que la soledad podría estar relacionada con un aumento en el riesgo de mortalidad en pacientes con cáncer ya que puede debilitar la respuesta al tratamiento y del sistema inmunológico y promover comportamientos perjudiciales, lo que puede empeorar el pronóstico y aumentar la probabilidad de muerte en estos pacientes. El abordar la soledad en la salud pública es esencial para brindar apoyo social y mejorar los resultados en los pacientes con cáncer. Objetivo. Obtener un estimador de la asociación soledad no deseada – mortalidad en pacientes con cáncer. Materiales y métodos. Se le hizo el seguimiento durante dos años a una cohorte prospectiva de 400 pacientes (exposición=niveles de soledad; desenlace=tiempo hasta la muerte). Se incluyeron variables de control sociodemográficas y clínicas. Se utilizó un modelo de supervivencia paramétrico (log normal). Resultados. En la cohorte se encontró una mediana de supervivencia de 20,2 meses y una tasa de mortalidad de 3,2 muertes por 100 pacientes-mes (IC95 %: 2,8 a 3,7). En el modelo de supervivencia se encontraron las siguientes razones de tiempo (RT): nivel moderado-nivel bajo: RT=0,55; IC95 %: 0,39 a 0,77; nivel moderadamente alto-nivel bajo: RT=0,62; IC95 %: 0.41 a 0.93; nivel alto-nivel bajo: RT=1,17; IC95 %: 0,31 a 4,42. Conclusión. En comparación con los pacientes con niveles bajos de soledad, los pacientes con niveles moderados o moderadamente altos llegan más rápidamente a la muerte (RT estadísticamente significativas, habiendo ajustado por el efecto de las demás variables del modelo). Esto sugiere la utilidad de las intervenciones para mitigar la soledad y promover el apoyo social en los pacientes con cáncer.

Objetivo: Identificar la presencia de desigualdades sociales en la mortalidad por lesiones de tránsito en las jurisdicciones argentinas, según su nivel de desarrollo socioeconómico. Metodología: Se realizó un estudio ecológico con nivel de agregación jurisdiccional para los años 2005, 2011 y 2016. La desigualdad entre jurisdicciones se estimó mediante el índice y la curva de concentración. Se utilizó como variable socioeconómica de ordenamiento el índice de desarrollo humano por jurisdicción y sus componentes por separado. Resultados: El índice de concentración arrojó un valor negativo en los tres años (−0,032 en 2005, −0,094 en 2011 y −0,065 en 2016), indicando que existe una mayor concentración de la mortalidad por lesiones de tránsito en las jurisdicciones con menor índice de desarrollo humano, aunque los valores muestran una tendencia a la disminución de estas desigualdades sociales entre los años 2011 y 2016. El componente que explica en mayor medida esta concentración es el indicador de ingresos. Conclusión: Existen desigualdades sociales en la mortalidad por lesiones de tránsito en las jurisdicciones argentinas según su nivel de desarrollo socioeconómico, principalmente explicadas por el nivel de ingreso. Las políticas de prevención de lesiones de tránsito deben tener en cuenta las cuestiones socioeconómicas de la población.

Introduction: In some studies, the peritoneal solute transfer rate (PSTR) through the peritoneal membrane has been related to an increased risk of mortality. It has been observed in the literature that those patients with rapid diffusion of solutes through the peritoneal membrane (high/fast transfer) and probably those with high average transfer characterized by the Peritoneal Equilibrium Test (PET) are associated with higher mortality compared to those patients who have a slow transfer rate. However, some authors have not documented this fact. In the present study, we want to evaluate the (etiological) relationship between the characteristics of peritoneal membrane transfer and mortality and survival of the technique in an incident population on peritoneal dialysis in RTS Colombia during the years 2007–2017 using a competing risk model. Materials and methods: A retrospective cohort study was carried out at RTS Colombia in the period between 2007 and 2017. In total, there were 8170 incident patients older than 18 years, who had a Peritoneal Equilibration Test (PET) between 28 and 180 days from the start of therapy. Demographic, clinical, and laboratory variables were evaluated. The (etiological) relationship between the type of peritoneal solute transfer rate at the start of therapy and overall mortality and technique survival were analyzed using a competing risk model (cause-specific proportional hazard model described by Royston-Lambert). Results: Patients were classified into four categories based on the PET result: Slow/Low transfer (16.0%), low average (35.4%), high average (32.9%), and High/Fast transfer (15.7%). During follow-up, with a median of 730 days, 3025 (37.02%) patients died, 1079 (13.2%) were transferred to hemodialysis and 661 (8.1%) were transplanted. In the analysis of competing risks, adjusted for age, sex, presence of DM, HTA, body mass index, residual function, albumin, hemoglobin, phosphorus, and modality of PD at the start of therapy, we found cause-specific HR (HRce) for high/fast transfer was 1.13 (95% CI 0.98–1.30) p = 0.078, high average 1.08 (95% CI 0.96–1.22) p = 0.195, low average 1.09 (95% CI 0.96–1.22) p = 0.156 compared to the low/slow transfer rate. For technique survival, cause-specific HR for high/rapid transfer of 1.22 (95% CI 0.98–1.52) p = 0.66, high average HR was 1.10 (95% CI 0.91–1.33) p = 0.296, low average HR of 1.03 (95% CI 0.85–1.24) p = 0.733 compared with the low/slow transfer rate, adjusted for age, sex, DM, HTA, BMI, residual renal function, albumin, phosphorus, hemoglobin, and PD modality at start of therapy. Non-significant differences. Conclusions: When evaluating the etiological relationship between the type of peritoneal solute transfer rate and overall mortality and survival of the technique using a competing risk model, we found no etiological relationship between the characteristics of peritoneal membrane transfer according to the classification given by Twardowski assessed at the start of peritoneal dialysis therapy and overall mortality or technique survival in adjusted models. The analysis will then be made from the prognostic model with the purpose of predicting the risk of mortality and survival of the technique using the risk subdistribution model (Fine & Gray). Resumen: Introducción: La tasa de transferencia de moléculas pequeñas (PSTR) a través de la membrana peritoneal ha sido relacionado con un aumento en el riesgo de mortalidad en algunos estudios. Se ha observado en la literatura que aquellos pacientes con rápida difusión de solutos a través de la membrana peritoneal (transferencia alta/rápida) y probablemente aquellos con transferencia promedio alto caracterizado en la Prueba de Equilibrio Peritoneal (PET) se asocian a una mayor mortalidad comparado con aquellos pacientes quienes tienen transferencia lenta. Sin embargo, algunos autores no han documentado este hecho. En el presente estudio queremos evaluar la relación (etiológica) entre las características de transferencia de la membrana peritoneal y mortalidad y supervivencia de la técnica en una población incidente en diálisis peritoneal en RTS Colombia durante los años 2007 a 2017 utilizando un modelo de riesgos competitivos. Materiales y métodos: Se realizó un estudio de cohortes retrospectivo en RTS Colombia en el período comprendido entre los años 2007 y 2017. En total fueron 8170 pacientes incidentes mayores de 18 años, quienes tenían una prueba de equilibrio peritoneal (PET) entre los 28 y 180 días de inicio de terapia. Se evaluaron variables demográficas, clínicas y de laboratorio. Se analizó la relación (etiológica) entre el tipo de transferencia de la membrana peritoneal al inicio de la terapia y mortalidad global y la supervivencia de la técnica utilizando un modelo de riesgos competitivos (modelo de riesgo proporcional causa específico descrito por Royston-Lambert). Resultados: Los pacientes se clasificaron en cuatro categorías según el resultado del PET: transferencia Lento/Bajo (16,0%), promedio bajo (35,4%), promedio alto (32,9%) y transferencia Alta/Rápido (15.7%). Durante el seguimiento, mediana de 730 días, fallecieron 3025 (37,02%) pacientes, 1.079 (13,2%) fueron transferidos a hemodiálisis (HD) y 661 (8,1%) fueron trasplantados. En el análisis de riesgos competitivos, ajustado por edad, sexo, presencia de DM, HTA, índice de masa corporal, función residual al inicio de la terapia, albúmina, hemoglobina, fósforo y terapia de inicio encontramos que el HR causa específico (HRce) para transferencia alto/rápido fue de 1,13 (IC 95% 0,98-1,30) p = 0,078, promedio alto 1,08 (IC 95% 0,96-1,22) p = 0,195, promedio bajo 1,09 (IC 95% 0,96-1,22) p = 0,156 comparados con el tipo de transferencia bajo. Para la supervivencia de la técnica, el HR causa-específico para transferencia alto/rápido de 1,22 (IC 95% 0,98-1,52) p = 0,66, promedio alto el HR fue de 1,10 (IC 95% 0,91-1,33) p = 0,296, promedio bajo HR de 1,03 (IC 95% 0,85-1,24) p = 0,733 comparados con el tipo de transferencia bajo/lento, ajustado por edad, sexo, DM, HTA, IMC, función renal residual, albúmina, fósforo, hemoglobina y terapia de inicio. Diferencias no significativas. Conclusiones: Al evaluar la relación etiológica entre el tipo de transferencia de membrana peritoneal y mortalidad global y supervivencia de la técnica utilizando un modelo de riesgos competitivos, no encontramos relación etiológica entre las características de transferencia de la membrana peritoneal de acuerdo con la clasificación dada por Twardowski evaluada al inicio de la terapia de diálisis peritoneal y la mortalidad global o en la supervivencia de la técnica en los modelos ajustados. Se hará posteriormente el análisis desde el modelo pronostico con el propósito de predecir el riesgo de mortalidad y sobrevida de la técnica utilizando el modelo de subdistribución de riesgos (Fine & Gray).

Introduction: Our aim was to determine which foetal or neonatal growth curves discriminate the probability of dying of newborns with low birth weight for their gestational age (small for gestational age, SGA) and sex (weight < 10th percentile) and to establish the curves that are presumably most useful for monitoring growth through age 10 years. Material and methods: The analysis included every neonate (15 122) managed in our hospital (2013–2022) and all neonates born preterm before 32 weeks (6913) registered in the SEN1500 database (2019–2022). We considered most useful those curves with the highest likelihood ratio (LR) for dying with or without a history of SGA in each subgroup of gestational ages. Theoretically, the optimal curves for monitoring growth would be those with a higher R2 in the quantile regression formulas for the 50th percentile. Results: The growth curves exhibiting the strongest association between SGA and hospital mortality are the Intergrowth fetal curves and the Fenton neonatal curves in infants born preterm before 32 weeks. However, the optimal curves for premature babies and neonates overall were those of Olsen and Intergrowth. The most useful curves to monitor anthropometric values alone until age 10 years of age are the longitudinal Intergrowth curves followed by the WHO standards, but if a single reference is desired from birth through age 10 years, the best option is the Fenton curves followed by the WHO standards. Conclusions: The Intergrowth reference provides the most discriminating foetal growth curves. In neonatal clinical practice, the optimal references are the Fenton followed by the WHO charts. Resumen: Introducción: Se pretende determinar qué curvas de crecimiento fetal o neonatal discriminan la probabilidad de fallecer de los recién nacidos de bajo peso para su edad gestacional (BPEG) y sexo (peso inferior al percentil 10) y conocer las curvas teóricamente más útiles para seguir el crecimiento hasta los 10 años. Material y método: Se estudian todos los neonatos (15.122) atendidos en nuestro hospital (2013-2022) y todos los prematuros menores de 32 semanas (6.913) incluidos en la base de datos SEN1500 (2019-2022). Las curvas más útiles serán las que tengan un mayor cociente de probabilidad (LHR=likelihood ratio) de fallecer siendo o no BPEG en cada subgrupo de edades gestacionales. Las curvas más indicadas teóricamente en el seguimiento serán las que tengan una mayor R2 en las fórmulas de regresión de las tendencias del percentil 50. Resultados: Las curvas de crecimiento que mejor relacionan BPEG con mortalidad hospitalaria son las fetales de Intergrowth y las neonatales de Fenton en los prematuros menores de 32 semanas. Sin embargo, en todos los prematuros y neonatos en su conjunto, son las de Olsen e Intergrowth. Las curvas más útiles para seguir sólo la evolución antropométrica hasta los 10 años son las longitudinales de Intergrowth más OMS, pero si se desea una curva única desde el nacimiento hasta los 10 años son las de Fenton más OMS. Conclusiones: Las curvas de crecimiento fetal más discriminante son las de Intergrowth fetales. En la práctica clínica del neonatólogo, las curvas más indicadas son las de Fenton más OMS.

RESUMEN Introducción y objetivos: En pacientes con infarto agudo de miocardio con elevación del segmento ST (IAMCEST), el retraso en el tratamiento afecta de manera importante los resultados. El efecto del horario de atención en los pacientes con IAMCEST es dudoso cuando la intervención coronaria percutánea (ICP) es la estrategia de reperfusión preferida. Este estudio tuvo como objetivo determinar la asociación entre los resultados del IAMCEST y el momento de la admisión en un centro con ICP del suroeste de Europa. Métodos: Estudio de cohorte retrospectivo en el que se analizaron los datos electrónicos locales de 1.222 pacientes consecutivos con IAMCEST tratados con ICP. El horario de atención laboral se definió como la admisión de lunes a viernes de 8 a 18 horas, en días no festivos. Resultados: Un total de 439 pacientes (36%) ingresaron en horario laboral y 783 (64%) se admitieron fuera del horario. Las características iniciales estaban bien equilibradas entre los grupos, incluyendo el porcentaje de pacientes ingresados en shock cardiogénico (en horario laboral el 5% y fuera del horario laboral el 4%; p = 0,62). La mediana de tiempo desde el primer contacto médico hasta la reperfusión no fue diferente entre los 2 grupos (dentro del horario laboral 120 min y fuera del horario laboral 123 min; p = 0,54). No se observó asociación entre el tiempo de admisión y la mortalidad hospitalaria (dentro del horario laboral el 5% y fuera del horario laboral el 5%; p = 0,90) ni la mortalidad a 1 año (en horario laboral el 10% y fuera del horario el 10%; p = 0,97). El análisis de supervivencia no mostró diferencias entre la admisión dentro del horario laboral y la admisión fuera del horario laboral (HR = 1,1; IC95%, 0,74-1,64; p = 0,64). Conclusiones: En una red de código infarto contemporáneo, el horario de admisión de pacientes con IAMCEST no se asoció con retrasos en la reperfusión ni con un aumento de la mortalidad.

Objetivo. 1) Describir la carga de la enfermedad renal crónica en países de América Latina entre 1990 y 2019 y, 2) estimar la correlación entre los años de vida saludables perdidos (AVISA) con el índice sociodemográfico y el índice de acceso y calidad de salud. Métodos. Análisis secundario y ecológico, basado en el Estudio de la Carga Global de Enfermedades, Lesiones y Factores de Riesgo 2019. Se reportaron las tasas estandarizadas de mortalidad, años perdidos por muertes prematuras (APMP), años de vida ajustados por discapacidad (AVAD) y AVISA por enfermedad renal crónica para 1990, 2005 y 2019. La información se desagregó por países, sexo, grupos etarios y subcausas. Resultados. Entre 1990 y 2019, la carga de la enfermedad renal crónica aumentó considerablemente en los países de América Latina, convirtiéndose en una de las principales causas de mortalidad y de AVISA. La tasa estandarizada de AVISA por enfermedad renal crónica se debió, en gran medida, al peso de las muertes prematuras más que a la discapacidad. En 2019, Nicaragua, El Salvador, México y Guatemala se destacaron por tener las tasas estandarizadas de mortalidad por enfermedad renal crónica y de AVISA más elevadas, mientras que Uruguay presentó las más bajas. Conclusiones. La enfermedad renal crónica es una epidemia invisibilizada que representa una carga excesiva, en mortalidad y AVISA, para los países de América Latina. Es indispensable aunar esfuerzos regionales para enfrentar la enfermedad, además de impulsar acciones locales que atiendan las particularidades de cada país.

Counterfactual estimates of excess deaths in Russian regions in the period 2020–21 are compared with officially reported COVID deaths to analyse underreporting. COVID mortality levels at the end of years 2020 and 2021 as well as annual growth during 2021 and the first half of 2022 reveal that COVID is a real threat to high labour productivity regions and those with relatively bigger defence and civilian sectors. Corruption lowers COVID mortality growth, suggesting a public health system where better care is obtained informally. Improved access to a doctor just before the pandemic lowered the level of mortality during the worst year (2021) but did not impact the mortality growth or the mortality level in 2020. Better prevention of any virus including COVID in the future would include more regionally decentralised vaccine and testing initiatives to boost compliance plus a fundamentally reformed health system that includes access to foreign-made vaccines and higher quality mortality data. [ABSTRACT FROM AUTHOR]

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Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Anthropogenic stressors threaten large whales globally. Effective management requires an understanding of where, when, and why threats are occurring. Strandings data provide key information on geographic hotspots of risk and the relative importance of various threats. There is currently considerable public interest in the increased frequency of large whale strandings occurring along the US East Coast of the United States since 2016. Interest is accentuated due to a purported link with offshore wind energy development. We reviewed spatiotemporal patterns of strandings, mortalities, and serious injuries of humpback whales (Megaptera novaeangliae), the species most frequently involved, for which the US government has declared an “unusual mortality event” (UME). Our analysis highlights the role of vessel strikes, exacerbated by recent changes in humpback whale distribution and vessel traffic.  Humpback whales have expanded into new foraging grounds in recent years. Mortalities due to vessel strikes have increased significantly in these newly occupied regions, which show high vessel traffic that also increased markedly during the UME. Surface feeding and feeding in shallow waters may have been contributing factors. We found no evidence that offshore wind development contributed to strandings or mortalities. This work highlights the need to consider behavioral, ecological, and anthropogenic factors to determine the drivers of mortality and serious injury in large whales and to provide informed guidance to decision‐makers. [ABSTRACT FROM AUTHOR]

Objective. To evaluate the mortality rates of prostate cancer in Latin American and the Caribbean (LAC) countries and predict their mortality to 2030. Materials and methods. The data was retrieved from the World Health Organization mortality database. The age-standardized mortality rates for prostate cancer were estimated per 100 000 men between 1997 and 2017 for most LAC countries. The annual percent change was calculated by country and age group. The Nordpred was used to project prostate cancer mortality to 2030. Results. From 1997 to 2017, the countries with the highest mortality rates from prostate cancer were Trinidad and Tobago, Cuba, and Venezuela. For all ages, ten LAC countries presented significant decreases between -0.5 and -2.8%, whereas Brazil, Cuba, Guatemala, and Venezuela showed increases. Mortality by prostate cancer will increase in 2030 due to changes in the structure and size of the population. Conclusions. Despite the decline in statistiprostate cancer mortality rates over the last two decades in most countries in the region, some countries still have very high mortality rates. By 2030, most countries in the region will show overall increases in the number of deaths, mainly due to population size. [ABSTRACT FROM AUTHOR]

Introduction: To characterize the population of patients hospitalized for acute heart failure with an ejection fraction of less than 50% in the Departmental Hospital of Villavicencio. Materials and method: This is a descriptive retrospective cohort study of patients hospitalized for acute heart failure with an ejection fraction (LVEF) of less than 50% between January 1, 2020, and December 31, 2021. Results: A total of 206 participants were included, with a median age of 70 years, of the participants, 71.8% were men, the most frequent comorbidities were hypertension (76.2%), coronary disease (47.1%), and diabetes (32%). The main etiologies of heart failure were ischemic (62.1%) and hypertensive (27.2%), with 6.8% attributed to Chagas disease. The most common causes of decompensation were acute coronary syndrome (39.3%) and poor adherence to treatment (25.7%). The median hospital stay was 7.5 days, and the hospital mortality rate was 14.6%, acute coronary syndrome was the leading cause of death (56.7%). A high requirement for intensive care unit (ICU) management was observed (20.4%), which was higher in patients with slightly reduced LVEF compared to those with reduced LVEF (35.7% vs. 18%, RR = 1.98, p = 0.03), however, the mortality rate was similar between both groups (17.9% vs. 14%, RR = 1.32, p = 0.54). Conclusions: It was found a high prevalence of ischemic heart disease, along with a high requirement for ICU management and high in-hospital mortality. [ABSTRACT FROM AUTHOR]

Mechanical small bowel obstruction is a significant surgical problem in terms of prevalence, morbimortality, and associated economic costs. In recent years, advances have been made in: detection of physio pathological mechanisms of adhesion genesis, improvement in diagnosis of patients suitable for conservative treatment, assessment the efficacy of intraoperative tools that define the need for intestinal resection, and development of preventive therapies. The objective of this narrative review is to synthesize the updated scientific evidence published, regarding the diagnosis and treatment of mechanical small bowel obstruction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine antimicrobial susceptibility and mortality in patients with Pseudomonas aeruginosa infection. MATERIALS AND METHODS: An observational, transversal, descriptive and retrospective study was done to evaluate sensitivity pattern in Pseudomonas aeruginosa isolation; mortality on infected patients was also assessed. RESULTS: There were included 59 patients, the median age was 57 years (range 41 to 71 years), lung isolation was the most common in 26 cases; 48 cases of infection were hospital-acquired, 20 patients died; 32/59 patients received antibiotic treatment with activity against Pseudomonas and had a favorable outcome. Resistance to ceftazidime, amikacin, gentamicin, and ciprofloxacin was more common among those who died. Risk factors for mortality included SARS-CoV-2 infection, hospitalacquired, stay in intensive care unit, mechanical ventilation and treatment without coverage against Pseudomonas. CONCLUSIONS: In Pseudomonas aeruginosa infection, receiving ineffective antimicrobial treatment is the most important risk factor associated to death. Antimicrobial resistance showed no impact on outcome. [ABSTRACT FROM AUTHOR]

Introduction. Gastric cancer in Colombia is the second most common neoplasm in men and the fourth in women. In recent years, the benefits of the laparoscopic approach in gastric cancer against bleeding, postoperative recovery com and complications have been widely described, without affecting oncological results. Methods. Retrospective observational study of patients undergoing laparoscopic gastrectomy at the Clínica Universitaria Colombia over a period of ten years, between 2013 and 2023. Perioperative results were described in terms of hospital stay, operative bleeding, duration of the procedure, complications, causes of reintervention, and mortality in the first 30 days. Results. 418 patients were included, 58.9% men, with an average age of 60.88 years. An average surgical time of 228.7 minutes was documented, with a blood loss of 150 ml. The mean number of lymph nodes resected was 26.1 ± 11.4. The average hospital stay was 4 ± 4 days, and complications were recorded in 104 subjects, with an average rate of 24%, of which 29 (27.4%) obtained a Clavien-Dindo IIIB classification. Conclusions. Laparoscopic gastrectomy in a high-volume center and with experienced surgeons in Colombia has perioperative results similar to those reported in the world literature. Studies with greater strength of association are still required to establish recommendations on the routine use of this approach in advanced malignant pathology. [ABSTRACT FROM AUTHOR]

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Introduction: The present study explored maternal mortality during the COVID-19 pandemic, with a specific focus on pregnant women with COVID-19. Material and methods: After registration of the research protocol in PROSPERO (CRD42024506108), a review of studies during the period January 2020 to December 2023 was conducted in PubMed, Scopus, Ovid, Web of Science, Google Scholar, Virtual Health Library, and Scielo databases using an advanced search and using terms such as ['COVID-19' AND ('pregnancy' OR 'pregnant') AND (Peru)]. Studies reporting maternal mortality due to COVID-19 were included. In addition, the results were compared with epidemiological reports proposed by the Peruvian Ministry of Health (MINSA). Results: Six studies with 44 pregnant women who died from COVID-19 were included. The studies covered four regions of Peru (Lima, Cajamarca, Huancayo, and Callao). Significant maternal complications were observed, including pre-eclampsia, eclampsia, prematurity, intrauterine growth restriction, and fetal death. Among the most frequent comorbidities were hypertension, diabetes, and obesity. According to MINSA epidemiological data, a total of 1,486 pregnant women were reported to have died between 2020 and 2023. Of these, 15.1% (n = 224) of deaths were directly attributed to COVID-19. Conclusions: COVID-19 represents a significant risk for pregnant women in Peru, with deaths attributed to the disease and severe maternal complications such as pre-eclampsia and prematurity, highlighting the need for maternal health care during the pandemic. It is essential that health authorities protect pregnant women from COVID-19 through vaccination, education on preventive measures, and specialized monitoring, especially for those with comorbidities. [ABSTRACT FROM AUTHOR]

Introduction: The severity of COVID-19 infection in kidney transplant patients has been well-documented. Objectives: This study aims to determine the epidemiological and clinical data and identify predictors of poor prognosis during the epidemic's early stages. Material and methods: This is a national semi-prospective, multicenter study of subjects with functioning grafts who were infected during the first wave of the pandemic in Chile between March 1 and September 31, 2020. Results: during this period, we recorded the hospitalization of 97 adult patients throughout the entire national territory. The average age was 52.5 years, 62% men, 45% hypertensive, 11% coronary, 10% diabetic, and 5% with chronic obstructive pulmonary disease, with an average post-transplant follow-up of 7.2 years and an average previous renal function of 47.7ml/min/1.7m2 (CKD-EPI formula). Between the onset of symptoms and diagnosis, there was an average period of 4.8 days, with a predominance of cough (44%), dyspnea (42%), and fever (42%). 34% developed acute kidney injury, and 36% of them required dialysis support. The lethality was 30%, prevailing in those with multiple organ failure (80%) and those who required invasive mechanical ventilation (52%). In the multivariate analysis, the best predictors of mortality were older age (OR: 2.92) and living in a low-income commune (OR: 2.35). Conclusions: This national project of the Chilean Society of Nephrology provided valuable information for monitoring the epidemiological evolution of the pandemic. It also helped to propose priority vaccination strategies, adjust immunosuppressive therapy, and design logistical aspects to reduce the risks for transplant patients. [ABSTRACT FROM AUTHOR]

Traffic accidents pose a significant challenge to public health worldwide. Each year, millions of people are injured or killed in vehicle collisions on roads, resulting in a considerable burden on healthcare systems and irreplaceable loss of human lives. The aim of this study was to analyze the findings on traffic accidents and their impact on public health through a review of available evidence. The study design was exploratory, documentary, and descriptive, involving a systematic literature search for full-text articles published in the past 5 years in indexed journals in scientific databases and search engines including PubMed, MEDLINE, Cochrane, Google Scholar, Scielo, Scopus, Redalyc, Elsevier, and WOS, as well as official health websites, based on inclusion and exclusion criteria. Keywords used were "traffic accident", "costs", "public health", "rehabilitation", connected with AND OR operators with terms "traffic accident" relation "costs", "public health", "public health traffic accidents", "rehabilitation costs to public health traffic accidents". Ultimately, 21 articles were selected. Traffic accidents represent a global challenge with significant geographic variations. While men are typically more affected, women in Zambia face a higher risk. Prevention targeting specific demographic groups and consideration of factors such as vehicle condition and driver behavior are critical for enhancing road safety. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To validate an artificial intelligence model that can predict the mortality prognosis of hospitalized patients with sepsis. MATERIALS AND METHODS: An ambispective observational cohort study, which included electronic records of adult patients from the Central Hospital of the State of Chihuahua, Mexico, from July 2018 to March 2020 and January 2021 to January 2022. Three models were analyzed: neural networks, support vector machine and random forests. For model validation, the sample was divided into 80% for training and 20% for testing. For the last group (20%), a 10-fold cross-validation was implemented to calculate sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: A total of 353 files were analyzed, of which only 218 were chosen. The best model was the neural networks; however, its area under the curve (AUC) score barely reached 0.80, the random forests algorithm (AUC 0.667) and the support vec- tor machine algorithm (AUC 0.641) were below this value. Of the 3 models, only the cross-validation with the neural networks was done, of 20% of the test data, 10 validations were implemented. The AUC scores obtained in each fold ranged from 0.771 to 0.830. CONCLUSIONS: The model is good, even working with few data. It is intended to collect a larger sample to retrain and validate the model with more data and improve learning and performance and finally be applicable to patients. [ABSTRACT FROM AUTHOR]

With the aim of describing the association between sociodemographic characteristics and contextual factors with COVID-19 mortality during 2020-2021 in the provinces of Mendoza and San Juan in Argentina, we conducted an ecological study, which included the sociodemographic factors: age, sex and educational level, and the contextual factors: poverty and urbanization at the departmental level. The analyses were estimated using negative binomial Bayesian hierarchical models. Educational inequalities existed regardless of socioeconomic context and level of urbanization. The exception was the age group 65 years and older during 2021, which, regardless of educational level, showed a higher risk of death by COVID-19 in departments with high levels of structural poverty. In conclusion, educational inequality is an indicator of social inequality that increases vulnerability to COVID-19 mortality. [ABSTRACT FROM AUTHOR]

Mucormycosis is a disease with a high percentage of mortality. This opportunistic disease is caused by pathogens of the Zygomicota family of the order Mucorales, which affect considerably, mainly immunocompromised patients. We present the case of a patient approached at the Hospital Central Militar de México, diagnosed with rhino-orbito-cerebral mucormycosis, with histopathological report of non-septated hyaline hyphae of 90 º, referring to the aforementioned diagnosis. A multidisciplinary approach to the pathology was carried out with diagnosis, timely medical and surgical treatment, achieving a favorable evolution and prognosis in a condition whose outcome is usually fatal. [ABSTRACT FROM AUTHOR]

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