Comparación de distintas estrategias para la predicción de muerte a corto plazo en el paciente anciano infectado

Objective. The aim of this study was to determine the utility of a post hoc lactate added to SIRS and qSOFA score to predict 30-day mortality in older non-severely dependent patients attended for infection in the Emergency Department (ED). Methods. We performed an analytical, observational, prospective cohort study including patients of 75 years of age or older, without severe functional dependence, attended for an infectious disease in 69 Spanish ED for 2-day three seasonal periods. Demographic, clinical and analytical data were collected. The primary outcome was 30-day mortality after the index event. Results. We included 739 patients with a mean age of 84.9 (SD 6.0) years; 375 (50.7%) were women. Ninety-one (12.3%) died within 30 days. The AUC was 0.637 (IC 95% 0.587-0.688; p= 2 and 0.698 (IC 95% 0.635- 0.761; p= 2. Comparing receiver operating characteristic (ROC) there was a better accuracy of qSOFA vs SIRS (p=0.041). Both scales improve the prognosis accuracy with lactate inclusion. The AUC was 0.705 (IC95% 0.652-0.758; p<0.001) for SIRS plus lactate and 0.755 (IC95% 0.696-0.814; p<0.001) for qSOFA plus lactate, showing a trend to statistical significance for the second strategy (p=0.0727). Charlson index not added prognosis accuracy to SIRS (p=0.2269) or qSOFA (p=0.2573). Conclusions. Lactate added to SIRS and qSOFA score improve the accuracy of SIRS and qSOFA to predict short-term mortality in older non-severely dependent patients attended for infection. There is not effect in adding Charlson index

Identification of the bacteriochlorophyll homologues of Chlorobium phaeobacteroides strain UdG6053 grown at low light intensity

Detailed APCI LC-MS/MS analysis using an improved HPLC separation reveals the green sulphur bacterium Chlorobium phaeobacteroides strain UdG6053 to contain a wider range of distinct bacteriochlorophyll homologues than has been previously recognised in Chlorobiaceae. The diversity in the homologue distribution is confirmed as arising from differences in the extent of alkylation of the macrocycle and variation in the nature of the esterifying alcohol and a novel series of bacteriochlorophyll structures has been recognised. Homologues containing esterifying alcohols other than farnesol, a number of which have not previously been reported in Chlorobiaceae, are present in high relative abundance. Confirmation of the structures of the esterifying alcohols has been obtained by hydrolysis and analysis by GC-MS

Estimate of surface PCO2, in the Gulf of California from underway pH measurements and satellite imagery

The feasibility of estimating the partial pressure of CO2 (PCO2) from underway measurements of sea-surface temperature, pH, salinity and specific alkalinity was tested in the Gulf of California; PCO2 was also estimated from satellite-obtained sea-surface temperature (SST) by applying the pH-temperature relationship of the underway data to the imagery. The pH and PCO2 values were correlated with the major thermal features of the area studied. At the southern, warmer end of the gulf, estimated PCO2 values are approximately 30 to 40 µatm above an expected surface equilibrium value of ca. 356 µatm. Maximum PCO2 values of about 550 µatm were found in the region of the midriff islands. For the 700-km transect, positive correlations were found between pH, in situ measured temperature (IST) and SST. For the warm zone, there was also a negative correlation between satellite-derived pigment (IogP) and pH and temperature. LogP did not correlate with the other variables in the cold zone. The feasibility of using “ships of opportunity” to monitor pH and surface temperature as part of a world-wide PCO2 monitoring program is discussed. La viabilidad de estimar la presión parcial del bióxido de carbono (PCO;) utilizando mediciones superficiales de pH, temperatura, salinidad y alcalinidad específica se probó en el Golfo de California. El PCO2 también fue calculado utilizando la temperatura superficial del agua de mar obtenida de imágenes de satélite (SST), aplicándoles la relación pH-temperatura de las mediciones continuas, Los valores de pH y PCO2 se correlacionaron con las principales características termales del área estudiada. Los valores estimados de PCO2 para la parte sur, más tibia, del golfo estuvieron aproximadamente entre 30 y 40 µatm más altos que lo esperado en aguas superficiales en equilibrio (cn. 356 µatm). Se encontraron valores máximos de PCO, en la región entre las grandes islas. Para los 700 km de recorrido. se encontró una correlación positiva entre el pH y la temperatura medida in situ y la SST. Para la zona sur, hubo una correlación negativa entre el logaritmo de la concentración de pigmentos fotosintéticos de satélite (IogP) y el pH y la temperatura. El IogP no se correlacionó con las demás variables en la zona fría. Se discute la viabilidad de usar “barcos de oportunidad” para medir la temperatura y el pH como parte de programas de monitoreo del PCO2 a gran escala

Random non-response in multi-character surveys

Multi-characteristics, Random non-response, Relative efficiency, Horvitz-Thompson estimator, Super-population model,