Consecuencias legales derivadas de un accidente laboral

Traballo fin de grao (UDC.DER). Dereito. Curso 2014/201

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Sensitivity of two Iberian lakes to North Atlantic atmospheric circulation modes

15 páginas, 5 tablas, 5 figurasThe North Atlantic Oscillation (NAO) exerts a major influence on the climate of the North Atlantic region. However, other atmospheric circulation modes (ACMs), such as the East Atlantic (EA) and Scandinavian (SCAND) patterns, also play significant roles. The dynamics of lakes on the Iberian Peninsula are greatly controlled by climatic parameters, but their relationship with these various ACMs has not been investigated in detail. In this paper, we analyze monthly meteorological and limnological long-term datasets (1950–2011 and 1992–2011, respectively) from two lakes on the northern and central Iberian Peninsula (Sanabria and Las Madres) to develop an understanding of the seasonal sensitivity of these freshwater systems to the NAO, EA and SCAND circulation modes. The limnological variability within Lake Sanabria is primarily controlled by fluctuations in the seasonal precipitation and wind, and the primary ACMs associated with the winter limnological processes are the NAO and the SCAND modes, whereas only the EA mode appears to weakly influence processes during the summer. However, Lake Las Madres is affected by precipitation, wind and, to a lesser extent, temperature, whereas the ACMs have less influence. Therefore, we aim to show that the lakes of the Iberian Peninsula are sensitive to these ACMs. The results presented here indicate that the lake dynamics, in some cases, have a higher sensitivity to variations in the ACMs than single local meteorological variables. However, certain local features, such as geography, lake morphology and anthropic influences, are crucial to properly record the signals of these ACMs.The PALEONAO (CGL2010-15767) and RAPIDNAO (CGL2013-40608-R) projects from the Spanish Ministry of Economy and Competitiveness and the Q-SECA project (PTDC/ AAG-GLO/4155/2012) from Portuguese Foundation for Science and Technology (FCT) funded the research. Armand Hernández is supported by a BPD fellowship from Portuguese Foundation for Science and Technology (FCT).Peer reviewe

Seasonal influence of the north Atlantic atmospheric circulation patterns over Iberian lakes

A large fraction of the Iberian Peninsula climate is controlled by the North Atlantic Oscillation (NAO) circulation pattern. However, besides the NAO mode, the East Atlantic (EA) and Scandinavian (SCAND) patterns also play significant roles. The conjunction of these atmospheric circulation patterns (ACPs) exerts a strong effect on air temperatures, precipitation and wind patterns over the south-western Europe during the boreal winter, but the effects of these ACPs are not restricted to the winter. Summer conditions do not follow a simple pattern and, particularly in Mediterranean regions, other ACPs besides the NAO may better explain the climate variability. It is well-known that lake dynamics on the Iberian Peninsula is greatly controlled by climatic parameters, but the relationships between these various ACPs and lake dynamics have not yet been investigated in detail. We have analyzed seasonal averaged instrumental meteorological and limnological long term datasets from two lakes in northern and central Iberian Peninsula (Lakes Sanabria and Las Madres) to unveil the seasonal influence of the NAO, EA and SCAND circulation patterns over these freshwater systems. The limnological variability within Lakes Sanabria and Las Madres is primarily controlled by fluctuations in precipitation, wind and to lesser extent, by temperature. The primary ACPs associated with the winter limnological processes on Lake Sanabria are the NAO and the SCAND modes, whereas only the EA mode appears to weakly influence during the summer. In contrast, the ACPs influence on Lake Las Madres is less evident. The results obtained from both lakes indicate that the impact of the ACPs over the lake dynamics can be higher than that owing to single local meteorological variables. However, certain local features, such as the altitude, orientation, relief, lake morphology and anthropic influence, are crucial to properly record the signals of these ACPs.Peer Reviewe

Externado de Medicina Interna - ME212 - 202101

Curso de la carrera de medicina, de carácter teórico-práctico del ciclo 9, en el que los estudiantes presentan una historia clínica con su respectivo plan diagnóstico, terapéutico y de procedimientos en un paciente con una condición médica, a través de la realización de actividades de simulación y metodología activa. El curso del externado de medicina interna busca desarrollar la competencia general de comunicación escrita (nivel 3) y las competencias específicas de práctica clínica-diagnóstico(nivel 3) y profesionalismo-sentido ético y legal y responsabilidad profesional(nivel 3). El externado de medicina al estudiante le permitirá plantear un adecuado tratamiento y plan de trabajo según el diagnóstico de los principales problemas médicos que le servirá en su futura vida profesional

The International Linear Collider: Report to Snowmass 2021

International audienceThe International Linear Collider (ILC) is on the table now as a new global energy-frontier accelerator laboratory taking data in the 2030s. The ILC addresses key questions for our current understanding of particle physics. It is based on a proven accelerator technology. Its experiments will challenge the Standard Model of particle physics and will provide a new window to look beyond it. This document brings the story of the ILC up to date, emphasizing its strong physics motivation, its readiness for construction, and the opportunity it presents to the US and the global particle physics community

The International Linear Collider: Report to Snowmass 2021

The International Linear Collider (ILC) is on the table now as a new global energy-frontier accelerator laboratory taking data in the 2030s. The ILC addresses key questions for our current understanding of particle physics. It is based on a proven accelerator technology. Its experiments will challenge the Standard Model of particle physics and will provide a new window to look beyond it. This document brings the story of the ILC up to date, emphasizing its strong physics motivation, its readiness for construction, and the opportunity it presents to the US and the global particle physics community

The International Linear Collider: Report to Snowmass 2021

International audienceThe International Linear Collider (ILC) is on the table now as a new global energy-frontier accelerator laboratory taking data in the 2030s. The ILC addresses key questions for our current understanding of particle physics. It is based on a proven accelerator technology. Its experiments will challenge the Standard Model of particle physics and will provide a new window to look beyond it. This document brings the story of the ILC up to date, emphasizing its strong physics motivation, its readiness for construction, and the opportunity it presents to the US and the global particle physics community