Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Spatial diversification of Panstrongylus geniculatus (Reduviidae : Triatominae) in Colombia

Presentamos la primera aproximación de diversidad genética, relaciones filogenéticas y estructura poblacional de Panstrongylus geniculatus en Colombia. Compilamos un amplio muestreo para construir una filogenia y estimar la estructura genética de las poblaciones encontradas.We present the first approximation of genetic diversity, phylogenetic relationships and population structure of Panstrongylus geniculatus in Colombia. We compiled an extensive sampling to construct a phylogeny and estimate the genetic structure of the populations found

Evaluación de los niveles de minerales (calcio, fósforo y magnesio) de vacas sometidas a dos protocolos de sincronización de la ovulación, y su correlación con la tasa de preñez y prácticas de manejo en fincas productoras de leche del municipio de Puerres - Nariño

Se seleccionaron 70 vacas mestizas Holstein lactantes de pequeños productores, con tres a cuatro lactancias, más de 120 días postparto y una condición corporal entre 2,5 y 3,5; divididas aleatoriamente en dos grupos (tratamientos) de 35 vacas cada uno. Al T1, se aplicó un dispositivo intravaginal con 1,3 g de P4, más 2 mg de BE, al retiro, 7 días después, se aplicaron 150 g. de PgF2α, más 500 UI eCG y 56 horas después, a la inseminación se aplicaron 100 g de GnRH. Al T2 lo mismo, pero al retiro, se aplicaron 150 g PgF2α y 24 horas después 1 mg de BE. Se inseminaron 56 horas después y el diagnóstico de preñez a 50 días de la IATF; se tomaron muestras de sangre al inicio ésta para determinar los niveles de Ca, P y Mg; los datos se analizaron mediante estadística descriptiva y se correlacionó estos niveles con porcentaje de preñez mediante correlación de Pearson

Oral administration of phytochemicals protects honey bees against cognitive and motor impairments induced by the insecticide fipronil.

Pollution produced by exposure to pesticides is a major concern for food security because the negative impacts on pollinators. Fipronil, an insecticide broadly used around the globe has been associated with the ongoing decline of bees. With a characteristic neuroactive toxicodynamic, fipronil leads to cognitive and motor impairments at sublethal dosages. Despite of regional bans, multilevel strategies are necessary for the protection of pollinators. Recent evidence suggests that specific nutrients in the diets of bees may induce protection against insecticides. Here, we evaluated whether the administration of three phytochemicals, namely rutin, kaempferol and p-coumaric acid provide protection to the Africanized honey bee Apis mellifera against oral administration of realistic dosages of fipronil. We tested the potential impairment produced by fipronil and the protection induced by the phytochemicals in learning, 24h memory, sucrose sensitivity and motor control. We found that the administration of fipronil induced a concentration-dependent impairment in learning and motor control, but not 24h memory or sucrose sensitivity across a 24h window. We also found that the administration of rutin, p-coumaric acid, kaempferol and the mixture was innocuous and generally offered protection against the impairments induced by fipronil. Overall, our results indicate that bees can be prophylactically protected against insecticides via nutrition, providing an alternative to the ongoing conflict between the use of insecticides and the decline of pollinators. As the studied phytochemicals are broadly present in nectar and pollen, our results suggest that the nutritional composition, and not only its production, should be considered when implementing strategies of conservation via gardens and co-cropping

Portraying the gut bacterial communities and blood feeding sources of triatomine bugs (Hemiptera : Reduviidae), vectors of Chagas disease

Se realizó una primera caracterización del bacterioma intestinal de triatominos capturados en condiciones naturales en Colombia dada la falta de información sobre este bacterioma y los cambios que puede tener cuando Trypanosoma cruzi está presente o la fuente alimenticia del insecto cambiaWe provide a first characterization of the gut bacteriome of triatomines captured in natural conditions in Colombia given the lack of information about this bacteriome and the possible changes it can undergo when Trypanosoma cruzi is present or the feeding source of the triatomine varie

Planear para transformar: Aproximación a los resultados de la ejecución del Plan de Desarrollo Territorial ‘El Tolima nos une 2020 - 2023

El presente documento se construyó a partir de un diseño metodológico mixto (cualitativo y cuantitativo), y comprometió la revisión de un importante volumen de fuentes documentales, institucionales y no institucionales, así como la utilización de técnicas de análisis socioespacial, que permitieron establecer distintos tipos de hallazgos en el orden de la planeación, los criterios de la priorización de las acciones del gobierno, la distribución presupuestal y, finalmente, la solución de problemas. Acudimos a distintos niveles o capas de análisis, que van de lo superficial - el seguimiento-, a una evaluación más profunda que parte del contraste, por un lado, de la ejecución del gasto a nivel territorial, el cual se analiza a partir de tres criterios: gastos per cápita, gastos por pilar del PDT, y gastos por sector; y por el otro, de los resultados del proceso de implementación general respecto de los propósitos del Plan. Esta es nuestra apuesta metodológica, todavía en construcción: contrastar lo que se ha obtenido hasta el momento en el proceso de implementación con la “teoría del cambio” contenida en la visión del PDT. Lo anterior, tiene tres ventajas cruciales. Primero, permite considerar el documento en sus propios términos, y no en los de un estándar idealizado de lo que debería hacerse. Segundo, presta atención a dimensiones que de otra manera podrían pasar desapercibidas (por ejemplo, la convergencia y coordinación entre los diagnósticos, la planeación estratégica y financiera en la implemen- tación). Tercero, podría contribuir a la comprensión de las implicaciones de los problemas relacionados con la implementación de programas, proyectos y metas contenidos en el Plan. El presente documento se divide en cinco secciones: la primera parte se dedica al seguimiento del cumplimiento de las metas físicas y financieras del PDT por pilar, la segunda, a la distribución presupuestal por provincias y municipios; la tercera sección contiene el análisis sectorial por temas, teniendo en cuenta actores/fuentes de contraste; la cuarta expone las conclusiones del documento y la quinta, finalmente, está dedicada a las recomendaciones por parte del CERE.El Plan de Desarrollo Territorial (PDT) “Tolima nos Une” 2020-2023, de la Gobernación del departamento del Tolima, es el instrumento que guía y articula las distintas estrategias, políticas y metas que tienen por objetivo promover el desarrollo económico, social, cultural y medioambiental del departamento, de forma democrática e incluyente, respetando y promoviendo el cumplimiento de los derechos humanos. Por su parte, el documento “Análisis de seguimiento Plan de Desarrollo Territorial “Tolima nos Une” 2020 - 2023”, que acá se resume y amplía - construido por el Centro de Estudios Regionales de la Universidad del Tolima (CERE), en alianza con el Consejo Territorial de Planeación (CTP)-, tiene como propósito evaluar el ritmo de la implementación del principal instrumento de planeación del departamento en la vigencia 2021, a fin de establecer las fortalezas y debilidades del ejercicio, y las oportunidades de mejora tendientes a la solución de los problemas más sentidos por las y los tolimenses1ª. Ed

Genetic diversification of Panstrongylus geniculatus (Reduviidae: Triatominae) in northern South America

Triatomines are the vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. Although Triatoma and Rhodnius are the most-studied vector genera, other triatomines, such as Panstrongylus, also transmit T. cruzi, creating new epidemiological scenarios. Panstrongylus has at least 13 reported species but there is limited information about its intraspecific genetic variation and patterns of diversification. Here, we begin to fill this gap by studying populations of P. geniculatus from Colombia and Venezuela and including other epidemiologically important species from the region. We examined the pattern of diversification of P. geniculatus in Colombia using mitochondrial and nuclear ribosomal data. Genetic diversity and differentiation were calculated within and among populations of P. geniculatus. Moreover, we constructed maximum likelihood and Bayesian inference phylogenies and haplotype networks using P. geniculatus and other species from the genus (P. megistus, P. lignarius, P. lutzi, P. tupynambai, P. chinai, P. rufotuberculatus and P. howardi). Using a coalescence framework, we also dated the P. geniculatus lineages. The total evidence tree showed that P. geniculatus is a monophyletic species, with four clades that are concordant with its geographic distribution and are partly explained by the Andes orogeny. However, other factors, including anthropogenic and eco-epidemiological effects must be investigated to explain the existence of recent geographic P. geniculatus lineages. The epidemiological dynamics in structured vector populations, such as those found here, warrant further investigation. Extending our knowledge of P. geniculatus is necessary for the accurate development of effective strategies for the control of Chagas disease vectors. © 2019 Caicedo-Garzón et al

Genetic diversification of Panstrongylus geniculatus (Reduviidae: Triatominae) in northern South America

"Triatomines are the vectors of Trypanosoma cruzi, the etiological agent of Chagas disease. Although Triatoma and Rhodnius are the most-studied vector genera, other triatomines, such as Panstrongylus, also transmit T. cruzi, creating new epidemiological scenarios. Panstrongylus has at least 13 reported species but there is limited information about its intraspecific genetic variation and patterns of diversification. Here, we begin to fill this gap by studying populations of P. geniculatus from Colombia and Venezuela and including other epidemiologically important species from the region. We examined the pattern of diversification of P. geniculatus in Colombia using mitochondrial and nuclear ribosomal data. Genetic diversity and differentiation were calculated within and among populations of P. geniculatus. Moreover, we constructed maximum likelihood and Bayesian inference phylogenies and haplotype networks using P. geniculatus and other species from the genus (P. megistus, P. lignarius, P. lutzi, P. tupynambai, P. chinai, P. rufotuberculatus and P. howardi). Using a coalescence framework, we also dated the P. geniculatus lineages. The total evidence tree showed that P. geniculatus is a monophyletic species, with four clades that are concordant with its geographic distribution and are partly explained by the Andes orogeny. However, other factors, including anthropogenic and eco-epidemiological effects must be investigated to explain the existence of recent geographic P. geniculatus lineages. The epidemiological dynamics in structured vector populations, such as those found here, warrant further investigation. Extending our knowledge of P. geniculatus is necessary for the accurate development of effective strategies for the control of Chagas disease vectors. © 2019 Caicedo-Garzón et al.