(el caso del Macizo de Caroig)

Se estudian los regímenes selvícolas más adecuados para la utilización energética y maderable de las masas de pino carrasco (Pinus halepensis) del Macizo del Caroig, partiendo de los datos de un inventario LIDAR y de una revision bibliográfica amplia sobre la especie. Se proporcionan datos sobre los sistemas de aprovechamiento más adecuados, sus rendimientos y costes estimados para los distintos tipos de masas forestales inventariadas, se estudia la influencia de esos tratamientos sobre el riesgo de incendios forestales y se recomiendan prácticas para reducir su incidencia y gravedad a través de selvicultura preventiva e infraestructuras de defensa optimizadas mediante algoritmos basados en lógica fuzzy. Se proporcionan también datos sobre transformación energética y características de los combustibles

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

Barreras socioculturales en el manejo de la diabetes en hombres de origen mexicano: revisión sistemática

Introducción: La diabetes mellitus tipo 2 es considerada como la pandemia del siglo XXI por sus tasas de mortalidad y su crecimiento en los próximos años. Metodología: se realizó una revisión sistemática en las bases de datos como MEDICLATINA (vía EBSCO), PUBMED, ELSEVIER, SPRINGER, ANNUAL REVIEW, SCOPUS, SAGE PREMIER, OVID, REDALYC SCIELO y EMERALD, seleccionando los artículos con temáticas de diferencias de género o de hombres con diabetes mellitus tipo 2 y el señalamiento de barreras socioculturales en el manejo de la diabetes entre los años de 2000 al 2017. Resultados: surgieron diferentes barreras tanto sociales y culturales que pudieran afectar las actividades de autocuidado y el control glucémico. Conclusiones: Es importante realizar más investigación para determinar cómo pueden afectar estas barreras en el manejo de la enfermedad, el desarrollo de complicaciones y la muerte prematura

Barreras socioculturales en el manejo de la diabetes en hombres de origen mexicano: revisión sistemática

Introducción: La diabetes mellitus tipo 2 es considerada como la pandemia del siglo XXI por sus tasas de mortalidad y su crecimiento en los próximos años. Metodología: se realizó una revisión sistemática en las bases de datos como MEDICLATINA (vía EBSCO), PUBMED, ELSEVIER, SPRINGER, ANNUAL REVIEW, SCOPUS, SAGE PREMIER, OVID, REDALYC SCIELO y EMERALD, seleccionando los artículos con temáticas de diferencias de género o de hombres con diabetes mellitus tipo 2 y el señalamiento de barreras socioculturales en el manejo de la diabetes entre los años de 2000 al 2017. Resultados: surgieron diferentes barreras tanto sociales y culturales que pudieran afectar las actividades de autocuidado y el control glucémico. Conclusiones: Es importante realizar más investigación para determinar cómo pueden afectar estas barreras en el manejo de la enfermedad, el desarrollo de complicaciones y la muerte prematura. Palabras clave: Diabetes mellitus tipo 2, autocuidado, hombres, revisión sistemática

Augmented renal clearance. An unnoticed relevant event

Altres ajuts: Blood Purification Therapies Collaboration Group; Catalan Society of Intensive Care Medicine.Augmented renal clearance (ARC) is a phenomenon that can lead to a therapeutic failure of those drugs of renal clearance. The purpose of the study was to ascertain the prevalence of ARC in the critically ill patient, to study the glomerular filtration rate (GFR) throughout the follow-up and analyze the concordance between the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimation formula and measured GFR. Observational, prospective, multicenter study. ARC was defined as a creatinine clearance greater than 130 ml/min/1.73 m. Eighteen hospitals were recruited. GFR measurements carried out twice weekly during a 2-month follow-up period. A total of 561 patients were included. ARC was found to have a non-negligible prevalence of 30%. More even, up to 10.7% already had ARC at intensive care unit (ICU) admission. No specific pattern of GFR was found during the follow-up. Patients in the ARC group were younger 56.5 (53.5-58.5) versus 66 (63.5-68.5) years than in the non-ARC group, p < 0.001. ICU mortality was lower in the ARC group, 6.9% versus 14.5%, p = 0.003. There was no concordance between the estimation of GFR by the CKD-EPI formula and GFR calculated from the 4-h urine. ARC is found in up to 30% of ICU patients, so renal removal drugs could be under dosed by up to 30%. And ARC is already detected on admission in 10%. It is a dynamic phenomenon without an established pattern that usually occurs in younger patients that can last for several weeks. And the CKD-EPI formula does not work to estimate the real creatinine clearance of these patients