Effects of the COVID-19 Pandemic on Incidence and Epidemiology of Catheter-Related Bacteremia, Spain

We compared hospital-acquired catheter-related bacte-remia (CRB) episodes diagnosed at acute care hospitals in Catalonia, Spain, during the COVID-19 pandemic in 2020 with those detected during 2007-2019. We com-pared the annual observed and predicted CRB rates by using the negative binomial regression model and calcu-lated stratified annual root mean squared errors. A total of 10,030 episodes were diagnosed during 2007-2020. During 2020, the observed CRB incidence rate was 0.29/103 patient-days, whereas the predicted CRB rate was 0.14/103 patient-days. The root mean squared er-ror was 0.153. Thus, a substantial increase in hospital-acquired CRB cases was observed during the COVID-19 pandemic in 2020 compared with the rate predicted from 2007-2019. The incidence rate was expected to increase by 1.07 (95% CI 1-1.15) for every 1,000 COVID-19-re-lated hospital admissions. We recommend maintaining all CRB prevention efforts regardless of the coexistence of other challenges, such as the COVID-19 pandemic

Trends in the epidemiology of catheter-related bloodstream infections; towards a paradigm shift, Spain, 2007 to 2019

Altres ajuts: Departament de Salut. Generalitat de Catalunya ("Pla estratègic de recerca i innovació en salut (PERIS) 2019-2021"); Ministerio de Asuntos Económicos y Transformación Digital; Red Española de Investigación en Patología Infecciosa (REIPI).Background: Catheter-related bloodstream infections (CRBSI) are frequent healthcare-associated infections and an important cause of death. Aim: To analyse changes in CRBSI epidemiology observed by the Infection Control Catalan Programme (VINCat). Methods: A cohort study including all hospital-acquired CRBSI episodes diagnosed at 55 hospitals (2007-2019) in Catalonia, Spain, was prospectively conducted. CRBSI incidence rates were adjusted per 1,000patientdays. To assess the CRBSI rate trend per year, negative binomial models were used, with the number of events as the dependent variable, and the year as the main independent variable. From each model, the annual rate of CRBSI diagnosed per 1,000patientdays and the incidence rate ratio (IRR) with its 95% confidence intervals (CI) were reported. Results: During the study, 9,290 CRBSI episodes were diagnosed (mean annual incidence rate:0.20episodes/1,000patientdays). Patients' median age was 64.1years; 36.6% (3,403/9,290) were female. In total, 73.7% (n=6,845) of CRBSI occurred in non-intensive care unit (ICU) wards, 62.7% (n=5,822) were related to central venous catheter (CVC), 24.1% (n=2,236) to peripheral venous catheters (PVC) and 13.3% (n=1,232) to peripherally-inserted central venous catheters (PICVC). Incidence rate fell over the study period (IRR:0.94;95%CI:0.93-0.96), especially in the ICU (IRR:0.88;95%CI:0.87-0.89). As a whole, while episodes of CVC CRBSI fell significantly (IRR:0.88;95%CI:0.87-0.91), peripherally-inserted catheter CRBSI (PVC and PICVC) rose, especially in medical wards (IRR PICVC:1.08;95%CI:1.05-1.11; IRR PVC: 1.03; 95% 1.00-1.05). Conclusions: Over the study, CRBSIs associated with CVC and diagnosed in ICUs decreased while episodes in conventional wards involving peripherally-inserted catheters increased. Hospitals should implement preventive measures in conventional wards

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Transport i emmagatzematge de les àmfores en l'antiguitat:l'aportació de les ciències dels materials

[spa]Las ánforas son ejemplos claros de cerámicas utilitarias que requieren de unas características técnicas necesarias para cumplir su funcionalidad: servir de envase de almacenamiento y transporte. En este trabajo se propone el estudio del comportamiento funcional de estos envases a través de la evaluación de las propiedades mecánicas de resistencia y tenacidad a la fractura. Propiedades mecánicas, ámforas ibéricas, ámforas romanas, tecnología, funcionalidad.[eng]Amphorae represent clear examples of utilitarian pottery. Their functionality as transport and storage vessels require specific performance characteristics, specially related to functional properties. This paper focuses on the study of the mechanical behaviour through the evaluation of strength and fracture toughness. Mechanical properties, Iberian amphorae, Roman amphorae, technology, functionality

Involvement of citizenship in hazardous waste management and in use of recycling centres in Madrid city (Spain)

4 pages, 1 figure, 1 table.-- En: 1st Spanish National Conference on Advances in Materials Recycling and Eco – Energy Madrid, 12-13 November 2009.-- Editors: F. A. López, F. Puertas, F. J. Alguacil and A. Guerrero.The present study analyses the hazardous waste management by citizens via Fixed Recycling (FRC) and Mobile Centres (MRC) with the aim of suggesting improvements of both services. In addition, the effectiveness of a campaign for environmental education developed by the Madrid council was assessed. A questionnaire was carried out on a sample of 5644 inhabitants of four different districts of Madrid City. Data were treated quantitatively using SPSS 17.0 and categorized using content analysis. It was found that the campaign effectively promoted the existence and use of Recycling Centres and was able to identify possible amendments to improve future campaigns.We acknowledge main support of Environmental Education Group in last years.Peer reviewe

Assessment of urban air pollution related to potential nanoparticle emission from photocatalytic pavements

@ 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/The main objective was to evaluate whether wearing and weathering of nanofunctionalized photocatalytic pavement in real urban environment can lead to undesirable emission of potentially toxic nanoparticle aerosols in urban air. The photocatalytic material was thoroughly tested before its application for conformity criteria in terms of photocatalytic effectiveness, intrinsic performance and undesired secondary effects, and then applied on a pilot scale in downtown Madrid. The aerosol monitoring on the pilot street before the coating applications as well as on the neighbouring streets during 10 months was used as a benchmark for evaluation of spatial and temporal variations. Analysis of the experimental data did not reveal any statistically significant variations in the aerosol concentrations on the pilot street in comparison with the benchmark. The concentration of Ti-containing particles was assessed by aerosol sampling and yielded values below 10 cm−3 that is more than three orders of magnitude below the toxicological limits. A theoretical model was developed to assess the upper bound of nanoparticle aerosol concentration in air. These findings indicated that photocatalytic pavement materials, which comply with conformity criteria under laboratory tests, can have low impact on the particulate contamination of urban air.All of the sources of funding for the work described in this publication are acknowledged below: Program LIFE+ of the European Union, project LIFE PHOTOSCALING, LIFE 13/ENV/ES/001221, http://www.life-photoscaling.eu/.Peer reviewe

Transport i emmagatzematge de les àmfores en l'antiguitat:l'aportació de les ciències dels materials

[spa]Las ánforas son ejemplos claros de cerámicas utilitarias que requieren de unas características técnicas necesarias para cumplir su funcionalidad: servir de envase de almacenamiento y transporte. En este trabajo se propone el estudio del comportamiento funcional de estos envases a través de la evaluación de las propiedades mecánicas de resistencia y tenacidad a la fractura. Propiedades mecánicas, ámforas ibéricas, ámforas romanas, tecnología, funcionalidad.[eng]Amphorae represent clear examples of utilitarian pottery. Their functionality as transport and storage vessels require specific performance characteristics, specially related to functional properties. This paper focuses on the study of the mechanical behaviour through the evaluation of strength and fracture toughness. Mechanical properties, Iberian amphorae, Roman amphorae, technology, functionality

Antioxidant CR-6 protects against reperfusion injury after a transient episode of focal brain ischemia in rats

Oxidative and nitrosative stress are targets for intervention after ischemia/reperfusion. The aim of this study was to explore the effect of CR-6, a vitamin-E analogue that is antioxidant and scavenger of nitrogen-reactive species. Sprague–Dawley rats had the middle cerebral artery (MCA) occluded either for 90 mins or permanently. Cortical perfusion was continuously monitored by laser–Doppler flowmetry. CR-6 (100 mg/kg) was administered orally either at 2 and 8 h after MCA occlusion, or at 2 h only. Infarct volume, neurological deficit, and signs of reperfusion injury were evaluated. CR-6 was detected in plasma and brain by HPLC. CR-6 reduced glutathione consumption in the ischemic brain and superoxide generation in the isolated MCA. CR-6 decreased infarct volume and attenuated the neurological deficit at 1 and 7 days after ischemia/reperfusion, but not after permanent ischemia. Immediately after reperfusion, cortical blood flow values returned to their baseline (±20%) in several animals, whereas others showed hyper-perfusion (>20% of baseline). Reactive hyperemia was associated with adverse events such as increased cortical BBB leakage, edema, protein nitrotyrosination, COX-2 expression, and neutrophil accumulation; and with a poorer outcome, and CR-6 attenuated these effects. In conclusion, oral CR-6 administration after transient ischemia protects the brain from reperfusion injury

Decreased mortality among patients with catheter-related bloodstream infections at catalan hospitals (2010-2019)

Background: The incidence of catheter-related bloodstream infections (CRBSI) has fallen over the last decade, especially in intensive care units (ICUs). Aim: to assess the existence of concomitant trends in outcomes and to analyse the current risk factors for mortality. Methods: A multicentre retrospective cohort study was conducted at 24 Catalan hospitals participating in the Surveillance of healthcare associated infections in Catalonia (VINCat). All hospital-acquired CRBSI episodes diagnosed from January 2010 to December 2019 were included. A common protocol including epidemiological, clinical and microbiological data was prospectively completed. Mortality at days after bacteraemia onset was analysed using the Cox regression model. Findings: Over the study period, 4,795 episodes of CRBSI were diagnosed. Among them, 75% were acquired in conventional wards and central venous catheters were the most frequently involved (61%). The 30-day mortality rate was 13.8%, presenting a significant downward trend over the study period: from 17.9% in 2010 to 10.6% in 2019 (HR 0.95 [0.92-0.98]). The multivariate analysis identified age (HR 1.03 83 [1.02-1.04]), femoral catheter (HR 1.78 [1.33-2.38]), medical ward acquisition (HR 2.07 [1.62-2.65] and ICU acquisition (HR 3.45 [2.7-4.41]), S. aureus (HR 1.59 [1.27-1.99]) and Candida sp. (HR 2.19 [1.64-2.94]) as risk factors for mortality while the mortality rate associated with episodes originating in peripheral catheters was significantly lower (HR 0.69 [0.54-0.88]). Conclusions: Mortality associated with CRBSI has fallen in recent years but remains high. Intervention programs should focus especially on ICUs and medical wards, where incidence and mortality rates are highest