Key Factors Associated With Pulmonary Sequelae in the Follow-Up of Critically Ill COVID-19 Patients

Introduction: Critical COVID-19 survivors have a high risk of respiratory sequelae. Therefore, we aimed to identify key factors associated with altered lung function and CT scan abnormalities at a follow-up visit in a cohort of critical COVID-19 survivors. Methods: Multicenter ambispective observational study in 52 Spanish intensive care units. Up to 1327 PCR-confirmed critical COVID-19 patients had sociodemographic, anthropometric, comorbidity and lifestyle characteristics collected at hospital admission; clinical and biological parameters throughout hospital stay; and, lung function and CT scan at a follow-up visit. Results: The median [p25–p75] time from discharge to follow-up was 3.57 [2.77–4.92] months. Median age was 60 [53–67] years, 27.8% women. The mean (SD) percentage of predicted diffusing lung capacity for carbon monoxide (DLCO) at follow-up was 72.02 (18.33)% predicted, with 66% of patients having DLCO < 80% and 24% having DLCO < 60%. CT scan showed persistent pulmonary infiltrates, fibrotic lesions, and emphysema in 33%, 25% and 6% of patients, respectively. Key variables associated with DLCO < 60% were chronic lung disease (CLD) (OR: 1.86 (1.18–2.92)), duration of invasive mechanical ventilation (IMV) (OR: 1.56 (1.37–1.77)), age (OR [per-1-SD] (95%CI): 1.39 (1.18–1.63)), urea (OR: 1.16 (0.97–1.39)) and estimated glomerular filtration rate at ICU admission (OR: 0.88 (0.73–1.06)). Bacterial pneumonia (1.62 (1.11–2.35)) and duration of ventilation (NIMV (1.23 (1.06–1.42), IMV (1.21 (1.01–1.45)) and prone positioning (1.17 (0.98–1.39)) were associated with fibrotic lesions. Conclusion: Age and CLD, reflecting patients’ baseline vulnerability, and markers of COVID-19 severity, such as duration of IMV and renal failure, were key factors associated with impaired DLCO and CT abnormalities

Terminología de los procesos de transformación. Extrusión

Se presenta y describe terminología usada en los procesos de transformación en especial extrusión

Creep and morphology comparison of gradient and IPN systems

Due to its performance, the importance of interpenetrating polymer networks (IPN's) has increased in recent years. If a composition gradient is included in the IPN, the expected gradient in properties expands the field of applications of multicomponent polymer systems. In this work, IPN's with and without gradient composition were prepared by photopolymerization using styrene and butyl acrylate as monomers one and two, respectively. Uniaxial creep measurements showed the superiority of the gradient material. SEM studies at different depths in the samples, allowed to observe domain sizes in the dispersed phase, and how the morphology gradient vary within a sample

Recomendaciones para el manejo de los pacientes críticos con COVID-19 en las Unidades de Cuidados Intensivos.

The COVID-19 pandemic has led to the admission of a high number of patients to the ICU, generally due to severe respiratory failure. Since the appearance of the first cases of SARS-CoV-2 infection, at the end of 2019, in China, a huge number of treatment recommendations for this entity have been published, not always supported by sufficient scientific evidence or with methodological rigor necessary. Thanks to the efforts of different groups of researchers, we currently have the results of clinical trials, and other types of studies, of higher quality. We consider it necessary to create a document that includes recommendations that collect this evidence regarding the diagnosis and treatment of COVID-19, but also aspects that other guidelines have not considered and that we consider essential in the management of critical patients with COVID-19. For this, a drafting committee has been created, made up of members of the SEMICYUC Working Groups more directly related to different specific aspects of the management of these patients

La investigación universitaria y sus contribuciones en Mesoamérica

La Universidad Autónoma de Chiapas a través de su Proyecto Académico 2014-2018, reafirma su compromiso con el desarrollo de nuestra región, al establecer líneas de desarrollo de nuestra región, al establecer líneas de desarrollo institucional, donde la vinculación de la investigación ocupa un lugar preponderante; en este sentido, a partir de 2015, junto con la comunidad académica internacional, se unió a la Agenda 2030 para el Desarrollo sostenible de la ONU y priorizó los 17 Objetivos de Desarrollo Sostenible (ODS) y sus 169 metas, con la finalidad de dar soluciona los grandes desafíos sociales, económicos y medioambientales que enfrenta la sociedad. Este libro es la recopilación de trabajos realizados por académicos de diversas Instituciones de Educación Superior y Centros de Investigación, de manera multidisciplinaria, interinstitucional e internacional, los cuales han permitido compartir intereses en diversas líneas de generación y aplicación del conocimiento

La investigación universitaria y sus contribuciones en Mesoamérica

La Universidad Autónoma de Chiapas a través de su Proyecto Académico 2014-2018, reafirma su compromiso con el desarrollo de nuestra región, al establecer líneas de desarrollo de nuestra región, al establecer líneas de desarrollo institucional, donde la vinculación de la investigación ocupa un lugar preponderante; en este sentido, a partir de 2015, junto con la comunidad académica internacional, se unió a la Agenda 2030 para el Desarrollo sostenible de la ONU y priorizó los 17 Objetivos de Desarrollo Sostenible (ODS) y sus 169 metas, con la finalidad de dar soluciona los grandes desafíos sociales, económicos y medioambientales que enfrenta la sociedad. Este libro es la recopilación de trabajos realizados por académicos de diversas Instituciones de Educación Superior y Centros de Investigación, de manera multidisciplinaria, interinstitucional e internacional, los cuales han permitido compartir intereses en diversas líneas de generación y aplicación del conocimiento

Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial.

BACKGROUND: Corticosteroids have been used to treat head injuries for more than 30 years. In 1997, findings of a systematic review suggested that these drugs reduce risk of death by 1-2%. The CRASH trial--a multicentre international collaboration--aimed to confirm or refute such an effect by recruiting 20000 patients. In May, 2004, the data monitoring committee disclosed the unmasked results to the steering committee, which stopped recruitment. METHODS: 10008 adults with head injury and a Glasgow coma score (GCS) of 14 or less within 8 h of injury were randomly allocated 48 h infusion of corticosteroids (methylprednisolone) or placebo. Primary outcomes were death within 2 weeks of injury and death or disability at 6 months. Prespecified subgroup analyses were based on injury severity (GCS) at randomisation and on time from injury to randomisation. Analysis was by intention to treat. Effects on outcomes within 2 weeks of randomisation are presented in this report. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN74459797. FINDINGS: Compared with placebo, the risk of death from all causes within 2 weeks was higher in the group allocated corticosteroids (1052 [21.1%] vs 893 [17.9%] deaths; relative risk 1.18 [95% CI 1.09-1.27]; p=0.0001). The relative increase in deaths due to corticosteroids did not differ by injury severity (p=0.22) or time since injury (p=0.05). INTERPRETATION: Our results show there is no reduction in mortality with methylprednisolone in the 2 weeks after head injury. The cause of the rise in risk of death within 2 weeks is unclear