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

Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Aerogeles compuestos multicapa a partir de biopolimeros y arcilla

En este trabajo se han desarrollado diferentes aerogeles con baja flamabilidad basados en la combinación de biopolimeros renovables y montmorillonta (MMT). Los compuestos fueron hechos usando agua como solvente y siguiendo un proceso de liofilización. Los compuestos se formaron agregando capas de los precursores de gel creados previamente a un aerogel basado en alcohol polivinílico / MMT. Para hacer los aerogeles se siguieron dos procesos sencillos en uno o dos etapas, comparando las propiedades resultantes de los diferentes sistemas de procesamiento. En términos de adhesión entre capas, ésta fue similar e independiente del proceso seguido. Con el objetivo de mejorar las propiedades mecánicas, se indujo la reticulación química de la base con alcohol polivinílico antes de la liofilización, sumergiendo el material en una solución de borato de sodio. Se encontró que la respuesta mecánica bajo compresión mejoró con respecto a los sistemas no reticulados. Se fabricó un compuesto altamente retardante de la llama mediante la superposicion de una capa de aerogel con alginato/MMT como el sistema más prometedor de protección a fuego en la capa externaAuthors acknowledge the financial support to this work given by the Ministerio de Economía y Competitividad for the MAT2016-80045R (AEI/FEDER, UE) project. Also L.G. De la Cruz thanks to CONACyT for the grant (num. 729201)receivedPostprint (published version

Estudio del biodeterioro en resinas alquídicas usadas como aglutinante en pinturas modernas mediante espectroscopía FTIR y pirólisis-cromatografía de gases-espectrometría de masas (Py-GC-MS)

Evaluation of the alteration produced by microbiological attack on alkyd resins has been carried out by FTIR spectroscopy and Pyrolysis-Gas Chromatography/Mass Spectrometry (Py-GC/MS). The latter included the online derivatisation of alkyd resins using hexamethyldisilazane during pyrolysis. Specimens consisting of thin films of resins formed on glass slides were used. Analyses performed on the specimens in which different genera of bacteria and fungi were inoculated and allowed to grow, indicate that the attack of microorganisms encourages the scissioning of the polymeric resins and the appearance of short-chain fatty acids. IR bands ascribed to carboxylic acids appearing in samples from inoculated specimens, as well as an increase in the content of short-chain fatty acids detected by Py-GC/MS from specimens inoculated with fungi, confirm these results and suggest that the effects of metabolic processes in these microorganisms are more significant than those of bacteria.Se ha llevado a cabo una evaluación mediante espectroscopía FTIR y pirólisis-cromatografía de gasesespectrometría de masas (Py-GC-MS) de las alteraciones causadas en resinas alquídicas comericales por microorganismos. Este ultimo método incluye la derivatización ¿on line¿ durante la pirólisis de las resinas alquídicas usando hexametildisilazano. A tal fin se han usado probetas constituidas por películas finas de resina aplicadas sobre vidrios portaobjetos. Los análisis efectuados sobre una serie de probetas inoculadas con diversos géneros de bacterias y hongos y posteriormente cultivadas en condiciones óptimas ponen de manifiesto que el ataque de microorganismos provoca la rotura de las cadenas poliméricas y la aparición de ácidos grasos de cadena corta. Una serie de bandas de absorción IR asociadas a grupos carboxílicos que aparecían en las muestras inoculadas con hongos así como el incremento del contenido de ácidos grasos de cadena corta detectado mediante Py-GC-MS confirman estos resultado y sugieren que los procesos metabólicos en estos microorganismos son más significativos que los asociados a bacterias.Domenech Carbo, MT.; Bitossi, G.; De La Cruz Cañizares, J.; Bolivar Galiano, F.; López Miras, MDM.; Romero Noguera, J.; Martin Sanchez, I.... (2008). Study on the biodeterioration of alkyd ah resin used as a binding medium for modern paintings by pyrolysis-gas chromatography-mass spectrometry and ftir spectroscopy. Arché. (3):191-196. http://hdl.handle.net/10251/31842191196

Soft Skills y empleabilidad: La capacidad de análisis y la comunicación escrita como herramientas clave en la empleabilidad de los estudiantes de Turismo

El objetivo de este proyecto es fomentar la empleabilidad de los estudiantes de Turismo mediante la mejora de la capacidad de comunicación escrita. Se plantea la realización de talleres "learning by doing" dirigidos a alumnos de Grado y de Posgrado

Risk factors and outcomes of organ-space surgical site infections after elective colon and rectal surgery

Abstract Background Organ-space surgical site infections (SSI) are the most serious and costly infections after colorectal surgery. Most previous studies of risk factors for SSI have analysed colon and rectal procedures together. The aim of the study was to determine whether colon and rectal procedures have different risk factors and outcomes for organ-space SSI. Methods A multicentre observational prospective cohort study of adults undergoing elective colon and rectal procedures at 10 Spanish hospitals from 2011 to 2014. Patients were followed up until 30 days post-surgery. Surgical site infection was defined according to the Centers for Disease Control and Prevention criteria. Oral antibiotic prophylaxis (OAP) was considered as the administration of oral antibiotics the day before surgery combined with systemic intravenous antibiotic prophylaxis. Results Of 3,701 patients, 2,518 (68%) underwent colon surgery and 1,183 (32%) rectal surgery. In colon surgery, the overall SSI rate was 16.4% and the organ-space SSI rate was 7.9%, while in rectal surgery the rates were 21.6% and 11.5% respectively (p < 0.001). Independent risk factors for organ-space SSI in colon surgery were male sex (Odds ratio -OR-: 1.57, 95% CI: 1.14–2.15) and ostomy creation (OR: 2.65, 95% CI: 1.8–3.92) while laparoscopy (OR: 0.5, 95% CI: 0.38–0.69) and OAP combined with intravenous antibiotic prophylaxis (OR: 0.7, 95% CI: 0.51–0.97) were protective factors. In rectal surgery, independent risk factors for organ-space SSI were male sex (OR: 2.11, 95% CI: 1.34–3.31) and longer surgery (OR: 1.49, 95% CI: 1.03–2.15), whereas OAP with intravenous antibiotic prophylaxis (OR: 0.49, 95% CI: 0.32–0.73) was a protective factor. Among patients with organ-space SSI, we found a significant difference in the overall 30-day mortality, being higher in colon surgery than in rectal surgery (11.5% vs 5.1%, p = 0.04). Conclusions Organ-space SSI in colon and rectal surgery has some differences in terms of incidence, risk factors and outcomes. These differences could be considered for surveillance purposes and for the implementation of preventive strategies. Administration of OAP would be an important measure to reduce the OS-SSI rate in both colon and rectal surgeries

Geology alive. GeoBizirik.org

Geology is the science that studies the Earth, its composition, structure and origin in addition to past and present phenomena that leave their mark on rocks. So why does society need geologists? Some of the main reasons are listed below: - Geologists compile and interpret information about the earth’s surface and subsoil, which allows us to establish the planet’s past history, any foreseeable changes and its relationship with the rest of the solar system. - Society needs natural resources (metals, non-metals, water and fossil fuels) to survive. The work of geologists is therefore a key part of finding new deposits and establishing a guide for exploring and managing resources in an environmentally-friendly way. - The creation of geological maps allows us to identify potential risk areas and survey different land uses; in other words, they make an essential contribution to land planning and proposing sustainable development strategies in a region. - Learning about Geology and the proper use of geological information contributes to saving lives and reducing financial loss caused by natural catastrophes such as earthquakes, tsunamis, volcanic eruptions, flooding and landslides, while also helping to develop construction projects, public works, etc. Through the proposed activities we aim to explain some of the basic elements of the different specialities within the field of Geological Sciences. In order to do this, four sessions have been organised that will allow for a quick insight into the fields of Palaeontology, Mineralogy, Petrology and Tectonics

Geologia bizirik. GeoBizirik.org

Geologia Lurra aztertzen duen zientzia da: lurraren osaera, egitura eta jatorria, eta bai arroketan aztarnak utzi dituzten iraganeko edo gaur egungo gertaerak ere. Baina, zergatik du gizarteak geologoen beharra? Hona hemen zenbait arrazoi: - Geologoek lurrazalari eta lurpeari buruzko informazioa bildu, eta interpretatu egiten dute. Informazio horrek guztiak ahalbidetzen du planetaren iraganeko historia, Lurrean aurreikus daitezkeen aldaketak eta gure planetak Eguzki-sistemarekin duen harremana finkatzea. - Gizarteak beharrezkoak ditu baliabide naturalak (metalikoak, ez-metalikoak, ura eta erregai fosilak). Geologoen parte-hartzea erabakigarria da hobi berriak aurkitzeko eta ingurumena zaintzen duten baliabide naturalen ustiapen eta kudeaketarako irizpideak ezartzeko. - Kartografia geologikoen bidez arrisku-eremuak identifikatu eta lurzoruaren erabilerak mugatzen dira. Geologoak beharrezkoak dira, beraz, lurraldearen planifikaziorako eta garapen iraunkorrerako estrategiak garatzeko. - Geologiaren ezagutzak eta informazio geologikoaren erabilera egokiak laguntzen dute bizitzak salbatzen eta lurrikarak, tsunamiak, erupzio bolkanikoak, uholdeak eta lurjausiak bezalako katastrofe naturalek eragindako diru-galerak murrizten. Halaber laguntzen dute eraikuntza-proiektuak, herri-lanak eta abar garatzen ere. Proposatutako jardueren bitartez, Zientzia Geologikoen adar desberdinen oinarrizko zenbait alderdi ezagutzera eman nahi ditugu. Horretarako, lau saio antolatu ditugu Paleontologia, Mineralogia, Petrologia eta Tektonika arloetan murgiltzeko

Geología en acción. GeoBizirik.org

La Geología es la ciencia que estudia la Tierra en su conjunto, su composición, estructura y origen, así como los fenómenos que han tenido lugar en el pasado o que se producen en la actualidad y que han dejado sus huellas en las rocas. Pero, ¿por qué necesita la sociedad a los geólogos? A continuación se citan algunas de las principales razones: - Los geólogos recopilan e interpretan información de la superficie terrestre y del subsuelo, lo que permite establecer la historia pasada del planeta, sus cambios previsibles y su relación con el resto del sistema solar. - La sociedad requiere para su subsistencia recursos naturales (metálicos, no metálicos, hídricos y combustibles fósiles). La labor de los geólogos es determinante para la localización de nuevos yacimientos y para establecer las guías de una explotación y gestión respetuosa con el medio ambiente. - La elaboración de cartografías geológicas permite identificar potenciales zonas de riesgo y acotar distintos usos del suelo; es decir, es esencial para la planificación del territorio y para proponer estrategias de desarrollo sostenible en una región. - La educación en Geología y el buen uso de la información geológica contribuye a salvar vidas y a reducir las pérdidas económicas originadas por catástrofes naturales tales como terremotos, tsunamis, erupciones volcánicas, inundaciones y desprendimientos, así como a desarrollar proyectos de construcción, obras públicas, etc. Con las actividades propuestas se pretende dar a conocer algunos aspectos básicos de distintas especialidades de las Ciencias Geológicas. Para ello se han organizado cuatro sesiones destinadas a realizar una pequeña inmersión en el campo de la Paleontología, la Mineralogía, la Petrología y la Tectónica