Portable single-lead electrocardiogram device is accurate for QTc evaluation in hospitalized patients

Q1Background: Many commonly used drugs can prolong the QTc interval (QTc), which can lead to potentially life-threatening arrhythmias. In the current era of the COVID-19 pandemic, it is worth mentioning that the disease itself and several drugs used for its treatment have been associated with QTc prolongation. Objective: To evaluate the agreement and clinical precision of a portable single-lead electrocardiogram (ECG) device to measure the QTc interval compared to the standard 12-lead ECG. Methods: In sequential tests, QTc of ECG recordings obtained with the KardiaMobile (KM-1L) device (AliveCor, San Francisco, CA) were compared to QTc obtained with conventional 12-lead ECG. Agreement was evaluated using Bland-Altman plots and Lin's concordance coefficient. Consistency between the 2 devices in determining QTc prolongation (QTc ≥470 ms in males or ≥480 ms in females) was evaluated with kappa statistics. Results: A total of 128 patients with a presumed or confirmed diagnosis of COVID-19 admitted to a university hospital were included. QTc intervals measured with KM-1L were similar to QTc measured with conventional ECG (442.45 ± 40.5 vs 441.65 ± 40.3 ms, P = .15). Bland-Altman analysis showed no significant difference in QTc values (average difference of -0.797, 95% limits of agreement:-13.179; 11.585). Lin's concordance coefficient showed an excellent agreement (0.988, P 0.90). Conclusion: ECG recordings obtained with KM-1L allow an accurate QTc interval assessment. Considering its simplicity of use, this approach has advantages over conventional ECG and can provide an alternative for the evaluation of QTc in hospitalized patients, during the current time of the COVID-19 pandemic and beyond.Revista Internacional - Indexad

Sublittoral soft bottom communities and diversity of Mejillones Bay in northern Chile (Humboldt Current upwelling system)

The macrozoobenthos of Mejillones Bay (23°S; Humboldt Current) was quantitatively investigated over a 7-year period from austral summer 1995/1996 to winter 2002. About 78 van Veen grab samples taken at six stations (5, 10, 20 m depth) provided the basis for the analysis of the distribution of 60 species and 28 families of benthic invertebrates, as well as of their abundance and biomass. Mean abundance (2,119 individuals m-2) was in the same order compared to a previous investigation; mean biomass (966 g formalin wet mass m-2), however, exceeded prior estimations mainly due to the dominance of the bivalve Aulacomya ater. About 43% of the taxa inhabited the complete depth range. Mean taxonomic Shannon diversity (H', Log e) was 1.54 ± 0.58 with a maximum at 20 m (1.95 ± 0.33); evenness increased with depth. The fauna was numerically dominated by carnivorous gastropods, polychaetes and crustaceans (48%). About 15% of the species were suspensivorous, 13% sedimentivorous, 11% detritivorous, 7% omnivorous and 6% herbivorous. Cluster analyses showed a significant difference between the shallow and the deeper stations. Gammarid amphipods and the polychaete family Nephtyidae characterized the 5-mzone, the molluscs Aulacomya ater, Mitrella unifasciata and gammarids the intermediate zone, while the gastropod Nassarius gayi and the polychaete family Nereidae were most prominent at the deeper stations. The communities of the three depth zones did not appear to be limited by hypoxia during non-El Niño conditions. Therefore, no typical change in community structure occurred during El Niño 1997–1998, in contrast to what was observed for deeper faunal assemblages and hypoxic bays elsewhere in the coastal Humboldt Current system

Tendencias de la investigación en Ingeniería Ambiental

Esta obra incluye las memorias del Simposio “Tendencias de la Investigación en Ingeniería Ambiental”, organizado por el Grupo de Investigaciones y Mediciones Ambientales (GEMA), realizado en la Universidad de Medellín en agosto de 2007. El texto está conformado por 14 capítulos agrupados en cuatro partes. En la primera se agrupan los trabajos relacionados con la calidad y alternativas de tratamiento del agua e hidráulica ambiental (capítulos 1 al 4). La segunda trata temas relacionados con la contaminación atmosférica y calidad del aire (capítulos 5 al 6). La tercera está relacionada con las tecnologías ambientales para la recuperación y conservación de suelos (capítulos 7 al 10) y la cuarta y última comprende las temáticas asociadas con la sostenibilidad ambiental del territorio (capítulos 11 al 14). En este sentido, estamos convencidos del valioso aporte que el libro dará a la comunidad científica, por ser este un documento de divulgación de resultados de investigación en ingeniería ambiental.PRÓLOGO............13 PRESENTACIÓN.............15 PRIMERA PARTE CALIDAD Y ALTERNATIVAS DE TRATAMIENTO DEL AGUA HIDRÁULICA AMBIENTAL Capítulo 1 PRETRATAMIENTO DE AGUAS RESIDUALES INDUSTRIALES MEDIANTE FOTO-FENTON SOLAR A ESCALA INDUSTRIAL ACOPLADO A BIOTRATAMIENTO CON FANGOS ACTIVOS INMOVILIZADOS Manuel Ignacio Maldonado, Isabel Oller, Wolfgang Gernjak, Sixto Malato 1.1 INTRODUCCIÓN............19 1.2 MATERIALES Y MÉTODOS.............21 1.2.1 Reactivos............21 1.2.2 Determinaciones analíticas.............22 1.2.3 Dispositivo experimental.............23 1.3 R ESULTADOS Y DISCUSIÓN............ 27 1.3.1 Tratamiento foto-Fenton solar............27 1.3.2 Biotratamiento mediante fangos activos inmovilizados.............33 1.3.3 Sistema combinado foto-Fenton solar-biológico aeróbico............35 1.4 CONCLUSIONES............. 42 Capítulo 2 DEGRADACIÓN DE LA ATRAZINA EN SOLUCIÓN ACUOSA USANDO RADIACIÓN UV Y PROCESOS DE OXIDACIÓN AVANZADA Margarita Hincapié, Gustavo Peñuela, Manuel I. Maldonado, Sixto Malato 2.1 INTRODUCCIÓN..............47 2.2 SECCIÓN EXPERIMENTAL..............53 2.2.1 Materiales.............53 2.2.2 Metodología...............53 2.2.3 Determinación analítica..............55 2.2.4 Determinación de la toxicidad...............55 2.3 R ESULTADOS Y DISCUSIÓN...............56 2.3.1 Hidrólisis..............56 2.3.2 Fotólisis y fotocatálisis con TiO2 Degussa P25.............56 2.3.3 Efecto de los agentes oxidantes peróxido de hidrógeno y persulfato de sodio en la fotocatálisis..............59 2.3.4 Proceso foto Fenton..............63 2.3.5 Evaluación de los aniones inorgánicos durante los dos tratamientos.............66 2.3.6 Cuantificación e identificación de los productos de degradación...............68 2.3.7 Evaluación de la toxicidad...............71 2.4 CONCLUSIONES...............74 Capítulo 3 HUMEDALES ARTIFICIALES PARA EL TRATAMIENTO DE AGUAS RESIDUALES Nazly E. Sánchez P., Gustavo A. Peñuela M., Juan C. Casas Z. 3.1 INTRODUCCIÓN...............81 3.2 MARCO TEÓRICO...............83 3.2.1 Humedales construidos para el tratamiento de aguas residuales..............84 3.2.2 Clasificación de los humedales.............85 3.2.3 Ventajas y desventajas de los humedales subsuperficiales..............87 3.2.4 Aspectos a considerar en los humedales subsuperficiales..............88 3.3 MATERIALES Y MÉTODOS.................89 3.3.1 Diseño y construcción de los humedales a escala piloto..............89 3.3.2 Componentes del agua residual sintética................90 3.3.3 Siembra y aclimatación de plantas............... 90 3.3.4 Muestreos............91 3.4 R ESULTADOS Y DISCUSIÓN..............91 3.4.1 pH..............91 3.4.2 Demanda bioquímica de oxígeno (DBO5)..............92 3.4.3 Carbono orgánico total (COT)................94 3.5 CONCLUSIONES................95 Capítulo 4 DESCRIPCIÓN DE LA DINÁMICA OCEANOGRÁFICA DEL GOLFO DE URABÁ UTILIZANDO MEDICIONES DE CAMPO Luis Javier Montoya Jaramillo, Francisco Mauricio Toro Botero 4.1 INTRODUCCIÓN...............103 4.2 DATOS Y MÉTODOS................107 4.3 DISCUSIÓN..............118 4.4 CONCLUSIONES............. 120 SEGUNDA PARTE CONTAMINACIÓN ATMOSFÉRICA Y CALIDAD DEL AIRE Capítulo 5 IMPACTO DE LAS MOTOCICLETAS EN LA CALIDAD DEL AIRE. ESTUDIO DE CASO: MONTERÍA Carlos Alberto Echeverri Londoño 5.1 INTRODUCCIÓN.................127 5.2 MATERIALES Y MÉTODOS...............131 5.2.1 S elección de los sitios de medición...............131 5.2.2 Período de medición................131 5.2.3 Parámetros seleccionados...............132 5.2.4 Equipos y materiales utilizados..............132 5.2.5 Índices de calidad del aire..............133 5.2.6 Legislación.............. 138 5.2.7 Inventario de emisiones..............141 5.3 RESULTADOS...............142 5.3.1 Calidad del aire y calidad acústica................142 5.3.2 Emisiones vehiculares.............150 5.3.3 Inventario de emisiones.............155 5.4 CONCLUSIONES.............. 158 5.5 RECOMENDACIONES............. 160 Capítulo 6 ROMPIMIENTO DE LA INVERSIÓN TÉRMICA EN EL VALLE DE ABURRÁ Ángela M. Rendón, José F. Jiménez, Carlos Palacio 6.1 INTRODUCCIÓN...............163 6.2 MEDICIÓN DE VARIABLES ATMOSFÉRICAS..............164 6.3 CAMPAÑAS DE MEDICIÓN.............165 6.4 RESULTADOS..............166 6.5 CONCLUSIONES................170 TERCERA PARTE TECNOLOGÍAS AMBIENTALES PARA LA RECUPERACIÓN Y CONSERVACIÓN DE SUELOS Capítulo 7 ESTRUCTURA MODELO DE LA PARTÍCULA FUNDAMENTAL DEL COMPOST Carlos E. Arroyave M., Carlos A. Peláez J. 7.1 INTRODUCCIÓN..............177 7.2 MATERIALES Y EQUIPOS.............178 7.2.1 Materias primas y planta de compostaje............178 7.2.2 Obtención de fracciones............. 182 7.2.3 Análisis estadístico.............184 7.3 RESULTADOS Y DISCUSIÓN.............184 7.3.1 Caracterización fisicoquímica del material de RSUsf...........184 7.3.2 Tamaño de partícula.............185 7.3.3 Análisis instrumental................187 7.3.4 Modelo de partícula..............194 7.4 CONCLUSIONES..............195 Capítulo 8 DEGRADACIÓN DE HEXACLOROCICLOHEXANO (HCH) CON HONGOS DE PODREDUMBRE DE LA MADERA Juan Carlos Quintero Díaz, Gumersindo Feijoo, Juan Manuel Lema 8.1 INTRODUCCIÓN..............199 8.2 MATERIALES Y MÉTODOS..............204 8.2.1 Microorganismos.............204 8.2.2 Ensayos de selección de los hongos de podredumbre de la madera.............204 8.2.3 Ensayos de degradación de HCH en medio líquido.............205 8.2.4 Ensayos de degradación de HCH en sobre suelo contaminado.............205 8.2.5 Extracción y análisis de los isómeros de HCH.............208 8.3 RESULTADOS Y DISCUSIÓN..............209 8.3.1 Selección de los microorganismos.............209 8.3.2 Degradación de HCH en medio líquido.............210 8.3.3 Degradación de HCH en fase sólida.............212 8.4 CONCLUSIONES.............. 220 Capítulo 9 AVANCES EN LA PROPAGACIÓN ASIMBIÓTICA IN VITRO DE ORQUÍDEAS CON ESPECIAL ÉNFASIS EN EL GÉNERO CATTLEYA Liliana R. Botero, María A. Jaramillo, Óscar O. Ossa R., Tatiana Saldarriaga F., Estefanía Ortiz R. 9.1 INTRODUCCIÓN...............227 9.2 MATERIALES Y MÉTODOS...............231 9.2.1 Evaluación de la metodología de desinfección de cápsulas de orquídeas.............231 9.2.2 Evaluación del efecto de un abono comercial y un suplemento comercial de banano............239 9.3 R ESULTADOS Y DISCUSIÓN..............242 9.3.1 Ensayos de desinfección...............242 9.3.2 Resultados del efecto de un abono comercial y un suplemento de banano comercial....246 9.4 CONCLUSIONES..............254 Capítulo 10 MOVILIDAD DEL BRAVONIL 720 (CLOROTALONILO) A TRAVÉS DE LA ZONA NO SATURADA Y SATURADA DE UN ACUÍFERO LIBRE SIMULADO Idalia Jacqueline López Sánchez, Gustavo Antonio Peñuela Mesa 10.1 INTRODUCCIÓN...............259 10.2 MATERIALES Y MÉTODOS...............261 10.3 RESULTADOS Y DISCUSIÓN..............269 10.4 CONCLUSIONES..............292 CUARTA PARTE SOSTENIBILIDAD AMBIENTAL DEL TERRITORIO Capítulo 11 LA RESPONSABILIDAD SOCIAL EMPRESARIAL COMO COMPONENTE DE SOSTENIBILIDAD AMBIENTAL John Fredy López Pérez 11.1 INTRODUCCIÓN...............299 11.2 UNA LECTURA DE LA SOSTENIBILIDAD AMBIENTAL DESDE UN PUNTO DE VISTA SOCIAL..............300 11.3 EL CONCEPTO DE LA RESPONSABILIDAD SOCIAL EMPRESARIAL...............303 11.4 LA RESPONSABILIDAD SOCIAL COMO ESPACIO PARA L A SOSTENIBILIDAD AMBIENTAL.............309 11.5 ESBOZOS DE UN CASO: EL SECTOR ELÉCTRICO COLOMBIANO..............311 11.6 CONCLUSIONES..............319 Capítulo 12 DETERMINACIÓN ESPACIAL DE ÁREAS DE IMPORTANCIA ESTRATÉGICA El caso de microcuencas abastecedoras de acueductos veredales del municipio de Medellín Joaquín Hincapié, Álvaro Lema 12.1 INTRODUCCIÓN................323 12.2 LA NOCIÓN DE ÁREA DE IMPORTANCIA ESTRATÉGICA...............325 12.3 LA IDEA DE LOS SERV ICIOS AMBIENTALES..............328 12.4 ESTRATEGIA METODOLÓGICA EN LA IDENTIFICACIÓN Y DETERMINACIÓN DE LAS ÁREAS DE IMPORTANCIA ESTRATÉGICA............332 12.5 L OS RESULTADOS DEL MODELO...............359 12.6 CONCLUSIONES............. 361 Capítulo 13 LA EDUCACIÓN AMBIENTAL EN LA TRANSFORMACIÓN DE LA CULTURA Luz Ángela Peña Marín, Alba Miriam Vergara Vargas 13.1 INTRODUCCIÓN..............369 13.2 APROXIMACIÓN CONCEPTUAL...............370 13.2.1 La reflexividad...............372 13.2.2 La construcción del otro...............374 13.2.3 El discurso.............. 372 13.2.4 La autonomía y la participación..............375 13.2.5 La educación ambiental y el desarrollo humano..............378 13.2.6 Base conceptual de la educación ambiental..............380 13.2.7 Contexto sociocultural..............382 13.2.8 Diagnóstico de la educación ambiental y la administración de los recursos naturales..............392 13.2.9 Criterios corporativos de educación ambiental.............394 13.3 CONCLUSIONES...............398 Capítulo 14 ENFOQUE CONCEPTUAL DE UN SISTEMA DE INDICADORES AMBIENTALES PARA LA EVALUACIÓN DE LOS POT: municipios del Valle de San Nicolás Oriente Antioqueño Carolina Arias Muñoz, Diana Elizabeth Valencia Londoño, Boris Puerto López 14.1 INTRODUCCIÓN...............401 14.2 ENFOQUE CONCEPTUAL DEL SISTEMA DE INDICADORES..............406 14.2.1 Primera aproximación: el enfoque de impacto ambiental..............406 14.2.2 Enfoque sistémico: de la sostenibilidad ambiental..............408 14.3 PROPUESTA FINAL DE INDICADORES E ÌNDICE DE SOSTENIBILIDAD AMBIENTAL DEL POT ISAPOT.............424 14.4 R EFLEXIONES FINALES..............42

Association between Use of Enhanced Recovery after Surgery Protocol and Postoperative Complications in Total Hip and Knee Arthroplasty in the Postoperative Outcomes Within Enhanced Recovery after Surgery Protocol in Elective Total Hip and Knee Arthroplasty Study (POWER2)

Importance: The Enhanced Recovery After Surgery (ERAS) care protocol has been shown to improve outcomes compared with traditional care in certain types of surgery. Objective: To assess the association of use of the ERAS protocols with complications in patients undergoing elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). Design, Setting, and Participants: This multicenter, prospective cohort study included patients recruited from 131 centers in Spain from October 22 through December 22, 2018. All consecutive adults scheduled for elective THA or TKA were eligible for inclusion. Patients were stratified between those treated in a self-designated ERAS center (ERAS group) and those treated in a non-ERAS center (non-ERAS group). Data were analyzed from June 15 through September 15, 2019. Exposures: Total hip or knee arthroplasty and perioperative management. Sixteen individual ERAS items were assessed in all included patients, whether they were treated at a center that was part of an established ERAS protocol or not. Main Outcomes and Measures: The primary outcome was postoperative complications within 30 days after surgery. Secondary outcomes included length of stay and mortality. Results: During the 2-month recruitment period, 6146 patients were included (3580 women [58.2%]; median age, 71 [interquartile range (IQR), 63-76] years). Of these, 680 patients (11.1%) presented with postoperative complications. No differences were found in the number of patients with overall postoperative complications between ERAS and non-ERAS groups (163 [10.2%] vs 517 [11.4%]; odds ratio [OR], 0.89; 95% CI, 0.74-1.07; P =.22). Fewer patients in the ERAS group had moderate to severe complications (73 [4.6%] vs 279 [6.1%]; OR, 0.74; 95% CI, 0.56-0.96; P =.02). The median overall adherence rate with the ERAS protocol was 50.0% (IQR, 43.8%-62.5%), with the rate for ERAS facilities being 68.8% (IQR, 56.2%-81.2%) vs 50.0% (IQR, 37.5%-56.2%) at non-ERAS centers (P <.001). Among the patients with the highest and lowest quartiles of adherence to ERAS components, the patients with the highest adherence had fewer overall postoperative complications (144 [10.6%] vs 270 [13.0%]; OR, 0.80; 95% CI, 0.64-0.99; P <.001) and moderate to severe postoperative complications (59 [4.4%] vs 143 [6.9%]; OR, 0.62; 95% CI, 0.45-0.84; P <.001) and shorter median length of hospital stay (4 [IQR, 3-5] vs 5 [IQR, 4-6] days; OR, 0.97; 95% CI, 0.96-0.99; P <.001). Conclusions and Relevance: An increase in adherence to the ERAS program was associated with a decrease in postoperative complications, although only a few ERAS items were individually associated with improved outcomes

Genetic Ancestry, Race, and Severity of Acutely Decompensated Cirrhosis in Latin America

Background & Aims: Genetic ancestry or racial differences in health outcomes exist in diseases associated with systemic inflammation (eg, COVID-19). This study aimed to investigate the association of genetic ancestry and race with acute-on-chronic liver failure (ACLF), which is characterized by acute systemic inflammation, multi-organ failure, and high risk of short-term death. / Methods: This prospective cohort study analyzed a comprehensive set of data, including genetic ancestry and race among several others, in 1274 patients with acutely decompensated cirrhosis who were nonelectively admitted to 44 hospitals from 7 Latin American countries. / Results: Three hundred ninety-five patients (31.0%) had ACLF of any grade at enrollment. Patients with ACLF had a higher median percentage of Native American genetic ancestry and lower median percentage of European ancestry than patients without ACLF (22.6% vs 12.9% and 53.4% vs 59.6%, respectively). The median percentage of African genetic ancestry was low among patients with ACLF and among those without ACLF. In terms of race, a higher percentage of patients with ACLF than patients without ACLF were Native American and a lower percentage of patients with ACLF than patients without ACLF were European American or African American. In multivariable analyses that adjusted for differences in sociodemographic and clinical characteristics, the odds ratio for ACLF at enrollment was 1.08 (95% CI, 1.03–1.13) with Native American genetic ancestry and 2.57 (95% CI, 1.84–3.58) for Native American race vs European American race. / Conclusions: In a large cohort of Latin American patients with acutely decompensated cirrhosis, increasing percentages of Native American ancestry and Native American race were factors independently associated with ACLF at enrollment

Impact of biological agents on postsurgical complications in inflammatory bowel disease: A multicentre study of Geteccu

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research