Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved

Effect of the COVID-19 pandemic on surgery for indeterminate thyroid nodules (THYCOVID): a retrospective, international, multicentre, cross-sectional study

Background Since its outbreak in early 2020, the COVID-19 pandemic has diverted resources from non-urgent and elective procedures, leading to diagnosis and treatment delays, with an increased number of neoplasms at advanced stages worldwide. The aims of this study were to quantify the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic; and to evaluate whether delays in surgery led to an increased occurrence of aggressive tumours.Methods In this retrospective, international, cross-sectional study, centres were invited to participate in June 22, 2022; each centre joining the study was asked to provide data from medical records on all surgical thyroidectomies consecutively performed from Jan 1, 2019, to Dec 31, 2021. Patients with indeterminate thyroid nodules were divided into three groups according to when they underwent surgery: from Jan 1, 2019, to Feb 29, 2020 (global prepandemic phase), from March 1, 2020, to May 31, 2021 (pandemic escalation phase), and from June 1 to Dec 31, 2021 (pandemic decrease phase). The main outcomes were, for each phase, the number of surgeries for indeterminate thyroid nodules, and in patients with a postoperative diagnosis of thyroid cancers, the occurrence of tumours larger than 10 mm, extrathyroidal extension, lymph node metastases, vascular invasion, distant metastases, and tumours at high risk of structural disease recurrence. Univariate analysis was used to compare the probability of aggressive thyroid features between the first and third study phases. The study was registered on ClinicalTrials.gov, NCT05178186.Findings Data from 157 centres (n=49 countries) on 87 467 patients who underwent surgery for benign and malignant thyroid disease were collected, of whom 22 974 patients (18 052 [78 center dot 6%] female patients and 4922 [21 center dot 4%] male patients) received surgery for indeterminate thyroid nodules. We observed a significant reduction in surgery for indeterminate thyroid nodules during the pandemic escalation phase (median monthly surgeries per centre, 1 center dot 4 [IQR 0 center dot 6-3 center dot 4]) compared with the prepandemic phase (2 center dot 0 [0 center dot 9-3 center dot 7]; p<0 center dot 0001) and pandemic decrease phase (2 center dot 3 [1 center dot 0-5 center dot 0]; p<0 center dot 0001). Compared with the prepandemic phase, in the pandemic decrease phase we observed an increased occurrence of thyroid tumours larger than 10 mm (2554 [69 center dot 0%] of 3704 vs 1515 [71 center dot 5%] of 2119; OR 1 center dot 1 [95% CI 1 center dot 0-1 center dot 3]; p=0 center dot 042), lymph node metastases (343 [9 center dot 3%] vs 264 [12 center dot 5%]; OR 1 center dot 4 [1 center dot 2-1 center dot 7]; p=0 center dot 0001), and tumours at high risk of structural disease recurrence (203 [5 center dot 7%] of 3584 vs 155 [7 center dot 7%] of 2006; OR 1 center dot 4 [1 center dot 1-1 center dot 7]; p=0 center dot 0039).Interpretation Our study suggests that the reduction in surgical activity for indeterminate thyroid nodules during the COVID-19 pandemic period could have led to an increased occurrence of aggressive thyroid tumours. However, other compelling hypotheses, including increased selection of patients with aggressive malignancies during this period, should be considered. We suggest that surgery for indeterminate thyroid nodules should no longer be postponed even in future instances of pandemic escalation.Funding None.Copyright (c) 2023 Published by Elsevier Ltd. All rights reserved

Esbozo de la semiótica con perspectiva sistémica

La Comunicación humana esté compuesta por fenómenos sociales que no estén totalmente caracterizados, por lo tanto no hay un acuerdo que identifique su problema u objeto de estudio. Este trabajo presenta una revisión del concepto de Comunicación desde la Metodología de Sistemas Suaves, obteniendo una visión holística de los fenómenos comunicativos. Concluimos con la propuesta de una semiótica cuantitativa para caracterizar los eventos comunicativos plurales y sus cualidades. The human communication is integrated by social phenomena, not yet characterized at all, therefore there isn’t an agreement identifying its problem or aim of study. This work presents a review of the concept of communication from the Soft Systems Methodology obtaining an holistic vision of the communicative phenomena. We conclude suggesting a quantitative Semiotics proposal to characterize the plural communicative events and its qualitie

Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved

Development of Methods for the Determination of PhACs in Soil/Earthworm/Crop System Irrigated with Reclaimed Water

Pharmaceuticals have been becoming a major concern of environmental pollution since the beginning of the century. The ways in which these contaminants are introduced into the environment are very different, but almost always associated with wastewater. In fact, current wastewater treatment plants are not designed for the removal of pharmaceutical products. Indeed, the problem of water scarcity has played an important role in the introduction of pharmaceutical products into the environment, particularly in the agricultural sector. Because of the drought, more and more countries are resorting to the use of treated wastewater to irrigate vegetables for human consumption. Consequently, the reuse of wastewater in agriculture constitutes a continuous introduction of these molecules into the soil. The effects of this practice are not entirely clear. However, the probability that these compounds can enter the food chain directly is high. In fact, through radical absorption, plants could uptake pharmaceuticals from soil and water, leading to the accumulation of drugs in the tissues. The development of analytical methods of solid matrices such as soil or plant tissues requires substantial work due to the great complexity of the matrices and the differences between the physico-chemical properties of analytes of interest. Several multi-class methods have recently been developed to determine a large number of pharmaceutical products in soil or plants using different extraction techniques. This chapter addresses to list all the analytical procedures published so far used for the extraction and analysis of pharmaceutical products from plant tissues and from the soil irrigated with treated wastewater.This study has been financially supported by the EU through the WaterJPI-2015 AWARE project (PCIN-2017-067). This work was supported by the Spanish Ministry of Science and Innovation (Project CEX2018-000794-S). The authors thank the Water Challenges for a Changing World Joint Programming Initiative.Peer reviewe