Estudio aerobiológico de la diversidad polínica y su potencial alergénico en el oasis del sur de Mendoza, Argentina

Los conocimientos provenientes del campo de estudio de la Aerobiología favorecen el análisis inmunológico de los alérgenos atmosféricos procedentes de polen y esporas fúngicas. Esto posibilita conocer la carga alergénica del aire en el ambiente y de esta manera, valorar mejor la relación exposición / reacción / clínica en los pacientes en tratamiento por alergias. No existen estudios previos de este tema realizados a nivel regional ni provincial en Mendoza. Una base de datos de identificación de posibles alérgenos provenientes de la polinización de espacios verdes urbanos en la ciudad de San Rafael y General Alvear contribuye a la epidemiología ambiental sobre las afecciones alérgicas respiratorias inducidas por polen y esporas. En esta presentación damos a conocer un proyecto de investigación en Aerobiología, con el fin de generar conocimiento aerobiológico de la zona urbana del oasis del sur mendocino (San Rafael y General Alvear), que contribuye a conocer la carga alergénica proveniente de granos de polen y esporas presentes en el ambiente. Para ello, se están llevando a cabo tres líneas de trabajo que consisten en: (1) el relevamiento, localización y mapeo de la vegetación urbana en floración, (2) la elaboración de una colección de referencia palinológica, y (3) el muestreo diario de aeropartículas atmosféricas urbanas. Se presentan los resultados preliminares obtenidos desde el inicio del proyecto y se muestran las líneas de trabajo que seguirá el curso de esta investigación. A futuro, los estudios aerobiológicos permitirían el desarrollo de programas de seguimiento, prevención y control en los índices de la cantidad de polen y esporas presentes en la atmósfera. Esta herramienta puede describir el potencial alergénico en espacios urbanos sus perjuicios ambientales. De esta manera, una investigación con estas características puede ser un aporte directo a la formulación de políticas de salud pública y planificación urbana de la ciudad.Fil: Guerci, Alejandra. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; Argentina. Museo Municipal de Historia Natural San Rafael - Unidad Asociada al CCT Mendoza; Argentina. Instituto de Enseñanza Superior 9-011 del Atuel; ArgentinaFil: Rojo, Leandro David. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; Argentina. Museo Municipal de Historia Natural San Rafael - Unidad Asociada al CCT Mendoza; ArgentinaFil: Indiveri, Martina. Gobierno de la Provincia de Mendoza. Hospital Teodoro Schestakow.; ArgentinaFil: Nuñez Sada, Maria Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto Nacional de Tecnología Agropecuaria; ArgentinaFil: Farina, Lucia. Museo Municipal de Historia Natural San Rafael - Unidad Asociada al CCT Mendoza; ArgentinaFil: Aguilar, Mariano. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; Argentina. Instituto Nacional de Tecnología Agropecuaria; ArgentinaFil: Llano, Carina Lourdes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Mendoza; ArgentinaFil: Lucero, A.. Universidad de Mendoza; ArgentinaFil: Negreira, Gabriel Alfredo. Instituto de Enseñanza Superior 9-011 del Atuel; ArgentinaFil: Vazquez, Maria Soledad. Universidad Tecnologica Nacional. Facultad Reg.san Rafael. Instituto de Evolucion, Ecologia Historica y Ambiente. - Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico Conicet - Mendoza. Instituto de Evolucion, Ecologia Historica y Ambiente.; ArgentinaFil: Rodriguez, L. F.. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Gallardo, C. A.. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Giraudo, S. B.. Museo Municipal de Historia Natural San Rafael - Unidad Asociada al CCT Mendoza; ArgentinaXIV Encuentro del Centro Internacional de Ciencias de la TierraSan RafaelArgentinaCentro Internacional para Estudios de la TierraComisión Nacional de Energía AtómicaUniversidad Nacional de CuyoUniversidad Tecnológica Nacional. Facultad Regional San Rafae

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat