Estudio de las otoemisiones acústicas provocadas por clic en recién nacidos tratados con tobramicina

[Resumo] A tobramicina é un antibiótico aminoglicósido utilizado para tratar infeccións perinatais, caracterizado polo potencial ototóxico. Esta toxicidade coclear ocorre, inicialmente, danando as células ciliadas externas, células contractis do órgano de Corti relacionadas coa produción de emisións otoacústicas. O obxectivo deste estudo é determinar a afectación da coclea en nenos tratados con tobramicina través da gravación e análise de emisións otoacústicas provocadas por clic (TEOAE). Rexistráronse TEOAE en ambos ouvidos de 46 neonatos tratados con tobramicina durante unha media de 7,1 días (entre 5 e 11 días) e 47 neonatos sen tratamento, todos eles sen factores de risco para perda auditiva. A análise non revelou diferenzas significativas entre as dúas mostras nas características da emisión otoacústica rexistrada (intensidade do total de resposta, reproducibilidade e respostas por bandas de frecuencia) e non atoparon correlación significativa entre os valores de resposta e a carga de antibiótico (dose, tempo de tratamento e dose dose acumulada). Concluíuse que o tratamento con tobramicina de corta duración curta en acabados de nacer non afecta emisións otoacústicas provocadas por clic, o que está relacionado coa ausencia de dano coclear.[Resumen] La tobramicina es un antibiótico aminoglucósido utilizado en el tratamiento de infecciones perinatales, caracterizado por su potencial ototóxico. Esta toxicidad sobre la cóclea se produce dañando inicialmente las células ciliadas externas, células contráctiles del órgano de Corti relacionadas con la producción de otoemisiones acústicas. El objetivo de este estudio es determinar la afectación coclear en recién nacidos tratados con tobramicina mediante el registro y análisis de otoemisiones acústicas provocadas por clic (TEOAE). Para ello se registraron las TEOAE en los dos oídos de 46 recién nacidos tratados con tobramicina durante una media de 7,1 días (entre 5 y 11 días) y 47 recién nacidos sin tratamiento, todos ellos sin factores de riesgo de hipoacusia. El análisis no reveló diferencias significativas entre las dos muestras en las características de las otoemisiones registradas (intensidad de la respuesta total, reproductibilidad y respuesta por frecuencias), ni encontró correlación significativa entre los valores de respuesta y la carga de antibiótico (dosis, el tiempo de tratamiento y dosis acumulada). De ello se concluye que el tratamiento con tobramicina, de corta duración, en recién nacidos, no afecta a las otoemisiones acústicas provocadas por clic, lo que se relaciona con ausencia de daño coclear.[Abstract] Tobramycin is an aminoglycoside antibiotic used to treat certain perinatal infections, characterized by ototoxic potential. Its cochlear toxicity occurs initially damaging outer hair cells, contractile cells of the organ of Corti related to the production of otoacoustic emissions. The aim of this study is to determine cochlear damage in infants treated with tobramycin by recording and analysing transient evoked otoacoustic emissions (TEOAE). TEOAE were recorded in both ears from 46 infants treated with tobramycin for an average of 7.1 days (5 to 11 days) and 47 newborns without treatment, all of them without risk factors for hearing loss. The analysis revealed no significant differences between the two samples in the characteristics of the registered otoacoustic emission (total response amplitude, reproducibility and response by frequency) and do not found significant correlation between the response values and antibiotic (dose, treatment time and cumulative dose). It is concluded that treatment with short course of tobramycin in newborns does not affect otoacoustic emissions caused by click, which is related to absence of cochlear damage

COVID-19; SARS-Cov-2; COVID-19 Testing; Otolaryngology

The SARS CoV-2 (COVID-19) disease has caused millions of cases since the pandemic status was declared by the World Health Organization (WHO) in March 2020, changing the usual medical and surgical practices. Doctors and nurses represent a significant percentage of the general population infected. Among them, the special risk of infection in otorhinolaryngologists and head and neck surgeons (ENT) stands out, due to the proximity to the upper airway and the risk of generation of bioaerosols during procedures./nThe objective of this article is to prepare a document on safe otorhinolaryngological practice during the COVID19 pandemic, based on a compilation of the best evidence adapted to the risk of transmission, according to the combination of the results of the risk indicators established by the Ministry of Health, Consumption and Social Welfare (MSCBS). This document is the result of the collaboration of the scientific commissions and the COVID-19 committee of the SEORLCCC.La enfermedad por el SARS CoV-2 (COVID-19) ha provocado millones de casos desde que se declarase el estado de pandemia por la Organización Mundial de la Salud (OMS) en marzo de 2020, cambiando las prácticas médicas y quirúrgicas habituales. Los sanitarios representan un importante porcentaje de la población general contagiada. Entre ellos, destaca el especial riesgo de infección en otorrinolaringólogos y cirujanos de cabeza y cuello (ORL), debido a la cercanía a la vía aérea superior y al riesgo de generación de bioaerosoles durante los procedimientos./nEl objetivo de este artículo es la elaboración de un documento de práctica otorrinolaringológica segura durante la pandemia COVID19, basado en una recopilación de la mejor evidencia adaptada al riesgo de transmisión, según la combinación de los resultados de los indicadores de riesgo establecidos por el Ministerio de Sanidad, Consumo y Bienestar Social (MSCBS). El presente documento es fruto de la colaboración de las comisiones científicas y del comité COVID-19 de la SEORLCCC

ENT practice during the COVID19 pandemic

Introducción: La enfermedad por el SARS CoV-2 (COVID-19) ha provocado millones de casos desde que se declarase el estado de pandemia por la Organización Mundial de la Salud (OMS) en marzo de 2020, cambiando las prácticas médicas y quirúrgicas habituales. Los sanitarios representan un importante porcentaje de la población general contagiada. Entre ellos, destaca el especial riesgo de infección en otorrinolaringólogos y cirujanos de cabeza y cuello (ORL), debido a la cercanía a la vía aérea superior y al riesgo de generación de bioaerosoles durante los procedimientos. Objetivo: El objetivo de este artículo es la elaboración de un documento de práctica otorrinolaringológica segura durante la pandemia COVID19. Método: Revisión bibliográfica. Resultados: Recopilación de la mejor evidencia adaptada al riesgo de trans misión, según la combinación de los resultados de los indicadores de riesgo establecidos por el Ministerio de Sanidad, Consumo y Bienestar Social (MSCBS). El presente documento es fruto de la colaboración de las comisiones científicas y del comité COVID-19 de la SEORLCCC.Introduction: The SARS CoV-2 (COVID-19) disease has caused millions of cases since the pandemic status was declared by the World Health Organization (WHO) in March 2020, changing the usual medical and surgical practices. Doctors and nurses represent a significant percentage of the general population infected. Among them, the special risk of infection in otorhinolaryngologists and head and neck surgeons (ENT) stands out, due to the proximity to the upper airway and the risk of generation of bioaerosols during procedures. Objective: The objective of this article is to prepare a document on safe otorhinolaryngological practice during the COVID19 pandemic. Results: Compilation of the best evidence adapted to the risk of transmission, according to the combination of the results of the risk indicators established by the Ministry of Health, Consumption and Social Welfare (MSCBS). This document is the result of the collaboration of the scientific commissions and the COVID-19 committee of the SEORLCCC

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

Evaluación subjetiva de las alteraciones del olfato y del gusto en pacientes con afectación leve por COVID-19 en España

International audienceBackground: Has been described the loss of smell and taste as onset symptoms in SARS-CoV-2. The objective of this study was to investigate the prevalence in Spain. Methods: Prospective study of COVID-19 confirmed patients through RT-PCR in Spain. Patients completed olfactory and gustatory questionnaires. Results: A total of 1043 patients with mild COVID-19 disease. The mean age was 39 ± 12 years. 826 patients (79.2%) described smell disorder, 662 (63.4%) as a total loss and 164 (15.7%) partial. 718 patients (68.8%) noticed some grade of taste dysfunction. There was a significant association between both disorders (p<.001). The olfactory dysfunction was the first symptom in 17.1%. The sQOD-NS scores were significantly lower in patients with a total loss compare to normosmic or hyposmic individuals (p =.001). Female were significantly more affected by olfactory and gustatory dysfunctions (p<.001). The early olfactory recover in 462 clinically cured patients was 315 (68.2%), during the first 4 weeks. Conclusion: The sudden onset smell and/or taste dysfunction should be considered highly suspicious for COVID-19 infection

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

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