Incidencia de alteraciones cardiovasculares en caballos criollos colombianos mediante diagnóstico ecocardiográfico

Páginas 61-68Recurso ElectrónicoEl trabajo se realizó en la ciudad de Ibagué con 47 caballos criollos colombianos con un peso medio de 282 ± 20 kg con una edad media de 6 ± 1,4 años. Todos sospechosos de padecer alteraciones cardiacas, con tos persistente, disnea e intolerancia al ejercicio. En el examen semiológico, mediante toma de pulso, frecuencia cardiaca, auscultación de sonidos cardiacos y pulmonares para determinar signología que reflejarán una afección cardiovascular, resultaron 25 equinos con signos evidentes de padecer alteraciones cardiacas. Se hizo evaluación con ecocardiografías en modo B y M, con el animal en reposo físico. Posteriormente se procedió a ejercitarlos, por veinte minutos, para tomar nuevamente y en forma inmediata el pulso, la frecuencia cardiaca, hacer auscultación cardiopulmonar y ecocardiografía en modo B y M, con el fin de detectar anormalidades cardiacas que no fueron mostradas por el animal en reposo. De estos, cinco mostraron insuficiencia mitral y dos presentaron arritmias cardiacas. Se construyeron intervalos de confianza, usando distribución de probabilidad exacta para una binomial, determinando así la probabilidad de que un equino sospechoso manifestara insuficiencia mitral (entre el 3,55 % y 23,10 %) o de que apareciera arritmia (entre el 0,05 % y el 11,29 %), igual probabilidad para la arritmia por vagotonía.ABSTRACT. The work was carried out in Ibague, with 47 Colombian Creole horses, between 250 and 350 kg with 6 ± 1,4 years-old, suspected of suffering cardiac alterations, persistent cough, dyspnea and exercise intolerance. After the semiological examination, with taking the pulse, heart rate, auscultation of heart and lung sounds to determine signs that reflected a cardiovascular affection, twenty-five horses showed evident signs of suffering heart alterations, evaluating them with B and M mode echocardiography and with the animal in physical rest, proceeding to exercise them for twenty minutes and taking the pulse and the heart frequency immediately, auscultating the heart again to detect heart abnormalities that were not shown by the animal in rest. According to test results, five showed mitral insufficiency and two had cardiac arrhythmias. As the sample size of the equine cardiac diseases is small, intervals of trust were built using distribution of exact probability for a binomial one, determining the probability that a suspected equine manifested mitral insufficiency it would be between 3,55 % and 23,10 %; or that arrhythmia appeared (between 0,05 % and 11,29 %),the same probability for the arrhythmia by vagotonia

Incidencia de alteraciones cardiovasculares en caballos criollos colombianos mediante diagnóstico ecocardiográfico

El trabajo se realizó en la ciudad de Ibagué con 47 caballos criollos colombianos con un peso medio de 282 ± 20 kg con una edad media de 6 ± 1,4 años. Todos sospechosos de padecer alteraciones cardiacas, con tos persisten- te, disnea e intolerancia al ejercicio. En el examen semiológico, mediante toma de pulso, frecuencia cardiaca, auscultación de sonidos cardiacos y pulmonares para determinar signología que reflejaran una afección car- diovascular, resultaron 25 equinos con signos evidentes de padecer alteraciones cardiacas. Se hizo evaluación con ecocardiografías en modo B y M, con el animal en reposo físico. Posteriormente se procedió a ejercitarlos, por veinte minutos, para tomar nuevamente y en forma inmediata el pulso, la frecuencia cardiaca, hacer aus- cultación cardiopulmonar y ecocardiografía en modo B y M, con el fin de detectar anormalidades cardiacas que no fueron mostradas por el animal en reposo. De estos, cinco mostraron insuficiencia mitral y dos presentaron arritmias cardiacas. Se construyeron intervalos de confianza, usando distribución de probabilidad exacta para una binomial, determinando así la probabilidad de que un equino sospechoso manifestara insuficiencia mitral (entre el 3,55 % y 23,10 %) o de que apareciera arritmia (entre el 0,05 % y el 11,29 %), igual probabilidad para la arritmia por vagotonía

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

Incidencia de alteraciones cardiovasculares en caballos criollos colombianos mediante diagnóstico ecocardiográfico

Páginas 61-68Recurso ElectrónicoEl trabajo se realizó en la ciudad de Ibagué con 47 caballos criollos colombianos con un peso medio de 282 ± 20 kg con una edad media de 6 ± 1,4 años. Todos sospechosos de padecer alteraciones cardiacas, con tos persistente, disnea e intolerancia al ejercicio. En el examen semiológico, mediante toma de pulso, frecuencia cardiaca, auscultación de sonidos cardiacos y pulmonares para determinar signología que reflejarán una afección cardiovascular, resultaron 25 equinos con signos evidentes de padecer alteraciones cardiacas. Se hizo evaluación con ecocardiografías en modo B y M, con el animal en reposo físico. Posteriormente se procedió a ejercitarlos, por veinte minutos, para tomar nuevamente y en forma inmediata el pulso, la frecuencia cardiaca, hacer auscultación cardiopulmonar y ecocardiografía en modo B y M, con el fin de detectar anormalidades cardiacas que no fueron mostradas por el animal en reposo. De estos, cinco mostraron insuficiencia mitral y dos presentaron arritmias cardiacas. Se construyeron intervalos de confianza, usando distribución de probabilidad exacta para una binomial, determinando así la probabilidad de que un equino sospechoso manifestara insuficiencia mitral (entre el 3,55 % y 23,10 %) o de que apareciera arritmia (entre el 0,05 % y el 11,29 %), igual probabilidad para la arritmia por vagotonía.ABSTRACT. The work was carried out in Ibague, with 47 Colombian Creole horses, between 250 and 350 kg with 6 ± 1,4 years-old, suspected of suffering cardiac alterations, persistent cough, dyspnea and exercise intolerance. After the semiological examination, with taking the pulse, heart rate, auscultation of heart and lung sounds to determine signs that reflected a cardiovascular affection, twenty-five horses showed evident signs of suffering heart alterations, evaluating them with B and M mode echocardiography and with the animal in physical rest, proceeding to exercise them for twenty minutes and taking the pulse and the heart frequency immediately, auscultating the heart again to detect heart abnormalities that were not shown by the animal in rest. According to test results, five showed mitral insufficiency and two had cardiac arrhythmias. As the sample size of the equine cardiac diseases is small, intervals of trust were built using distribution of exact probability for a binomial one, determining the probability that a suspected equine manifested mitral insufficiency it would be between 3,55 % and 23,10 %; or that arrhythmia appeared (between 0,05 % and 11,29 %),the same probability for the arrhythmia by vagotonia

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

New insights into the genetic etiology of Alzheimer’s disease and related dementias

Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele