Analysis and description of HOLTIN service provision for AECG monitoring in complex indoor environments

In this work, a novel ambulatory ECG monitoring device developed in-house called HOLTIN is analyzed when operating in complex indoor scenarios. The HOLTIN system is described, from the technological platform level to its functional model. In addition, by using in-house 3D ray launching simulation code, the wireless channel behavior, which enables ubiquitous operation, is performed. The effect of human body presence is taken into account by a novel simplified model embedded within the 3D Ray Launching code. Simulation as well as measurement results are presented, showing good agreement. These results may aid in the adequate deployment of this novel device to automate conventional medical processes, increasing the coverage radius and optimizing energy consumption.The authors wish to thank the support given under project ENEIDA TEC2010-21563-C02-01, funded by the Ministry of Economy and Competitiveness of Spain

Bacteraemic pneumococcal pneumonia and SARS-CoV-2 pneumonia: differences and similarities

OBJECTIVE: To analyse differences in clinical presentation and outcome between bacteraemic pneumococcal community-acquired pneumonia (B-PCAP) and sSvere Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pneumonia. METHODS: This observational multi-centre study was conducted on patients hospitalized with B-PCAP between 2000 and 2020 and SARS-CoV-2 pneumonia in 2020. Thirty-day survival, predictors of mortality, and intensive care unit (ICU) admission were compared. RESULTS: In total, 663 patients with B-PCAP and 1561 patients with SARS-CoV-2 pneumonia were included in this study. Patients with B-PCAP had more severe disease, a higher ICU admission rate and more complications. Patients with SARS-CoV-2 pneumonia had higher in-hospital mortality (10.8% vs 6.8%; P=0.004). Among patients admitted to the ICU, the need for invasive mechanical ventilation (69.7% vs 36.2%; P<0.001) and mortality were higher in patients with SARS-CoV-2 pneumonia. In patients with B-PCAP, the predictive model found associations between mortality and systemic complications (hyponatraemia, septic shock and neurological complications), lower respiratory reserve and tachypnoea; chest pain and purulent sputum were protective factors in these patients. In patients with SARS-CoV-2 pneumonia, mortality was associated with previous liver and cardiac disease, advanced age, altered mental status, tachypnoea, hypoxaemia, bilateral involvement, pleural effusion, septic shock, neutrophilia and high blood urea nitrogen; in contrast, ≥7 days of symptoms was a protective factor in these patients. In-hospital mortality occurred earlier in patients with B-PCAP. CONCLUSIONS: Although B-PCAP was associated with more severe disease and a higher ICU admission rate, the mortality rate was higher for SARS-CoV-2 pneumonia and deaths occurred later. New prognostic scales and more effective treatments are needed for patients with SARS-CoV-2 pneumonia

High‐flow nasal cannula oxygen therapy for the treatment of acute respiratory failure secondary to SARS‐CoV‐2 pneumonia out of ICU

Abstract Introduction and objectives High‐flow nasal cannula oxygen therapy (HFNC) has been successfully used for the treatment of acute hypoxaemic respiratory failure (AHRF) secondary to SARS‐CoV‐2 pneumonia and being effective in reducing progression to invasive mechanical ventilation. The objective of this study was to assess the usefulness of HFNC on a hospital ward for the treatment of AHRF secondary to SARS‐CoV‐2 pneumonia and its impact on the need for intensive care unit (ICU) admission and endotracheal intubation. Other objectives include identifying potential physiological parameters and/or biomarkers for predicting treatment failure and assessing the clinical course and survival. Methods Observational study based on data collected prospectively between March 2020 and February 2021 in a single hospital on patients diagnosed with AHRF secondary to SARS‐CoV‐2 pneumonia who received HFNC outside an ICU. Results One hundred and seventy‐one patients out of 1090 patients hospitalised for SARS‐CoV‐2 infection. HFNC was set as the ceiling of treatment in 44 cases; 12 survived (27.3%). Among the other 127 patients, intubation was performed in 25.9% of cases with a mortality of 11.8%. Higher creatinine levels (OR 1.942, 95% CI 1.04; 3.732; p = 0.036) and Comorbidity‐Age‐Lymphocyte‐LDH (CALL) score (OR 1.273, 95% CI 1.033; 1.617; p = 0.033) were associated with a higher risk of intubation. High platelet count at HFNC initiation was predictive of good treatment response (OR 0.935, 95% CI 0.884; 0.983; p = 0.012). Conclusions HFNC outside an ICU is a treatment with high success rate in patients with AHRF secondary to SARS‐CoV‐2 pneumonia, including in patients in whom this therapy was deemed to be the ceiling of treatment

Nitric oxide and phytoglobin PHYTOGB1 are regulatory elements in the Solanum lycopersicum–Rhizophagus irregularis mycorrhizal symbiosis

The regulatory role of nitric oxide (NO) and phytoglobins in plant response to pathogenic and mutualistic microbes has been evidenced. However, little is known about their function in the arbuscular mycorrhizal (AM) symbiosis. We investigated whether NO and phytoglobin PHYTOGB1 are regulatory components in the AM symbiosis. Rhizophagus irregularis in vitro-grown cultures and tomato plants were used to monitor AM-associated NO-related root responses as compared to responses triggered by the pathogen Fusarium oxysporum. A genetic approach was conducted to understand the role of PHYTOGB1 on NO signaling during both interactions. After a common early peak in NO levels in response to both fungi, a specific NO accumulation pattern was triggered in tomato roots during the onset of the AM interaction. PHYTOGB1 was upregulated by the AM interaction. By contrast, the pathogen triggered a continuous NO accumulation and a strong downregulation of PHYTOGB1. Manipulation of PHYTOGB1 levels in overexpressing and silenced roots led to a deregulation of NO levels and altered mycorrhization and pathogen infection. We demonstrate that the onset of the AM symbiosis is associated with a specific NO-related signature in the host root. We propose that NO regulation by PHYTOGB1 is a regulatory component of the AM symbiosis.This research was supported by grants P12BIO296 and AGL2015-64990-C2-1-R from Junta de Andalucıa and the Spanish Ministry of Economy and Competitiveness, respectively

Cardiovascular Events During and After Bronchiectasis Exacerbations and Long-term Mortality

[EN] BACKGROUND: Population-based and retrospective studies have shown that risk for cardiovascular events such as arrythmias, ischemic episodes, or heart failure, increase during and after bronchiectasis exacerbations. RESEARCH QUESTION: What are the risk factors for cardiovascular events (CVE) during and after bronchiectasis exacerbations and their impact on mortality? STUDY DESIGN AND METHODS: This was a post hoc retrospective analysis of a prospective observational study of 250 patients with bronchiectasis at two tertiary care hospitals. Only the first exacerbation was considered for each patient, collecting demographic, comorbidity, and severity data. The main outcomes were the appearance of CVE and mortality. Risk factors for CVE were analyzed using a semi-competing risks model. RESULTS: During a median follow-up of 35 months, 74 (29.6%) patients had a CVE and 93 (37.2%) died. Semi-competing risk analysis indicated that age, arterial hypertension, COPD, and potentially severe exacerbations significantly increased the risk for developing CVE. Compared with patients without CVE, those with CVE had higher mortality. INTERPRETATION: Demographic factors and comorbidities are risk factors for the development of CVE after an acute exacerbation of bronchiectasis. The appearance of CVE worsens long-term prognosis.This study was supported by Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR [793/2018]) and Sociedad Valenciana de Neumologia (SVN [2018]). Raul Mendez is the recipient of a Rio Hortega grant supported by the Instituto de Salud Carlos III (ISCIII [CM19/00182]). Paula Gonzalez-Jimenez is the recipient of a Post-resident research grant supported by the Health Research Institute La Fe.Méndez, R.; Feced, L.; Alcaraz-Serrano, V.; González-Jiménez, P.; Bouzas, L.; Alonso, R.; Martínez-Dolz, L.... (2022). Cardiovascular Events During and After Bronchiectasis Exacerbations and Long-term Mortality. CHEST Journal. 161(3):629-636. https://doi.org/10.1016/j.chest.2021.10.013629636161