Sociodemographic and clinical data predicting unplanned pregnancy in young 13 to 24 years, Spain

Fundamentos: El embarazo no planificado (EnoP) sigue siendo un problema de salud pública. El objetivo de este estudio fue conocer los comportamientos sexuales y prácticas contraceptivas relacionados con EnoP en las mujeres jóvenes. Métodos: 583 mujeres de edades entre 13 y 24 años, atendidas en una consulta de anticoncepción durante el año 2012. Variable dependiente: EnoP. Independientes: sociodemográficas, comportamientos sexuales y prácticas contraceptivas. Análisis bivariante, pruebas de chi2 y t de Student. Análisis multivariante mediante regresión logística binaria. Resultados: 174 (29,8%) mujeres tuvieron un EnoP. El riesgo de EnoP aumentó en mujeres inmigrantes [OR: 2,858 (IC95%:1,808-4,519)], en las jóvenes con menor nivel de estudios (OR: 2,343 [IC95% 1,361-4,035]), en las que no utilizaron un método anticonceptivo seguro (todos menos el coitus interruptus) durante su primer coito (OR:3,043 (IC95% 1,900-4,875)], en las que manifestaron inconvenientes con el uso de los métodos anticonceptivos (OR: 2,092 [IC95% 1,267-3,454]) y en las que tuvieron asistencia irregular a la consulta (OR: 2,063 [IC95% 1,275-3,339]). No hubo relación con la edad (adolescentes/jóvenes). El modelo se consideró aceptable: Hosmer-Lemeshow no significativo y con un poder de discriminación del 77%. Conclusiones: Las variables predictoras de embarazo no planificado en mujeres jóvenes son: ser inmigrante, tener bajo nivel de estudios, no utilizar método anticonceptivo seguro durante el primer coito, manifestar inconvenientes con los métodos anticonceptivos y tener una asistencia irregular a la consulta de anticoncepción

Accurate gamma and MeV-electron track reconstruction with an ultra-low diffusion Xenon/TMA TPC at 10 atm

We report the performance of a 10 atm Xenon/trimethylamine time projection chamber (TPC) for the detection of X-rays (30 keV) and gamma-rays (0.511-1.275 MeV) in conjunction with the accurate tracking of the associated electrons. When operated at such a high pressure and in similar to 1%-admixtures, trimethylamine (TMA) endows Xenon with an extremely low electron diffusion (1.3 +/- 0.13 mm-sigma (longitudinal), 0.95 +/- 0.20 mm-sigma (transverse) along 1 m drift) besides forming a convenient Penning-Fluorescent' mixture. The TPC, that houses 1.1 kg of gas in its fiducial volume, operated continuously for 100 live-days in charge amplification mode. The readout was performed through the recently introduced microbulk Micromegas technology and the AFTER chip, providing a 3D voxelization of 8 mm x 8 mm x 1.2 mm for approximately 10 cm/MeV-long electron tracks. Resolution in energy (epsilon) at full width half maximum (R) inside the fiducial volume ranged from R = 14.6% (30 keV) to R = 4.6% (1.275 MeV). This work was developed as part of the R&D program of the NEXT collaboration for future detector upgrades in the search of the neutrino-less double beta decay (beta beta 0 nu) in Xe-136, specifically those based on novel gas mixtures. Therefore we ultimately focus on the calorimetric and topological properties of the reconstructed MeV-electron tracks. In particular, the obtained energy resolution has been decomposed in its various contributions and improvements towards achieving the R =1.4%root MeV/epsilon levels obtained in small sensors are discussedThe NEXT collaboration acknowledges funding support from the following agencies and institutions: European Research Council under Advanced Grant 339787-NEXT and Starting Grant 240054-TREX, Spanish Ministerio de Economia y Competitividad under grants Consolider-Ingenio 2010 CSD2008-0037 (CUP) and CSD2007-00042 (CPAN), contracts FPA2008-03456 and FPA2009-13697; Portuguese Fundacao para a Ciencia e a Tecnologia; European FEDER under grant PPTDC/FIS/103860/2008; US Department Of Energy under contract DE-AC02-05CH11231.Gonzalez Diaz, D.; Álvarez Puerta, V.; Borges, FIG.; Camargo, M.; Carcel, S.; Cebrian, S.; Cervera, A.... (2015). Accurate gamma and MeV-electron track reconstruction with an ultra-low diffusion Xenon/TMA TPC at 10 atm. Nuclear Instruments and Methods in Physics Research Section A: Accelerators, Spectrometers, Detectors and Associated Equipment. 804:8-24. https://doi.org/10.1016/j.nima.2015.08.033S82480

Multiplex Real-Time PCR Assay Using TaqMan Probes for the Identification of Trypanosoma cruzi DTUs in Biological and Clinical Samples

Background: Trypanosoma cruzi has been classified into six Discrete Typing Units (DTUs), designated as TcI–TcVI. In order to effectively use this standardized nomenclature, a reproducible genotyping strategy is imperative. Several typing schemes have been developed with variable levels of complexity, selectivity and analytical sensitivity. Most of them can be only applied to cultured stocks. In this context, we aimed to develop a multiplex Real-Time PCR method to identify the six T. cruzi DTUs using TaqMan probes (MTq-PCR).Methods/Principal Findings: The MTq-PCR has been evaluated in 39 cultured stocks and 307 biological samples from vectors, reservoirs and patients from different geographical regions and transmission cycles in comparison with a multi-locus conventional PCR algorithm. The MTq-PCR was inclusive for laboratory stocks and natural isolates and sensitive for direct typing of different biological samples from vectors, reservoirs and patients with acute, congenital infection or Chagas reactivation. The first round SL-IR MTq-PCR detected 1 fg DNA/reaction tube of TcI, TcII and TcIII and 1 pg DNA/reaction tube of TcIV, TcV and TcVI reference strains. The MTq-PCR was able to characterize DTUs in 83% of triatomine and 96% of reservoir samples that had been typed by conventional PCR methods. Regarding clinical samples, 100% of those derived from acute infected patients, 62.5% from congenitally infected children and 50% from patients with clinical reactivation could be genotyped. Sensitivity for direct typing of blood samples from chronic Chagas disease patients (32.8% from asymptomatic and 22.2% from symptomatic patients) and mixed infections was lower than that of the conventional PCR algorithm.Conclusions/Significance: Typing is resolved after a single or a second round of Real-Time PCR, depending on the DTU. This format reduces carryover contamination and is amenable to quantification, automation and kit production.This work received financial support from the Ministry of Science and Technology of Argentina [PICT 2011-0207 to AGS] and the National Scientific and Technical Research Council in Argentina (CONICET) [PIP 112 2011-010-0974 to AGS]. Work related to evaluation of biological samples was partially sponsored by the Pan-American Health Organization (PAHO) [Small Grants Program PAHO-TDR]; the Drugs and Neglected Diseases Initiative (DNDi, Geneva, Switzerland), Wellcome Trust (London, United Kingdom), SANOFI-AVENTIS (Buenos Aires, Argentina) and the National Council for Science and Technology in Mexico (CONACYT) [FONSEC 161405 to JMR]

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort study

Background: To date, 750 000 patients with COVID-19 worldwide have required mechanical ventilation and thus are at high risk of acute brain dysfunction (coma and delirium). We aimed to investigate the prevalence of delirium and coma, and risk factors for delirium in critically ill patients with COVID-19, to aid the development of strategies to mitigate delirium and associated sequelae. Methods: This multicentre cohort study included 69 adult intensive care units (ICUs), across 14 countries. We included all patients (aged 6518 years) admitted to participating ICUs with severe acute respiratory syndrome coronavirus 2 infection before April 28, 2020. Patients who were moribund or had life-support measures withdrawn within 24 h of ICU admission, prisoners, patients with pre-existing mental illness, neurodegenerative disorders, congenital or acquired brain damage, hepatic coma, drug overdose, suicide attempt, or those who were blind or deaf were excluded. We collected de-identified data from electronic health records on patient demographics, delirium and coma assessments, and management strategies for a 21-day period. Additional data on ventilator support, ICU length of stay, and vital status was collected for a 28-day period. The primary outcome was to determine the prevalence of delirium and coma and to investigate any associated risk factors associated with development of delirium the next day. We also investigated predictors of number of days alive without delirium or coma. These outcomes were investigated using multivariable regression. Findings: Between Jan 20 and April 28, 2020, 4530 patients with COVID-19 were admitted to 69 ICUs, of whom 2088 patients were included in the study cohort. The median age of patients was 64 years (IQR 54 to 71) with a median Simplified Acute Physiology Score (SAPS) II of 40\ub70 (30\ub70 to 53\ub70). 1397 (66\ub79%) of 2088 patients were invasively mechanically ventilated on the day of ICU admission and 1827 (87\ub75%) were invasively mechanical ventilated at some point during hospitalisation. Infusion with sedatives while on mechanical ventilation was common: 1337 (64\ub70%) of 2088 patients were given benzodiazepines for a median of 7\ub70 days (4\ub70 to 12\ub70) and 1481 (70\ub79%) were given propofol for a median of 7\ub70 days (4\ub70 to 11\ub70). Median Richmond Agitation\u2013Sedation Scale score while on invasive mechanical ventilation was \u20134 (\u20135 to \u20133). 1704 (81\ub76%) of 2088 patients were comatose for a median of 10\ub70 days (6\ub70 to 15\ub70) and 1147 (54\ub79%) were delirious for a median of 3\ub70 days (2\ub70 to 6\ub70). Mechanical ventilation, use of restraints, and benzodiazepine, opioid, and vasopressor infusions, and antipsychotics were each associated with a higher risk of delirium the next day (all p 640\ub704), whereas family visitation (in person or virtual) was associated with a lower risk of delirium (p<0\ub70001). During the 21-day study period, patients were alive without delirium or coma for a median of 5\ub70 days (0\ub70 to 14\ub70). At baseline, older age, higher SAPS II scores, male sex, smoking or alcohol abuse, use of vasopressors on day 1, and invasive mechanical ventilation on day 1 were independently associated with fewer days alive and free of delirium and coma (all p<0\ub701). 601 (28\ub78%) of 2088 patients died within 28 days of admission, with most of those deaths occurring in the ICU. Interpretation: Acute brain dysfunction was highly prevalent and prolonged in critically ill patients with COVID-19. Benzodiazepine use and lack of family visitation were identified as modifiable risk factors for delirium, and thus these data present an opportunity to reduce acute brain dysfunction in patients with COVID-19. Funding: None. Translations: For the French and Spanish translations of the abstract see Supplementary Materials section