7 research outputs found
Suport vital bàsic pediàtric 2021
El suport vital bàsic pediàtric (SVBP), abans RCP bàsica pediàtrica (RCPBP), és una de les anelles en la cadena de supervivència de l'infant en aturada cardiorespiratòria (ACR) 1. La seva importància ve donada pel paper clau que té en l'atenció immediata a l'emergència i perquè és un element essencial de suport a la reanimació avançada. Les principals novetats en les recomanacions en SVBP fetes per l'ERC (Consell Europeu de Ressuscitació) els anys 2005, 2010 i 2015 han estat difoses pel Comitè d'RCP de la Societat Catalana de Pediatria (CRCPSCP) a través de Pediatria Catalana 2-4. En aquest article es presenten els aspectes que representen una novetat o que són particularment rellevants de les noves guies 2021 de l'ERC pel que fa al SVBP Cal recordar que l'ús del desfibril·lador extern automatitzat (DEA) i l'atenció a l'obstrucció de la via aèria per cos estrany (OVACE) són part integral del SVBP
Almagate interference in breath test results for the diagnosis of Helicobacter pylori infection
Background: Infection by Helicobacter pylori is common and affects both genders at any age. The 13C-urea breath test is a widely used test for the diagnosis of this infection. However, multiple drugs used for the treatment of Helicobacter pylori infection symptoms have interactions with this breath test that generate false negative results. This observational study was to assess the potential interaction between almagate and the breath test. Methods: Thirty subjects on almagate therapy who underwent a breath test were included. If the result was negative, almagate was withdrawn for a month and the breath test was then repeated. Results: In general, 51.9 % of assessed subjects had a negative result after the first test, and 100 % of these also had a negative result after the second test. Conclusions: It was concluded that the use of almagate does not interfere in breath test results. These results provide a drug therapy option for the treatment of symptoms associated with Helicobacter pylori infection during the diagnostic process
Effects of atmospheric carbon dioxide fertilization on biomass and secondary metabolites of some plant species with pharmacological interes under greenhouse conditions
RESUMEN
El aumento del CO2 atmosférico debido al cambio global
y/o a las prácticas hortícolas promueve efectos directos
sobre crecimiento vegetal y el desarrollo. Estas respuestas
pueden ocurrir en ecosistemas naturales, pero también
se pueden utilizar para aumentar la producción de algunas
plantas y de algunos compuestos secundarios. El
actual trabajo intenta estudiar los efectos del enriquecimiento
atmosférico del CO2 bajo condiciones de invernadero
en el crecimiento y la concentración y la composición
de metabolitos secundarios de Taxus bacatta,
Hypericum perforatum y Echinacea purpurea en condiciones
ambientales mediterráneas. La fertilización del
CO2 muestra perspectivas interesantes para la mejorara
y aplicabilidad de técnicas hortícolas para aumentar productividad
de plantas medicinales, a pesar de diferencias
claras entre la especie. En general esta técnica promueve
aumentos importantes y significativos en producción
primaria y, en algunos casos, también en compuestos
secundarios. Esto tiene una gran importancia hortícola
porque la productividad a nivel de cosecha total aumenta,
directamente porque se aumenta la concentración e
indirectamente porque se aumenta la biomasa.
SUMMARY
The increase of atmospheric CO2 due to global change
and/or horticultural practices promotes direct effects on
plant growth and development. These responses may
occur in natural ecosystems, but also can be used to
increase the production of some plants and some secondary
compounds. Present work tries to study the effects
of atmospheric CO2 enrichment under greenhouse conditions
on growth and in the concentration and composition
of secondary metabolites of Taxus bacatta,
Hypericum perforatum and Echinacea purpurea under
Mediterranean environmental conditions.
CO2 fertilization shows interesting perspectives to increase
and improve horticultural techniques in order to increase
plant medicinal productivity, in spite of clear differences
among the species. In general this technique
promotes important and significant increases in primary
productivity and, in some cases, also in secondary compounds.
This has a great horticultural relevance because
the total productivity of this kind of products increase
at crop level, directly because concentration is
increased and /or indirectly because biomass is increased.
RESUM
L'augment del CO2 atmosfèric a causa del canvi global i/o
a les pràctiques hortícoles promou efectes directes sobre
creixement vegetal i el desenvolupament. Aquestes respostes
poden ocórrer en ecosistemes naturals, però també
es poden utilitzar per a augmentar la producció d'algunes
plantes i d'alguns compostos secundaris. L'actual
treball intenta estudiar els efectes de l'enriquiment
atmosfèric del CO2 sota condicions d'hivernacle en el creixement
i la concentració i la composició de metabòlits
secundaris de Taxus bacatta, Hypericum perforatum i
Echinacea purpurea en condicions ambientals mediterrànies.
La fertilització del CO2 mostra perspectives interessants
per a la millora i aplicabilitat de tècniques hortícoles
per a augmentar productivitat de plantes medicinals,
a pesar de diferències clares entre l'espècie. En general
aquesta tècnica promou augments importants i significatius
en producció primària i, en alguns casos, també en
compostos secundaris. Això té una gran importància hortícola
perquè la productivitat a nivell de collita total augmenta,
directament perquè s'augmenta la concentració i
indirectament perquè s'augmenta la biomassa
Características clínicas, asistenciales y evolutivas de la insuficiencia cardiaca aguda en el clima subtropical: resultados del estudio CANAR-ICA
Objectives: To determine whether there are differences in the clinical characteristics, management, and outcome of episodes of acute heart failure (AHF) in residents of the Canary Islands, where the climate is subtropical, and episodes in continental Spain. Material and methods: Cases were identified in the registry for Epidemiology of Acute Heart Failure in Emergency Departments and categorized as in the Canary Islands or continental Spain. Data for 38 demographic, baseline, clinical, and therapeutic variables were extracted. We analyzed statistics for in-hospital and 30-day mortality, long hospital stay (more than 7 days), and a composite outcome after discharge (revisits or death within 30 days). The results for island and continental patients were compared and adjusted for between-group differences. Results: A total of 18 390 patients were studied, 697 islanders (3.8%) and 17 673 continental patients (96.2%). Comparisons showed that the islanders were younger; more often women; and more likely to have hypertension, diabetes, and a prior AHF episode. Their New York Heart Association functional class was also likely to be higher. However, their rates of dyslipidemia, valve disease, and functional dependence were lower, and they were also less likely to be on reninangiotensin system blockers. Although the severity of cardiac decompensation was similar in island and continental patients, the islanders received more intravenous treatments in the emergency department and were admitted less often. The adjusted risk of a long hospital stay was higher for the islanders (odds ratio [OR], 2.36; 95% CI, 1.52-3.02) but their risk for mortality and the composite outcome did not differ: in-hospital mortality, OR 0.97 (95% CI, 0.68-1.37); 30-day mortality, OR, 0.9 (95% CI, 0.67-1.27); and the post-discharge composite, OR, 1.19 (95% CI, 0.93-1.53). Conclusion: Baseline patient characteristics and clinical management of AHF episodes differ between the subtropical region and those in southern continental Europe. Hospitalization was required less often, but hospital stays were longer
Influence of the length of hospitalisation in post-discharge outcomes in patients with acute heart failure: Results of the LOHRCA study.
To investigate the relationship between length of hospitalisation (LOH) and post-discharge outcomes in acute heart failure (AHF) patients and to ascertain whether there are different patterns according to department of initial hospitalisation. Consecutive AHF patients hospitalised in 41 Spanish centres were grouped based on the LOH (15 days). Outcomes were defined as 90-day post-discharge all-cause mortality, AHF readmissions, and the combination of both. Hazard ratios (HRs), adjusted by chronic conditions and severity of decompensation, were calculated for groups with LOH >6 days vs. LOH 6 days vs. LOH We included 8563 patients (mean age: 80 (SD = 10) years, 55.5% women), with a median LOH of 7 days (IQR 4-11): 2934 (34.3%) had a LOH 15 days. The 90-day post-discharge mortality was 11.4%, readmission 32.2%, and combined endpoint 37.4%. Mortality was increased by 36.5% (95%CI = 13.0-64.9) when LOH was 11-15 days, and by 72.0% (95%CI = 42.6-107.5) when >15 days. Conversely, no differences were found in readmission risk, and the combined endpoint only increased 21.6% (95%CI = 8.4-36.4) for LOH >15 days. Stratified analysis by hospitalisation departments rendered similar post-discharge outcomes, with all exhibiting increased mortality for LOH >15 days and no significant increments in readmission risk. Short hospitalisations are not associated with worse outcomes. While post-discharge readmissions are not affected by LOH, mortality risk increases as the LOH lengthens. These findings were similar across hospitalisation departments
Clinical phenotypes of acute heart failure based on signs and symptoms of perfusion and congestion at emergency department presentation and their relationship with patient management and outcomes
Objective To compare the clinical characteristics and outcomes of
patients with acute heart failure (AHF) according to clinical profiles
based on congestion and perfusion determined in the emergency department
(ED).
Methods and results Overall, 11 261 unselected AHF patients from 41
Spanish EDs were classified according to perfusion (normoperfusion =
warm; hypoperfusion = cold) and congestion (not = dry; yes = wet).
Baseline and decompensation characteristics were recorded as were the
main wards to which patients were admitted. The primary outcome was
1-year all-cause mortality; secondary outcomes were need for
hospitalisation during the index AHF event, in-hospital all-cause
mortality, prolonged hospitalisation, 7-day post-discharge ED revisit
for AHF and 30-day post-discharge rehospitalisation for AHF. A total of
8558 patients (76.0%) were warm+ wet, 1929 (17.1%) cold+ wet, 675
(6.0%) warm+ dry, and 99 (0.9%) cold+ dry; hypoperfused (cold)
patients were more frequently admitted to intensive care units and
geriatrics departments, and warm+ wet patients were discharged home
without admission. The four phenotypes differed in most of the baseline
and decompensation characteristics. The 1-year mortality was 30.8%, and
compared to warm+ dry, the adjusted hazard ratios were significantly
increased for cold+ wet (1.660; 95% confidence interval 1.400-1.968)
and cold+ dry (1.672; 95% confidence interval 1.189-2.351).
Hypoperfused (cold) phenotypes also showed higher rates of index episode
hospitalisation and in-hospital mortality, while congestive (wet)
phenotypes had a higher risk of prolonged hospitalisation but decreased
risk of rehospitalisation. No differences were observed among phenotypes
in ED revisit risk.
Conclusions Bedside clinical evaluation of congestion and perfusion of
AHF patients upon ED arrival and classification according to phenotypic
profiles proposed by the latest European Society of Cardiology
guidelines provide useful complementary information and help to rapidly
predict patient outcomes shortly after ED patient arrival