Comparación de distintas estrategias para la predicción de muerte a corto plazo en el paciente anciano infectado

Objective. The aim of this study was to determine the utility of a post hoc lactate added to SIRS and qSOFA score to predict 30-day mortality in older non-severely dependent patients attended for infection in the Emergency Department (ED). Methods. We performed an analytical, observational, prospective cohort study including patients of 75 years of age or older, without severe functional dependence, attended for an infectious disease in 69 Spanish ED for 2-day three seasonal periods. Demographic, clinical and analytical data were collected. The primary outcome was 30-day mortality after the index event. Results. We included 739 patients with a mean age of 84.9 (SD 6.0) years; 375 (50.7%) were women. Ninety-one (12.3%) died within 30 days. The AUC was 0.637 (IC 95% 0.587-0.688; p= 2 and 0.698 (IC 95% 0.635- 0.761; p= 2. Comparing receiver operating characteristic (ROC) there was a better accuracy of qSOFA vs SIRS (p=0.041). Both scales improve the prognosis accuracy with lactate inclusion. The AUC was 0.705 (IC95% 0.652-0.758; p<0.001) for SIRS plus lactate and 0.755 (IC95% 0.696-0.814; p<0.001) for qSOFA plus lactate, showing a trend to statistical significance for the second strategy (p=0.0727). Charlson index not added prognosis accuracy to SIRS (p=0.2269) or qSOFA (p=0.2573). Conclusions. Lactate added to SIRS and qSOFA score improve the accuracy of SIRS and qSOFA to predict short-term mortality in older non-severely dependent patients attended for infection. There is not effect in adding Charlson index

An Intercomparison Exercise on the Capabilities of CFD Models to Predict Deflagration of a Large-Scale H2-Air Mixture in Open Atmosphere

This paper presents a compilation of the results supplied by HySafe partners participating in the Standard Benchmark Exercise Problem (SBEP) V2, which is based on an experiment on hydrogen combustion that is first described. A list of the results requested from participants is also included. The main characteristics of the models used for the calculations are compared in a very succinct way by using tables. The comparision between results, together with the experimental data, when available, is made through a series of graphs. The results show quite good agreement with the experimental data. The calculations have demonstrated to be sensitive to computational domain size and far field boundary condition.JRC.F.4-Nuclear design safet

An intercomparison exercise on the capabilities of CFD models to reproduce a large-scale hydrogen deflagration in open atmosphere

Within the HySafe Network of Excellence, several organizations with experience in numerical combustion modeling participated to Standard Benchmark Exercise Problem 2 (SBEP-V2), trying to reproduce numerically the explosion of a stoichiometric hydrogen-air mixture in a 10 m radius balloon. Different codes and models have been applied in the validation exercise. The simulation results and experimental data for the flame speed, the maximum pressures, the rate of pressure rise and the maximum impulse are discussed and compared by means of statistical analysis. An overall satisfactory agreement for the flame speed and maximum pressure is found. © 2010 Professor T. Nejat Veziroglu

Individual progression of carotid intima media thickness as a surrogate for vascular risk (PROG-IMT) : rationale and design of a meta-analysis project

Carotid intima media thickness (IMT) progression is increasingly used as a surrogate for vascular risk. This use is supported by data from a few clinical trials investigating statins, but established criteria of surrogacy are only partially fulfilled. To provide a valid basis for the use of IMT progression as a study end point, we are performing a 3-step meta-analysis project based on individual participant data. Objectives of the 3 successive stages are to investigate (1) whether IMT progression prospectively predicts myocardial infarction, stroke, or death in population-based samples; (2) whether it does so in prevalent disease cohorts; and (3) whether interventions affecting IMT progression predict a therapeutic effect on clinical end points. Recruitment strategies, inclusion criteria, and estimates of the expected numbers of eligible studies are presented along with a detailed analysis plan