Effects of the CPAP Treatment on the NON-REM Sleep Microstructures in Patients with Severe Apnea-Hypoapnea Syndrome

Sleep quality is affected in patients with sleep apnea- hypopnea syndrome (SAHS) with nocturnal and diurnal consequences. Most of these patients who are treated with positive airway pressure (CPAP) return to normal sleep patterns. We could consider good sleepers those patients who present more sleep spindles in stage II, and slower wave sleep as a good sign of better sleep quality. The objective in this research study was to compare the microstructure of stage II using the number of spindles and the increase of slow wave sleep before and after CPAP night titration. We developed a wavelet filter using a spline cubic function from a wavelet mother, which was appropriate to be used over electroencephalographic signal. By means of this filter in a multi-resolution mode, the spindles were detected from the increase of the IV band power; the sampling rate of the device determined the filter characteristics. The staging of polysomnographic studies was made by an expert according AASM (American Academy of Sleep Medicine) and then processed by the filter to get the index of sleep spindles before-and-after CPAP during stage II as well as the relationship between fast and slow powers from the EEG signal. An increase in the power of the slow waves vs. fast activity was observed in all the cases as a feature of better sleep. The neuroprotective effect described in previous research works regarding the density of the sleep spindles seems to be detected in patients improving their sleep quality after the correction of the apnea-hypopnea syndrome using CPAP.Fil: Smurra, Marcela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Enrique Tornú; ArgentinaFil: Blanco, Susana Alicia Ana. Universidad de Belgrano. Facultad de Ingeniería; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Eguiguren, Veronica. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Enrique Tornú; ArgentinaFil: Di Risio, Cecilia Diana. Universidad de Belgrano. Facultad de Ingeniería; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Molecular characterization of Cystoisospora belli and unizoite tissue cyst in patients with Acquired Immunodeficiency Syndrome

Cystoisospora belli is a coccidian protozoan that can cause chronic diarrhoea, acalculous cholecystitis and cholangiopathy in AIDS patients. We applied molecular methods to identify Cystoisospora at species level in AIDS patients presenting with and without the presence of unizoites in lamina propria. Coprological and histological analyses were performed in stool and/or biopsy samples from 8 Cystoisospora-infected patients. DNA from the same samples was used to amplify 2 fragments of the SSU-rRNA gene and the ITS-1 region. Sequencing of the resulting amplicons identified C. belli infections in all cases, independent of the presence or absence of unizoite tissue cysts. Further work should be considered in order to find molecular targets related to strain variations in C. belli.Fil: Velásquez, Jorge Néstor. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Astudillo, Osvaldo Germán. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas; ArgentinaFil: Di Risio, Cecilia Diana. Hospital Municipal General de Agudos Doctor José Penna; ArgentinaFil: Etchart, Cristina. Hospital Municipal General de Agudos Doctor José Penna; ArgentinaFil: Chertcoff, Agustín Víctor. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas; ArgentinaFil: Perissé, Gladys Elisabet. Hospital Municipal General de Agudos Doctor José Penna; ArgentinaFil: Carnevale, Silvana. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

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

La digitalización de equipos de mamografía: elementos fundamentales a tener en cuenta para beneficiarnos de la tecnología

La mamografía digital resolvió muchos de los problemas asociados a la mamografía analógica. Una opción utilizada con mucha frecuencia para migrar a la técnica digital directa consiste en digitalizar equipos analógicos. Aquí, se describen las características que deben considerarse al momento de digitalizar un mamógrafo analógico para obtener del proceso las mayores ventajas, la mejor imagen y la dosis más baja posible compatible con el contraste óptimo y el ruido más bajo.Digital mammography solved many of the problems associated with analog mammography. A frequently used option to migrate to direct digital technique is to digitize analog equipment. Characteristics which must be taken into account to digitize an analog mammography and get the most advantages of the process, the best picture and the lowest dose possible consistent with optimal contrast and lower noise are described.Fil: Blanco, Susana Alicia Ana. Universidad de Belgrano. Facultad de Ingeniería; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Andisco, Daniel Enrique. Universidad de Buenos Aires. Facultad de Medicina; ArgentinaFil: Di Risio, Cecilia Diana. Universidad de Belgrano. Facultad de Ingeniería; ArgentinaFil: Buzzi, A.E.. Universidad de Buenos Aires. Facultad de Medicina; Argentin

Mammography parameters: compression, dose, and discomfort

Objetivo: Confirmar la importancia de la compresión en mamografía, y relacionarla con eldisconfort manifestado por las pacientes.Materiales y métodos: Se emplearon 2 muestras de 402 y 268 mamografías, obtenidas en doscentros de diagnóstico que poseen el mismo equipo mamográfico pero diferentes técnicas decompresión. Las edades variaron entre los 21 y los 50 a?nos.Resultados: Se observó una sensible disminución en la dosis recibida a mayor compresión. Sinembargo, no se obtuvo una diferencia significativa en lo que respecta a los reclamos de laspacientes en relación con el disconfort experimentado.Discusión y Conclusión: La compresión en mamografía, siguiendo los estándares internacionalesde una fuerza entre 80-120 N, es efectiva en cuanto a la reducción de dosis, sin por eso serinsoportable para la paciente. Este disconfort tampoco está relacionado con la glandularidadde la mama.Objective To confirm the importance of compression in mammography and relate it to the discomfort expressed by the patients. Materials and methods Two samples of 402 and 268 mammographies were obtained from two diagnostic centres that use the same mammographic equipment, but different compression techniques. The patient age range was from 21 to 50 years old. Results A significant decrease in the dose received was observed at higher compression. However, there was no significant difference as regards patients complaining about the discomfort experienced. Discussion and Conclusion Compression in mammography, following the international standards of a pressure between 80-120 N, is effective in reducing the dose without being unbearable for the patient. This discomfort is also unrelated to the glandularity of the breastFil: Blanco, Susana Alicia Ana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Belgrano. Facultad de Ingeniería; Argentina. Instituto Nacional del Cáncer; ArgentinaFil: Di Risio, Cecilia Diana. Universidad de Belgrano. Facultad de Ingeniería; ArgentinaFil: Andisco, D.. Instituto Nacional del Cáncer; ArgentinaFil: Rojas, R. R.. Centro de Diagnóstico Rojas; ArgentinaFil: Rojas, R. M.. Centro de Diagnóstico Rojas; Argentin

Direct, immunological and molecular techniques for a fasciolosis survey in a rural area of San Luis, Argentina

Fasciolosis is a zoonosis caused by the trematode Fasciola hepatica, prevalent in cattle, that is actually emerging as a cause of disease in humans. The goal of this work was to describe the characteristics of fasciolosis in arroyo El Juncal region, La Toma, San Luis province, Argentina. In order to get this objective, a transversal, quantitative study was carried out by a fieldwork that allowed the collection of data, human, animal, and environmental samples. The materials were processed by direct, immunological and/or molecular diagnostic techniques. According to the geographical characteristics and in presence of all the definitive and intermediate hosts, reservoirs, and sources of infection, it was possible to describe the persistence of fasciolosis in the area. The prevalence was 11.90 % in humans (by serology), 5.26 % in cattle (by coprological analysis) and 61.76 % in snails (by PCR). The situation that was found for this area indicates that any measure of intervention for the control of this zoonosis should be adopted by multidisciplinary teams.Fil: Carnevale, Silvana. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud. Instituto Nacional de Enfermedades Infecciosas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Cabrera, Marta Graciela. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud; ArgentinaFil: Cucher, Marcela Alejandra. Universidad de Buenos Aires. Facultad de Medicina. Departamento de Microbiología. Area Parasitología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Di Risio, Cecilia Diana. Universidad de Buenos Aires. Ciclo Básico Común; Argentina. Hospital Municipal General de Agudos Doctor José Penna; ArgentinaFil: Malandrini, Jorge Bruno. Universidad Nacional de Catamarca. Facultad de Ciencias de la Salud; ArgentinaFil: Kamenetzky, Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones en Microbiología y Parasitología Médica; ArgentinaFil: Alazraqui, Marcio. Universidad Nacional de Lanús. Rectorado. Instituto de Salud Colectiva; ArgentinaFil: Etchart, Cristina Beatriz. Hospital Municipal General de Agudos Doctor José Penna; ArgentinaFil: Pantano, Maria Laura. Dirección Nacional de Institutos de Investigación. Administración Nacional de Laboratorios e Institutos de Salud; ArgentinaFil: Velásquez, Jorge Néstor. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas F. J. Muñiz; Argentin

Recursos Hídricos: Conceptos básicos y estudios de caso en Iberoamérica

El agua como fuente de vida y en el desempeño de sus funciones: sociales, ambientales, económicas y culturales, condiciona el desarrollo de una región, nación o continente, pues, la concentración urbana, el incremento de la superficie de riego para la producción de alimentos y la creciente contaminación someten a los recursos hídricos a una fuerte presión que no es posible soportar, originando situaciones de crisis. Así, mientras encuentran localidades la satisfacción de las necesidades en agua de sus habitantes representa un esfuerzo cotidiano, en otras, el desperdicio es una práctica generalizada pero inadmisible. Sin duda alguna en el mediano y largo plazo la tendencia actual en el uso de agua es simplemente insostenible. No es posible sufragar permanentemente el costo económico, social ay ambiental de abastecer a las grandes urbes con escurrimientos superficiales importados desde enormes distancias, de agotar los acuíferos de alterar la calidad de las agua rebasando límites de renovación económicamente factibles. Tampoco es posible enfrentar el problema del agua como si la disponibilidad del recurso fuera ilimitada y gratuita..

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