Echocardiography findings in COVID-19 patients admitted to intensive care units: a multi-national observational study (the ECHO-COVID study)

Purpose: Severely ill patients affected by coronavirus disease 2019 (COVID-19) develop circulatory failure. We aimed to report patterns of left and right ventricular dysfunction in the first echocardiography following admission to intensive care unit (ICU). Methods: Retrospective, descriptive study that collected echocardiographic and clinical information from severely ill COVID-19 patients admitted to 14 ICUs in 8 countries. Patients admitted to ICU who received at least one echocardiography between 1st February 2020 and 30th June 2021 were included. Clinical and echocardiographic data were uploaded using a secured web-based electronic database (REDCap). Results: Six hundred and seventy-seven patients were included and the first echo was performed 2 [1, 4] days after ICU admission. The median age was 65 [56, 73] years, and 71% were male. Left ventricle (LV) and/or right ventricle (RV) systolic dysfunction were found in 234 (34.5%) patients. 149 (22%) patients had LV systolic dysfunction (with or without RV dysfunction) without LV dilatation and no elevation in filling pressure. 152 (22.5%) had RV systolic dysfunction. In 517 patients with information on both paradoxical septal motion and quantitative RV size, 90 (17.4%) had acute cor pulmonale (ACP). ACP was associated with mechanical ventilation (OR > 4), pulmonary embolism (OR > 5) and increased PaCO2. Exploratory analyses showed that patients with ACP and older age were more likely to die in hospital (including ICU). Conclusion: Almost one-third of this cohort of critically ill COVID-19 patients exhibited abnormal LV and/or RV systolic function in their first echocardiography assessment. While LV systolic dysfunction appears similar to septic cardiomyopathy, RV systolic dysfunction was related to pressure overload due to positive pressure ventilation, hypercapnia and pulmonary embolism. ACP and age seemed to be associated with mortality in this cohort

El futuro anterior. La universidad como sistema de producción de conocimientos, aprendizajes e innovación social

En este trabajo se apuesta al futuro. No a cualquier futuro, sino a uno creado de forma deliberada por una sociedad con acción transformadora de sus universidades. El contexto, América Latina y el Caribe, integración y esfuerzo compartido, para lograr que el conocimiento, aprendizaje significativo, ciencia, tecnología e innovación social, sean la base de un desarrollo con justicia y equidad. Se discurre sobre cambios durante las últimas décadas, desde la perspectiva consustancial a las tareas fundamentales de la universidad: docencia e investigación; pero, sobre todo, desde nuevos conocimientos y aprendizajes, focalizados en perspectiva crítica, poniendo acentos en lo que se ha perdido o no se ha hecho, y que es necesario empezar a re-construir. Al final, se expone una agenda política de transformación, para la universidad re-orientada hacia el bien común

An Overview of Regional Perspectives on the Role of Higher Education in Social and Human Development

In Part I this report studied selected global issues on higher education’s role in social and human development. This overview is a synthesis of the regional perspectives on higher education’s role for human and social development based on the contribution of the authors in four key areas – one of which is the state of higher education in each region since the World Conference on Higher Education (WCHE) held in 1998, the other is possible future roles, strategies and actions of higher education in order to foster social and human development – for the regions classified as: Sub-Saharan Africa, Arab States, Asia and the Pacific, Europe, North America (USAand Canada) and Latin America and the Caribbean.Peer Reviewe