The influence of postoperative albumin levels on the outcome of cardiac surgery

Background: The prognostic role of low postoperative serum albumin levels (SAL) after cardiac surgery (CS) remains unclear in patients with normal preoperative SAL. Our aim was to evaluate the influence of SAL on the outcome of CS.MethodsProspective observational study. Patients undergoing CS with normal preoperative SAL and nutritional status were included and classified into different subgroups based on SAL at 24h after CS. We assessed outcomes (i.e., in-hospital mortality, postoperative complications and long-term survival) and results were analyzed among the different subgroups of SAL. Results: We included 2818 patients. Mean age was 64.511.6years and body mass index 28.0 +/- 4.3Kg.m(-2). 5.8%(n=162) of the patients had normal SAL levels(>= 35g.L-1), 32.8%(n=924) low deficit (30-34.9g.L-1), 44.3%(n=1249) moderate deficit (25-29.9g.L-1), and 17.1%(n=483) severe deficit(<25g.L-1). Higher SAL after CS was associated with reduced in-hospital (OR:0.84;95% CI:0.80-0.84; P=0.007) and long-term mortality (HR:0.85;95% CI:0.82-0.87;P<0.001). Subgroups of patients with lower SAL showed worst long-term survival (5-year mortality:94.3% normal subgroup, 87.4% low, 83.1% moderate and 72.4% severe;P<0.001). Multivariable analysis showed higher in-hospital mortality, sepsis, hemorrhage related complications, and ICU stay in subgroups of patients with lower SAL. Predictors of moderate and severe hypoalbuminemia were preoperative chronic kidney disease, previous CS, and longer cardiopulmonary bypass time. Conclusions: p id=Par The presence of postoperative hypoalbuminemia after CS is frequent and the degree of hypoalbuminemia may be associated with worst outcomes, even in the long-term scenario

Creación de nuevo recurso educativo virtual para estudiantes de grado en Farmacia

Depto. de Farmacia Galénica y Tecnología AlimentariaFac. de FarmaciaFALSEsubmitte

Creación de un nuevo recurso educativo virtual para estudiantes de grado en Farmacia

Creación de un nuevo recurso educativo virtual para estudiantes de grado en Farmacia sobre la serialización de los medicamentos y los procesos de mezclado

Influence of acute kidney injury on short- and long-term outcomes in patients undergoing cardiac surgery: risk factors and prognostic value of a modified RIFLE classification

Introduction: The development of acute kidney injury (AKI) is associated with poor outcome. The modified RIFLE (risk, injury, failure, loss of kidney function, and end-stage renal failure) classification for AKI, which classifies patients with renal replacement therapy needs according to RIFLE failure class, improves the predictive value of AKI in patients undergoing cardiac surgery. Our aim was to assess risk factors for post-operative AKI and the impact of renal function on short- and long-term survival among all AKI subgroups using the modified RIFLE classification. Methods: We prospectively studied 2,940 consecutive cardiosurgical patients between January 2004 and July 2009. AKI was defined according to the modified RIFLE system. Pre-operative, operative and post-operative variables usually measured on and during admission, which included main outcomes, were recorded together with cardiac surgery scores and ICU scores. These data were evaluated for association with AKI and staging in the different RIFLE groups by means of multivariable analyses. Survival was analyzed via Kaplan-Meier and a risk-adjusted Cox proportional hazards regression model. A complete follow-up (mean 6.9 ± 4.3 years) was performed in 2,840 patients up to April 2013. Results: Of those patients studied, 14% (n = 409) were diagnosed with AKI. We identified one intra-operative (higher cardiopulmonary bypass time) and two post-operative (a longer need for vasoactive drugs and higher arterial lactate 24 hours after admission) predictors of AKI. The worst outcomes, including in-hospital mortality, were associated with the worst RIFLE class. Kaplan-Meier analysis showed survival of 74.9% in the RIFLE risk group, 42.9% in the RIFLE injury group and 22.3% in the RIFLE failure group (P <0.001). Classification at RIFLE injury (Hazard ratio (HR) = 2.347, 95% confidence interval (CI) 1.122 to 4.907, P = 0.023) and RIFLE failure (HR = 3.093, 95% CI 1.460 to 6.550, P = 0.003) were independent predictors for long-term patient mortality. Conclusions: AKI development after cardiac surgery is associated mainly with post-operative variables, which ultimately could lead to a worst RIFLE class. Staging at the RIFLE injury and RIFLE failure class is associated with higher short- and long-term mortality in our population

The Influence of Body Mass Index on Outcomes in Patients Undergoing Cardiac Surgery: Does the Obesity Paradox Really Exist?

Purpose: Obesity influences risk stratification in cardiac surgery in everyday practice. However, some studies have reported better outcomes in patients with a high body mass index (BMI): this is known as the obesity paradox. The aim of this study was to quantify the effect of diverse degrees of high BMI on clinical outcomes after cardiac surgery, and to assess the existence of an obesity paradox in our patients. Methods: A total of 2,499 consecutive patients requiring all types of cardiac surgery with cardiopulmonary bypass between January 2004 and February 2009 were prospectively studied at our institution. Patients were divided into four groups based on BMI: normal weight (18.524.9 kg∙m−2; n = 523; 21.4%), overweight (2529.9kg∙m−2; n = 1150; 47%), obese (≥30≤34.9kg∙m−2; n = 624; 25.5%) and morbidly obese (≥35kg∙m−2; n = 152; 6.2%). Follow-up was performed in 2,379 patients during the first year. Results: After adjusting for confounding factors, patients with higher BMI presented worse oxygenation and better nutritional status, reflected by lower PaO2/FiO2 at 24h and higher albumin levels 48h after admission respectively. Obese patients showed a higher risk for Perioperative Myocardial Infarction (OR: 1.768; 95% CI: 1.0353.022; p = 0.037) and septicaemia (OR: 1.489; 95% CI: 1.2821.997; p = 0.005). In-hospital mortality was 4.8% (n = 118) and 1-year mortality was 10.1% (n = 252). No differences were found regarding in-hospital mortality between BMI groups. The overweight group showed better 1-year survival than normal weight patients (91.2% vs. 87.6%; Log Rank: p = 0.029. HR: 1.496; 95% CI: 1.0622.108; p = 0.021). Conclusions: In our population, obesity increases Perioperative Myocardial Infarction and septicaemia after cardiac surgery, but does not influence in-hospital mortality. Although we found better 1-year survival in overweight patients, our results do not support any protective effect of obesity in patients undergoing cardiac surgery

Descripción de las saponinas en quinua (Chenopodium quinoa willd) en relación con el suelo y el clima: Una revisión

Increasingly, the production of quinoa (Chenopodium quinoa Willd) in different regions of the world becomes more&nbsp;important, due to the fact that it has been sought to position the crop as an alternative to food security. However, this plant&nbsp;has metabolites such as tannins and saponins, which are chemical substances that serve as protective barriers to biotic and&nbsp;abiotic factors. In the case of saponins, 31 chemical structures are recognized, present in leaves, stems, panicles, husk and&nbsp;seeds of different species and genotypes. In this regard, this review seeks to describe general characteristics of the saponins&nbsp;present in quinoa and its relations with soil and climate. Finding that the edaphoclimatics characteristic of each place as well as the genetic characteristics of each variety are determinants in the content of saponin compounds stimulated mainly by water and saline stress.Cada vez, toma mayor importancia la producción de la quinua (Chenopodium quinoa Willd) en diferentes regiones del mundo, debido a que se ha buscado posicionar el cultivo como una alternativa de seguridad alimentaria. Sin embargo, esta&nbsp;planta presenta metabolitos como taninos y saponinas que son sustancias químicas que sirven de barreras de protección a factores bióticos y abióticos. En el caso de las saponinas, se reconocen 31 estructuras químicas, presentes en hojas, tallos,&nbsp;panojas, cascarilla y semillas de diferentes especies y genotipos. Al respecto, esta revisión busca describir características generales de las saponinas presentes en la quinua y su relación con el suelo y el clima. Encontrando que las edafoclimáticas&nbsp;propias de cada lugar, así como las características genéticas de cada variedad son determinantes en el contenido de compuestos saponínicos, estimulados principalmente por estrés de tipo hídrico y salino

Evaluation of the PaO2/FiO2 ratio after cardiac surgery as a predictor of outcome during hospital stay

Background: the arterial partial pressure of O2 and the fraction of inspired oxygen (PaO2/FiO2) ratio is widely used in ICUs as an indicator of oxygenation status. Although cardiac surgery and ICU scores can predict mortality, during the first hours after cardiac surgery few instruments are available to assess outcome. The aim of this study was to evaluate the usefulness of PaO2/FIO2 ratio to predict mortality in patients immediately after cardiac surgery. Methods: we prospectively studied 2725 consecutive cardiac surgery patients between 2004 and 2009. PaO2/FiO2 ratio was measured on admission and at 3 h, 6 h, 12 h and 24 h after ICU admission, together with clinical data and outcomes. Results: all PaO2/FIO2 ratio measurements differed between survivors and non-survivors (p  242; Group 2, with PaO2/FIO2 from 202 to 242; and Group 3, with PaO2/FIO2 < 202. Group 3 showed higher in-ICU mortality and ICU length of stay and Groups 2 and 3 also showed higher respiratory complication rates. The presence of a PaO2/FIO2 ratio < 202 at 3 h after admission was shown to be a predictor of in-ICU mortality (OR:1.364; 95% CI:1.212-1.625, p < 0.001) and of worse long-term survival (88.8% vs. 95.8%; Log rank p = 0.002. Adjusted Hazard ratio: 1.48; 95% CI:1.293-1.786; p = 0.004). Conclusions: a simple determination of PaO2/FIO2 at 3 h after ICU admission may be useful to identify patients at risk immediately after cardiac surgery

Creación de nuevos recursos educativos virtuales para estudiantes de grado en Farmacia

Depto. de Farmacia Galénica y Tecnología AlimentariaFac. de FarmaciaFALSEsubmitte

Creación de nuevo recurso educativo virtual para estudiantes de grado en Farmacia.

Creación de nuevo recurso educativo virtual para estudiantes de grado en Farmacia. El presente proyecto es continuación de un proyecto concedido con financiación el año 2019 y en él se continuarán desarrollando nuevos recursos educativos virtuales como los que ya se han hecho este curso, y que han tenido excelente acogida por los alumnos, para facilitar la adquisición del conocimiento de los estudiantes de Farmacia especialmente de aquellos temas en los que la bibliografía disponible es escasa como en el caso de la Asignatura de Tecnología Farmacéutica III en los temas dedicados a la industria farmacéutica.Depto. de Farmacia Galénica y Tecnología AlimentariaSección Deptal. de Farmacología y Toxicología (Veterinaria)Fac. de FarmaciaFac. de VeterinariaFALSEsubmitte

Las desigualdades de género en el Sistema Universitario de Galicia. El caso de las enseñanzas técnicas

La progresiva incorporación de las mujeres a los niveles educativos más elevados no ha derivado en una presencia equilibrada de las mismas en todas las ramas de conocimiento. Así, tanto los ámbitos educativos como los profesionales relacionados con la ciencia y la tecnología sufren una preocupante falta de mujeres, las cuales a menudo eligen carreras con menos salidas profesionales, que además conducen, fundamentalmente, a sectores y categorías de trabajo con un nivel más bajo de retribución económica. El presente estudio tiene dos objetivos generales: en primer lugar, proporcionar y conectar los datos estadísticos más recientes de la situación de las mujeres en el ámbito de estudio universitario en Galicia; y en segundo lugar, analizar cuáles son las condiciones sociales, económicas y de otras índoles que llevan a las mujeres a realizar la elección de una determinada titulación universitaria, que en la mayoría de los casos va a condicionar su futuro profesional. Para poder alcanzar todos los objetivos indicados se utiliza como fuente de datos una encuesta cubierta por más de quinientos alumnos y alumnas de las tres instituciones universitarias del Sistema Universitario de Galicia.The gradual incorporation of women into higher education has not ensured a balanced presence of them in all fields of knowledge. Thus, educational spheres as much as professional ones which are related to science and technology suffer from an alarming lack of women, who tend to choose degrees with less chance of getting work. In addition, these degrees lead them to professional sectors and categories with lower pay. The present study has two global aims: first, to provide and to connect the most recent statistical data about the condition of women in the field of higher education in Galicia; second, the analysis of what are the social, economic and other kinds of conditions that lead women to make the choice of a particular degree, which in most cases is going to determine their professional future. In order to achieve the aforementioned aims, the study uses data from a survey of more than five hundred students from the three universities which are part of the Sistema Universitario de Galicia