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renal markers, as well as individualized fluid management, can play a key role in AKI prevention.
Hypovolemia and dehydration are a frequent cause of AKI among COVID-19 patients. Those who develop AKI during hospitalization display worse prognostic factors in terms of pulmonary damage, renal damage, and analytical findings. We believe that monitorization of renal markers, as well as individualized fluid management, can play a key role in AKI prevention.
Community Acquired Pneumonia (CAP) is common disease that can be treated in Hospital At Home (HAH). Corticosterone mouse In this paper we evaluate the room of improvement in the use of antibiotics in CAP in HH.
Patients with CAP were retrospectively recruited in two Spanish hospitals from 1/1/18 to 10/30/19. Demographic, clinical and quality of antibiotic prescription variables were recorded. Subsequently, we created a new variable that collected six quality of care indicator, categorizing and comparing patients into two groups good quality of care (4 or more indicators performed) or poor quality of care (3 or less indicators performed).
We recruited 260 patients. The request for diagnostic tests and the adequacy to Clinical Practice Guidelines were 85.4% and 85.8% respectively. Percentages of de-escalation (53.7%) and sequential therapy (57.7%) when indicated were low. The average length of treatment was 7.3 days for intravenous and 9.5 days for total. Quality of prescription was good in 134 (63.2%) patients, being more frequent in those who were admitted directly to HAD from the emergency room. It was also associated with less readmission at 30 days.
There is a wide room for improvement in some fields of antimicrobials use in HAH that could stimulate the implementation of Antimicrobial Stewardship Programs.
There is a wide room for improvement in some fields of antimicrobials use in HAH that could stimulate the implementation of Antimicrobial Stewardship Programs.
Estimate IgG antibody prevalence against SARS-CoV-2 in healthcare personnel (HCP) of a healthcare department (HD).
Prevalence study. The presence of IgG antibodies against SARS-CoV-2 was determined in HCP of the HD. Enzyme linked immunosorbent assays (ELISA) tests were used. Field work took place from April 24, 2020 to May 8, 2020. The age, sex, occupation (physician, nurse, etc.) and the work area (Primary Care, Emergency Room, etc.) were gathered. The IgG antibody prevalence was then calculated with its 95% confidence interval (95%CI). To study the association between HCP characteristics and the presence IgG the Chi Square test was used, and to study the magnitude of association, the Odds Ratio (95%CI) was calculated.
Of the 4813 HCP in the HD, 4179 (87,1%) participated. Of these, 73,3% (3065) were women and 26,7% (1114) men. The global prevalence of IgG antibodies against SARS-CoV-2 was 6,6% (95%CI 5,8-7,3). There were statistically significant differences depending on the occupation, from 8,7% (95%CI 6,9-10,6) on medics down to 3,2% (95%CI 1,0-8,0) on personnel not associated with health care. The other characteristics did not associate significantly to antibody presence against SARS-CoV-2.
The SARS-CoV-2 infection frequency in HCP is similar to the estimated in the general population for big cities in Spain. This highlights the effectiveness of the infection control and prevention programme in this healthcare department targeted at healthcare personnel.
The SARS-CoV-2 infection frequency in HCP is similar to the estimated in the general population for big cities in Spain. This highlights the effectiveness of the infection control and prevention programme in this healthcare department targeted at healthcare personnel.
Neuromyelitis optica (NMO) is an inflammatory disease of the central nervous system characterised by attacks of optic neuritis and longitudinally extensive transverse myelitis. The discovery of anti-aquaporin-4 (anti-AQP4) antibodies and specific brain MRI findings as diagnostic biomarkers have enabled the recognition of a broader and more detailed clinical phenotype, known as neuromyelitis optica spectrum disorder (NMOSD).
This study aimed to determine the demographic and clinical characteristics of patients with NMO/NMOSD with and without seropositivity for anti-AQP4 antibodies, in 2 quaternary-level hospitals in Bogotá.
Our study included patients > 18 years of age and diagnosed with NMO/NMOSD and for whom imaging and serology results were available, assessed between 2013 and 2017 at the neurology departments of hospitals providing highly complex care. Demographic, clinical, and imaging data were gathered and compared in patients with and without seropositivity for anti-AQP4 antibodies.
The sample included 35 patients with NMO/NMOSD; the median age of onset was 46.5 years (P25-P75, 34.2-54.0); most patients had sensory (n = 25) and motor manifestations (n = 26), and a concomitant autoimmune disease was identified in 6. Twenty patients were seropositive for anti-AQP4 antibodies. Only age and presence of optic nerve involvement showed statistically significant differences between groups (p = .03).
Clinical, imaging, and laboratory variables showed no major differences between patients with and without anti-AQP4 antibodies, with the exception of age of onset and presence of optic nerve involvement (uni- or bilateral); these factors should be studied in greater detail in larger populations.
Clinical, imaging, and laboratory variables showed no major differences between patients with and without anti-AQP4 antibodies, with the exception of age of onset and presence of optic nerve involvement (uni- or bilateral); these factors should be studied in greater detail in larger populations.Land use regression model (LUR) is a widespread method for predicting air pollution exposure. Few studies have explored the performance of independently developed daytime/nighttime LUR models. In this study, fine particulate matter (PM2.5), inhalable particulate matter (PM10), and nitrogen dioxide (NO2) concentrations were measured by mobile monitoring during non-heating and heating seasons in Taiyuan. Pollutant concentrations were higher in the nighttime than the daytime, and higher in the heating season than the non-heating season. Daytime/nighttime and full-day LUR models were developed and validated for each pollutant to examine variations in model performance. Adjusted coefficients of determination (adjusted R2) for the LUR models ranged from 0.53-0.87 (PM2.5), 0.53-0.85 (PM10), and 0.33-0.67 (NO2). The performance of the daytime/nighttime LUR models for PM2.5 and PM10 was better than that of the full-day models according to the results of model adjusted R2 and validation R2. Consistent results were confirmed in the non-heating and heating seasons.
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