Seven Epidemic Waves of COVID-19 in a Hospital in Madrid: Analysis of Severity and Associated Factors.

(1) Background: COVID-19 has evolved during seven epidemic waves in Spain. Our objective was to describe changes in mortality and severity in our hospitalized patients. (2) Method: This study employed a descriptive, retrospective approach for COVID-19 patients admitted to the Hospital de Fuenlabrada (Madrid, Spain) until 31 December 2022. (3) Results: A total of 5510 admissions for COVID-19 were recorded. The first wave accounted for 1823 (33%) admissions and exhibited the highest proportion of severe patients: 65% with bilateral pneumonia and 83% with oxygen saturation under 94% during admission and elevated levels of CRP, IL-6, and D-dimer. In contrast, the seventh wave had the highest median age (79 years) and comorbidity (Charlson: 2.7), while only 3% of patients had bilateral pneumonia and 3% required intubation. The overall mortality rate was 10.3%. The first wave represented 39% of the total. The variables related to mortality were age (OR: 1.08, 1.07-1.09), cancer (OR: 1.99, 1.53-2.60), dementia (OR: 1.82, 1.20-2.75), the Charlson index (1.38, 1.31-1.47), the need for high-flow oxygen (OR: 6.10, 4.94-7.52), mechanical ventilation (OR: 11.554, 6.996-19.080), and CRP (OR: 1.04, 1.03-1.06). (4) Conclusions: The variables associated with mortality included age, comorbidity, respiratory failure, and inflammation. Differences in the baseline characteristics of admitted patients explained the differences in mortality in each wave. Differences observed between patients admitted in the latest wave and the earlier ones suggest that COVID-19 has evolved into a distinct disease, requiring a distinct approach.

Use of complementary and alternative medicine by cancer patients in Colombia.

BACKGROUND: The use of complementary and alternative medicines (CAM) among cancer patients varies greatly. The available data suggest an increasing use of CAM over time and a higher prevalence in low- and middle-income countries. However, no reliable data are available from Latin America. Accordingly, we examined the prevalence of CAM use among cancer patients from six Colombian regions. METHODS: We conducted a survey on cancer patients attending comprehensive cancer centres in six capital cities from different regions. The survey was designed based on a literature review and information gathered through focus groups on CAM terminology in Colombia. Independent random samples of patients from two comprehensive cancer centres in every city were obtained. Patients 18 years and older with a histopathological diagnosis of cancer undergoing active treatment were eligible. The prevalence of CAM use is reported as a percentage with the corresponding confidence interval. CAM types are reported by region. The sociodemographic and clinical characteristics of CAM users and non-users were compared using Chi square and t tests. RESULTS: In total, 3117 patients were recruited. The average age 59.6 years old, and 62.8% were female. The prevalence of CAM use was 51.7%, and compared to non-users, CAM users were younger, more frequently women, affiliated with the health insurance plan for low-income populations and non-Catholic. We found no differences regarding the clinical stage or treatment modality, but CAM users reported more treatment-related side effects. The most frequent types of CAM were herbal products, specific foods and vitamins, and individually, soursop was the most frequently used product. Relevant variability between regions was observed regarding the prevalence and type of CAM used (range: 36.6% to 66.7%). The most frequent reason for using CAM was symptom management (30.5%), followed by curative purposes (19.5%). CONCLUSIONS: The prevalence of CAM use among cancer patients in Colombia is high in general, and variations between regions might be related to differences in cultural backgrounds and access to comprehensive cancer care. The most frequently used CAM products and practices have little scientific support, suggesting the need to enhance integrative oncology research in the country.

Web 2.0 y trabajo colaborativo en el sector Salud en Colombia / Web 2.0 and collaborative work in the Health sector in Colombia / Web 2.0 e trabalho colaborativo no sector Saúde em Colombia

Se analiza el uso de las aplicaciones de la web 2.0 por profesionales y estudiantes del sector sanitario en Colombia, así como lo factores que inciden en la promoción del trabajo colaborativo de estos. Los datos se obtuvieron a partir de una encuesta aplicada a 420 miembros de la población de estudio, con un ± 4,8 de error muestral y un 95 % de confianza. Los resultados obtenidos muestran cómo la promoción de la eSalud y la Salud 2.0 en Colombia está siendo liderada por actores sanitarios jóvenes adultos con hijos, con escasos niveles (bajos y medios) socioeconómicos y formativos. El trabajo colaborativo bajo la mediación tecnológica del sector sanitario colombiano estaría siendo liderado por aquellos profesionales de perfil profesional y técnico, y no por los médicos existentes en dicho sistema.

An analysis was conducted of the use of web 2.0 applications by professionals and students from the health sector in Colombia and the factors affecting the promotion of collaborative work among them. Data were collected from a survey applied to 420 members of the study population, with ± 4.8 sampling error and 95 % confidence. Results show that eHealth and health 2.0 promotion in Colombia is led by young health providers who are parents and have a low to medium socioeconomic level and training background. Collaborative work based on technology in the Colombian health sector is led by personnel with a professional and technical profile, not by physicians from the system.

O artigo analisa o uso das aplicações da web 2.0 nos profissionais e estudantes do sector sanitário na Colombia, assim como os factores que incidem na promoção do trabalho colaborativo deles. O tema abordado parte duma sondagem aplicada a 420 membros da povoação de estudo em dito país, com um ± 4,8 de erro amostral e um 95 % de confiança. Os dados obtidos nos permitem ver como a promoção da eSaúde e a Saúde 2.0 na Colombia está sendo gerida por actores sanitários jovens adultos com filhos, com escassos níveis (baixos e médios) socioeconômicos e formativos. O trabalho colaborativo sob a mediação tecnológica do setor sanitário colombiano estaria sendo gerido por aqueles profissionais de perfil profissional e técnico, e não pelos médicos existentes em dito sistema.

Evaluation of Staphylococcus aureus resistance profile isolated from nursing students in an institution of higher education / Avaliação do perfil de resistência de staphylococcus aureus isolados de estudantes de enfermagem de uma instituição de ensino superior

Staphylococcus aureus causes a large variety of infections, where many of them are acquired in the hospital environment. A significant part of the population is a nasal carrier of this type of microorganism. The present study evaluated the nasal colonization by S. aureus, identifying its resistance profile in nursing students from a private educational institute of higher education. Nasal swab samples were collected and identified for S. aureus. Moreover, an antibiogram assay was performed, followed by the search for ermA and ermC genes using PCR. Sixty -two students were included and we isolated 20 positive samples (32,5%) for S. aureus. For the phenotypic profile, 30% were found to be resistant to Erythromycin and 10% to Oxacillin and Cefoxitin. For the D-test in the genotypic profile, 25% presented mecA gene (MRSA), 5% of ermA gene, 35% of ermC gene and 10% with ermC and mecA genes. These data reinforce the necessity of monitoring bacterial colonization in hospital environment, which are potentially resistant in health professionals.

Staphylococcus aureus causa uma grande variedade de infecções, muitas delas adquiridas no ambiente hospitalar. Uma parcela significativa da população é carreadora nasal desses micro-organismos. O presente trabalho avaliou a colonização nasal por S. aureus identificando seu perfil de resistência em estudantes de enfermagem de uma instituição privada de ensino superior. Foram coletadas e identificadas amostras de swab nasal para S. aureus e realizado o antibiograma e a detecção por PCR dos genes mecA, ermA e ermC. Foram incluídos 62 alunos e isoladas 20 amostras (32,3%) positivas para S. aureus, no perfil fenotípico, 30% apresentaram resistência à Eritromicina e 10% para Oxacilina, Cefoxitina e para o teste D, no perfil genotípico 25% apresentaram gene mecA (MRSA), 5% do gene ermA e 35% do gene ermC, e 10% com genes ermC e mecA. Esses dados reforçam a necessidade de monitoramento de colonização por bactérias potencialmente resistente em profissionais da saúde.

Effect of a new device for sustained progesterone release on the progesterone concentration, ovarian follicular diameter, time of ovulation and pregnancy rate of ewes.

This study evaluated the effectiveness of a new progesterone intravaginal device (DPR) in ewes through four experiments: Experiment 1 compared the circulating progesterone concentration of ovariectomized ewes that received either a new or a re-used DPR. Experiment 2 compared the progesterone concentration between DPR-estrous-synchronized ewes and naturally estrous-cycling ewes. Experiment 3 evaluated the effect of new and re-used DPRs on ovarian follicular dynamics and time of ovulation of estrous cycling ewes. Experiment 4 compared the pregnancy rate after the use of a DPR and Controlled Internal Drug Releasing Device (CIDR). The mean concentration of progesterone released by the DPR device during its first use (New Group: 5.1 ± 0.5 ng/ml) was greater than that during the second use (Re-used Group: 2.4 ± 0.3 ng/ml). There was no difference between the animals that received DPR devices for first and second use in terms of ovulatory follicle diameter, follicular wave emergence day for ovulatory follicle and period of ovulatory wave of ovarian follicular development. However, there was a significant difference between groups regarding the time between DPR device removal and first ovulation (New Group: 71.7 ± 2.5h and Re-Used Group: 63.9 ± 2.7h). Pregnancy rates were similar between ewes with DPR and CIDR devices. It was concluded that DPR is effective in increasing and maintaining progesterone concentrations, controlling follicular dynamics, promoting synchronized times of ovulation from healthy follicles, promoting development of a competent corpus luteum and when used results in pregnancy rates similar to that with use of the CIDR.

Slow-release urea in supplement fed to beef steers

Replacing regular urea (RU) by slow-release urea (SRU) at two levels of non-protein nitrogen (NPN) in concentrate, offered with low-quality roughage, was evaluated in beef steers on dry matter intake (DMI), ruminal fermentation parameters, plasma urea nitrogen (PUN), total tract apparent digestibility of diets and in situ degradability of nitrogen sources. Eight ruminally cannulated steers were allocated into two 4x4 Latin squares, totalizing four treatments: 40 NPN/0 SRU: 40% of concentrate crude protein (CP) as NPN, resulting from 0% of SRU and 100% of RU; 40 NPN/50 SRU: 40% of concentrate CP as NPN, resulting from 50% of SRU and 50% of RU; 40 NPN/100 SRU: 40% of concentrate CP as NPN, resulting from 100% of SRU and 0% of RU; 80 NPN/100 SRU: 80% of concentrate CP as NPN, resulting from 100% of SRU and 0% of RU. Results showed that partial substitution of regular urea by slow-release urea did not alter dry matter intake, pattern of ruminal fermentation or plasma urea nitrogen concentrations and increased the total tract apparent digestibility of crude protein in steers diets. The increase in non-protein nitrogen content in crude protein of the concentrate could compromise feed intake and the efficiency of nutrient utilization in the steers fed complete diets based on low quality forage.

Probiotics association in the suckling and nursery in piglets challenged with Salmonella typhimurium

This work aimed to study the probiotics association in 144 piglets from birth to 62 days old. In lactation, the design was completely randomized with two treatments, CTL, 1 mL of distilled water and ProbA, 5g in 15 ml of distilled water, both orally, and in the nursery in randomized block design, with 2x3 factorial arrangement of treatments, ProbA ProbB: 30g/ton of ProbB in the ration; CTL ProbB: 30g/ton of ProbB in the ration; ProbA ProbA, CTL CTL; ProbA CHA (challenged); CTL CHA. At 35 days of age the animal of the nursery were inoculated with Salmonella typhimurium orally. There was no effect of the parameters evaluated during the maternity. In nursery, the feed conversion was favorable to the ProbA. In the evaluation of fecal score, the challenged group had more diarrhea and increased elimination of S. typhimurium. Results showed the positive action of probiotics when applied at birth by the direct influence on the formation of the intestinal microbiota.

Relación entre signos clínicos e hipoxemia en niños menores de 5 años con enfermedad respiratoria aguda baja / Relation between clinical signs and hypoxaemia in children under 5 years with acute respiratory disease

Objetivo: determinar la sensibilidad, especificidad, valores predictivos y razones de verosimilitud de polipnea, tiraje y taquicardia como signos de hipoxemia en niños menores de 5 años con enfermedad respiratoria aguda baja. Metodología: se realizó un estudio prospectivo que incluyó niños de 1 mes a 5 años previamente sanos, ingresados con diagnóstico de infección respiratoria aguda baja o crisis asmática. Se definió hipoxemia como una saturación de oxígeno de la hemoglobina < 95 por ciento medida con oxímetro de pulso. Se registraron simultáneamente frecuencia respiratoria, cardíaca y tiraje. El tamaño de la muestra calculado fue de 96 niños hipoxémicos y 120 no hipoxémicos. Resultados: para polipnea, tiraje y taquicardia la sensibilidad fue de 64 por ciento, 59 por ciento y 66 por ciento respectivamente; la especificidad de 56 por ciento, 63 por ciento y 42 por ciento; el VPP de 54 por ciento, 56 por ciento y 48 por ciento, el VPN de 66 por ciento, 66 por ciento y 61 por ciento; el LR+ de 1,4 , 1,6 y 1,1. Conclusiones: los signos clínicos estudiados carecen de suficiente valor predictivo en el diagnóstico de hipoxemia en estos pacientes