Water quality of Danube Delta systems: ecological status and prediction using machine-learning algorithms.

Environmental issues have a worldwide impact on water bodies, including the Danube Delta, the largest European wetland. The Water Framework Directive (2000/60/EC) implementation operates toward solving environmental issues from European and national level. As a consequence, the water quality and the biocenosis structure was altered, especially the composition of the macro invertebrate community which is closely related to habitat and substrate heterogeneity. This study aims to assess the ecological status of Southern Branch of the Danube Delta, Saint Gheorghe, using benthic fauna and a computational method as an alternative for monitoring the water quality in real time. The analysis of spatial and temporal variability of unicriterial and multicriterial indices were used to assess the current status of aquatic systems. In addition, chemical status was characterized. Coliform bacteria and several chemical parameters were used to feed machine-learning (ML) algorithms to simulate a real-time classification method. Overall, the assessment of the water bodies indicated a moderate ecological status based on the biological quality elements or a good ecological status based on chemical and ML algorithms criteria.

[Heart arrest caused by CO2 embolism during a laparoscopic cholecystectomy]. / Paro cardíaco por embolia por CO2 en una colecistectomía laparoscópica.

A 41-year-old woman developed a gas embolism while inserting a Veress needle to achieve pneumoperitoneum for laparoscopic cholecystectomy. The embolism led to asystole, which was corrected after advanced cardiopulmonary resuscitation maneuvers, and was followed by sequelae and a prolonged hospital stay. The anesthesiologist should be vigilant during laparoscopic surgery and be ready and able to act in case of major complications.

Paro cardíaco por embolia por CO2 en una colecistectomía laparoscópica / Heart failure due to carbon dioxide embolism during laparoscopic cholecystectomy

Una mujer de 41 años sufrió una embolia gaseosa durante la colocación de la aguja de Veress, para iniciación del neumoperitoneo, en una colecistectomía laparoscópica. La embolia provocó una asistolia que se remontó tras maniobras de reanimación cardiopulmonar avanzada y ocasionó morbilidad y una estancia hospitalaria prolongada. En la cirugía laparoscópica el anestesiólogo debe extender su vigilancia a aspectos técnicos de la cirugía, estar capacitado y en un medio adecuado, para actuar frente a complicaciones mayores (AU)