Performance of oxygenation indices and risk scores to predict invasive mechanical ventilation and mortality in COVID-19.

BACKGROUND: Information on the performance of oxygenation indices (OIs) and risk scores in patients requiring invasive mechanical ventilation (IMV) is limited. We determine the performance of the OIs and risk scores in hospitalized patients with COVID-19 to predict the requirement of IMV and death at 28 days after admission. METHODS: A retrospective study of diagnostic tests in patients admitted to the emergency department, hospitalization, and intensive care unit diagnosed with COVID-19. The receiver operating characteristic curve (ROC-curve) were built with the OIs and risk scores to predict IMV and mortality. RESULTS: A total of 1402 subjects entered the final analysis, of whom 19.5% (274/1402) received IMV and 23.0% (323/1402) died at 28 days. The ROC-curve of the delta PaO2/FiO2 ratio for the requirement of IMV and mortality at 28-day was 0.589 (95% CI: 0.546-0.632) and 0.567 (95% CI: 0.526-0.608), respectively. PaO2/FiO2 ≤ 300 shows a ROC curve of 0.669 (95% CI: 0.628-0.711) to predict IMV. PaO2/FiO2 ≤ 300 and 4 C mortality score in mortality at 28 days showed an ROC-curve of 0.624 (95% CI: 0.582-0.667) and 0.706 (95% CI: 0.669-0.742), respectively. CONCLUSION: PaO2/FiO2 ≤ 300, 4 C mortality score ≥ 8, SOFA score ≥ 4 y SaO2/FiO2 ≤ 300 were weak predictors of the IMV requirement from admission, and 4 C mortality score ≥ 8 was weak predictors of the mortality from admission in patients with pulmonary involvement by COVID-19.

Association between olfactory dysfunction and COVID-19 severity: A prospective study in a highly complex hospital in Peru.

INTRODUCTION: Olfactory dysfunction has been included among the early symptoms of coronavirus disease (COVID-19). Evidence suggests that a relationship exists between the duration of olfaction disorders and the probability of developing severe COVID-19. Given the scope of the COVID-19 pandemic, this study aimed to determine the frequency of smell alteration and its association with the severity of COVID-19 in a referral hospital in Peru, which is one of the most affected countries in the Latin American region. MATERIALS AND METHODS: This study was an observational, prospective cohort study that included patients with COVID-19 who were treated at the Hospital Nacional Edgardo Rebagliati Martins from August to November 2020. To assess the association, the chi-square test of independence or Fisher's exact test was performed. The outcome variable was COVID-19 severity, and the exposure variable was olfactory dysfunction. The first data collection was in the emergency department and the follow-up was via telephone. RESULTS: A total of 179 patients were included. The mean age was 61.6 ± 15.5 years, and 129 patients (72.1%) were male. Olfactory dysfunction was observed in 43 patients (24%). An inverse association was found between age and olfactory dysfunction (P = .002). No significant association was found between COVID-19 severity level and olfactory alteration (P = .056). However, a direct association was found between COVID-19 severity and age (P = .003), cough (P < .001), and respiratory distress (P = .003). CONCLUSION: This study did not find any association between the severity of COVID-19 and olfactory dysfunction. It showed a low incidence rate of smell alteration compared with studies from other regions. Moreover, smell alteration was associated with younger age.

Factor de riesgo para suicidio según dos cuestionarios y factores asociados en población estudiantil de la Universidad de Manizales (Colombia), 2011 / Risk factor for suicide according to two questionnaires and factors linked to the student population of a university in Manizales (Colombia), 2011

El suicidio es una conducta producto de la interacción de muchas variables que llevan al ser humano a tratar de terminar con su vida por sus propios medios. Este estudio pretende identificar el factor de riesgo suicida; además de factores asociados en los estudiantes de pregrado de la Universidad de Manizales. Es un estudio de corte transversal, en el cual se seleccionó una muestra probabilística de 355 alumnos de programas de dicha universidad y se aplicaron los cuestionarios de Beck y Plutchik para riesgo suicida y factores asociados. El estudio mostró un factor de riesgo para suicidio según la Escala de Plutchik de 13,5% y según la Escala de Desesperanza de Beck entre riesgo suicida alto y moderado de un 16,7%. Y como factores asociados se encontraron significativos, según la Escala de Plutchik, el estrato socioeconómico (p= 0,005), presencia de un diagnóstico psiquiátrico (p=0,000), consumo de alcohol (p=0,000) y sustancias psicoactivas (p=0,000), antecedentes familiares de suicidio (p=0,034), funcionalidad familiar (p=0,000), nivel de autoestima (p=0,000), ansiedad (p=0,000) y depresión (p=0,000); según la Escala de Beck, además de los anteriores factores asociados, se encontró la asociación significativa con raza (p=0,003), estado civil (p=0,007), espiritualidad (p=0,000) y el programa de pregrado que se encuentre cursando el estudiante (p=0,000). El Factor de Riesgo para Suicidio, según Escala de Plutchik, es parecido al encontrado en otras poblaciones análogas. Las escalas de Plutchik y de Beck, aunque relacionadas, no son equivalentes.

Suicide is a conduct as a result of the interaction of many variables that lead a human being to end with his/her life through their own means. This study pretends to identify the suicidal risk factor and associated factors in undergraduate students of the Universidad de Manizales. This is a Cross-sectional study, of a probabilistic sample of 355 student of the undergraduate programs of the Universidad de Manizales. The student population that was studied consisted of three hundred and fifty five students. The Plutchik's Scale and Beck's Hopelessness Scale for suicide risk were employed, the associated factors also were measured. This study showed, according to Plutchik's Scale, a suicide risk factor of 13.5%, and a 16.7% of a high and moderate suicide risk factor according to Beck's Scale. The study also threw out important associated factors on the Plutchik's Scale: socioeconomic stratum (p= 0,005), psychiatric diagnosis (p= 0,000), intake of alcohol (p= 0,000) and psychoactive substances consumption (p=0,000), family members with suicidal background (p=0,034), family functionality (p= 0,000), self-esteem levels (p= 0,000), anxiety (p= 0,000) and depression (p= 0,000). In relation to Beck's Scale, besides the factors that were previously mentioned, the following were found race (p=0,003), marital status (p= 0,007), spirituality (p= 0,000), and the undergraduate program that each student is part of (p= 0,000). Plutchik Risk factor for suicide, is similar to that found in others similar populations. Plutchik and Beck scales are not equivalent but related.

Café y gusanos, mosquitos y petróleo: el transito desde la higiene hacia la medicina tropical y la salud pública en Colombia, 1873-1953 / Coffee and worms, mosquitoes and oil: from hygiene to tropical medicine and public health in Colombia, 1873-1953

Emprende un viaje por la historia de Colombia y sus relaciones con la economía y la política internacional, durante la última parte del siglo diecinueve y la primera mitad del veinte, vista desde la historia de la salud. Se trabajan muchos aspectos de la historia de la salud pública colombiana, como es el caso del papel de la Fundación Rockefeller y del Instituto de Asuntos Interamericanos en el desarrollo de la salud pública en el país.

Café y gusanos, mosquitos y petróleo: el transito desde la higiene hacia la medicina tropical y la salud pública en Colombia, 1873-1953 / Coffee and worms, mosquitoes and oil: from hygiene to tropical medicine and public health in Colombia, 1873-1953

Emprende un viaje por la historia de Colombia y sus relaciones con la economía y la política internacional, durante la última parte del siglo diecinueve y la primera mitad del veinte, vista desde la historia de la salud. Se trabajan muchos aspectos de la historia de la salud pública colombiana, como es el caso del papel de la Fundación Rockefeller y del Instituto de Asuntos Interamericanos en el desarrollo de la salud pública en el país.(AU)