Evidences of SARS-CoV-2 virus air transmission indoors using several untouched surfaces: A pilot study.

Nowadays, there is an important controversy about coronavirus air transmission. The aim of this study was to determine aerosol transmission from patients with coronavirus infection using "COVID-19 traps" that included different untouched surfaces within them. 42 swab samples of 6 different surfaces placed in the rooms of 6 patients with a positive diagnostic of COVID-19 were analyzed with RT-PCR technique to evaluate the presence of the virus and its stability. Samples were collected at 24, 48 and 72 h. Patients were in an intensive care unit (ICU) and in a COVID-19 ward unit (CWU) at a Spanish referral hospital. None of the samples placed in the ICU unit were positive for COVID-19. However, two surfaces, placed in a CWU room with a patient that required the use of respiratory assistance were positive for coronavirus at 72 h. Surfaces could not be touched by patients or health workers, so viral spreading was unequivocally produced by air transmission. Thus, fomites should be considered as a possible mode of transmission of coronavirus and frequent disinfection of surfaces should be taken into account. Our results, although preliminary, point the importance of SARS-CoV-2 virus air transmission indoors and may shed some light in this debate.

Diferencias en los hallazgos clínicos en dos grupos de población inmigrante afecta de tuberculosis / Differences in clinical features of two immigrant populations with tuberculosis

Se realizó un estudio descriptivo para identificar posibles diferencias en la presentación clínica de la tuberculosis entre 2 grupos de población inmigrante. Se incluyeron 94 pacientes visitados en urgencias y que fueron diagnosticados de tuberculosis activa en el periodo 2006-12. Cuarenta y nueve pacientes era originarios de Asia Central (A) y 45 de Latinoamérica (LA). La edad media (años [DE]) fue de 35,3 (13) años en los procedentes de A por 33,9 (10) en los de LA. Existía un predominio de varones en asiáticos (40/49 vs. 25/45; p = 0,006). Los pacientes procedentes de LA tenían mayor porcentaje de tuberculosis pulmonar. Los pacientes de A vivían en condiciones de hacinamiento con mayor frecuencia. Los pacientes de LA tenían más antecedentes de seropositividad para el VIH. La mayoría recibió tratamiento cuádruple. Dos pacientes latinoamericanos eran resistentes a isoniazida

A study was performed to assess differences in the clinical presentation of tuberculosis between two groups of immigrants. Ninety-four patients seen in the emergency room for newly diagnosed tuberculosis between 2006 and 2012 were included. Forty-nine patients were from Asian countries and 45 from Latin America. Mean age [years (SD)] was 35.3 (13) in Asian patients and 33.9 (10) in Latin American patients. Asian subjects were predominantly male (40/49 vs 25/45; P=0.006). Patients from Latin American countries had a higher rate of pulmonary tuberculosis. A higher percentage of Asian patients lived in overcrowded conditions, whereas HIV infection was more frequent among Latin Americans. Most patients were treated with a quadruple regimen. Resistance to isoniazid was documented in two patients from Latin America

Differences in clinical features of two immigrant populations with tuberculosis.

A study was performed to assess differences in the clinical presentation of tuberculosis between two groups of immigrants. Ninety-four patients seen in the emergency room for newly diagnosed tuberculosis between 2006 and 2012 were included. Forty-nine patients were from Asian countries and 45 from Latin America. Mean age [years (SD)] was 35.3 (13) in Asian patients and 33.9 (10) in Latin American patients. Asian subjects were predominantly male (40/49 vs 25/45; P=0.006). Patients from Latin American countries had a higher rate of pulmonary tuberculosis. A higher percentage of Asian patients lived in overcrowded conditions, whereas HIV infection was more frequent among Latin Americans. Most patients were treated with a quadruple regimen. Resistance to isoniazid was documented in two patients from Latin America.

Ritmo nodal secundario a descarga eléctrica de alto voltaje: Report of one case / Transient high frequency nodal rhythm after a high voltage electric shock

Electrical shock can cause a direct myocardial damage and different types of arrhythmias, which are uncommon and occur more often when there is a high voltage exposure. We report a 19-year-old male that received a high voltage shock, falling thereafter from an altitude of four meters. On admission to the emergency room, he had second and third degree burns in the right hand and the left thigh. The electrocardiogram showed a nodal rhythm of 72 beats per minute. After four hours of monitoring, sinus rhythm returned spontaneously.

[Transient high frequency nodal rhythm after a high voltage electric shock. Report of one case]. / Ritmo nodal secundario a descarga eléctrica de alto voltaje.

Electrical shock can cause a direct myocardial damage and different types of arrhythmias, which are uncommon and occur more often when there is a high voltage exposure. We report a 19-year-old male that received a high voltage shock, falling thereafter from an altitude of four meters. On admission to the emergency room, he had second and third degree burns in the right hand and the left thigh. The electrocardiogram showed a nodal rhythm of 72 beats per minute. After four hours of monitoring, sinus rhythm returned spontaneously.

Factores predictivos de infección por el virus de la gripe H1N1 2009 en pacientes con síndrome gripal / Predictive factors of 2009 H1N1 virus infection in patients with influenza syndrome

Introducción: La técnica de reacción en cadena de la polimerasa en frotis nasofaríngeo es uno de los mejores métodos para la detección de virus gripales. El objetivo de este estudio es conocer el porcentaje de frotis nasofaríngeos positivos durante la pandemia de gripe de 2009 y determinar si existe algún factor predictor de positividad para el virus H1N1 2009. Métodos: Estudio retrospectivo de todos los pacientes que consultaron en Urgencias por síndrome gripal entre el 15 de julio y el 15 de diciembre de 2009 a los que se realizó un frotis nasofaríngeo. Se identificaron aquellos casos en los que el frotis estaba correctamente solicitado. Se dividieron en dos grupos según la positividad para el virus H1N1 2009. Resultados: Se realizó un frotis nasofaríngeo a 362 pacientes. En 87 casos estaba incorrectamente indicado. De los 275 restantes, fue positivo en 141. Los pacientes con frotis positivo eran más jóvenes (36,1(15) años vs 42,3(18); p=0,002), tenían menor recuento de leucocitos, neutrófilos y linfocitos, menor valor de proteína C reactiva (5,15(5) vs 10,5(12); p<0,001) y menor incidencia de infiltrados radiológicos (20,5% vs 33%; p=0,036). La regresión logística identificó la edad, una proteína C reactiva baja y un recuento linfocitario bajo como factores independientes de infección por el virus H1N1 2009. Conclusiones: En pacientes con síndrome gripal, el porcentaje de positividades del frotis para detectar H1N1 2009 se sitúa en el 50%. La edad, los niveles de proteína C reactiva y el recuento linfocitario son factores independientes para predecir el resultado(AU)

Introduction: Polymerase chain reaction (PCR) testing is one of the better techniques for viral detection in nasopharyngeal swabs. The objective of this study was to assess the percentage of positive swabs and to determine whether there were differences according to PCR positivity. Material and Methods: A retrospective study of 362 patients with flu syndrome attended at the Emergency Department between July 15 and December 15, 2009, in whom PCR of nasopharyngeal swabs for the detection of H1N1 2009 influenza virus was performed. Those cases in which swab testing was adequately requested were identified, and patients were divided into two groups according to positive or negative results for H1N1 2009 influenza virus. Results: Nasopharyngeal swab was inadequately ordered in 87. In the remaining 275 patients, PCR was positive in 141. Patients with positive nasopharyngeal swabs were younger (mean [SD] age 36.1 [15] vs 42.3 [18] years, P = 0.002), had lower white blood cell, neutrophil and lymphocyte counts, lower serum concentrations of C-reactive protein (5.15 [5] vs 10.5 [12] mg/dL, P = 0.036) and lower incidence of radiological infiltrates (20.5% vs 33%, P = 0.036). In the logistic regression analysis, age, serum C-reactive protein levels, and lymphocyte count were independently associated with a positive nasopharyngeal swab. Conclusions:About 50% of patients with flu syndrome had positive nasopharyngeal swabs for H1N1 2009 influenza virus. Age, C-reactive protein, and lymphocyte count were independent predictors of positivity(AU)

Reduction in door-to-needle time to meet clinical guideline recommendations. Outcomes after 1 year.

The aim of this study was to reduce the door-to-needle time in patients with ST-elevation acute myocardial infarction by setting up a chest pain service. We compared the door-to-needle time and outcomes at the end of first year of follow-up in patients who received fibrinolysis in the 2 years before implementation of the service (Group 1) and those who received fibrinolysis in the 2 years after its creation (Group 2). In Group 1, the median door-to-needle time was 40 min (P(25-75), 23-52 min); in Group 2, it was 27 min (P(25-75), 15-43 min; P=.003). In addition, the use of reperfusion therapy increased from 55.2% in Group 1 to 64.7% in Group 2 (P< .01). After a follow-up period of 1 year, there was no difference in the rate of revascularization, hospital readmission, reinfarction or cardiovascular mortality.

Reducción del tiempo puerta-aguja a los objetivos recomendados en las guías clínicas. Pronóstico a 1 año de seguimiento / Reduction in Door-To-Needle Time to Meet Clinical Guideline Recommendations. Outcomes After 1 Year

El objetivo del estudio es disminuir el tiempo puerta-aguja en el infarto con elevación del ST mediante la creación de un box de dolor torácico. Se compara el tiempo puerta-aguja entre los pacientes que recibieron fibrinolisis en los 2 años previos a la creación del box (grupo 1) y los que se sometieron a trombolisis en los 2 años siguientes (grupo 2), y el pronóstico a 1 año de ambos grupos.En el grupo 1, la mediana de tiempo puerta-aguja fuede 40 (P25-75, 23-52) min y en el grupo 2, 27 (15-43) min(p = 0,003). Se incrementó el tratamiento de reperfusióndel 55,2% en el grupo 1 al 64,7% en el grupo 2 (p <0,01). A 1 año de seguimiento, no hubo diferencias en larevascularización, el reingreso, el reinfarto o la muerte de causa cardiovascula

The aim of this study was to reduce the door-to-needletime in patients with ST-elevation acute myocardialinfarction by setting up a chest pain service. Wecompared the door-to-needle time and outcomes at theend of first year of follow-up in patients who receivedfibrinolysis in the 2 years before implementation of theservice (Group 1) and those who received fibrinolysis inthe 2 years after its creation (Group 2). In Group 1, themedian door-to-needle time was 40 min (P25-75, 23-52min); in Group 2, it was 27 min (P25-75, 15-43 min;P=.003). In addition, the use of reperfusion therapyincreased from 55.2% in Group 1 to 64.7% in Group 2(P<.01). After a follow-up period of 1 year, there was nodifference in the rate of revascularization, hospital readmission, reinfarction or cardiovascular mortality (AU)

Golpe de calor en pacientes tratados con topiramato / Heatstroke during topiramate treatment

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