Sediment toxicity and bioaccumulation assessment in abandoned copper and mercury mining areas of the Nalón River basin (Spain).

Sediment toxicity and metal bioaccumulation were assessed at sites affected by historical copper (Cu) and mercury (Hg) mining activities in the Nalón River basin, Asturias, Spain. Toxicity assessment of stream sediments was based on a 28-day oligochaete Tubifex tubifex sediment bioassay, which allowed the classification of sites into three levels of toxicity: 11 sites were classified as nontoxic (including Cu mine sites), three sites as potentially toxic, and seven sites as toxic (all located in Hg mine districts). The greatest levels of arsenic (As), chromium, Hg, lead (Pb), and zinc (Zn) in T. tubifex were measured at sites affected by Hg mining and the highest Cu levels in tissues at Cu mining sites. Chronic toxicity responses were best explained by As and Hg sediment concentrations and by As, Pb, and Zn tissue residues. Residue levels of As, Hg, Zn, and Pb were successfully used to predict sediment chronic toxicity and estimate effective tissue residues.

[Internal validity and reliability of an instrument for evaluating quality of nursing care services for patients, nurses, and family members]. / Validación y fiabilidad de un instrumento para la evaluación de la calidad de servicios, adaptado a familiares, pacientes y personal de enfermería.

AIM: To analyze the internal validity and reliability of the instrument for evaluating the quality of services adapted to three interest groups: patients, nurses, family members, and primary caregivers. MATERIAL AND METHOD: Our research was conducted meticulously, employing a mixed methodology with two phases: qualitative, using the focus group for internal validation of the instrument, and quantitative. Subsequently, the survey was passed to the interest group of 430 patients, 525 relatives, and 298 nurses. Chronbac's alpha reliability analysis, the multiple linear regression model as a point estimator of the parameters, and exploratory factor analysis with a maximum likelihood factor using Kaiser-Meyer-Olkin to analyze the constructor and its indicators were performed to validate the adaptation. Finally, confirmatory factor analysis determines their respective measurement models' unidimensionality, validity, and reliability. RESULTS: The result shows that the factor loading of each subconstruct is more significant than 0.5 in the three models, which indicates that the aptitude indices of the model were met. In addition, the model meets the discriminant validity criteria. The behavior of the SERVPERF questionnaire was analyzed in terms of consistency, Cronbach's alpha=0.94. CONCLUSION: The scale items' discrimination concerning the questions on global satisfaction is confirmed. This shows that the instrument is valid, reliable, and useful.

Roasting and packaging in nitrogen atmosphere protect almond var. Guara against lipid oxidation.

The effect of packaging in nitrogen (N2) atmosphere or in air on the quality of peeled and roasted almond var. Guara during storage for 20 weeks at 20 °C ± 1 °C and 65-70% relative humidity (RH) was studied. No changes in the sugar, fat, protein or fiber contents were observed during the storage period nor in color. Only the lipid fraction showed significant changes with the kind of packaging atmosphere. The composition of fatty acids remained unchanged during the 5 month storage in all the samples. Packaging in N2 atmosphere was seen to have a protective effect against the accumulation of conjugated dienes (CD) in peeled almonds, while in roasted almonds, the protective effect was lower and even nil by the end of storage. The contrary effect was observed for the ultraviolet (UV; K270) index which increased more slowly in the roasted samples packaged in N2, while in peeled samples it reached the same levels at the end of storage regardless of the packaging atmosphere. No effect of the packaging atmosphere was observed on the evolution of the peroxide value in the tested samples (peeled or roasted almonds). None of these changes in the lipid fraction was reflected in the final sensory quality of the samples and the taster panel found no changes in the sensory quality in any case.

[Design and evaluation of a booklet for the Oral Health Program in children from birth].

BACKGROUND: There is no preventive control of oral health from birth in Spain. This situation entails a number of risks, such as increased caries lesions in children. The objective of this study was to design a pediatric dentistry booklet for the clinical assessment and follow-up of oral health in children, as well as its evaluation by health professionals and parents. METHOD: Design of the booklet, in 2018, by pediatric dentists of the Murcia University Dental Clinic, based on a biblio-graphic review, to instruct in preventive (dietary and oral hygiene) and curative (planning of pediatric dental visits and treatments) habits. A convenience sampling of forty pediatric dentists, dentists, pediatricians and parents was carried out to evaluate the preliminary design, in 2019. They completed a questionnaire with their data, opinion on different aspects of the booklet and suggestions. RESULTS: The evaluation of the preliminary version of the booklet by health professionals and parents was positive. It was modified in line with their suggestions and the final version was made: a 16-page booklet, with data on the child's affilia-tion and parents, with a preventive and curative approach, making pediatric and pediatric dental check-ups coincide in time. CONCLUSIONS: The pediatric dentistry booklet was created and has been positively valued by professionals and parents, its use is recommended for early dental care, and can be extended to other health systems at the regional level in Spain.

Carotenoids from persimmon juice processing.

The aim of this study was the use and revalorization of two persimmon by-products A and B generated in the juice production process. The by-product B resulting from a pectinase enzymatic treatment of peels and pulp to optimize juice extraction was especially suitable for recovery of valuable bioactive carotenoids. The extraction solvents and solvent combinations used were: ethanol, acetone, ethanol/acetone (50:50 v/v) and ethanol/acetone/hexane (25:25:50 v/v/v). HPLC-DAD analysis detected and identified a total of nine individual carotenoids namely violaxanthin, neoxanthin, antheraxanthin, lutein, zeaxanthin, ß-cryptoxanthin 5,6-epoxide, ß-cryptoxanthin, α-carotene, and ß-carotene. ß-cryptoxanthin and ß-carotene represented 49.2% and 13.2% of the total carotenoid content (TCC) in the acetone extract from by-product B. TCC contributed greatly to antioxidant activity of acetone extract derived from this by-product. Pectinase enzymatic treatment of persimmon peels and pulp followed by absolute acetone extraction of carotenoids could be an efficient method to obtain a rich extract in these compounds that could be used as nutraceutical ingredient.

Relaxation dynamics of tryptophan in water: A UV fluorescence up-conversion and molecular dynamics study.

We report on an ultrafast experimental and simulations study of the early relaxation events of photoexcited tryptophan in water. Experimentally, we used fluorescence up-conversion in both polychromatic and single wavelength detection modes in the 300-480 nm range with polarization dependence. We report on the time evolution of the Stokes shift, bandwidth, and anisotropy from tens of femtoseconds to picoseconds. These observables contain signatures of the simultaneous occurrence of intramolecular and solvent-molecule interactions, which we disentangle with the help of nonequilibrium molecular dynamics simulations. We also observe a breakdown of the linear response approximation to describe our results.

Does mercury presence in soils promote their microbial activity? The Almadenejos case (Almadén mercury mining district, Spain).

Mercury is considered a very toxic element and important efforts are currently being made aimed at reduce or even eliminating its usage. Despite this trend, there are still sites where contamination by this metal is very marked, especially in the mining environment of Almadén where it has been exploited for thousands of years. The several forms in which Hg occurs in the soil interact differently with the organisms that live in/on it. The soil is a place where many biotic and abiotic variables act together. Through a detailed study of the edaphic characteristics of a decommissioned metallurgical enclosure, the presence of different chemical forms of Hg, the study of microbial activity (DHA) and, finally, parameters of the vegetation cover, such as specific distribution and biomass, we have tried to elucidate the effect of the presence of Hg in this precinct with a very high Hg pollution. The obtained results showed the affection patterns by which the different measured parameters vary, with special incidence to the microbial activity of the topsoil and to the specific distribution of the plants found in the studied area. The statistical multivariate analysis showed that significant correlations have been found between soil Hg fractions and between Hg fractions in plants; furthermore, soil conditions seem to be not related with Hg transfer from soils to plants. Biomass and DHA data indicate that the studied area is not affected by the presence of Hg species and lacks the expected toxic effects on the living organisms.

Physico-chemical and toxicological characterization of the historic estuarine sediments: a multidisciplinary approach.

The accumulation rates, the geochronology of metals and PAH contamination, and the Microtox toxicity are studied in five sediment cores (50 cm length) covering different areas of the Santander Bay, Northern Spain. Chronology given by (210)Pb and (137)Cs reveals significant differences in accumulation rates between sites (0.2-1.1 cm/year), as well as a variable degree of anthropogenic enrichment factors for Fe, Mn, Cu, Pb, Zn, Ni (from 1 to 15) and concentrations of summation Sigma 16PAHs (from 0.01 to 23.84 mg/kg dw) in sediments over the last 90 years. The results indicate the increasing contamination pressure from industrial and urban activities along the Bay. No toxic results from the Microtox test are obtained either with pore water or with normalised sediment aqueous extracts (European Norm EN 12457), suggesting low water solubility and low availability of contaminants in the studied sediments. However, the EC50 values from the Microtox Basic Solid Phase Test (BSPT) ranged from 0.03% to 2.35%, showing vertical toxicity profiles in accordance with metal and PAHs behaviour. The correlation degrees of Microtox BSPT toxicity to chemical concentration in sediment profiles are widely variable showing a high site-dependent toxicity. The oligochaete Limnodrilus hoffmeisteri has been used as a chronic bioassay over surface sediments of two of the studied sites, showing results coherent with the Microtox BSPT acute test results. Global results of the present work provide regional geochemical baselines for metals and PAHs and toxicological data now make it possible to obtain a preliminary quality assessment of the Santander Bay sediment profiles.

Silo discharge of binary granular mixtures.

We present numerical and experimental results on the mass flow rate during the discharge of three-dimensional silos filled with a bidisperse mixture of grains of different sizes. We analyzed the influence of the ratio between coarse and fine particles on the profile of volume fraction and velocity across the orifice. By using numerical simulations, we have shown that the velocity profile has the same shape as that in the monodisperse case and is insensitive to the composition of the mixture. On the contrary, the volume fraction profile is strongly affected by the composition of the mixture. Assuming that an effective particle size can be introduced to characterize the mixture, we have shown that previous expression for the mass flow rate of monodisperse particles can be used for binary mixtures. A comparison with Beverloo's correlation is also presented.

Treatment of cerebral aneurysms with hydrogel-coated platinum coils (HydroCoil): early single-center experience.

PURPOSE: The authors report their experience using HydroCoils in the treatment of cerebral aneurysms. METHODS: We performed a retrospective review of the first 100 nonrandomized patients (104 coiled saccular cerebral aneurysms) treated with HydroCoils during a 27-month period. RESULTS: The average percentage of HydroCoil by length detached in treated aneurysms was 45.5% (range, 9.9-100%). Immediate postprocedure angiography demonstrated complete aneurysm occlusion in 34%, neck remnant in 35%, and incomplete occlusion in 32%. Immediate procedure-related morbidity and mortality rates were 5.8% and 0%, respectively. Angiographic follow-up was obtained in 51% (51/100 patients; 53/104 aneurysms; average, 10.3 months; range, 0-31 months). In these 53 angiographically followed aneurysms, the overall recanalization rate was 21%: no recanalization occurred in 23 aneurysms with small size (<10 mm)/small neck (<4 mm) (S/S); 4 recanalizations occurred in 7 aneurysms with small size/wide neck (>4 mm) (S/W); 6 recanalizations (27%) occurred in 22 large (L) aneurysms (>10-25 mm, 70% angiographic follow-up); and 1 giant (G) (>25 mm) aneurysm recanalized. A large proportion of aneurysms that were not initially completely occluded were completely occluded on follow-up (15/43 [35%]). Clinical follow-up was obtained in 73 patients (73%; average, 5.3 months; range, 0-24 months): 93% of these patients were neurologically improved or unchanged. Three patients rehemorrhaged and 3 patients with unruptured aneurysms developed delayed hydrocephalus. CONCLUSIONS: The overall safety profile of HydroCoils appears acceptable. Preliminary midterm observations suggest less coil compaction/aneurysm recanalization in large aneurysms. However, HydroCoil-related delayed hydrocephalus is a concern.

Diseño y evaluación de una cartilla para el Programa de Salud Bucodental en niños desde el nacimiento / Design and evaluation of a booklet for the Oral Health Program in children from birth

Fundamento: En España no existe un control preventivo de la salud bucodental desde el nacimiento. Estoconlleva una serie de riesgos, como el aumento decaries en niños. El objetivo de este trabajo fue diseñar una cartilla odontopediátrica para la valoración yseguimiento clínico de la salud bucodental en niños,así como su evaluación por profesionales de la salud yprogenitores/tutores. Método: Diseño de la cartilla, en 2018, por odontopediatras de la Clínica Odontológica Universitaria de Murcia,a partir de una revisión bibliográfica, para instruir enhábitos preventivos (dietéticos e higiene bucodental) ycurativos (planificación de visitas y tratamientos odontopediátricos). Evaluación del diseño preliminar, en2019, por un grupo de cuarenta odontopediatras, odontólogos, pediatras y progenitores/tutores, muestreadospor conveniencia. Cumplimentaron un cuestionario consus datos, opinión sobre distintos aspectos de la cartilla y sugerencias. Resultados: La evaluación de la versión preliminar de lacartilla por profesionales de salud y progenitores/tutoresfue positiva; se modificó atendiendo a sus sugerencias yse confeccionó la versión final: cartilla de 16 páginas, condatos de filiación del niño y progenitores/tutores, conenfoque preventivo y curativo, haciendo coincidir en eltiempo revisiones pediátricas y odontopediátricas. Conclusiones: La cartilla odontopediátrica se ha creado y ha sido valorada positivamente por distintosprofesionales y tutores. Se recomienda su uso para laatención odontológica temprana, pudiendo ampliarse aotros sistemas de salud a nivel autonómico en España.(AU)

Background: There is no preventive control of oralhealth from birth in Spain. This situation entails anumber of risks, such as increased caries lesions inchildren. The objective of this study was to design apediatric dentistry booklet for the clinical assessmentand follow-up of oral health in children, as well as itsevaluation by health professionals and parents.Method: Design of the booklet, in 2018, by pediatricdentists of the Murcia University Dental Clinic, basedon a bibliographic review, to instruct in preventive(dietary and oral hygiene) and curative (planning ofpediatric dental visits and treatments) habits. A convenience sampling of forty pediatric dentists, dentists,pediatricians and parents was carried out to evaluatethe preliminary design, in 2019. They completed a questionnaire with their data, opinion on different aspects ofthe booklet and suggestions. Results: The evaluation of the preliminary version ofthe booklet by health professionals and parents waspositive. It was modified in line with their suggestionsand the final version was made: a 16-page booklet, withdata on the child’s affiliation and parents, with a preventive and curative approach, making pediatric andpediatric dental check-ups coincide in time. Conclusions: The pediatric dentistry booklet was created and has been positively valued by professionalsand parents, its use is recommended for early dentalcare, and can be extended to other health systems atthe regional level in Spain.(AU)

[Phenotypic variations in Aicardi-Goutieres syndrome caused by RNASEH2B gene mutations: report of two new cases]. / Variaciones fenotípicas en el síndrome de Aicardi-Goutières causado por mutaciones en el gen RNASEH2B: presentación de dos nuevos casos.

INTRODUCTION: Aicardi-Goutieres syndrome is a rare immune disorder due to mutations in seven different genes that encode proteins called TREX1, ribonuclease H2 complex, SAMHD1, ADAR and IDIH1 (MDA5), which are involved in acid nucleic metabolism. Two cases are described in detail below caused by RNASEH2B gene mutation, one of which displays a mutation no described to date. CASE REPORTS: Case 1: male consulting because from 5-month-old shows loss of maturity items acquired until then, coming with several fever episodes. Case 2: a 4-month-old boy showing since 2-month-old great irritability and oral-feeding trouble with severe psychomotor impairment. In both cases it was found an increase of pterines in the cerebrospinal fluid, mainly neopterine, with calcifications in the basal ganglia. The diagnosis was proved by sequencing RNASEH2B gene, founding in case 2 a new mutation not described previously. CONCLUSIONS: The reported cases belong to the description already done by Aicardi-Goutieres, it should be noticed this syndrome in a patient with a subacute encephalopathy of debut in the first year of life, dystonia/spasticity in variable degree and important affectation/regression of psychomotor development, particularly in those with increase of pterines (neopterine) in the cerebrospinal fluid and calcifications in the basal ganglia.

TITLE: Variaciones fenotipicas en el sindrome de Aicardi-Goutieres causado por mutaciones en el gen RNASEH2B: presentacion de dos nuevos casos.Introduccion. El sindrome de Aicardi-Goutieres es un trastorno inmunitario raro debido a mutaciones en siete genes que codifican proteinas llamadas TREX1, el complejo ribonucleasa H2, SAMHD1, ADAR e IFIH1 (MAD5), las cuales estan implicadas en el metabolismo de los acidos nucleicos. A continuacion se presentan dos nuevos casos por mutacion en el gen RNASEH2B, uno de los cuales presenta una mutacion no descrita hasta la fecha. Casos clinicos. Caso 1: varon que consulto porque desde los 5 meses, coincidiendo con cuadros febriles de repeticion, presentaba perdida de los items madurativos adquiridos hasta la fecha. Caso 2: niño de 4 meses que desde los 2 meses mostraba gran irritabilidad con dificultades en la alimentacion, asociado a un grave retraso psicomotor. En ambos casos se constato un aumento de las pterinas en el liquido cefalorraquideo, principalmente de la neopterina, con calcificaciones en los ganglios basales. El diagnostico se confirmo mediante secuenciacion del gen RNASEH2B; el caso 2 presentaba una mutacion no descrita en la literatura medica. Conclusiones. Los casos corresponden a la descripcion clasica realizada por Aicardi-Goutieres. Debe tenerse en cuenta este sindrome ante un paciente con un cuadro de encefalopatia subaguda de comienzo en el primer año de vida, distonia/espasticidad en grado variable e importante afectacion/regresion del desarrollo psicomotor, especialmente si asocia aumento de las pterinas (neopterina) en el liquido cefalorraquideo y calcificaciones en los ganglios basales.

Comparison of experimentally determined protein structures by solution of Bloch equations.

Nuclear Overhauser enhancement (NOESY) spectra were theoretically generated by solving the generalized Bloch equations with the appropriate initial conditions. The input to the equations were the coordinates of the protons of two similar crystal structures of basic pancreatic trypsin inhibitor. The two NOESY spectra obtained were compared to published experimental spectra of the protein in solution. It was found that the two crystal structures of basic pancreatic trypsin inhibitor give different theoretical spectra. The solution of the Bloch equations is very sensitive to small variations in the distance between protons (approx. 0.2 A), and to differences in the surrounding configurations. The method allows a detailed comparison of the crystal and solution structures of proteins. The structure of the trypsin inhibitor in solution was found to be similar to either one or the other crystal forms in different regions of the molecule.

Refined solution structure and ligand-binding properties of PDC-109 domain b. A collagen-binding type II domain.

We have determined, via 1H-n.m.r., the solution conformation of the collagen-binding b-domain of the bovine seminal fluid protein PDC-109 (PDC-109/b). The structure determination is based on 341 interproton distance estimates and 42 dihedral angle estimates: a set of 24 initial structures were computed; 12 using the variable target function program DIANA, and 12 using the metric matrix program DISGEO. These structures were optimized by restrained energy minimization and dynamic simulated annealing using the CHARMM and X-PLOR programs. The average pairwise root-mean-square difference (r.m.s.d) between the optimized DIANA (DISGEO) structures is 0.71 A (0.82 A) for the backbone atoms, and 1.73 A (2.03 A) for all atoms. Both sets of structures exhibit the same global fold, secondary structure and placement of most non-polar side-chains. Two central antiparallel beta-sheets, which lie roughly perpendicular to each other, and two irregular loops support a large, partially exposed, hydrophobic surface that defines a putative binding site. A test of a hybrid relaxation matrix-based distance refinement protocol (MIDGE program) was performed using a normalized 250 millisecond NOESY spectrum. The resulting distances were input to the molecular mechanics/dynamics procedures mentioned above in order to optimize the DIANA structures. Our results indicate that relaxation matrix refinement of distances is most useful when used conservatively for identifying underestimated distance constraints. 1H-n.m.r. monitored ligand titration experiments revealed definite, albeit weak, binding interactions for phenethylamine and leucine analogs (Ka less than or equal to 25 M-1). Residues perturbed by ligand binding include Tyr7, Trp26, Tyr33, Asp34 and Trp39. These results suggest that PDC-109/b may recognize specific leucine and/or isoleucine-containing sequences within collagen.

A novel low oxygen affinity recombinant hemoglobin (alpha96val--> Trp): switching quaternary structure without changing the ligation state.

Using our Escherichia coli expression plasmid (pHE2) in which synthetic human alpha and beta-globin genes are coexpressed with the E. coli methionine aminopeptidase gene under the control of separate tac promoters, we have constructed a new artificial hemoglobin in which the valine residue at position 96 of the alpha chain, located in the alpha 1 beta 2 subunit interface, has been replaced by a tryptophan residue using site-directed mutagenesis. We have determined the oxygen-binding properties of this recombinant hemoglobin, r Hb (alpha 96Val-->Trp), and have used proton nuclear magnetic resonance spectroscopy to investigate its tertiary structure around the heme group and the quaternary structure in the alpha 1 beta 2 subunit interface. This artificial hemoglobin shows a low oxygen affinity, but high cooperativity in oxygen binding, and exhibits no unusual subunit dissociation when ligated. Molecular dynamics simulations suggest that the unique oxygen-binding property of r Hb (alpha 96Val-->Trp) may be due to an extra hydrogen bond between alpha 96Trp and beta 99Asp in the alpha 1 beta 2 subunit interface in the deoxy form. Despite the replacement of a small amino acid residue, valine, by a large tryptophan residue in the alpha 1 beta 2 subunit interface, this artificial hemoglobin shows very similar tertiary structure around the heme pockets and quaternary structure in the alpha 1 beta 2 subunit interface compared to those of human normal adult hemoglobin. Another unique feature of this artificial hemoglobin is that the ligated form, e.g. carbonmonoxy form, of this hemoglobin in the oxy-quaternary structure can be converted to the deoxy-like quaternary structure by the addition of an allosteric effector, inositol hexaphosphate, as well as by lowering the temperature in the absence of inositol hexaphosphate, without changing its ligation state. Thus, this recombinant hemoglobin can be used to gain new insights regarding the nature of subunit interactions in the alpha 1 beta 2 interface and the molecular basis for the allosteric mechanism of hemoglobin.

Oil quality and sensory evaluation of almond (Prunus amygdalus) stored after electron beam processing.

The changes in the lipid fraction and the deterioration of its quality were studied in almonds (Prunus amygdalus) of the variety Guara after treatment with accelerated electrons at doses of 3, 7, and 10 kGy, during a storage period of 5 months. In almond oil, the most significant difference from the nutritional point of view was seen in the fatty acid linolenic (18:3), which shows at 3 kGy a maintenance of the initial content during the whole storage period, whereas, at 7 and 10 kGy, the content in 18:3 disappears from the first moment. The quality indices of the oil (K(232), K(270)) decreased at all doses and remained stable during the time of storage. The peroxide value did not show changes at the doses of 3 and 7 kGy, in non-irradiated samples, but significantly increased when the maximum dose of 10 kGy was applied. These changes were reflected in the sensory analysis, in which the tasters did not find sensory differences between the controls and those irradiated at doses of 3 or 7 kGy, whereas almonds irradiated at 10 kGy exhibited a rancid flavor and a significant decrease in general quality.

Reductive decolourisation of azo dyes by mesophilic and thermophilic methanogenic consortia.

The contribution of acidogenic bacteria and methanogenic archaea on the reductive decolourisation of azo dyes was assessed in anaerobic granular sludge. Acidogenic bacteria appeared to play an important role in the decolourising processes when glucose was provided as an electron donor; whereas methanogenic archaea showed a minor role when this substrate was supplemented in excess. In the presence of the methanogenic substrates acetate, methanol, hydrogen and formate, methane production became important only after colour was totally removed from the batch assays. This retardation in methane production may be due to either a toxic effect imposed by the azo dyes or to the competitive behaviour of azo dyes to the methanogenic consortia for the available reducing equivalents.

Traqueostomía en pacientes con COVID-19: recomendaciones actuales / Traqueostomy in COVID-19 patients: current recomendations

Resumen El nuevo coronavirus (SARS-CoV-2), causante de la enfermedad COVID-19, es una pandemia con alta morbimortalidad mundial. Uno de los factores más importantes es su alta tasa de transmisibilidad por gotitas, aerosoles y fómites. La tendencia actual es el aumento progresivo de pacientes contagiados en nuestro país y, por consiguiente, de mayor cantidad de enfermos en unidades de cuidados intensivos (UCI) con uso de ventilación mecánica invasiva (VMI). La traqueostomía (TQT) se utiliza en pacientes críticos para facilitar la VMI a largo plazo y el destete de la ventilación. Una TQT temprana, definida como la realizada en los primeros 7 días después de la intubación orotraqueal (IOT), se asocia a una reducción en el tiempo de la VMI, mortalidad y permanencia en UCI. La TQT es una técnica quirúrgica con alta generación de aerosoles la cual implica medidas especiales frente a la realización de ésta en pacientes con COVID-19. Para limitar el contagio del SARS-CoV-2 en los trabajadores de salud es necesario el uso de elementos de protección personal (EPP) adecuados según la intervención a realizar. Es por esta razón que en el presente artículo se propone utilizar el acrónimo C-O-RO-NA para no olvidar elementos y pasos fundamentales al momento de realizar esta técnica, minimizando de esta manera el contagio en los trabajadores de salud.

The new coronavirus (SARS-CoV-2), which causes COVID-19 disease, is a high mortality pandemic illness. One of the most important factors is its high rate of transmissibility by respiratory droplets, aerosols and fomites. The reigning trend of this disease is progressively increasing infected patients in our country, therefore, more patients in intensive care units (ICU) with invasive mechanical ventilation (IMV). Tracheostomy (TQT) is used in critical patients to facilitate long-term IMV and ventilation weaning. An early TQT, defined as performed in the first 7 days after orotracheal intubation (IOT) is associated with a reduction IMV duration, mortality rate and length of stay in ICU. TQT is a surgical procedure which generates a huge amount of aerosols that need special measures to perform in COVID-19 patients. It is necessary to use appropriate personal protection elements (PPE) according to the intervention, limiting the spread of SARS-CoV-2 in health workers. It is for this reason that this article proposes to use the acronym C-O-RO-NA to remember fundamental elements and steps when performing this technique in order to minimize health workers infection.