Reduction in catheter-related bloodstream infections in critically ill patients through a multiple system intervention.

Els catéters venosos centrals són necessaris per al maneig del pacient crític però poden ser l´origen d´una bacteriemia. Aquest estudi prospectiu de cohort té com a objectiu determinar la utilitat de l´aplicació d´unes mesures bàsiques de prevenció per disminuir la incidència de bacteriemia associada a catéter. Els resultats de l´estudi confirmen que l´aplicació d´aquest sistema d´intervenció múltiple basat en l´evidencia redueix de forma significativa les bacteriemies associades a catéter a la nostra UCI.

Estimating arterial blood gases with the EABC® System (“Earlobe Arterialized Blood Collector”) in critically ill patients. A validation study.

The Earlobe Arterialized Blood Collector® is a minimally invasive system able to perform arterialized capillary blood gas analysis from the earlobe (EL). A prospective validation study was performed in 55 critical ill patients. Sampling failure rate was high (53.6%). Risk factors were age > 65 years, diabetes, vasoactive drug therapy and noradrenaline (NA) doses above 0.22 μg / kg / min. Multivariate analysis showed age > 65 years was the only factor independently associated with failure. Concordance analysis with arterial blood gases and Bland-Altman agreement evaluation were insufficient for validating the new system for all gasometrical variables.

4th International LIS-EPI meeting: una mirada al futuro de la información

Informe sobre el 4th International LIS-EPI Meeting que tuvo lugar en Valencia en noviembre de 2009 bajo el lema ¿La información en 2015¿. Los temas que se trataron fueron el futuro del sector de la información y de las bibliotecas, las rich internet applications (RIAs), el software libre en bibliotecas, el acceso abierto y los dispositivos móviles

Some game-theoretic grounds for meeting people half-way

It is well known that, in distributions problems, fairness rarely leads to a single viewpoint (see, for instance, Young (1994)). In this context, this paper provides interesting bases that support the simple and commonly observed behavior of reaching intermediate agreements when two prominent distribution proposals highlight a discrepancy in sharing resources. Specifi cally, we formalize such a conflicting situation by associating it with a `natural' cooperative game, called bifocal distribution game, to show that both the Nucleolus (Schmeidler (1969)) and the Shapley value (Shapley (1953a)) agree on recommending the average of the two focal proposals. Furthermore, we analyze the interpretation of the previous result by means of axiomatic arguments. Keywords: Distribution problems, Cooperative games, Axiomatic analysis, Nucleolus, Shapley value. JEL Classi fication Numbers: C71, D63, D71.

Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus SEMICYUC-SENPE: Oncohematological patient

Patients with cancer, irrespective of the stage of their disease, can require admission to the intensive care unit as a result of the complications of their underlying process or the surgical or pharmacological treatment provided. The cancer itself, as well as the critical status that can result from the complications of the disease, frequently lead to a high degree of hypermetabolism and inadequate energy intake, causing a high incidence of malnutrition in these patients. Moreover, cancer causes anomalous use of nutritional substrates and therefore the route of administration and proportion and intake of nutrients may differ in these patients from those in noncancer patients.

The path: sustainable development in conjunction with meeting the demands of a changing environment.

In the context of severe economic recession, the Library is compelled to adapt to this changing environment, in order to meet the requirements and demands of users with very specific needs. Taking the pillars of sustainable development as a reference point, and extrapolating them to our domain, we establish the next main goals

Evaluación de los factores de riesgo y los tipos de superficie para el desarrollo de las úlceras por presión en el enfermo crítico = Assessment of risk factors and the types of surface for the development of pressure ulcers on critical ill patients

The main objective of this article is to assess the risk factors and the types of surface for the development of pressure ulcers (PU) on critical ill patients in an Intensive Care Unit (ICU)

Blanco bajo negro. Trabajos desde lo imperceptible / 3. Freya Powell: I’ll smile and I’m not sad. Y otros pasados presentes

Las instalaciones de vídeo de la primera exposición de Freya Powell en Barcelona invitan a una meditación sobre los vínculos entre la memoria y el archivo, el registro, el repertorio y las huellas de la Historia. En esta exposición se tensa un hilo entre la memoria de los condenados a muerte norteamericanos, la memoria de la Segunda Guerra Mundial, la de la propia artista y los diferentes mapas del mundo creados por la historia colonial. Es un hilo que pregunta por nuestro vínculo no solo con las voces y las palabras archivadas, sino con ésas que queremos recoger y recibir.

Cycle: White under Black. Works from the imperceptible / 3. Freya Powell: I’ll smile and I’m not sad, and other past presents

The video installations of Freya Powell's first exhibition in Barcelona call for an analysis of the links between memory and the archive, between compilation, registration, and the traces of History. Powell's work establishes a fine link between the memory of those sentenced to death in the United States, the memory of the Second World War, the artist's own memory, and the different world maps produced by colonial history. This link forces us to take into account our own connection not only with the voices and words that have been archived, but also with those voices that we want to hear and register.

Stratification of the severity of critically ill patients with classification trees

Background: Development of three classification trees (CT) based on the CART (Classification and Regression Trees), CHAID (Chi-Square Automatic Interaction Detection) and C4.5 methodologies for the calculation of probability of hospital mortality; the comparison of the results with the APACHE II, SAPS II and MPM II-24 scores, and with a model based on multiple logistic regression (LR). Methods: Retrospective study of 2864 patients. Random partition (70:30) into a Development Set (DS) n = 1808 and Validation Set (VS) n = 808. Their properties of discrimination are compared with the ROC curve (AUC CI 95%), Percent of correct classification (PCC CI 95%); and the calibration with the Calibration Curve and the Standardized Mortality Ratio (SMR CI 95%). Results: CTs are produced with a different selection of variables and decision rules: CART (5 variables and 8 decision rules), CHAID (7 variables and 15 rules) and C4.5 (6 variables and 10 rules). The common variables were: inotropic therapy, Glasgow, age, (A-a)O2 gradient and antecedent of chronic illness. In VS: all the models achieved acceptable discrimination with AUC above 0.7. CT: CART (0.75(0.71-0.81)), CHAID (0.76(0.72-0.79)) and C4.5 (0.76(0.73-0.80)). PCC: CART (72(69- 75)), CHAID (72(69-75)) and C4.5 (76(73-79)). Calibration (SMR) better in the CT: CART (1.04(0.95-1.31)), CHAID (1.06(0.97-1.15) and C4.5 (1.08(0.98-1.16)). Conclusion: With different methodologies of CTs, trees are generated with different selection of variables and decision rules. The CTs are easy to interpret, and they stratify the risk of hospital mortality. The CTs should be taken into account for the classification of the prognosis of critically ill patients.