An observational study of oceanic eddy generation mechanisms by tall deep-water islands (Gran Canaria)

[EN]Oceanic eddy generation by tall deep-water islands is common phenomenon. It is recognized that these eddies may have a significant impact on the marine system and related biogeochemical fluxes. Hence, it is important to establish favourable conditions for their generation. With this objective, we present an observational study on eddy generation mechanisms by tall deep-water islands, using as a case study the island of Gran Canaria. Observations show that the main generation mechanism is topographic forcing, which leads to eddy generation when the incident oceanic flow is sufficiently intense. Wind shear at the island wake may acts only as an additional eddy-generation trigger mechanism when the impinging oceanic flow is not sufficiently intense. For the case of the island of Gran Canaria we have observed a mean of ten generated cyclonic eddies per year. Eddies are more frequently generated in summer coinciding with intense Trade winds and Canary Current.

Assessment of candidemia-attributable mortality in critically ill patients using propensity score matching analysis

[EN] Introduction: Candidemia in critically ill patients is usually a severe and life-threatening condition with a high crude mortality. Very few studies have focused on the impact of candidemia on ICU patient outcome and attributable mortality still remains controversial. This study was carried out to determine the attributable mortality of ICU-acquired candidemia in critically ill patients using propensity score matching analysis. Methods: A prospective observational study was conducted of all consecutive non-neutropenic adult patients admitted for at least seven days to 36 ICUs in Spain, France, and Argentina between April 2006 and June 2007. The probability of developing candidemia was estimated using a multivariate logistic regression model. Each patient with ICU-acquired candidemia was matched with two control patients with the nearest available Mahalanobis metric matching within the calipers defined by the propensity score. Standardized differences tests (SDT) for each variable before and after matching were calculated. Attributable mortality was determined by a modified Poisson regression model adjusted by those variables that still presented certain misalignments defined as a SDT > 10%. Results: Thirty-eight candidemias were diagnosed in 1,107 patients (34.3 episodes/1,000 ICU patients). Patients with and without candidemia had an ICU crude mortality of 52.6% versus 20.6% (P < 0.001) and a crude hospital mortality of 55.3% versus 29.6% (P = 0.01), respectively. In the propensity matched analysis, the corresponding figures were 51.4% versus 37.1% (P = 0.222) and 54.3% versus 50% (P = 0.680). After controlling residual confusion by the Poisson regression model, the relative risk (RR) of ICU- and hospital-attributable mortality from candidemia was RR 1.298 (95% confidence interval (CI) 0.88 to 1.98) and RR 1.096 (95% CI 0.68 to 1.69), respectively. Conclusions: ICU-acquired candidemia in critically ill patients is not associated with an increase in either ICU or hospital mortality.