Despite SARS-CoV-19 infection has a stereotypical clinical picture, isolated cases with unusual manifestations have been reported, some of them being well-known to be triggered by viral infections. ...However, the real frequency in COVID-19 is unknown. Analysing data of 63 822 COVID patients attending 50 Spanish emergency department (ED) during the COVID outbreak, before hospitalisation, we report frequencies of (myo)pericarditis (0.71‰), meningoencephalitis (0.25‰), Guillain–Barré syndrome (0.13‰), acute pancreatitis (0.71‰) and spontaneous pneumothorax (0.57‰). Compared with general ED population, COVID patients developed more frequently Guillain–Barré syndrome (odds ratio (OR) 4.55, 95% confidence interval (CI) 2.09–9.90), spontaneous pneumothorax (OR 1.98, 95% CI 1.40–2.79) and (myo)pericarditis (OR 1.45, 95% CI 1.07–1.97), but less frequently pancreatitis (OR 0.44, 95% CI 0.33–0.60).
Objective
To investigate the relationship between ambient temperature and atmospheric pressure (AP) and the severity of heart failure (HF) decompensations.
Methods
We analysed patients coming from ...the Epidemioloy Acute Heart Failure Emergency (EAHFE) Registry, a multicentre prospective cohort study enrolling patients diagnosed with decompensated HF in 26 emergency departments (EDs) of 16 Spanish cities. We recorded patient and demographic data and maximum temperature (
T
max
) and AP (AP
max
) the day before ED consultation. Associations between temperature and AP and severity endpoints were explored by logistic regression. We used restricted cubic splines to model continuous non-linear associations of temperature and AP with each endpoint.
Results
We analysed 16,545 patients. Daily
T
max
and AP
max
(anomaly) of the day before patient ED arrival ranged from 0.8 to 41.6° and from − 61.7 to 69.9 hPa, respectively. A total of 12,352 patients (75.2%) were hospitalised, with in-hospital mortality in 1171 (7.1%). The probability of hospitalisation by HF decompensation showed a U-shaped curve versus
T
max
and an increasing trend versus AP
max
. Regarding temperature, hospitalisation significantly increased from 20 °C (reference) upwards (25 °C: OR = 1.12, 95% CI = 1.04–1.21; 40 °C: 1.65, 1.13–2.40) and below 5.4 °C (5 °C: 1.21, 1.01–1.46). Concerning the mean AP of the city (anomaly = 0 hPa), hospitalisation increased when AP
max
(anomaly) was above + 7.0 hPa (atmospheric anticyclone; + 10 hPa: 1.14, 1.05–1.24; + 30 hPa: 2.02. 1.35–3.03). The lowest probability of mortality also corresponded to cold-mild temperatures and low AP, with a significant increased risk only found for
T
max
above 24.3 °C (25 °C: 1.13, 1.01–1.27; 40 °C: 2.05, 1.15–3.64) and AP
max
(anomaly) above + 3.4 hPa (+ 10 hPa: 1.21, 1.07–1.36; + 30 hPa: 1.73, 1.06–2.81). Sensitivity analysis confirmed the main analysis results.
Conclusion
Temperature and AP are independently associated with the severity of HF decompensations, with possible different effects on the need for hospitalisation and in-hospital mortality.
Introducción. La captura corporativa es el proceso en el que las decisiones políticas responden a un interés particular de carácter privado, en detrimento del interés público. La industria del ...cannabis ha desarrollado estrategias de captura de políticas y de difusión de fake news (noticias falsas) con el objeto de fomentar una visión del cannabis como sustancia inocua e, incluso, sanadora de enfermedades, promoviendo así una buena imagen de esta sustancia, de las corporaciones y consumidores, presionando para su legalización. Objetivos. (1) Analizar las estrategias de difusión de mensajes y fake news promotoras del cultivo, consumo y regulación del cannabis a través de distintos canales, y (2) explorar el posicionamiento frente al debate legislativo sobre esta sustancia en una muestra de estudiantes universitarios consumidores de cannabis. Metodología. (1) Estudio de carácter exploratorio para identificar y analizar las estrategias de la industria y, (2) estudio no probabilístico con muestreo por conveniencia mediante encuesta telemática difundida entre estudiantes de 11 universidades españolas (439 participantes). Resultados y conclusiones. La promoción del cultivo y del consumo de cannabis, relativizando sus efectos perjudiciales y presentándolo como una sustancia medicinal, aparece en las distintas estrategias utilizadas por la industria para difundir una imagen positiva del cannabis y de los consumidores. Estos mensajes tienen correspondencia con el posicionamiento de los consumidores, de los que el 82.6 % apoya alguna forma de regulación del cannabis.
Smoke inhalation is a common cause of cyanide poisoning during fires, resulting in injury and even death. In many cases of smoke inhalation, cyanide has increasingly been recognized as a significant ...toxicant. The diagnosis of cyanide poisoning remains very difficult, and failure to recognize it may result in inadequate or inappropriate treatment. Findings suggesting cyanide toxicity include the following: (a) a history of enclosed-space fire; (b) any alteration in the level of consciousness; (c) any cardiovascular changes (particularly inexplicable hypotension); and (d) elevated plasma lactate. The feasibility and safety of empiric treatment with hydroxocobalamin for fire smoke victims have been reported in the literature. On the basis of a literature review and a panel discussion, a group of European experts has proposed emergency management protocols for cyanide toxicity in fire smoke victims.
Despite SARS-CoV-19 infection has a stereotypical clinical picture, isolated cases with unusual manifestations have been reported, some of them being well-known to be triggered by viral infections. ...However, the real frequency in COVID-19 is unknown. Analysing data of 63 822 COVID patients attending 50 Spanish emergency department (ED) during the COVID outbreak, before hospitalisation, we report frequencies of (myo)pericarditis (0.71‰), meningoencephalitis (0.25‰), Guillain-Barré syndrome (0.13‰), acute pancreatitis (0.71‰) and spontaneous pneumothorax (0.57‰). Compared with general ED population, COVID patients developed more frequently Guillain-Barré syndrome (odds ratio (OR) 4.55, 95% confidence interval (CI) 2.09-9.90), spontaneous pneumothorax (OR 1.98, 95% CI 1.40-2.79) and (myo)pericarditis (OR 1.45, 95% CI 1.07-1.97), but less frequently pancreatitis (OR 0.44, 95% CI 0.33-0.60).
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