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Advances in Artificial Intelligence (AI) are giving rise to a multitude of AI-embedded technologies that are increasingly impacting all aspects of modern society. Yet, there is a paucity of rigorous research that advances understanding of when, and which type of, individuals are more likely to question AI-based recommendations due to perceived racial and gender bias. This study, which is part of a larger research stream contributes to knowledge by using a scenario-based survey that was issued to a sample of 387 U.S. participants. The findings suggest that, considering perceived racial and gender bias, Human Resource (HR) recruitment and financial product/service procurement scenarios exhibit a higher questioning likelihood. Meanwhile, the healthcare scenario presents the lowest questioning likelihood. Furthermore, in the context of this study, U.S. participants tend to be more susceptible to questioning AI-based recommendations due to perceived racial bias rather than gender bias.

Background Clostridioides difficile infection (CDI) is a disease that is potentially preventable by vaccination. A good knowledge of its epidemiology, which can change over time, is warranted for prevention purposes and to help decision-making on the use of vaccines in public health programs. The objective of the research was to determine the epidemiology of healthcare-associated CDI (HA-CDI) and community-associated CDI (CA-CDI) in hospitalized patients in Spain using point prevalence data. Methods Point prevalence survey data on infections of hospitalized patients for years 2012–2019 were analyzed. HA-CDI and CA-CDI prevalence rates were calculated. Both HA-CDI and CA-CDI, as well as age group prevalence rates, were examined for trends. Patient comorbidities were tested for association to CDI. Results The prevalence of CDI in Spanish hospitals has grown exponentially from 14.1% in 2012 to 35.9% in 2019 (cases/10.000 hospitalized patients). Almost two thirds of the cases are of nosocomial onset. This increase was observed for HA-CDI and CA-CDI at an annual rate of 1.11% (CI 95% 1.08–1.15) and 1.09% (CI 95% 1.04–1.13), respectively. Patients 50 years old or older represent 87% of the total number of cases. Patients suffering from neoplasm (OR 1.39), immunodeficiency (OR 3.26), neutropenia (OR 3.70), cirrhosis (OR 1.92) and chronic renal failure (OR 1.91) have a significant increased risk of developing CDI, after adjusting for age. Conclusion In Spain, the prevalence rate of both HA-CDI and CA-CDI have been increasing. Burden of CDI as well as clinical and epidemiological characteristics of CDI patients will help to support public health decision-making.

Introduction: Commercial video games are considered an effective tool to improve postural balance in different populations. However, the effectiveness of these video games for patients with multiple sclerosis (MS) is unclear. Objectives: To analyse existing evidence on the effects of commercial video games on postural balance in patients with MS. Material and method: We conducted a systematic literature search on 11 databases (Academic-Search Complete, AMED, CENTRAL, CINAHL, WoS, IBECS, LILACS, Pubmed/Medline, Scielo, SPORTDiscus, and Science Direct) using the following terms: “multiple sclerosis”, videogames, “video games”, exergam*, “postural balance”, posturography, “postural control”, balance. Risk of bias was analysed by 2 independent reviewers. We conducted 3 fixed effect meta-analyses and calculated the difference of means (DM) and the 95% confidence interval (95% CI) for the Four Step Square Test, Timed 25-Foot Walk, and Berg Balance Scale (BBS). Results: Five randomised controlled trials were included in the qualitative systematic review and 4 in the meta-analysis. We found no significant differences between the video game therapy group and the control group in Four Step Square Test (DM: −.74; 95% CI, −2.79 to 1.32; P = .48; I2 = 0%) and Timed 25-Foot Walk scores (DM: .15; 95% CI, −1.06 to .76; P = .75; I2 = 0%). We did observe intergroup differences in BBS scores in favour of video game therapy (DM: 5.30; 95% CI, 3.39–7.21; P

Background Healthcare workers (HCWs) have been a critical and vulnerable population during SARS-CoV-2 pandemic. The aim of this study was to determine the overall seroprevalence and to evaluate occupational risk factors among HCWs in one of the countries most affected by this pandemic. Methods We conducted a seroprevalence study for SARS-CoV-2 in a tertiary hospital in Madrid (Spain) between 24 April and 8 May 2020. A total of 4894 HCWs were invited for serologic testing. Serum samples were tested for SARS-CoV-2 IgM and IgG antibodies using Enzyme Immunoassay (ELISA) and Electro-Chemiluminescence Immunoassay (ECLIA) techniques. We calculated odds ratios to assess association between demographic and occupational characteristics with SARS-CoV-2 seroconversion. Results We processed 4324 serum samples. Overall, seroprevalence was of 16.6% (95% CI: 15.5-17.7). We found statistically significant differences in SARS-CoV-2 seroprevalence by type of employee, professional category, department and type of activity performed during the pandemic period, while no differences were identified between the personnel working in the COVID-19 wards compared to those working in non-COVID-19 wards. We confirmed 268 (26.7%) infections among 1005 hospital staff members tested by PCR. 60.5% of HCWs infected by SARS-CoV-2, assessed either by PCR or serology, could be considered asymptomatic or paucisymptomatic. Conclusions HCWs have an increased risk of SARS-CoV-2 infection but COVID-19 patient exposure was not a determining factor. Universal mask wearing should be mandatory in healthcare settings given the important number of asymptomatic and paucisymptomatic cases.

Operating room (OR) fires are rare but devastating events requiring immediate and effective response. Virtual Reality (VR) simulation training can provide a safe environment for practice of skills in such highly stressful situation. This study assessed interprofessional participants’ ability to respond to VR-simulated OR fire scenarios, attitudes, numbers of attempt of the VR simulation do participants need to successfully respond to OR fires and does prior experience, confidence level, or professional role predict the number of attempts needed to demonstrate safety and pass the simulation. 180 surgical team members volunteered to participate in this study at Beth Israel Deaconess Medical Center, Boston, MA. Each participant completed five VR OR simulation trials; the final two trials incorporated AI assistance. Primary outcomes were performance scores, number of attempts needed to pass, and pre- and post-survey results describing participant confidence and experiences. Differences across professional or training role were assessed using chi-square tests and analyses of variance. Differences in pass rates over time were assessed using repeated measures logistic regression. One hundred eighty participants completed simulation testing; 170 (94.4%) completed surveys. Participants included surgeons (17.2%), anesthesiologists (10.0%), allied health professionals (41.7%), and medical trainees (31.1%). Prior to training, 45.4% of participants reported feeling moderately or very confident in their ability to respond to an OR fire. Eight participants (4.4%) responded safely on the first simulation attempt. Forty-three participants (23.9%) passed by the third attempt (VR only); an additional 97 participants (53.9%) passed within the 4–5th attempt (VR with AI assistance). Providers are unprepared to respond to OR fires. VR-based simulation training provides a practical platform for individuals to improve their knowledge and performance in the management of OR fires with a 79% pass rate in our study. A VR AI approach to teaching this essential skill is innovative, feasible, and effective.

Tricuspid regurgitation is associated with a poor outcome and its quantification remains a challenge. Tricuspid annulus dilatation is one of the parameters that influences clinical decision-making. The aim of this study was to compare the use of 2D transoesophageal echocardiography with surgical assessment for the measurement of the tricuspid annulus. Sixty-one cardiac patients (median age 64 years) were included in the study. Echocardiographic tricuspid annulus measurements were obtained from four chamber and transgastric short axis views and compared with the surgical measurements of this valve. The study was approved by the Ethics Committee of our institution. The tricuspid annulus measurements were obtained from the four chamber and the short axis views in 57 and 49 patients, respectively, while surgical measurement was performed in all 61 patients. Bland–Altman analysis of 49 tricuspid annulus-matched dimensions of the short axis view and surgical values showed a mean bias of 0.223 mm/m2, with limits of agreement of −5.86 to 6.31 mm/m2. Echocardiographic measurements of the tricuspid annulus dimension were accurate (90% sensitivity and 90% specificity for a four chamber view cut-off value ≥ 24.5 mm/m2, and 89% sensitivity and 97% specificity for a short axis view cut-off value ≥ 37.6 mm/m2, P

El objetivo del trabajo era conocer el perfil de salud y la prevencion cardiovascular mediante la historia personal, familiar y electrocardiograma de los adolescentes para mejorar las indicaciones sobre la realizacion de ejercicio fisico en los centros escolares. Se realizo un estudio observacional descriptivo de una cohorte de alumnado de escuelas publicas y privadas. Muestra. 1391 adolescentes (667 chicos y 724 chicas). Metodologia. Estudio observacional descriptivo. Cuestionario estructurado sobre la historia familiar y personal de ejercicio fisico y factores de riesgo, y realizacion de un electrocardiograma. Resultados. El ejercicio fisico entre 2 y 5 horas a la semana era realizado por el 45 % de los chicos y 47 % de las chicas y mas de 5 horas, por el 39.7 % y 23 %, respectivamente. Sintomas: palpitaciones aisladas (23.7 % chicos y 39.1 % chicas), mareo y/o perdida de conocimiento transitorio sin consecuencias (7.3 % y 13.8 % respectivamente), algun tipo de patologia cardiaca controlada (4.2 % chicos y 2.1 % chicas). En los electrocardiogramas 59 presentaron alteraciones inespecificas de la repolarizacion y 9 bloqueo incompleto de rama derecha, en todos se descartaron cardiopatias. Factores de riesgo detectados: hipertension arterial (2.3 %), hipercolesterolemia (7.3 %), diabetes (2.3 %), preobesos (7.6 % chicos y 6.5 % chicas), obesidad (2.2 % y 1.5 % respectivamente) y fumadores de mas de 6 cigarrillos al dia (1.2 % chicos y 2.2 % chicas). Conclusion. La informacion del alumnado sobre sus antecedentes personales, familiares cardiovasculares, electrocardiograma y nivel de actividad fisica que realizan, permite llevar a cabo un programa de educacion sanitaria que facilite mejorar los habitos dieteticos, implementar la actividad fisica y eliminar los habitos toxicos o no saludables.

Objective: To analyse the rate of occurrence and the clinical variables associated with readmission of patients who had previously been discharged after admission for COVID-19. Setting: University hospital in Madrid (Spain). Participants: Sixty-one patients (74% male) who presented COVID-19 were readmitted during the 3 weeks after discharge from hospital. Interventions: Nested case-control study paired (1:1 ratio) by age, sex and period of admission. Outcome Measures: Rate of readmission rate of patients discharged after suffering COVID-19 and identification of the clinical variables associated with it. Results: Out of 1368 patients who were discharged during the study period, 61 patients (4.4%) were readmitted. Immunocompromised patients (N=10.2%) were at increased risk for readmission (p=0.04). There was also a trend towards a higher probability of readmission in hypertensive patients (p=0.07). Cases had had a shorter hospital stay and a higher prevalence of fever during the 48 hours prior to discharge. There were no significant differences in oxygen levels measured at admission and discharge by pulse oximetry intra-subject or between the groups. Neutrophil-to-lymphocyte ratio at hospital admission tended to be higher in cases than in controls (p=0.06). Neither glucocorticoids nor anticoagulants prescribed at hospital discharge were associated with a lower readmission rate. Patients who were readmitted due to a thrombotic event (8 patients, 13.1%) presented a higher level of D-dimer at discharge of initial admission. Conclusion: The rate of readmission after discharge from hospital for COVID-19 was low. Immunocompromised patients and those presenting with fever during the 48 hours prior to discharge were at greater risk of readmission to hospital.

Background Bloodstream infections (BSIs) are a major cause of mortality in hospitalized patients. Rapid diagnosis is crucial because any delay in the antimicrobial treatment is associated with an increase in adverse patient outcomes. The application of matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) technology directly to blood cultures permits earlier identification of BSIs and facilitates treatment management. Methods A total of 470 positive blood cultures from patient samples were analyzed using Standard Aerobic/F and Anaerobic/F blood culture media. Isolates were identified using conventional identification methods and by the direct method using the MALDI-TOF MS system. Results In 470 blood cultures, the direct method showed good identification results (420/470, 89%); specifically, accurate species and genus identification in 283/470 (60%), and only correct genus identification in 137/470 (29%). The direct protocol had better performance for Gram-negative compared to Gram-positive bacteria (97% vs 76%) and was unable to identify the positive blood cultures for both yeasts and some bacteria, mostly Gram-positive (50/470). Conclusions The protocol used here gave good and reliable results, being available up to 24 h earlier, while also leading to better use of MALDI-TOF.

Patent foramen ovale (PFO) is a prevalent congenital septal atrial defect usually without pathological significance. In certain pathogenic situations, PFO can trigger episodes of recurrent hypoxemia, a specific condition known as platipnea-orthodeoxia syndrome (POS). We report a 73 years old female presenting with dyspnea and low arterial oxygen saturation. On admission the patient had a hemoglobin saturation of 81% and an arterial oxygen partial pressure of 50 mmHg. After breathing 100% a 17% arterial-venous shunt was found (normal: less than 12%). A transesophageal echocardiogram and a cardiac catheterization showed the presence of a PFO. A percutaneous closure was performed.

Myeloid sarcomas (MS) are a rare manifestation of myeloid malignancies and can often be misdiagnosed, leading to a delay in treatment. The objective of this clinical case is to highlight the challenges of the clinical presentation and to emphasize the importance of this manifestation ensuring timely diagnosis and therapy. Here, we present a 43-year-old man who was diagnosed with acute myeloblastic leukemia (AML) after being evaluated for unintentional weight loss, subcutaneous nodules, thrombocytopenia, and anemia. The patient underwent chemotherapy with complete remission and presented 4 months later with dysphagia and cranial nerve palsies. Appropriate imaging and biopsy led to a diagnosis of myeloid sarcoma, and a decision was made to begin reinduction chemotherapy for AML achieving a second complete remission although his neurological deficits did not improve. Our case illustrates the protean presentation of myeloid sarcomas; clinicians should have a high suspicion for MS and remain vigilant when unexplained signs and symptoms arise in the background of a myeloid malignancy although challenges still remain when presentation is de novo. Advancements in understanding the pathophysiology of MS have been performed but remain not completely understood. High clinical suspicion, appropriate imaging, biopsy techniques, and expertise are paramount for timely diagnosis and treatment.

The knowledge of the reference levels for diagnoses and therapeutic studies is important, because it contributes to the optimization of the radiological protection of the patients, avoiding them to be exposed to unnecessarily high doses. However, there was no evidence of these levels in interventionist cardiology procedures in Ecuador, so the objective of this study was to estimate the diagnostic reference levels of dose at the entrance surface in adult patients undergoing interventional cardiology procedures (cinecoronariography, catheterization and coronary percutaneous interventionism) in the Unit of Hemodynamic of the Hospital of Specialties Carlos Andrade Marín in Ecuador.The measurements of product dose-area, dose in input surface, number of images and the time of fluoroscopy performed using the Axiom Artis angiographer, and the obtained data was tabulated and processed with the Excel computer program. For this study, 145 patients older than 18 years were selected, and the values obtained from diagnostic reference dose levels were compared with others reported in previous investigations and with the permissible limits for the appearance of deterministic effects on the skin.This study made it possible to establish reference levels for diagnosis in interventional cardiology procedures (coronary angiography, catheterization and percutaneous coronary intervention) in the Hemodynamics Unit of the Carlos Andrade Marín Specialty Hospital in Ecuador.The results showed that the intake surface doses obtained were lower than the maximum levels recommended by the International Atomic Energy Agency.El conocimiento de los niveles de referencia para estudios diagnósticos y terapéuticos es importante, dado que contribuye a la optimización de la protección radiológica de los pacientes y evita que se expongan a dosis innecesariamente altas; sin embargo, no se encontraron evidencias de estos niveles en procedimientos de cardiología intervencionista en Ecuador, por lo cual el objetivo de este estudio fue calcular los niveles de referencia diagnósticos de dosis en la superficie de entrada en pacientes adultos sometidos a procedimientos intervencionistas de cardiología (cinecoronariografía, cateterismo e intervencionismo percutáneo coronario) en la Unidad de Hemodinámica del Hospital de Especialidades Carlos Andrade Marín de Ecuador.Las mediciones del producto dosis-área, dosis en superficie de entrada, número de imágenes y tiempo de fluoroscopia se realizaron con el angiógrafo Axiom Artis y los datos obtenidos se tabularon y procesaron con el programa informático Excel. Para este estudio se seleccionó a 145 pacientes mayores de 18 años y los valores obtenidos de niveles de referencia diagnósticos de dosis se compararon con otros informados en investigaciones anteriores y con los límites permisibles para la aparición de efectos deterministas en piel.Este estudio permitió establecer los niveles de referencia para diagnóstico en los procedimientos intervencionistas de cardiología (cinecoronariografía, cateterismo e intervencionismo percutáneo coronario) en la Unidad de Hemodinámica del Hospital de Especialidades Carlos Andrade Marín de Ecuador.Los resultados mostraron que las dosis en superficie de entrada obtenidas fueron menores a los niveles máximos recomendados por la International Atomic Energy Agency.

In this meta-analysis, central venous catheter exposure (pooled odds ratio, 8.02; 95% confidence interval [CI], 2.19–29.31; P < .01) in neonates and length of stay (standardized mean difference, 0.65; 95% CI, 0.26–1.05; P = .01) in an adult population were associated with acquisition of waterborne healthcare-associated infections or colonization in ICUs. The quality of evidence was low.

Background: We describe the management and control of an outbreak of mediastinitis in a cardiac surgery department. Method: We performed a retrospective cohort study of 87 patients who und...

In this study we present an autopoietic social systems model based on Collectively Prevalent Interpretants (CPIs). We adapt this model to represent and exemplify how Information and Communication Technologies (ICTs) may enable the emergence of severe moral communities. In particular, we argue that ICTs may help severe moral communities promote increasingly polarized, radicalized and even extremist viewpoints. We also discuss our propositions in the context of the current pandemic (caused by Covid19) and warn about the possible emergence of new and related severe moral communities. In an effort to help understand and manage the enabling role of ICTs, the study also presents recommendations for theory and practice, which may prove useful in advancing digital resiliency (by empowering individuals and communities to recognize when this may be occurring). /© 2020 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

https://repisalud.isciii.es/handle/20.500.12105/11202 [Datos] https://repisalud.isciii.es/handle/20.500.12105/9378 [Preprint] Background: Social engagement (SE) has been consistently shown to improve survival among community-dwelling older people, but the evidence in nursing home residents is inconclusive and prone to short-term reverse causation and confounding by major health determinants. Our main objective was to study the potential causal effect of within-the-facility social engagement (SE) on long-term all-cause mortality in care home residents. Methods: A representative cohort of 382 nursing home residents in Madrid without severe physical and cognitive impairments at baseline was followed up for 10-year all-cause mortality. Standardized mortality curves for residents with low/null, moderate, and high levels of SE at baseline were estimated using Kaplan-Meier methods and spline-based survival models with inverse probability of exposure weights conditional on baseline sociodemographic characteristics, facility features, comorbidity, and disability. Standardized 5-year mortality risks and median survival times were compared across levels of SE. Results: The baseline prevalences of low/null, moderate, and high SE were 36, 44, and 20%, respectively. Compared with residents with low/null SE at baseline, the standardized differences (95% confidence intervals) in 5-year mortality risk were - 2.3% (- 14.6 to 10.0%) for moderately engaged residents and - 18.4% (- 33.8 to - 2.9%) for highly engaged residents. The median survival time increased by 0.4 (- 1.4 to 2.2) and 3.0 (0.8 to 5.2) years, respectively. Conclusion: Residents with high SE within the nursing home had an 18% lower 5-year mortality risk and a 3-year increase in their median survival, as compared with residents with similar health determinants but low/null SE. The development of adequate tailored intervention programs, addressed to increase SE in nursing home residents, could improve their long-term survival, in addition to expected gains in quality of life. This work was supported by the Institute of Health Carlos III (Grant PI15CIII00037). The funding body had no role in decisions regarding the design, analysis or interpretation of the present study. Sí

Background This study sought to determine the long-term impact of multidisciplinary simulated operating room (OR) team training. Method Two-wave survey study (immediate post-training survey 2010–2017, follow-up 2018). Differences across time, specialty, and experience with adverse events were assessed using chi-square and t -tests. Results Immediately after training, more than 90% of respondents found simulation scenarios realistic and reported team training would provide safer patient care. However, follow-up participants reported less enthusiasm toward training, with 58% stating they would like to take similar training again. A majority of participants (77%) experienced adverse events after training; those reporting adverse events reported more positive long-term evaluations. Conclusions Simulated OR team training is initially highly valued by participants and is perceived as contributing to patient safety. Diminution of participant enthusiasm over time suggests that repeat training requirements be reconsidered, and less costly, alternative methods (such as asynchronous learning or virtual reality) should be explored.

This review summarizes the reports of Zygomycete fungi infection in Colombia, as well as include the geographical distribution, species identification, and treatment of those clinical cases. Zygomycosis is not a new disease. However, the use of molecular tools has allowed the identification of some recently described species as their causal agents. In Colombia, the prevalence of zygomycosis is unclear because reporting is not mandatory and because in many cases the etiological agent was not identified. It is important to establish the mandatory reporting of cases, to know the circulating fungal species, the treatment used, and the outcome of the patients. Regarding the treatment, amphotericin B remains as the best alternative. To our knowledge, this is the first compilation of the published cases of zygomicosis in the country.

Background: Candida auris is a recently reported Candida species that is phenotypically similar to Candida haemulonii and related to hospital outbreaks. This organism can be misidentified as Candida haemulonii, Candida famata, Candida catenulata, or Rhodotorula glutinis by phenotypic approaches. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and DNA sequence analysis using internal transcribed spacer rDNA bar-coding provide an accurate identification. Case reports: Three cases of C. auris infection in patients with risk factors for fungal infection (one admitted to the intensive care unit, one with lymphoma, and one with HIV; all three with previous antibiotic use) are reported; these infections were not epidemiologically related. Yeast isolates were recovered from blood, ocular secretion, and bronchoalveolar lavage and were misidentified as C. catenulata and Candida albicans by the phenotypic MicroScan method. The isolates were confirmed to be C. auris by means of MALDI-TOF MS and DNA sequence analysis. Antifungal susceptibility testing was performed on these C. auris isolates, which exhibited high minimum inhibitory concentrations to triazoles and amphotericin B. One patient survived and the other two died. Only one of these deaths was related to fungemia. Conclusions: C. auris is an emerging and opportunistic multidrug-resistant human pathogen. It is necessary to strengthen measures to achieve an accurate and quick identification and also to avoid its dissemination. This will require improvements in health and infection control measures, as well as the promotion of antifungal stewardship in healthcare facilities. Keywords: Candida auris, Multidrug resistance, Sporadic, Fungal, Colombia

Objectives: Research on how major disruptive events – pandemics, wars, and economic recessions – influence people's pregnancy intentions and fertility yields mixed findings. Experts have speculated about the impact of the COVID-19 pandemic on pregnancy desires, but existing research has major limitations, including being cross-sectional, relying on people's perceptions of their preference changes (rather than documenting actual changes), and lacking valid measures. Methods: Using longitudinal data collected from March 2019 to March 2021, we assessed changes in trajectories of pregnancy preferences among women aged 15-34 in Arizona, New Mexico, and Texas (N=630, n=2,860). At baseline and quarterly for one year, participants responded to a validated measure of feelings and desires around pregnancy within 3 months (Desire to Avoid Pregnancy [DAP] scale, range 0-4, 4=higher preference to avoid pregnancy). We used multivariable mixed effects segmented regression to examine changes in pregnancy preferences before and during the pandemic. Results: Over the 12-months prior to the first shelter-in-place order (April 2020), marginal DAP scores decreased steadily over time (coefficient.=-0.24/year [95% CI: -0.31- -0.17], p

Prior research on alcohol and the immune system has tended to focus on binge doses or chronic heavy drinking. The aim of this single-session preliminary study was to characterize immune response to moderate alcohol (0.60 g alcohol per kilogram body weight) in healthy, nonchronic drinkers. The sample (N = 11) averaged 26.6 years of age and was balanced in gender. Plasma samples were collected at baseline and 1, 2 and 3 hours postconsumption. Markers of microbial translocation [lipopolysaccharide (LPS)] and innate immune response [LPS-binding protein (LBP), soluble cluster of differentiation 14 (sCD14), and selected cytokines] were measured using immunoassays. Participants completed self-report questionnaires on subjective alcohol response and craving. Linear mixed models were used to assess changes in biomarkers and self-report measures. Breath alcohol concentration peaked at 0.069 ± 0.008% 1 hour postconsumption. LPS showed a significant linear decrease. LBP and sCD14 showed significant, nonlinear (U-shaped) trajectories wherein levels decreased at 1 hour then rebounded by 3 hours. Of nine cytokines tested, only MCP-1 and IL-8 were detectable in ≥50% of samples. IL-8 did not change significantly. MCP-1 showed a significant linear decrease and also accounted for significant variance in alcohol craving, with higher levels associated with stronger craving. Results offer novel evidence on acute immune response to moderate alcohol. Changes in LBP and sCD14, relative to LPS, may reflect their role in LPS clearance. Results also support further investigation into the role of MCP-1 in alcohol craving. Limitations include small sample size and lack of a placebo condition.

Exposure to Pneumocystis jirovecii (P. jirovecii) can lead to a wide variety of presenting features ranging from colonization in immunocompetent patients with lung disease, to invasive infections in immunocompromised hosts. Colonization by this fungus in patients with chronic obstructive pulmonary disease (COPD) could be associated with higher rates of exacerbations and impaired lung function in these patients.Our objective was to determine whether colonization by P. jirovecii in patients with COPD is associated with increased exacerbations and deterioration of lung function.This was a prospective cohort study on patients with COPD. All participants meeting selection criteria underwent clinical and microbiological assessments and were then classified as colonized vs. non-colonized patients. Chi-squared tests were performed and multivariate logistic models were fitted in order to obtain risk ratios (RR) with 95% confidence intervals (CI).We documented a frequency of colonization by P. jirovecii of 32.3%. Most patients were categorized as having GOLD B and D COPD. The history of significant exacerbations in the last year, health status impairment (COPD Assesment Tool ≥10), airflow limitation (percent of post-bronchodilator FEV1), and BODEx score (≥5) were similar between groups. After a 52-week follow-up period, the rate of adjusted significant exacerbations did not differ between groups. However, a decrease in FEVI was found in both groups. Keywords: Pneumocystis spp., Pneumocystis jirovecii, Chronic obstructive pulmonary disease, Colombia

This study models information security interactions in two scenarios: a) corporate and intermediary information security disclosure platforms and b) a direct interaction between heavyweight actors with high stakes. Using bargaining games, we analyze and discuss equilibrium conditions. Our results indicate that equilibrium conditions are easily attained when gains are small, vulnerabilities are shallow and when disclosure platforms are used to facilitate interactions between actors. Contrastingly, when stakes are high, our models arrive at conditions for equilibrium that are very difficult to achieve and maintain. We extend this model to a high stakes scenario to help explain the value proposition of Black Market Brokers.

Invasive Candidiasis (IC) and candidemia (as its most frequent manifestation) have become the main cause of opportunistic mycosis at hospital settings. This study, made by members of the Colombian Association of Infectious Diseases (ACIN), was aimed at providing a set of recommendations for the management, follow-up and prevention of IC / candidemia and mucous membrane candida infection in adult, pediatric and neonatal patients in a hospital setting, including the hemato-oncological and critical care units. All the data obtained through an exhaustive search were reviewed and analyzed in a comprehensive manner by all the members of the group, and the recommendations issued are being made after a careful review of the scientific literature available and the consensus of all specialists involved; the emergence of Candida Spp. problem is highlighted and a correct orientation to health professionals regarding the management of patients with candidiasis is provided in a rational and practical way, emphasizing patient evaluation, diagnostic strategies, prophylaxis, empirical treatment, directed treatment and preventative therapy. Resumen La Candidiasis Invasora (CI) y la candidemia, como su manifestación más frecuente, se ha convertido en la principal causa de micosis oportunista a nivel hospitalario. Este manuscrito realizado por miembros de la Asociación Colombiana de Infectología (ACIN), tuvo como objetivo proporcionar un conjunto de recomendaciones para manejo, seguimiento y prevención de la CI/candidemia y de la infección candidiásica de mucosas, en población adulta, pediátrica y neonatal, en un entorno hospitalario, incluyendo las unidades hemato-oncológicas y unidades de cuidado crítico. Todos los datos obtenidos mediante una búsqueda exhaustiva, fueron revisados y analizados de manera amplia por todos los miembros del grupo, y las recomendaciones emitidas se elaboraron luego de la evaluación de la literatura científica disponible, y el consenso de todos los especialistas involucrados, reconociendo el problema de la emergencia de las infecciones por Candida Spp. y brindando una correcta orientación a los profesionales de la salud sobre el manejo de pacientes con enfermedad candidiásica, de una forma racional y práctica, enfatizando en la evaluación del paciente, estrategias de diagnóstico, profilaxis, tratamiento empírico, tratamiento dirigido y terapia preventiva.

Rationale: Diffusion tensor imaging (DTI), diffusion tensor tractography (DTT), as well as resting-state-functional magnetic resonance imaging (rsfMRI) are promising methods for assessing patients with disorders of consciousness (DOCs). Patient concerns: This work describes the main findings using DTI, DTT, and rsfMRI in a patient with a DOC secondary to an anoxic encephalopathy who had a fatal outcome. She was an 85-year-old woman who presented a cardiac arrest and underwent cardiopulmonary resuscitation for 20 minutes then returning to spontaneous circulation. After sedation withdrawal, 2 days after the event, she remained with a Glasgow Coma Scale score of 3/15 and with an absence of brainstem reflexes. Diagnoses: DOC secondary to an anoxic encephalopathy after cardiovascular resuscitation. Interventions: A complete brain MRI scan was performed 72 hours after the initial event, including DTI, DTT, and rsfMRI. DTT demonstrated disruption of both ventral and dorsal tegmental tracts bilaterally. DTI showed a reduction of fractional anisotropic level in the mesencephalic nuclei. Moreover, changes in the number of fiber tracts were not evidenced in any portions of the ascending reticular activating system (ARAS). Finally, an increase in the anticorrelated and correlated association among the nuclei in the ARAS and the cortex was evidenced. Outcomes: Patient deceased. Lessons: Neuroimaging demonstrated low FA values in the ARAS, destruction of dorsal and ventral tegmental tracts, as well as hyper-connective (highly correlated or anti-correlated) association among ARAS and cortical nuclei compared with 3 healthy control subjects. Abbreviations: AAN = Arousal Network Atlas, ADC = apparent diffusion coefficient, ARAS = ascending reticular activating system, BOLD = blood-oxygen-level dependent imaging, DIPY = Diffusion Imaging in Python, DOC = disorder of consciousness, DTI = diffusion tensor imaging, DTT = diffusion tensor tractography, DWI = diffusion weighted imaging, FA = fractional anisotropy, FC = functional connectivity, FSL = FMRIB Software Library, ODF = orientation distribution function, ROI = region of interest, rsfMRI = resting-state functional magnetic resonance imaging, TBI = traumatic brain injury.

Background Microbiota has been linked to the development of multiple cancers through various mechanisms. In bladder cancer (BC), preliminary studies have found alterations in the urinary microbiota of patients with urothelial carcinoma in comparison with healthy individuals. However, the bladder microbiota (BMi) has not been explored. The aims of this study were to characterize the BMi in a cohort of BC patients, to explore differences in the BMi composition between tumor (T) and normal (N) mucosa, and to identify its correlation with clinicopathologic features. Methods A total of 58 samples obtained by cystectomy from 32 BC patients (frozen tumor tissues and normal appearing mucosa for 26 patients and 6 tumor tissues) from Hospital General de Elche Biobank (Spain) were included. DNAs isolated from bladder samples were used to perform 16S rRNA gene sequencing (V3 and V4 region). A paired-end 2 × 300 bp cycle run on Illumina MiSeq. Ribosomal Database Project Classifier was used for taxonomical assignment. Statistical analysis was performed using Rstudio platform. Groups of data were compared using Wilcoxon test and Mann Whitney test for 26T vs 26N (paired group) and 32T vs 26N (unpaired group), respectively. Results There were no statistically significant differences of diversity between T and N, but there were differences of richness between T and N at the genus level (Chao1 index, p = 0.049). Globally, the most abundant phylum was Firmicutes, followed by Bacteroidetes, Proteobacteria and Actinobacteria. We found that the microbial composition differed significantly between T and N in both groups. At the phylum level, while Cyanobacteria.Chloroplast (0.74% vs 2.44%; p = 0.025) was enriched in T, Actinobacteria were reduced in T. Principal component analysis based on the relative abundance of phylum (36.9% PC1 and 28.7% PC2 of explained variance) revealed a significant separation in bacterial community composition between tumor tissues associated with histological tumor grade (permanova grade =0.036). Conclusions Significant differences in the BMi composition associated with tumor grade were observed. Additional studies are needed to determine the role of BMi in the evolution of BC and its therapeutic implications. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

ResumenObjetivoDisponemos de una nueva clase de prótesis aórticas de despliegue rápido para tratamiento quirúrgico de la estenosis aórtica. Permitirían disminuir los tiempos quirúrgicos y facilitarían la cirugía mínimamente invasiva. Presentamos nuestra experiencia inicial con la válvula Edwards Intuity en el contexto del estudio multicéntrico Foundation.Pacientes y métodosEntre septiembre de 2012 y febrero de 2014 se implantaron 25 prótesis aórticas Edwards Intuity en 26 pacientes (77±4,3años; 52% varones). Veinticuatro (96%) fueron reemplazo valvular aislado, y 9 pacientes (36%) tuvieron abordaje mínimamente invasivo. Los pacientes fueron estudiados al alta, a los 3meses y al año de la intervención.ResultadosHubo éxito en el implante en el 96,2% de los pacientes (25/26). No hubo mortalidad hospitalaria. Seguimiento medio de 11±5,4meses, supervivencia acumulada del 96%. Un paciente falleció a los 11meses por un ictus isquémico. El tiempo medio de pinzamiento aórtico fue de 38,2±10,1min y el tiempo medio de circulación extracorpórea, de 62,4±11,1min. A los 3meses, el área valvular efectiva media fue de 1,70±0,42cm2. El 91% de los pacientes (23/25) estaban en grado funcionali en el seguimiento.ConclusionesEl implante de la válvula Edwards Intuity para el tratamiento de la estenosis aórtica ha sido factible, seguro y eficaz. Los tiempos de isquemia miocárdica y de circulación extracorpórea parecen reducirse en comparación con la cirugía valvular aórtica habitual. El comportamiento hemodinámico inicial de la prótesis Edwards Intuity es excelente.AbstractObjectiveA new class of rapid deployment prostheses is now available for surgical treatment of aortic stenosis. These prostheses offer the possibility of reducing the duration of cardiopulmonary bypass and aortic clamping times, and facilitate the use of minimally invasive surgery. We present our initial experience with the Edwards Intuity valve in the context of a multicentre Foundation study.Patients and methodsBetween September 2012 and February 2014, 25 Edwards Intuity valves were implanted in 26 patients (77±4.3years; 52% male). Twenty-four (96%) were isolated aortic valve replacement; a minimally invasive approach was used on 9 patients (36%). Patients were studied at discharge, three months, and one year after surgery.ResultsImplantation success rate was 96.2% (25/26). There was no hospital mortality. Mean follow-up of 11±5.54months, cumulative survival of 96%. One patient died eleven months after surgery due to ischaemic stroke. The mean aortic clamping time was 38.2±10.1minutes, and the mean cardiopulmonary bypass (CPB) time was 62.4±11.1minutes. In the echocardiography at 3months, the mean effective valve area was 1.70±0.42cm2, and 91% of patients (23/25) were in functional classi NYHA at follow-up.ConclusionsThe implantation of the Edwards Intuity valve for surgical treatment of aortic stenosis has shown to be feasible, safe and effective. Times of myocardial ischaemia and extracorporeal circulation appear to be reduced compared with normal aortic valve surgery. The initial haemodynamic performance of the Edwards Intuity prosthesis is excellent.

Objective To evaluate the use of third-trimester ultrasound screening for late fetal growth restriction (FGR) on a contingent basis, according to risk accrued in the second trimester, in an unselected population. Methods Maternal characteristics, fetal biometry and second-trimester uterine artery (UtA) Doppler were included in logistic regression analysis to estimate risk for late FGR (birth weight

The objective of the XV Applied Mathematics Meeting and XII Statistics Meeting was to promote a space for the exchange of knowledge between the academic and industrial sectors and physics; this event is a space to promote reflection and debate on mathematics, statistics, its history, evolution, didactics and application in physics and other sciences. In this meeting, researchers and teachers of mathematics interacted, socialized research results, consolidated networks for the exchange of ideas and successful experiences; moreover, these spaces allowed the strengthening of mathematics and statistics as a science. This science with its pedagogical principles promoted innovation and encouraged the creation of other learning scenarios; these scenarios are oriented to the application of mathematics in various areas of knowledge and to encourage students’ interest in research in these sciences. List o Organizing Committee, National Scientific Committee, International Scientific Committee, Invited Speakers, Sponsor and Sponsor logos, Partners and Partners logos are also available in this pdf.

In 2002, the Colombian ministry of education released statute 1278, for teaching professionalization, superseding statute 2277 of 1977. Although statute 1278 was intended to increase the quality of the education service and teachers&rsquo, remuneration, there is evidence that the abundant evaluations and hindered promotion system introduced by statute 1278 resulted in an impairment of the quality of life of the teachers, and a higher incidence of burnout syndrome. We used two techniques for machine learning interpretability, SHapley Additive exPlanation summary plots and predictor importance, to interpret support vector machine and decision tree machine learning models, respectively, to better understand the differences on risk factors and symptoms of burnout syndrome in school teachers under statutes 2277 and 1278. We have surveyed 54 school teachers between August and October 2018, 17 under statute 2277, and 37 under statute 1278. Among the risk factors and symptoms of burnout syndrome considered in this study, we found that the satisfaction with earnt income was the most relevant risk factor, followed by the overtime work and the perceived severity of the sanctions on lower performance. The most relevant symptoms of burnout were fatigue at the end of the day, and frequent headaches. This methodology can be potentially used in other contexts and social groups, allowing institutional authorities and policy makers to allocate resources to specific issues affecting a particular group of workers.

In the last decade, the risk benefits ratio of MHT has been evaluated mainly in terms of cardiovascular risk. Present Consensus Statement is largely inspired by the Global Consensus on Menopausal Hormone Therapy in 2013 and 2016 by leading global menopause societies (The American Society for Reproductive Medicine, The Asia Pacific Menopause Federation, The Endocrine Society, The European Menopause and Andropause Society, The International Menopause Society, The International Osteoporosis Foundation and The North American Menopause Society). The aim of these Recommendations is to provide a simple and updated reference on postmenopausal MHT. The term MHT typically includes estrogen replacement therapy (ERT) and estrogen-progestogen therapy (EPT). EPT can be sequential (Seq) when progestogen is added to ERT for 10-14 days a month, or continuous combined (CC) when progestogen is administered continuously every day along with a fixed amount of estrogen. MHT also includes Tibolone and the Tissue Selective Estrogen Complex (TSEC).

Objectives Hypoparathyroidism, sensorineural deafness and renal disease (HDR) syndrome, also known as Barakat syndrome, is an autosomal dominant transmission hereditary disease with a wide range of penetrance and expressivity. Haploinsufficiency of the GATA3 two finger zinc transcription factor is believed to be its cause. This is the first time this orphan disease is reported in Latin America, so the publishing of this report is expected to raise awareness on these types of syndrome, that are usually underdiagnosed in our region, which in turn causes an increase in the years lost to disability (YLDs) rates, as well as higher costs to be assumed by public health systems.Methods A 36-year-old Colombian woman diagnosed with parathyroid gland agenesis was referred from the Endocrinology Service to the Outpatient Service. According to her medical record, in the past she had developed hypocalcaemia, left renal agenesis, hypoparathyroidism, bicornate uterus and sensorineural hearing loss. Through a gene-tic analysis a pathological mutation on the short arm of the GATA 3 gen (c.404dupC, p Ala136 GlyfsTER 167) was confirmed, which led to a HDR syndrome diagnosis. Discussion This case proves that there is a possibility that mutations described in other continents may be developed by individuals from our region. Regardless of eth-nicity, Barakat syndrome should be considered as a possible diagnosis in patients pre-senting the typical triad that has been described for this condition, since there could be underdiagnosis of this disease in Latin-America due to the lack of knowledge on this condition in said region, and that genetic counseling in these patients is of great impor-tance for the implications of the syndrome in future generations. Objetivos El síndrome de hipoparatiroidismo, sordera neurosensorial y displasia renal (HDR) también llamado síndrome de Barakat, es una enfermedad hereditaria de trans-misión autosómica dominante con amplia penetrancia y expresividad genética. El síndrome es causado por la haploinsuficiencia del factor de transcripción de dedos de Zinc GATA3. Esta es la primera vez que esta enfermedad huérfana es reportada en Latinoamérica, y buscamos generar consciencia de la presencia de estas enfermedades, las cuales usualmente son infradiagnósticadas en nuestro medio y llevan a un aumento de años perdidos por discapacidad y costos para el sistema de salud pública. Métodos Una mujer colombiana de 36 años ingresó a consulta externa de genética referida por el servicio de endocrinología por una agenesia de paratiroides. La paciente tenía antecedentes de hipocalcemia, agenesia renal izquierda, hipoparatiroidismo, sordera neurosensorial y útero bicorneo. Se realizó un análisis genético que confirmo una mutación patológica en el brazo corto del gen GATA3 (c.404dupC, p Ala136 GlyfsTER 167) diagnóstica del síndrome de Barakat. Discusión Este caso demuestra la posibilidad de existencia de mutaciones descritas en otros continentes en nuestra población. Sin importar la etnia, el síndrome de Barakat debe ser estudiado en pacientes que presenten la triada típica, ya que podría existir un infra diagnóstico de la enfermedad secundario al desconocimiento de la misma en Latinoamérica y teniendo en cuenta la importancia que tiene la consejería genética en estos pacientes por las implicaciones de la enfermedad en futuras generaciones.

Background Candidemia and invasive candidiasis are major causes of morbidity and mortality among critically ill patients and neonates. Every year more than 250,000 people develop invasive candidiasis, causing more than 50,000 deaths worldwide. Candida albicans is the most frequently isolated species worldwide. However, species distribution, epidemiology, and resistance have changed. C. parapsilosis complex (CPC), which has a global rate of fluconazole (FCZ) resistance range between 2 and 5% and has been related to echinocandins resistance, is the second most isolated species at Fundación Valle del Lili (FVL). We aim to describe the clinical and microbiological characteristics of fungal infections by C. parapsilosis, and determine FCZ resistance rates. Methods An observational prospective study was conducted. The study included patients with CPC isolations attended at FVL from 2016 to 2017. The strains were identified by mass spectrometry (MALDI TOF® Bruker, Biotyper 3.1). Minimal inhibitory concentrations (MIC) were determined by broth microdilution (M27 A3 CLSI). Statistical univariate analysis was performed; Differences between resistant cases and nonresistant cases were assessed through U Mann–Whitney test, Pearson chi-squared test or Fisher exact test. Results 55 patients had CPC isolations during the study period: 18 newborns, 13 children, and 24 adults. Most isolations were from blood cultures (n = 31) (14 of them newborns), bronchoalveolar lavage (n = 9), peritoneal fluid (n = 8), and catheter tips (n = 3). The resistance was 36%. 52 strains were C. parapsilosis ss, of them, 20 were FCZ resistant; 3 strains were C. orthopsilosis, all of them FCZ sensitive. The MIC50 = 1 µg/mL and MIC90 = 16 µ/mL. Patients with previous antifungal treatment had a higher risk of FCZ resistance (RR: 2.14, 95% IC 1.07–4.26). The mortality brute rate was 30%, patients with diabetes and renal failure death risk (RR: 3.1, 95% CI: 1.4 – 6.9) and (RR: 2.96, 95% CI: 1.4 – 6.4), respectively. Candidemia was present in 50% of deaths among children with parenteral nutrition. Conclusion Fluconazole resistance in CPC has increased in the last decade. Newborns receiving parenteral nutrition had a higher proportion of CPC fungemia; we also found higher mortality rates among this population. Disclosures All authors: No reported disclosures.

Background: Aortic valve stenosis (AS) is the most common valvular disease. Its surgical indication is undisputed in symptomatic severe AS, however, 30% of patients are at high surgical risk or inoperable. Transcatheter Valve Implantation (TAVI) is an alternative for this group of patients. Aim: To describe the clinical outcomes of TAVI in a group of patients treated at the Instituto Nacional del Torax, Santiago, Chile. Patients and Methods: Prospective study including all patients referred for TAVI due to their high surgical risk or being inoperable. All-cause mortality, secondary stroke, permanent pacemaker implantation, vascular complications, prosthetic and periprosthetic regurgitation, Karnosfky test and Functional Capacity (FC) were assessed as endpoints. Results: We evaluated 26 patients with a mean age of 82 years (74% women) in whom 27 procedures were done. The mean Society of Thoracic Surgeons score was 8.8%. Overall mortality at 30 days, one and two years was 11.1, 18.5 and 29.6% respectively. Karnofsky score increased significantly from 62.3% at baseline to 83.9, 88.6 and 88.8% at six months, one and two years, respectively. Prior to the procedure, FC was 3.1 ± 0.6, decreasing significantly to 1.2, 1.3 and 1 at six months, one and two years of follow up. Conclusions: TAVI is an effective alternative treatment for patients with severe symptomatic AS and high surgical risk.

To characterize patients with atypical preeclampsia (PE), in relation to socio-demographic characteristics, clinical presentation, maternal complications and perinatal outcome.Between July 1, 2011 and November 30, 2013, a cohort was created of women attended at a Obstetric High-dependency Unit who met criteria for atypical PE: gestational hypertension with severe hypertension or symptoms or laboratory signs suggestive of microangiopathy/hemolysis; normotensive proteinuria with the presence of symptoms or laboratory signs suggestive of microangiopathy/hemolysis; presence of PE or eclampsia or HELLP syndrome appearing after 48 h postpartum, and, PE or eclampsia appearing before 20 weeks of pregnancy.A total of 200 women fulfilling criteria for atypical PE, were included: 61.5% corresponded to non-proteinuric gestational hypertension, 35.5% to normotensive proteinuria and 3% to PE/eclampsia in late postpartum. Criteria for severe maternal morbidity were present in 12% of the cases and there were no maternal deaths. There were 6 perinatal deaths.Atypical preeclampsia is a type of preeclampsia not fully recognized that is associated with maternal and neonatal morbidity, mainly related to smallness-for-gestational-age and low birth weight. Vasospasm symptoms are a key element to detect this condition.

Objective To investigate whether signs of placental underperfusion (PUP), defined as any maternal and/or fetal vascular pathology, confer an increased risk of neonatal morbidity in late-onset small-for-gestational-age (SGA) fetuses with normal umbilical artery (UA) Doppler indices. Methods A cohort of 126 SGA singleton fetuses with normal UA Doppler indices that were delivered after 34 weeks' gestation was studied. For each case, the placenta was evaluated histologically for signs of PUP using a hierarchical and standardized classification system. Neonatal morbidity was assessed according to the score calculated from the morbidity assessment index for newborns (MAIN), a validated outcome scale. The independent association between PUP and neonatal morbidity was evaluated using multivariable median regression analysis. Results In 84 (66.7%) placentae, 97 placental histological findings that qualified as signs of PUP were observed. These PUP cases had a significantly higher incidence of emergency Cesarean section for non-reassuring fetal status (44.1% vs 21.4%, respectively; P = 0.013) and neonatal metabolic acidosis at birth (33.3% vs 14.3%, respectively; P = 0.023), than did those without PUP. The median MAIN score differed significantly between those with PUP and those without (89 vs 0, respectively; P = 0.025). This difference remained significant after adjustment for potential confounders. The proportion of cases with scores indicative of mild to severe morbidity was also significantly higher in the PUP group (31% vs 14.3%, respectively; P = 0.043). Conclusion In late-onset SGA fetuses with normal UA Doppler indices, signs of PUP imply a higher neonatal morbidity. These findings allow the phenotypic profiling of fetal growth restriction among the general population of late-onset SGA. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

Background: Pneumocystis jirovecii (P. jirovecii) colonization has been postulated to cause lung function deterioration in patients with chronic obstructive pulmonary disease (COPD) and its prevalence is unknown in this group of patients in Colombia. Objective: to document the prevalence of colonization in patients over 40 years old with COPD diagnosis, excluding those requiring immunosuppressive threatment or infected with Human Immunodeficiency Virus (HIV). Method: cross-sectional study in non-probabilistic sampling for convenience with continuous patient selection. Real time PCR (qPCR) of P. jirovecii in induced sputum sample with LighMix Kit (Roche) by the amplification of 244 base pairs fragment from the major surface glycoprotein gene of the fungus. Results: we have found a prevalence of 15.4% of the 52 analyzed patients. All of those were 65 years older, with high symptomatology indexes according to modified Medical Research Council scale (mMRC) and COPD Evaluation Test (CAT), the majority of colonized patients were GOLD D (62.5%), rated by the Global Initiative for COPD. Conclusions: this is, to our knowledge, the first study of its kind to include Colombian population. P. jirovecii colonization prevalence as detected by qPCR in sputum samples was 15,4% and it is similar to prevalence reported in other populations. Further studies are needed in order to assess the impact of this colonization in COPD progression (i.e. number of exacerbations and pulmonary function decline), and this may lead to the proposal of novel interventions to eradicate the microorganism in these patients.