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[Background] The effect of supplemental oxygen therapy in patients with intermediate-risk pulmonary embolism (PE) who do not have hypoxemia at baseline is uncertain., [Research Question] Does supplemental oxygen improve echocardiographic parameters in nonhypoxemic patients with intermediate-risk PE?, [Study Design And Methods] This pilot trial randomly assigned nonhypoxemic patients with stable PE and echocardiographic right ventricle (RV) enlargement to receive anticoagulation plus supplemental oxygen for the first 48 h vs anticoagulation alone. The primary outcome was normal echocardiographic RV size 48 h after randomization. Secondary efficacy outcomes were the numerical change in the RV to left ventricle (LV) diameter ratio measured 48 h and 7 days after randomization with respect to the baseline ratio measured at inclusion., [Results] The study was stopped prematurely because of the COVID-19 pandemic after recruiting 70 patients (mean ± SD age, 67.3 ± 16.1 years; 36 female [51.4%]) with primary outcome data. Forty-eight h after randomization, normalization of the RV size occurred in 14 of the 33 patients (42.4%) assigned to oxygen and in eight of the 37 patients (21.6%) assigned to ambient air (P = .08). In the oxygen group, the mean RV to LV ratio was reduced from 1.28 ± 0.28 at baseline to 1.01 ± 0.16 at 48 h (P < .001); in the ambient air group, mean RV to LV ratios were 1.21 ± 0.18 at baseline and 1.08 ± 0.19 at 48 h (P < .01). At 90 days, one major bleeding event and one death (both in the ambient air group) had occurred., [Interpretation] In analyses limited by a small number of enrollees, compared with ambient air, supplemental oxygen did not significantly increase the proportion of patients with nonhypoxemic intermediate-risk PE whose RV to LV ratio normalized after 48 h of treatment. This pilot trial showed improvement in some ancillary efficacy outcomes and provides support for a definitive clinical outcomes trial., [Trial Registry] ClinicalTrials.gov; No.: NCT04003116; URL: www.clinicaltrials.gov

[Background] In patients with intermediate-risk pulmonary embolism (PE), reversal of hypoxic vasoconstriction could constitute a target for treatment that protects the right ventricular (RV) function until endogenous fibrinolysis occurs. The Air vs oxygen for Intermediate-Risk pulmonary embolism (AIR) trial aims to assess the effect of oxygen therapy in patients with intermediate-risk acute PE who do not have hypoxemia at baseline., [Methods and analyses] AIR is a prospective, multicenter, randomized, open-label, parallel-group, proof-of-concept trial. A total of 90 patients hospitalized with intermediate-risk PE and an oxygen saturation of 90% or higher at baseline will be randomized in a 1:1 fashion to receive supplemental oxygen or ambient air. The primary outcome is a RV/LV diameter ratio equal or less than 1.0 on echocardiography measured 48 hours after the start of treatment. Secondary efficacy outcomes are the numerical change in the ratio of the RV to the LV diameter measured 48 hours and 7 days after the start of treatment, with respect to the baseline ratio measured at randomization. Clinical adverse events will be also collected., [Results] Enrollment started in July 2019 and is expected to proceed until 2022. Median age of the first 50 patients was 74 years (interquartile range, 61-81), and 50% were female., [Conclusions] This multicenter trial will provide information about the value of supplemental oxygen in patients with intermediate-risk acute PE who do not have hypoxemia at baseline. The results will contribute to research that may assist patients with intermediate-risk PE in the future.

[Background] Various risk assessment tools have been proposed to identify stable patients with acute pulmonary embolism (PE) who are at high risk of early adverse outcome (i.e., intermediate-high risk)., [Methods] We evaluated the ability of the 2019 ESC, Bova, modified FAST and PEITHO-3 models for predicting a 30-day complicated course (death, haemodynamic collapse, and/or recurrent PE) in a cohort of 848 stable patients with acute PE. We also tested whether replacement of echocardiographic right ventricle (RV) dysfunction by computed tomographic (CT) RV enlargement provides comparable prognostic information for identifying these patients., [Results] A complicated course occurred in 63 (7.4 %) of the 848 patients with PE during the first month of follow-up. The proportion of patients designated as having intermediate-high risk PE was 6.7 % with the ESC model, 4.4 % with the Bova score, 15.7 % with the FAST score, and 5.2 % with the PEITHO-3 model. However, among patients identified as intermediate-high risk, the 30-day complicated course rate was higher with the Bova score (21.6 %) than with the ESC model (17.5 %), the PEITHO-3 model (15.9 %), or the modified FAST score (14.3 %). When echocardiographic RV dysfunction was replaced by CT RV enlargement in the models, the proportion of patients classified as having intermediate-high risk PE and the rate of an adverse outcome among them slightly increased., [Conclusions] The Bova score might identify patients with intermediate-high risk PE slightly better than the ESC, PEITHO-3, and modified FAST score. When echocardiography is not readily available, CT-assessed RV enlargement might be used for identifying intermediate-high risk PE.

La producció avícola enfronta diversos desafiaments relacionats amb l'ús dels recursos naturals, sent l'eficiència alimentària el factor que pot ser influenciat mitjançant l'ús de diferents estratègies nutricionals. L'ús adequat d'enzims exògenes, com la xilanasa, pot millorar el rendiment productiu, la conversió alimentària, la salut intestinal i millorar els problemes ambientals, a causa de la menor excreció de nutrients no digerits. D'aquesta manera, el present treball busca incrementar el coneixement sobre els mecanismes d'acció suggerits d'aquest enzim així com investigar la rellevància d'alguns factors associats a l'aliment que poden estar afectant l'eficiència de la xilanasa en la producció de pollastres d'engreix. En la present tesi doctoral es van dissenyar quatre estudis amb l'objectiu de provar les següents hipòtesis. Les carbohidrases, especialment la xilanasa, podrien ser part d'una estratègia multidisciplinària per al reemplaçament dels antibiòtics en la producció animal. Així l'Article I és una revisió de la literatura realitzada per tal de comparar els mecanismes suggerits per la xilanasa en les dietes a base de blat de moro i dels antibiòtics quan s'utilitzen com a promotors de l'creixement en dietes animals. La literatura disponible mostrar que és difícil concloure que els enzims per se puguin reemplaçar als antibiòtics en la producció animal intensiva, però és plausible pensar que poden ser part d'un programa holístic que redueixi l'impacte negatiu dels components fibrosos de la dieta que tenen efectes antinutritius que desafien la salut intestinal i l'eficiència. La variació de la composició fisicoquímica de l'blat de moro podria afectar la resposta de la xilanasa. En aquest sentit, l'Article II és un assaig ""n vitro" que es va dur a terme utilitzant el component genètic de la dacsa i la posició dels grans a la panotxa com a font de variabilitat de nutrients per avaluar la resposta de la xilanasa. Els resultats van mostrar que la suplementació a, La producción avícola enfrenta varios desafíos relacionados con el uso de los recursos naturales, siendo la eficiencia alimenticia el factor que puede ser influenciado mediante el uso de diferentes estrategias nutricionales. El uso adecuado de enzimas exógenas, como la xilanasa, puede mejorar el rendimiento productivo, la conversión alimenticia, la salud intestinal y mejorar los problemas ambientales, debido a la menor excreción de nutrientes no digeridos. De esta forma, el presente trabajo busca incrementar el conocimiento sobre los mecanismos de acción sugeridos de esta enzima así como investigar la relevancia de algunos factores asociados al alimento que pueden estar afectando la eficiencia de la xilanasa en la producción de pollos de engorde. En la presente tesis doctoral se diseñaron cuatro estudios con el objetivo de probar las siguientes hipótesis. Las carbohidrasas, especialmente la xilanasa, podrían ser parte de una estrategia multidisciplinaria para el remplazo de los antibióticos en la producción animal. Así el Artículo I es una revisión de la literatura realizada con el fin de comparar los mecanismos sugeridos por la xilanasa en las dietas a base de maíz y de los antibióticos cuando se utilizan como promotores del crecimiento en dietas animales. La literatura disponible mostró que es difícil concluir que las enzimas per se puedan reemplazar a los antibióticos en la producción animal intensiva, pero es plausible pensar que pueden ser parte de un programa holístico que reduzca el impacto negativo de los componentes fibrosos de la dieta que tienen efectos antinutritivos que desafían la salud intestinal y la eficiencia. La variación de la composición fisicoquímica del maíz podría afectar la respuesta de la xilanasa. En este sentido, el Artículo II es un ensayo "in vitro" que se llevó a cabo utilizando el componente genético del maíz y la posición de los granos en la mazorca como fuente de variabilidad de nutrientes para evaluar la respuesta de la xilanasa. L, Poultry production faces several challenges related to the use of natural resources, with feed efficiency being the factor that can be influenced through the use of different nutritional strategies. Proper use of exogenous enzymes, such as xylanase, could improve growth performance, feed conversion, gut health, and improve environmental problems as fewer undigested nutrients are excreted. In this way, the present work seeks to increase the knowledge about the suggested action mechanisms of this enzyme as well as to investigate the relevance of some dietary factors that may be affecting the efficiency of xylanase in the production of broiler chickens. Four studies were designed with the aim of testing the following hypotheses. The carbohydrases, specially xylanase, could be a part of a multidisciplinary antibiotic's displacement strategy. Therefore, the Article I is a literature review performed in order to compare the xylanase suggested mechanisms (nutrient digestibility, microbiota modulation and improvement of intestinal health) and the described antibiotic effects when are used as growth promotors in animal diets. The available literature showed that it is difficult to consider that enzymes per se can replace antibiotics in efficient animal production, but it is plausible to think that they can be part of a holistic program that reduces the negative impact of antinutritional components as challenging compounds for intestinal health and efficiency. The variability in the physicochemical composition of corn could affects the xylanase response. Therefore, Article II is an "in vitro" test that was carried out using the genetic background of corn and the position of the ear as a source of nutrient variability and where the xylanase response was evaluated. The results showed that the xylanase supplementation increase the soluble components of the corn independently of the physicochemical variation, however, the xylotriose production interact for both the position of th, Universitat Autònoma de Barcelona. Programa de Doctorat en Producció Animal

¡Honorables representantes! -- Documentos justificativos : introducción del Águila de Júpiter ; último parágrafo del Águila de Júpiter ; el eco de Colombia ; el equilibrio -- A su escelencia el presidente de la república de la Nueva Granada : documento no. 2 / Arganil -- El Escmo. señor presidente del Estado informó lo que sigue : al Escmo. señor presidente de la Cámara del Senado : documento no. 3 / F. de Paula Santander -- Certificados / Miguel S. Uribe, Diego F. Gómez, Pablo Durán, Francisco Soto -- Resumen histórico / Arganil, 31 p.