ABSTRACT Background: Accelerated diagnostic protocols for chest pain, with the advancement of high-sensitivity troponin, make it possible to identify patients admitted to the emergency department with chest pain and low risk for a major adverse cardiovascular event, who could be discharged immediately, early and safely, saving time and resources. Objective: The aim of this study was to assess clinical trials using accelerated diagnostic protocols based on high-sensitivity troponin. Methods: A search of randomized clinical trials evaluating accelerated diagnostic protocols based on high-sensitivity troponin in emergency services was carried out in MEDLINE/Ovid, Cochrane and EMBASE database, using the assessment criteria of the Cochrane manual and the PRISMA strategy. Results: After screening 3509 studies, 5 clinical trials, including 1513 patients, were analyzed. Early discharges were identified in 409 (27%) of patients, in 91% of cases for ESC 0/3-h protocols, 72% for 0/1-h, 48% for EDACS, 40% for HEART, 19% and 32% for ADAPT and 8% and 18% for standard care protocols. The negative predictive value was high, in the 99.1-100% range. Mean length of hospital stay was lower for the 0/1-h and ESC 0/3-h protocols, with 4.6 and 5.6 hours, respectively. Conclusions: Accelerated diagnostic protocols in chest pain using high-sensitivity troponin allow a higher proportion of early discharges with a low rate of major cardiovascular events, with reduction in length of hospital stay and resources used.

RESUMEN Introducción: Los protocolos de diagnóstico acelerado de dolor torácico, con el avance de la troponina de alta sensibilidad, permiten identificar a los pacientes que ingresan al servicio de urgencias con dolor torácico de bajo riesgo para un evento cardiovascular adverso mayor, que podrían ser dados de alta de forma temprana y segura, con ahorro de tiempo y recursos. Objetivo: Evaluar ensayos clínicos que utilicen protocolos de diagnóstico acelerado basados en troponina de alta sensibilidad. Material y métodos: se realizó una búsqueda de ensayos clínicos aleatorizados que evaluaran protocolos de diagnóstico acelerado basados en troponina de alta sensibilidad en los servicios de urgencias, en las bases de datos MEDLINE/Ovid, Cochrane y EMBASE utilizando los criterios de evaluación del manual Cochrane y la estrategia PRISMA Resultados: Tras una tamización de 3509 estudios se incluyeron 5 ensayos clínicos que incluyeron 1513 pacientes; se identificaron 409 (27%) altas tempranas, el 91% para el protocolo 0/3 h ESC, 72% para el 0/1 h, 48% para el EDACS, 40% para el HEART, 19 y 32% para ADAPT y 8 y 18% para el cuidado usual. El valor predictivo negativo fue alto, en un rango de 99,1 al 100% La duración media de la estancia hospitalaria fue más baja para los protocolos 0/1 h y 0/3 h ESC, con 4,6 y 5,6 horas respectivamente. Conclusiones: Los protocolos de diagnóstico acelerado en dolor torácico que implementan el uso de troponina de alta sensibilidad permiten lograr alta proporción de altas tempranas con baja tasa de eventos cardiovasculares mayores, con disminución del tiempo de estancia y recursos consumidos.

Four new zinc complex derivatives of azoles and ligands were synthesized and isolated as white air-stable solids and characterized by elemental analyses, thermogravimetric analysis (TGA), infrared spectroscopy, nuclear magnetic resonance (NMR) and mass spectra. The elemental analysis, theoretical calculations and NMR show that the complexes likely have a 1:1 (M:L) stoichiometry and tetrahedral geometry. To evaluate the biological activity of the complexes and to discuss the role of metal ions and structural properties, the ligands and their metal complexes have been studied. Their antimicrobial activity was determined in vitro by agar-well diffusion and broth microdilution against nine bacterial strains and seven fungal strains with clinical relevance. In vitro assays showed that the complexes exhibited moderate antibacterial and/or antifungal activities. The antimicrobial activity was found to be more active for the metal complexes than the ligands. The metal complexes that contained copper and cobalt, respectively, displayed notable antibacterial and antifungal effects against all the tested bacterial strains. The minimum inhibitory concentration 50 (MIC50) values were in the range 2454-0.7 µg mL-1. Metal complexes were more effective at inhibiting bacteria than fungi. The results could provide a high-potential solution for antimicrobial growth resistance, for both bacteria and fungi.

El presente trabajo analiza el mecanismo focal de 49 terremotos con magnitud Mw ≥ 4,8 en la región del Valle del Cauca y zonas aledañas, durante el periodo 1978-2010. Las soluciones fueron tomadas de los catálogos del Centro Internacional de Sismología (ISC, sigla en inglés) y del Centride Tensor de Momento Sísmico (GCMT, sigla en inglés). La profundidad de los eventos se distribuye entre superficiales e intermedios, hasta 215 km aproximadamente, asociados a la subducción de la placa Nazca, y unos pocos eventos superficiales que corresponden a la actividad de fuentes corticales en la placa continental Sudamericana. Concordante con el modelo de ambientes de regímenes de esfuerzos asociados con la deformación "estática" de la placa en subducción, se identifican cuatros ambientes sismotectónicos, que se distinguen por sus propias características sismológicas, tectónicas y régimen de esfuerzos. Se establece la tasa de deformación sismotectónica para cada uno de estos ambientes. El modelamiento del campo de esfuerzos de Coulomb muestra que el esfuerzo de cizalla crea una barrera que impide que el esfuerzo compresivo se proyecte al interior del continente en dirección SW-NE, interrumpiéndose en la zona en la fosa Colombo-Ecuatoriana. Mientras que el esfuerzo de tensión, aunque también es interrumpido, logra proyectarse al continente en dirección NW-SE, perpendicular al esfuerzo compresivo.

This paper analyzes the focal mechanism of 49 earthquakes with magnitude Mw ≥ 4.8 in the region of Valle del Cauca and surrounding areas during the period 1978-2010. The solutions were taken from the catalogs of the International Seismological Centre (ISC) and The Global Centroid-Moment-Tensor (GCMT) Project. The depth of the events is distributed between surface and intermediate about 215 km, associated with the subduction of the Nazca plate, and a few superficial events that correspond to the activity of cortical sources in the South American continental plate. In accord with model environments strong regimes associated with the "static" deformation of the subducting plate, four seismotectonic environments, are distinguished by its own seismic, tectonic and strong regime characteristics. The seismotectonic deformation rate is presented for each of these environments. The modeling of the Coulomb effort field shows that the shear creates a barrier that prevents the compressive effort is projected into the continent in SW-NE direction, interrupted in the Colombo-Ecuadorian trench. While the tensile effort, although is also interrupted, it manages to project the continent in NW-SE direction, perpendicular to compressive effort.