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Identify risk factors associated with mortality in HIV patients admitted to an ICU in the city of Bogotá. Retrospective cohort study of patients treated in an ICU during the years 2017-2019. The analysis included descriptive statistics, association tests, and a logistic regression model. A predictive model of mortality at the time of admission to the ICU was developed. 110 HIV patients were identified. Association was found between a Charlson index ≥ 6 and mortality (OR = 2.3, 95% CI 1.0-5.1) and an increase in mortality in the first 21 days of ICU stay (OR = 2.2, 95% CI 1.0-4.9). In the logistic regression analysis, the absence of highly active antiretroviral therapy (HAART) upon admission to the ICU (OR = 2.5 95% CI 1.0-6.1) and the first 21 days of ICU stay (OR = 2.3 95% CI 1.0-5.4) were associated with an increase in mortality. The predictive mortality model established that mortality was higher in patients admitted to the ICU without having previously received HAART than in those who did receive therapy at the time of admission to the ICU. In patients with HIV admitted to the ICU, the absence of HAART will negatively impact mortality during their hospital stay.

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Resumen El dolor torácico es uno de los principales motivos de consulta al sistema de urgencias, y este es secundario a condiciones como el síndrome coronario agudo entre otras. Para su diagnóstico se requiere no sólo el resultado de la troponina, sino una evaluación clínica completa en la que se tengan en cuenta factores de riesgo cardiovascular, características del dolor y hallazgos electrocardiográficos. La interpretación inadecuada de las troponinas ultrasensibles lleva a que se someta al paciente a riesgos innecesarios a causa de estudios como el cateterismo cardiaco. Se llevó a cabo un estudio de corte trasversal en un hospital de Bogotá, en el que la causa principal de consulta en el servicio de urgencias fue el dolor torácico, y la primera causa de hospitalización en Cardiología el síndrome coronario agudo. Se recolectaron datos de 411 pacientes a quienes se les realizó arteriografía coronaria, la mayoría hombres con factores de riesgo como hipertensión arterial, tabaquismo y un evento coronario previo. Dentro de los estudios paraclínicos, la fracción de eyección promedio estuvo cercana al 50% y sólo en 201 pacientes se encontraron lesiones epicárdicas significativas.De la muestra analizada, el 13% tenía creatinina mayor de 1,5 mg/dl como causa alterna de elevación del biomarcador y 28% tenía disfunción ventricular izquierda de algún grado. La mayoría de los pacientes en quienes no se documentaron lesiones angiográficamente significativas en el cateterismo cardiaco, la troponina no cumplía criterios de positividad con base en el aumento del 20% respecto al valor inicial si este era positivo o de 50% en caso de que el primer valor fuese negativo. Adicionalmente, del grupo de pacientes con enfermedad coronaria angiográficamente significativa fue más frecuente la combinación de tres o más factores de riesgo cardiovascular en presencia de biomarcador positivo.

Abstract Chest pain is one of the main reasons for consulting the Emergency Department, and it is secondary to conditions, such as acute coronary syndrome. For its diagnosis, it not only requires a Troponin result, but also a full clinical evaluation, in which factors like cardiovascular risk have to be taken into account, as well as characteristics of the pain and the findings on the electrocardiogram. The poor interpretation of the ultrasensitive Troponins leads to the patient being subjected to unnecessary risks due to studies such as cardiac catheterisation. A cross-sectional study was conducted in a hospital in Bogota, in which chest pain was the main reason for consulting the Emergency Department, and acute coronary syndrome the first cause of admission to Cardiology. The study included a total of 411 patients on whom a coronary angiography was performed. The majority were males with risk factors such as arterial hypertension, smokers, and with a previous coronary event. Among the para-clinical studies, the mean ejection fraction was around 50%, and significant epicardial lesions were found in only 201 patients.Of the sample analysed, 13% had a creatinine greater than 1.5 mg/dl as an alternative cause of the elevation of the biomarker, and 28% had some degree of left ventricular function. the majority of patients that did not have significant angiographic lesions in the cardiac catheterisation documented, the Troponin did not meet the criteria for being positive, based on an increase of 20% as regards the initial value if this was positive or 50% in the case where the first value was negative. Furthermore, of the patient group with significant angiographic coronary disease, the combination of three or more cardiovascular risk factors was the most frequent in the presence of a positive biomarker.

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The production and characterization of an active recombinant N-acetylgalactosamine-6-sulfate sulfatase (GALNS) in Escherichia coli BL21(DE3) has been previously reported. In this study, the effect of the signal peptide (SP), inducer concentration, process scale, and operational mode (batch and semi-continuous) on GALNS production were evaluated. When native SP was presented, higher enzyme activity levels were observed in both soluble and inclusion bodies fractions, and its removal had a significant impact on enzyme activation. At shake scale, the optimal IPTG concentrations were 0.5 and 1.5 mM for the strains with and without SP, respectively, whereas at bench scale, the highest enzyme activities were observed with 1.5 mM IPTG for both strains. Noteworthy, enzyme activity in the culture media was only detected when SP was presented and the culture was carried out under semi-continuous mode. We showed for the first time that the mechanism that in prokaryotes recognizes the SP to mediate sulfatase activation can also recognize a eukaryotic SP, favoring the activation of the enzyme, and could also favor the secretion of the recombinant protein. These results offer significant information for scaling-up the production of human sulfatases in E. coli.

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