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001). The most common ultrasound findings in confirmed COVID-19 cases were focal and confluent B-lines in the basal and posterior regions of the lung (R1, 85.2%; R2, 77.8%; L1, 88.9%; and L2, 88.9%) and associated pleural involvement (70.4%, 70.4%, 81.5%, and 85.2%, respectively). The sensitivity of point-of-care ultrasound in the diagnosis of COVID-19 was 92.6% (95% CI, 75.7%-99.1%). Specificity was 85.2% (95% CI, 66.3%-95.8%); positive predictive value, 75.8% (95% CI, 59.6%- 91.9%); negative predictive value, 92% (95% CI, 74.0%-99.0%); and positive and negative likelihood ratios, 6.2 (95% CI, 6.0-6.5) and 0.1 (95% CI, 0.1-0.1), respectively.

Point-of-care lung ultrasound could be useful for the diagnosis of noncritical SARS-CoV-2 infection when chest radiographs are inconclusive.

Point-of-care lung ultrasound could be useful for the diagnosis of noncritical SARS-CoV-2 infection when chest radiographs are inconclusive.

To identify factors associated with worsening renal function (WRF) and explore associations with higher mortality in patients with acute heart failure (AHF).

Seven emergency departments (EDs) in the EAHFE-EFRICA study (Spanish acronym for Epidemiology of AHF in EDs - WRF in AHF) consecutively included patients with AHF and creatinine levels determined in the ED and between 24 and 48 hours later. Patients with WRF were identified by an increase in creatinine level of 0.3 mg/dL or more. Forty-seven clinical characteristics were explored to identify those associated with WRF. To analyze for 30-day all-cause mortality we calculated odds ratios (ORs). To analyze mortality at the end of follow-up and by trimester, adjusted for between-group differences, we calculated hazard ratios (HRs). The data were analyzed by subgroups according to age, sex, baseline creatinine levels, AHF type, and risk group.

A total of 1627 patients were included. The subgroup of 220 (13.5%) with WRF were older, had higher systolic blood pressure, were more often treated with morphine, and had chronic renal failure; there was also a higher rate of hypertensive crisis as the trigger for AHF in patients with WRF. However, only chronic renal failure was independently associated with WRF (adjusted OR, 1.695; 95% CI, 1.264-2.273). The rate of 30-day mortality was 13.1% overall but higher in patients with WRF (20.9% vs 11.8% in patients without WRF; adjusted OR, 1.793; 95% CI, 1.207-2.664). Accumulated mortality at 18 months (average follow-up time, 14 mo/patient) was 40.0% overall but higher in patients with WRF (adjusted HR, 1.275; 95% CI, 1.018-1.598). Increased risk was greater in the first trimester. Subgroup analyses revealed no differences.

AHF with WRF in the first 48 hours after ED care is associated with higher mortality, especially in the first trimester after the emergency.

AHF with WRF in the first 48 hours after ED care is associated with higher mortality, especially in the first trimester after the emergency.

To estimate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the organization of Spanish hospital emergency departments (EDs). To explore differences between Spanish autonomous communities or according to hospital size and disease incidence in the area.

Survey of the heads of 283 EDs in hospitals belonging to or affiliated with Spain's public health service. Respondents evaluated the pandemic's impact on organization, resources, and staff absence from work in March and April 2020. Assessments were for 15-day periods. Results were analyzed overall and by autonomous community, hospital size, and local population incidence rates.

A total of 246 (87%) responses were received. The majority of the EDs organized a triage system, first aid, and observation wards; areas specifically for patients suspected of having COVID-19 were newly set apart. The nursing staff was increased in 83% of the EDs (with no subgroup differences), and 59% increased the number of physicians (especially in large hospitarked differences between autonomous communities were detected.

The COVID-19 pandemic led to organizational changes in EDs. Oxaliplatin molecular weight Certain resources became scarce, and marked differences between autonomous communities were detected.

To describe the process of implementing the Spanish Triage System (SET, in its Spanish abbreviation) in nonspecialist hospital emergency departments (EDs) in the public health service.

Multicenter cross-sectional study at 4 time cut-points (6 months before implementation and at the end of 1, 2 and 3 semesters afterwards). The study was carried out in 29 public hospital EDs in Andalusia. We recorded the following data type of hospital, proportion of cases in which the SET was applied, priority classifications assigned on triage, wait time before triage, and duration of the triage process. We also recorded the following proportions patients waiting less than 10 minutes for the assigned priority, cases with a triage processing time less than 5 minutes, ED revisits within 72 hours, ED deaths, and patients leaving before discharge.

We saw SET use increase progressively over the 3 semesters. The mean wait time decreased, and the proportion of patients waiting less than 10 minutes increased. The mean triage processing time tended to decrease nonsignificantly as the proportion of cases triaged in less than 5 minutes rose. The proportion of patients leaving before discharge increased with time; in overall and by hospital type. The proportion of ED deaths did not change significantly, and revisits within 72 hours increased only in more complex hospitals (P = .019).

Implementing a structured triage approach like SET is a gradual process. Quality indicators must be followed over time so that the impact of a triage system on ED care processes can be assessed.

Implementing a structured triage approach like SET is a gradual process. Quality indicators must be followed over time so that the impact of a triage system on ED care processes can be assessed.In this study a commercial H-ZSM-5 zeolite (Si/Al=11) was post-synthetically modified by a combined dealumination procedure to adjust its catalytic properties for the selective formation of aromatics from ethanol. The solid-state properties of original and modified zeolites are determined by structural, textural and acidity analysis. The formation of aromatics and durability of the zeolites were investigated depending on space velocity or contact time in the catalyst bed. In particular, the formation rate and desorption of aromatics from solid-state surface as well as their tendency to form coke precursors by consecutive build-up reactions determine the formation of coke. Therefore, the rate of build-up and finished aromatization by hydride transfer (pre-determined by the kind, location and geometric arrangement of surface acid sites) and the statistical number of reaction events until final desorption at the specific contact time have to be harmonized to increase aromatics yield and to decrease catalyst decay by coke simultaneously.