The present research is focused on an experimental investigation to evaluate the mechanical, durability, and thermal performance of compressed earth blocks (CEBs) produced in Portugal. CEBs were analysed in terms of electrical resistivity, ultrasonic pulse velocity, compressive strength, total water absorption, water absorption by capillarity, accelerated erosion test, and thermal transmittance evaluated in a guarded hotbox setup apparatus. Overall, the results showed that compressed earth blocks presented good mechanical and durability properties. Still, they had some issues in terms of porosity due to the particle size distribution of soil used for their production. The compressive strength value obtained was 9 MPa, which is considerably higher than the minimum requirements for compressed earth blocks. Moreover, they presented a heat transfer coefficient of 2.66 W/(m2·K). This heat transfer coefficient means that this type of masonry unit cannot be used in the building envelope without an additional thermal insulation layer but shows that they are suitable to be used in partition walls. Although CEBs have promising characteristics when compared to conventional bricks, results also showed that their proprieties could even be improved if optimisation of the soil mixture is implemented.
Objective: To determine the initial management and in-hospital mortality of patients with acute coronary syndrome who attended referral hospitals in Paraguay. Method: Observational, multicenter study, in patients over 18 years with a confirmed diagnosis of acute coronary syndrome. Results: 780 patients were included from May 2015 to February 2016; the mean age was 64.1 ± 12.3 years, 64.1% male. The clinical presentation were acute coronary syndrome with ST elevation in 40.1% and without elevation in 59.9%. In patients with ST elevation there is a high percentage of late attendance, more than 12 h of evolution in 49.8%; those with less than 12 h of evolution underwent reperfusion in 52.2% of the cases, received fibrinolytics in 36.3% of the cases, and primary percutaneous coronary intervention 15.9%. In-hospital mortality for acute coronary syndrome was 10.3%, with ST-segment elevation was 12.8%, and without ST-segment elevation was 8.6%. Conclusions: The management of acute coronary syndrome in Paraguay needs a comprehensive approach, which promotes earlier care, and increases the implementation of reperfusion therapies in the health services network, in order to improve the therapeutic response rates and decrease hospital mortality.
Objetivo: Determinar el tratamiento inicial y la mortalidad intrahospitalaria de pacientes con síndrome coronario agudo que acudieron a centros hospitalarios de referencia de Paraguay. Método: Estudio observacional y multicéntrico en pacientes mayores de 18 años con diagnóstico confirmado de síndrome coronario agudo. Resultados: Se incluyó a 780 pacientes desde mayo de 2015 hasta febrero de 2016; la edad media fue de 64.1 ± 12.3 años y el género masculino representó el 64.1%. La presentación clínica fue la de síndrome coronario agudo con elevación del ST en 40.1% y sin elevación del ST en 59.9%. En pacientes con elevación del ST se observó un alto porcentaje de consultas tardías, mayor de 12 h de evolución en 49.8%; en aquéllos con menos de 12 h de evolución se indicó la reperfusión en 52.2%, el 36.3% recibió fibrinolíticos y 15.9% intervención coronaria percutánea primaria. La mortalidad hospitalaria del síndrome coronario agudo fue de 10.3%, con elevación del segmento ST en 12.8% y sin elevación del segmento ST en 8.6%. Conclusiones: El tratamiento del síndrome coronario agudo en el Paraguay requiere un abordaje integral, que promueva consultas más tempranas y aumente la institución de tratamientos de reperfusión en la red de servicios de salud; el objetivo es mejorar los índices de respuesta terapéutica y disminuir la mortalidad hospitalaria.
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