Alma Rosa Contreras Contreras, Eduardo Alberto Nájera González, Ana Beatriz Bolio Ruiz, Braulia Aurelia Martínez Díaz, Juvenal Franco Granillo, Janet Silvia Aguirre Sánchez
Introduction: Obesity is a mortality protector factor in sepsis; this phenomenon is known as «obesity paradox». Furthermore, obesity is a chronic inflammatory state in which adaptive and innate immunity mediators play key roles. Lymphopenia is an adaptive immunity marker and it has been related to poor outcomes and greater mortality. Objective: To determine the relationship between body mass index and lymphocyte count and its association with the survival of septic patients. Methods and materials: A cohort retrospective study of patients older than 18 years old with sepsis, septic shock and no history of autoimmune diseases nor immunosuppressor treatments. Outcomes included determining BMI and lymphopenia. Results: 206 patients were included, 8.7% with low weight, 46.6% with normal weight, 24.8% with normal weight, 19.9% with obesity. The group with the lowest BMI (median of 21.37) and lymphopenia was associated with the greatest mortality. The survival analysis revealed that a BMI lower than 22.5 and lymphopenia are independent risk factors for mortality. Conclusions: Obesity is associated to a higher lymphocyte count and a greater survival in sepsis and septic shock. Since BMI and lymphocyte count are statistically significant independent risk factors for mortality, we propose an APACHE II score adjusted to these variables. The role of the obesity paradox and lymphocytic count sepsis
{"title":"El papel de la paradoja de la obesidad y el conteo linfocitario en sepsis","authors":"Alma Rosa Contreras Contreras, Eduardo Alberto Nájera González, Ana Beatriz Bolio Ruiz, Braulia Aurelia Martínez Díaz, Juvenal Franco Granillo, Janet Silvia Aguirre Sánchez","doi":"10.35366/89124","DOIUrl":"https://doi.org/10.35366/89124","url":null,"abstract":"Introduction: Obesity is a mortality protector factor in sepsis; this phenomenon is known as «obesity paradox». Furthermore, obesity is a chronic inflammatory state in which adaptive and innate immunity mediators play key roles. Lymphopenia is an adaptive immunity marker and it has been related to poor outcomes and greater mortality. Objective: To determine the relationship between body mass index and lymphocyte count and its association with the survival of septic patients. Methods and materials: A cohort retrospective study of patients older than 18 years old with sepsis, septic shock and no history of autoimmune diseases nor immunosuppressor treatments. Outcomes included determining BMI and lymphopenia. Results: 206 patients were included, 8.7% with low weight, 46.6% with normal weight, 24.8% with normal weight, 19.9% with obesity. The group with the lowest BMI (median of 21.37) and lymphopenia was associated with the greatest mortality. The survival analysis revealed that a BMI lower than 22.5 and lymphopenia are independent risk factors for mortality. Conclusions: Obesity is associated to a higher lymphocyte count and a greater survival in sepsis and septic shock. Since BMI and lymphocyte count are statistically significant independent risk factors for mortality, we propose an APACHE II score adjusted to these variables. The role of the obesity paradox and lymphocytic count sepsis","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130050305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Ferrer, J. Díaz, Yenny Rocío Cárdenas, Peter Vergara, Marcela Rivera Portilla, Manuel Andrés Garay Fernández, Bladimir Alejandro Gil Valencia, M. Vargas, H. Meléndez F., C. Dueñas Castell
{"title":"Alternativas para la sedación, analgesia, relajación y delirium en pacientes COVID-19. Revisión narrativa","authors":"L. Ferrer, J. Díaz, Yenny Rocío Cárdenas, Peter Vergara, Marcela Rivera Portilla, Manuel Andrés Garay Fernández, Bladimir Alejandro Gil Valencia, M. Vargas, H. Meléndez F., C. Dueñas Castell","doi":"10.35366/106512","DOIUrl":"https://doi.org/10.35366/106512","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"CE-23 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132757333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pedro Alejandro Elguea Echavarría, Karla González Sánchez, Quetzal Iván Hernández Arriola, Gabriela Gutiérrez Salgado, Omar Flores Ángeles
Teams (RRT) constitutes a window of opportunity for the detection and timely treatment. There are several tools for activating an RRT and a sepsis code. Among the most important are quick SOFA, SIRS, CARS, MEWS and NEWS that constitute severity scales that allow the detection of sepsis based on criteria. The NEWS scale has shown superiority. The results of different studies conducted after the implementation of sepsis code report a positive impact on early initiation of antibiotics and compliance with goals, as well as mortality. One area of opportunity to improve the effectiveness of the RRT is the activation by automated devices. Sepsis code an RRT consolidates and strengthens the culture of safety in the hospitalized patient.
{"title":"Código sepsis: sistemas de respuesta rápida","authors":"Pedro Alejandro Elguea Echavarría, Karla González Sánchez, Quetzal Iván Hernández Arriola, Gabriela Gutiérrez Salgado, Omar Flores Ángeles","doi":"10.35366/88516","DOIUrl":"https://doi.org/10.35366/88516","url":null,"abstract":"Teams (RRT) constitutes a window of opportunity for the detection and timely treatment. There are several tools for activating an RRT and a sepsis code. Among the most important are quick SOFA, SIRS, CARS, MEWS and NEWS that constitute severity scales that allow the detection of sepsis based on criteria. The NEWS scale has shown superiority. The results of different studies conducted after the implementation of sepsis code report a positive impact on early initiation of antibiotics and compliance with goals, as well as mortality. One area of opportunity to improve the effectiveness of the RRT is the activation by automated devices. Sepsis code an RRT consolidates and strengthens the culture of safety in the hospitalized patient.","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127846165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paul Palacios-Moguel, J. Aguirre-Sánchez, Juvenal Franco-Granillo, Gilberto Camarena-Alejo, Alfredo Aisa-Álvarez
pós-operatórios de biomarcadores cardíacos são significativamente maiores em pacientes com LRA. O tempo da CEC e a elevação da mioglobina demonstraram ser preditores independentes de LRA. Esses biomarcadores podem ser adequados para identi fi car pacientes com alto risco de LRA após cirurgia cardíaca. Palavras-chave: Lesão renal aguda, cirurgia cardíaca, biomarcadores de lesão cardíaca.
{"title":"Utilidad de biomarcadores cardiacos como predictores de lesión renal aguda en pacientes de cirugía cardiaca: cohorte prospectiva","authors":"Paul Palacios-Moguel, J. Aguirre-Sánchez, Juvenal Franco-Granillo, Gilberto Camarena-Alejo, Alfredo Aisa-Álvarez","doi":"10.35366/87290","DOIUrl":"https://doi.org/10.35366/87290","url":null,"abstract":"pós-operatórios de biomarcadores cardíacos são significativamente maiores em pacientes com LRA. O tempo da CEC e a elevação da mioglobina demonstraram ser preditores independentes de LRA. Esses biomarcadores podem ser adequados para identi fi car pacientes com alto risco de LRA após cirurgia cardíaca. Palavras-chave: Lesão renal aguda, cirurgia cardíaca, biomarcadores de lesão cardíaca.","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127242338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rafael García Sánchez, Irving Iván Morales Pogoda, Deniria Alejandra Rugerio Trujillo
the Intensive Medicine Department of the Central Military Hospital became a national reference center for patients with severe and critical COVID-19. The objective is to define the effects of vaccination in severe COVID-19. Material and methods : descriptive, cross-sectional, retrospective study, in records of patients with severe COVID-19 in the period from January 1, 2020 to December 31, 2021, information regarding demographic and clinical characteristics and the state of vaccination to carry out the statistical analysis. Results : 378 cases met the inclusion criteria, 280 men and 98 women; average age 52 years; 326 cases without vaccination, 24 partially vaccinated and 28 fully vaccinated; 266 deaths within 28 days. Conclusion : vaccination against COVID-19 decreases the risk of severe disease in healthy, young people and in men. Arterial hypertension and immunosuppression increase the risk of aggravation of COVID-19 even in the presence of vaccination.
{"title":"Efectos de la vacunación en el COVID-19 severo en el Departamento de Medicina Intensiva del Hospital Central Militar","authors":"Rafael García Sánchez, Irving Iván Morales Pogoda, Deniria Alejandra Rugerio Trujillo","doi":"10.35366/111300","DOIUrl":"https://doi.org/10.35366/111300","url":null,"abstract":"the Intensive Medicine Department of the Central Military Hospital became a national reference center for patients with severe and critical COVID-19. The objective is to define the effects of vaccination in severe COVID-19. Material and methods : descriptive, cross-sectional, retrospective study, in records of patients with severe COVID-19 in the period from January 1, 2020 to December 31, 2021, information regarding demographic and clinical characteristics and the state of vaccination to carry out the statistical analysis. Results : 378 cases met the inclusion criteria, 280 men and 98 women; average age 52 years; 326 cases without vaccination, 24 partially vaccinated and 28 fully vaccinated; 266 deaths within 28 days. Conclusion : vaccination against COVID-19 decreases the risk of severe disease in healthy, young people and in men. Arterial hypertension and immunosuppression increase the risk of aggravation of COVID-19 even in the presence of vaccination.","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115395490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marcelo Díaz Conde, Itzel Oralia Amaya Díaz de León
{"title":"Síndrome de choque tóxico por Streptococcus pyogenes en un hospital de la Ciudad de México","authors":"Marcelo Díaz Conde, Itzel Oralia Amaya Díaz de León","doi":"10.35366/91605","DOIUrl":"https://doi.org/10.35366/91605","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115068596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cuidado de Alto Valor en Medicina Crítica","authors":"S. Ñamendys-Silva","doi":"10.35366/87295","DOIUrl":"https://doi.org/10.35366/87295","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116160611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jacob García Regalado, José Luis Espinosa Camacho, Koritza Aguirre Rolón
{"title":"Disfagia secundaria a ascitis en preeclampsia con criterios de severidad","authors":"Jacob García Regalado, José Luis Espinosa Camacho, Koritza Aguirre Rolón","doi":"10.35366/108716","DOIUrl":"https://doi.org/10.35366/108716","url":null,"abstract":"","PeriodicalId":344697,"journal":{"name":"Medicina Crítica","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116162829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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