Background. Sepsis is a public health problem with high prevalence and mortality. Biomarkers are a tool to determine diagnosis, severity and prognosis in these patients. Platelet mean volume (MPV), a biomarker reported in routine blood counts, has been investigated and shows promise for determining strong outcomes in septic patients Objective. To assess whether the VMP is an independent predictor of severity and mortality in patients with sepsis. In addition, verify the behavior of the VMP / platelets ratio for the same outcome variables. Materials and methods. Prospective study of secondary data that included 163 adult patients admitted to the intensive care unit, diagnosed with sepsis under SEPSIS criteria. 3; in which the MPV in fentoliters (fL) and the MPV / platelet ratio were measured on days 1, 2 and 3. Mortality at 28 days and clinical severity (estimated as SOFA score and presen...

Introducción: Es imprescindible disponer de biomarcadores confiables que puedan predecir la mortalidad y severidad en COVID-19, debido a su rápida expansión y colapso de los sistemas sanitarios. Objetivo: Este estudio se realizó para determinar la capacidad predictiva de mortalidad de las variables inmunológicas-inflamatorias y hematológicas en pacientes críticos con COVID-19 en una ciudad de altitud elevada (2850 msnm). Métodos: 223 pacientes con COVID-19 severo, ventilados mecánicamente e ingresados en una unidad de cuidados intensivos de altitud elevada (2850 msnm), entre el 1 de abril de 2020 al 1 de agosto de 2021, fueron analizados. Se evaluaron las variables inmunológicas-inflamatorias: interleuquina (IL-6), ferritina, dímero D y lactato deshidrogenasa (LDH) y las variables hematológicas: volumen medio plaquetario (VMP), cociente VMP/plaquetas y el índice neutrófilo/...

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus causing the ongoing pandemic. In general, patients infected with SARS-CoV-2 develop respiratory diseases. The first symptoms are fever, cough and dyspnea that rapidly progress to pneumonia. Additionally, extrapulmonary manifestations, such as those in the gastrointestinal system, have been reported. It has been described that the angiotensin-converting enzyme 2 (ACE2) receptor and the transmembrane serine protease 2(TMPRSS2) for S protein priming favor SARS-CoV-2 entry into the cells. These proteins are expressed in alveolar type II cells as well as in ileum and colon enterocytes, thus detecting the virus in the digestive tract. We present the case of a patient with COVID-19 pneumonia and gastrointestinal findings such as pneumatosis intestinalis and ischemic colitis.

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome,is a rare systemic vasculitis affecting small- and medium-sized vessels. It is characterized by late-onset asthma, peripheral eosinophilia and multiorgan involvement, which may include respiratory, cutaneous, renal, neurological and hematological manifestations. Diagnosis is challenging due to clinical variability and overlapping manifestations with other inflammatory diseases.We present the case of a 58-year-old woman with a history of hypertension and Class III obesity,who was admitted to the emergency department with severe respiratory failure and a six-monthhistory of asthma. During her hospitalization, she developed marked hypereosinophilia, painlesscutaneous lesions compatible with vasculitis, acute renal impairment and thrombocytopeniaassociated with a positive Coombs test. Despite negat...

No description

Conocer el perfil bacteriano del shock séptico permitirá una adecuada elección de antibióticos empíricos. Objetivos: a) Describir el perfil bacteriano del shock séptico en una unidad de cuidados intensivos de la altitud. b) Conocer la localización de los cultivos positivos. c) Identificar la sensibilidad y el mecanismo de resistencia bacteriana. d) Encontrar diferencias de los perfiles bacterianos de la altitud. Estudio retrospectivo transversal. Realizado en una unidad de cuidados intensivos a 3,250 “msnm”. Se incluyeron los cultivos positivos y antibiogramas de residentes de la altitud con shock séptico extraídos antes del inicio de los antibióticos durante 7 años. 1,212 muestras. Escherichia coli (18.48%). Las bacterias gramnegativas presentaron sensibilidad para colistina (94-99%) el principal mecanismo de resistencia fue betalactamasa de espectro extendido (43-91%). S...

A pesar de un enfoque creciente en la medicina en la altitud, hay mucha variabilidad en la aproximación clínica y las variables de investigación. El desarrollo de unidades de cuidados intensivos en ciudades de la altitud ha permitido recolectar información crucial para la medicina intensiva en este contexto. Es responsabilidad de los grupos de investigación de medicina en la altitud, estandarizar los conceptos clínicos y de investigación para llenar los vacíos existentes de esta rama de la medicina. Este documento informa sobre una revisión crítica de alcance para la medicina intensiva en la altitud, explorando los dominios de las definiciones, cambios fisiopatológicos y variables clínicas. Métodos: Se desarrolló una estrategia de revisión de alcance. La búsqueda en siete bases de datos bibliográficas identificó 218 artículos relacionados con los términos de interés....

El lactato es un metabolito altamente dinámico que, en condiciones anaerobias, es producido por hipoxia o isquemia; y en condiciones aerobias, es sintetizado por un mecanismo impulsado por la estimulación adrenérgica, a través del receptor β2, que potencia la acción de la bomba sodio-potasio, y por un estado de glicólisis aerobia acelerada. Este metabolito es capaz de intercambiarse entre diferentes células productoras y consumidoras, con lo que asegura la materia prima para obtener energía. El sistema nervioso simpático responde a los estímulos de estrés con la liberación de catecolaminas, que actúan como hormonas y como neurotransmisores en varios tejidos del cuerpo y permiten un aumento del metabolismo que eleva los valores de glucosa y el oxígeno disponible. Existe una relación fisiológica de dependencia entre las catecolaminas y la producción de lactato que predisp...

Lactate is a highly dynamic metabolite that is produced, under anaerobic conditions, due to hypoxia or ischemia. Under aerobic conditions, it is synthesized by a mechanism driven by the stimulation of the β2 adrenergic receptor, which increases the activity of the sodium-potassium pump, and by a state of accelerated aerobic glycolysis. This metabolite is capable of being exchanged between different producing and consuming cells, ensuring the raw material for energy production.The sympathetic nervous system responds to stress stimuli through the release of catecholamines, which act as hormones and neurotransmitters in various tissues of the body, allowing an increase in metabolism that raises glucose and available oxygen levels.There is a physiological dependence between catecholamine levels and lactate production, predisposing the body to respond effectively to a stressful situation. Ho...

The Janus-Kinase signal transducer and the transcription activation pathway known as JAK /STAT is a major signaling pathway for the transduction of information in many inflammatory cytokines involved during sepsis. The JAK / STAT pathway has been shown to be strongly related to multiorgan failure, and many cytokines can exert their biological effects through this pathway. In recent years, considerable progress has been made in understanding functions of this complex; however, its role in sepsis as a therapeutic target remains under experimentation. This review describes the specific functions of the JAK / STAT pathway, its role in sepsis, and presents a translational approach to the therapeutic perspective aiming to inhibit this signaling pathway during sepsis and its interaction with inflammatory diseases such as COVID-19.

The Janus-Kinase signal transducer and the transcription activation pathway known as JAK /STAT is a major signaling pathway for the transduction of information in many inflammatory cytokines involved during sepsis. The JAK / STAT pathway has been shown to be strongly related to multiorgan failure, and many cytokines can exert their biological effects through this pathway. In recent years, considerable progress has been made in understanding functions of this complex; however, its role in sepsis as a therapeutic target remains under experimentation. This review describes the specific functions of the JAK / STAT pathway, its role in sepsis, and presents a translational approach to the therapeutic perspective aiming to inhibit this signaling pathway during sepsis and its interaction with inflammatory diseases such as COVID-19.