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OBJECTIVE: To analyze the presence of frailty in survivors of severe COVID-19 admitted in the Intensive Care Unit (ICU) and followed six months after discharge. DESIGN: An observational, prospective and multicenter, nation-wide study. SETTING: Eight adult ICU across eight academic acute care hospitals in Mexico. PATIENTS: All consecutive adult COVID-19 patients admitted in the ICU with acute respiratory failure between March 8, 2020 to February 28, 2021 were included. Frailty was defined according to the FRAIL scale, and was obtained at ICU admission and 6-month after hospital discharge. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: The primary endpoint was the frailty status 6-months after discharge. A regression model was used to evaluate the predictors during ICU stay associated with frailty. RESULTS: 196 ICU survivors were evaluated for basal frailty at ICU admission and were included in this analysis. After 6-months from discharge, 164 patients were evaluated for frailty: 40 patients (20.4%) were classified as non-frail, 67 patients (34.2%) as pre-frail and 57 patients (29.1%) as frail. After adjustment, the need of invasive mechanical ventilation was the only factor independently associated with frailty at 6 month follow-up (Odds Ratio [OR] 3.70, 95% confidence interval 1.40-9.81, Pâ¯=â¯.008). CONCLUSIONS: Deterioration of frailty was reported frequently among ICU survivors with severe COVID-19 at 6-months. The need of invasive mechanical ventilation in ICU survivors was the only predictor independently associated with frailty.
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COVID-19 , Fragilidade , Unidades de Terapia Intensiva , Respiração Artificial , Sobreviventes , Humanos , Fragilidade/epidemiologia , COVID-19/terapia , COVID-19/complicações , COVID-19/epidemiologia , México/epidemiologia , Estudos Prospectivos , Masculino , Feminino , Unidades de Terapia Intensiva/estatística & dados numéricos , Pessoa de Meia-Idade , Idoso , Sobreviventes/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos , Alta do Paciente/estatística & dados numéricos , Índice de Gravidade de Doença , SeguimentosRESUMO
RESUMEN Objetivos. Determinar la asociación entre el tiempo de enfermedad previo a broncoscopia y el tiempo de alta posbroncoscopia en pacientes pediátricos con aspiración de cuerpo extraño. Materiales y métodos. Estudio de cohorte retrospectivo. El estudio y la revisión de historias clínicas se realizó en el Hospital de Emergencias Pediátricas de Lima, Perú. Se revisaron 324 historias clínicas, de las cuales, 183 historias fueron seleccionadas por contar con diagnóstico de cuerpo extraño en vías aéreas y estar adecuadamente llenadas. Para el análisis bivariado se utilizó la prueba exacta de Fisher y U de Mann Whitney, mientras que para el cálculo del riesgo relativo (RR) y su respectivo intervalo de confianza (IC) al 95% se utilizó regresión de Poisson. Resultados. Se incluyeron 183 pacientes, de los cuales, el 65,6% fueron hombres con una media de 2,4 años. La localización más frecuente fue el árbol bronquial derecho y cuerpo extraño de material orgánico. La mayoría (72,7%) de pacientes tuvieron un alta temprana antes de las 24 horas. Se encontró una asociación entre el tiempo de enfermedad previo a la broncoscopia y el tiempo alta posbroncoscopia (RR: 2,94, IC 95%: 1,72-5,01). Conclusiones. Existe una asociación estadísticamente significativa entre el tiempo de enfermedad previo a la broncoscopia y el tiempo de estancia hospitalaria posextracción del cuerpo extraño al ajustar por edad, sexo tipo de cuerpo extraño y maniobra de boca como medida de rescate. Este hallazgo es relevante debido a que pone en evidencia la importancia de una atención temprana, diagnóstico oportuno y manejo precoz en el paciente pediátrico.
ABSTRACT Objective. To determine the association between pre-bronchoscopy time of illness and post-bronchoscopy discharge time in pediatric patients with foreign body aspiration. Materials and methods. Retrospective cohort study. Medical records were studied and reviewed at the Pediatric Emergency Hospital of Lima, Peru. We reviewed 324 medical records, and selected 183 because they had the diagnosis of foreign body aspiration and complete data. Fisher's exact test and Mann Whitney U test were used for the bivariate analysis, while Poisson regression was used to calculate the Relative Risk (RR) and its 95% confidence interval (CI). Results. We included 183 patients, of whom 65.6% were men with a mean age of 2.4 years. The most frequent location of the foreign body was the right bronchial tree and most of them were made of organic material. The majority (72.7%) of patients were discharged before 24 hours. We found an association between the time of illness prior to bronchoscopy and post-bronchoscopy discharge time (RR: 2.94, 95%CI: 1.72 - 5.01). Conclusions. The time of illness prior to bronchoscopy and the length of hospital stay after removal of the foreign body were significantly associated when adjusted for age, sex, type of foreign body and mouth sweep maneuver as a rescue measure. Our findings are relevant because they highlight the importance of early care, timely diagnosis and early management of pediatric patients.
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Humanos , Masculino , Feminino , BroncoscopiaRESUMO
Introducción: El cáncer de mama triple negativo (TNBC) se caracteriza por la ausencia de receptores hormonales estrogénicos y progesterona; así como, del receptor 2 del factor de crecimiento epidérmico humano (HER2). Los TNBC se asocian con altas tasas de recurrencia, metástasis rápidas, supervivencia deficiente y mayor mortalidad en comparación con otros subtipos histológicos de cáncer de mama. El objetivo de este estudio fue establecer la prevalencia del TNBC; Así también, las características clínicas, en pacientes atendidas en un centro oncológico de referencia en Bogotá. Metodología: Estudio retrospectivo descriptivo transversal observacional, donde se evaluó la frecuencia del cáncer de mama subtipo triple negativo, Asimismo, las variables clínicas. En mujeres atendidas en la Organización Clínica Bonnadona Prevenir S.A.S. en Barranquilla, Colombia en el periodo 2021-2022. Resultados: Se estudiaron 350 pacientes, de los cuales 61 pacientes (17.4%) presentaban el inmunofenotipo triple negativo. La edad promedio fue de 54.5 años, 74% eran multíparas, 85% brindaron lactancia materna, 70% eran postmenopáusicas y el estadio clínico más frecuente fue el IIIB. Conclusión: En el presente estudio el 57.35% de la población exhibió un estadio clínico avanzado en el momento del diagnóstico; así mismo, las características clínicas son congruentes con los reportes en la literatura.
Introduction: Triple-negative breast cancer (TNBC) is characterized by the absence of estrogen, progesterone hormone receptors, and human epidermal growth factor receptor 2 (HER2). TNBC is associated with an increased recurrence rate, distant metastasis, poor survival, and higher mortality than other pathological breast cancer subtypes. The objective of this study was to establish the prevalence of TNBC, likewise, with the clinical characteristics, in patients treated in a reference cancer center in Bogotá. Methodology: A retrospective descriptive cross-sectional observational study, where the frequency of triple negative subtype breast cancer was evaluated, as well as clinical variables and gynecologic and obstetric history, women treated at the Organización Clínica Bonnadona Prevenir S.A.S. in Barranquilla, Colombia in the period 2021-2022. Results: 350 patients were studied, of which 61 (17.4%) presented the triple-negative immunophenotype. The average age was 54, 74% were multiparous, 85% were breastfed, 70% were menopausal, and the most frequent clinical stage was IIIB. Conclusion: In this study, 57.35% of the population exhibited an advanced clinical stage at the time of diagnosis; Likewise, the clinical characteristics are consistent with the reports in the literature.
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Humanos , Adulto , Fatores de Risco , Neoplasias de Mama Triplo Negativas , Neoplasias da Mama , EpidemiologiaRESUMO
OBJECTIVE.: To determine the association between pre-bronchoscopy time of illness and post-bronchoscopy discharge time in pediatric patients with foreign body aspiration. MATERIALS AND METHODS.: Retrospective cohort study. Medical records were studied and reviewed at the Pediatric Emergency Hospital of Lima, Peru. We reviewed 324 medical records, and selected 183 because they had the diagnosis of foreign body aspiration and complete data. Fisher's exact test and Mann Whitney U test were used for the bivariate analysis, while Poisson regression was used to calculate the Relative Risk (RR) and its 95% confidence interval (CI). RESULTS.: We included 183 patients, of whom 65.6% were men with a mean age of 2.4 years. The most frequent location of the foreign body was the right bronchial tree and most of them were made of organic material. The majority (72.7%) of patients were discharged before 24 hours. We found an association between the time of illness prior to bronchoscopy and post-bronchoscopy discharge time (RR: 2.94, 95%CI: 1.72 - 5.01). CONCLUSIONS.: The time of illness prior to bronchoscopy and the length of hospital stay after removal of the foreign body were significantly associated when adjusted for age, sex, type of foreign body and mouth sweep maneuver as a rescue measure. Our findings are relevant because they highlight the importance of early care, timely diagnosis and early management of pediatric patients.
OBJETIVOS.: Determinar la asociación entre el tiempo de enfermedad previo a broncoscopia y el tiempo de alta posbroncoscopia en pacientes pediátricos con aspiración de cuerpo extraño. MATERIALES Y MÉTODOS.: Estudio de cohorte retrospectivo. El estudio y la revisión de historias clínicas se realizó en el Hospital de Emergencias Pediátricas de Lima, Perú. Se revisaron 324 historias clínicas, de las cuales, 183 historias fueron seleccionadas por contar con diagnóstico de cuerpo extraño en vías aéreas y estar adecuadamente llenadas. Para el análisis bivariado se utilizó la prueba exacta de Fisher y U de Mann Whitney, mientras que para el cálculo del riesgo relativo (RR) y su respectivo intervalo de confianza (IC) al 95% se utilizó regresión de Poisson. RESULTADOS.: Se incluyeron 183 pacientes, de los cuales, el 65,6% fueron hombres con una media de 2,4 años. La localización más frecuente fue el árbol bronquial derecho y cuerpo extraño de material orgánico. La mayoría (72,7%) de pacientes tuvieron un alta temprana antes de las 24 horas. Se encontró una asociación entre el tiempo de enfermedad previo a la broncoscopia y el tiempo alta posbroncoscopia (RR: 2,94, IC 95%: 1,72-5,01). CONCLUSIONES.: Existe una asociación estadísticamente significativa entre el tiempo de enfermedad previo a la broncoscopia y el tiempo de estancia hospitalaria posextracción del cuerpo extraño al ajustar por edad, sexo tipo de cuerpo extraño y maniobra de boca como medida de rescate. Este hallazgo es relevante debido a que pone en evidencia la importancia de una atención temprana, diagnóstico oportuno y manejo precoz en el paciente pediátrico.
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Broncoscopia , Corpos Estranhos , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Broncoscopia/métodos , Corpos Estranhos/diagnóstico , Corpos Estranhos/epidemiologia , Alta do Paciente , Peru , Encaminhamento e Consulta , Aspiração Respiratória , Estudos Retrospectivos , TraqueiaRESUMO
BACKGROUND: Prone positioning reduces mortality in patients with moderate/severe ARDS. It remains unclear which physiological parameters could guide clinicians to assess which patients are likely to benefit from prone position. This study aimed to determine the association between relative changes in physiological parameters at 24 h of prone positioning and ICU mortality in adult subjects with ARDS. METHODS: We conducted a cohort study using the VENTILA database, including adults with ARDS receiving prone positioning. We used multivariable logistic regression to assess the association between relative changes in physiological parameters (PaO2 /FIO2 , dynamic driving pressure, PaCO2 , and ventilatory ratio defined as [minute ventilation [mL/min] × PaCO2 [mm Hg]]/[predicted body weight × 100 [mL/min] × 37.5 [mm Hg] with ICU mortality) (primary outcome). We report adjusted odds ratios with 95% CI as measures of association. RESULTS: We included 156 subjects of which 82 (53%) died in the ICU. A relative decline in the ventilatory ratio at 24 h was associated with lower ICU mortality (odds ratio 0.80 [95% CI 0.66-0.97], every 10% decrease). Relative changes in PaO2 /FIO2 (odds ratio 0.89 [95% CI 0.77-1.03], every 25% increase), PaCO2 (odds ratio 0.97 [95% CI 0.82-1.16], every 10% decrease), and dynamic driving pressure (odds ratio 0.98 [95% CI 0.89-1.07], every 10% decrease) were not associated with ICU mortality. CONCLUSIONS: In subjects with ARDS receiving prone positioning, a relative decline in the ventilatory ratio at 24 h was associated with lower ICU mortality.
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INTRODUCCIÓN. El cáncer de ovario es uno de los principales diagnósticos de malignidad en mujeres en nuestro país. La Tomografía por Emisión de Positrones -Tomografía Computarizada es importante porque puede establecer de manera correcta el estadio de la enfermedad así como puede determinar la recurrencia, incluso mejor que métodos diagnósticos como la Tomografía Simple o la Resonancia Magnética. OBJETIVO. Establecer los principales aspectos demográficos de los pacientes diagnosticados con cáncer de ovario que fueron evaluados en la Unidad Tomografía por Emisión de Positrones Ciclotrón del Hospital de Especialidades Carlos Andrade Marín de Quito-Ecuador. MATERIALES Y MÉTODOS. Estudio descriptivo retrospectivo. El número total de la población fue de 166 pacientes, y una muestra de 103 pacientes con criterios de inclusión y exclusión en la Unidad PET Ciclotrón del Hospital de Especialidades Carlos Andrade Marín de la ciudad de Quito, desde 2013 al 2018, obtenidas de bases estadísticas de la Unidad PET Ciclotrón y en la base de datos del sistema AS400 del Hospital. RESULTADOS. La mediana de edad de las pacientes con cáncer de ovario fue de 56 años (IQR 48 64; mínima: 13 y máxima 85). Al momento del estudio estuvieron casadas el 58,3% (60;103). El 43,7% (45;103) tuvieron un hijo. El 47,6% (49;103) tuvieron estudios de tercer nivel. El 64,0% (66;103) residieron en Quito. CONCLUSIÓN. Este perfil demográfico resaltó el poco acceso de este tipo de tecnología diagnóstica en pacientes con bajo nivel educativo y en lugares geográficamente alejados de Quito.
INTRODUCTION. Ovarian cancer is one of the main diagnoses of malignancy in women in our country. Positron Emission Tomography - Computed Tomography is important because it can correctly establish the stage of the disease as well as determine recurrence, even better than diagnostic methods such as Simple Tomography or Magnetic Resonance. OBJECTIVE. To establish the main demographic aspects of the patients diagnosed with ovarian cancer that were evaluated in the Cyclotron Positron Emission Tomography Unit of the Carlos Andrade Marín Specialty Hospital of Quito-Ecuador. MATERIALS AND METHODS. Retrospective descriptive study. The total number of the population was 166 patients, and a sample of 103 patients with inclusion and exclusion criteria in the PET Cyclotron Unit of the Carlos Andrade Marín Specialty Hospital of the city of Quito, from 2013 to 2018, obtained from statistical bases PET Cyclotron Unit and in the database of the AS400 system of the Hospital. RESULTS Hospital. The median age of ovarian cancer patients was 56 years (IQR 48-64; minimum: 13 and maximum 85). At the time of the study, 58,3% were married (60; 103). 43,7% (45; 103) had a child. 47,6% (49; 103) had third level studies. 64,0% (66; 103) resided in Quito. CONCLUSION. This demographic profile highlighted the little access of this type of diagnostic technology in patients with low educational level and in geographically remote places of Quito.
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Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Ovarianas , Ovário , Mulheres , Demografia , Tomografia por Emissão de Pósitrons , Mortalidade , Cônjuges , Consentimento Livre e EsclarecidoRESUMO
Introducción. Revisión de los hallazgos clínicos y radiológicos de la atresia de la vía biliar, una anomalía del desarrollo biliar que tiene un riesgo alto de mortalidad por las complicaciones asociadas si no se la corrige oportunamente. Material y métodos. Serie de siete casos reportados en el Hospital de Especialidades Carlos Andrade Marín en el periodo enero 2016 a marzo 2017, seis mujeres y un varón, todos con cuadro clínico de ictericia prolongada, acolia, patrón de colestasis, hallazgos por imagen y biopsias sugestivas de atresia de vías biliares. Resultados. Todos los pacientes presentaron ictericia y coluria, en exámenes de laboratorio patrón colestásico en todos los pacientes, en los estudios de imagen el hallazgo predominante en sospecha de atresia de vías biliares fue la ausencia de la vesícula biliar y el signo del cordón triangular solamente en tres pacientes, en la biopsia hepática todos mostraron algún grado de fibrosis hepática. Discusión. La atresia de la vía biliar es una enfermedad compleja y grave, en nuestra serie de casos se confirma la utilidad del ultrasonido como método de diagnóstico de atresia de vías biliares ya que es un método mucho más accesible que la resonancia magnética que generalmente tiene menor disponibilidad y mayor costo. Conclusión. El ultrasonido abdominal es una herramienta extremadamente valiosa en sospecha clínica de atresia de vías biliares, debe realizarse un diagnóstico oportuno para mejorar el pronóstico de los pacientes.
Introduction. This is a review of clinical and radiological findings of biliary atresia, an anomaly of biliary tree development that carries a high risk of mortality due to complications unless they are corrected in a short time. Materials and methods. We reviewed a series of seven cases reported at Carlos Andrade Marín Specialties Hospital, from January 2016 to March 2017. Six women and one male were followed. All of them showed clinical signs such as long term jaundice, cholestasis, as well as, imaging findings and liver biopsies, suggesting biliary tract atresia. Results. All patients presented jaundice and choluria, in laboratory tests a cholestasic pattern in all of them, in the imaging studies the predominant finding in suspicion of biliary atresia was the absence of gallbladder and the triangular cord sign in only three patients, in the liver biopsy all of them showed some degree of liver fibrosis. Discussion. Bile duct atresia is a complex and serious disease. In our case serie we confirmed the utility of ultrasound as diagnosis method in biliary duct atresia, is more available than magnetic resonance which is more expensive and less available in different centers. Conclusion. Abdominal ultrasound is an extremely valuable tool in clinical suspicion of biliary atresia, a timely diagnosis must be made to improve patient´s prognosis.
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Humanos , Atresia Biliar , Diagnóstico por Imagem , Colestase , Ultrassom , IcteríciaRESUMO
Introducción El presente artículo hace una revisión sobre los hallazgos radiológicos mediante radiografía simple, así como también los hallazgos clínicos en el diagnóstico de la osteopetrosis una enfermedad poco común que afecta el desarrollo normal óseo, se trata de un caso clínico reportado en el Hospital Pediátrico Baca Ortiz de la Ciudad de Quito. Reporte de Caso: Nos apoyamos en la presentación de un caso clínico de una paciente que acude por consulta externa con cuadro de fatiga y decaimiento de 2 años de evolución, se realizan exámenes complementarios demostrando presencia de anemia así como los hallazgos característicos de osteopetrosis por imagen posteriormente detallados. Conclusiones: La osteopetrosis es una enfermedad poco común, compleja y por lo menos con cuatro subtipos que difieren en la forma de herencia o de las manifestaciones adicionales asociadas, sin embargo todas se caracterizan por presentarse clínicamente con fatiga debido a anemia crónica, puede presentar o no hepatoesplenomegalia, conjuntamente asociadas siempre a osteoesclerosis difusa con ensanchamiento óseo, fracturas patológicas.
Introduction This article reviews the radiological findings by simple radiography as well as the clinical findings in the diagnosis of osteopetrosis, a rare disease that affects normal bone development. This is a case report reported in the Hospital Pediátrico Baca Ortiz at Quito City. Case Report: We rely on the presentation of a clinical case of a patient who goes by external consultation with fatigue and decay of 2 years of evolution, complementary tests are performed demonstrating the presence of anemia as well as the characteristic findings of osteopetrosis by image later detailed. Conclusions: Osteopetrosis is an uncommon, complex disease and with at least four subtypes that differ in the form of inheritance or associated additional manifestations, however all are characterized by presenting clinically with fatigue due to chronic anemia, may present or not hepatosplenomegaly, Always associated with diffuse osteosclerosis with bone spreading, pathological fractures.
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Humanos , Feminino , Pré-Escolar , Osteopetrose , Radiologia , Anemia , Equador , FadigaRESUMO
Introducción: El presente caso nos permite revisar la utilidad de los diferentes métodos de imagen en la ascaridiasis en vía biliar a través del ultrasonido abdominal (US), la colangioresonancia (MRCP), la colangiopancreatografía retrógrada endoscópica (CPRE/ERCP) para el diagnóstico y/o tratamiento, para conocer el escenario de esta patología y definir los protocolos de diagnóstico por imagen y abordaje de la misma. La sensibilidad y especificidad de cada uno de los mismos en las diferentes series mundiales. Reporte de Caso: Nos apoyamos en la presentación de un caso clínico de una paciente proveniente del Oriente, que acude con cuadro de dolor abdominal tipo cólico en hipocondrio derecho, ictericia de 15 días de evolución, es transferida al Hospital Carlos Andrade Marín donde se realizaron estudios complementarios dentro de los cuales varios métodos de imagen, se describen los hallazgos en esta patología, así como protocolizar los métodos de imagen. Discusión: El ultrasonido es un método eficaz, accesible, no costoso, en manos expertas tiene elevada sensibilidad, al encontrar hallazgos concluyentes no se requiere el apoyo de otros métodos de imagen adicionales y en caso de ascaridiasis complicada como en nuestra paciente se debe proceder directamente a CPRE con extracción del parásito, en caso de no tener hallazgos concluyentes nos podemos apoyar de métodos como una colangioresonancia.
Introduction: This report let us review the usefulness of different imaging methods in common bile duct ascariasis like abdominal ultrasound, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis and / or treatment, to know the stage of this disease and to define the imaging protocols and addressing it. The sensitivity and specificity of each of them in different world series. Case Report: This is a clinical case of a patient from the Eastern región of Ecuador who was admitted to our hospital with a crampy abdominal pain focused in the right upper quadrant and jaundice that started 15 days before he was transferred to us. Imaging tests performed helped us to find out the problem and prescribe a propper treatment. Discusion: Ultrasound is an effective, accesible and inexpensive tool in expert hands. When the initial findings are not conclusive, other imaging methods can be applied, like Nuclear Magnetic Resonance cholangiopancreatography. Endoscopic retrograde cholangiopancreatography (ERCP) can be used in case of complicated ascariasis, as in our patient, to remove the parasite.
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Humanos , Feminino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Operatórios , Ultrassom , Ductos Biliares , Espectroscopia de Ressonância Magnética , Ascaris lumbricoides , Colangiopancreatografia por Ressonância Magnética , Adulto , Trato Gastrointestinal , Colecistite AgudaRESUMO
Traumatic brain injury is the main cause of death and disability in the young population, which presumes a large number of years of potential life lost and a great economic impact. Vital and functional outcomes after suffering a traumatic brain injury depend both on the severity of the initial biomechanical impact (primary injury) and on the presence and the severity of systemic or intracranial insults that magnify and/or produce new brain injuries, the so-called secondary injuries. Currently, no treatment in effective in improving functional recovery, except for usual medical care. Therefore, the main purpose of the care provided to a patient with severe cranial trauma is based on preventing and treating secondary brain injuries by maintaining an adequate cerebral perfusion and oxygenation. Increased intracranial pressure is associated with mortality and with unfavorable functional outcomes is patients with severe traumatic brain injury. The main clinical practice guidelines recommend using a number of staggered therapeutic measures. However, although these measures seem to be efficient in reducing intracranial pressure, this effect is not often translated into clinical improvement. This review describes the essential principles of the management of patients with severe traumatic brain injury in intensive care units.
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Humanos , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/tratamento farmacológico , Lesões Encefálicas Traumáticas/terapia , Convulsões/prevenção & controle , Hipertensão Intracraniana , Bloqueio Neuromuscular , Monitorização Neurofisiológica , Tomografia Computadorizada por Raios XRESUMO
Se utilizaron 24 corderos Katahdin x Pelibuey, distribuidos al azar en cuatro grupos desafiados con los siguientes tratamientos: a) 25 larvas infectantes (L3) de nematodos gastrointestinales (NGI) por kg de peso vivo (PV); b) 50 L3 PV, c) 100 L3 PV y el grupo testigo (0 larvas). El experimento se dividió en tres etapas: 1) infección experimental y estabulación de corderos, 2) reinfección en pastoreo y 3) estabulación. En cada etapa se determinó el número de huevos de nematodos por gramo de heces (HPG), el peso vivo (PV) y el volumen celular aglomerado (VCA). El análisis se realizó con medidas repetidas en el tiempo. Los corderos infectados con 100 L3 tuvieron mayor HPG (1.642 ± 1.183) que los infectados con 50 L3 (1.140 ± 1.313 HPG) y los de 25 L3 (458 ± 371 HPG). Con 50 L3 los corderos tuvieron el menor VCA (23,7 ± 4,8%). Con 100 L3 se observó menor VCA que el grupo testigo y el de 25 L3 (26,2 ± 3,9; 28,0 ± 4,1 y 27,3 ± 4,2 %, respectivamente). Las ganancias de peso se redujeron respecto al testigo en un 22% en los de 25 larvas, 60% en los de 50 larvas y 61% en los de 100 larvas. El grupo infectado con 100 larvas obtuvo, durante la segunda etapa, el menor HPG (2.033 ± 2.553 HPG), un incremento del VCA (27,8%) y mayor ganancia de peso (3,7 kg) que los otros grupos, por lo que se concluye que con la dosis de 100 L3 se obtienen menores conteos fecales de huevos de NGI, mayor VCA y mejor ganancia de peso bajo condiciones de reinfección en pastoreo.
24 Katahdin x Pelibuey male lambs were used. The lambs were random in four groups with the following treatments: a) 25 infective larvae (L3) of gastrointestinal nematodes (GIN) per kg of body weight (BW), b) 50 L3 BW, c) 100 L3 BW and the control group (0 L3). The experiment was divided into three stages: 1) Experimental infection in stabling, 2) grazing infection and 3) housed lambs. At each stage were determined the number of nematode eggs per gram of feces (EPG), body weight and packed cell volume (PCV). The data analysis was performed using a repeated measures model in time. The lambs infected with 100 L3 had higher EPG (1642 ± 1183) in comparison with the treatment of 50 L3 (1140 ± 1313 EPG) and 25 L3 (458 ± 371 EPG). With 50 L3 the lambs had the lowest PCV (23.7 ± 4.8%). With the application of 100 L3 also had lower PCV than control group and 25 L3 (26.2 ± 3.9, 28.0 ± 4.1 and 27.3 ± 4.2%, respectively). It was observed a decrease in weight gain of all infected groups compared to the control group, by 22% in lambs with 25 larvae, 60% in the 50 larvae and 61% in animals of 100 larvae. During the second stage, the group infected with 100 larvae there was a reduction of EPG (2033 ± 2553 EPG), an increase in PCV (27.8%) and increased kg (3.7 kg) with respect to other infected for this reason was concluding that lambs receiving 100 L3 had lowest nematode faecal egg count, highest PCV and gain daily weight during the grazing reinfection.
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Background: The outcome oí' mechanically ventilated patients can be inñuenced byfactors such as the indication of mechanical ventilation (MV) and ventilator parameters. Aim: To describe the characterístics of patients receiving MV in Chilean critical care uníts. Material and methods: Prospective cohort of consecutive adult patients admitted to 19 intensive care uníts ([CU) from 9 Chilean cities who received MV for more than 12 hours between September lst, 2003, and September 28th, 2003. Demographic data, severity of illness, reason for the initiation of MV, ventilation modes and settings as well as weaning strategies were registered at the initiation and then, daily throughout the course of MV for up to 28 days. ¡CU and hospital mortality were recorded. Resulte: Of 588 patients admitted, 156 (26.5 percent) received MV (57 percent males). Mean age and Simplified Acute Physiology Score-II (SAPSII) were 54.6±18years and 40.6±16.4 points respectively The most common indications for MV were acute respiratory failure (71.1 percent) and coma (22.4 percent). Assist-control mode (71.6 percent) and synchronized intermittent mandatory ventilation (SIMV) (14,2 percent) were the most frequently used. T-tube was the main weaning strategy. Mean duration of MV and length of stay in ICU were 7.8±8.7 and 11.1± 14 days respectively. OverallICUmortality was 33.9 percent (53patients). The main factors independently associated with increased mortality were (1) SAPS II ≥ 60 points (Odds Patio (OR), 10.5; 95 percent CI, 1.04-106.85) and (2) plateaupressure ≥ 30 cm Hfi atsecond day (OR, 3.9; 95 percent CI, 1.17-12.97). Conclusions: Conditionspresent at the onsetofMVand ventilator management were similar to those reported in the literature. Magnitude ofmultiorgan dysfunction and high plateau pressures are the most important factors associated with mortality).