Fracción de óxido nítrico exhalado: una herramienta clínica para las enfermedades pulmonares / Measurement of exhaled nitric oxide fraction in lung diseases

Exhaled Nitric Oxide fraction measurement is a new method for the evaluation of respiratory diseases. It has good correlation with airway inflammation and decreases with the administration of corticosteroids. It is useful as a complement for the diagnosis of asthma, Chronic Obstructive Pulmonary Disease, Cystic Fibrosis and Primary Ciliary Dyskinesia among other respiratory diseases that generate inflammation in the airway. Its assessment is easy, non-invasive, and safe, and the result is obtained immediately. It can be used routinely to evaluate the response and adherence to treatments. This article reviews the biology of Nitric Oxide, and the measurement, interpretation, and main clinical uses of Exhaled Nitric Oxide Fraction.

Hiperglicemia por sepsis: del mecanismo a la clínica / Sepsis hyperglycemia in the ICU: from the mechanism to the clinic

Stress hyperglycemia is frequently diagnosed in septic patients in critical care units (ICU) and it is associated with greater illness severity and higher morbimortality rates. In response to an acute injury, high levels of counterregulatory hormones such as glucocorticoids and catecholamines are released causing increased hepatic gluconeogenesis and insulin resistance. Furthermore, during sepsis, proinflammatory cytokines also participate in the pathogenesis of this phenomenon. Septic patients represent a subtype of the critical ill patients in the ICU: this metabolic disarrangement management strategies and insulin therapy recommendations had been inconsistent. In this article, we describe the pathophysiological mechanisms of stress hyperglycemia in critical patients including the action of hormones, inflammatory cytokines and tissue resistance to insulin. In addition, we analyzed the main published studies for the treatment of acute hyperglycemia in critical patients.

Para entender la acción de cortisol en inflamación aguda: una mirada desde la glándula suprarrenal hasta la célula blanco / Understanding cortisol action in acute inflammation: a view from the adrenal gland to the target cell

Glucocorticoids (cortisol in humans) are essential for numerous biological functions. Among critically ill patients, therapy with cortisol has gained strength in recent years, but clinical results have been mixed. A series of events, that may explain the diversity of clinical responses, occur from the synthesis of cortisol in the adrenal gland to the activation of the cortisol receptor by the hormone when it enters the nucleus of the target cell. Some of these events are revised; a proposition for identifying critically ill patients who may benefit with this therapy is suggested.

Factores de riesgo psicosocial y satisfacción laboral en una empresa chilena del área de la minería / Psychosocial risk factors and job satisfaction in a Chilean company mining area

El objetivo de esta investigación es identificar la relación entre Factores de Riesgo Psicosocial y Satisfacción Laboral en trabajadores de una empresa subcontratista del sector minero en Chile. Se utilizó el cuestionario SUSESO-ISTAS 21, adaptación a la población chilena y el Cuestionario de Satisfacción Laboral S20/23 (Meliá y Peiró, 1989), aplicados a una muestra de 100 trabajadores. Los resultados dan cuenta de que existe una relación significativa y negativa entre factores de riesgo y satisfacción laboral; en las dimensiones trabajo activo y posibilidades del desarrollo, apoyo social en la empresa y calidad de liderazgo, compensaciones y doble presencia, indicando que a mayor riesgo psicosocial percibido menor es la satisfacción laboral. Para la dimensión trabajo activo y posibilidades de desarrollo, se encontró que operarios/ayudantes poseen un rango de exposición alto y los demás en un rango medio, además de una relación significativa entre la dimensión exigencias psicológicas según la sección donde trabajan. Se discuten las implican del estudio para futuras investigaciones e intervenciones organizacionales.

The objective of this research is to identify wether a relationship exists between Psychosocial Risk factors and Job satisfaction in a subcontractor workers in the mining sector in Chile. Questionnaire was used SUSESO-ISTAS 21, adapted to the Chilean population and the Job Satisfaction Questionnaire S20/23 (Meliá & Peiró, 1989), applied to a sample of 100 workers. The results show that there is a significant negative correlation between risk factors and job satisfaction in active labor dimensions and possibilities of development, social support and quality in the company leadership, compensation and dual presence, indicating that greater psychosocial risk lower perceived job satisfaction. For the dimension active work and development opportunities, it was found that operators/attendants have a high exposure range and the other on a mid-range, others in a meaningful relationship between the psychological demands dimension according to the section where they work. We discuss the study's implications to future research and organizational interventions.

Diálisis con albúmina MARS (Molecular Adsorbent Recirculating System) como puente para el trasplante hepático en insuficiencia hepática fulminante: presentación de 3 casos / Albumin dialysis MARS (Molecular Adsorbent Recirculating System) in acute liver failure, before liver transplantation: report of three cases

The most successful therapy for acute liver failure is liver transplantation. However, due to the low number of donors, organ support therapies need to be used as a bridge to liver transplantation. Molecular Adsorbents Recirculating System (MARS) is a dialysis treatment that uses a recirculating dialysate containing albumin. This allows the removal of both hydrosoluble and albumin-related substances. This system improves hepatic encephalopathy, renal dysfunction and some clinical parameters in acute liver failure, but there is no clear decrease in mortality. We report three women aged 23, 21 and 61 years, that were subjected to liver transplantation, in whom this therapy was successfully used.