Retos de hoy en Medicina Intensiva: diversidad, equidad e inclusión. Posicionamiento de género de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) / Challenges in intensive medicine: Diversity, equity and inclusion. Gender statement of the Spanish Society of Intensive and Critical Medicine and Coronary Units (SEMICYUC)

El género es un determinante social que impacta en el ámbito de la salud y genera desigualdades a todos los niveles; repercute en los pacientes y en la patología crítica, en los profesionales y en el desarrollo de la carrera profesional y las sociedades científicas, desde una perspectiva de justicia social. Todas las sociedades científicas internacionales de medicina intensiva comprometidas en aportar una perspectiva de género coinciden en la necesidad de un compromiso formal por parte de las instituciones. La Sociedad de Medicina Intensiva y Unidades Coronarias (SEMICYUC) se compromete a velar por la equidad, la inclusión y la representatividad de sus profesionales y combatir la brecha de género en el ámbito de la medicina intensiva (AU)

Gender is a social determinant that impacts on health and generates inequities at all levels; it has an impact on patients and critical pathology, professionals and professional career development, and scientific societies, from a social justice perspective. All the international scientific societies of Intensive Care Medicine committed to contributing a gender perspective agree on the need for a formal positioning by the institutions. The Society of Intensive Medicine and Coronary Units (SEMICYUC) is committed to ensuring the equity, inclusion and representativeness of its professionals and combating the gender gap in the field of Intensive Medicine (AU)

Challenges in intensive medicine: Diversity, equity and inclusion. Gender statement of the Spanish Society of Intensive and Critical Medicine and Coronary Units (SEMICYUC).

Gender is a social determinant that impacts health and generates inequalities at all levels. It has impacts patients and critical conditions, health professionals and professional career development, and scientific societies from a perspective of social justice. All the International scientific societies of Intensive Care Medicine committed to contributing a gender perspective agree on the institutional need for achieving a formal positioning standpoint. The Spanish Society of Intensive and Critical Medicine and Coronary Units (SEMICYUC) is committed to ensuring the equality, inclusion and representativeness of its health professionals to fight the existing gender gap in the field of Intensive Medicine.

Plasmapheresis in the Treatment of Refractory Myoclonic Status. A Case Report.

A case of myoclonic status treated with plasmapheresis in a patient of 63 years of age who was admitted to a Spanish intensive care unit is reported. The patient showed clinical and radiological evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; molecular tests did not verify this.

Generalized myoclonus in COVID-19.

OBJECTIVE: To report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus. METHODS: Patient data were obtained from medical records from the University Hospital "12 de Octubre," Madrid, Spain. RESULTS: Three patients (2 men and 1 woman, aged 63-88 years) presented with mild hypersomnia and generalized myoclonus following the onset of the so-called inflammatory phase of coronavirus disease 2019 (COVID-19). All of them had presented previously with anosmia. Myoclonus was generalized with both positive and negative jerks, predominantly involving the facial, trapezius, sternocleidomastoid, and upper extremities muscles. These myoclonic jerks occurred spontaneously and were extremely sensitive to multisensory stimuli (auditive and tactile) or voluntary movements, with an exaggerated startle response. Other causes of myoclonus were ruled out, and none of the patients had undergone respiratory arrest or significant prolonged hypoxia. All of them improved, at least partially, with immunotherapy. CONCLUSIONS: Our 3 cases highlight the occurrence of myoclonus during the COVID-19 pandemic as a post- or para-infectious immune-mediated disorder. However, we cannot rule out that SARS-CoV-2 may spread transneuronally to first- and second-order structures connected with the olfactory bulb. Further investigation is required to clarify the full clinical spectrum of neurologic symptoms and optimal treatment.

Development of an automated liver perfusion system: The benefit of a hemofilter.

INTRODUCTION:: Liver perfusion machines are close to becoming a reality in the transplantation field. However, depending on the techniques used and the goals pursued, their application is limited in the research field. Here, we present the entire development of a perfusion system with self-made engineering, completely autonomous controls, and a high degree of versatility that allows the design of different studies on liver functionality. METHODS:: A user-friendly interface permits real-time monitoring and remote control by the devices within the circuit. Centrifugal pumps allow the perfusate enter the organ with controlled pressures and flows at both hepatic artery and portal vein. The implementation of a hemofilter as a novel tool permits to control and maintain homeostasis. Peristaltic pumps adjust pH, extraction rate, and total volume by means of sensors. RESULTS:: Real-time monitoring facilitates liver functionality assessment. The controlled system shows rapid stabilization and quick responses to changes during 6 h of perfusion experiments. Furthermore, the integration of a hemofilter helps the system to eliminate toxic waste and maintain homeostasis. DISCUSSION:: The machine provides the basis of a perfusion system with autonomous controls and the implementation of a hemofilter that enables a more efficient control of hemostasis. Moreover, the developed hardware and software are subjected to further tuning for additional purposes such as pathophysiologic studies, suboptimal grafts recovery, or recellularization of decellularized scaffolds among others.