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Copyright of Acta Neurológica Colombiana is the property of Colombian Association of Neurology / Asociacion Colombiana de Neurologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Objectives: The COVID-19 pandemic brought with it a large number of adverse consequences for public health with serious socioeconomic repercussions. In this study we characterize the social, demographic, morbidity and mortality conditions of individuals treated for COVID-19 in one of the SARS-CoV-2 reference hospitals in Mexico City. Method: A descriptive cross-sectional study was carried out in 259 patients discharged from the Instituto Nacional de Cardiología Ignacio Chávez, between April 11, 2020 and March 14, 2021. A multivariate logistic regression model was used to identify the association between sociodemographic and clinical variables. An optimization was performed using maximum likelihood calculations to choose the best model compatible with the data. The maximum likelihood model was evaluated using ROC curves, goodness-of-fit estimators, and multicollinearity analysis. Statistically significant patterns of comorbidities were inferred by evaluating a hypergeometric test over the frequencies of co-occurrence of pairs of conditions. A network analysis was implemented to determine connectivity patterns based on degree centrality, between comorbidities and outcome variables. Results: The main social disadvantages of the studied population are related to the lack of social security (96.5%) and the lag in housing conditions (81%). Variables associated with the probability of survival were being younger (p < 0.0001), having more durable material goods (p = 0.0034) and avoiding: pneumonia (p = 0.0072), septic shock (p < 0.0001) and acute respiratory failure (p < 0.0001); (AUROC: 91.5%). The comorbidity network for survival cases has a high degree of connectivity between conditions such as cardiac arrhythmias and essential arterial hypertension (degree centrality = 90 and 78, respectively). Conclusions: Given that among the factors associated with survival to COVID-19 there are clinical, sociodemographic and social determinants of health variables, in addition to age; it is imperative to consider the various factors that may affect or modify the health status of a population, especially when addressing emerging epidemic phenomena such as the current COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Cardiología is the property of Sociedad Argentina de Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Terapia Intensiva is the property of Sociedad Argentina de Terapia Intensiva (SATI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería Nefrológica is the property of Sociedad Espanola de Enfermeria Nefrologica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Argentinian Journal of Respiratory & Physical Therapy (AJRPT) is the property of Asociacion Civil Cientifica de Difusion y Promocion de la Kinesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Pediatría de Atención Primaria is the property of LUA Ediciones 3.0 S.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gaceta Médica de Caracas is the property of Academia Nacional de Medicina and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Ciencias Médicas de Pinar del Río is the property of Editorial Ciencias Medicas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Salud UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Enfermería en Cardiologia is the property of Asociacion Espanola de Enfermeria en Cardiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Dilemas Contemporáneos: Educación, Política y Valores is the property of Dilemas Contemporaneos: Educacion, Politica y Valores and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of INSPILIP. Revista Ecuatoriana de Ciencia, Tecnología e Innovacion en Salud Pública is the property of Instituto Nacional de Investigacion en Salud Publica (INSPI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The lack of a clear definition of cytokine release syndrome (CRS) allowed this study to analyze the utility of interleukin-6 (IL-6), ferritin, and D-dimer (DD) with other variables and their clinical evolution. Methods: A prospective, observational, and analytical study was conducted from October 2020 to July 2021 in 125 patients in the intensive care unit (ICU) of Hospital Obrero Nro. 2 of the Caja Nacional de Salud in Cochabamba, Bolivia. The three markers and other exams were requested to determine correlations, survival, and relationship with CRS. Results: The mean ferritin was 1193.7±814.8 ng/ml, D-dimer 1427±1005 ng/ml, and IL-6 58.5±34.1 pg/mL. No statistical association was found between these markers, but a Spearman's Rho of 0.5 between ferritin and DD (p<0.05) was found in patients who died. In addition, there were associations between male gender and ferritin, DD and dyspnea, and IL-6 and tracheostomy. Survival was 9 days 95% CI (8.02-9.98) with similar values of DD and ferritin for both normal and elevated levels. The values of the area under the curve (AUC) did not show prediction of mortality, but a rate of 70%. Survival was better in those who did not suffer from acute respiratory distress syndrome (ARDS), with eight days (p=0.011). Conclusions: It is not possible to relate CRS to IL-6, DD, and ferritin, or to define it with fever, leukocytosis, renal failure, tracheostomy, due to the heterogeneous values of IL-6 in relation to COVID-19 and other inflammatory pathologies. The position of a hypoinflammatory disease rather than a hypercytokinemia remains in doubt. [ABSTRACT FROM AUTHOR]

Copyright of Revista Cuarzo (REC) is the property of Fundacion Universitaria Juan N. Corpas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Entramado is the property of Universidad Libre Seccional Cali and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Terapia Intensiva is the property of Sociedad Argentina de Terapia Intensiva (SATI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Argentina de Terapia Intensiva is the property of Sociedad Argentina de Terapia Intensiva (SATI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

On March 11, 2020, covid 19 was considered a pandemic by the WHO, that same day the first case in Cuba is confirmed from an Italian tourist. In the province of Las Tunas during the month of August there is a deliberate increase in the number of cases straining the health system, we refer to the medical treatment of a 32-year-old male patient with a history of insulin-dependent diabetes mellitus, extreme obesity, arterial hypertension and adverse reaction to thiomersal which prevented him from using anticovid vaccines, which developed the severe form of the disease (acute respiratory distress syndrome moderated by viral bronchopneumonia associated with covid), diabetic ketoacidosis) he had clinical and laboratory signs of poor prognosis, after therapy with innovative drugs specifically anti-inflammatory (jusvinza) developed in Cuba for the treatment of other conditions but with good results in severely ill patients with covid 19, presented favorable evolution and medical discharge with mild sequelae of the disease. [ABSTRACT FROM AUTHOR]

Objectives: To describe clinical, epidemiological, mechanical ventilation (MV) parameters and to determine overall mortality and that related to MV parameters in patients with acute respiratory distress syndrome (ARDS) in an ICU in Lima, Peru. Methods: A retrospective cohort including 133 patients with ARDS due to Covid-19 requiring MV in the Hospital Cayetano Heredia's ICU was built from March to November 2020. Results: Males accounted for 75% of the cohort; 68% had no comorbidities; 97% has severe ARDS and 82% received extended 72h prone MV. Overall mortality was 38%; bivariate analysis found that alive patients had lower plateau pressure 27±1 cm H20 vs. 30±1 cm H20 (p=0.007), lower driving pressure 15±4 vs. 17±5 (p=0.008), higher static lung compliance 32±1 vs. 28±1 ml/cm H20 (p=0.01) and higher Pa02/Fi02 ratio 194±86 mm Hg vs. 157±66 mm Hg (p=0.01) than patients who died. Patients on extended prone MV had better survival (p=0.03). Conclusions: 97% of patients in the cohort had severe ARDS; overall mortality was 38%, alive patients had lower plateau pressure and less driving pressure and extended prone MV improved survival. [ABSTRACT FROM AUTHOR]

The maternal nutritional status determines the health and nutritional conditions of the newborn, as well as complications during pregnancy and childbirth. The study was carried out in 894 women who had their delivery in the Hospitals of the city of Loja Ecuador during the period January - June 2019. The anthropometry of the mother and her child was determined, as well as data on complications during pregnancy and delivery, from their clinical history. In addition, the correlation was made between the pre-gestational nutritional status of the mother with the newborn, in the same way with the health status of the mother. The objective of this work was to determine the pre-gestational nutritional status and its relationship with the health and nutritional condition of the child. The pre-gestational BMI reported 47.3 % overweight and obesity and 2.6 % underweight. In a percentage higher than 10 %, mothers with overweight and obesity had large children for gestational age, in the same way, mothers with low weight had 26.1 % small newborns. The main complications of the mothers related to overweight and obesity were: gestational diabetes, postpartum hemorrhage and pre-eclampsia during pregnancy. It is important to note the high frequency of urinary tract infections 53.9% (478); and vaginitis 22.3% (199; although these are not directly related to metabolic processes such as etiology, more if they are favored by them. During delivery, the most frequent complication was dystocic delivery with 8.9 % (77), in addition to the total deliveries 42.5 % (374) that ended in cesarean section, of which 51.6 % (193) correspond to overweight and obesity. The complications of the newborn were: Acute respiratory distress syndrome, neonatal asphyxia and hypoglycemia. In conclusion, the pre-gestational nutritional status of the mother is directly related to the health and nutritional status of the newborn. [ABSTRACT FROM AUTHOR]

Copyright of INSPILIP. Revista Ecuatoriana de Ciencia, Tecnología e Innovacion en Salud Pública is the property of Instituto Nacional de Investigacion en Salud Publica (INSPI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of INSPILIP. Revista Ecuatoriana de Ciencia, Tecnología e Innovacion en Salud Pública is the property of Instituto Nacional de Investigacion en Salud Publica (INSPI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Médicas UIS is the property of Universidad Industrial de Santander and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute lung injury (ALI) is a frequent entity in intensive care units, with a high incidence and mortality, and constitutes the center of the pathophysiology of acute respiratory distress syndrome. This involves an acute and inflammatory lung damage, which causes an increase in pulmonary vascular permeability, with increased lung weight and loss of aerated lung tissue, accompanied by hypoxemia, decreased lung elasticity, and increased physiologic dead space. Nevertheless, the pathogeny underlying this phenomenon has not been clarified in detail. The events occurring in ALI may be divided in those that occur locally--such as the increase in lung capillary permeability, surfactant dysfunction, alveolar edema, and alveolar mechanic disorders--and generalized and systemic phenomena affecting the lungs, among which inflammation is notorious. In ensemble, these elements act additively and in synergy, finalizing in a significant decrease of residual functional capacity, as well as a heterogeneous or patchy collapse of airspaces. Revision and feedback from the molecular basics of pathophysiology is necessary to closely examine this condition, with the objective of proposing novel and promising modalities and strategies for treatment. This is fertile terrain for future research, with ample space for innovation based on potential discoveries. This article offers a molecular vision of the pathogeny of ALI. [ABSTRACT FROM AUTHOR]

Transfusion-Related Acute Lung Injury (TRALI) is a relatively unusual, life threatening clinical syndrome, characterized by acute respiratory failure, hypotension, and non-cardiogenic pulmonary edema during or within 6 hours after a blood product transfusion. Although its true incidence is unknown, it has been attributed one case per 5.000 transfusions of any blood product and has been one of the most frequent causes of transfusion-related death. We present a case of TRALI in the perioperative period of cardiac surgery with extreme clinical manifestations, whose therapeutic approach was extremely difficult for the medical surgical team, due to its complex clinical setting: cardiac surgery with cardiopulmonary bypass due to diagnosis of infective endocarditis, previous lung injury and history of other post-transfusion reaction. [ABSTRACT FROM AUTHOR]

Copyright of Ciencia, Tecnología y Salud is the property of Ciencia, Tecnologia y Salud and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Currently, multiple clinical and paraclinical variables have been found to predict prognosis in patients with VOC-19. The clinical presentation may be mild, moderate, or even present as acute respiratory distress syndrome (ARDS) and multisystem organ failure (MSF) with fatal outcome. The identification of prognostic factors, both clinical and paraclinical, will allow the grading of patients' risk and the active control of the severity of the disease. The main objective was to determine the clinical and paraclinical variables predicting prognosis in patients with FOM- 19. A systematic review will be conducted. The search will be performed in the following databases: PubMed, Taylor and Francis, LILACS, Springer, Scopus, Web of Science and CINAHL. The search will use keywords based on DeCs and MeSH categorization, using the Boolean AND and OR connections. The variables (clinical history) for this study will be as follows: Age, signs and symptoms, history, mortality, laboratory tests, habits and treatments. The aim is to provide scientific evidence and create national statistics to facilitate the use of prognostic variables in the evolution of the disease; in this way, we will be able to get a close look at this new disease we are facing, according to our population reality. [ABSTRACT FROM AUTHOR]

Copyright of Araucaria is the property of Araucaria-Revista Iberoamericana de Filosofia, Politica y Humanidades and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Mechanical ventilation is a therapeutic measure frequently used in intensive care which, although highly useful, can cause important damage to lung tissue. Ventilation-induced lung injury (VILI) is also frequent, and has been associated with a significant increase in mortality in patients with acute respiratory distress syndrome. Nevertheless, this has notoriously decreased in recent decades, which has been especially ascribed to reductions in the tidal volume selected for patients on ventilation, in independent association with increased survival. These advances have arisen greatly due to advances on the knowledge of these entities' pathogeny. Classically, the pathophysiology of VILI has been systematized into four main elements: volutrauma, barotrauma, atelectrauma, and biotrauma. Novel observations have led to the inclusion of new factors, such as regional heterogeneity in mechanical dysfunction within the lung, alteration in local vascular flow and permeability, and the amplifying effect on these processes mediated by the inflammatory response. This article explores the pathophysiology of VILI with emphasis on the possible clinical correlates. [ABSTRACT FROM AUTHOR]

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ciberrevista Enfermeriadeurgencias.com is the property of Sociedad Espanola de Enfermeria de Urgencias y Emergencias and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Extracorporeal membrane oxygenation (ECMO) is an important procedure because it provides assistance to patients suffering from some type of cardiac and/or respiratory condition that prevents them from proper blood circulation. There are mainly two types of ECMO, veno-venous and venoarterial, the first being used in patients with purely respiratory problems. With regard to its evolution, numerous advances have shown an increase in its efficiency in relation to the riskbenefit of the affected, as well as its application in people with acute respiratory diseases such as Acute Respiratory Distress Syndrome (ARDS), which cannot be solved through regular techniques. Basically it is a procedure that is carried out to prevent the cardiopulmonary system from failing, after complications that can make this condition intractable through traditional methods. In relation to ECMO therapy, ARDS is one of the situations that has most led to studies due to its complications that endanger the life of the individual, several analyzes show that this technique is indeed effective as evidenced by the CESAR test, improving the survival of the patient and in general refining the mortality rates. The results of this method have been encouraging, implying a great improvement against mechanical ventilation, however, not everything is positive because it also has difficulties linked to bleeding and nosocomial infection. In general, it is concluded that this technique seeks and in a significant proportion of cases it manages to optimize the condition of life of the person. [ABSTRACT FROM AUTHOR]

Carrion's disease is an endemic disease in Peru caused by Bartonella bacilliformis presenting with an acute or hemolytic form and a chronic verrucous form with asymptomatic bacteremia. The acute form is usually serious and is associated with high morbidity and mortality. We report the case of a case of a young pregnant woman from Yungay, Ancash who presented with the acute form complicated with multi organ failure and acute respiratory distress syndrome needing mechanical ventilation and dying. [ABSTRACT FROM AUTHOR]

Copyright of Galicia Clínica is the property of Sociedad Gallega de Medicina Interna and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acute fibrinous organized pneumonia is a rare lung disease of non-infectious origin characterized by the presence of fibrinous plugs at the alveoli. There are a few cases reported in the literature. It occurs in almost all age groups and it is in association with other systemic diseases. There are two forms of presentation: a severe form that leads to acute respiratory failure and a subacute form that has a better prognosis. We present the case of an 80-year-old woman in whom the diagnosis of acute fibrinous organized pneumonia was confirmed. This disease is subdiagnosed, therefore there is insufficient information about it. [ABSTRACT FROM AUTHOR]

Acute lung injury/acute respiratory distress syndrome (ALI/ARDS) is currently considered a serious health problem. However, until now no effective therapeutic strategies are available for the treatment of this pathology. D-005, lipid extract obtained from the fruit of Acrocomia crispa, endemic palm of Cuba, protected from lipopolysaccharide-induced ALI in mice, associated, at least in part, with its antioxidant and anti-inflammatory effects in lung tissue. The aim of this work is to evaluate the effects of D-005 on ALI induced by oleic acid (OA) in mice. The animals were randomly distributed in seven groups: a negative control without damage and six groups to which ALI was induced by injection of OA: a positive control treated with vehicle, four with D-005 (5, 25, 100 and 200 mg/kg) and one with dexamethasone (20 mg/kg). All treatments were administered as single and repeated doses. The administration of single and repeated oral doses of D-005 significantly reduced the histological score of lung damage with respect to the positive control group (with ALI). In addition, it markedly and significantly reduced the enzymatic activity of myeloperoxidase as well as the concentrations of malondialdehyde and sulfhydryl groups while restoring the activity of the catalase and superoxide dismutase enzymes in lung tissue. In conclusion, treatment with single and repeated oral doses of D-005 (5, 25, 100 and 200 mg/kg) prevented histopathological changes in damaged lung tissue evidenced by quantitative and qualitative changes, which was associated with an antiinflammatory and antioxidant effect that could explain, at least in part, its protective effect on ALI induced by OA. [ABSTRACT FROM AUTHOR]

Background: Intensive care unit (ICU) survivors from severe COVID-19 acute respiratory distress syndrome (CARDS) with chronic critical illness (CCI) may be considered vast resource consumers with a poor prognosis. We hypothesized that a holistic approach combining an early intensive rehabilitation with a protocol of difficult weaning would improve patient outcomes. Methods: A single-center retrospective study in a five-bed post-ICU weaning and intensive rehabilitation center with a dedicated fitness room specifically equipped to safely deliver physical activity sessions in frail patients with CCI. Results: Among 502 CARDS patients admitted to the ICU from March 2020 to March 2022, 50 consecutive tracheostomized patients were included in the program. After a median of 39 ICU days, 25 days of rehabilitation were needed to restore patients' autonomy (ADL, from 0 to 6; p < 0.001), to significantly improve their aerobic capacity (6-min walking test distance, from 0 to 253 m; p < 0.001) and to reduce patients' vulnerability (frailty score, from 7 to 3; p < 0.001) and hospital anxiety and depression scale (HADS, from 18 to 10; p < 0.001). Forty-eight decannulated patients (96%) were discharged home. Conclusion: A protocolized weaning strategy combined with early intensive rehabilitation in a dedicated specialized center boosted the physical and mental recovery. [ABSTRACT FROM AUTHOR]

Objectives: To identify the effectiveness of the Prone Position (PP) in the care of Pregnant Women diagnosed with Covid-19 with Acute Respiratory Distress Syndrome (ARDS). The specific objectives were: to study the suitability of PP in this group of pregnant women, to define the effects and complications of PP in the mother and fetus, as well as identifying the most appropriate prone positioning technique. Methods: A bibliographic search was carried out between the months of July 2021-January 2022, in the databases: Embase, UpToDate, Scopus, Pubmed and WoS. In addition, from a manual search in Medicina Crítica and Intensive Care Medicine journals, the HUVR Protocols archives, and the Argentine Ministry of Health archives, including papers published between 2017-2022. Results: 15 studies were selected. All the documents and cases reviewed recommend/apply pronation in pregnant women in the case of severe ARDS. 75% of the cases affirmed an improvement in maternal gas exchange after pronation, while in 100% of the cases it was possible to prevent prematurity after the technique. As main complications: exit of the endotracheal tube, routes and/or drains, and facial edema. Conclusions: Currently, we cannot collect a concise recommendation on whether the prone position in Covid-19 pregnant women with acute respiratory distress syndrome is a care alternative, in any case, other therapeutic measures should be taken in pronation. However, the prone position algorithm for pregnant women published in the Journal of the American College of Obstetricians is perhaps the most useful document for making decisions on the subject. The individual study of each case and the experience of the multidisciplinary team are key in the decision. [ABSTRACT FROM AUTHOR]

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Background: Mechanical ventilation (MV) is the basis of supportive treatment of acute respiratory failure. However, the perpetuation of ventilatory support beyond what is necessary can mean a greater chance of nosocomial infection, respiratory muscle atrophy and increased hospital stay and costs. Thus, the fan-off maneuver, conducted by testing spontaneous ventilation (TSV) must be designed appropriately and early in the evolution of a patient connected to VM. However, the failure of extubation also has a significant morbidity and mortality, and there are currently no suitable parameters to predict its success or failure. The CROP index in prospective cohort study found that a score of 13 mL/breath/min predicted successful weaning with positive and negative predictive values of 71% and 70%, respectively, in a population with a success rate of weaning of about 60%, which dates from 1991, without since then having any more studies, or reports of this index in the Mexican population taken. Objective: To assess the effectiveness of the CROP index as a prognostic indicator for removal of mechanical ventilatory support. Material and method: An observational, comparative, longitudinal and prolective cohort. A sample was determined of patients (men and women) under mechanical ventilatory support, in protocol withdrawal of ventilation. Initial measurements were taken to calculate CROP index, index Tobin and MIP, with a subsequent measurement at 48 hours to determine the success or failure of the extubation process. Univariate statistics were used to determine the association of the CROP index greater than 13 and the successful extubation as dichotomous qualitative variables using the χ² test. This association was also evaluated by the value of the relative risk (Hazard ratio, RR). Results: Sixty-five patients were included in the recall protocol of invasive mechanical ventilation, of whom 55.3% were women. Association with the CROP index > 13 and successful extubation was determined by finding a χ²=23.4, with a p value <0.001. This association was also evaluated by the value of the finding that the relative risk CROP index > 13 has an RR = 3.01 for successful extubation, with a confidence interval of 95% from 1.59 to 5.67. Conclusions: The CROP index above 13 (as recommended by the weaning protocol) was statistically significantly associated with successful extubation, proving to be superior even to other predictors of successful extubation. [ABSTRACT FROM AUTHOR]