Innate Lymphoid Cells Have Decreased HLA-DR Expression but Retain Their Responsiveness to TLR Ligands during Sepsis.

Sepsis, one of the leading causes of death in intensive care units, is caused by a dysregulated host response to infection that leads to life-threatening organ dysfunction. The proinflammatory and anti-inflammatory responses activated by the infecting microorganism become systemic, and the sustained anti-inflammatory response induces a state of immunosuppression that is characterized by decreased expression of HLA-DR on monocytes, T cell apoptosis, and reduced production of TNF-α by monocytes and macrophages in response to TLR ligands. Innate lymphoid cells (ILCs) are lymphocytes that lack Ag-specific receptors and lineage-specific markers; they express HLA-DR and are activated by cytokines and by direct recognition of microbial molecules.

[Healthcare-associated infections: Appropriate empirical antibiotic treatment].

Background: Health-care Associated Infections (HAI) are one of the main causes of death in critically ill patients. The aim of this paper is to establish an appropriate empirical antibiotic treatment for the main HAI in an Intensive Care Unit (ICU).

Methods: A retrospective, observational, descriptive and analytical study of the culture results from January, 2014 to December, 2015.

[Predictors of extubation failure in neurosurgical patients].

Background: The information regarding the factors that affect the success of extubation in neurosurgical patients is limited; thus, it is necessary to determine the prevalence, and the associated factors, of extubation failure in neurosurgical patients.

Methods: It was performed a prospective, longitudinal, observational and comparative study in neurosurgical patients with criteria for extubation. In those who the number of endotracheal aspirations had failed 24 hours before extubation, it was analyzed the presence of cough reflex, length of stay and mechanical ventilation days.

Influenza A (H1N1pdm09)-Related Critical Illness and Mortality in Mexico and Canada, 2014.

Objectives: The 2009-2010 influenza A (H1N1pdm09) pandemic caused substantial morbidity and mortality among young patients; however, mortality estimates have been confounded by regional differences in eligibility criteria and inclusion of selected populations. In 2013-2014, H1N1pdm09 became North America's dominant seasonal influenza strain. Our objective was to compare the baseline characteristics, resources, and treatments with outcomes among critically ill patients with influenza A (H1N1pdm09) in Mexican and Canadian hospitals in 2014 using consistent eligibility criteria.

[Constrictive pericarditis: the story of a constrained heart].

Background: Symptoms of constrictive pericarditis may be nonspecific, misleading and may delay or lead to an incorrect diagnosis.

Clinical Case: We present the case of a 28-year-old male who was admitted to the hospital with progressive dyspnea, thoracic pain and a history of 25 kg of weight gain during the last 2 years. He was evaluated at another facility and his clinical presentation led to an erroneous diagnosis of primary hepatic disease (cirrhosis and portal hypertension).

[Ogilvie syndrome. Report of two cases].

Acute colonic pseudo-obstruction or "Ogilvie syndrome (OS)," is a gastrointestinal motility disorder characterized by marked dilatation of the colon in the absence of mechanical obstruction. It occurs most commonly in the postoperative state or with severe medical illness; it has been associated with a wide range of comorbidities, including trauma, pelvic surgery (orthopedic, gynecologic, urologic), metabolic disorders, central nervous system disorders, and prostaglandin abnormalities. OS may also be drug induced or idiopathic.

[Respiratory tract fluid microbiology in an intensive care unit].

Objective: to know patterns of antimicrobial resistance of bacterial isolates from tracheal aspirates in an Intensive Care Unit and to evaluate the cases of ventilator-associated pneumonia.

Methods: antibiotic sensitivity test was done. A comparison was made between patients with nosocomial pneumonia reported by infection surveillance team against those reported by the attending physician with the infectious disease consultant.

[Mean airway pressure during pressure-controlled ventilation with static vs. dynamic positive end-expiratory pressure].

Background: Positive end-expiratory pressure increases mean airway pressure (Paw) in patients with mechanical ventilation. We undertook this study to compare mean airway pressure (Paw) generated with static PEEP (sPEEP) vs. dynamic PEEP (dPEEP) at the same level of total PEEP (tPEEP) in the same patient with pressure-controlled mechanical ventilation (PC).

[Effects of different positive end expiratory pressure levels on resting energy expenditure measured by indirect calorimeter in patients with pressure-controlled ventilation].

Objective: To identify variations during measurements of resting energy expenditure (REE), oxygen consumption (VO2) and CO2 production (VCO2) by indirect calorimetry (IC) in patients with pressure-controlled ventilation and different levels of positive end expiratory pressure (PEEP).

Design: Prospective and comparative study.

Setting: Intensive care unit (ICU) of a university-affiliated hospital.

[Pulmonary mechanics, oxygenation index, and alveolar ventilation in patients with two controlled ventilatory modes. A comparative crossover study].

Objective: To compare in a crossover study pulmonary mechanics, oxigenation index (PaO(2)/FiO(2)), and partial pressure of CO(2) in arterial blood (PaCO(2)) in patients with mechanical ventilation in two controlled ventilatory modes.

Setting: Intensive care unit of a university affiliated hospital.

Design: Prospective crossover clinical trial.

[Cerebral Blood flow velocity spectrum by transcranial doppler ultrasound in patients with brain death clinical criteria].

Objective: To evaluate cerebral blood flow (CBF) direction, speed, and shape of Doppler profile in patients with clinical criteria of brain death (BD).

Patients: A total of 42 consecutive patients with clinical criteria for BD were included.

Measurements And Interventions: After anemia, hypothermia and hypocapnia were ruled out; confirmatory electroencephalogram (EEG) and a complete transcranial Doppler ultrasonography (TCDU) profile of circle of Willis and basilar arteries were done in all patients.

[Plasmapheresis in Guillain-Barre syndrome].

Objective: To evaluate the efficacy of early therapeutic plasmapheresis in severely affected patients with Guillain-Barré syndrome (GBS).

Patients And Method: Patients between 16 to 70 years of age, with GBS according to NINCDS criteria, in stage > or = 3 of Huges severity score and with less than 7 days of onset of symptoms were admitted for therapeutic plasmapheresis. All patients completed a total of five sessions of plasma exchange every other day using 25% albumin and saline in a 1:1 proportion.