Patients with autoimmune diseases (ADs) are a challenge for the intensivist; it is hard to differentiate among infection, disease activity, and combinations of both, leading to high mortality. This study is a retrospective analysis of 124 critically ill patients admitted to the intensive care unit (ICU) in a university hospital between 2008 and 2016. Bivariate case–control analysis was performed, using patients who died as cases; later, analysis using a logistic regression model with variables that were associated with mortality was conducted. Four variables were consistently associated with mortality in the logistic regression model and had adequate prediction value (Hosmer and Lemeshow statistic = 0.760; Nagelkerke R-squared = 0.494). The risk of death was found to be statistically associated with the following: shock at admission to ICU [odds ratio (OR): 7.56; 95% confidence interval (CI): 1.78–31.97, p = 0.006], hemoglobin level <8 g/dL (OR: 16.12; 95% CI: 3.35–77.52, p = 0.001), use of cytostatic agents prior to admission to the ICU (OR: 8.71; 95% CI: 1.23–61.5, p = 0.03), and low levels ofcomplement C3 (OR: 5.23; 95% CI: 1.28–21.35, p = 0.02). These variables can guide clinicians in the early identification of patients with AD with increased risk of death during hospitalization, leading to initial therapies seeking to improve survival. These results should be evaluated prospectively in future studies to establish their predictive power.
Background and aims Introduction: systemic lupus erythematosus (SLE) is one of most prevalent autoimmune diseases in critical care in the last years and is associated with many complications, the infections are an important cause of mortality which makes necessary a rapid and precise diagnostic approach. Methods A retrospective study was conducted, 56 patients with SLE were admitted to the intensive care unit (ICU) at a University Hospital in Bogotá, Colombia, between 2008 and 2016. The average age was 40.7 years old (SD ±17.7 y/o), female sex was predominant (71% vs 29%). Correlation between procalcitonin and eosinopenia in patients with positive cultures in bivariate analysis was performed to identify if there was a possible association to include those variables in a logistic regression model to establish an association with positive cultures. Results two variables consistently associated with positive cultures in the logistic regression model, which had adequate prediction parameters: procalcitonin !2.0 ng/ml (OR: 6.076; 95% CI 1.75 to 20.79, p=0.004), absolute count of eosinophil <30 cells/mm 3 (OR: 3.45; 95% CI 1.01 to 11.7, p=0.047). Conclusion These variables could guide clinicians in early identification of patients with SLE and infectious diseases as a cause of critical illness, leading to early antibiotic therapy to Abstract 200 Table 3 A review of the treatments in reported cases.
Las representaciones que tradicionalmente tenemos de la Amazonia omiten o minimizan los fenómenos urbanos que han sido parte fundamental de su configuración territorial, dejándonos la imagen de “espacios vacíos”, “incógnitos” o “salvajes”, que encierran selvas exuberantes, ampliamente diversas en fauna y flora, pero que no tienen dueños o habitantes civilizados y, por lo tanto, sus riquezas pueden ser aprovechadas por quienes describen el territorio. Sin embargo, esos mismos espacios se encuentran internamente demarcados por poblaciones que por lo menos en la representación cartográfica ponen en cuestión el discurso del vacío, lo cual evidencia que la construcción de dichos vacíos se encuentra enmarcada en disputas por el control territorial en las cuales borrar o no representar formas humanas de habitación, así como establecer enclaves urbanos, bien sea en la práctica o solo en la representación, resulta funcional para el ejercicio de apropiación territorial. En este sentido, como parte del inicio exploratorio de esta investigación, reflexionaré sobre el papel de la ciudad en la producción espacial amazónica y las formas como lo urbano ha sido representado en el marco de las disputas asociadas a la consolidación de los espacios territoriales Estado-nacionales en la Amazonia, enfatizando particularmente en los ejercicios simbólicos de representar a Colombia en la Amazonia. Para ello, trabajaremos a partir del análisis y la deconstrucción del mapa, siguiendo la propuesta metodológica de Bryan Harley (2005), e intentaremos comprender los sentidos y razones de la representación iconográfica de lo urbano en algunos mapas que incluyen la región amazónica a finales del siglo XIX.
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