Medicina intensiva
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Mitochondrial and microcirculatory distress syndrome (MMDS) can occur during systemic inflammatory response syndrome (SIRS), and is characterized by cytopathic tissue hypoxia uncorrected by oxygen transport optimization, and associated with an acquired defect in the use of oxygen and energy production in mitochondria, leading to multiple organ dysfunction (MOD). We examine the pathogenesis of MMDS, new diagnostic methods, and recent therapeutic approaches adapted to each of the three phases in the evolution of the syndrome. ⋯ Once the latter is established, the aim is to restore flow of the electron chain, mitochondrial respiration, and to avoid cellular energy collapse. Finally, in the third (resolution) stage, treatment should focus on stimulating mitochondrial biogenesis and the repair or replacement of damaged mitochondria.
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The third edition of the Surviving Sepsis Campaign guidelines opens the door to the use of albumin for fluid resuscitation in patients with severe sepsis and septic shock. This recommendation is based on a recent meta-analysis that included studies with evidence of insufficient plasma expansion in the control group and studies performed in children with malaria with clear statistical heterogeneity (P for interaction=.02). ⋯ Two new randomized studies reported after publication of the meta-analysis found no benefit in patients treated with albumin. Given the uncertainty about the true effect of albumin (due to the existence of indirectness and imprecision) and its cost considerations, it is suggested not to use albumin in the initial resuscitation of patients with severe sepsis and septic shock (GRADE2C).
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Lung transplant recipients are at high risk of suffering many complications during the immediate postoperative period, such as primary graft dysfunction, acute graft rejection or infection. The most common symptom is the presence of acute respiratory failure, and the use of biomarkers could be useful for establishing an early diagnosis of these conditions. Different biomarkers have been studied, but none have proven to be the gold standard in the differential diagnosis of acute respiratory failure. This paper offers a review of the different biomarkers that have been studied in this field.
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Review
[Google Scholar and the h-index in biomedicine: the popularization of bibliometric assessment].
The aim of this study is to review the features, benefits and limitations of the new scientific evaluation products derived from Google Scholar, such as Google Scholar Metrics and Google Scholar Citations, as well as the h-index, which is the standard bibliometric indicator adopted by these services. The study also outlines the potential of this new database as a source for studies in Biomedicine, and compares the h-index obtained by the most relevant journals and researchers in the field of intensive care medicine, based on data extracted from the Web of Science, Scopus and Google Scholar. Results show that although the average h-index values in Google Scholar are almost 30% higher than those obtained in Web of Science, and about 15% higher than those collected by Scopus, there are no substantial changes in the rankings generated from one data source or the other. Despite some technical problems, it is concluded that Google Scholar is a valid tool for researchers in Health Sciences, both for purposes of information retrieval and for the computation of bibliometric indicators.