Med Clin Barcelona
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Essential thrombocythemia is a chronic myeloproliferative neoplasm characterized by sustained thrombocytosis, bone marrow megakaryocytic hyperplasia and an increased risk of thrombosis and hemorrhage. The goal of treatment is to prevent the development of vascular complications without increasing the risk of transformation. ⋯ Anagrelide is the most suitable option for patients with resistance or intolerance to hydroxyurea. All patients must be submitted to a rigorous control of cardiovascular risk factors.
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The relationship between lactate and mortality in patients without hypotension has not been appropriately explored. Our aim was to determine the usefulness of serum lactate as a prognostic factor of 28-day mortality in patients admitted to the Emergency Department with clinical diagnosis of sepsis without septic shock. ⋯ Serum lactate is independently and significantly associated with 28-day mortality among patients with infection who present to the Emergency Department without hypotension. Besides, mortality increases in a linear way with serum lactate from any detectable value.
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Comparative Study Observational Study
[Inflammation and oxidative stress in respiratory and limb muscles of patients with severe sepsis].
Oxidative stress and inflammation contribute to the diaphragm contractile dysfunction observed in animal models of sepsis and endotoxemia. In septic patients, molecular events have never been explored in their respiratory muscles. Levels of oxidative stress and inflammation were evaluated in a respiratory muscle, the external intercostal, and a limb muscle, the vastus lateralis, of patients with sepsis. ⋯ Differences in activity between the respiratory and limb muscles may account for the differential pattern of oxidative stress and inflammation observed among patients with severe sepsis. These findings may have relevant implications for the clinical and therapeutic management of these patients.