RESUMO
Introducción: El objetivo del estudio es describir y analizar la función tiroidea en el paciente crítico. Describir si algún patrón se asocia a una mayor tasa de mortalidad. Métodos: Se analizó a todos los pacientes ingresados en nuestra Unidad de Cuidados Intensivos, entre enero de 2015 y agosto de 2016, y que permanecieron allí, al menos, siete días. Resultados: Se incluyeron 242 pacientes. Se hallaron diferencias significativas en los valores medios de los índices de gravedad entre los no supervivientes y los supervivientes: SOFA (10,45 vs. 7,9); APACHE II (24,42 vs. 20,71); SAPS II (63,14 vs. 50,69). Se encontraron diferencias estadísticamente significativas en los valores medios de T3 en el grupo de supervivientes y no supervivientes: 1,5 pg/ml vs. 1,15 pg/ml (p <0,001; IC95% 0,224 ± 0,487). No hubo diferencias estadísticamente significativas en los valores medios de T4 y TSH. Al realizar el subanálisis según grupo de ingreso, no se hallaron diferencias estadísticamente significativas entre las cifras de TSH, T3 o T4. Sí hubo diferencias significativas en los valores medios de T3 en la mayor parte de los subgrupos. Conclusiones: Se hallaron diferencias estadísticamente significativas entre los valores medios de T3 en el grupo de supervivientes y no supervivientes. Los valores de T3 parecen asociarse a la mortalidad. Su descenso no parece asociarse a la enfermedad subyacente, sino a su gravedad.(AU)
Introduction: The aim of this study is to describe and analyse the thyroid function in the critically ill patient, and to describe if any pattern is associated with a higher mortality rate. Methods: Patients admitted to the Intensive Care Unit, between January 2015 and August 2016, with a stay of seven days or more, were enrolled. Results: Two hundred and forty-two patients were included. Significant differences were observed in the severity scores related to mortality during their stay in the Intensive Care Unit (no survivors vs. survivors): SOFA (10.45 vs. 7.9); APACHE II (24.42 vs. 20.71); SAPS II (63.14 vs. 50.69). Statistically significant differences were observed in the mean values of T3 between survivors and non-survivors: 1.5 pg/ml vs. 1.15 pg/ml (p <0.001; CI95% 0.224 ± 0.487). There were no statistically significant differences in the mean values of T4 and TSH. After subgroup analysis according to the admission group, no significant differences among the TSH, T3 and T4 values were detected. However a statistically difference in T3 average value was found in most subgroups. Conclusions: A statistically significant difference was found in mean T3 values in survivors and non-survivors. T3 concentration appears to be associated with mortality. Decrease of this thyroid hormone does not seem to associate with the underlying disease, but with its severity.(AU)
Assuntos
Humanos , Glândula Tireoide , Glândulas Endócrinas , MortalidadeRESUMO
The distribution of HLA-A, -B, -C, -DRB1 and -DQB1 alleles in the Peruvian population was studied and compared with those of other populations in order to provide further information about their anthropological origin. Our data are consistent with the Mestizo character of this population. In terms of genetic distance Peruvians are closest to Bolivians, which is in agreement with the geographical location and the cultural and anthropological background of the two human groups. Several HLA-B alleles originally described in genetically isolated Amerindian tribes are also present in the sample studied here. This fact and the reported finding of these alleles in several Amerindian groups suggests that they were present in the first wave of humans that populated South America (Paleoindians) before they split to give rise to the different South American tribes.
Assuntos
Demografia , Antígenos de Histocompatibilidade Classe II/genética , Antígenos de Histocompatibilidade Classe I/genética , Indígenas Sul-Americanos/genética , Povo Asiático/genética , População Negra/genética , Frequência do Gene/imunologia , Haplótipos/imunologia , Humanos , Peru , População Branca/genéticaRESUMO
A novel HLA-Cw*15 allele , Cw*1508, has been found in the Peruvian population. This new allele, initially detected as a polymerase chain reaction with sequence-specific primers (PCR-SSP) variant, shows greatest similarity to Cw*1502. The nucleotide sequence of Cw*1508 only differs from that of Cw*1502 at position 539; this change determines the replacement of Leu by Arg 156 in Cw*1508.