Introduction. There is a high prevalence of mortality in the Pediatric Intensive Care Units (PICU) in developing countries. Association has been found between disglyce mia and mortality in the PICU; however, there is a lack of standardization of the utility of such ranges. Objectives. To analyze the association between glycemia levels in PICU admission and mortality in patients hospitalized at Instituto Nacional de Salud del Niño (INSN). Methods. Retrospective cohort in PICU patients admitted to INSN between 2012 and 2013. A Poisson regression model with robust variance was used to quantify the association. Diagnostic Test performance evaluation was used to describe sensitivit y, specificity, positive predictive value, negative predictive value and likelihood ratios for each range of glycemia. Results. 552 patients were included (Age range 5 to 79,8 months). The mean glycemia on admission was 121.3 mg/dL. Ninety two (16.6%) patients died during hospitalization. In multivariable analyses, significant associatio ns between glycemia <65 mg/dL (RR: 2.01, 95%CI 1.14-3.53), glycemia >200 mg/dL (RR: 2.91, 95%CI 1.71-4.55), malnutrition (RR: 1.53, 95%CI 1.04-2.25), mechanica l ventilation (RR: 3.71, 95%CI 1.17-11.76) and mortality at discharge were found. There was low sensitivity (between 17.39% and 39.13%) and high specificity (between 49.13% and 91.74%) for different glucose cut-off levels. Conclusions. There is an increased risk of death at discharge in patients who developed hypoglycemia and hyperglycemia on admission to the PICU. Certain glucose ranges (>200mg/dL and <65mg/dL) have a high specificity as predictors of death at discharge.

Memoria para optar al Título Profesional de Médico Veterinario. / Se evaluaron las concentraciones sanguíneas de glucosa, cortisol y la relación neutrófilo:linfocito (N:L) en equinos Fina Sangre de Carrera (FSC) sometidos a dos tipos de ejercicio en el curso del entrenamiento. Un total de 15 ejemplares fueron distribuidos según el tipo de trabajo realizado en 3 grupos de 5 animales cada uno, Grupo (Gr.) I: control, sin ejercicio desde hace 60 días por no encontrarse aún incorporados al plan de trabajo del corral, el Gr. II: galope de 1000 metros y Gr. III: trabajo competitivo, galope de 600 metros seguido en forma inmediata de 400 metros a velocidad supramaximal. De cada animal se extrajeron 2 muestras de sangre por punción yugular, una antes del ejercicio (T0) y otra a las 2 horas (T1). Se determinaron las concentraciones plasmáticas de cortisol (RIA) y glucosa (espectrofotometría por técnica enzimática), y se realizó un recuento leucocitario (contador hematológico automático). Los valores se expresaron mediante media y D.E.. Las variaciones por efecto del tiempo, grupo e interacción grupo por tiempo, se determinaron con ANDEVA con un intervalo de confianza de 95% y nivel de significancia de p≤0,05. La intensidad del ejercicio fue la suficiente para generar un aumento significativo de la glicemia en los Gr. II y III al T1; sólo el grupo III fue significativamente mayor al Gr. I al T1 . La concentración plasmática de cortisol dentro de grupo, presentó una disminución significativa para el T1 del Gr. II, respecto de su T0. En cuanto a la relación N:L, los valores entre grupos al T0 presentaron que el Gr. II fue significativamente mayor que los otros grupos; al comparar los valores dentro de grupo, mostraron una disminución significativa en el Gr. II. El grupo que presenta la mayor concentración basal de cortisol y la mayor relación N:L es el grupo II, que precisamente se encuentra en un tipo de trabajo intermedio del entrenamiento. Además, al tener un mayor descenso del cortisol plasmático y de la relación N:L en T1 respecto de T0, refleja que la intensidad del ejercicio al que fue sometido es inferior al del grupo III. Los resultados descritos permitirían concluir que la respuesta del organismo al ejercicio físico tiene directa relación con el tipo de trabajo al cual es sometido el animal y la adaptación de éste al entrenamiento. / Fifteen thoroughbred racing horses were evaluated for plasma concentrations of glucose and cortisol, and blood neutrophil:lymphocyte (N:L) ratio. According to their training work, they were separated into three groups of five animals each: control group (GI), 1000m gallop training group (GII) and competitive work group (GIII). Blood samples were obtained from jugular vein at resting (T0) and 2 hours after wards (T1). Plasma glucose and cortisol, and total leukocyte counts were expressed as mean and SD. Group and time effect variations and group-time interactions were determined by ANOVA with 95% confidence interval and p≤ 0.05 significance level. The intensity of this excercise was enough for generate a notable glycemia increase on GII and GIII on T1; only GIII was significantly greater than GI on T1. The plasma cortisol concentration inside the group presents a significant decrease for T1 of GII, in relation to their T0. About the N:L ratio, values between groups on T0 demonstrate that GII was significantly greater than other groups; if comparing values inside the group the results shown a significant decrease on GII. The group that presents greater cortisol basal concentration and N:L ratio is GII, which precisely has done an intermediate work training when comparing with GIII. In addition, having a greater decrease of plasma cortisol and N:L ratio on T1 respect T0 shows that intensity of excercise which was subjected was inferior than GIII excercise. The results described allow conclude that the answer of organism to physic excercise have an direct relation with the kind of job which is subjected the animal and their training.