Post-COVID cholangiopathy: A narrative review.

Since the spread of the first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection much progress has been made in understanding the disease process. However, we are still facing the complications of coronavirus disease 19 (COVID-19). Multiple sequelae may appear as a consequence of acute infection. This set of entities called post-COVID-19 syndrome involves a wide variety of new, recurrent or persistent symptoms grouped together as a consequence of the acute disease process. One of those that has attracted the most attention is the liver and bile duct involvement called post-COVID-19 cholangiopathy. This is characterized by elevation of liver markers such as alkaline phosphatase, bilirubin and transaminases as well as alterations in the bile ducts in imaging studies. Thus, a narrative review of the cases reported until the end of 2021 was carried out. From the findings found, we concluded that patients who have had COVID-19 or during the process have required hospitalization should remain under follow-up for at least 6 months by a multidisciplinary team.

Social Vulnerability and Macroeconomic Forecast: A Review from the Current Context.

In the current context, various factors add to the existing social and economic crisis, such as the COVID-19 pandemic and the Russian invasion of Ukraine, which, when articulated with common conflicting facts, increase projections regarding the slowdown in the economy, with an impact on inflation and declines in global economic growth. As part of the adverse effects of these variables, if the increase in the cost of basic products and services was anticipated, the supply chain escaped, food safety, the widening of social gaps, poverty, contributing to the massification of restrictive medicines, increasing vulnerabilities in social and political scenarios, in addition to less dynamism in the global economy, in the availability of food resources, increases in energy prices, inflationary pressure, among others. Previously, this investigative note explores the macroeconomic forecast, taking as reference the informants of the year 2022 brought by the World Bank, the International Monetary Fund, the Economic Committee for Latin America and the Caribbean and the Inter-American Development Bank. (English) [ FROM AUTHOR] En el contexto actual, diversos factores se suman a la crisis social y económica a existente, como la pandemia COVID-19 y la invasión rusa a Ucrania que, al articularse con los hechos conflictivos comunes, aumentan las proyecciones con respecto a la desaceleración de la economía, con incidencia en la inflación y mermas en el crecimiento económico global. Como parte de los efectos adversos de estas va1riables, se prevé el aumento en el costo de los productos y servicios básicos, escasez en la cadena de suministros, inseguridad alimentaria, ampliación de las brechas sociales, de la pobreza, contribuyendo a la toma de medidas restrictivas, aumentando las vulnerabilidades en los escenarios sociales y en materia política, además de un menor dinamismo en la economía global, en la disponibilidad de recursos alimentarios, aumentos de los precios de la energía, presión inflacionaria, entre otros. En virtud de lo anterior, la presente nota de investigación explora la prognosis macroeconómica, tomando como referentes los informes del año 2022 aportados por el Banco Mundial, el Fondo Monetario Internacional, la Comisión Económica para América Latina y el Caribe y el Banco Interamericano de Desarrollo. (Spanish) [ FROM AUTHOR] Copyright of Revista de Filosofía is the property of Revista de Filosofia-Universidad del Zulia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COLANGIPATÍA POST COVID: REVISIÓN NARRATIVA POST COVID CHOLANGIOPATHY: A NARRATIVE REVIEW

Desde la propagación de los primeros casos del síndrome respiratorio agudo severo por coronavirus 2 (SARS-CoV-2) se ha avanzado mucho en la comprensión del proceso de enfermedad. Sin embargo, todavía nos enfrentamos a las complicaciones del coronavirus 19 (COVID-19). Se han reportado múltiples secuelas como consecuencia de la infección aguda. Este conjunto, denominado síndrome post-COVID-19 involucra una amplia variedad de síntomas nuevos, recurrentes o persistentes agrupados como consecuencia del proceso agudo de la enfermedad. Una de las que más ha llamado la atención es la afectación hepática y de vías biliares denominada colangiopatía post-COVID-19. Esta, se caracteriza por elevación de marcadores hepáticos tales como fosfatasa alcalina, bilirrubina y transaminasas, así como alteraciones en las vías biliares en los estudios de imagen. Así, se realizó una revisión narrativa de los casos reportados hasta finales de 2021. De los hallazgos encontrados concluimos que los pacientes que han tenido COVID-19 o que han requerido hospitalización deben permanecer en seguimiento por al menos 6 meses por un equipo multidisciplinario.

Flood Risk and Exposure: The Case of the Tajuña Valley (Madrid, Spain)

This paper aims to update the exposure to flood risk in a catchment area of the Community of Madrid (Spain) linked to primary sector activities, albeit affected by the urban expansion of the capital. This research starts with the updating of the flood inventory, encompassing episodes documented between 1629 and 2020. The inadequate occupation of the territory means that floods continue to cause significant damage nowadays. It is worth highlighting the two recent floods (2019) that occurred just 15 days apart and caused serious damage to several towns in the basin. The areas at risk of flooding are obtained from the National Floodplain Mapping System, and the maximum and minimum floodable volume in the sector of the Tajuña River basin with the highest exposure to flooding has been calculated. The Sentinel 2 image in false colour (RGB bands 11-2-3, 11-8-3 and 12-11-8) and its transformation to colour properties (Intensity, Hue and Saturation) has made it possible to determine the extension of the riparian vegetation and the irrigated crops located in the alluvial plain. The SPOT 6 image with higher spatial resolution has allowed us to update the mapping of buildings located in areas at risk of flooding. Finally, based on cadastral data, a detailed cartography of built-up areas in areas at risk of flooding is provided. They affect buildings built mainly between the 1960s and 1990s, although the most recent buildings are built on agricultural land in the alluvial plain, even though current regulations prevent the occupation of these lands.

Long-term effect of SARS-CoV-2 infection: Post-Covid-19 neurological syndrome / Efecto a largo plazo de la infección por SARS-CoV-2: Síndrome neurológico post-Covid-19

RESUMEN La pandemia de la COVID-19 ha provocado aproximadamente 182 millones de casos y cerca de cuatro millones de muertes en todo el mundo, comprometiendo con mayor frecuencia a personas de 25 y 64 años de edad. Esta infección afecta principalmente al sistema respiratorio, pero otros órganos y sistemas pueden verse afectados a corto plazo como el neurológico. Una gran población de pacientes ha logrado superar la infección por el SARS-CoV-2, sin embargo, han comenzado a reportarse una serie de manifestaciones clínicas tardías, básicamente neuropsiquiátricas, dentro de ellas se ha referido a la ansiedad, depresión, deterioro del sueño, dolor muscular, mareos, cefaleas, fatiga, anosmia, entre otros; a este conjunto de manifestaciones tardías se le ha denominado síndrome neurológico post-Covid-19 y requiere por un lado, la atención de la comunidad médica para investigar las manifestaciones tardías o secuelas de esta enfermedad y por otro lado, una vigilancia médica ante la consulta de pacientes con estas manifestaciones.

ABSTRACT The COVID-19 pandemic has caused approximately 182 million cases and nearly four million deaths worldwide, most frequently involving people between 25 and 64 years of age. This infection primarily affects the respiratory system, but other organs and systems can be affected in the short term, such as the neurological system. A large population of patients has managed to overcome the SARS-CoV-2 infection, however, a serie of late clinical manifestations have begun to be reported, basically neuropsychiatric, including anxiety, depression, disorder of sleep, muscle pain, dizziness, headaches, fatigue, anosmia, among others; this set of late manifestations has been called post-Covid-19 neurological syndrome and requires, on the one hand, the attention of the medical community to investigate the late manifestations or sequel of this disease and, on the other hand, medical vigilance when consulting patients with these manifestations.

Access limitations and level of psychological distress during the COVID-19 pandemic in a geographically-limited sample of individuals with spinal cord injury.

OBJECTIVES: Assess changes in access and psychological status during the COVID-19 pandemic in people with spinal cord injury (SCI). STUDY DESIGN: Cohort telephone survey study. SETTING: South Florida SCI Model System (SF-SCIMS). PARTICIPANTS: A convenience sample of 51 individuals with traumatic SCI who had previously completed SCIMS Form II follow-up interviews. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE(S): Questionnaire administration included assessments of resilience, depressive symptoms, satisfaction with life, anxiety, pain, alcohol and substance use, COVID-19 diagnoses and symptoms, and impact of early COVID-19 community restrictions on various aspects of life. RESULTS: Of the individuals interviewed, 78% reported limited access to their regular activities, 40% to healthcare information and services, 38% to personal protective equipment (PPE), 37% to food/groceries, and 34% to medication refills. Sixteen percent of the participants had at least moderate levels of depression, and 10% had at least moderate levels of anxiety. Statistically significant increases in depressive symptoms (Patient Health Questionnaire 9; P = 0.004) and significant decreases in resilience (SCI-Quality of Life Resilience subscore; P = 0.010) were found when comparing scores on measures of psychological function at the time of the study to scores collected during the previous SCIMS Form II interview (within 2 years pre-COVID-19). CONCLUSION(S): Limitations to basic needs and face-to-face communication can exacerbate challenges in access for persons with disabilities. Our results show increased levels of psychological distress related to decreased access to goods and services in individuals with SCI due to the COVID-19 pandemic. The results of this study can help the SCI community to target strategies for enhanced access, outreach, shared information, and social support in preparation for future community health or weather emergencies.

Assessment and management of asymptomatic COVID-19 infection: A systematic review.

BACKGROUND: COVID-19 can be asymptomatic in a substantial proportion of patients. The assessment and management of these patients constitute a key element to stop dissemination. AIM: To describe the assessment and treatment of asymptomatic infection in patients with a confirmed diagnosis of COVID-19. METHODS: We searched five databases and search engines for preprints/preproofs, up to August 22, 2020. We included cohort, cross-sectional, and case series studies, reporting the assessment and management of asymptomatic individuals. We extracted data on total discharges with negative PCR, length of hospitalization, treatment, and number of patients who remained asymptomatic. A random-effects model with inverse variance method was used to calculate the pooled prevalence. RESULTS: 41 studies (nine cross-sectional studies, five retrospective studies and 27 reports/case series; 647 asymptomatic individuals), were included, of which 47% were male (233/501). The age of patients was between 1month and 73 years. In patients who became symptomatic, length of hospitalization mean was 13.6 days (SD 6.4). Studies used lopinavir/ritonavir, hydroxychloroquine plus ritonavir/lopinavir, hydroxychloroquine with and without azithromycin, ribavirin plus interferon and interferon alfa. The proportion of individuals who remained asymptomatic was 91% (463/588 patients; 95%CI: 78.3%-98.7%); and asymptomatic individuals discharged with negative PCR was 86% (102/124 individuals; 95%CI: 58.4%-100%). CONCLUSIONS: There is no standard treatment for asymptomatic COVID-19 individuals. There are no studies of adequate design to make this decision. It has been shown that most asymptomatic individuals who were followed have recovered, but this cannot be attributed to standard treatment.

Treating Opioid Use Disorder in Puerto Rico During the COVID-19 Pandemic: Providers' Leadership Efforts in Unprecedented Times.

Opioid use disorder (OUD) is an unprecedented medical and public health issue both in Puerto Rico (PR) and the greater US with an increase incidence of opioid use every year. Unprecedented and compounded emergencies in PR such as those caused by hurricanes, earthquakes, and the COVID-19 pandemic coupled with limited national and local governmental support, has forced most clinics in PR to take action to be able to continue providing care. This commentary summarizes the leadership and clinical initiatives of 3 community organizations in PR to maintain services for people with OUD during the COVID-19 pandemic. Local legislation that supported the continuity of OUD care is summarized, along with unique experiences specific to each organization. In addition, the vulnerability of economically disadvantaged people or experiencing homelessness as well as those affected by these compounded events in PR is discussed, with an emphasis on how some challenges were addressed and future directions for continuity of care as our country adjusts to new demands caused by the COVID-19 pandemic.