Lithium salts as a treatment for COVID-19: Pre-clinical outcomes.

INTRODUCTION: Identifying effective drugs for Coronavirus disease 2019 (COVID-19) is urgently needed. An efficient approach is to evaluate whether existing approved drugs have anti-SARS-CoV-2 effects. The antiviral properties of lithium salts have been studied for many years. Their anti-inflammatory and immune-potentiating effects result from the inhibition of glycogen synthase kinase-3. AIMS: To obtain pre-clinical evidence on the safety and therapeutic effects of lithium salts in the treatment of COVID-19. RESULTS: Six different concentrations of lithium, ranging 2-12 mmol/L, were evaluated. Lithium inhibited the replication of SARS-CoV-2 virus in a dose-dependent manner with an IC50 value of 4 mmol/L. Lithium-treated wells showed a significantly higher percentage of monolayer conservation than viral control, particularly at concentrations higher than 6 mmol/L, verified through microscopic observation, the neutral red assay, and the determination of N protein in the supernatants of treated wells. Hamsters treated with lithium showed less intense disease with fewer signs. No lithium-related mortality or overt signs of toxicity were observed during the experiment. A trend of decreasing viral load in nasopharyngeal swabs and lungs was observed in treated hamsters compared to controls. CONCLUSIONS: These results provide pre-clinical evidence of the antiviral and immunotherapeutic effects of lithium against SARS-CoV-2, which supports an advance to clinical trials on COVID-19's patients.

Nonsurgical Procedures for Keratoconus Management.

OBJECTIVES: To describe the past 20 years' correction modalities for keratoconus and their visual outcomes and possible complications. METHODS: A review of the published literature related to the visual outcomes and possible complications in the context of keratoconus management using nonsurgical procedures for the last 20 years (glasses and contact lenses) was performed. Original articles that reported the outcome of any correction modalities of keratoconus management were reviewed. RESULTS: The most nonsurgical procedure used on keratoconus management is the contact lens fitting. Soft contact lenses and soft toric contact lenses, rigid gas-permeable contact lenses, piggyback contact lens system, hybrid contact lenses, and scleral and corneoscleral contact lenses form the contemporary range of available lens types for keratoconus management with contact lenses. All of them try to restore the vision, improve the quality of life, and delay surgical procedures in patients with this disease. Complications are derived from the intolerance of using contact lens, and the use of each depends on keratoconus severity. CONCLUSIONS: In the context of nonsurgical procedures, the use of contact lenses for the management of keratoconic patients represents a good alternative to restore vision and improve the quality of live in this population.

Desarrollo psicomotor e influencia de los ejercicios en el lactante / Psychomotor development and influence of exercise in the infant

Se realiza una revisión bibliográfica acerca del desarrollo psicomotor y la influencia de los ejercicios en el lactante; algunos aspectos actuales del mismo. Se enfatiza en cuanto a los ejercicios que estimulan el mismo, relacionándose con diferentes ciencias y sus puntos de vista. Se relacionan algunos movimientos que resultan favorables y de necesario conocimiento por el médico, promotor de salud, profesor de educación física y padres para mejorarlo y/o estimularlo (AU)

A bibliographical review is done about psychomotor development and the influence of exercise on the infant, besides some current aspects of it. As is emphasized in the exercises that stimulate the same, related to different sciences and their points of view. Some movements are linked and are favorable and necessary for the doctors knowledge, health worker, physical education teacher and parents to improve and or encourage these children

Neuralgia braquial amiotrófica bilateral que evoluciona a esclerosis lateral amiotrófica / Bilateral amyotrophic brachial neuralgia that progresses to become amyotrophic lateral sclerosis

No disponible

Hacia modelos asistenciales más eficientes para pacientes con morbilidad psíquica y somática / No disponible

No disponible

[Hyperhomocysteinemia as a risk factor for central retinal vein thrombosis in a young patient]. / Hiperhomocistinemia como un factor de riesgo para la trombosis de la vena central de la retina en un paciente joven.

INTRODUCTION: Central retinal vein thrombosis (CRVT) is a multifactorial disease and known risk factors include high blood pressure, diabetes mellitus, hypercholesterolemia and primary open-angle glaucoma. Yet in patients below the age of 60, a state of hyperviscosity and hypercoagulability in the absence of other vascular risk factors are important factors, as is hyperhomocysteinemia, an independent risk factor for venous thromboses. Homocysteine is an essential amino acid produced by the transmethylation of methionine. It can be remethylated using enzymes that require folate and cobalamin to re-form methionine or to catabolize for cystathionine beta-synthetase, which is dependent on pyridoxine to form cysteine. Hyperhomocysteinemia can give rise to a dysfunction in the endothelium of the vessel, with a proliferation of vascular smooth muscle and prothrombotic homostatic changes. CASE REPORT: A male, aged 33, with no vascular risk factors except cigarette smoking who presented a sharp drop in visual acuity in the right eye. An ophthalmological examination revealed the presence of CRVT, which was confirmed by fluorescein angiography. The results of all analytical and imaging studies conducted while the patient was in hospital were negative. Later analytical monitoring showed a moderate increase in homocysteine. CONCLUSION: From a survey of the literature we have found an important relation between CRVT and hyperhomocysteinemia, which has been noted as a potential risk factor and which requires therapy.

[Deferred Horner syndrome following thoracoplasty]. / Sindrome de Horner diferido tras toracoplastia.

INTRODUCTION: Horner syndrome (HS) involves an injury affecting the ocular sympathetic nerve, which gives rise to myosis, palpebral ptosis and enophthalmos, and is accompanied by hemifacial anhidrosis in its complete forms. Its extension means that its involvement can occur in different structures and as a result of different medical and surgical processes. CASE REPORT: We describe the case of two patients who developed a subacute form of HS without involvement of the sweating process and which was not accompanied by any other clinical features affecting the orbit, neck, brain, spinal cord or of a radicular nature. Both of them had been submitted to thoracoplasty as therapy for tuberculosis over 30 years earlier. The complementary studies that were conducted did not reveal involvement of the ocular sympathetic nerve anywhere other than in the pleura. CONCLUSIONS: The lesion would have been produced in the endothoracic fascia, where the cervical sympathetic chain is closely related to the apical pleura, and the physiopathological mechanism would be fibrosis of the aforementioned structures. Many reports have been published that describe the onset of HS as an acute complication following thoracic surgery, but its late development is infrequent.

Eosinophilic gastroenteritis: our recent experience: one-year experience of atypical onset of an uncommon disease.

Eosinophilic gastroenteritis is an unusual entity that is rarely found in daily clinical practise. Its aetiology is unknown and diagnosis can be made microscopically with evidence of massive eosinophilic infiltration in patients with chronic gastrointestinal symptoms, excluding entities that may cause such findings (parasitic infestation, medical therapy, inflammatory bowel disease, and so on). Allergic processes are usually associated and these normally respond well to steroids. We present our last year's experience of four women with eosinophilic gastroenteritis with an extraordinary atypical clinical onset. Two of the women presented with an acute abdomen and two with isolated colonic involvement. The management of acute abdomen avoiding surgery and a complete response with azathioprine are the outstanding variables that make our recent cases of special interest. Demographic variables were similar to others reported from our medium, with the exception of a higher incidence of women. Our cases suggest the wide spectrum of clinical presentations and show the high suspicion index needed for a diagnosis that is made by pathologists.

[Pseudotumorous hepatic tuberculosis: laparoscopic appearance]. / Tuberculosis hepática seudotumoral. Aspecto laparoscópico.

Local hepatic tuberculosis without active pulmonary or miliary tuberculosis is an uncommon diagnosis. Even less common is the finding of a nodular form of local hepatic tuberculosis. There is a growing incidence of the disease related to human immunodeficiency virus. The authors report a case of pseudotumoral hepatic tuberculosis in a patient without AIDS, manifesting as prolonged fever, diagnosed previously as metastatic liver. Imaging studies of the liver and laparoscopic findings suggested metastatic disease. The correct diagnosis was made by histology of biopsies obtained in laparoscopy, which is an easy and cheap method, with less morbidity and mortality than surgical intervention. The case report illustrates the difficulty in reaching the correct diagnosis, most often confused with carcinoma of the liver, primary or metastatic. A greater awareness of this rare clinical entity may prevent needless surgical intervention since the majority of patients respond well to antituberculous chemotherapy.

[Laparoscopic diagnosis of hepatic angiomas after erroneous imaging techniques]. / Diagnóstico laparoscópico de angiomas hepáticos tras error por técnicas de imagen.

Hemangiomas are de most frequent benign liver tumours. Their clinical relevance is small but they can cause to the patient and/or the physician a great worry because can be indistinguishable from hepatic malignances. From 1991 to 1994 five patients with liver hemangiomas were diagnosed by laparoscopy after a erroneous and/or contradictory interpretation by various imaging techniques. In four cases hemangiomas resembled metastatic carcinoma of the liver, and in the other patient hemangioma was interpreted as focal nodular hyperplasia. Diagnosis and treatment are discussed.

[Emergency laparoscopy. A 20-year experience]. / Laparoscopia de urgencia. Experiencia de 20 años.

We revised 7988 laparoscopies over twenty years. Three hundred and ninety three were urgent laparoscopies: 325 patients with acute spontaneous abdomen and 68 acute traumatic abdomen. Emergency laparoscopy is made in patients with, both spontaneous and traumatic acute abdomen, when diagnosis is not made in 8 hours with the usual clinical and imaging methods. Acute diffuse peritonitis was the commonest finding in the first group (21%) and splenic rupture in the traumatic group (34%). There were two severe complications (0.5%): pulmonary oedema in a patient with myocardial disease and a respiratory failure in a old patient, which were resolved. We had two deaths related to laparoscopic diagnosis: massive mesenteric thrombosis and fecal peritonitis. There are few contraindications and tolerance is very good. This study shows a sensitivity of 98%, a specificity of 90%, a predictive positive value greater than 98% and a negative predictive value of 100%. In summary, the present study demonstrates that emergency laparoscopy is a effective diagnostic method in acute abdominal pain of uncertain aetiology.

[Wegener's granulomatosis with gastrointestinal involvement]. / Granulomatosis de Wegener con afectación gastrointestinal.

Wegener's granulomatosis is a necrotizing granulomatous vasculitis often characterized by involvement of the upper respiratory tract, lungs and kidney, although any organic system can be affected. We present the case of a female patient with Wegener's granulomatosis diagnosed by biopsy of the kidney, and severe gastrointestinal bleeding with fatal course. Endoscopic findings of the colon and the histopathology of the biopsy are discussed.

Pneumonia caused by Listeria monocytogenes.

Pneumonia due to Listeria monocytogenes is extremely uncommon. We report the case of an 87-year-old woman with no underlying immunosuppressive disease who presented with listerial pneumonia. Cutaneous anergy and a decrease in total lymphocyte count in this elderly woman could predispose her to listerial infection.

Epidemiology of inflammatory bowel disease in the Province of Granada, Spain: a retrospective study from 1979 to 1988.

An epidemiological study of inflammatory bowel disease in the Province of Granada, Spain, was conducted between 1979 and 1988. Altogether, 257 cases were identified: 167 ulcerative colitis, 79 Crohn's disease, and 11 indeterminate colitis. The mean incidence of ulcerative colitis in the 10 year period was 2/10(5) and 0.9/10(5) for Crohn's disease. This is the first epidemiological study in Spain of the incidence of ulcerative colitis and corroborates the results of an earlier population based study on the incidence of Crohn's disease in Spain.

[Retrospective study of Crohn disease at a hospital in Andalucía (1978-1988)]. / Estudio retrospectivo de la enfermedad de Crohn en un hospital de Andalucía (1978-1988).

We reviewed 46 cases of Crohn's disease diagnosed during the period between 1978-1988, with the intention to analyse the age, sex, presentation, evolution, complications and diagnosis. The majority of patients were women, with a mean age of 39. In the last years we have seen an increment in our number of cases. The mean time to diagnosis was about 3.5 years. The main symptoms were abdominal pain, diarrhoea and loss of weight. The complications was of 40% in colonic disease and 75% when the affection was in ileum and colon. During the evolution 4 patients died, 2 of them from their Crohn's disease. One patient had a colonic carcinoma. In 15% of the cases there was a previous appendectomy. The most frequent radiological findings were in the small intestine: lack of haustration and cobblestone appearance. In the colon: lack of haustration and ulceration. The most frequent endoscopical findings were ulcers and a cobblestone appearance.