ABSTRACT
Background: Mexico declared the first case of novel coronavirus disease (COVID-19) in February 2020. At the time we write this article, our country is facing a community spread phase, expecting a rapid increase in the number of cases and fatalities. The Fray Antonio Alcalde Civil Hospital of Guadalajara has been declared a non-COVID-19 hospital with the mission of providing care to patients already registered and also those transferred from neurosurgical departments of neighboring centers, which have been converted into COVID-19 only hospitals. Methods: An organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara. Results: Distancing actions by the staff and residents, including ward case discussions, neurosurgery rounds, and classes, will be carried out virtually. We classified neurosurgical patients into 4 groups depending on whether their condition demands care in 0-6 hours, 6-48 hours, 48 hours to 14 days, and >14 days. Subsequently, a questionnaire with epidemiologic, radiologic, clinical, and serologic criteria will be applied to determine the risk of COVID-19 infection to define to which area they are going to be transferred according to the different risk zones in our facility. Conclusions: Despite not being a COVID-19 center, we consider all patients at the neurosurgical ward and staff members as asymptomatic carriers or infected in the preclinical period. Specific measures must be taken to ensure the safety and care of neurosurgical patients and medical staff during the community spread phase.
Subject(s)
Coronavirus Infections/epidemiology , Neurosurgery , Operating Rooms , Personal Protective Equipment , Personnel Staffing and Scheduling , Pneumonia, Viral/epidemiology , Triage , Betacoronavirus , COVID-19 , Environment Design , Hospital Departments , Hospital Units , Humans , Mexico/epidemiology , Neurosurgical Procedures , Pandemics , Risk Assessment , SARS-CoV-2Subject(s)
Antipsychotic Agents/adverse effects , Haloperidol/adverse effects , Hypnotics and Sedatives/administration & dosage , Lorazepam/administration & dosage , Psychotic Disorders , Adult , Antidepressive Agents/therapeutic use , Antipsychotic Agents/administration & dosage , Female , Haloperidol/administration & dosage , Humans , Psychotic Disorders/diagnosis , Psychotic Disorders/drug therapy , Recurrence , Risperidone/therapeutic use , Sertraline/therapeutic use , Sleep Initiation and Maintenance Disorders/drug therapy , Sleep Initiation and Maintenance Disorders/etiologyABSTRACT
La trombosis intraluminal total de aneurismas gigantes, es un fenómeno raro. La presentación clínica y las imágenes diagnósticas sugieren un tumor, y debe ampliarse el diagnóstico diferencial. Nosotros reportamos el caso de una paciente con lesión en la región temporosilviana izquierda, asociada a neurismas sacuales bilaterales. Se discute la presentación clínica, los estudios radiológicos además de los mecanismos fisiopatológicos involucrados en la trombosis total en aneurismas gigantes. El neurocirujano debe considerar esta posibilidad, en los casos de lesiones intracraneales bien definidas, sin llenado angiográfico
Subject(s)
Middle Aged , Humans , Female , Cerebral Angiography , Cerebral Veins , Intracranial Aneurysm/surgery , Intracranial Embolism and Thrombosis/physiopathology , Neurologic Manifestations , Tomography, Emission-Computed/methodsABSTRACT
Manual destinado para ser utilizado por el vendedor ambulante de alimentos en cursos de capacitación en la manipulación de alimentos. Señala que el vendedor ambulante debe comprender que la salud de su comensal está en sus manos y para que para protegerlo debe mantener un hábito de higiene personal, debe manipular adecuadamente los alimentos y limpiar el establecimiento y menaje de cocina. Asimismo, el vendedor ambulante debe tener en cuenta que es una utopía pretender preparar o vender alimentos exentos de contaminación en un ambiente por si insalubre