ABSTRACT
Sixth nerve palsy is the most common post-vaccination oculomotor palsy. It is generally transient with most patients making a complete recovery. We report the case of a 46-year-old healthy male patient who presented with a painless sixth nerve palsy after the second dose of the Pfizer BioNTech COVID-19 vaccine, which recovered over the course of the next month. We confirmed the lesion localisation by demonstrating enhancement of the root exit zone and the cisternal portion of the sixth nerve on sequential magnetic resonance imaging during the symptomatic period. Here, a temporal relationship between vaccine application and diplopia onset suggests an aetiologic relationship. Moreover, the lack of pre-existing medical conditions suggests a post-vaccination inflammatory process.
ABSTRACT
The US Food and Drug Administration approved a 6-month regimen of pretomanid, bedaquiline, and linezolid for extensively drug-resistant or multidrug-intolerant tuberculosis after a trial in South Africa demonstrated 90% effectiveness 6 months posttreatment. We report on a patient who completed the regimen using a lower linezolid dose.
Subject(s)
Tuberculosis, Multidrug-Resistant , Tuberculosis , Antitubercular Agents/therapeutic use , Diarylquinolines/therapeutic use , Humans , Linezolid/therapeutic use , South Africa/epidemiology , Tuberculosis/drug therapy , Tuberculosis, Multidrug-Resistant/drug therapy , United States/epidemiologyABSTRACT
Abstract Introduction Attention deficit hyperactivity disorder (ADHD) is one of the most common neuropsychiatric conditions in childhood and a multifactorial condition attributable to genetic and/or environmental influence. Allelic variants in the serotonin transporter gene (SLC6A4) have been associated to lower transcriptional efficiency, changes in serotonin concentration in several brain regions, and ADHD development. Objective To identify the association between the SLC6A4 alleles and ADHD diagnosis and risk factor phenotypes in children from a Mexican mestizo population. Method In this study, 134 unrelated children were included and evaluated for ADHD, genotypification for the 5HTTLPR polymorphism, and identification of multiple phenotypes from their clinical records and family background for association analysis. Results The following distribution of genotypes was observed: 23% SS, 49% SL, and 28% LL. From the phenotypes evaluated in the present study, gestational diabetes mellitus (p = .045), history of epilepsy (p = .047), and parental substance abuse (p = .033) showed an association with ADHD development in regression analysis along with the S variant. Discussion and conclusion Results suggest that interaction of the S allele and some of the phenotypes analyzed may play a relevant role in the development of ADHD in the studied population.
Resumen Introducción El trastorno por déficit de atención e hiperactividad (TDAH) es uno de los padecimientos neuropsiquiátricos más comunes en la infancia. Como su naturaleza es multifactorial, es atribuible a influencias genéticas y/o ambientales. Las variantes alélicas del gen transportador de serotonina (SLC6A4) se han asociado previamente con cambios en los niveles de serotonina en algunas regiones cerebrales, así como con el desarrollo de TDAH. Objetivo Identificar la posible asociación entre los alelos del gen SLC6A4 y el diagnóstico de TDAH, así como factores de riesgo en niños mestizos mexicanos. Método En el presente estudio se incluyeron 134 niños, los cuales fueron evaluados para TDAH, genotipificación del polimorfismo 5HTTLPR e identificación de múltiples fenotipos en su historia clínica y antecedentes familiares para su análisis de asociación estadística. Resultados Se mostró la siguiente distribución de genotipos: 23% SS, 49% SL y 28% LL. En un modelo de regresión, los fenotipos de diabetes mellitus gestacional (p = .045), historia de epilepsia (p = .047) y el abuso de sustancias de los padres (p = .033) mostraron asociación con la variante S y el desarrollo de TDAH. Discusión y conclusión El presente estudio sugiere que el alelo S en conjunto con algunos fenotipos puede cumplir un papel importante en el desarrollo de TDAH en nuestra población.
ABSTRACT
Rural telemedicine began in the 1950s in the Papago, Arizona Reservation with the program Starphac. The Anáhuac University began the program in 2002. In the Anáhuac, the project was developed to provide specialty consultations in a virtual way to a highly marginalized population, creating clinical fields of high technology and fulfilling social obligations. The program began in Guerrero and was complemented with video conferences to an open population, courses to general physicians, continuing medical education, activities to promote health, and emergency disaster plans. From May 2002 until the end of 2004, 11,576 general consults have been provided and 2,420 specialty consults. The most frequent diagnoses in surgery were peptic ulcer disease, cholecystitis, diabetic foot and superficial venous insufficiency. The telemedicine program has allowed us to bring high specialty consults with great productivity, efficiency, less wait time and cost-benefit impact, along with a high quality of humane care. Resident physicians do their social service in a positive manner, with a permanent consultation office and a program of continuing medical education.
