ABSTRACT
INTRODUCTION: Neuropsychiatric symptoms are common in patients with mild cognitive impairment and dementia. This symptomatology can appear or be exacerbated with changes in routine and in the patient's usual environment. The lockdown situation during the COVID-19 pandemic has meant a drastic and unexpected change in the daily life of the general population, with a particular impact on the most physically and mentally vulnerable groups, including patients with cognitive impairment. AIM: To know the impact of lockdown measures imposed due to the COVID-19 pandemic on neuropsychiatric symptomatology in people with mild cognitive impairment and dementia. MATERIALS AND METHODS: Exploratory systematic review, in accordance with the PRISMA guidelines, of Pubmed and Psycinfo databases papers published from January 2020 to April 2021 which related confinement due to COVID-19 with the presentation or worsening of neuropsychiatric symptoms in patients with mild cognitive impairment mild or dementia. RESULTS: Worsening of neuropsychiatric symptoms was observed in patients with dementia and mild cognitive impairment, especially agitation/aggression, anxiety, depression and apathy. Neuropsychiatric symptoms were more common in patients with dementia than in those with mild cognitive impairment, although their typology varied depending on the severity of dementia. CONCLUSIONS: During lockdown a worsening in the psychobehavioral area has been observed in people with mild cognitive impairment or dementia. Therefore, considerations arise on the need of promoting social contact in people with mild cognitive impairment and dementia, avoiding situations of isolation and low stimulation.
TITLE: Síntomas neuropsiquiátricos en personas con demencia relacionados con el confinamiento por la pandemia de la COVID-19. Revisión sistemática exploratoria.Introducción. En pacientes con deterioro cognitivo leve y demencia, son frecuentes los síntomas neuropsiquiátricos, que pueden aparecer o exacerbarse ante los cambios en la rutina y el entorno habitual del paciente. La situación de confinamiento durante la pandemia de la COVID-19 ha supuesto un cambio en la vida cotidiana de la población general, con especial impacto en los grupos más vulnerables, como los pacientes con afectación cognitiva. Objetivo. Conocer la repercusión de las medidas de confinamiento y cuarentena impuestas por la pandemia de la COVID-19 en la sintomatología neuropsiquiátrica en personas con deterioro cognitivo leve (DCL) y demencia. Materiales y métodos. Revisión sistemática exploratoria, siguiendo las directrices PRISMA, de artículos en las bases datos PubMed y PsycINFO publicados entre enero de 2020 y abril de 2021, que relacionaron el confinamiento por la COVID-19 con la presentación o el empeoramiento de síntomas neuropsiquiátricos en pacientes con DCL o con demencia. Resultados. Se observó un empeoramiento de los síntomas neuropsiquiátricos en los pacientes con demencia y DCL, especialmente agitación/agresión, ansiedad, depresión y apatía. Los síntomas neuropsiquiátricos fueron más comunes en los pacientes con demencia que en los que presentaban DCL, aunque su tipología varió en función de la gravedad de la demencia. Conclusiones. Durante el confinamiento se ha objetivado un detrimento en la esfera psicoconductual en personas con DCL o demencia. Consecuentemente, surge la reflexión sobre la necesidad de fomentar el contacto social en las personas con DCL y demencia, evitando las situaciones de aislamiento y baja estimulación.
Subject(s)
COVID-19/psychology , Cognitive Dysfunction/psychology , Dementia/psychology , Pandemics , Quarantine/psychology , SARS-CoV-2 , Activities of Daily Living , Aggression , Anxiety/etiology , Apathy , Argentina , COVID-19/prevention & control , Depression/etiology , Europe , Humans , Mental Disorders/etiology , Mood Disorders/etiology , Neuropsychological Tests , Psychomotor Agitation/etiology , Retrospective Studies , Sleep Initiation and Maintenance Disorders/etiology , Social Isolation/psychology , United StatesABSTRACT
Electrolyte disorders are a not infrequent alteration in patients with anorexia nervosa. Itsmechanisms are multifactorial, depending on the electrolytic alteration. Hyponatremia is described in 7% of patients and generally does not reach serious values. We present the case of a female patient with difficult-to-manage anorexia nervosa who was hospitalized for hyponatremia with values not described in the literature, with a good final outcome. Literature and the main physiopathological mechanisms are reviewed.
Subject(s)
Humans , Female , Adolescent , Anorexia Nervosa/complications , Hyponatremia/etiology , MalnutritionABSTRACT
PURPOSE: Bevacizumab is the only therapeutic target approved for patients with persistent, recurrent or advanced cervical cancer from a phase III study that combined with chemotherapy; it proves a significant increase in overall survival. To retrospectively assess the efficacy and safety of bevacizumab as the first-line treatment in patients from usual clinical practice with recurrent/persistent or advanced cervical cancer. PATIENTS AND METHODS: Treatment consisted of cisplatin 50 mg/m2 or carboplatin AUC 5 plus paclitaxel 175 mg/m2 for 6-8 cycles and bevacizumab 15 mg/kg every 3 weeks up to progression or unacceptable toxicity. The endpoints were progression-free survival (PFS), overall survival (OS), response rates (RR) and toxicity. RESULTS: Twenty-seven patients were included from January 2014 to June 2017, with a median follow-up 10, 1 months. Eleven percent had recurrent/persistent disease and 89% had metastatic disease at diagnosis. The prior exposition to platinum was 70%. The median PFS and OS were 9, 6 and 21, 5 months, respectively. There was an increase of fistula formation (22%). All of them had pelvic and peritoneal disease at the beginning of treatment and previous treatment with chemoradiotherapy; non-incidence differences were found according to the type of platinum agent used. There were two treatment-related deaths, one from intestinal perforation and another from severe sepsis. CONCLUSION: Finally, although our study does have certain limitations, we believe that it can provide useful information and encouraging evidence that the routine use of bevacizumab as part of first-line treatment of patients with advanced cervical cancer may be associated with outcomes comparable with those obtained in GOG240 study.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Neoplasm Recurrence, Local/drug therapy , Uterine Cervical Neoplasms/drug therapy , Adenocarcinoma/pathology , Adult , Bevacizumab/administration & dosage , Carboplatin/administration & dosage , Carcinoma, Squamous Cell/pathology , Cisplatin/administration & dosage , Clinical Trials, Phase III as Topic , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Paclitaxel/administration & dosage , Prognosis , Retrospective Studies , Survival Rate , Uterine Cervical Neoplasms/pathologyABSTRACT
Los gliomas nasales son restos de tejido neuroglial que se presentan como una masa craneofacial. Es poco frecuente y no tiene características malignas, pero local-mente es bastante agresivo. Se encuentra dentro del diagnóstico diferencial de masas congénitas de la línea media. Se presenta el caso de un recién nacido que presenta un pólipo nasal derecho y distrés respiratorio. La RNM revela una masa intranasal sin conexión intracraneal. Vía endoscópica se realiza exéresis de la masa sin complicaciones. Biopsia confirma diagnóstico de glioma.
Nasal gliomas are glial tissue residues presented as a craniofacial mass. It is rare and has no malignant features, but locally it is quite aggressive. It is included in the differential diagnosis of congenital midline masses. The case of a newborn is reported which presents a right nasal polyp and respiratory distress. The MRI reveals an intracranial mass with no intranasal connection. Endoscopic resection of the mass is done with no complications. Biopsy confirms glioma diagnosis.
Subject(s)
Humans , Male , Infant , Nose Neoplasms/surgery , Nose Neoplasms/diagnosis , Glioma/surgery , Glioma/diagnosis , Biopsy , Magnetic Resonance ImagingABSTRACT
The present study is a non-inferiority study based on a descriptive and comparative case series for comparison of generic vs. original intravenous antimicrobials in septic oncology patients at an oncology private ICU. 1906 cancer patients admitted to Arturo Lopez Perez Foundation, Chile, were included in this study. After recruitment, a first retrospective group of 206 septic cancer patients recorded from 1st January, 2008 until July 14th, 2010, treated with original antibiotics (cefoperazone-sulbactam, imipenem-cilastatin, piperacillin-tazobactam) were included for analyses and a second prospective group of 143 septic cancer patients recorded from July 15th, 2010 until January 02, 2013, treated with the same but generic antibiotics were also included for comparisons. The trial protocol was developed in accordance with Helsinki and Good Clinical Practices recommendations. The results of this study showed no significant differences between the 2 groups in days of treatment, rate of success and lab test determinations (white cell count, PCR and procalcitonin), with lower, but not significant, total bed days and CPU bed days for generic antibiotics. Therefore, we conclude that the safety and efficacy of the generic antibiotics cefactam®, imipen® and Piperazam® are not inferior to original antibiotics for the treatment of severe sepsis in hospitalised patients at the Arturo Lopez Perez Foundation.
Subject(s)
Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/therapeutic use , Cefoperazone/therapeutic use , Cilastatin/therapeutic use , Imipenem/therapeutic use , Oncology Service, Hospital , Penicillanic Acid/analogs & derivatives , Sepsis/drug therapy , Sulbactam/therapeutic use , Administration, Intravenous , Anti-Bacterial Agents/administration & dosage , Cefoperazone/adverse effects , Cilastatin/adverse effects , Cilastatin, Imipenem Drug Combination , Drug Combinations , Drugs, Generic/adverse effects , Drugs, Generic/therapeutic use , Female , Humans , Imipenem/adverse effects , Male , Middle Aged , Penicillanic Acid/adverse effects , Penicillanic Acid/therapeutic use , Pilot Projects , Piperacillin/adverse effects , Piperacillin/therapeutic use , Piperacillin, Tazobactam Drug Combination , Prospective Studies , Retrospective Studies , Sulbactam/adverse effects , Treatment OutcomeABSTRACT
Enamel acid etching plays an important role in treatment on direct bracket bonding. Several studies have been carried out concerning the damage this procedure causes to the enamel. A valuable alternative seems to be the use of photopolymerizable resin-reinforced glass ionomer without acid etching of enamel. This study compares the strength of bracket debonding, the amount of remnant adhesive on the tooth, and the enamel condition in 3 adhesive systems. Three groups were set; in the first group, a glass ionomer with a photopolymerizable resin reinforce and enamel etching with orthophosphoric acid at 37% was used; in the second group, the same ionomer was used but without acid etching; and in the third group, a photopolymerizable resin was used after etching enamel with orthophosphoric acid at 37%. Debonding strength was determined in MPa; a stereoscopic microscope was used to determine the amount of remnant adhesive on the tooth in accordance to ARI and a scanning electron microscope study was made to observe the enamel conditions, existing in debonding among groups (P <.0001), with etching and without etching. The remnant adhesive on the tooth did not show a significant difference (P = 1.000); greater irregularities were found in the enamel in the etching groups. It was demonstrated that the etching was a critical factor in obtaining adequate adhesion strength and that it alters the enamel conditions. Teeth with ionomer and etching had a greater material remnant.
Subject(s)
Dental Bonding/methods , Dental Debonding , Dental Enamel , Glass Ionomer Cements/chemistry , Orthodontic Brackets , Acid Etching, Dental , Acrylic Resins , Adhesiveness , Aluminum Silicates , Analysis of Variance , Bisphenol A-Glycidyl Methacrylate , Humans , Light , Metals , Microscopy, Electron, Scanning , Polymers/chemistry , Surface PropertiesABSTRACT
Se analizan y clasifican 25.000 frotis cervicales desde un punto de vista inflamatorio-infeccioso, correspondientes a un total de 25.000 pacientes, 172 de las cuales tuvieron frotis sospechosos de neoplasia. Solo en 50,53% se encontraron signos de "bienestar" cervico-vaginal, y el resto tenia algun tipo de infeccion o alteracion. En 6,84% de los casos no se pudo identificar flora o signos especificos de inflamacion. La infeccion especifica mas importante fue Gardnerela vaginalis, en 23,35% de los casos. Un tercio de la poblacion tenia algun tipo de infeccion por agente transmision sexual. La evidencia citologica de infeccion por condiloma fue varias veces mas frecuente en las pacientes con sospecha de neoplasia. Se discute el modo de informacion citologica en lo que se refiere a evidencia y sospecha de infeccion por virus condiloma