COVID-19 asociada a nistagmo / COVID-19 presenting with nystagmus

Presentamos el caso de una mujer de 20años que se encontraba en el norte de Italia cuando se decretó el estado de alarma el 31 de enero de 2020 y volvió a España. A los 15 días de su regreso presentó un cuadro respiratorio de vías altas con fiebre, cefalea y anosmia que fue tratado como una sinusitis y a las 3semanas comenzó con sensación de mareo y un nistagmo horizontal en ambos ojos con componente rotatorio. La exploración otorrinolaringológica y neurológica con resonancia magnética fueron normales. Las pruebas serológicas para COVID-19 dieron un resultado positivo para anticuerpos IgG. En el contexto actual de pandemia, los síntomas y signos en esta paciente asociados a un test serológico IgG positivo nos permite considerar como causa del nistagmo adquirido la infección por SARS-CoV-2 (AU)

This case reports a 20-year-old female patient who was in northern Italy when the state of emergency was declared on the 31st of January 2020, developing 15days after return to Spain upper respiratory symptoms characterized by fever, headache and anosmia that was treated as sinusitis. Three weeks later presented with dizziness and an intermittent horizontal nystagmus with rotatory component. Otorhinolaryngology and neurological examination including MRI were normal. COVID-19 IgG antibodies where positive. In the context of the ongoing pandemic, and associating the symptoms with positive IgG antibodies, we can consider the infection of SARS-CoV-2 as a probable cause of the acquired nystagmus (AU)

Necrólisis epidérmica tóxica versus enfermedad injerto contra huésped cutánea aguda después de un trasplante de células madre hematopoyéticas: un desafío diagnóstico y terapéutico / Toxic Epidermal Necrolysis vs. Acute Cutaneous Graft Versus Host Disease after Hematopoietic Stem Cell Transplantation: A Diagnostic and Therapeutic Challenge

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COVID-19 presenting with nystagmus. / COVID-19 asociada a nistagmo.

This case reports a 20-year-old female patient who was in northern Italy when the state of emergency was declared on the 31st of January 2020, developing 15days after return to Spain upper respiratory symptoms characterized by fever, headache and anosmia that was treated as sinusitis. Three weeks later presented with dizziness and an intermittent horizontal nystagmus with rotatory component. Otorhinolaryngology and neurological examination including MRI were normal. COVID-19 IgG antibodies where positive. In the context of the ongoing pandemic, and associating the symptoms with positive IgG antibodies, we can consider the infection of SARS-CoV-2 as a probable cause of the acquired nystagmus.

[COVID-19 presenting with nystagmus]. / COVID-19 asociada a nistagmo.

This case reports a 20-year-old female patient who was in northern Italy when the state of emergency was declared on the 31st of January 2020, developing 15 days after return to Spain upper respiratory symptoms characterized by fever, headache and anosmia that was treated as sinusitis. Three weeks later presented with dizziness and an intermittent horizontal nystagmus with rotatory component. Otorhinolaryngology and neurological examination including MRI were normal. COVID-19 IgG antibodies where positive. In the context of the ongoing pandemic, and associating the symptoms with positive IgG antibodies, we can consider the infection of SARS-CoV-2 as a probable cause of the acquired nystagmus.

COVID-19 asociada a nistagmo / COVID-19 presenting with nystagmus

Presentamos el caso de una mujer de 20 años que se encontraba en el norte de Italia cuando se decretó el estado de alarma el 31 de enero de 2020 y volvió a España. A los 15 días de su regreso presentó un cuadro respiratorio de vías altas con fiebre, cefalea y anosmia que fue tratado como una sinusitis y a las 3semanas comenzó con sensación de mareo y un nistagmo horizontal en ambos ojos con componente rotatorio. La exploración otorrinolaringológica y neurológica con resonancia magnética fueron normales. Las pruebas serológicas para COVID-19 dieron un resultado positivo para anticuerpos IgG. En el contexto actual de pandemia, los síntomas y signos en esta paciente asociados a un test serológico IgG positivo nos permite considerar como causa del nistagmo adquirido la infección por SARS-CoV-2

This case reports a 20-year-old female patient who was in northern Italy when the state of emergency was declared on the 31st of January 2020, developing 15days after return to Spain upper respiratory symptoms characterized by fever, headache and anosmia that was treated as sinusitis. Three weeks later presented with dizziness and an intermittent horizontal nystagmus with rotatory component. Otorhinolaryngology and neurological examination including MRI were normal. COVID-19 IgG antibodies where positive. In the context of the ongoing pandemic, and associating the symptoms with positive IgG antibodies, we can consider the infection of SARS-CoV-2 as a probable cause of the acquired nystagmus

Magnesium monitoring practice in monoclonal anti-epidermal growth factor receptor antibodies therapy.

WHAT IS KNOWN AND OBJECTIVE: It is now estimated that about 5% of cetuximab-treated patients and about 3% of panitumumab-treated patients will develop grade 3-4 hypomagnesemia. The aim of this study was to assess the extent of magnesium monitoring in patients treated with epidermal growth factor receptor (EGFR)-targeting antibodies and to estimate the incidence of hypomagnesemia in these patients at our institution. METHODS: A 2-year retrospective study was carried out. At least four doses of weekly cetuximab or two doses of bi-weekly panitumumab were required for inclusion. Serum magnesium profiles were reviewed from 1 month before treatment until 3 months after treatment discontinuation, and patients with <2 determinations were excluded. RESULTS AND DISCUSSION: Two hundred and one patients received at least one dose of EGFR-targeting antibodies, but only 68 met the inclusion criteria. Seventy patients had <2 magnesium determinations. The overall hypomagnesemia was 58·82% (40 of 68 patients), with a 4·41% grade 3 hypomagnesemia (three of 68 patients). No grade 4 hypomagnesemia was detected. WHAT IS NEW AND CONCLUSION: There is a lack of magnesium monitoring in these patients. Serum magnesium determinations should be done every 4-8 weeks in patients treated with EGFR-targeting antibodies, as it is a useful surrogate marker for both toxicity and efficacy.

Resultados de efectividad de un grupo de estrategias de afrontamiento para pacientes dependientes de sustancias en el contexto de un hospital de día / Effectiveness of the application of a coping behaviour group in addicts in an out-patient day hospital environment

Objetivo. El objetivo del presente estudio es mostrar los resultados en términos de efectividad de la aplicación de un grupo de terapia de estrategias de afrontamiento para pacientes dependientes de sustancias psicoactivas en el contexto de un hospital de día a fin de facilitar el mantenimiento de la abstinencia. Material y métodos. La muestra del estudio se compone de 38 pacientes asistentes a un programa de 12 sesiones de terapia de apoyo. Para evaluar la eficacia del tratamiento, se ha precisado la administración de un Cuestionario de Estrategias de Afrontamiento adaptado del Coping Behaviours Inventory, así como una subescala de mejoría global de la Escala de Impresión Clínica Global. Por último, también se ha dispuesto de un autoinforme a rellenar al final de cada sesión para evaluar la evolución clínica de cada paciente a lo largo del tratamiento. Resultados. Los datos muestran que los pacientes aprendieron nuevas estrategias de afrontamiento al final del tratamiento (X = 84,17), así como una mayor concienciación de la utilidad de dichas estrategias (X = 89,82) para afrontar aquellas situaciones que podrían suponer un riesgo de recaída. Los pacientes refieren una menor intensidad del deseo de consumir, así como un mayor grado de control en relación con este al final del tratamiento. Se observa que a mayor frecuencia en el uso de estrategias de afrontamiento hay una mayor efectividad de las mismas (p < 0,751). Conclusiones. Este trabajo plantea que el grupo de estrategias de afrontamiento en un formato terapéutico de grupo puede incluirse como un elemento más dentro del abordaje cognitivo-conductual en la intervención en psicología clínica en el ámbito de las adicciones (AU)

Introduction. The objective of the present study is to show the results in terms of effectiveness of the application of a coping behaviour group in psychoactive substance addicts in an out-patient hospital environment with the aim of providing the maintenance of abstinence. Material and methods. The sample of this study is composed of 38 subjects who attended a 12 session program. In order to assess the effectiveness of this treatment, The Cuestionario de Estrategias de Afrontamiento adapted from Coping Behaviours Inventory has been applied, and also the Global Clinic Impresion Scale Global. Finally, a self-assessment form at the end of each session has also been used to evaluate the clinical evolution of each patient during the entire treatment period. Results. The data show that the patients are able to learn new coping behaviours at the end of the treatment (X = 84.17), and they are aware of the utility of these coping behaviours (X = 89.82) to be used in high risk situations. Patients exhibit lower intensity of craving as well as a higher perception of control towards it at the end of the treatment. This study reveals that as higher coping behaviours frequency is the higher their efficacy is (p < 0.751). Conclusions. This study proposes that a coping behaviour group is an element to be included in cognitive-behavioural therapy approaches in the clinical psychology intervention of addictions (AU)

Condroblastoma de escafoides carpiano / Chondroblastoma of the carpal scaphoids

El condroblastoma es un tumor benigno de origen cartilaginoso que representa menos del 1% de todos los tumores óseos primarios. Se localiza típicamente en la epífisis de los huesos largos. Un 10% de los condroblastomas afectan a huesos del pie y de la mano. El asiento de esta lesión en el carpo es extraordinariamente raro. Se presenta un caso de condroblastoma del escafoides del carpo que fue tratado mediante curetaje de la lesión y relleno con injerto óseo autólogo de cresta iliaca (AU)

A chondroblastoma is a benign tumour of cartilaginous origin which represents less than 1% of all primary osseous tumours. It is typically localised in the epiphysis of the long bones. Some 10% of chondroblastomas affect the bones of the foot and the hand. It is extremely rare for the seat of this lesion to be in the carpal bones. We present a case of chondroblastoma of the carpal scaphoids that was treated through curretage of the lesion and filling with autologous osseous graft from the iliac crest (AU)

[Chondroblastoma of the carpal scaphoids]. / Condroblastoma de escafoides carpiano.

A chondroblastoma is a benign tumour of cartilaginous origin which represents less than 1% of all primary osseous tumours. It is typically localised in the epiphysis of the long bones. Some 10% of chondroblastomas affect the bones of the foot and the hand. It is extremely rare for the seat of this lesion to be in the carpal bones. We present a case of chondroblastoma of the carpal scaphoids that was treated through curretage of the lesion and filling with autologous osseous graft from the iliac crest.

[Primary pyomyositis caused by Streptococcus intermedius]. / Piomiositis primaria causada por Streptococcus intermedius.

Pyomyositis is a sub-acute bacterial infection that affects the striated muscle and is usually accompanied by the formation of an abscess in this muscle. It was initially described as an endemic disease in the tropics and only in recent years has an increase been observed in the number of cases in countries with a temperate climate in relation to an increase of immuno-depressed patients. The causal germ is Staphylococcus aureus in more than 75% of cases. The most useful imaging test is magnetic resonance. Treatment consists of complete surgical draining of the abscess combined with a suitable antibiotic therapy. We present a case of primary pyomyositis of the quadriceps in a diabetic patient with a remote traumatic antecedent of the affected zone and caused by an unusual germ. A complete recovery was obtained, without sequels, following surgical draining and 4 weeks of endovenous antibiotic treatment.

Piomiositis primaria causada por Streptococcus intermedius / Primary pyomyositis caused by Streptococcus intermedius

La piomiositis es una infección subaguda bacteriana que afecta al músculo estriado y suele acompañarse de la formación de un absceso en dicho músculo. Fue descrita inicialmente como una enfermedad endémica en los trópicos y sólo en los últimos años se ha observado un incremento del número de casos en países de clima templado en relación a un aumento de pacientes inmunodeprimidos. El germen causal es Staphylococcus aureus en más del 75% de los casos. La prueba de imagen más útil es la resonancia magnética. El tratamiento consiste en el drenaje quirúrgico completo del absceso combinado con una antibioterapia adecuada. Presentamos un caso de piomiositis primaria del cuádriceps en un paciente diabético con un antecedente traumático remoto de la zona afectada y causado por un germen inusual. Se obtuvo una recuperación completa y sin secuelas tras drenaje quirúrgico y 4 semanas de tratamiento antibiótico endovenoso

Pyomyositis is a sub-acute bacterial infection that affects the striated muscle and is usually accompanied by the formation of an abscess in this muscle. It was initially described as an endemic disease in the tropics and only in recent years has an increase been observed in the number of cases in countries with a temperate climate in relation to an increase of immuno-depressed patients. The causal germ is Staphylococcus aureus in more than 75% of cases. The most useful imaging test is magnetic resonance. Treatment consists of complete surgical draining of the abscess combined with a suitable antibiotic therapy. We present a case of primary pyomyositis of the quadriceps in a diabetic patient with a remote traumatic antecedent of the affected zone and caused by an unusual germ. A complete recovery was obtained, without sequels, following surgical draining and 4 weeks of endovenous antibiotic treatment

Técnicas de intervención cognitivo-conductuales para el tratamiento de la dependencia de la cocaína / Cognitive-behavioral therapy for the treatment of cocaine dependence

Las dos últimas décadas se han caracterizado por un notable avance en el desarrollo de terapias cognitivo-conductuales efectivas para la dependencia de cocaína, trastorno para el cual aún no se han identificado tratamientos farmacológicos efectivos. Se revisa la creciente literatura sobre la eficacia de diferentes tipos de técnicas cognitivoconductuales para el tratamiento de los trastornos por uso de cocaína (la integración del abordaje de refuerzo comunitario y las técnicas de manejo de contingencias, el tratamiento de exposición a estímulos, las técnicas de prevención de recaídas y la entrevista motivacional) y se comentan algunos de los desafíos y dificultades que surgen al transferir a la práctica clínica dichas intervenciones cognitivo-conductuales. En conjunto, la presente revisión describe un área pujante de investigación que todavía tiene mucho que aportar al tratamiento de los trastornos por uso de cocaína

The past two decades have been characterized by marked progress in the development of effective cognitive- behavioral therapies for cocaine dependence, for which no generally effective pharmacotherapies have been identified. The increasing literature on the efficacy of several types of cognitive-behavioral therapies (community reinforcement approach plus vouchers, cue exposure treatment, relapse prevention therapy and motivational interviewing) for cocaine use disorders is reviewed, followed by discussion of a number of issues that arise when integrating these cognitive-behavioral interventions into clinical practice. Overall, this review describes a vigorous area of research that has much to contribute to the treatment of cocaine use disorders

[Cognitive-behavioral therapy for the treatment of cocaine dependence]. / Técnicas de intervención cognitivo-conductuales para el tratamiento de la dependencia de la cocaína.

The past two decades have been characterized by marked progress in the development of effective cognitive- behavioral therapies for cocaine dependence, for which no generally effective pharmacotherapies have been identified. The increasing literature on the efficacy of several types of cognitive-behavioral therapies (community reinforcement approach plus vouchers, cue exposure treatment, relapse prevention therapy and motivational interviewing) for cocaine use disorders is reviewed, followed by discussion of a number of issues that arise when integrating these cognitive-behavioral interventions into clinical practice. Overall, this review describes a vigorous area of research that has much to contribute to the treatment of cocaine use disorders.

[Exposure to environmental tobacco smoke at home increases the need for medical attention for respiratory diseases in childhood]. / La exposición al humo de tabaco en el hogar aumenta la frecuentación por patología respiratoria en la infancia.

OBJECTIVES: Children are highly vulnerable to damage from passive smoking as they are unable to avoid environmental tobacco, if present. Some reports have suggested that domestic exposure to environmental tobacco smoke can increase respiratory diseases in children. The aim of this study was to assess whether domestic passive smoking is associated with new respiratory events. METHODS: A descriptive, retrospective study was performed of 410 children aged less than 14 years old. The variables studied were: a) smokers in the household, b) the number of cigarettes smoked per day, c) school attendance, d) the number of siblings, e) previous respiratory diseases among parents and siblings, f) maternal smoking in pregnancy, and g) the number of respiratory events recorded in the previous year. Univariate, bivariate and multivariate analyses were performed. RESULTS: A total of 50.2 % of the children cohabited with smokers at home. The mean number of upper respiratory tract events per child living in environments free of tobacco smoke was 2.53 versus 3.52 when one of the household members smoked. For respiratory disease as a whole, an inverse association with age was found [OR = 0.83; (95 % CI: 0.76-0.90)] and a direct association was found with maternal smoking [OR = 4.56 (95 % CI; 1.84-11.34)]. With upper respiratory tract disease, the OR was 1.4 if the mother smoked 11-20 cigarettes/day, and was 1.9 if the number of cigarettes was > 20. With lower respiratory diseases, the odds ratio was 3.48 (95 % CI; 2.07-6.06) if the mother smoked. CONCLUSIONS: Fifty percent of the children studied were exposed to environmental tobacco smoke in the home. Younger children were at higher risk. The major risk factor for respiratory disease was maternal smoking and the risk increased with the number of cigarettes smoked. Health education is essential to protect children from tobacco smoke exposure.

La exposición al humo de tabaco en el hogar aumenta la frecuentación por patología respiratoria en la infancia / Exposure to environmental tobacco smoke at home increases the need for medical attention for respiratory diseases in childhood

Objetivos: Los niños son muy vulnerables al tabaquismo pasivo dado que no pueden evitar la exposición al tabaco si ésta se presenta. Hay datos indicativos de que la exposición doméstica al humo de tabaco puede aumentar la patología respiratoria en la infancia. El objetivo de este estudio fue comprobar si la exposición se asociaba a la aparición de nuevos episodios respiratorios. Métodos: Se estudiaron 410 menores de 14 años. Se trata de un estudio retrospectivo descriptivo. Variables: a) fumadores entre los convivientes; b) cigarrillos/día; c) escolarización; d) hermanos; e) antecedentes patológicos respiratorios en los padres/hermanos; f) tabaquismo materno durante la gestación, y g) episodios respiratorios registrados en el ultimo año. Se hizo análisis univariante, bivariante y multivariante. Resultados: El 50,2 % de los niños conviven con fumadores en el hogar. La media de episodios de vías altas por cada niño con hogar libre de exposición al tabaco fue de 2,53 frente a 3,52 episodios que aparecieron en caso de existir fumadores en la casa. Para el conjunto de patología respiratoria se observó relación inversa con la edad: odds ratio (OR): 0,83 (intervalo de confianza del 95 % [IC 95 %]: 0,76-0,90) y directa con el hábito tabáquico de la madre: OR: 4,56 (IC 95 %: 1,84-11,34). Patología de vías altas, si la madre fuma 11-20 cigarrillos, OR: 1,4, y si fuma más de 20, OR: 1,9. Patología de vías bajas, si la madre fuma: OR: 3,48 (IC 95 %: 2,07-6,06). Conclusiones: Uno de cada 2 menores está expuesto al humo de tabaco en el hogar. Los riesgos son mayores cuando menor es la edad. El hábito tabáquico de la madre es el que más influye y se incrementa en función del número de cigarrillos. La educación sanitaria es fundamental para proteger a los niños del humo del tabaco

Objectives: Children are highly vulnerable to damage from passive smoking as they are unable to avoid environmental tobacco, if present. Some reports have suggested that domestic exposure to environmental tobacco smoke can increase respiratory diseases in children. The aim of this study was to assess whether domestic passive smoking is associated with new respiratory events. Methods: A descriptive, retrospective study was performed of 410 children aged less than 14 years old. The variables studied were: a) smokers in the household, b) the number of cigarettes smoked per day, c) school attendance, d) the number of siblings, e) previous respiratory diseases among parents and siblings, f) maternal smoking in pregnancy, and g) the number of respiratory events recorded in the previous year. Univariate, bivariate and multivariate analyses were performed. Results: A total of 50.2 % of the children cohabited with smokers at home. The mean number of upper respiratory tract events per child living in environments free of tobacco smoke was 2.53 versus 3.52 when one of the household members smoked. For respiratory disease as a whole, an inverse association with age was found [OR = 0.83; (95 % CI: 0.76-0.90)] and a direct association was found with maternal smoking [OR = 4.56 (95 % CI; 1.84-11.34)]. With upper respiratory tract disease, the OR was 1.4 if the mother smoked 11-20 cigarettes/day, and was 1.9 if the number of cigarettes was > 20. With lower respiratory diseases, the odds ratio was 3.48 (95 % CI; 2.07-6.06) if the mother smoked. Conclusions: Fifty percent of the children studied were exposed to environmental tobacco smoke in the home. Younger children were at higher risk. The major risk factor for respiratory disease was maternal smoking and the risk increased with the number of cigarettes smoked. Health education is essential to protect children from tobacco smoke exposure