Principales secuelas de SARS-CoV-2 en trabajadores de la salud en Baja California, México / Principal sequels of sars-cov-2 in health workers in Baja California, Mexico

Introducción: La pandemia por COVID-19, impactó en la vida de los trabajadores de la salud por su elevado riesgo de contagio. Objetivo: El objetivo fue describir las principales secuelas secundarias a la infección por SARS-CoV-2 en trabajadores de la salud. Material y Métodos: Estudio retrospectivo en los expedientes clínicos y Nuevo Sistema de Subsidios y Ayudas de los trabajadores de la salud que fueron valuados por una secuela secundaria a la COVID-19 adscritos al Órgano de Operación Administrativa Desconcentrada de Baja California del Instituto Mexicano del Seguro Social de marzo 2020 a diciembre 2021. Resultados: Se valuaron 41 secuelas: 36,56 % presentaron secuela neuromuscular y 29,26 % pulmonares. Predominaron: el sexo femenino, el personal médico y de enfermería. Conclusiones: Es necesario identificar oportunamente aquellas secuelas asociadas al SARS-CoV-2, para brindar una atención especial a los pacientes vulnerables y otorgar un seguimiento que mejore su calidad de vida. (AU)

Introduction: The COVID-19 pandemic impacted the lives of health workers due to its high risk of contagion. Objetives: The objective was to describe the principal sequels secondary to SARS-CoV-2 in healthcare workers. Material and methods: Retrospective study of clinical records and the Nuevo Sistema de Subsidios y Ayudas of health workers who were valued for a secondary sequel to COVID-19 assigned to the Órgano de Operación Administrativa Desconcentrada de Baja California of the Instituto Mexicano del Seguro Social, from March 2020 to December 2021. Results: 41 sequelae were valuated, 36,56 % presented neuromuscular sequelae and 29,26 % pulmonary sequelae. Predominated: the female sex, the medical and nursing staff. Conclusions: It is necessary to timely identify those sequelae associated with SARS-CoV-2, to provide special care to vulnerable patients and follow-up that improve their quality of life. (AU)

Characteristics of patients treated for suicidal behavior during the pandemic in a psychiatric emergency department in a Spanish province.

INTRODUCTION: Different studies have suggested that psychological, social and economic factors could contribute to an increase in the suicide. That is why the scientific community fear an epidemic of suicides secondary to this crisis. The objective is to evaluate the variables related to suicidal behavior during the two states of alarm and to review if there were sociodemographic or clinical differences with respect to periods prior to the COVID-19 pandemic. MATERIAL AND METHODS: We compared visits to the emergency room and their characteristics of all patients with suicidal behavior before and after the pandemic in Lérida. Information on sociodemographic status, reason for consultation, diagnosis and characteristics of suicidal behavior was obtained from the electronic medical record. RESULTS: No differences were observed in the percentage of suicidal ideation or attempts in the three periods (p=0.201). The characteristics in the multiple logistic regression associated with suicidal behavior are: being a woman (OR: 1.81 [1.27-2.56]), living with relatives (OR: 1.55 [1.05-2.32]) and have a diagnosis of non-alcohol related substance use disorder (OR: 1.94 [1.09-3.42]). As protective factors, being visited in the emergency room during the second state of alarm (OR: 0.68 [0.48-0.96]) and having depression (OR: 0.67 [0.47-0.96]). CONCLUSIONS: Emergency care for suicidal behavior did not increase during the pandemic and, in fact, in 2020 completed suicides decreased by almost half in the province. Risk factors for suicide attempt were female gender, living with relatives, and having a substance use disorder diagnosis. Instead, depression was a protective factor.

Post-COVID condition: dispensation of drugs and diagnostic tests as proxies of healthcare impact.

With the goal to increase knowledge on the healthcare impact of the post-COVID-19 condition we exploited the administrative claims database of Lombardy, the largest Italian region and the first after China to be heavily hit by the SARS-CoV-2 pandemic in February-May 2020. We chose to employ the dispensation of drugs and diagnostic tests as proxies of the impact of the post-COVID condition in 46,574 cases who recovered from COVID-19 and were negative at PCR testing within June 20, 2020. Data were obtained throughout the 18-month post-negativization period until December 2021 and results on the use of drugs and diagnostic tests were compared with those accrued in the same cases during the pre-COVID period in July-December 2019. After an increase in the first semester after SARS-CoV-2 negativization (July-December 2020), trends in the dispensation of drugs according to the broad ATC classes and of diagnostic tests decreased or remained substantially stable. However, dispensation of drugs for acid related disorders (A02), diabetes (A10), heparins (B01AB), direct oral anticoagulants (B01AP), antipsychotics (N05A), antidepressants (N06A) and for obstructive airways diseases (R03) was still higher than in the pre-COVID period. These findings, based upon drug and diagnostic test dispensation as proxies of the healthcare impact of the post-COVID condition, show that in a substantial proportion of recovered cases the post-COVID condition is active and clinically relevant 18 months after the acute disease. The findings also provide indirect evidence of the body organs and systems more compromised in the post-COVID period.

Urgent care and suicidal behavior in the child and adolescent population in a psychiatric emergency department in a Spanish province during the two COVID-19 states of alarm.

Introduction: The COVID-19 outbreak and lockdown may have an impact in mental health among youth, but reports of psychiatry emergency department encounters in young Spanish population are scarce. The aim of this study is to characterize the reasons for psychiatric urgent care of youth during COVID-19 pandemic in our hospital. Material and methods: This cross-sectional study compare visits to the psychiatry emergency department and their characteristics in young patients in the province of Lleida before and after the pandemic with special attention to the two states of alarm and suicidal behavior. Information regarding sociodemographic status, chief complaints, diagnosis, characteristics of suicidal behavior, and other data were obtained from the electronic medical records. Results: Within the total psychiatric emergency attendances, youth patients increased a 83.5% in the second state of alarm (p = 0.001). In this period patients were younger (p = 0.006), had less psychiatric history (p = 0.017) and their living conditions changed with an increase of those living with relatives (p = 0.004). Suicidal ideation care increased without statistical significance (p = 0.073). Multiple logistic regression identifies independent risk factors for suicidal behavior being female (OR: 2.88 [1.39-5.98]), living with relatives (OR: 3.49 [1.43-8.54]), and having a diagnosis of depression (OR: 6.34 [3.58-11.24]). Conclusions: The number of young people seen in psychiatric emergencies during the chronic stage of the pandemic increased, and these were getting younger and without previous psychiatric contact. The trend to higher rates of suicidal ideation indicates that youth experienced elevated distress during these periods, especially women, living with relatives and presenting depression.

Introducción: El brote de COVID-19 y el confinamiento pueden tener un impacto en la salud mental entre los jóvenes, pero los estudios de visitas al servicio de urgencias de psiquiatría en la población joven española son escasos. El objetivo de este estudio es caracterizar los motivos de atención de urgencia psiquiátrica de los jóvenes durante la pandemia de COVID-19 en nuestro hospital. Material y métodos: Este estudio transversal compara las visitas a urgencias de psiquiatría y sus características en pacientes jóvenes de la provincia de Lleida antes y después de la pandemia, con especial atención a los 2 estados de alarma y la conducta suicida. La información sobre el estatus sociodemográfico, las principales quejas, el diagnóstico, las características de la conducta suicida y otros datos se obtuvieron de la historia clínica electrónica. Resultados: Dentro del total de atenciones de urgencias psiquiátricas, los pacientes jóvenes aumentaron un 83,5% en el segundo estado de alarma (p = 0,001). En este período los pacientes eran más jóvenes (p = 0,006), tenían menos antecedentes psiquiátricos (p = 0,017) y sus condiciones de vida cambiaron, con un aumento de los que vivían con familiares (p = 0,004). La atención a la ideación suicida aumentó sin significación estadística (p = 0,073). La regresión logística múltiple identifica factores de riesgo independientes para la conducta suicida: ser mujer (OR: 2,88 [1,39-5,98]), vivir con familiares (OR: 3,49 [1,43-8,54]) y tener un diagnóstico de depresión (OR: 6,34 [3,58-11,24]). Conclusiones: Aumentó el número de jóvenes atendidos en urgencias psiquiátricas durante la etapa crónica de la pandemia, y estos cada vez eran más jóvenes y sin contacto psiquiátrico previo. La tendencia a tasas más altas de ideación suicida indica que los jóvenes experimentaron una angustia elevada durante estos períodos, especialmente las mujeres, que vivían con familiares y presentaban depresión.

E depois da doença Covid-19?: Cuidados de enfermagem de reabilitação / What about after Covid-19 disease?: Rehabilitation nursing care

A pandemia COVID-19 apresenta-se como o maior desafio global do século XXI, é a primeira vez que um vírus atinge proporções alarmantes em todos os continentes, as sequelas desta doença ainda não são totalmente conhecidas, desta forma, é importante intervir na recuperação e manutenção da capacidade funcional de todos os doentes com a síndroma pós-COVID-19, sendo fulcral a intervenção do enfermeiro especialista em enfermagem de reabilitação. Procurou-se estudar a intervenção do EEER ao doente com sequelas da doença Covid 19, uma vez que é considerada uma necessidade emergente de investigação pela falta de informação disponível. A doença COVID-19 afeta principalmente o aparelho respiratório, que pode ir desde doença respiratória ligeira, sem insuficiência respiratória, até pneumonia mais extensa com hipoxemia significativa e eventual evolução para ARDS e/ou Sépsis. A esta doença está associada a necessidade de medidas de isolamento, logo uma maior restrição ao espaço físico e ao leito, existindo maior intolerância ao exercício, diminuição da força muscular, um padrão ventilatório ineficaz e falta de capacidade para eliminar eficazmente a expetoração (Rocha, 2020). A teoria de enfermagem que norteou este trabalho foi a teoria do défice do autocuidado de Dorothea Orem em que o objetivo é a recuperação do autocuidado. A teoria do défice do autocuidado, pretende definir os momentos em que os cuidados de enfermagem são necessários. A necessidade de intervenção do enfermeiro especialista em enfermagem de reabilitação é fundamental pelas sequelas decorrentes da COVID-19. A ação do EEER vai centrar-se na minimização das sequelas e na promoção do autocuidado com vista a melhorar a capacidade funcional. Definiram-se 7 objetivos que procuram responder ao desenvolvimento das competências do EEER e à problemática em questão, para tal procedeu-se a um revisão sistemática da literatura, nas bases de dados CINAHL Complete e MEDLINE Complete, tendo em consideração certos critérios de elegibilidade e exclusão definidos. Este relatório demonstra que na abordagem ao doente com sequelas após doença COVID 19 obtiveram-se ganhos ao nível das alterações respiratórias como a melhoria da dispneia e fadiga, a nível musculosquelético como o aumento da força muscular e ao nível do autocuidado e do estado funcional, constataram-se ganhos na independência.

The COVID-19 pandemic presents itself as the greatest global challenge of the 21st century, it is the first time that a virus has reached alarming proportions on all continents, the sequels of this disease are not yet fully known, therefore, it is important to intervene in the recovery and maintenance of the functional capacity of all patients with post COVID-19 syndrome, in which the intervention of a specialist nurse in rehabilitation nursing is crucial. It was sought to study the rehabilitation specialist nurse intervention to the patient with sequels of Covid-19 disease, as it is considered an emerging research need due to the lack of available information. COVID-19 disease mainly affects the respiratory system, which may range from mild respiratory disease without respiratory failure to more extensive pneumonia with significant hypoxemia and eventual evolution to ARDS and/or sepsis. This disease is associated with the need for isolation measures, thus a greater restriction to the physical space and bedding, increased exercise intolerance, decreased muscle strength, an ineffective ventilatory pattern, and lack of ability to effectively eliminate sputum (Rocha, 2020). The nursing theory that guided my work as Dorothea Orem's self-care deficit theory, in which the goal is the recovery of self-care. The self-care deficit theory aims to define the moments when nursing care is needed. The need for intervention by the nurse specialist in rehabilitation nursing is fundamental due to the sequels resulting from COVID-19. The rehabilitation specialist nurses action will focus on minimizing the sequels and promoting self-care with a view to improving functional capacity. To this end, a systematic literature review was conducted in the CINAHL Complete and MEDLINE Complete databases, taking into account certain defined eligibility and exclusion criteria. This report shows that, in the approach to patients with sequels after COVID-19 disease, gains were obtained in terms of respiratory changes, such as the improvement of dyspnea and fatigue, and musculoskeletal level, such as the increase in muscle strength. In terms of self-care and functional status, gains in independence were observed.

Fatiga pandémica como secuela psicológica de la COVID-19 en la provincia Matanzas, Cuba / Pandemic fatigue as psychological sequel of COVID-19 in Matanzas province, Cuba

Introducción: El carácter prolongado de la actual pandemia hace que las personas tengan que adoptar un estilo diferente de afrontamiento al asumido en sus inicios, como resultado puede ser la fatiga y la desmotivación. Objetivo: Caracterizar las manifestaciones de la fatiga pandémica en población de la localidad de Santa Marta, provincia Matanzas. Métodos: Se realizó un estudio descriptivo observacional de corte transversal, del 7 al 10 de mayo del 2021 en 105 miembros de 51 familias seleccionadas aleatoriamente del Consultorio Médico de la Familia #27 de la localidad de Santa Marta. Las variables fueron agrupadas en sociodemográficas, clínicas y relacionadas con las características de la fatiga pandémica; exploradas a través de una encuesta. Los datos se almacenaron y procesaron en hojas de cálculo de Microsoft Excel. Resultados: El 38,1 por ciento se encontraba en el grupo etario 46-59 años de edad; el 36,2 por ciento de la población ha realizado viajes al menos una vez; el 22,9 por ciento refirió tener problemas esporádicos de convivencia; el 78,1 por ciento ha sentido preocupación por la salud de todos los miembros de su familia; el 40 por ciento experimentó cambios bruscos en su humor y el 28,6 por ciento no realizaba actividades físicas ni didácticas. Conclusiones: La fatiga pandémica se manifestó en la población estudiada mediante la presencia de estrés psicológico, descuido de las medidas higiénico sanitarias, desinformación sobre la situación epidemiológica y otros síntomas de desgaste(AU)

Introduction: The prolonged nature of the current pandemic means that people have to adopt a different style of coping than assumed at the beginning, and as a result it can be fatigue and demotivation. Objective: To characterize the manifestations of pandemic fatigue in the population of the town of Santa Marta, Matanzas province. Methods: A descriptive observational cross-sectional study was conducted from May 7 to 10, 2021 in 105 members of 51 randomly selected families from the Family Doctor´s Office #27 in the town of Santa Marta. The variables were grouped into socio-demographic, clinical and related to the characteristics of pandemic fatigue explored through a survey. The data was stored and processed in Microsoft Excel spreadsheets. Results: 38.1percent were in the age group 46-59 years of age; 36.2percent of the population has made trips at least once; 22.9percent reported having sporadic problems of coexistence; 78.1percent have felt concern for the health of all members of their family; 40percent experienced sudden changes in their mood and 28.6percent did not perform physical or didactic activities. Conclusions: Pandemic fatigue manifested itself in the population studied through the presence of psychological stress, neglect of hygienic-sanitary measures, misinformation about the epidemiological situation and other symptoms of attrition(AU)

Post-Coronavirus Disease 2019 Triggers the Appearance of Mixed Polyneuropathy and Brain Fog: A Case Report.

Coronavirus disease 2019 (COVID-19) can directly or indirectly affect the central and peripheral nervous systems, resulting in cognitive impairment, memory problems, and a wide range of neuromuscular involvement, including neuropathies. However, the long-term neurological complications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection are not clear. The aim this study was to analyze a case report the presence of neurological sequelae due to post-Coronavirus disease 19 in a patient without apparent previous neurological symptoms. Clinical case: A 46-year-old patient, with no relevant history for the described condition, who, after severe COVID-19 infection, started a mixed neuropathy and mental fog syndrome as the main sequel. Multiple laboratory and imaging studies were performed during and after his hospital stay, and it was corroborated by an electromyography that it occurred from a neuropathy triggered by COVID-19 infection. Conclusions: This case provides additional evidence that mixed neuropathy and brain fog syndrome are potential complications of post-coronavirus disease 2019 syndrome. The neurological sequelae that manifest after a COVID-19 episode can be rapidly enhanced as a consequence of another alteration in some systems of the organism. However, future studies are necessary to elucidate the incidence of these neurological complications, their pathophysiological mechanisms and their therapeutic options.

Síndrome de COVID-19 persistente. Una revisión narrativa / Persistent COVID-19 syndrome. A narrative review

A medida que ha avanzado la pandemia de la enfermedad por coronavirus 2019 (COVID-19), originada por la infección por el coronavirus de tipo 2, causante del síndrome respiratorio agudo severo (SARS-CoV-2), el síndrome de COVID-19 persistente es un problema cada vez más reconocido y sobre el que se está desarrollando un importante volumen de publicaciones. Los síntomas pueden ser persistentes o aparecer, tras un periodo asintomático, semanas o meses después de la infección inicial. El cuadro clínico es tan marcadamente heterogéneo y multisistémico como en la fase aguda, por lo que se requiere un manejo multidisciplinar. Además, su aparición no está relacionada con la gravedad de la infección inicial, por lo que pueden afectar tanto a pacientes leves, incluso asintomáticos, como a enfermos graves que han requerido hospitalización. Aunque puede afectar a personas de cualquier edad, es más frecuente en mujeres de edad media. Las secuelas pueden generar un elevado impacto en la calidad de vida y en el ámbito laboral y social. El objetivo de este trabajo es hacer una revisión sobre el síndrome de COVID-19 persistente, conocer sus manifestaciones clínicas y las estrategias para el manejo y el seguimiento de estos pacientes (AU)

As the coronavirus-2019 disease (COVID-19) pandemic, caused by the infection with severe acute respiratory syndrome (SARS-CoV-2) coronavirus type 2, has progressed, persistent COVID-19 syndrome is an increasingly recognized problem on which a significant volume of medical literature is developing. Symptoms may be persistent or appear, after an asymptomatic period, weeks or months after the initial infection. The clinical picture is as markedly heterogeneous and multisystemic as in the acute phase, so multidisciplinary management is required. In addition, their appearance is not related to the severity of the initial infection, so they can affect both mild patients, even asymptomatic, and seriously ill patients who have required hospitalization. Although it can affect people of any age, it is more common in middle-aged women. The sequelae can generate a high impact on the quality of life, and in the work and social environment. The objective of this paper is to review persistent COVID-19 syndrome, to know its clinical manifestations and the strategies for the management and follow-up of these patients (AU)

Persistent COVID-19 syndrome. A narrative review.

As the coronavirus-2019 disease (COVID-19) pandemic, caused by the infection with severe acute respiratory syndrome (SARS-CoV-2) coronavirus type 2, has progressed, persistent COVID-19 syndrome is an increasingly recognized problem on which a significant volume of medical literature is developing. Symptoms may be persistent or appear, after an asymptomatic period, weeks or months after the initial infection. The clinical picture is as markedly heterogeneous and multisystemic as in the acute phase, so multidisciplinary management is required. In addition, their appearance is not related to the severity of the initial infection, so they can affect both mild patients, even asymptomatic, and seriously ill patients who have required hospitalization. Although it can affect people of any age, it is more common in middle-aged women. The sequelae can generate a high impact on the quality of life, and in the work and social environment. The objective of this paper is to review persistent COVID-19 syndrome, to know its clinical manifestations and the strategies for the management and follow-up of these patients.

[Persistent COVID-19 syndrome. A narrative review]. / Síndrome de COVID-19 persistente. Una revisión narrativa.

As the coronavirus-2019 disease (COVID-19) pandemic, caused by the infection with severe acute respiratory syndrome (SARS-CoV-2) coronavirus type 2, has progressed, persistent COVID-19 syndrome is an increasingly recognized problem on which a significant volume of medical literature is developing. Symptoms may be persistent or appear, after an asymptomatic period, weeks or months after the initial infection. The clinical picture is as markedly heterogeneous and multisystemic as in the acute phase, so multidisciplinary management is required. In addition, their appearance is not related to the severity of the initial infection, so they can affect both mild patients, even asymptomatic, and seriously ill patients who have required hospitalization. Although it can affect people of any age, it is more common in middle-aged women. The sequelae can generate a high impact on the quality of life, and in the work and social environment. The objective of this paper is to review persistent COVID-19 syndrome, to know its clinical manifestations and the strategies for the management and follow-up of these patients.

[Neurological sequels and follow-up of the child victim of non-accidental head trauma]. / Séquelles neurologiques et suivi de l'enfant victime.

Babies who suffer non-accidental head injuries systematically show sequels, whether they are neurological, cognitive or behavioural. Some of these disorders are immediately identified, such as neurological sequels, but others, such as cognitive or behavioural disorders, are revealed much later. Regular monitoring by a neuro-paediatrician is therefore essential in order to be able to adapt the child's care as closely as possible to his or her needs according to the sequels presented.

[The Iceman : Life scenarios and pathological findings from 30 years of research on the glacier mummy "Ötzi"]. / Der Mann aus dem Eis : Lebensszenario und Pathologische Befunde aus 30 Jahren Forschung an der Gletschermumie "Ötzi".

The comprehensive investigation of the excellently preserved mummy of Ötzi, the Iceman, and his equipment over the last 30 years has provided a wealth of information about the life and disease of this late Neolithic individual. This research has indicated that his origin was from a local southern Alpine population, that he grew up in the valleys of the Southern Alps, and that he had considerable local mobility. He had well-balanced nutrition with a mixed vegetable and animal diet. He was very mobile in the alpine terrain and of athletic constitution. The Iceman suffered from mild to moderate degenerative joint disease primarily of the right hip joint, slight spondylosis of the cervical and lumbar spine, a minor focal (premature) arteriosclerosis, lung anthracosis and possibly silicosis, previous pleuritic inflammation (possibly of post-specific origin), intestinal infections of the stomach by Helicobacter pylori and Trichuris trichiura worm infestation in the intestines, a mild osteomalacia of cancellous bone, and diverse pathologies of his teeth with dental caries and periodontitis, as well as hair anomalies. The presence of borreliosis is still under debate. As potential remedies, the Iceman carried some anthelmintic substances with him: a birch polypore and an anthelmintic fern. The numerous tattoos may also have had therapeutic effects. Finally, the last days of Ötzi could be reconstructed quite precisely: his gastrointestinal content indicates that the Iceman moved from Alpine heights to a lower location and then again up to the glacier region where he died. During this journey he encountered two attacks: the first, several days before his death, lead to a stabbing wound in his right hand; the second was an arrow hit that wounded the Iceman lethally at his left axilla by laceration of the subclavian artery.

Fractura de cuello femoral en niños, reporte de caso clinico / Fractures of the femoral neck in children, report of case

Paciente de 10 años 2 meses de sexo femenino quien sufrió politraumatismo en accidente de tránsito al ser arrollada por automóvil en vía pública generando trauma craneoencefálico leve y fractura de cuello femoral derecho clasificación III de Delbet con desplazamiento completo, se manejó inicialmente con tracción cutánea con 3kg y posteriormente se realizó intervención quirúrgica realizando reducción cerrada y fijación percutánea exitosa. Continuó en control ambulatorio cada 3 meses con buena evolución. Se realizó retiro de material de osteosíntesis sin complicaciones. Continúa en controles por parte del servicio de Ortopedia y Traumatología periódicamente sin presencia de secuelas. Aunque poco frecuente, la fractura de cuello femoral se presenta como un traumatismo que conlleva retos para el médico tratante dados los altos índices de fracaso terapéutico, por lo que se hace necesario conocer el impacto de ésta patología en el momento en que ocurre la lesión y en el transcurso del tiempo, a fin de mejorar las opciones terapéuticas y mejorar el pronóstico de la lesión.

A 10 years and 2 months old patient of female gender who suffered multiple trauma in traffic accident when being rolled by automobile in public road generating mild traumatic brain injury and fracture of right femoral neck classification III of Delbet with complete displacement, she was initially handled with cutaneous traction with 3kg and later surgical intervention by closed reduction, successfull procedure. She continued in ambulatory control every 3 months with good evolution. Removal of osteosynthesis material was performed without complications. She continues in controls by the service of Orthopedics and Traumatology periodically without presence of sequels. Although infrequent, femoral neck fracture presents as a trauma that presents challenges for the treating physician, given the high rates of therapeutic failure, so it is necessary to know the impact of this pathology at the moment of injury and In the course of time, in order to improve therapeutic options and improve the prognosis of the lesión.

Algunos aspectos clínicos y epidemiológicos relacionados con mordeduras de perro en niños / Some clinical and epidemiological aspects related to dog bites in children

Introducción: Las mordeduras de perro afectan fundamentalmente a pacientes en la edad pediátrica, estas engendran peligros como secuelas estéticas y la posibilidad implícita de transmisibilidad del virus de la rabia a seres humanos. Objetivo: caracterizar el comportamiento clínico-epidemiológico de las mordeduras de perro en niños. Métodos: Se realizó un estudio observacional, longitudinal y prospectivo en pacientes con diagnóstico de mordedura de perro con necesidad de inmunización pasiva y activa, ingresados en el Servicio de Miscelánea del Hospital Infantil Sur Antonio María Béguez César de Santiago de Cuba, del 1ro de enero de 2017 al 31 de diciembre de 2018. Resultados: En los pacientes incluidos en el estudio predominaron los del sexo masculino (57,7 por ciento), los grupos de edades de 1 a 5 años 11 meses y 29 días, y de 6 a 10 años 11 meses y 29 días fueron los de mayor incidencia. Aunque no existió asociación estadística entre la localización anatómica de las lesiones y la edad, fueron las de miembros inferiores las más frecuentes en todas las edades con 63 pacientes (40,4 por ciento); destacándose como complicaciones la celulitis, las lesiones óseas y las secuelas estéticas; ningún niño presentó infección rábica. En el 50 por ciento de los casos la mordedura ocurrió en el horario nocturno y los perros de otro domicilio causaron la mayor parte de las agresiones. Conclusiones: El diagnóstico de mordeduras de perro se realizó con mayor frecuencia en niños del sexo masculino de uno y más años, en el horario nocturno y la principal complicación fue la celulitis(AU)

Introduction: Dog bites mainly affect patients in pediatric ages. They pose dangers such as esthetic sequels and the implicit possibility of transmission of the rabies virus to human beings. Objective: Characterize the clinical-epidemiological behavior of dog bites in children. Methods: An observational longitudinal prospective study was conducted of patients diagnosed with dog bite requiring passive and active immunization admitted to the Miscellany Service of Antonio María Béguez César South Children's Hospital in Santiago de Cuba from 1 January 2017 to 31 December 2018. Results: Among the patients included in the study there was a predominance of the male sex (57.7 percent). The age groups 1 to 5 years 11 months and 29 days and 6 to 10 years 11 months and 29 days showed the greatest incidence. Though no statistical association was found between anatomical location of the injuries and age, bites on the lower limbs were the most common at all ages with 63 patients (40.4 percent). Outstanding complications were cellulitis, bone lesions and esthetic sequels. No child had rabies infection. In 50 percent of the cases the bite occurred in the night hours. Most of the attacks were performed by dogs from other households. Conclusions: Dog bite diagnosis was more common among male children aged one year and over. Most bites occurred in the night hours. The main complication was cellulitis(AU)

Update on HSV and VZV infections of the brain.

HSV and VZV are the most frequently identified pathogen in encephalitis cases in France. Recent guidelines were provided by some scientific societies, for the management of encephalitis. PCR is the gold standard for the diagnosis, and the first-line imaging tool is MRI. Sequels are important and there is an absolute need for a better evaluation and management in the future to reduce the short- and long-term consequences, beyond reducing the case fatality rate. A better management of sequels is important. Autoimmune encephalitis triggered by HSV is a recent syndrome, which leads to consider it as a major issue in the management of patients. The final point is the importance of inflammation in explaining disorders and severity, meaning that anti-inflammatory treatments of whatever nature have to be validated.

[Pulmonary tuberculosis: Radiological evolution of broncho-pulmonary lesions at the end of treatment]. / Tuberculose pulmonaire : évolution radiologique des lésions broncho-pulmonaires en fin de traitement.

OBJECTIVES: To describe the residual broncho-pulmonary lesions and evaluate the role of CT scanning at the end of treatment of pulmonary tuberculosis. MATERIALS AND METHODS: Analysis of the initial and end of treatment CT scans of 56 patients with pulmonary tuberculosis according to a reading grid including parenchymatous and airways lesions. The CT data at the end of treatment were analysed in relation to the clinical and microbiological data, and the original CT scan. RESULTS: Active lesions (thick walled cavities and/or centrilobular micronodules) persisted in 24 patients (43%) after a mean treatment period of 7 months. The persistence of these signs of activity was correlated with the initial presence of a cavitary syndrome (p=0.027), with predominant sub-segmentary bronchial involvement, with extensive micronodular spread (p=0.024) and with bronchiectasis (p=0.04). These residual lesions were not associated with an increased risk of relapse. CONCLUSION: The persistence of signs of activity on the CT scan at the end of treatment of tuberculosis do not necessarily correspond to an absence of cure but to a radiological delay. This imaging is nevertheless useful to make an assessment of any subsequent changes in the bronchial tree and to estimate the risk of later complications.

Consecuencias clínicas posgastrectomía vertical tubular: enfermedad por reflujo gastroesofágico / Clinical consequences post tubular vertical gastrectomy: gastroesophageal reflux disease

Varias publicaciones informan un aumento en la tasa de enfermedad por reflujo gastroesofágico (ERGE) después de la gastrectomía vertical tubular (GVT) o en manga a pesar que no existe aún consenso al respecto. El objetivo de este artículo es mostrar nuestra propia experiencia y de la literatura respecto a los aspectos clínicos de la enfermedad por ERGE después de la gastrectomía vertical tubular. Del análisis de nuestros resultados y de los datos de la literatura, los estudios que evalúan la prevalencia de la enfermedad de reflujo gastroesofágico posoperatorio muestran que la GVT puede provocar síntomas de ERGE de novo o empeoramiento de la ERGE preexistente.

Several publications report an increase in the rate of gastroesophageal reflux disease (GERD) after surgery, although there is still no consensus on this. The aim of this article is to show our own experience and literature regarding the clinical aspects of GERD disease after tubular vertical gastrectomy. From the analysis of our results and data from the literature, studies evaluating the prevalence of postoperative gastro-oesophageal reflux disease show that GVT can cause symptoms of de novo GERD or worsening of pre-existing GERD.

[Congenital Analgesia: report of 2 cases]. / Analgesia congénita: reporte de dos casos.

Congenital analgesia is a rare condition, reporting in the international literature in rare cases since 1932, when it was first described. Its cause has been the subject of development of multiple theories and studies through the years. Currently various studies and experiments as its origin point mutation in the gene encoding SC9NA sodium channels, which have an important role in nociceptive transmission signals in the human body. The purpose of this study is to present two cases that were valued in the department of pediatric orthopedics at UMAE HTYOLV, patients whose insensitivity to pain has produced significant injuries that were once cause for valuation of the hospital.

La analgesia congénita es un padecimiento poco frecuente, en la literatura internacional se ha reportado en contados casos desde 1932, año en el que fue descrita por primera vez. Su causa ha sido motivo del desarrollo de múltiples teorías y numerosos estudios a través de los años. Actualmente diversos estudios y experimentos apuntan como origen la mutación en el gen SCN9A que codifica para los canales de sodio, los cuales tienen un papel muy importante en la transmisión de señales nociceptivas en el cuerpo humano. El motivo del presente estudio es dar a conocer dos casos que fueron valorados en el servicio de ortopedia pediátrica de la UMAE HTYOLV, pacientes en quienes la falta de sensibilidad al dolor ha producido lesiones importantes que fueron en su momento motivo de valoración por parte del hospital.

Analgesia congénita: reporte de dos casos / Congenital Analgesia: report of 2 cases

Resumen: La analgesia congénita es un padecimiento poco frecuente, en la literatura internacional se ha reportado en contados casos desde 1932, año en el que fue descrita por primera vez. Su causa ha sido motivo del desarrollo de múltiples teorías y numerosos estudios a través de los años. Actualmente diversos estudios y experimentos apuntan como origen la mutación en el gen SCN9A que codifica para los canales de sodio, los cuales tienen un papel muy importante en la transmisión de señales nociceptivas en el cuerpo humano. El motivo del presente estudio es dar a conocer dos casos que fueron valorados en el servicio de ortopedia pediátrica de la UMAE HTYOLV, pacientes en quienes la falta de sensibilidad al dolor ha producido lesiones importantes que fueron en su momento motivo de valoración por parte del hospital.

Abstract: Congenital analgesia is a rare condition, reporting in the international literature in rare cases since 1932, when it was first described. Its cause has been the subject of development of multiple theories and studies through the years. Currently various studies and experiments as its origin point mutation in the gene encoding SC9NA sodium channels, which have an important role in nociceptive transmission signals in the human body. The purpose of this study is to present two cases that were valued in the department of pediatric orthopedics at UMAE HTYOLV, patients whose insensitivity to pain has produced significant injuries that were once cause for valuation of the hospital.

Manejo interdisciplinario de pacientes quemados. Pilar fundamental para la reducción de secuelas funcionales / Multidisciplinary management of burned patients: Fundamental pillar for reduction of functional sequelae

Las secuelas de quemaduras representan una patología muy frecuente en nuestro medio y su impacto en la calidad de vida de los pacientes que las padecen es muy importante. El objetivo del trabajo fue demostrar la eficacia del manejo interdisciplinario en pacientes con quemaduras AB y B de zonas funcionales para reducir las secuelas. Se realizó un estudio retrospectivo que incluyó 53 pacientes tratados en nuestro servicio, detectando 15 pacientes secuelados; en el 90% de los casos la causa fue el incumplimiento de la terapia indicada luego del alta y el 10% la cicatrización patológica rebelde al tratamiento. Los pacientes con secuelas funcionales por abandono del tratamiento kinesiológico indicado fueron: cinco con retracción en la región cervical anterior, cuatro con retracción en la articulación del codo y cuatro con retracción axilar. Se detectaron dos pacientes que a pesar del tratamiento instaurado sufrieron cicatrices retráctiles, uno de ellos en cuello y el otro paciente en axila.

Sequels of burns represent a very frequent pathology in our environment and its impact on the quality of life of patients suffering from them is very important. The objective of the study was to demonstrate the effectiveness of the interdisciplinary management in patients with burns AB and B of functional areas to reduce the consequences. This is a retrospective study that included 53 patients treated in our service. Fifteen patients with sequelae were detected. In 90% of the cases the cause was a failure in following the prescriptions ordered in hospital discharge, and in10% it was due to rebel to treatment scarring. The patients with functional sequelae due to the absence of the indicated kinesiological treatment were: five with retraction in the anterior cervical region, four with retraction in the elbow joint and four with axillary retraction. Two patients were detected that in spite of the established treatment they suffered retractile scars, one of them in neck and the other patient in armpit.