Tromboembolismo pulmonar durante la pandemia por SARS-CoV-2: características clínicas y radiológicas / Pulmonary embolism during SARS-CoV-2 pandemic: clinical and radiological features

Antecedentes Se ha descrito una elevada incidencia de tromboembolismo pulmonar (TEP) durante la pandemia por coronavirus. Métodos Estudio retrospectivo unicéntrico, con revisión de las angiografías pulmonares por tomografía computarizada solicitadas por sospecha de tromboembolismo pulmonar durante dos períodos, del 01 de marzo del 2020 al 31de mayo del 2020 (pandemia), e igual intervalo en 2019 (control). Resultados Se diagnosticaron 22 tromboembolismos pulmonares durante el período control y 99 en el pandémico, 74 asociados con COVID-19. El 5,3% de los pacientes hospitalizados con COVID-19 sufrió un tromboembolismo pulmonar, con un retraso entre ambos diagnósticos de 9,1 ± 8,4 días. Durante la pandemia, los pacientes con tromboembolismo pulmonar tenían menos condiciones predisponentes (tromboembolismo pulmonar previo 5,1 vs. 18,2%, p = 0,05, cirugía previa 2 vs. 35,4%, p = 0,0001, trombosis venosa profunda 11,1 vs. 45,5%, p = 0,0001), y los tromboembolismos pulmonares periféricos eran más frecuentes (73,5 vs. 50%, p = 0,029). Conclusiones Existe un riesgo incrementado de sufrir un TEP durante la pandemia por SARS-CoV-2, que afecta a pacientes con perfil clínico diferente y causa más frecuentemente TEP distales (AU)

Background A high incidence of pulmonary embolism has been described during the coronavirus pandemic. Methods This work is a single-center retrospective study which reviewed computed tomography pulmonary angiograms ordered due to suspected pulmonary embolism during two periods: from March 1, 2020 to May 31, 2020 (pandemic) and during the same interval in 2019 (control). Results Twenty-two pulmonary embolism were diagnosed during the control period and 99 in the pandemic, 74 of which were associated with COVID-19. Of all patients hospitalized with COVID-19, 5.3% had a pulmonary embolism, with a delay between the two diagnoses of 9.1 ± 8.4 days. During the pandemic, patients with pulmonary embolism had fewer predisposing conditions (previous pulmonary embolism 5.1 vs. 18.2%, p = .05; previous surgery 2 vs. 35.4%, p = .0001; deep vein thrombosis 11.1 vs. 45.5%, p = .0001); peripheral pulmonary embolisms were the most frequent (73.5 vs. 50%, p = . 029). Conclusions There is an increased risk of having a pulmonary embolism during the SARS-CoV-2 pandemic, which affects patients with a different clinical profile and more often causes distal pulmonary embolisms (AU)

[Pulmonary embolism during SARS-CoV-2 pandemic: clinical and radiological features]. / Tromboembolismo pulmonar durante la pandemia por SARS-CoV-2: características clínicas y radiológicas.

Background: A high incidence of pulmonary embolism has been described during the coronavirus pandemic. Methods: This work is a single-center retrospective study which reviewed computed tomography pulmonary angiograms ordered due to suspected pulmonary embolism during two periods: from March 1, 2020 to May 31, 2020 (pandemic) and during the same interval in 2019 (control). Results: Twenty-two pulmonary embolism were diagnosed during the control period and 99 in the pandemic, 74 of which were associated with COVID-19. Of all patients hospitalized with COVID-19, 5.3% had a pulmonary embolism, with a delay between the two diagnoses of 9.1 ± 8.4 days. During the pandemic, patients with pulmonary embolism had fewer predisposing conditions (previous pulmonary embolism 5.1 vs. 18.2%, p = .05; previous surgery 2 vs. 35.4%, p = .0001; deep vein thrombosis 11.1 vs. 45.5%, p = .0001); peripheral pulmonary embolisms were the most frequent (73.5 vs. 50%, p = . 029). Conclusions: There is an increased risk of having a pulmonary embolism during the SARS-CoV-2 pandemic, which affects patients with a different clinical profile and more often causes distal pulmonary embolisms.

Pulmonary embolism during SARS-CoV-2 pandemic: Clinical and radiological features.

BACKGROUND: A high incidence of pulmonary embolism has been described during the coronavirus pandemic. METHODS: This work is a single-center retrospective study which reviewed computed tomography pulmonary angiograms ordered due to suspected pulmonary embolism during two periods: from March 1, 2020 to May 31, 2020 (pandemic) and during the same interval in 2019 (control). RESULTS: Twenty-two pulmonary embolisms were diagnosed during the control period and 99 in the pandemic, 74 of which were associated with COVID-19. Of all patients hospitalized with COVID-19, 5.3% had a pulmonary embolism, with a delay between the two diagnoses of 9.1 ± 8.4 days. During the pandemic, patients with pulmonary embolism had fewer predisposing conditions (previous pulmonary embolism 5.1 vs. 18.2%, p = .05; previous surgery 2 vs. 35.4%, p = .0001; deep vein thrombosis 11.1 vs. 45.5%, p = .0001); peripheral pulmonary embolisms were the most frequent (73.5 vs. 50%, p = . 029). CONCLUSIONS: There is an increased risk of having a pulmonary embolism during the SARS-CoV-2 pandemic, which affects patients with a different clinical profile and more often causes distal pulmonary embolisms.

[Prevalence of osteoporosis assessed by densitometry in the Spanish female population]. / Prevalencia de osteoporosis determinada por densitometría en la población femenina española.

BACKGROUND: Osteoporotic fractures represent an important clinic and socioeconomic problem. Although it is well known the incidence of fractures in Spain, we do not know how many persons are at risk. The World Health Organization (WHO) has approved a densitometric criteria to define osteopenia (OSPE) and osteoporosis (OSP). The aim of this study has been to evaluate the prevalence of OSP and OSPE in women of the Spanish population. SUBJECTS AND METHOD: With the data of a study of bone mass in the Spanish population, stratified according to age, using dual-energy X-ray absortiometry (DXA) with a QDR/1000 Hologic device and according the WHO criteria, we have calculated the prevalence of OSP and OSPE in normal Spanish women at the lumbar spine (LS) and/or femoral neck (FN). RESULTS: The prevalence of osteoporosis at LS is: 0.34% in the group aged 20-44 years; 4.31% in the group aged 45-49 years; up to 9.09% in the group aged 50-59 years; 24.29% in the 60-69 years, and 40.0% in the group aged 70-79 years. The overall prevalence of osteoporosis is 11.13%, confidence interval (CI) 95% from 9.4 to 12.8%. The prevalence of osteoporosis at FN is: 0.17% in the group aged 20-44 years, 0% in the 45-49 years, up to 1.3% in the 50-59 years, 5.71% in the 60-69 years and 24.24% in the group aged 70-79 years. The overall prevalence of osteoporosis is 4,29% (CI 95% 3.2-5.4%). The prevalence in female older than 50 years was 22.8% at LS and 9.1% at FN. 12.73% of Spanish women population has osteoporosis at LS or FN, which represent about 1,974,400 women; 2.68% of total population has osteoporosis in both sites. CONCLUSIONS: Even we do not include in this study women with established osteoporosis (with fractures), the number of Spanish women with osteoporosis is very high.

Prevalencia de osteoporosis determinada por densitometría en la población femenina española / Prevalence of osteoporosis assessed by densitometry in the Spanish female population

FUNDAMENTO: La osteoporosis y sus fracturas consecuentes representan un importante problema clínico y socioeconómico. Aunque se conoce la incidencia de fracturas en España, no se dispone de información de cuántas personas tienen riesgo de presentarlas. Recientemente, un comité de la Organización Mundial de la Salud (OMS) ha aprobado unos criterios densitométricos para definir la osteopenia (OSPE) y la osteoporosis (OSP). La intención de este estudio ha sido valorar la prevalencia de OSP y OSPE en mujeres de la población española. POBLACIÓN Y MÉTODO: Utilizando los datos de un estudio de la normalidad de masa ósea en la población española, estratificado por grupos de edad, utilizando densitometría radiológica de doble haz (DEXA) mediante aparatos Hologic QDR 1000, y aplicando los criterios de la OMS, hemos calculado la prevalencia de OSP y OPSE en las mujeres españolas, en la columna lumbar (CL), cuelllo de fémur (CF), ambas partes o algunas de ellas. RESULTADOS: La prevalencia de OSP en CL es del 4,31 por ciento en el grupo de 45 a 49 años; del 9,09 por ciento en el de 50 a 59 años; del 24,29 por ciento en el de 60 a 69 años, y del 40,0 por ciento en el de 70 a 79 años. La prevalencia global fue del 11,12 por ciento, con un intervalo de confianza (IC) del 95 por ciento del 9,4-12,8 por ciento. La prevalencia de OSP en CF es del 0,17 por ciento en el grupo de 20 a 44 años; del 0 por ciento a los 45 a 49 años; del 1,3 por ciento a los 50 a 59 años; 5,71 por ciento a los 60 a 69 años, y del 24,24 por ciento a los 70 a 79 años. La prevalencia global es del 4,29 por ciento (IC del 95 por ciento, 3,2-5,4 por ciento).La prevalencia de OSP en mujeres mayores de 50 años fue del 22,8 por ciento en CL y del 9,1 por ciento en CF. Un 26,07 por ciento de las mujeres mayores de 50 años tiene OSP en CL o CF.Un 12,73 por ciento (IC del 95 por ciento de 10,92-14,54 por ciento) de la población femenina española tiene OSP ya en CL o en CF, lo que representa alrededor de 1.974.400 mujeres. Un 2,68 por ciento presenta osteoporosis en ambas zonas. CONCLUSIONES: Aunque en este estudio no están incluidas las personas con osteoporosis ya establecida (con fracturas), la cifra de mujeres españolas que presentan esta enfermedad es muy elevada (AU)

Measuring quality of life in women with vertebral fractures due to osteoporosis: a comparison of the OQLQ and QUALEFFO.

INTRODUCTION: Studies comparing the performance of health-related quality of life instruments in osteoporosis are lacking. We compared the feasibility, validity and reliability of the osteoporosis quality of life questionnaire (OQLQ) and the QUALEFFO (test version) in women with vertebral deformities due to osteoporosis. METHODS: Three hundred and thirty-eight patients diagnosed with primary osteoporosis and vertebral deformity and a random sample of 304 women from the general population (control group) were recruited. Patients and controls were randomly assigned to receive either the OQLQ or the QUALEFFO, and the SF-36 and EQ-5D. Test-retest reliability was assessed in the patient group. RESULTS: The QUALEFFO had more items with missing data and took slightly longer to administer (20.7 vs. 18.7 min). Cronbach's alpha and intraclass correlation coefficient (ICC) values for OQLQ domains (alpha: 0.75-0.91; ICC: 0.85-0.93) were slightly higher than for the QUALEFFO (alpha: 0.63-0.90; and ICC: 0.80-0.93). OQLQ and QUALEFFO domain scores correlated as expected with SF-36 and EQ-5D domains. Both questionnaires discriminated between patients and controls though the OQLQ showed slightly better discriminant power. DISCUSSION: The superior performance of the OQLQ in terms of administration time, missing responses, and discriminatory capacity needs to be weighed against the advantages of using a self-administered instrument such as the QUALEFFO. A full comparison also requires data on sensitivity to change.

Retroneumoperitoneo como manifestación de diverticulitis atípica de sigma / Retropneumoperitoneum as a manifestation of atypical diverticulitis from the sigma

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2-Hydroxyestradiol is not mediating the effects of estradiol on tuberoinfundibular dopaminergic neurons controlling prolactin secretion in female rats.

Conversion of estrogens in their hydroxylated derivatives has been proposed as one of the mechanisms of action for these steroids in the brain. However, the actions of catechol estrogens on the hypothalamic control of the prolactin (PRL) release seem to be different to the effects caused by native estrogens. To clarify this question, we have examined the activity of tuberoinfundibular dopaminergic (TIDA) neurons in ovariectomized rats treated with estradiol (E2) or 2-hydroxyestradiol (OHE2), both administered alone or previously to progesterone (P). L-3,4 dihydroxyphenylacetic acid (DOPAC)/dopamine (DA) ratio in the medio basal hypothalamus (MBH), the anterior pituitary (AP) content of DA and the PRL release into the peripheral blood have been used as indexes of neural activity of TIDA system. Ovariectomy caused a significant reduction in plasma PRL levels, with increases of the DOPAC/DA ratio in MBH and of the AP content of DA. These changes were reversed by administration of E2, suggesting that this steroid exerted its stimulatory effect on PRL release by decreasing the activity of TIDA neurons. In contrast, OHE2 was unable to alter plasma PRL levels, the DOPAC/DA ratio in the MBH and the AP content of DA. On the other hand, P was able to stimulate the PRL release, but it needed a previous priming action of E2 since it was unable to modify plasma PRL levels when it was injected alone. This priming effect of E2 for the P action was not exerted by OHE2. Hence, we can conclude that the conversion of E2 in its 2-hydroxylated derivative is not mediating the effects of this steroid, nor its priming action for the P effect, on the hypothalamic dopaminergic control of the PRL release.

Effects of discrete medial preoptic hypothalamic lesions on the androgen gonadotropin feedback system in the male rat.

The effect of discrete lesions of the Anterior Medial Preoptic Area of the Hypothalamus (MPOA) in the control of pituitary gonadotropins in the adult male Wistar rat has been studied. Electrolytic lesions were made by passing an anodal current through tungsten electrodes. Electrodes were oriented stereotaxically into the MPOA and lesion placement was histologically checked. In sham controls, electrodes were lowered into the MPOA but no current was applied. Serum LH and FSH were measured by RIA. MPOA lesioned animals showed significantly lower plasma LH (p less than 0.01) in comparison to sham lesioned group. Plasma FSH remained unaltered. To test whether these results were related to an alteration in the negative feedback system, the response to administration of Testosterone Propionate (TP) and the secretion patterns of LH and FSH after castration were analyzed. Administration of TP revealed similar LH and FSH 24 and 48 h decrements and the pattern of LH and FSH secretion after gonadectomy was not significantly different in lesioned and sham lesioned animals. Responsiveness to exogenous LHRH was not impaired by MPOA lesions. The results suggest that neural elements within the MPOA are functionally related to pituitary LH secretion in the male rat. The LH control alteration in lesioned animals is not associated with modifications in negative feedback of androgens and pituitary sensitivity to LHRH remains unaltered.