Intravenous thrombolysis for acute ischemic stroke in centenarians.

PURPOSE: The benefit of intravenous alteplase is well established for patients with disabling stroke symptoms regardless of age, although data on outcomes in centenarian patients are scarce. We present our experience in patients beyond 100 years. METHODS: Descriptive study including centenarians from our single-centre prospective registry who underwent intravenous thrombolysis with alteplase for acute ischemic stroke in our tertiary university hospital. Clinical variables and functional outcome at 3 months were collected. RESULTS: Four patients, all women, functionally independent (mRS ≤ 2) were included. Treatment with alteplase was applied within 4.5 h of stroke onset. One patient complicated with pneumonia and died. Two patients were functionally independent (mRS ≤ 2) at discharge, while the third was partially dependent (mRS of 3 at discharge), improving after 3 months, (mRS 2). No serious hemorrhagic or systemic adverse events were registered. CONCLUSION: In our experience, intravenous thrombolysis may be beneficial and should be considered in patients over 100 years old with no previous disability.

COVID-19 in Parkinson's disease: what holds the key?

INTRODUCTION: Parkinson's disease (PD) is more frequent in the elderly and increases the risk of respiratory infections. Previous data on PD and SARS-CoV-2 are scarce, suggesting a poor prognosis in advanced disease and second-line therapies. METHODS: A retrospective case-control study comparing patients with PD and COVID-19 and patients with PD without COVID-19 was conducted during the pandemic period in Spain (March 1st-July 31st 2020) in a tertiary university hospital. RESULTS: Thirty-nine (COVID-19 +) and 172 (COVID-19-) PD patients were included. Fifty-nine percent were males in both groups, with similar age (75.9 ± 9.0 COVID-19 + , 73.9 ± 10.0 COVID-19-), disease duration (8.9 ± 6.2 COVID-19 + , 8.5 ± 5.6 COVID-19-) and PD treatments. COVID-19 was mild in 10 (26%), required admission in 21 (54%) and caused death in 8 (21%) patients. Dementia was the only comorbidity more frequent in COVID-19 + patients (36% vs. 14%, p = 0.0013). However, in a multivariate analysis, institutionalization was the only variable associated with COVID-19 + (OR 17.0, 95% CI 5.0-60.0, p < 0.001). When considering severe COVID-19 (admission or death) vs. mild or absent COVID-19, institutionalization, neoplasm, dementia and a lower frequency of dopamine agonists were associated with severe COVID-19. In multivariate analysis, only institutionalization [OR 5.17, 95% CI 1.57-17, p = 0.004] and neoplasm [OR 8.0, 95%CI 1.27-49.8, p = 0.027] remained significantly associated. CONCLUSION: In our experience, institutionalization and oncologic comorbidity, rather than PD-related variables, increased the risk of developing COVID-19, and impacted on its severity. These findings suggest that epidemiologic factors and frailty are key factors for COVID-19 morbidity/mortality in PD. Appropriate preventive strategies should be implemented in institutionalized patients to prevent infection and improve prognosis.

Evaluación de la duración del efecto de la toxina botulínica en la práctica clínica / Evaluation of the duration of the effect of botulinum toxin in clinical practice

No disponible

Características clínicas y epidemiológicas de los pacientes infectados por el virus influenza B/Hong Kong/330/2001 en las Islas Baleares (2002-2003) / clinical and epidemiological characteristics of patients infected by influenza B/Hong Kong/330/2001 virus in Balearic Islands (2002-2003)

Se revisan las características clínicas y epidemiológicas de los niños infectados por el virus influenza B/Hong Kong/330/01 (IB) en la temporada epidémica 2002-2003 y se compara con los diagnosticados en dos temporadas previas. Todas las muestras fueron sometidas a la detección antigénica y al cultivo viral (línea celular MDCK). Sólo se pudo realizar el seguimiento en 40 (87 por ciento) niños infectados por el virus IB. De los casos estudiados, 24 (60 por ciento) eran niños y 16 (40 por ciento) niñas. La edad media fue de 4,6 años (rango 27 días-15 años). Quince niños (37,5 por ciento) fueron considerados inmunodeprimidos. Se detectó fiebre en el 92,5 por ciento, síntomas respiratorios en el 85 por ciento, manifestaciones neurológicas en el 15 por ciento, exantemas en el 12,5 por ciento y síntomas musculares en el 12,5 por ciento. Los diagnósticos clínicos defintivos fueron: infección del tracto respiratorio superior 40 por ciento, neumonía 20 por ciento, fiebre y exantema 7,5 por ciento, otitis aguda media 7,5 por ciento, miositis 5 por ciento, bronquiolitis 2,5 por ciento y poliartralgias 2,5 por ciento. Se observó un posible caso, no confirmado, de encefalopatía asociado a infección por el virus IB. Un paciente oncológico (2,5 por ciento) falleció de una neumonía asociada al virus IB. Ninguno de los pacientes había sido vacunado frente a los virus gripales. De acuerdo con los datos obtenidos los niños infectados por el virus influenza B/Hong Kong/330/01 poseerían una edad media de 4,6 años y presentarían un síndrome febril con patología respiratoria y/o manifestaciones clínicas atípicas que requieren ingreso hospitalario (AU)

[Use of an amorphous dressing in the skin care of patients after radiotherapy]. / Utilización de un apósito amorfo en el cuidado de la piel de pacientes en curso de tratamiento radioterápico.

INTRODUCTION: Skin wounds caused by acute radiogen toxicity are an important side effect caused by radiotherapy treatment, therefore the prevention and immediate care is a challenge for the nursing staff. The actual traditional treatment is based on Liniment Oleocalcareo creams with Zinc Oxide as a principal agreement, but we have discovered a new alternative that at a first instance respond more effectively to the patients needs, and are classified with the terminology "amourphous dressing". MATERIAL AND METHODS: Retrospective study of the application of the amorphous dressing on 41 patients during the period between February and June 1998 in the Radiotherapy Unit of the "Hospital Universitario Sant Joan de Reus" (Tarragona). RESULTS: The application of the amorphous dressing has allowed us to evidence a slowness and decrease in the intensity of the skin damage caused by the radiation treatment. There has been a 63.86% decrease of the nursing treatment of the skin wounds as a consequence of the radiotherapy. The use of the amourphous dressing with Zinc Oxide favours the ephithelization of the moist wounds. No adverse reaction of the dressing has been observed during the time of the study, and no infections process has been detected, in none of the case was the radiotherapy treatment interrupted due to radiodermatitis, and in none of the cases an alternative dressing was needed. In some cases the amourphous dressing in combination with a tulle and a polyamide grille the healing time of the radiodermitis wound was significantly decreased. It has also been verified that the application as well as the removal of the dressing does not involve any difficulty neither for the patients nor for the nursing staff. There also has been a better level of acceptance of the new amourphous dressing as well from both patients and staff, seeing that the therapeutic results is significantly superior than that of the previously used methods. CONCLUSIONS: Having carried out the study in our Radiotherapy Unit we can assure that the new amourphous dressing, along with a strict control of the patient's evolution, increases the comfort and the quality of life of the patients. The multidisciplinary acceptance of the new treatment in a protocolized manner implies an increase in the patient quality care as well as contributing to a more efficient allocation of resources.

Variation of some secondary metabolites in juvenile stages of three plant species from tropical rain forest.

Results from qualitative and quantitative evaluation of some chemical constituents, particularly phenols and volatile terpenes, from juvenile stages of three primary species belonging to the perennial rain forest are presented. The degree of infection and the time of the year were taken into account. TLC, GC, and simple chemical methods were used to estimate differences among components. Biological assays were conducted to evaluate fungicide potential of the extracts from studied plants. In general terms, the results show significant differences in the chemical composition of the species studied (Nectandra ambigens, Omphalea oleifera, andLicaria alata) related to the time of the year and the degree of infection. These differences can be related as well to their intrinsic resistance to infection and ability to grow to the adult stage.