Early-Phase Perceptions of COVID-19's Impact on Ophthalmology Practice Patterns: A Survey from the Pan-American Association of Ophthalmology.

Purpose: The COVID-19 pandemic affected medical practice worldwide due to interventions to prevent spreading. Its effect on ophthalmology practices in Latin America has not yet been explored. We aimed to assess the perceptions about the pandemic from countries' ophthalmological national and subspecialty retina societies affiliated to the Pan-American Association of Ophthalmology (PAAO). Patients and Methods: A survey-based study of leaders of national ophthalmological and retinal societies was conducted. The survey was sent by email to 30 societies, from which 20 responded (12 countries, 66.6% response rate). It included closed- and open-ended questions about (1) operational capacity and precautions, (2) telemedicine and virtual care, (3) procedures, and (4) post-pandemic considerations. Results: There was a marked decline in ophthalmology patient visits (80-95%) and elective surgeries (90%) during 2020 compared to before the pandemic. Precautions like temperature checks, mask usage, and social distancing were widely implemented while personal protective equipment (PPE) availability varied. Telemedicine use was limited due to lack of experience with it. Reopening plans focused on maintaining precautions and gradually resuming activities. Economic and security concerns were raised, and adherence to guidelines was emphasized. Respondents acknowledged the need to adapt to a "new normal". Long duration drugs, fewer imaging studies, and shorter wait times were preferred; however, availability of long duration drugs was limited. Conclusion: The pandemic impacted ophthalmology in Latin America, with reduced patient visits, procedures, and surgeries. Delayed treatment and complications were likely the result of the pandemic.

Verrucous tumor mimicking squamous cell carcinoma in immunocompetent patient.

Mycobacteria cause a range of diseases in both immunocompetent and immunosuppressed individuals. An increase in non-tuberculous mycobacterial (NTM) infections targeting skin has been described. Many hypotheses have been developed in order to explain it: the increasing burden of immunocompromised individuals, immigration from endemic countries, improved laboratory identification techniques, and changes inhuman behavior that expose individuals to this NTM. Mycobacterium mucogenicum group comprises M. mucogenicum, Mycobacterium aubagnense, and Mycobacterium phocaicum. This group of organisms was first named Mycobacterium chelonae-like organism in 1982. Most clinically significant cases of those organisms involved catheter-related infections. Nevertheless, we report an interesting patient with a cutaneous infection produced by M. mucogenicum mimicking a squamous cell carcinoma; an excellent response to combined therapy with rifampicin and clarythromicin was observed.

Resultados del uso de etanercept en pacientes con psoriasis / Results from the use of etanercept in psoriatic patients

La psoriasis es una enfermedad crónica, inflamatoria, mediada inmunológicamente, con una considerable repercusión en la calidad de vida de los pacientes. Su importancia, además, está dada, entre otros factores, por su elevada prevalencia en la población. Los avances en el conocimiento de la inmunopatología de esta enfermedad y de la biología molecular han permitido el desarrollo de nuevos fármacos que representan una nueva forma de abordar la situación de estos pacientes, y que se encuadran en la denominada terapia biológica. El etanercept se empleó por primera vez en estudios clínicos con seres humanos en 1992 y ya son varios cientos de miles los enfermos tratados en todo el mundo por diferentes afecciones. Actualmente, la Agencia Europea de Evaluación de Medicamentos tiene aprobada la indicación de etanercept en las siguientes enfermedades: 1. Psoriasis en placa en adultos (“adultos con psoriasis en placa, de moderada a grave, que no han respondido o que tienen contraindicada, o no toleran, otra terapia sistémica incluyendo ciclosporina, metotrexato o PUVA”); 2. Psoriasis pediátrica grave en placa. 3. Artritis psoriásica; 4. Artritis reumatoidea; 5. Artritis idiopática juvenil poliarticular; 6. Espondilitis anquilosante. Su utilización en la psoriasis, ya bien conocida, ha hecho que poco a poco empiecen a surgir cuestiones sobre su manejo en situaciones especiales que requieren tener en cuenta las particularidades de su aplicación (lactancia, vacunaciones, infecciones) que abordaremos en este trabajo...