Do immunosuppressive treatments influence immune responses against adenovirus-based COVID-19 vaccines in patients with multiple sclerosis? An Argentine multicenter study.

Introduction: There are no reports in LATAM related to longitudinal humoral and cellular response to adenovirus based COVID-19 vaccines in people with Multiple Sclerosis (pwMS) under different disease modifying therapies (DMTs) and neutralization of the Omicron and Wuhan variants of SARS-COV-2. Methods: IgG anti- SARS-COV-2 spike titer were measured in a cohort of 101 pwMS under fingolimod, dimethyl fumarate, cladribine and antiCD20, as well as 28 healthy controls (HC) were measured 6 weeks after vaccination with 2nd dose (Sputnik V or AZD1222) and 3nd dose (homologous or heterologous schedule). Neutralizing capacity was against Omicron (BA.1) and Wuhan (D614G) variants and pseudotyped particles and Cellular response were analyzed. Results: Multivariate regression analysis showed anti-cd20 (ß= -,349, 95% CI: -3655.6 - -369.01, p=0.017) and fingolimod (ß=-,399, 95% CI: -3363.8 - -250.9, p=0.023) treatments as an independent factor associated with low antibody response (r2 adjusted=0.157). After the 2nd dose we found a correlation between total and neutralizing titers against D614G (rho=0.6; p<0.001; slope 0.8, 95%CI:0.4-1.3), with no differences between DMTs. Neutralization capacity was lower for BA.1 (slope 0.3, 95%CI:0.1-0.4). After the 3rd dose, neutralization of BA.1 improved (slope: 0.9 95%CI:0.6-1.2), without differences between DMTs. A fraction of pwMS generated anti-Spike CD4+ and CD8+ T cell response. In contrast, pwMS under antiCD20 generated CD8+TNF+IL2+ response without differences with HC, even in the absence of humoral response. The 3rd dose significantly increased the neutralization against the Omicron, as observed in the immunocompetent population. Discussion: Findings regarding humoral and cellular response are consistent with previous reports.

Synchronous pneumothorax and venous thromboembolism after body contouring surgery.

INTRODUCTION: Lipoabdominoplasty is one of the most common abdominal body contouring procedures performed today; however, it carries the risk of significant complications. Pneumothorax is a rare complication of liposuction, while, venous thromboembolism has a low short-term mortality and long-term morbidity. PRESENTATION OF CASE: A 57-year-old woman with a history of diabetes mellitus, hypertension, obesity, and severe COVID-19 three years earlier. The patient underwent 360-degree liposuction and abdominoplasty. In the immediate postoperative period, the patient developed a right pneumothorax and followed by deep vein thrombosis (DVT) and pulmonary embolism (PE), which were diagnosed and treated early. After six months of follow-up, the patient presented a complete recovery. DISCUSSION: Pneumothorax is recognized as a rare complication of liposuction and has been limited to case reports and small case series in the medical literature with an incidence of 0.04 %. In plastic and aesthetic surgery, body contouring procedures such as lipoabdominoplasty are associated with a risk of DVT and PE of 0.2-0.6 %, and 0.3 %, respectively. In addition, we believe that performing combined aesthetic procedures may increase the risk of complications. CONCLUSION: This is the first reported case of pneumothorax, DVT and PE after body contouring surgery. We highlight the importance of awareness of these complications and the need for a high index of suspicion for early diagnosis and treatment, which is critical for patient survival.

Larrea divaricata a native Argentine plant with potential activity against SARS-CoV-2? / ¿Larrea divaricata una planta nativa argentina con actividad potencial sobre SARS-CoV-2?

Larrea divaricata Cav. is an autochthonous South American plant popularly used in inflammatory and infectious diseases with reported anti - inflammatory, immunomodulatory, antimicrobial and antioxidant activities. Covid - 19 is an infection ca used by the severe acute respiratory syndrome coronavirus 2 (SARS - CoV - 2). This virus can cause pneumonia and even death in about 5% of the cases. The objective of the article was to demonstrate, through a literature review, that L. divaricata has sufficie nt attributes to be assayed against SARS - CoV - 2. For this, the chemical composition, reported activities and docking studies were taken into account. This review demonstrated that the plant extracts are capable of inhibiting the proliferation of fungi, bact eria and viruses and that they exert anti - inflammatory and immunomodulatory actions in different " in vitro " and " in vivo " models. These results suggest that the plant is a good candidate to be studied for the prevention and/or treatment of SARS - CoV - 2.

Larrea divaricata Cav. es una planta autóctona Sudamericana, utilizada popularmente en enfermedades inflamatorias e infecciosas, con activida d anti - inflamatoria, inmunomoduladora, antimicrobiana y antioxidante reportada. El Covid - 19 es una infección causada por una cepa de coronavirus, SARS - CoV - 2 (coronavirus tipo 2 causante del síndrome respiratorio agudo severo). Este virus puede originar neu monía e incluso la muerte en alrededor del 5% de los casos. Nuestro objetivo fue demostrar, a través de una revisión bibliográfica, que esta planta tiene atributos suficientes para ser ensayada en estudios contra SARS - CoV - 2. Se tuvo en cuenta la composici ón química, los antecedentes científicos y los estudios de acoplamiento molecular. Esta revisión permitió demostrar que extractos de la planta son capaces de inhibir la proliferación de hongos, bacterias y virus y que presentan acción anti - inflamatoria en diferentes modelos " in vitro " e " in vivo ", lo que los hace candidatos a ser estudiados en la prevención y/o tratamiento de la infección contra SARS - CoV - 2.

Mucormicosis maxilar asociado a COVID-19, tratamiento médico-quirúrgico y manejo multidisciplinario. Reporte de caso / Maxillary mucormycosis associated with COVID-19, medical-surgical treatment and multidisciplinary management. Case report

Resumen Introducción: Durante la actual pandemia de COVID-19 múltiples complicaciones se han desarrollado posterior a la enfermedad, dentro de las cuales se encuentran las infecciones fúngicas, como la mucormicosis, que puede resultar directamente de la infección por COVID-19 y/o como efecto secundario de los fármacos utilizados en su tratamiento. La mucormicosis es una infección causada por un grupo de hongos llamados mucormycetes; a nivel rinocerebral se presenta con celulitis facial, cefalea, proptosis, movilización del diente afectado y secreción nasal. Reporte de caso: Se presenta a un paciente femenino de 57 años con antecedente de neumonía grave por COVID-19 con posterior desarrollo de absceso periodontal que ameritó extracción del segundo molar superior derecho con posterior formación de fistula. Se toma TC de macizo facial donde se evidencia erosión ósea con pérdida de la morfología habitual y en pared anterior del seno maxilar derecho. Se realiza biopsia reportando tejido óseo con elementos micóticos (hifas aseptadas) morfológicamente compatibles con mucor sp. Se realizó tratamiento con anfotericina B y hemimaxilectomia derecha. Actualmente se encuentra en tratamiento con pozaconazol, y lavados quirúrgicos. Conclusión: La enfermedad de COVID-19 es una enfermedad muy común actualmente a nivel mundial, por lo que es importante identificar y llevar un seguimiento de aquellas personas con factores de riesgo para desarrollar mucormicosis; el diagnóstico y un plan de tratamiento temprano es fundamental para evitar complicaciones, las cuales pueden originar un desenlace fatal.

Abstract Introduction: During the current pandemic of COVID-19 multiple complications have developed after the disease, among which are fungal infections, such as mucormycosis, which can result directly from COVID-19 infection and/or as a side effect of the drugs used in its treatment. Mucormycosis is an infection caused by a group of fungi called mucormycetes; at the rhinocerebral level it presents with facial cellulitis, headache, proptosis, mobilization of the affected tooth and nasal secretion. Case report: the following is a 57-year-old female patient with a history of severe pneumonia due to COVID-19 with subsequent development of periodontal abscess that merited extraction of the upper right second molar with subsequent fistula formation. The patient started an infection with the presence of purulent secretion in the extraction area of the right molar. A CT scan of the facial mass was taken showing bone erosion with loss of the usual morphology in the right upper maxillary bone and anterior wall of the right maxillary sinus, as well as a biopsy of the right maxilla reporting bone tissue with mycotic elements (aseptates hyphae) morphologically compatible with mucor sp. Treatment with amphotericin B and right hemimaxillectomy was performed. She is currently being treated with pozaconazole and surgical washings. Conclusion: COVID-19 disease is currently a very common disease worldwide, so it is important to identify and follow up those people with risk factors for developing mucormycosis; early diagnosis and treatment plan is essential to avoid complications, which can lead to a fatal outcome.

Fast, cheap and sensitive: Homogenizer-based RNA extraction free method for SARS-CoV-2 detection by RT-qPCR.

Background: The SARS-CoV-2 gold standard detection method is an RT-qPCR with a previous step of viral RNA extraction from the patient sample either by using commercial automatized or manual extraction kits. This RNA extraction step is expensive and time demanding. Objective: The aim of our study was to evaluate the clinical performance of a simple SARS-CoV-2 detection protocol based on a fast and intense sample homogenization followed by direct RT-qPCR. Results: 388 nasopharyngeal swabs were analyzed in this study. 222 of them tested positive for SARS-CoV-2 by the gold standard RNA extraction and RT-qPCR method, while 166 tested negative. 197 of those 222 positive samples were also positive for the homogenization protocol, yielding a sensitivity of 88.74% (95% IC; 83.83 - 92.58). 166 of those negative samples were also negative for the homogenization protocol, so the specificity obtained was 97% (95% IC; 93.11 - 99.01). For Ct values below 30, meaning a viral load of 103 copies/uL, only 4 SARS-CoV-2 positive samples failed for the RNA extraction free method; for that limit of detection, the homogenizer-based method had a sensitivity of 97.92% (95% CI; 96.01 - 99.83). Conclusions: Our results show that this fast and cheap homogenization method for the SARS-CoV-2 detection by RT-qPCR is a reliable alternative of high sensitivity for potentially infectious SARS-CoV-2 positive patients. This RNA extraction free protocol would help to reduce diagnosis time and cost, and to overcome the RNA extraction kits shortage experienced during COVID-19 pandemic.

Psicotrópicos: uso por estudantes universitários antes e durante a pandemia de doença por coronavírus 2019 / Psicotrópicos: uso por estudiantes universitarios antes y durante la pandemia de enfermedad del coronavirus 2019 / Psychotropics: use by college students before and during the coronavirus disease 2019 pandemic

Objetivo: descrever a utilização de psicotrópicos por estudantes universitários antes e durante a pandemia de doença por coronavírus 2019. Métodos: estudo transversal com 464 estudantes que frequentaram uma disciplina ofertada durante a pandemia. Utilizou-se um questionário via Google Forms com questões autoaplicáveis. As informações coletadas foram transferidas para o Microsoft Excel 2007 e analisadas no software Statistical Package for the Social Sciences 25.0. Resultado: 37,3% referiram fazer uso de psicotrópicos antes ou durante a pandemia. Destes, mais de 80,0% relataram fazer uso antes e 17,5% iniciaram após o início da pandemia, sendo a maioria do sexo feminino, solteiras e cursando o primeiro ou o último semestre da graduação. Os antidepressivos foram os mais utilizados pelos participantes (64,0%). Conclusões: a prevalência do uso de psicotrópicos entre estudantes pode ter se acentuado na pandemia. O desenvolvimento de programas e políticas voltadas à promoção e cuidado à saúde mental dos universitários é necessário.(AU)

Objective: to describe the use of psychotropic drugs by university students before and during the 2019 coronavirus disease pandemic. Method: cross-sectional study with 464 students who attended a course offered during the pandemic. A questionnaire was used via Google Forms with self- administered questions. The collected information was transferred to the Microsoft Excel 2007 and analyzed in the Statistical Package for the Social Sciences 25.0 software. Result: 37.3% reported using psychotropic drugs before or during the pandemic. Of these, more than 80.0% reported using it before and 17.5% started after the beginning of the pandemic, the majority being female, single, and attending the first or last semester of graduation. Antidepressants were the most used by participants (64.0%). Conclusions: the prevalence of psychotropic use among students may have increased during the pandemic. The development of programs and policies aimed at promoting and caring for the mental health of university students is necessary.(AU)

Objetivo: describir el uso de psicofármacos por parte de estudiantes universitarios antes y durante la pandemia de la enfermedad por coronavirus 2019. Método: estudio transversal con 464 estudiantes que asistieron un curso ofrecido durante la pandemia. Se utilizó un cuestionario en Google Forms con preguntas autoadministradas. La información recolectada fue transferida al Microsoft Excel 2007 y analizada en el software Statistical Package for the Social Sciences 25.0. Resultado: el 37,3% informó usar psicofármacos antes o durante la pandemia. De estos, más del 80,0% reportaron usarlo antes y el 17,5% iniciaron después, siendo la mayoría mujeres, solteras y cursando el primer o último semestre de graduación. Los antidepresivos fueron los más utilizados por los participantes (64,0%). Conclusiones: la prevalencia del consumo de psicotrópicos entre estudiantes puede haber aumentado durante la pandemia. Es necesario el desarrollo de programas y políticas dirigidas a promover y cuidar la salud mental de estudiantes universitarios.(AU)

Gravidade respiratória e fatores sociodemográficos associados ao desfecho clínico de pacientes com COVID-19 no Ceará / Respiratory severity and sociodemographic factors associated with the clinical outcome of patients with COVID-19 in Ceará

A COVID-19 causa complicações pulmonares importantes, oferecendo risco à vida. Objetivou-se compreender como a gravidade respiratória e os fatores sociodemográficos interferem no desfecho clínico de pacientes com COVID-19. Pesquisa descritiva, transversal, de abordagem quantitativa, realizada em hospital de referência em Fortaleza-Ceará, Brasil. Os dados foram coletados de novembro/2020 a setembro/2021, totalizando 470 pacientes com testagem positiva, sendo analisados pelo programa Microsoft Office Excel 2019. Quanto ao gênero, 56,8% eram do sexo masculino, com média de idade de 57,32 anos e 67,1% dos pacientes que evoluíram com alta hospitalar não apresentaram suporte de oxigênio à internação. Indivíduos residentes em regiões com Índice de Desenvolvimento Humano muito baixo foram mais suscetíveis à contaminação e maior mortalidade (46,1%), e as doenças crônicas degenerativas foram preditivas de letalidade. Os perfis sociodemográfico e clínico influenciaram os aspectos fisiopatológicos de desenvolvimento da doença e a evolução preditiva relacionada à permanência hospitalar e ao desfecho.

COVID-19 causes major, life-threatening lung complications. This study aimed to understand how respiratory severity and sociodemographic factors affect the clinical outcome of patients with COVID-19. It was a descriptive, cross-sectional research with quantitative approach conducted in a referral hospital in Fortaleza-Ceará, Brazil. Data collection occurred from November 2020 to September 2021, totaling 470 patients who tested positive for COVID-19, being analyzed in Microsoft Office Excel 2019. Regarding gender, 56.8% were male, with a mean age of 57.32 years and 67.1% of patients who evolved to hospital discharge did not have oxygen support at admission. Individuals living in regions with very low Human Development Index were more susceptible to contamination and higher mortality (46.1%), and chronic degenerative diseases were predictive of lethality. Sociodemographic and clinical profiles influenced the pathophysiological aspects of disease development and the predictive evolution related to hospital stay and outcome.

Estado de salud mental en personal de salud frente al COVID - 19 / Mental health's status in health personnel against COVID-19 / O estado de saúde mental no pessoal da saúde contra COVID-19

En el Perú, se muestra un panorama inquietante en el personal de salud, debido a la constante exposición al contagio y saturación del sistema sanitario, aún más, en zonas de alta tasa de mortalidad y riesgo; es un sector de la población que genera mayores expectativas para el cuidado de la salud, acrecentando su nivel de responsabilidad y la dispersión individual y colectiva de capacidades ante la adversidad, no obstante es vulnerable desde el punto de vista psicológico. Se buscó determinar el estado de salud mental, según sexo, estado civil, especialidad y áreas del hospital en personal de salud frente al COVID - 19. Estudio de tipo descriptivo, n=90 participantes, se utilizó el Cuestionario General de Salud de Goldberg 28. Obteniéndose que el 34% de evaluados presentó indicadores de problemas en salud mental, donde prevaleció la ansiedad, 15.6%, problemas psicosomáticos, 9% y depresión 3.3%. Asimismo la ansiedad se evidenció en mujeres, 13%; solteros, 7%; personal técnico de enfermería, 4% y trabajadores de hospitalización, 6%. En efecto, la salud mental en el personal de salud frente al COVID - 19, se reflejó en indicadores de ansiedad, depresión y disfunción social, generando posibles afectaciones emocionales en los dominios de su vida.

In Peru, a worrying view is shown in health personnel, due to constant exposure to infection and saturation of the health system, even more so, in areas with a high mortality and risk rate; it is a sector of the population that generates higher expectations for health care, increasing its level of responsibility and the individual and collective dispersion of capacities in the face of adversity, however being vulnerable from the psychological point of view. We sought to determine the state of mental health, according to sex, marital status, specialty and areas of the hospital in health personnel in the face of COVID - 19. Descriptive study, n = 90 participants. We have used the Goldberg General Health Questionnaire 28. Obtaining that 34% of those evaluated there were presented indicators of mental health problems, where anxiety prevailed, 15.6%, psychosomatic problems, 9% and depression 3.3%. In addition, anxiety was evidenced in women, 13%; single, 7%; technical nursing staff, 4% and hospitalization workers, 6%. Indeed, mental health in health personnel in the face of COVID-19 was reflected in indicators of anxiety, depression and social dysfunction, generating possible emotional effects in the domains of their life.

No Peru, mostra-se um panorama preocupante no pessoal da saúde, devido à constante exposição ao contágio e saturação do sistema de saúde, ainda mais em áreas com alta taxa de mortalidade e risco; é um setor da população que gera maiores expectativas para os cuidados da saúde, aumentando o seu nível de responsabilidade e a dispersão individual e coletiva das capacidades em frente às adversidades, apesar de ser vulnerável do ponto de vista psicológico. Nós procuramos determinar o estado de saúde mental, segundo o sexo, estado civil, especialidade e áreas do hospital em profissionais da saúde frente ao COVID-19. Estudo descritivo, n = 90 participantes, foi utilizado o Questionário Geral da Saúde de Goldberg 28. Obtendo-se que o 34% dos avaliados apresentaram indicadores de problemas de saúde mental, onde prevaleceu a ansiedade, 15,6%, problemas psicossomáticos 9% e depressão 3,3%. Além do mais, a ansiedade evidenceu-se nas mulheres, 13%; solteiro, 7%; pessoal técnico de enfermagem 4% e trabalhadores de internação 6%. De fato, a saúde mental dos profissionais de saúde frente ao COVID-19 refletiu-se em indicadores de ansiedade, depressão e disfunção social, gerando possíveis efeitos emocionais nos domínios de sua vida.

Desfechos de partos em gestantes que positivaram COVID-19 em município paranaense / Outcomes of deliveries in pregnant women who tested positive for COVID-19 in a municipality in Paraná

A Síndrome Respiratória Aguda Grave Coronavírus 2 foi declarada pela Organização Mundial da Saúde como pandemia, em março de 2020. O quadro clínico da COVID-19 é bastante variável, visto que alguns pacientes são assintomáticos. Diante desta problemática objetivou-se quantificar e descrever os principais desfechos de partos em gestantes e recém-nascidos com resultado positivo para COVID-19. Trata-se de pesquisa epidemiológica, documental, retrospectiva, com abordagem quantitativa, utilizando-se das fichas de notificação das gestantes positivas para COVID-19 e a declaração de nascidos vivos dos casos com desfecho do parto. O estudo foi realizado com 119 gestantes, destas, 48 eram puérperas, sendo pacientes que tiveram resultado positivo para COVID-19, apresentando maior contaminação mulheres em idade fértil de 15 a 39 anos, solteiras e com ensino superior incompleto. Os sintomas mais relatados nas gestantes com COVID-19 foram cefaleia e tosse. A grande maioria dos casos teve desfecho positivo em relação à gestação.

Severe Acute Respiratory Syndrome Coronavirus 2 was declared a pandemic by the World Health Organization in March 2020. The clinical picture of COVID-19 is quite variable, as some patients are asymptomatic. In view of this problem, the objective was to quantify and describe the main outcomes of childbirth in pregnant women and newborns with a positive result for COVID-19.This an epidemiological, documentary, retrospective research, with a quantitative approach, using the notification forms of pregnant women positive for COVID-19 and the declaration of live births of cases with delivery outcome. The study was carried out with 119 pregnant women, of which 48 were postpartum women, being patients who tested positive for COVID-19, with greater contamination women childbearing age from 15 to 39 years old, single and with incomplete higher education. The most reported symptoms in pregnant women with

Reconstrucción microquirúrgica en pandemia por Covid-19 / Microsurgical Reconstruction during the COVID-19 Pandemic

Introducción: la Pandemia por SARS CoV ­ 2 (COVID ­ 19) tuvo un impacto significativo en el desarrollo de los servicios quirúrgicos en general y obligo a establecer protocolos de actuación para las distintas patologías a fin de cuidar al máximo los recursos humanos y la capacidad instalada de los hospitales para hacer frente a esta contingencia mundial. Objetivos: presentar una casuística de 7 pacientes con reconstrucción microquirúrgica de patología de cabeza y cuello en estadios avanzados y patología de miembros inferiores durante la pandemia por COVID - 19. Materiales y Métodos: trabajo retrospectivo, se revisaron las historias clínicas físicas y digitales. Se incluyeron 5 pacientes con patología avanzada de cabeza y cuello y 2 pacientes con patología de miembros inferiores. Resultados: cinco pacientes fueron operados por patología avanzada de cabeza y cuello: 3 pacientes con carcinomas escamosos de cavidad oral estadio IVa, 1 paciente con carcinoma escamoso de piel avanzado estadio IV y 1 paciente con fractura compleja de maxilar inferior por herida de arma de fuego con fistula oro-cutánea crónica, con exposición del material de osteosíntesis, mala oclusión y pérdida de peso importante por dificultad para alimentación. Dos pacientes fueron operados por patología de miembros inferiores en tercio inferior de pierna, uno por fractura expuesta grave con defecto de tejidos blandos y el otro por una ulcera arterial. Conclusión: la cirugía reconstructiva microquirúrgica puede realizarse con buenos niveles de seguridad para el personal de salud y para los pacientes afectados por patologías avanzadas de cabeza y cuello y otras patologías que requieran colgajos libres. Es fundamental respetar estrictamente los protocolos para evitar los contagios en el medio intrahospitalario, entendiendo que debe considerarse todo paciente que ingrese al hospital como COVID (+) hasta que se demuestre lo contrario

Introduction: the SARS CoV ­ 2 (COVID ­ 19) Pandemic had a significant impact on the development of surgical services in general and forced the establishment of action protocols for the different pathologies in order to take maximum care of human resources and capacity. installed in hospitals to deal with this global contingency. Objectives: to present a casuistry of 7 patients with microsurgical reconstruction of head and neck pathology in advanced stages and lower limb pathology during the COVID - 19 pandemic. Materials and Methods: retrospective work, physical and digital medical records were reviewed. Five patients with advanced head and neck disease and 2 patients with lower limb disease were included. Results: five patients underwent surgery for advanced head and neck disease: 3 patients with stage IVa squamous cell carcinoma of the oral cavity, 1 patient with stage IV advanced squamous cell carcinoma of the skin, and 1 patient with a complex fracture of the lower jaw due to a gunshot wound. with chronic oro-cutaneous fistula, with exposure of the osteosynthesis material, poor occlusion and significant weight loss due to difficulty feeding. Two patients underwent surgery for pathology of the lower limbs in the lower third of the leg, one for a severe open fracture with a soft tissue defect and the other for an arterial ulcer. Conclusion: microsurgical reconstructive surgery can be performed with good levels of safety for health personnel and for patients affected by advanced pathologies of the head and neck and other pathologies that require free flaps. It is essential to strictly respect the protocols to avoid contagion in the hospital environment, understanding that every patient who enters the hospital must be considered as COVID (+) until proven otherwise.

Relación causa - efecto entre manifestaciones bucales y pacientes con la COVID-19 / Cause - effect relationship between the oral manifestations and the patients with COVID-19

Las manifestaciones clínicas en los pacientes con la COVID-19 han sido notificadas en numerosas investigaciones; sin embargo, respecto a la cavidad bucal es escasa la información. En este artículo se abordan las manifestaciones bucales más frecuentes y su localización. Asimismo, se considera que no puede establecerse la relación causa - efecto entre la infección por coronavirus y la aparición de lesiones bucales, puesto que estas lesiones pueden estar relacionadas con la inmunosupresión; además, se presentan como coinfecciones y manifestaciones secundarias con múltiples aspectos clínicos.

The clinical signs in patients with COVID-19 have been notified in numerous investigations; however, there is lack of information regarding the oral cavity. The most frequent oral manifestations and their localization are approached in this work. Also, it is considered that the cause-effect relationship between the infection by coronavirus and the emergence of oral lesions cannot be established, since these lesions can be related to the immunosupression; also, they are presented as coinfections and secondary signs with multiple clinical aspects.

Emergent Pneumonia in Children.

In recent decades there have been multiple pathogens, viruses and bacteria, which have emerged as causal agents of pneumonia affecting adults, albeit less frequently, to children. For the purposes of this article we have classified emerging pathogens as follows: True emerging, to pathogens identified for the very first time affecting human population (SARS-CoV-1, SARS-CoV-2, MERS-CoV, avian influenza, and hantavirus); Re-emerging, to known pathogens which circulation was controlled once, but they have reappeared (measles, tuberculosis, antimicrobial resistant bacteria such as CA-MRSA, Mycoplasma pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia, and new serotypes of post-vaccine pneumococcal); and finally, those that we have called old known with new presentations, including common pathogens that, in particular condition, have changed their form of presentation (rhinovirus, and non-SARS coronavirus). We will review for each of them their epidemiology, forms of presentation, therapy, and prognosis in children compared to the adult with the aim of being able to recognize them to establish appropriate therapy, prognostics, and effective control measures.

RESISTANCE TO ANTIBIOTIC AGENTS: PERSPECTIVE AND REALITY

Microorganisms have infected humans since time immemorial and in this context, we have lived through an endless war that has produced increasingly complex adaptation and selection pressure. Although antibiotics marked a new era beginning in 1928, it is interesting to mention that traces of tetracycline were found in human bone samples from ancient Sudanese Nubia dating from 350­550 AD. C (1). Paul Erlich, by his staining methods, already deduced at the end of the 19th century and the beginning of the 20th century, that there may be a magic bullet that acts on microorganisms to eliminate them, without affecting other cell types. This molecule is currently known as an antibiotic or antimicrobial in relation to its natural or synthetic origin. Of this interest, in 1910 the first molecule with studies in rabbits infected with syphilis to demonstrate antimicrobial activity was described (2,3).

Enfrentamiento a la COVID - 19 desde un enfoque bioético en la Facultad de Enfermería - Tecnología de Santiago de Cuba / Confrontation to the COVID - 19 from a bioethics approach in the Nursing - Technology Faculty from Santiago de Cuba

Ante la situación que existe actualmente a escala mundial, a partir del brote de la COVID - 19, las organizaciones Mundial y Panamericana de la Salud han trabajado en el control de este virus. El sistema de salud cubano labora para disminuir los riesgos, teniendo en cuenta la prioridad que tiene la salud de las personas, la anticipación al riesgo, la prevención y el control de esta enfermedad, a través del actuar comunitario de estudiantes y profesores, donde la facultad de Enfermería - Tecnología ha tenido una labor destacada. En tal sentido, se comenta brevemente sobre el trabajo desarrollado por los directivos, docentes y estudiantes de dicha institución en el combate activo contra esta pandemia.

Before the situation that exists worldwide at the moment, taking the COVID - 19 outbreak as a starting point, the World and Pan-American Health Organizations have worked in the control of this virus. The Cuban health system works to diminish the risks, taking into account the priority that people health has, in anticipation to the risk, prevention and control of this disease, through the community performance of students and professors, where the Nursing - Technology Faculty has had an outstanding work. In such a sense, it is briefly commented on the work developed by the directors, teaching staff and students from this institution in the active fight against this pandemic.

Espectro Autista y Covid­19: Sugerencias para el manejo durante la pandemia / Autism Spectrum Disorder and COVID-19: Management Advice during the Pandemic

Introducción: La pandemia del COVID-19, nos acompaña desde marzo de 2020, trayendo una serie de medidas de confinamiento y alteración de las rutinarias diarias para controlar su expansión. Estos cambios alterarían la salud mental, tanto de los niños con trastorno del espectro autista (TEA), como la de sus cuidadores. Objetivo: Explorar diseño de estrategias para el manejo de pacientes con TEA durante la pandemia. Método: Se realizó una búsqueda de información bibliográfica de estudios publicados entre enero y octubre del 2020 en Pubmed, PsychINFO, Science Direct, Google y Google Scholar. Se seleccionaron 19 trabajos para revisión en base a términos libres y MeSH. Desarrollo: Los gobiernos debieron tomar medidas extremas para el control de la pandemia, como el confinamiento. Los cuidadores de niños con TEA dan cuenta del aumento de irritabilidad, angustia, y conductas auto y heteroagresivas en los niños con TEA. En relación a los cuidadores, se ha reportado un aumento de su nivel de ansiedad, y sobre todo preocupaciones sobre el futuro y su estabilidad laboral. Sin embargo, esto les permitió estar más atentos a los cambios emocionales y conductuales de sus hijos. Son variadas las estrategias sugeridas en la literatura, coincidiendo la mayoría en el uso de material didáctico y audiovisual para explicar la infección y su prevención, lo que a su vez ayudaría a los niños con TEA a la comprensión del cambio en sus rutinas. El mantener contacto social con sus amigos y profesores, realizar actividad física y adecuar las rutinas diarias a este nuevo escenario, son algunas de las estrategias más recomendadas. Conclusión: La incertidumbre que acompaña a la pandemia nos mantiene expectante a los nuevos cambios. El poder entregar una información clara y concreta a los niños con TEA sobre el COVID-19, además de mantener sus rutinas, actividades físicas y contacto con sus pares y educadores, ayudará a sortear de mejor manera las alteraciones emocionales y conductuales que puedan presentar.

Abstract. Introduction: The COVID-19 pandemic has been with us since March 2020, bringing a series of confinement measures and alteration of daily routines to control its expansion. These changes might affect the mental health of both children with autism spectrum disorder (ASD) and their caregivers. Aim: To explore the design of strategies for the management of patients with ASD during the pandemic. Method: A search of bibliographic information of studies published between January and October 2020 in Pubmed, PsychINFO, Science Direct, Google and Google Scholar was carried out. 19 papers were selected for review based on free terms and MeSH. Results: Governments had to take extreme measures, such as confinement, to control the pandemic. Caregivers report increased irritability, distress, and self and hetero-aggressive behaviors in children with ASD. In relation to caregivers, an increase in their level of anxiety has been reported, and especially concerns about the future and their job stability. However, this has allowed them to be more attentive to their children's emotional and behavioral changes. The strategies suggested in the literature are varied, with the majority agreeing on the use of educational and audiovisual material to explain the infection and its prevention measures, which in turn would help children with ASD to understand the change in their routines. Maintaining social contact with friends and teachers, engaging in physical activity and adapting daily routines to this new scenario are some of the most recommended strategies. Conclusion: The uncertainty that accompanies the pandemic keeps us waiting for new changes. Being able to deliver clear and concrete information to children with ASD about COVID-19, in addition to maintaining their routines, physical activities and contact with their peers and educators, will help them to deal better with the emotional and behavioral changes that they may face.

Desafío hospitalario: experiencia de un equipo de ginecología en el manejo integral de pacientes COVID 19 / A hospital challenge: experience of a gynecology team in the comprehensive management of patients COVID 19

INTRODUCCIÓN: La infección por el coronavirus SARS-CoV2 (COVID 19), causal de la pandemia actual, ha significado a nivel mundial la hospitalización simultánea de múltiples pacientes poniendo a prueba la infraestructura hospitalaria y la capacidad de reacción del personal de salud. Una de las estrategias para el manejo es la reconversión de camas y servicios clínicos. OBJETIVOS: presentar experiencia de un equipo ginecológico en el manejo integral de pacientes no gineco-obstétricas con COVID 19, durante el mes de junio de 2020 en un hospital público de la Región Metropolitana. MÉTODOS: Estudio de corte transversal observacional, descriptivo. Se consideró el total de pacientes adultos hombres y mujeres sin patología gineco-obstétrica con COVID 19 ingresados al puerperio del Hospital Santiago Oriente, obteniéndose datos clínicos y demográficos a través del registro interno de la unidad y del sistema de información de red asistencial. RESULTADOS: Ingresaron 82 pacientes, 32 mujeres y 50 hombres, promedio de edad 64. El promedio de días de hospitalización fue 5, con diagnóstico de ingreso principal neumonía viral por COVID-19. Las comorbilidades frecuentes fueron hipertensión arterial sistémica y diabetes mellitus. La complicación más frecuente fue el tromboembolismo pulmonar agudo. Hubo una alta cobertura de entrega de información vía telefónica a familiares. De los 82 ingresos, 54 pacientes egresaron a su domicilio. El resto a otras unidades dentro de la institución, centros de menor complejidad o residencias sanitarias. Una paciente sexo femenino de 75 años fallece a causa de descompensación de patologias de base secundario a neumonia por Staphylococus aereus. En ella, se descarta la infección por COVID 19 dado tres exámenes por reacción de polimerasa en cadena negativos realizado antes y durante su hospitalización. CONCLUSIONES: Esta experiencia constituyó un desafío para todo el equipo de salud gineco-obstétrico, considerando que nos enfrentamos a otro tipo de pacientes y a una patología nueva. Los resultados médicos son promisorios, la experiencia humana y sentido de trabajo en equipo fue extraordinario.

INTRODUCTION: The infection by the SARS-CoV2 coronavirus (COVID 19), the cause of the current pandemic we are experiencing, has meant the simultaneous hospitalization of many patients worldwide, putting the hospital infrastructure and the reaction capacity of health personnel to the test. One of the management strategies is the reconversion of clinical services. OBJECTIVES: present the experience of a gynecological team in the comprehensive management of non-gyneco-obstetric patients with COVID 19, during the month of June 2020 in a public hospital in the Metropolitan Region. METHODS: descriptive, observational cross-sectional study. The total number of patients admitted to the ex-puerperium of the Santiago Oriente Hospital was considered, obtaining clinical and demographic data through the unit's internal registry and the healthcare network information system. RESULTS: 82 patients were admitted, 32 women and 50 men, average age 64. The average number of days of hospitalization was 5, with the main admission diagnosis being viral pneumonia due to COVID-19. Frequent comorbidities were systemic arterial hypertension and diabetes mellitus. The most frequent complication was acute pulmonary thromboembolism. There was a high coverage of the delivery of information via telephone to relatives. Of the 82 admissions, 54 patients were discharged home and the rest to other units within the institution, less complex centers or health residences. One 75 years old female patient dies from concomitant pathologies, and she wasn't positive for COVID-19. CONCLUSIONS: This experience was a challenge for the entire gynecological-obstetric health team, considering that we are facing other types of patients and a new pathology. The medical results are promising, the human experience and sense of teamwork was extraordinary.

Nota Informativa Novo Coronavírus (2019-Ncov) / Technical note: New coronavirus

Em 31 de dezembro de 2019 o escritório da Organização Mundial da Saúde (OMS) foi informado sobre casos de pneumonia de etiologia desconhecida detectados na cidade de Wuhan, na Província de Hubei, parte central da China. Em 12 de janeiro de 2020, a China divulgou a sequência genética de um novocoronavírus sendo responsável por estas infecções.Coronavírus (CoV) é uma ampla família de vírus que em humanos podem causar doenças semelhantes a gripe comum até casos mais severos. O novo coronavírus(2019-nCov) é uma nova cepa que ainda não havia sido previamente identificada em Humanos De acordo com as atualizações publicadas pela OMS o último boletim de 29 de janeiro de 2020, aproximadamente 6.000 casos foram confirmados oriundos da província de Hubei (China). Casos da infecção importados da China também já foram confirmados na Coréia do Sul, Tailândia, Japão, França e Estados Unidos. Atualmente o registro é de 170 óbitos. No Brasil O Ministério da Saúde declarou, nesta quarta-feira (29/1), que há 9 casos suspeitos de coronavírus no Brasil, do total de 33 notificados, registrados nos estados: Minas Gerais, Rio de Janeiro, Santa Catarina, São Paulo, Paraná e Ceará.