Stochastic simulation of successive waves of COVID-19 in the province of Barcelona.

Analytic compartmental models are currently used in mathematical epidemiology to forecast the COVID-19 pandemic evolution and explore the impact of mitigation strategies. In general, such models treat the population as a single entity, losing the social, cultural and economical specificities. We present a network model that uses socio-demographic datasets with the highest available granularity to predict the spread of COVID-19 in the province of Barcelona. The model is flexible enough to incorporate the effect of containment policies, such as lockdowns or the use of protective masks, and can be easily adapted to future epidemics. We follow a stochastic approach that combines a compartmental model with detailed individual microdata from the population census, including social determinants and age-dependent strata, and time-dependent mobility information. We show that our model reproduces the dynamical features of the disease across two waves and demonstrates its capability to become a powerful tool for simulating epidemic events.

Delayed glossopharyngeal and vagus nerve paralysis following occipital condyle fracture. Case report.

This report describes a case of delayed glossopharyngeal and vagus nerve paralysis following a closed head injury. A depressed fracture of the occipital condyle was diagnosed using high-resolution computerized tomography (CT) scanning and three-dimensional CT images. Magnetic resonance imaging complemented the study. The anatomical features, mechanisms, diagnosis, and treatment of this unusual lesion are discussed.

[Nursing achievement. Measurement of nursing time]. / Producto enfermero. Medida del tiempo por procesos.

OBJECTIVE: To study the nursing duties according to pathology, measuring the time required to give the necessary patient care. Both direct and indirect activities were analyzed. The patients were classified according to the Diagnostically Related Group (DRG) system. METHODS: The study was conducted with hospitalized ophthalmology patients. To increase accuracy the different methods of measuring the work loads were adjusted. A modified Delphi method was used as a time standard. The amount of time spent on direct and indirect activities per patient was analyzed according to the DRG for each day in the hospital as well as each shift. Differences between pathologies were also accounted for. RESULTS: The patients in the various groups had the following mean times per activity: DRG 036-1010.5 minutes; DRG 042 912.3 minutes; DRG 039-335.3 minutes; DRG 040-302.9 minutes. There are some significant differences between some pathologies but if they are adjusted for their average say they are not significant. CONCLUSION: The work load of ophthalmology nurses depends basically in the average stay in the hospital and not the pathology.

[Multiple nerve root tumors and neurofibromatosis: contribution of magnetic resonance imaging]. / Tumores radiculares múltiples y neurofibromatosis: aportación de la resonancia magnética.

Three patients (two females and one male) with radiculospinal neurologic involvement secondary to different forms of neurofibromatosis are reported. The first two met the diagnostic criteria for NF-1, although case 2 had a posterior fossa meningioma, which is an uncommon finding in this group. The male patient had an apparently sporadic NF-2, with bilateral acoustic nerve neurinoma, multiple meningioma, multiple radicular neurinoma and an intraspinal tumor apparent in magnetic resonance imaging. In the three cases the whole central nervous system was evaluated with gadolinium-enhanced magnetic resonance imaging. A great number of radicular tumors, many of which were asymptomatic, were detected. In spite of the severity of the clinical features, the three patients showed a dramatic improvement after the surgical removal of the symptomatic tumors. The use of magnetic resonance is encouraged, owing to its high resolution and safety, for the assessment of incidence, character and localization of tumors in neurofibromatosis and to establish a good clinico-lesional correlation before surgery. This technique may help to a better understanding of the spectrum of abnormalities in each type of neurofibromatosis, thus facilitating the evaluation of this complex condition.