Neurología hospitalaria y COVID-19: serie de 96 pacientes evaluados en un hospital universitario / Neurology and COVID-19: Case Series of Neurological Complications in 96 patients Admitted at a University Hospital

Background: There are multisystemic consequences secondary to SARS- CoV-2 infection. Aim: To characterize neurological complications in patients admitted due to SARS-CoV-2 infection. Methods: Review of medical records of patients aged over 15 years with COVID-19 evaluated by the neurology team between April and August 2020 at a university hospital. Severity of the infection, referral reasons, neurological diagnoses and laboratory results were registered. The diagnoses were defined by consensus among the members of the hospital neurology group. Cerebrovascular and inflammatory diseases of the central and peripheral nervous system were defined as "probably associated" or "possibly associated" to COVID-19. Results: Ninety-six patients had at least 1 new neu- rological complication. 74% were admitted due to pneumonia and 20% due to a neurological disease. The most common reasons for neurological referral were impaired consciousness (39%), focal neurological deficit (24%), headache (9%) and seizures (5%). The most relevant neurological diagnoses were delirium in 48 patients, stroke in 24, critical illness polyneuropathy and myopathy in 17, seizures in 14, brachial plexopathy in 3, compressive neuropathies in 5, encephalitis in 1, possible vasculitis in 1 and Guillain-Barré syndrome in 1. Stroke and epilepsy were associated with increased length of hospital stay, but without differences in mortality. Conclusions: The spectrum of neurological complications of COVID-19 is wide. There are clinical entities typical of critically ill patients and also diseases associated directly and indirectly with the SARS-CoV2 infection.

Assessment of depression, anxiety, hopelessness and suicidal risk in HIV+ inpatients / Evaluación de depresión, ansiedad, desesperanza y riesgo suicida en pacientes con VIH hospitalizados

Abstract Introduction. People living with HIV frequently experience anxiety, depression, hopelessness and suicide risk, particularly if they are hospitalized due to HIV complications. Objective. The aim of this study was to evaluate the presence of anxiety, depression, hopelessness and suicide risk in HIV+ inpatients at admission and discharge. Method. A comparative study was conducted with the HIV+ inpatient population of the National Institute for Respiratory Diseases in Mexico City, from February to November 2013. The Hospital Anxiety and Depression Scale, the Beck Hopelessness Scale and the Plutchik Suicide Risk Scale were applied at hospital admission and discharge. Results. One hundred and fifteen patients completed all three assessments. Upon admission, 10.4% of the patients scored above the cut-off point for suicide risk; 1.7% presented high levels of hopelessness; 5.2% had clinical depression, and 7% had clinical anxiety. The comparison of scores at admission and discharge showed significant decreases in all symptom levels. Discussion and conclusion. Most of the patients presented low levels of all symptoms assessed at admission and these decreased at discharge. Further research is necessary with the hospitalized HIV population.

Resumen Introducción. Las personas que viven con VIH experimentan con frecuencia ansiedad, depresión, desesperanza y riesgo suicida, particularmente si son hospitalizadas debido a complicaciones por el VIH. Objetivo. El propósito del presente estudio fue evaluar y comparar la presencia de ansiedad, depresión, desesperanza y riesgo suicida en pacientes hospitalizados con VIH, a su ingreso y su egreso. Método. Se llevó a cabo un estudio comparativo con pacientes de VIH+ hospitalizados en el Instituto Nacional de Enfermedades Respiratorias en la Ciudad de México de febrero a noviembre de 2013. Se aplicaron la Escala de Ansiedad y Depresión Hospitalaria, la Escala de Desesperanza de Beck y la Escala de Riesgo Suicida de Plutchik. Resultados. Ciento quince pacientes completaron las tres escalas. A su ingreso, 10.4% de los pacientes obtuvieron puntajes por encima del punto de corte en la Escala de Riesgo Suicida; 1.7% presentaron niveles altos de desesperanza; 5.2% puntuaron con depresión clínica; y 7% puntuaron para ansiedad clínica. La comparación entre los resultados obtenidos al ingreso y el egreso hospitalario mostró una disminución significativa en todos los síntomas al egreso. Discusión y conclusión. La mayoría de los pacientes presentaron niveles bajos de los síntomas evaluados y éstos disminuyeron al egreso. Son necesarias investigaciones adicionales de salud mental en población hospitalizada con VIH.

Cambios en la función vascular de hombres saludables, después de ejercicio físico prolongado y vigoroso: (función vascular y ejercicio vigoroso) / Changes in vascular function in healthy men after prolonged strenuous exercise: (vascular function and strenuous exercise)

Se investigó el efecto del ejercicio prolongado y vigoroso sobre la función endotelial en nueve corredores no-élite, determinando la función dependiente del endotelio de la arteria femoral (FDE-AF). Se observó que el ejercicio prolongado y vigoroso se asocia con menor FDE-AF, con tendencia no significativa a la recuperación a partir de las 24 horas hasta siete días después de la carrera. Se requieren estudios que involucren más participantes para determinar el impacto del ejercicio prolongado y vigoroso sobre la función endotelial.

The effect of prolonged and strenuous exercise on endothelial function in 9 non-elite runners was researched determining the endothelium-dependent function of the femoral artery (EDF-FA). We realized that prolonged and vigorous exercise is associated with lower EDF-FA, with non significant trend toward recovery from 24 hours to 7 days after the race. Studies with more participants are required to determine the impact of prolonged and vigorous exercise on endothelial function.

Effect of prolonged strenuous exercise on endothelial function in non-elite runners / Efeito de exercício extenuante e prolongado sobre a função endotelial em corredores não elite

Background: Prolonged exercise has been shown to result in an acute depression in endothelial function. However, little is known about the effect of this type of exercise in non-ekite runners. Objective: To determine the impact of prolonged strenuous exercise on endothelial function in non-elite runners. Methods: Nine males participating as recreatuional runners (age: 49,5 + ou -5.1y) at the Santiago of Cali Half-marathon (21.097m) were studied. Endothelium dependent femoral artery flow-mediated dilatation (FA-FMD) was evaluated one day before the race and at 1h, 24h, 48h, and 6 days after finishing the half-marathon. Results: A decrease on FA-FMD was observed at 1h after Half-marathon, followed by a non-significant recovery trend starting at 24h up to 6 days after the race. Increase in the posthyperemic diameter of the femoral artery was observed at 1h after race ending, with a trend to baseline values in subsequent measures. Conclusion: Femoral artery diameter increased after prolonged running could explain the reduction of FAFMD. More studies with larger sample size are needed to determine the effects of prolonged running on femoral artery endothelial function.

Fundamentos: O exercício prolongado tem se mostrado resultar em uma depressão aguda da função endotelial. No entanto, pouco se sabe sobre o efeito desse tipo de exercício em corredores não elite. Objetivos: Determinar o impacto do exercício prolongado e extenuante sobre a função endotelial em corredores não elite. Métodos: Foram estudados nove homens participando como corredores de lazer (idade: 49,5±5,1 anos) na Meia-Maratona de Santiago de Cali (21,097m). A dilatação fluxomediada endotélio-dependente da artéria femoral (DFMAF) foi avaliada um dia antes da corrida e em 1h, 24h, 48he em 6 dias depois de completar a Meia-Maratona. Resultados: Um decréscimo foi observado na DFM-AF 1h depois da Meia-Maratona, seguido por uma tendência à recuperação não significativa, começando em 24h e em6 dias depois da corrida. Um aumento no diâmetro póshiperêmico da artéria femoral foi observado 1h depois do final da corrida, com uma tendência a atingir valores de base nas medidas subsequentes. Conclusão: O diâmetro da artéria femoral aumentado depois de uma corrida prolongada poderia explicar a redução no DFM-AF. Estudos adicionais com amostras maiores são necessários para determinar os efeitos de corridas prolongadas sobre a função endotelial da artéria femoral.

Chromosome mapping of 5S rRNA genes differentiates Brazilian populations of Leporellus vittatus (Anostomidae, Characiformes)

Among the anostomid fishes, the genus Leporellus is represented by only three species: L. nattereri, endemic of the Amazon River, L. retropinnis, endemic of the Piracicaba River, and L. vittatus, widely distributed in rivers from Peru, Colombia, Guianas, and different major hydrographic basins of Brazil. A cytogenetic study carried out on specimens of Leporellus vittatus from three major Brazilian hydrographic basins evidenced a karyotype of 54 metacentric and submetacentric chromosomes. C-banding analysis revealed the presence of large pericentromeric heterochromatic segments in all chromosomes and a telomeric block coincident with the NOR sites. Ag, CMA3 or MM staining, and FISH with ribosomal probes located the 45S ribosomal genes on the terminal region of the long arm of the 12th chromosome pair of all populations. Nevertheless, in the specimens from the Paraná and São Francisco Basins the 5S rDNA clusters were interstitially located by FISH on the long arm of the 2nd chromosome pair, while in the specimens from the Tocantins-Araguaia Basin these sites were observed on the long arm of the 9th chromosome pair and on the short arm of the 17th chromosome pair. These data suggest that the species currently named Leporellus vittatus may comprise a complex of cryptic species.

A evaluación de latencia y duración de la analgesia de una dosis individual de morfina peridural para el manejo del paciente con dolor crónico oncológico agudizado / Assessment of latent period and duration of an epidural morphine single dose analgesia in patients with severe oncological chronic pain

Objetivo: Establecer la dosis del sulfato de morfina peridural para el manejo del dolor oncológico crónico agudizado, duración analgésica, tiempo de latencia y efectos colaterales. Material y métodos: Se estudiaron 30 pacientes de ambos sexos, de 30 a 70 años de edad, con diagnóstico de dolor oncológico crónico agudizado con EVA de 7 o mayor se dividieron en 3 Grupos cada uno de 10 pacientes, a los cuales se les administró morfina peridural dosis única: Grupo 1: 30 mcg/kg, Grupo 2: 50 mcg/kg, Grupo 3: 75 mcg/kg. Se valoró el tiempo de latencia y duración de la dosis a los 5ï, 10ï, 15ï, 20ï, 40ï, 60ï, 2, 3, 4, 5, 6 y posteriormente cada 2 horas hasta que el paciente presentara nuevamente el dolor. La valoración de la analgesia se realizó por medio de la Escala Visual Análoga (EVA). Se registraron los parámetros hemodinámicos (presión arterial, frecuencia cardiaca, frecuencia respiratoria). Resultados: Se estudiaron 30 pacientes, 18 pacientes del sexo femenino y 12 pacientes del sexo masculino, con un promedio de edad de 58.3 años. Encontramos durante la fase de estudio adecuado control del dolor de acuerdo a la calificación del EVA al disminuir los valores basales de 8.4 a 3.8 en el Grupo 1, de 8.4 a 3.9 en el Grupo 2, y de 8.3 a 3.4 en el Grupo 3. La latencia para el Grupo 1 fue de 14ñ 1.5 min con una duración de 417ñ29.8, Grupo 2 de15.1ñ6.1 min con una duración de 459ñ6.1, y el Grupo 3 de 9.5ñ1.0 con una duración de 648ñ120.1. Los efectos colaterales más evidentes fueron náusea, vómito, y prurito, siendo más frecuentes en el Grupo 3. Discusión: Consideramos que la dosis para el manejo del dolor oncológico crónico agudizado, con bolo inicial único de morfina por vía peridural es de 50 mcg/kg, encontrando una analgesia aceptable, con una duración adecuada y menos efectos colaterales.

Dacriogammagrafía como método de la evaluación del drenaje la crimonasal / Dacrigammagrafía like method of the evaluation of the drainage lacrimonasal

Los marcadores radiactivos se han utilizado como alternativa diagnóstica en la patología del sistema excretor lacrimal. Se estudiaron 20 vías lacrimonasales de pacientes considerados normales, que mostraron permeabilidad completa en todos los casos. De las 60 vías lacrimonasales, de 30 pacientes, de la población problema con epífora, 3 pacientes mostraron obstrucción parcial bilateral con pasaje tardío del trazador a los 60, 120 y 180 minutos, respectivamente. Presentaron obstrucción alta o proximal, 10 vías lacrimales y obstrucción baja o distal 13 vías lacrimales. Los pacientes con obstrucción completa fueron sometidos a cirugía; en todos se corroboró el diagnóstico gammagráfico. La dacriogammagrafía es en la actualidad una técnica útil en el estudio de la patología obstructiva de la vía lacrimonasal descartando la presencia de trastornos funcionales y localizando el nivel de la obstrucción.