Late onset and persistent parosmia and dysgeusia as neurosensorial complication by the SARS virus COV 2.

About the neurological manifestations of COVID-19, smell impairment with some distortion or parosmia is currently one of the longest-lasting post-covid sequelae affecting many young adults around the world, we present a case of a 25yo patient that after the COVID-19 infection initiates with anosmia and dysgeusia of difficult control and some weeks later begins with parosmia associated to general discomfort and vomiting preceded by nausea, accompanied by poor oral intake, generating weight loss in 3 weeks, and depression probably related to the clinical profile and the confinement due to the pandemic. She was treated with prednisone, gabapentin, nasal irrigations and olfactory rehabilitation, with mild improvement, which was greater after the second dose of covid-19 vaccine.

Association between the TAP1 gene polymorphisms and recurrent respiratory papillomatosis in patients from Western Mexico: A pilot study.

BACKGROUND: Recurrent respiratory papillomatosis (RRP) is a respiratory tract disease that affects children and adults and is characterized by the recurrent proliferation of multiple papillomas. The etiologic agent is the human papillomavirus, mainly genotypes 6 and 11. Furthermore, polymorphisms in TAP1 appear to influence the selection of antigenic peptides and the transport process to the rough endoplasmic reticulum, for their subsequent presentation to T lymphocytes, an essential process against viral diseases and tumor processes. Previous studies have shown that individuals with those polymorphisms are susceptible to immune, infectious, and tumor-related diseases. The present study aimed to determine the association between the TAP1 rs1057141 (c.1177A>G) and rs1135216 (c.2090A>G) single nucleotide polymorphisms (SNPs) and RRP. METHODS: A case-control study was carried out on a group of 70 individuals (35 controls and 35 patients). RRP diagnosis, HPV genotyping, and viral load were determined through histology and PCR. SNPs rs1057141 and rs1135216 were identified through allelic discrimination, using real-time PCR. The haplotypic analyses were performed using the Arlequin 3.5 program. RESULTS: HPV-6 and HPV-11 were the genotypes found in the samples. In the polymorphism analysis, rs1057141 showed no significant differences (p = 0.049, CI = 0.994-7.331). In contrast, a significant difference was found in rs1135216 (p = 0.039, OR = 2.4) in the allelic analysis, as well as in the dominant (p = 0.027, OR = 3.06), codominant (p = 0.033, OR = 3.06), and additive model (p = 0.043, OR = 2.505) in subjects with the G allele. CONCLUSION: The G allele in rs1135216 was associated with a genetic risk of susceptibility for RRP in a population in Western Mexico.

Sedoanalgesia en neonato a base de remifentanyl. En relación con un caso para epiglotopexia / Sedoanalgesia in neonate based on remifentanyl. In relation to a case for epiglottopexy

Resumen: La etapa neonatal comprende del primer día hasta el día 28 de vida. Se caracteriza por ser una etapa de inmadurez anatómica, fisiológica y metabólica. Por estas características del neonato, los fármacos anestésicos impactan de manera importante en su fisiología respiratoria y cardiovascular; además la farmacocinética se ve modificada por esta inmadurez. La laringomalacia es una de las principales causas de estridor en esta etapa, misma que, dependiendo de la severidad puede requerir manejo quirúrgico, siendo una opción la epiglotopexia. Dicho procedimiento requiere analgesia potente y a su vez la posibilidad de mantener la ventilación espontánea para su adecuada evaluación, mismas que pueden ser alcanzadas con el uso de remifentanyl. Presentamos el caso clínico de un neonato de término de 22 días de vida a quien se le administró remifentanyl como base de la sedoanalgesia para realización de epiglotopexia de manera exitosa. Su potencia analgésica, capacidad de mantener el automatismo ventilatorio y la farmacocinética predecible en el neonato, convierten al remifentanyl en un agente ideal para proporcionar adecuada sedoanalgesia para diferentes procedimientos con un perfil de fácil titulación y de recuperación rápida en el neonato.

Abstract. The neonatal stage comprises from the first day of birth until day 28 of life. It is characterized by being a stage of anatomical, physiological and metabolic immaturity. Due to these characteristics of neonates, anesthetic drugs have an important impact on their respiratory and cardiovascular physiology, and their immaturity on pharmacokinetics. Laryngomalacia is one of the main causes of stridor in this stage, which depending on its severity could require surgical treatment, such as an epiglotopexy. This procedure requires potent analgesia and at the same time the possibility of maintaining spontaneous ventilation for its appropriate evaluation. This can be achieved with the use of remifentanyl. We present the clinical case of a term neonate of 22 days of age who we administered Remifentanyl as the basis of sedoanalgesia for the successful completion of an epiglotopexy. Its analgesic potency, ability to maintain ventilatory automatism and predictable pharmacokinetics in the neonate, makes it an ideal agent to provide adecuate sedoanalgesia for different procedures with an easy titration profile and rapid recovery in the neonate.

Extended cricotracheal resection with posterior costochondral grafting for complex pediatric subglottic stenosis.

BACKGROUND AND OBJECTIVE: Severe laryngotracheal stenosis in childhood poses a complex surgical challenge for specialists in airway surgery. Patients with severe subglottic stenosis with vocal cord involvement are particularly difficult to manage successfully. The goal of this work was to review our experience with extended CTR in a cohort of young children with severe SGS and determine which clinical parameters would be associated with surgical success. METHODS: Retrospective analysis of the outcome of consecutive patients with severe glottic-subglottic stenosis submitted to an extended double-stage CTR between 2004 and 2014 at a large tertiary referral center. RESULTS: Twenty-five patients met inclusion criteria, with a mean age of 58.7 months at the time of repair. Overall decannulation rate was 80% (20/25), with a median time to deannulation of 120 days. Seven patients developed post-operative sequelae (4 arytenoid dislocations, 2 re-stenosis, and 1 anterior commissure adhesion). Patients with these sequelae had lower overall specific decannulation (42.8%) compared to those without any sequelae (94.4%) (Chi-square, p = 0.0123) with a longer time to decannulate (logrank, p = 0.0004). Notably, patients presenting with these sequelae on average had undergone a longer duration of post-operative stenting (27.14 days) compared to those presenting without any sequelae (14.8 days) (p = 0.0282). CONCLUSIONS: Extended CTR is an effective method for resolving a majority of severe glottic-subglottic stenosis cases in children. Duration of post-operative stenting may adversely impact overall outcome in these patients.