Multiple sclerosis following SARS-CoV-2 infection.

SARS-CoV-2 infection can produce neurological features. The most common are headache, anosmia and dysgeusia but patients may also develop other central nervous system (CNS) injuries. We present a patient affected by Covid-19 who initially consulted for decreased visual acuity. The MRI showed inflammation in the right optic nerve and demyelinating lesions in the CNS. We speculate that an immune mechanism induced by SARS-CoV-2, which can activate lymphocytes and an inflammatory response, plays a role in the clinical onset of the disease. This pathogen may be associated with either the triggering or the exacerbation of inflammatory/demyelinating disease.

Uso del correo electrónico en la consulta de Enfermería pediátrica en Atención Primaria / The use of e-mail in the Paediatric Nurse Office for Primary Care

OBJETIVO: conocer el grado de implementación del correo electrónico(e-mail) en la consulta de Enfermería en Atención Primaria. Como objetivos específicos: conocer el grado de satisfacción de los usuarios, la frecuencia de uso del correo electrónico entre los pacientes de la consulta de Enfermería pediátrica, los principales motivos de consulta que plantean los usuarios, el grado de accesibilidad percibido por parte de estos, si existe preocupación por parte de los usuarios en cuanto a la confidencialidad de sus datos y el grado de resolución a las demandas del correo electrónico. MÉTODO: estudio observacional, descriptivo y transversal en ámbito comunitario (consulta de Enfermería) durante los años 2012a 2014. Población y muestra: usuarios del e-mail con la enfermera. Muestreo no probabilístico: 128 sujetos. Cuestionario heteroadministrado por teléfono y contenido de los correos enviados. RESULTADOS: tasa de respuesta: 91,4% (117 sujetos). Media de edad: 36,1 años (DE: 5,0). El 88% eran mujeres, con estudios universitarios(61,5%) y trabajadores (74,3%), estando desempleados el 11,1%. Se registraron 428 correos, 3,6 correos por usuario;476 consultas, cuatro consultas por usuario/año. La principal consulta fue: administrativos (65%). Estaban muy satisfechos el97,4%, aunque al 59% le preocupaba la confidencialidad. Las mujeres consultan más sobre vacunas (p< 0,05), los jóvenes consultan más sobre alimentación (p= 0,002). El número de consultas se asocia a dudas sobre alimentación, vacunas, citas, diarrea y diagnósticos (p< 0,05).CONCLUSIONES: el perfil de usuario fue mujer joven, con estudios medios o superiores y trabajadora, que consulta por cuestiones administrativas y que el correo electrónico facilita la accesibilidad con la enfermera, con elevada satisfacción, útil, resolutivo, pero poco seguro

OBJECTIVE: to understand the level of implementation of e-mailin the Primary Care Nurse Office. The specific objectives were: To assess the level of user satisfaction, the frequency of use of e-mail among patients from the Paediatric Nurse Office, the main reasons for consultation by users, the level of accessibility as perceived by users, whether there is concern by users regarding data confidentiality, and the extent to which e-mail users' demands were met. METHOD: descriptive and transversal observational study in the outpatient setting (Nurse Office) during the period between 2012and 2014. Population and sample: users of e-mail with the nurse. Non-probabilistic sampling. 128 subjects. Hetero-administered questionnaire by phone, and contents of e-mails sent. RESULTS: response rate: 91.4% (117 subjects). Mean age: 36,1years (DE: 5.0). An 88.0% were female, with university studies(61.5%) and working (74.3%), while 11.1% were unemployed. In total, 428 e-mails were registered, with 3.6 e-mails per user, 476consultations, four consultations per user/year. The main consultation reason was: administrative matters (65.0%). A97.4% reported they were very satisfied, though 59.0% were concerned about confidentiality. Most consultations from women were about vaccines (p< 0.05), while young patients asked mostly about diet (p= 0.002). The number of consultations was associated with questions about diet, vaccines, appointments, diarrhoea, and diagnosis (p< 0.05).CONCLUSIONS: the profile of the user was: a young female, with intermediate or high studies, and working, asking about administrative matters. E-mail facilitates access to nurses, with a high degree of satisfaction; it is useful and provides solutions, but not very safe

Perforación de angiodisplasia duodenal luego del tratamiento con argón plasma, resuelta con endoclips / Angiodysplasia duodenal perforation after treatment with argon plasma settled with endoclips

El tratamiento estándar para la perforación gastrointestinal secundaria a un procedimiento endoscópico es la reparación quirúrgica; algunos autores propugnan un manejo médico conservador. Los datos actuales sugieren que los endoclips pueden ser usados satisfactoriamente en un grupo selecto de pacientes con perforación gastrointestinal como complicación de una terapia endoscópica. Se describe un caso de perforación duodenal producida con relación al tratamiento con argón plasma de una angiodisplasia sangrante, que se trató con éxito con endoclips.

The gastrointestinal perforation standard treatment secondary to endoscopic procedure is surgical reparation; some authors propose conservative management. Actual data suggest that endoclips could be used in a specific group of patients with gastrointestinal perforation related with an endoscopic therapy complication. Here, we describe a succesfull endoclips treatment of a duodenal perforation related with a bleeding angiodysplasia treated with argon plasma.

[Duodenal angiodysplasia perforation after argon plasma therapy; solved with endoclips]. / Perforación de angiodisplasia duodenal luego del tratamiento con argón plasma, resuelta con endoclips.

The gastrointestinal perforation standard treatment secondary to endoscopic procedure is surgical reparation; some authors propose conservative management. Actual data suggest that endoclips could be used in a specific group of patients with gastrointestinal perforation related with an endoscopic therapy complication. Here, we describe a succesfull endoclips treatment of a duodenal perforation related with a bleeding angiodysplasia treated with argon plasma.