Seric IgG anti-SARS-CoV-2 pre- and post- Covid-19 pandemic from Mexican asymptomatic subjects.

OBJECTIVE: To detect serum IgG anti-SARS-CoV-2 in pre-and post- Covid-19 pandemic in Mexican asymptomatic subjects in order to know the degree of viral dispersion. MATERIALS AND METHODS: Association of serum IgG antibodies (determined by ELISA) to sociodemographic and clinical data or contact with Covid-19 cases in three groups of subjects: 1) Covid-19 pre-pandemic blood donors (n= 538); 2) Covid-19 post-pandemic blood donors (n= 243); 3) Covid-19 post-pandemic neurological patients (n= 312). None of the subjects studied had been vaccinated. RESULTS: The positive rate of IgG anti-SARS-CoV-2 was notably higher in participants recruited during the pandemic (donors, 29.6%; neurological patients, 15.7%) than in those recruited pre-pan-demic (donors 0.6%) (p <0.001). Other conditions associated to antibody positivity were being a worker in sales or services, or having had previous contact with people with Covid-19, for donnors and neurological patients, and having diabetes mellitus, for neurological patients. Higher positivity levels of anti-SARS-CoV-2 IgG were found in females than in males. The highest proportion of subjects with anti-SARS-CoV-2 antibodies was found in central Mexico. CONCLUSIONS: The dispersion of SARS-CoV-2 in asymptomatic, unvaccinated subjects (donors and neurological patients) recruited in a Mexican health institution, who work in sales or services or had previously had contact with Covid-19 patients is 16 to 30%. The level of positivity for anti-SARS-CoV-2 IgG is higher in females than in males. SARS-CoV-2 antibody seropreva-lence follow-up studies must be favored among the general population, being mandatory for donors.

Seric IgG anti-SARS-CoV-2 pre- and post- Covid-19 pandemic from Mexican asymptomatic subjects / IgG sérica anti-SARS-CoV-2 pre y post pandemia de Covid-19 en mexicanos asintomáticos

Abstract: Objective: To detect serum IgG anti-SARS-CoV-2 in pre- and post- Covid-19 pandemic in Mexican asymptomatic subjects in order to know the degree of viral dispersion. Materials and methods: Association of serum IgG antibodies (determined by ELISA) to sociodemographic and clinical data or contact with Covid-19 cases in three groups of subjects: 1) Covid-19 pre-pandemic blood donors (n= 538); 2) Covid-19 post-pandemic blood donors (n= 243); 3) Covid-19 post-pandemic neurological patients (n= 312). None of the subjects studied had been vaccinated. Results: The positive rate of IgG anti-SARS-CoV-2 was notably higher in participants recruited during the pandemic (donors, 29.6%; neurological patients, 15.7%) than in those recruited pre-pandemic (donors 0.6%) (p <0.001). Other conditions associated to antibody positivity were being a worker in sales or services, or having had previous contact with people with Covid-19, for donnors and neurological patients, and having diabetes mellitus, for neurological patients. Higher positivity levels of anti-SARS-CoV-2 IgG were found in females than in males. The highest proportion of subjects with anti-SARS-CoV-2 antibodies was found in central Mexico. Conclusions: The dispersion of SARS-CoV-2 in asymptomatic, unvaccinated subjects (donors and neurological patients) recruited in a Mexican health institution, who work in sales or services or had previously had contact with Covid-19 patients is 16 to 30%. The level of positivity for anti-SARS-CoV-2 IgG is higher in females than in males. SARS-CoV-2 antibody seroprevalence follow-up studies must be favored among the general population, being mandatory for donors.

Resumen: Objetivo: Detectar IgG sérica anti-SARS-CoV-2 antes y después de la pandemia de Covid-19 en sujetos mexicanos asintomáticos, con la intención de conocer el grado de dispersión viral. Material y métodos: Se analizó la asociación de anticuerpos IgG séricos (determinados por ELISA), datos sociodemográficos y clínicos y contacto con casos de Covid-19 en tres grupos de sujetos: 1) donadores de sangre reclutados antes de la pandemia de Covid-19 (n= 538); 2) donadores (n= 243) y 3) pacientes neurológicos (n= 312) reclutados durante la pandemia de Covid-19. Ninguno de los sujetos estudiados había sido vacunado. Resultados: La tasa de positividad de IgG anti-SARS-CoV-2 fue notablemente mayor en los participantes reclutados durante la pandemia (donadores, 29.6%; pacientes neurológicos, 15.7%) que en los reclutados prepandemia (donadores 0.6%). Otras condiciones asociadas con positividad de anticuerpos fueron trabajar en ventas o servicios, o haber tenido contacto previo con pacientes Covid-19, en donadores y pacientes neurológicos, y haber tenido diabetes mellitus, en pacientes neurológicos. Se encontraron mayores niveles de positividad de IgG anti-SARS-CoV-2 en mujeres que en hombres. La mayor proporción de sujetos con anticuerpos anti-SARS-CoV-2 procedía del centro de México. Conclusiones: La dispersión del SARS-CoV-2 en sujetos asintomáticos, no vacunados (donadores y pacientes neurológicos), reclutados en una institución de salud mexicana, que trabajan en ventas o servicios, o tienen contacto previo con pacientes Covid-19 es de 16 a 30%. El nivel de positividad de IgG anti-SARS-CoV-2 es más alto en mujeres que en hombres. Los estudios de seguimiento de la seroprevalencia del SARS-CoV-2 deben favorecerse en la población general, siendo obligatorios en los donadores.

Reconversion of neurosurgical practice in times of the SARS-CoV-2 pandemic: a narrative review of the literature and guideline implementation in a Mexican neurosurgical referral center.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has forced the modification of surgical practice worldwide. Medical centers have been adapted to provide an efficient arrangement of their economic and human resources. Although neurosurgeons are not in the first line of management and treatment of COVID-19 patients, they take care of patients with neurological pathology and potential severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Here, the authors describe their institutional actions against the pandemic and compare these actions with those in peer-reviewed publications. METHODS: The authors conducted a search using the MEDLINE, PubMed, and Google Scholar databases from the beginning of the pandemic until July 11, 2020, using the following terms: "Neurosurgery," "COVID-19/SARS-CoV-2," "reconversion/modification," "practice," "academy," and "teaching." Then, they created operational guidelines tailored for their institution to maximize resource efficiency and minimize risk for the healthcare personnel. RESULTS: According to the reviewed literature, the authors defined the following three changes that have had the greatest impact in neurosurgical practice during the COVID-19 pandemic: 1) changes in clinical practices; 2) changes in the medical care setting, including modifications of perioperative care; and 3) changes in the academic teaching methodology. CONCLUSIONS: The Instituto Nacional de Neurología y Neurocirugía "Manuel Velasco Suárez" is one of the major referral centers for treating highly complex neurosurgical pathologies in Mexico. Its clinical and neurosurgical practices have been modified with the implementation of specific interventions against the spread of COVID-19. These practical and simple actions are remarkably relevant in the context of the pandemic and can be adopted and suited by other healthcare centers according to their available resources to better prepare for the next event.

Consenso multidisciplinario de diagnóstico y tratamiento del dolor neuropático periférico y localizado en México.

Neuropathic pain is an entity that causes patient disability and its diagnosis and treatment is a challenge for physicians. In a significant percentage of patients with neuropathic pain, it is restricted to one dermatome or to a particular region of the body; in this case, it is referred to as localized neuropathic pain. There are no Mexican clinical guidelines proposing recommendations for the diagnosis and treatment of localized neuropathic pain in our population. This article presents the recommendations of a multidisciplinary consensus of specialists from different areas involved in the diagnosis and treatment of this type of patients.

El dolor neuropático es una entidad que provoca discapacidad al paciente y su diagnóstico y tratamiento es un reto para los médicos. En un porcentaje importante de pacientes afectados, el dolor neuropático se presenta circunscrito a un dermatoma o a una región concreta del cuerpo, denominándose en ese caso dolor neuropático localizado. No existen guías clínicas mexicanas que postulen recomendaciones para el diagnóstico y tratamiento del dolor neuropático localizado en nuestra población. En este artículo se exponen las recomendaciones de un consenso multidisciplinario realizado con especialistas de distintas áreas implicadas en el diagnóstico y tratamiento de este tipo de pacientes.

Consenso multidisciplinario de diagnóstico y tratamiento del dolor neuropático periférico y localizado en México / Multidisciplinary consensus on diagnosis and treatment of peripheral and localized neuropathic pain in Mexico

Resumen El dolor neuropático es una entidad que provoca discapacidad al paciente y su diagnóstico y tratamiento es un reto para los médicos. En un porcentaje importante de pacientes afectados, el dolor neuropático se presenta circunscrito a un dermatoma o a una región concreta del cuerpo, denominándose en ese caso dolor neuropático localizado. No existen guías clínicas mexicanas que postulen recomendaciones para el diagnóstico y tratamiento del dolor neuropático localizado en nuestra población. En este artículo se exponen las recomendaciones de un consenso multidisciplinario realizado con especialistas de distintas áreas implicadas en el diagnóstico y tratamiento de este tipo de pacientes.

Abstract Neuropathic pain is an entity that causes patient disability and its diagnosis and treatment is a challenge for physicians. In a significant percentage of patients with neuropathic pain, it is restricted to one dermatome or to a particular region of the body; in this case, it is referred to as localized neuropathic pain. There are no Mexican clinical guidelines proposing recommendations for the diagnosis and treatment of localized neuropathic pain in our population. This article presents the recommendations of a multidisciplinary consensus of specialists from different areas involved in the diagnosis and treatment of this type of patients.