SUCCESSFUL USE OF COVID-19 CONVALESCENT PLASMA IN A PATIENT WITH MULTIPLE MYELOMA CHEMOTHERAPY / USO SATISFACTORIO DE PLASMA CONVALECIENTE DE COVID-19 EN UN PACIENTE CON MIELOMA MÚLTIPLE EN QUIMIOTERAPIA

Multiple myeloma (MM) is a clonal disease derived from plasma cells, whose biology and treatment can produce immunosuppression, which could explain the high mortality rate of patients with MM and COVID-19. The following describes the clinical course of a 63-year-old patient with arterial hypertension, type 2 diabetes mellitus, relapsed MM receiving chemotherapy and SARS-CoV-2 infection who presented a rapid deterioration of respiratory function, requiring orotracheal intubation and admission to the Intensive Care Unit of the HRLBO. Due to the progressive worsening of ventilatory parameters, and considering the different risk factors, it was decided to administer 200 cc of convalescent plasma, showing clinical improvement 24 hours after infusion; finally, the patient was extubated and transferred to the Intermediate Care Unit where she was subsequently discharged.

El mieloma múltiple (MM) es una enfermedad clonal que deriva de las células plasmáticas, cuya biología y tratamiento puede producir inmunosupresión, lo cual pudiera explicar la elevada tasa de mortalidad de los pacientes con MM y COVID-19. A continuación, se describe el curso clínico de un paciente de 63 años, con hipertensión arterial, diabetes mellitus tipo 2, MM en recaída recibiendo quimioterapia e infección por SARS-CoV-2 que cursó con un rápido deterioro de la función respiratorio, requiriendo intubación orotraqueal e ingreso a la Unidad de Cuidados Intensivos del HRLBO. Debido al empeoramiento progresivo de los parámetros ventilatorios, y considerando los diferentes factores de riesgo, se decidió administrar 200 cc de plasma convaleciente, objetivándose mejoría clínica 24 horas después de su infusión; finalmente, la paciente fue extubada y trasladada a la Unidad de Cuidados Intermedios donde posteriormente fue egresada.

Electromyographic activity during awake tooth grinding tasks at different jaw posture in the sagittal plane.

OBJECTIVE: The goal of this study was to evaluate the electromyographic (EMG) activity of the anterior temporalis, suprahyoid, infrahyoid and trapezius muscles during tooth grinding at different jaw posture tasks. MATERIALS AND METHODS: Participants were 30 healthy subjects with natural dentition, bilateral molar support and incisive protrusive guidance. Bipolar surface electrodes were located on the right side of the subject. EMG recordings were performed in the following tasks: (A) Eccentric grinding from intercuspal position to protrusive edge-to-edge contact position; (B) concentric grinding from protrusive edge-to-edge contact position to intercuspal position; (C) eccentric grinding from intercuspal position to the maximum voluntary retrusive position; and (D) concentric grinding from the maximum voluntary retrusive position to intercuspal position. The results were analyzed statistically by Friedman test and Wilcoxon signed rank-sum test. RESULTS: EMG activity in the anterior temporalis and infrahyoid muscles was significantly higher during task C than the other tasks. EMG activity in the suprahyoid muscles was significantly higher during task C than task D. EMG activity in the trapezius muscle was significantly higher during task C than tasks A and B. CONCLUSIONS: The higher EMG activity recorded in task C could become important when its frequency, duration and magnitude are enough to exceed the adaptation capability of the individual.