Cutaneous manifestations in COVID 19 infection: Bibliographic Review / Manifestaciones cutáneas en la infección de COVID 19: Revisión Bibliográfica

Introduction: In December 2019, they reported cases of unexplained pneumonia in Wuhan, China. The pathogen, a new coronavirus called severe acute respiratory syndrome (SARSCoV2), was named COVID-19 (coronavirus disease 2019). By February 15, COVID-19 spread across China and around the world, until a pandemic condition was announced on March 11. In Ecuador on February 20 the first case was identified. With the current literature on skin manifestations in COVID-19, in this review, we will focus on the analysis of the description of the skin manifestations presented in infected patients. Objective: to provide an updated descriptive analysis of a sample of patients with unexplained skin manifestations and a diagnosis of COVID-19. Method: it is a non-systematic bibliographic review based on article search using the criteria "skin manifestations and COVID-19" and "skin and COVID 19" in the search engines: PUBMed, ScieLo, Intramed and Psycinfo. Results: In this review, 20 scientific articles were collected, of which 16 were selected for the study, and only 12 met the inclusion criteria. Discussion: dermatological patterns are identified in this collection of articles: erythematous rash, gallbladder lesions, millimeter purpuric macules in flexures, purpuric plaques, urticaria, morbilliform exanthema, ischemic acral lesions, "androgenetic alopecia", these patterns could serve as diagnostic aid and also for research of alternative therapies. Conclusion: Considering all the current information collected on skin manifestations in patients with COVID-19, it is determined that there are not enough cases described to relate both pathologies, but if the number of the sample is increased, these would serve as diagnostic and research support. of possible therapeutic alternatives.

Introducción: En diciembre de 2019, informaron casos de neumonía sin explicación en Wuhan, China. El patógeno, un nuevo coronavirus llamado síndrome respiratorio agudo severo (SARSCoV-2), se denominó COVID-19 (enfermedad por coronavirus 2019). Para el 15 de febrero, COVID-19 se extendió por toda China y todo el mundo, hasta que se anunció una condición pandémica el 11 de marzo. En Ecuador el 20 de febrero se identificó el primer caso. Con la literatura actual sobre las manifestaciones cutáneas en COVID-19, en esta revisión, nos centramos en el análisis de la descripción de las manifestaciones cutáneas presentadas en pacientes infectados.Objetivo: brindar un análisis actualizado descriptivo de una muestra de pacientes con manifestaciones cutáneas inexplicables y diagnóstico de COVID-19. Método: es una revisión bibliográfica no sistemática basada en la búsqueda de artículos utilizando el criterio "manifestaciones cutáneas y COVID-19" y "piel y COVID 19" en los motores de búsqueda: PUBMed, ScieLo, Intramed y PsycInfo. Resultados: En esta revisión se recolectó 20 artículos, de los cuales 16 fueron seleccionados para el estudio, y solo 12 cumplieron con los criterios de inclusión.Discusión: en esta recopilación de artículos se identifica patrones dermatológicos: erupción eritematosa, lesiones vesículares, máculas purpúricas milimétricas en flexuras, placas purpúricas, urticaria, exantema morbiliforme, lesiones isquémicas acrales, "alopecia androgénica", these patrones poden servir como ayuda diagnostóstica y también para investigación de terapias alternativas. Conclusión: Considerando toda la información recogida actual de manifestaciones cutáneas en pacientes con COVID-19, se determina que no hay suficientes casos descritos para relacionar ambas patologías, pero si se aumenta el número de la muestra estas nos servirían como apoyo diagnóstico y en la investigación de posibles alternativas terapéuticas.

The Neutrophil to Lymphocyte Ratio Predicts the Response to Neoadjuvant Chemotherapy in Luminal B Breast Cancer.

Objective: Tumor response to neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients is a predictor for overall survival. The aim of our study was to determine a relationship between the neutrophil to lymphocyte ratio (NLR) prior to NAC, BC subtypes and the probability of a pathologic complete response (pCR). Materials and Methods: Medical records were collected retrospectively from Centro de Cancer at Red Salud UC-Christus. Clinical data collected included peripheral blood cell counts, BC subtype at diagnosis and the pathology report of surgery after chemotherapy. Results: A total of 88 patients were analyzed. Approximately, a 25% had a pCR, and displayed a significant correlation between BC subtype and pCR (p= 0.0138 Chi2); this was more frequent in epidermal growth factor receptor type 2 (HER2) enriched subtype patients (54%). Luminal B BC patients with a pCR had significantly lower NLR levels (t test, p= 0.0181). Conclusions: HER2-enriched tumors had a higher probability of pCR. In Luminal B tumors, NLR had a statistically significant relationship with the probability of pCR. In this subtype, NLR could be a useful biomarker to predict tumor response to NAC. Further studies including other clinical parameters for systemic inflammation such as platelet counts, intratumoral NLR or body mass index could help identify patients that would get the most benefit from NAC.

Anemia hemolítica secundaria a plastía mitral: caso clínico local y revisión de la literatura / Hemolytic anemia after mitral valve repair: case report

Una mujer de 54 años sometida a una reparación mitral se presenta 2 meses después con anemia hemolítica. El mecanismo de ésta correspondió a dehiscencia de la cuadrantectomía y a falta de endotelización de un sector del anillo, que se evidenció mediante ecografía transesofágica y se confirmó por hallazgos operatorios. Se resecó el anillo mitral y se implantó una prótesis de Saint Jude, y no hubo recurrencia de la hemólisis. Se incluye una discusión con revisión de la literatura.

A 54 year old woman was subjected to a mitral valve repair of a mixomatous degenerative valve with severe mitral insufficiency. Quadrantectomy, mitral chords transfer from P2 to a A2 and implantation of a rigid Edwards 28 ring were performed. Two months later the patient was diagnosed with severe hemolytic anemia. Trans esophageal echocardiography revealed severe mitral insufficiency and at surgery a dehiscence at the base of the qudrantectomy in addition to a non endothelysed sector of the mitral ring were found. A Saint-Jude mitral prosthesis was inserted. At follow up, no recurrence of hemolysis occurred.

OBSERVING LYAPUNOV EXPONENTS OF INFINITE-DIMENSIONAL DYNAMICAL SYSTEMS.

Can Lyapunov exponents of infinite-dimensional dynamical systems be observed by projecting the dynamics into ℝ N using a 'typical' nonlinear projection map? We answer this question affirmatively by developing embedding theorems for compact invariant sets associated with C1 maps on Hilbert spaces. Examples of such discrete-time dynamical systems include time-T maps and Poincaré return maps generated by the solution semigroups of evolution partial differential equations. We make every effort to place hypotheses on the projected dynamics rather than on the underlying infinite-dimensional dynamical system. In so doing, we adopt an empirical approach and formulate checkable conditions under which a Lyapunov exponent computed from experimental data will be a Lyapunov exponent of the infinite-dimensional dynamical system under study (provided the nonlinear projection map producing the data is typical in the sense of prevalence).

Amnesia produced by pre-training infusion of serotonin into the substantia nigra.

Interference with dopaminergic, GABAergic or cholinergic activity of the substantia nigra is sufficient to disrupt cognitive functions. In spite of the known interactions between these neurotransmitters and serotonin, there is a notable scarcity of data germane to the participation of nigral serotonin in learning and memory. It was important, therefore, to investigate the possible involvement of serotonin in cognition. Pre-training injections of serotonin into the nigra of rats produced strong amnesia of an aversively-motivated task (inhibitory avoidance) compared to similar injections into the cerebral cortex and zona incerta. The present findings support the hypothesis that nigral serotonergic activity is involved in memory functions.