Pandemia del SARS-CoV-2 y reproducción asistida / SARS-CoV-2 pandemic and assisted reproduction

La pandemia por el nuevo virus SARS-CoV-2 ha provocado un proceso de adaptación a la nueva situación por parte de toda de la sociedad y, con ello, los centros de reproducción asistida. Tras la fase aguda de la crisis sanitaria, en la que se redujo de forma drástica la actividad, se han reanudado los ciclos, guiados por las recomendaciones de las sociedades científicas. En este artículo revisamos toda la información publicada respecto al virus y el sistema reproductivo, señalando la presencia de enzima convertidora de angiotensina tipo ii(angiotensin-converting enzyme 2, ACE2) en el sistema reproductivo femenino y masculino, a nivel testicular, ovárico, endometrial y a nivel embrionario. Además, realizamos un análisis comparativo entre las recomendaciones de las sociedades científicas en cuanto al cribado de la infección, las normas de funcionamiento y las medidas generales de laboratorio

The pandemic caused by the new SARS-CoV-2 virus has led to a process of adaptation to the new situation by society as a whole and, therefore, by assisted reproduction centres. After the acute phase of the health crisis, when activity was drastically reduced, cycles have resumed, guided by the recommendations of scientific societies. In this article, a review is presented of all the published information regarding the virus and the reproductive system, pointing out the presence of angiotensin-converting enzyme 2 (ACE2) in the female and male reproductive system, at the testicular, ovarian, endometrial and embryonic levels. In addition, a comparative analysis is carried out between the recommendations of the scientific societies regarding the screening of infection, performance standards, and general laboratory measurements

[SARS-CoV-2 pandemic and assisted reproduction]. / Pandemia del SARS-CoV-2 y reproducción asistida.

The pandemic caused by the new SARS-CoV-2 virus has led to a process of adaptation to the new situation by society as a whole and, therefore, by assisted reproduction centres. After the acute phase of the health crisis, when activity was drastically reduced, cycles have resumed, guided by the recommendations of scientific societies.In this article, a review is presented of all the published information regarding the virus and the reproductive system, pointing out the presence of angiotensin-converting enzyme 2 (ACE2) in the female and male reproductive system, at the testicular, ovarian, endometrial and embryonic levels. In addition, a comparative analysis is carried out between the recommendations of the scientific societies regarding the screening of infection, performance standards, and general laboratory measurements.

Tremulous cervical dystonia is likely to be familial: clinical characteristics of a large cohort.

BACKGROUND: Primary cervical dystonia is the most common form of adult-onset focal dystonia. Although most frequently sporadic, 15-20% of patients report a positive family history, suggesting a possible genetic cause. Head tremor is often present in patients with cervical dystonia and may be a prominent symptom. OBJECTIVE: To describe the clinical characteristics of patients with tremulous cervical dystonia. METHODS: Patients with primary cervical dystonia attending our botulinum toxin clinic were assessed with an interview and neurological examination and their notes reviewed. Patients were classified as having either tremulous or non-tremulous cervical dystonia, according to the presence or absence of head tremor on examination. Clinical and demographic data were compared between groups. RESULTS: From 273 patients included (190 females, 83 males), 125 (46%) were classified as tremulous and 148 (54%) as non-tremulous. Tremulous patients were more likely to have a segmental distribution (61% vs. 25%), often involving the arms (48%), and had more frequently associated arm tremor (55% vs. 10%). A positive family history of dystonia and/or tremor was more frequent in tremulous patients (50% vs. 18%). CONCLUSIONS: Patients with cervical dystonia with associated head tremor are more likely to have a segmental distribution (with frequent arm involvement), associated arm tremor and a positive family history, suggesting a genetic etiology in this subgroup of patients.

Peripheral nerve hyperexcitability: a clinical and immunologic study of 38 patients.

OBJECTIVE: We studied a case series of peripheral nerve hyperexcitability (PNH) aiming to describe clinical characteristics, immunologic and cancer associations, antibodies against neuronal antigens (voltage-gated potassium channel antibodies [VGKC-Abs] and other), and muscle biopsy findings. METHODS: Patients presenting with clinical and electrophysiologic signs of PNH were selected. We studied clinical and electrophysiologic features; a panel of non-neuronal organ-specific antibodies, immunofluorescence on rat nervous tissues, and radioimmunoprecipitation for VGKC-Abs; and muscle biopsies. RESULTS: Thirty-eight patients were included. After the exclusion of 6 cases with axonopathy of known origin, patients were subdivided according to the presence of electrophysiologic findings of motor axonopathy and association with cancer: axonopathic-PNH (group A: 12 patients), isolated nonparaneoplastic PNH (group B: 16 patients), and isolated paraneoplastic PNH (3 with thymoma and myasthenia gravis, 1 with thyroid carcinoma). PNH clinical features were similar in groups A and B. We found an overall high prevalence of clinical autoimmunity (33% of group A and 63% of group B) and systemic non-neuronal autoantibodies (42% of group A and 75% of group B). However, VGKC-Abs were only positive in 2 patients of group B. Ten patients underwent muscle biopsy, which showed inflammatory changes in 2 cases and nonspecific myopathic features in 8. CONCLUSIONS: PNH is a heterogeneous disorder involving the peripheral nerves in patients with a high propensity for developing autoimmunity. Associated muscle diseases are frequent in the form of myositis, myasthenia gravis, or nonspecific myopathic pathologic findings. VGKC-Abs were uncommon in this series.

Neuro-Behçet con afectación encefálica y espinal / Brain and spinal involvement in Neuro-Behçet disease

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[Study of the health education process in liver transplant recipients]. / Estudio del proceso educativo en el paciente con trasplante hepático.

We present the results of a study carried out in Bellvitge University Hospital in Barcelona (Spain) in patients who underwent orthotopic liver transplantation and who are the subject of a health education program. Throughout the years, the structure of this program has undergone several changes. Initially, only verbal information supplied by a nurse on the knowledge required for patient self-care was envisaged. Through continuous evaluation, different forms of written and audiovisual information on patient self-care were introduced. The aim of this study was to evaluate patient knowledge on self-care by comparing compliance with recommendations at discharge among the patients who received verbal information only with that among patients who received verbal as well as written and/or audiovisual information. The study population comprised 434 patients who underwent liver transplantation from February 1984 to December 31, 1998. A retrospective cohort study was designed with two groups of patients. The first group was composed by 117 patients who received verbal, written and audiovisual information. The second group comprised 107 patients who received verbal information only. Data collection was through a telephone survey. Telephone interview was possible with only 98 patients in the first group and 60 in the second.In the overall evaluation of health education level, the score obtained by the first group was 8.3 (SD = 2.2) and that obtained by the second group was 6.8 (SD = 1.8). The possible score was between 0 and 11. The differences between groups were statistically significant (p < 0.001). In general, patients who received verbal information only showed lower compliance with recommendations at discharge than those also received written and/or audiovisual information.

Estudio del proceso educativo en el paciente con trasplante hepático / Study of the health education process in liver transplant recipients

Se presentan los resultados de un estudio realizado en la Ciudad Sanitaria y Universitaria de Bellvitge (Barcelona) en pacientes sometidos a trasplante hepático ortotópico (THO) y que son objeto de un programa de educación sanitaria. El programa ha sufrido diferentes cambios en su estructura a lo largo de los años. Inicialmente el método sólo contemplaba la información verbal suministrada por la enfermera en relación con los conocimientos necesarios para el autocuidado del paciente. Mediante evaluaciones continuadas se introdujeron diferentes sistemas de soporte escrito y audiovisual sobre los cuidados. El objetivo del estudio es evaluar los conocimientos que tiene el paciente sobre su autocuidado comparando el cumplimiento de las recomendaciones al alta entre los pacientes que sólo recibieron información verbal y los que disponían de información con soporte escrito y/o audiovisual. La población estuvo formada por 434 pacientes trasplantados desde febrero de 1984 hasta el 31 de diciembre de 1998. Se diseñó un estudio de cohortes con carácter retrospectivo y con dos grupos de pacientes. El primer grupo corresponde a 117 pacientes que recibieron información verbal, escrita y audiovisual. El segundo grupo a 107, que recibieron sólo información verbal. El método utilizado para la recolección de datos fue una encuesta telefónica. Sólo se pudieron entrevistar a 98 pacientes del primer grupo y a 60 del segundo. En la valoración global del nivel educativo, el primer grupo obtuvo una puntuación de 8,3 (DE = 2,2) y el segundo 6,8 (DE = 1,8) con un rango posible de puntuación de 0-11, apreciándose diferencias significativas entre los pacientes de ambos grupos (p < 0,001). En los pacientes que sólo tenían información verbal se observa en general un menor cumplimiento de las recomendaciones al alta con referencia a los pacientes que además recibieron información con soporte escrito y/o audiovisual (AU)