Association between olfactory dysfunction and COVID-19 severity: A prospective study in a highly complex hospital in Peru.

INTRODUCTION: Olfactory dysfunction has been included among the early symptoms of coronavirus disease (COVID-19). Evidence suggests that a relationship exists between the duration of olfaction disorders and the probability of developing severe COVID-19. Given the scope of the COVID-19 pandemic, this study aimed to determine the frequency of smell alteration and its association with the severity of COVID-19 in a referral hospital in Peru, which is one of the most affected countries in the Latin American region. MATERIALS AND METHODS: This study was an observational, prospective cohort study that included patients with COVID-19 who were treated at the Hospital Nacional Edgardo Rebagliati Martins from August to November 2020. To assess the association, the chi-square test of independence or Fisher's exact test was performed. The outcome variable was COVID-19 severity, and the exposure variable was olfactory dysfunction. The first data collection was in the emergency department and the follow-up was via telephone. RESULTS: A total of 179 patients were included. The mean age was 61.6 ± 15.5 years, and 129 patients (72.1%) were male. Olfactory dysfunction was observed in 43 patients (24%). An inverse association was found between age and olfactory dysfunction (P = .002). No significant association was found between COVID-19 severity level and olfactory alteration (P = .056). However, a direct association was found between COVID-19 severity and age (P = .003), cough (P < .001), and respiratory distress (P = .003). CONCLUSION: This study did not find any association between the severity of COVID-19 and olfactory dysfunction. It showed a low incidence rate of smell alteration compared with studies from other regions. Moreover, smell alteration was associated with younger age.

Efecto de la intervención nasal y nasosinusal en calidad de sueño en el Hospital Edgardo Rebagliati Martins 2017 / Effect of nasal and sinus surgery on sleep quality at the Hospital Edgardo Rebagliati Martins during 2017

Objetivo: Determinar el efecto de la cirugía nasal y nasosinusal endoscópica sobre la calidad de sueño en el Servicio de Otorrinolaringología del Hospital Edgardo Rebagliati Martins durante el año 2017.Materiales y métodos: Estudio retrospectivo y longitudinal. La muestra es de 92 pacientes operados en quienes se evaluó la calidad de sueño mediante el Índice de calidad de sueño de Pittsburgh. Los datos fueron analizados con SPSS versión 24 y se realizó análisis univariado, Mann-Whitney, correlación de Spearman y prueba de rango con signo de Wilcoxon. Resultados: La calidad de sueño mejoró después de la operación nasal y nasosinusal endoscópica (p<0,01), al igual que la obstrucción nasal (p<0,01). En los datos preoperatorios, se encontró correlación entre IMC (índice de masa corporal) y obstrucción nasal con calidad de sueño.Conclusiones: Las operaciones nasal y nasosinusal endoscópica tienen un efecto positivo sobre calidad de sueño en pacientes del Servicio de Otorrinolaringología del Hospital Edgardo Rebagliati Martins 2017.

Objective: To determine the effect of nasal and sinus endoscopic surgery on sleep quality at the Otorhinolaryngology Department of the Hospital Edgardo Rebagliati Martins during 2017. Materials and methods: A retrospective and longitudinal study was conducted with a sample of 92 patients who underwent surgery and whose sleep quality was assessed using the Pittsburgh Sleep Quality Index. The data was analyzed using software SPSS version 24. Additionally, a univariate analysis, Mann-Whitney U test, Spearman ́s rank correlation coefficient and Wilcoxon signed rank test were used in the study.Results: Both sleep quality (p <0.01) and nasal obstruction (p <0.01) improved after nasal and sinus endoscopic surgery. The preoperative data shows that BMI (body mass index) and nasal obstruction have a correlation with sleep quality.Conclusions: Nasal and sinus endoscopic surgery had a positive effect on sleep quality in patients of the Otorhinolaryngology Department of the Hospital Edgardo Rebagliati Martins during 2017.

Complications of cochlear implant surgery: A ten-year experience in a referral hospital in Peru, 2006-2015.

OBJECTIVES: To describe the frequency and characteristics of complications of cochlear implant (CI) surgery at Edgardo Rebagliati Martins Hospital of social security in Lima-Peru between 2006 and 2015. METHODS: A retrospective descriptive study of patients that underwent CI surgery between August 2006 and December 2015. RESULTS: Among the 107 patients with CIs, the overall proportion of complications was 18.7% (20/107): 14.9% (16/107) of minor complications, and 3.7% (4/107) of major complications. Regarding the time of onset of complications, 2.8% (3/107) were intraoperative and 14% (15/107) postoperative. CONCLUSION: CI surgery in Peru is a safe procedure with a low frequency of major complications, representing an effective therapy for patients with sensorineural hearing loss who do not respond to hearing aids.

Neurofibromatosis tipo-1 asociada a tumor maligno de las cubiertas de los nervios periféricos / Neurofibromatosis type-1 associated to malignant peripheral nerve sheath tumor

Varón de 24 años, natural de Lima, que desde hace tres años padece de limitación funcional de los miembros inferiores a predominio izquierdo, dolor abdómino-pélvico crónico, incremento del número y tamaño de manchas dérmicas y nódulos subcutáneos. Al examen físico: presencia de manchas café con leche, nódulos subcutáneos generalizados, pecas en ambas axilas e ingles y nódulos de Lisch en ambos iris. La resonancia magnética nuclear descubrió un incremento del volumen de las raíces y trayectos de los nervios D12-S2, un tumor hipodenso que desplazaba la cola del páncreas hacia adelante, infiltración tumoral del músculo psoas y hueso iliaco izquierdo; además, un tumor multinodular presacro-coccígeo. La biopsia de un nódulo cervical subcutáneo demostró neurofibromatosis plexiforme benigna. La biopsia del tumor presacro-coccígeo reveló la existencia de un tumor maligno de las vainas de los nervios periféricos (MPNST). Mientras se planeaba una resección quirúrgica tumoral y radioquimioterapia, el paciente falleció.

Limitation of lower limbs since 3 years ago, chronic abdominopelvic pain, increase in number and size of dark skin spots and subcutaneous nodules. The physical examination discovered widespread café-au-lait skin spots and subcutaneous nodules, freckles in armpits and inguinal areas, and Lisch nodules in both irises. Magnetic resonance images discovered enlargement of roots and shafts of D12-S2 nerves, an hypodense tumor that displaced forward the pancreas tail, a tumoral infiltration of psoas muscle and left iliac bone; besides, a multinodular tumor in the pre sacrumcoccyx area. The biopsy of a subcutaneous cervical nodule revealed a benign plexiform neurofibromatosis. A biopsy of the pre sacrum-coccyx tumor disclosed a malignant peripheral nerve sheath tumor (MPNST). While planning surgical resection and radio-chemotherapy, the patient died.