[Peripheral facial paralysis in patients with SARS-CoV-2 in prono position]. / Parálisis facial periférica en pacientes con SARS-CoV-2 en decúbito prono.

TITLE: Parálisis facial periférica en pacientes con SARS-CoV-2 en decúbito prono.

Oxigenoterapia de alto flujo y posición de prono con respiración espontánea en neumonía por SARS-CoV-2 / High-flow oxygen therapy with spontaneous breathing prono position in SARS-CoV-2 pneumonia

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Calcifediol mensual frente a calcifediol quincenal en el tratamiento de pacientes osteoporóticos. Estudio en la vida real / Monthly versus biweekley calcifediol in the treatment of osteoporotic patients. Study in real life

Objetivos: Valorar las concentraciones séricas de 25-hidroxivitamina D, 25(OH)D, en pacientes osteoporóticos tratados durante un año con calcifediol. Métodos: Se han estudiado 156 pacientes con osteoporosis (23 varones y 133 mujeres) de 71,9±9,6 años de edad que habían recibido tratamiento con calcifediol durante al menos un año. Noventa y dos de ellos recibieron 0,266 mg de calcifediol cada quince días y los 64 restantes la misma dosis una vez al mes. Se determinaron los niveles séricos de 25(OH)D, PTH intacta (PTHi), propéptido aminoterminal del procolágeno tipo I (PINP) y telopéptido carboxiterminal del colágeno tipo I (CTX), antes y un año después de iniciar el tratamiento. Resultados: Con ambas pautas de tratamiento se observó un aumento significativo en la concentración de 25(OH)D (p<0,001). El porcentaje de pacientes que alcanzaron niveles de 25(OH)D superiores a 20 y 30 ng/ml fue similar con ambas pautas, mientras que el de pacientes que sobrepasó los 60 ng/ml fue mayor con la dosis quincenal (p<0,01). La concentración de PTHi disminuyó de forma significativa tras la administración de calcifediol, aunque en esta ocasión no hubo diferencias entre las dos formas de tratamiento. Ambos marcadores, PINP y CTX, disminuyeron de forma similar en los pacientes tratados con antirresortivos (p<0,0001), sin que estos cambios guardaran relación con la pauta de calcifediol. Conclusiones: La administración mensual de 0,266 mg de calcifediol es adecuada para lograr unos niveles eficaces de vitamina D, y es también suficientemente segura como para evitar que se alcancen niveles potencialmente perjudiciales de la misma, por lo que sería preferible a la pauta quincenal en la práctica clínica habitual

Objectives: To assess serum concentrations of 25-hydroxyvitamin D, 25(OH)D, in osteoporotic patients treated for one year with calcifediol. Methods: We have studied 156 patients with osteoporosis (23 males and 133 females), aged 71,9±9,6 years who had received treatment with calcifediol for at least one year. Ninety-two of them received 0.266 mg of calcifediol every fifteen days and the remaining 64 the same dose once a month. Serum levels of 25(OH)D, intact PTH (iPTH), procollagen type 1 amino-terminal propeptide (PINP) and C-terminal crosslinked telopeptide of type I collagen (CTX) were determined before and one year after starting treatment. Results: A significant increase in the concentration of 25(OH)D was observed with both treatment regimens (p<0.001). The percentage of patients who reached levels of 25(OH)D higher than 20 and 30 ng/ml was similar with both guidelines, while the percentage of patients exceeding 60 ng/ml was higher with the biweekly dose (p<0.01). The concentration of iPTH decreased significantly after the administration of calcifediol, although on this occasion there were no differences between the two forms of treatment. Both bone remodeling markers, PINP and CTX, decreased similarly in patients treated with antiresorptives (p<0.0001), without these changes being related to the calcifediol regimen. Conclusions: The monthly administration of 0.266 mg of calcifediol is adequate to achieve effective levels of vitamin D, and it is also safe enough to avoid reaching potentially harmful levels of it, so it would be preferable to the biweekly schedule in the usual clinical practice

Gammagrafía pulmonar de perfusión / Lung perfusion scintigraphy

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Captación tiroidea del yodo / Thyroid uptake of iodine

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[The risk factors and bone mineral density in women on long-term levothyroxine treatment]. / Factores de riesgo y densidad mineral ósea en mujeres en tratamiento prolongado con levotiroxina.

BACKGROUND: It is controversial if the long-term treatment with thyroid hormone given at substitutive or suppressive doses has a negative effect on bone metabolism. In previous reports the lack of ultrasensitive TSH assays and densitometers with adequate precision, and the heterogeneity of the patients analyzed could explain these discordant results. PATIENTS AND METHODS: We have assessed bone mineral density (BMD) in 43 premenopausal and 53 postmenopausal women, who underwent near total thyroidectomy and I-131 ablation due to differentiated thyroid cancer, that have been followed up (mean duration, 75.5 [43] months) with suppressive thyroid hormone treatment (mean dose, 170 [42] micrograms) in our hospital. Patients with history of hyperthyroidism were excluded. Lumbar BMD (L2-L4) and BMD in three different sites of hip were measured (dual X-ray densitometry) to determine the contribution of several clinical and risk factors associated with thyroid hormone therapy given to BMD. RESULTS: We have not found significant decrease in BMD at spine or hip when patients were compared with healthy, age and sex matched. Age (inverse correlation) and weight (direct correlation) were the variables mostly influencing BMD). Histologic type of thyroid neoplasia, doses of thyroid hormones, thyroid hormone levels and duration of follow-up, were not associated with changes in BMD. A decrease in calcium intake in postmenopausal and less physical activity in premenopausal women were related with a decreased lumbar BMD. CONCLUSIONS: During long-term treatment of female patients with thyroid hormones, other risk factors should be studied in order to prevent possible loss of bone mass.