SAFETY AND EFFICACY OF THYMIC PEPTIDES IN THE TREATMENT OF HOSPITALIZED COVID-19 PATIENTS IN HONDURAS.

Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.

Estudio del lenguaje en las diferentes fases de la enfermedad de Alzheimer a través del Test de Boston / Study of language in the different phases of Alzheimer's disease through the Boston Test

Introducción. El incremento en la esperanza de vida en las sociedades desarrolladas ha provocado un aumento en la aparición de enfermedades que son desconocidas por el mundo médico y científico, y por tanto difíciles de abarcar por la comunidad terapéutica. El objetivo de este trabajo es el análisis exhaustivo del progreso en el deterioro de cada una de las áreas del lenguaje en las diferentes fases de la enfermedad de Alzheimer (EA). De esta forma, se podrá planificar la intervención del logopeda en estos pacientes en función de la fase en que se encuentren. Metodología. Para ello se ha diseñado un estudio para evaluar distintos aspectos del proceso cognitivo del lenguaje mediante la utilización del Test de Boston. Esta investigación se ha llevado a cabo con 32 participantes, de los cuales 8 no estaban diagnosticados de EA, 8 estaban diagnosticados de EA en la fase leve, 8 estaban diagnosticados de EA en la fase moderada y, por último, 8 estaban diagnosticados con EA en la fase grave, con el fin de poder estudiar cómo se van alterando las habilidades lingüísticas en las diferentes fases de la enfermedad. Resultados. Los resultados muestran cómo a medida que progresa la enfermedad, el habla espontánea, la comprensión auditiva y la expresión oral van deteriorándose en los participantes diagnosticados de EA. Sin embargo, no en todas las áreas del lenguaje el deterioro avanza de igual forma; de hecho, en el área de habla espontánea los participantes en fase leve ya comienzan a mostrar un deterioro significativo con respecto al grupo control. Sin embargo, dentro del área de comprensión auditiva, los participantes diagnosticados de EA son capaces de realizar de forma satisfactoria la tarea de discriminación auditiva, incluso en fases avanzadas de la enfermedad. Discusión y conclusiones. En esta investigación se observa cómo el curso de la alteración de las capacidades comunicativas difiere a lo largo del curso de la EA. Por ello, resalta la necesidad de estudiar en profundidad sus áreas del lenguaje para así ayudar a la planificación de la intervención del logopeda en cada momento específico de la enfermedad (AU)

Introduction. The increase in life expectancy in developed societies has led to an rise in the appearance of diseases that are unknown by the medical and scientific world and, therefore, are difficult to cover by the therapeutic community. The Alzheimer's disease (AD) is a neurodegenerative disease that has multiple cognitive disorders, being especially relevant the language impairment displayed by patients diagnosed with the disease. The objective of this research is the exhaustive analysis of the progress in the deterioration of each of the areas of language in the different phases of AD. Thus, the intervention of the speech therapist can be planned in these patients depending on the phase in which they are. Method. We have designed a study to evaluate various aspects of the cognitive process of language using the Boston Test. We have worked with 32 individuals, eight of which were not diagnosed with AD, eight diagnosed with AD in mild stage, eight with AD in moderate stage and finally, eight were diagnosed with AD in advanced stage. We analysed how it is disrupting language abilities at different stages of the disease. Results. The results show how Spontaneous Speech, Listening Comprehension and Oral Expression will be deteriorate in these patients as the disease progresses. However, deterioration does not proceed in the same way in all areas of language. In the Spontaneous Speech area, participants in the mild stage already begin to show a significant deterioration with respect to the control group. On the other hand, within the area of Listening Comprehension, all participants diagnosed with AD successfully perform the auditory discrimination task, even in advanced stages of the disease. Discussion and conclusions. This research shows how the course of the alteration of the communicative capacities differs along the course of AD. Therefore, it highlights the need to study in more depth the language of the AD to help planning a speech therapy intervention in each specific phase of the illness (AU)

Hemosuccus pancreaticus. A propósito de un caso / Hemosuccus pancreaticus. A case report

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Serologic behavior of S100B protein in patients who are brain dead: preliminary results.

OBJECTIVE: The objective of this study is to assess the S100B protein serum concentrations from brain dead (BD) donors to understand whether its level could provide clinical information during BD diagnosis as a potential confirmatory test. METHODS: During 12 months, 26 patients declared BD were prospectively included in this study. Once the diagnosis of BD was achieved, serum S100B protein levels were measured using an electrochemiluminescence assay. For analytical purposes, we selected the maximum S100B serum value reached during the first 5 days of evolution from a historical cohort of 124 survived patients after a severe brain injury (SBI), as well as from 18 healthy donors (HD) and a subgroup of patients who had severe traumatic brain injuries (TBIs) without extracranial injuries. RESULTS: Mean age was 53.48 years (SD, 18.91 years). The BD group had significantly higher S100B serum levels (1.44 µg/L; interquartile ratio [IR], 0.63-3.68) than the SBI (0.34 µg/L; IR, 0.21-0.60) and HD groups (0.06 µg/L; IR, 0.03-0.07; P < .001). Analysis of S100B levels depending on the main cause responsible for BD development showed significant differences between subgroups (P = .012). S100B serum levels were higher in the isolated TBI BD group (P = .004). The S100B value showed an odds ratio for BD diagnosis of 8.38 (95% confidence interval [CI], 1.16-60.45; P = .035). Reciever operating characteristic analysis revealed an area under the curve of 0.92 (95% CI, 0.79-1.00; P = .007). We set a cut-off value of 2 µg/L in S100B serum concentrations. At this level, the diagnostic properties of S100B would reach 100% of specificity and positive predictive value (PPV), and sensitivity and negative predictive value (NPV) of 60% and 86.7%, respectively. CONCLUSION: This preliminary analysis shows for the very first time that BD is associated with higher S100B serum levels, compared with other neurocritical care patients. We also found that the cause of BD development must be considered. Specifically, S100B serum levels in severe isolated TBI patients-with clinical exploration compatible with BD-could be used in a future as confirmatory test.

Clinical variables and neuromonitoring information (intracranial pressure and brain tissue oxygenation) as predictors of brain-death development after severe traumatic brain injury.

BACKGROUND AND PURPOSE: The aim of this study was to ascertain the role of clinical variables and neuromonitoring data as predictors of brain death (BD) after severe traumatic brain injury (TBI). PATIENTS AND METHODS: This prospective observational study involved severe TBI patients admitted to the intensive care unit between October 2009 and May 2011. The following variables were recorded: gender, age, reference Glasgow Coma Scale after resuscitation, pupillary reactivity, prehospital hypotension and desaturation, injury severity score, computed tomography (CT) findings, intracranial hypertension, and low brain tissue oxygenation (Pti02) levels (<16 mm Hg), as well as the final result of BD. RESULTS: Among 61 patients (86.9% males) who met the inclusion criteria, the average age was 37.69 ± 16.44 years. Traffic accidents were the main cause of TBI (62.3%). The patients at risk of progressing to BD (14.8% of the entire cohort) were those with a mass lesion on CT (odds ratio [OR] 33.6; 95% confidence interval [CI]: 3.75-300.30; P = .002), altered pupillary reaction at admission (OR 25.5; 95% CI: 2.27-285.65; P = .009), as well low Pti02 levels on admission (OR 20.41; 95% CI: 3.52-118.33; P < .001) and during the first 24 hours of neuromonitoring (OR 20; 95% CI: 2.90-137.83; P < .001). Multivariate logistic regression showed that a low Pti02 level on admission was the best independent predictor for BD (OR 20.41; 95% CI: 3.53-118.33; P = .001). CONCLUSIONS: Clinical variables and neuromonitoring information may identify TBI patients at risk of deterioration to BD.

Left subclavian artery pseudoaneurysm after a traffic accident: a case report.

The left subclavian artery pseudoaneurysm is a rare entity with few cases reported in the literature. Most injuries were related to iatrogenic manipulation with catheters for canalization of central lines. In rare cases, this injury has been described secondary to a blunt trauma. We present an unusual case of pseudoaneurysm that includes the origin of left subclavian artery in the context of severe multiple injuries after a traffic accident. There were not clavicular or rib fractures, or another type of chest trauma to justify such a vascular injury. Once the injuries that were life threatening for the patient were stabilized, it proceeded to the treatment of the pseudoaneurysm by placing an endovascular prosthesis successfully with a favorable clinical evolution.