Treatment of COVID-19 during the Acute Phase in Hospitalized Patients Decreases Post-Acute Sequelae of COVID-19.

BACKGROUND: The post-acute sequelae of SARS-CoV-2 (PASC) infection have caused a significant impact on our health system, but there is limited evidence of approved drugs focused on its prevention. Our objective was to identify risk factors that can determine the presence of PASC, with special attention to the treatment received in the acute phase, and to describe the profile of persistent symptoms in a multidisciplinary Post-Coronavirus Disease-19 (COVID-19) Unit. METHODS: This one-year prospective observational study included patients following an acute COVID-19 infection, irrespective of whether they required hospital admission. A standardized symptom questionnaire and blood sampling were performed at the first follow-up visit, and demographic and clinical electronic data were collected. We compared subjects with PASC with those who had fully recovered. Multivariate logistic regression was performed to identify factors associated with PASC in hospitalized patients, and Kaplan-Meier curves were used to assess duration of symptoms according to disease severity and treatments received in the acute phase. RESULTS: 1966 patients were evaluated; 1081 had mild disease, 542 moderate and 343 severe; around one third of the subjects had PASC, and were more frequently female, with obesity, asthma, and eosinophilia during acute COVID-19 disease. Patients who received treatment with dexamethasone and remdesivir during the course of the acute illness showed a lower median duration of symptoms, compared with those who received none of these treatments. CONCLUSION: Treatment with dexamethasone and/or remdesivir may be useful to reduce the impact of PASC secondary to SARS-CoV-2 infection. In addition, we identified female gender, obesity, asthma, and disease severity as risk factors for having PASC.

Schwannoma de la línea media cervical / Cervical midline schwannoma

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Sarcomas de cabeza y cuello. Nuestra experiencia / Head and neck sarcomas. Our experience

Introducción: Los sarcomas de cabeza y cuello son un grupo heterogéneo de tumores malignos con una alta variabilidad en la presentación clínica, en su clasificación histopatológica y sus características biológicas. Material y métodos: Estudio retrospectivo de los pacientes con un sarcoma localizado en cabeza y cuello tratado en nuestro centro a lo largo de un período de 25 años. Resultados: Durante el período de estudio fueron diagnosticados un total de 25 pacientes con sarcomas localizados en cabeza y cuello, que representaron un 0,5% del total de tumores malignos a dicho nivel. El tratamiento más habitual incluyó la resección quirúrgica del tumor, habitualmente complementado con un tratamiento de radioterapia y/o quimioterapia adyuvante. El control local final, incluyendo los tratamientos de rescate, fue del 52%, con una supervivencia ajustada a los 5 años del 51% y a los 12 años del 32%. Conclusiones: El tratamiento quirúrgico de los pacientes con sarcomas de cabeza y cuello consigue unos resultados aceptables de control local y supervivencia (AU)

Introduction: Head and neck sarcomas are a heterogeneous group of malignant tumours that vary greatly in clinical presentation, with different histopathological and biological characteristics. Material and methods: This was a retrospective study of patients with sarcoma located in the head and neck treated in our centre over a period of 25 years. Results: During the study period, a total of 25 patients were diagnosed with sarcomas in the head and neck, accounting for 0.5% of all malignancies at this level. The most common treatments included surgical resection of the tumour, often supplemented with radiotherapy and/or adjuvant chemotherapy. The final local control, including the salvage, was 52%, with an adjusted survival of 51% at 5 years and 32% at 12 years. Conclusions: Surgical treatment of patients with head and neck sarcomas achieves acceptable results of local control and survival (AU)

[Head and neck sarcomas. Our experience]. / Sarcomas de cabeza y cuello. Nuestra experiencia.

INTRODUCTION: Head and neck sarcomas are a heterogeneous group of malignant tumours that vary greatly in clinical presentation, with different histopathological and biological characteristics. MATERIAL AND METHODS: This was a retrospective study of patients with sarcoma located in the head and neck treated in our centre over a period of 25 years. RESULTS: During the study period, a total of 25 patients were diagnosed with sarcomas in the head and neck, accounting for 0.5% of all malignancies at this level. The most common treatments included surgical resection of the tumour, often supplemented with radiotherapy and/or adjuvant chemotherapy. The final local control, including the salvage, was 52%, with an adjusted survival of 51% at 5 years and 32% at 12 years. CONCLUSIONS: Surgical treatment of patients with head and neck sarcomas achieves acceptable results of local control and survival.

Miositis fulminante del compartimento muscular cervical posterior. A propósito de un caso / Sudden myositis of the posterior cervical muscular compartment. Case report

Presentamos un caso de infección cervical profunda atípica con afectación principalmente muscular, cuyo agente causal fue Streptococcus pyogenes, y cuya clínica y evolución se caracterizaron por un brusco deterioro hemodinámico y fallo sistémico severo que hizo necesaria una exploración quirúrgica urgente y su posterior ingreso en la UCI. Tras el diagnóstico de miositis estreptocócica y el pertinente cambio de pauta antibiótica, el paciente presentó una mejoría progresiva hasta su restitución completa (AU)

An atypical case of deep neck infection is presented with muscular involvement as the main feature. Streptococcus pyogenes was the causal agent and abrupt haemodynamic impairment and severe systemic failure characterized its clinical course, requiring emergency surgical examination and subsequent admission to the critical care unit. After the diagnosis of Streptococcal Myositis was obtained and the antibiotic treatment adjusted, the patient progressively recovered completely (AU)

Sudden myositis of the posterior cervical muscular compartment. Case report.

An atypical case of deep neck infection is presented with muscular involvement as the main feature. Streptococcus pyogenes was the causal agent and abrupt haemodynamic impairment and severe systemic failure characterized its clinical course, requiring emergency surgical examination and subsequent admission to the critical care unit. After the diagnosis of streptococcal myositis was obtained and the antibiotic treatment adjusted, the patient progressively recovered completely.

[Neurocognitive and behavioural abnormalities in paediatric sleep-related breathing disorders]. / Alteraciones neurocognitivas y conductuales en los trastornos respiratorios del sueño infantil.

INTRODUCTION: Behavioural and neurocognitive abnormalities in children may be a consequence of sleep-related breathing disorders. The effectiveness of assessments based on questioning parents is dubious and objective assessment tools are therefore required. AIM: To ascertain the impact of these abnormalities in children with sleep-related breathing disorders and compare the reliability of questioning parents in relation to validated psychological tests. METHOD: A prospective study was performed on 20 children with sleep-related breathing disorders and 20 healthy control children between 3 and 12 years of age. Both groups were subjected to a battery of validated psychological tests. The results of both groups were compared with each other and with the response to clinical questionnaires given to parents in the problem group. RESULTS: More than 75% of the cases in the problem group presented abnormalities with regard to attention, anxiety, memory and spatial structuring. The percentage involvement in all concepts was higher in the problem group. Comparisons of attention (40% of children affected in the control group and 80% in the problem group), memory (50% and 84.2%), and spatial structuring (45% and 75%) were statistically significant. More abnormality was observed in the parameters assessed with psychological tests than the equivalent concept obtained from interviewing the parents. Comparison of abnormal concentration assessed from the questionnaires (40% of children affected) with attention during the psychological test (80%), memory (15% and 84.21%), and delayed language development (10%) compared to spatial structuring (75%) was statistically significant. CONCLUSIONS: A high prevalence of behavioural and neurocognitive abnormalities was observed in children with sleep-related breathing disorders compared to a control group of healthy children. The use of objective assessment such as psychological tests revealed more abnormalities than were expressed by parents in response to clinical interviews.

Alteraciones neurocognitivas y conductuales en los trastornos respiratorios del sueño infantil / Neurocognitive and behavioural abnormalities in paediatric sleep-related breathing disorders

Introducción: Las alteraciones de conducta y neurocognitivas en los niños pueden ser consecuencia del trastorno respiratorio del sueño. Los medios de evaluación basados en el interrogatorio a los padres tienen una eficacia dudosa y por ello se requieren herramientas objetivas de valoración. Objetivo: Averiguar el impacto de estas alteraciones en niños con trastornos respiratorios del sueño y comparar la fiabilidad del interrogatorio a los padres respecto a los tests psicológicos validados. Método: Estudio prospectivo de 20 niños con trastornos respiratorios del sueño y 20 controles sanos entre 3 y 12 años de edad. Se sometió a ambos grupos a una batería de tests psicológicos validados. Se comparan los resultados entre ambos grupos y los resultados de estos tests con la respuesta a los cuestionarios aplicados a los padres en el grupo de casos. Resultados: En el grupo de casos, más del 75% presentaba alteraciones de atención, ansiedad, memoria y estructuración espacial. Los porcentajes de afección en todos los conceptos fueron superiores en el grupo de casos. Resultan estadísticamente significativas las comparaciones de la atención (el 40% de niños afectados en el grupo control y el 80% en el grupo de casos), la memoria (el 50 y el 84,2%) y la estructuración espacial (el 45 y el 75%). Se observa mayor alteración de los parámetros valorados con los tests psicológicos que en los conceptos equivalentes obtenidos del interrogatorio de los padres. Resultaron estadísticamente significativas las comparaciones entre alteración de concentración valorada en el interrogatorio (el 40% de niños afectados) con la atención en el test psicológico (80%), la memoria (el 15 y el 84,21%) y retraso en el lenguaje (10%) comparado con la estructuración espacial (75%). Conclusiones: Se observa una alta prevalencia de alteraciones de conducta y neurocognitivas en los niños con trastornos respiratorios del sueño comparados con un grupo equivalente de niños sanos. Con la utilización de tests psicológicos se observa mayor afección por estas alteraciones respecto a lo expresado por los padres en los interrogatorios clínicos (AU)

Introduction: Behavioural and neurocognitive abnormalities in children may be a consequence of sleep-related breathing disorders. The effectiveness of assessments based on questioning parents is dubious and objective assessment tools are therefore required. Aim: To ascertain the impact of these abnormalities in children with sleep-related breathing disorders and compare the reliability of questioning parents in relation to validated psychological tests. Method: A prospective study was performed on 20 children with sleep-related breathing disorders and 20 healthy control children between 3 and 12 years of age. Both groups were subjected to a battery of validated psychological tests. The results of both groups were compared with each other and with the response to clinical questionnaires given to parents in the problem group. Results: More than 75% of the cases in the problem group presented abnormalities with regard to attention, anxiety, memory and spatial structuring. The percentage involvement in all concepts was higher in the problem group. Comparisons of attention (40% of children affected in the control group and 80% in the problem group), memory (50% and 84.2%), and spatial structuring (45% and 75%) were statistically significant. More abnormality was observed in the parameters assessed with psychological tests than the equivalent concept obtained from interviewing the parents. Comparison of abnormal concentration assessed from the questionnaires (40% of children affected) with attention during the psychological test (80%), memory (15% and 84.21%), and delayed language development (10%) compared to spatial structuring (75%) was statistically significant. Conclusions: A high prevalence of behavioural and neurocognitive abnormalities was observed in children with sleep-related breathing disorders compared to a control group of healthy children. The use of objective assessment such as psychological tests revealed more abnormalities than were expressed by parents in response to clinical interviews (AU)

[Mucocele caused by postraumatic orbitary herniation]. / Mucocele por herniación orbitaria postraumática.

Sinusal mucoceles are expansive lesions related to ostium sinus obstruction and treatment is surgical. We present a case of frontal mucocele secondary to ostium drainage obstruction due to herniated orbital content. This entailed difficulties for intranasal surgical resolution so a combined approach was used. The different surgical options for treating such cases are discussed.

Mucocele por herniación orbitaria postraumática / Mucocele by postraumatic orbitary herniation

Los mucoceles de senos paranasales son lesiones expansivas relacionadas con la obstrucción del ostium sinusal, cuyo tratamiento es quirúrgico. Presentamos un caso de un mucocele frontal secundario a una obstrucción del ostium de drenaje por contenido orbitario herniado. Este hecho conllevó dificultad para la resolución quirúrgica endonasal, por lo que se optó por una vía combinada. Para tratar este tipo de casos, se analizan las diferentes opciones quirúrgicas

Sinusal mucoceles are expansive lesions related to ostium sinus obstruction and treatment is surgical. We present a case of frontal mucocele secondary to ostium drainage obstruction due to herniated orbital content. This entailed difficulties for intranasal surgical resolution so a combined approach was used. The different surgical options for treating such cases are discussed