Aortic thrombus in patients with severe COVID-19: review of three cases.

Coronavirus disease 2019 (COVID-19) could predispose to both venous and arterial thromboembolism, in an exaggerated immune response to the virus, especially in severe patients. Even though aortic clots are a rare entity, the pro-coagulant nature of COVID-19 is associated with thrombosis in atypical locations and should be considered in patients with severe abnormalities in coagulation parameters. We describe a series of three cases of aortic thrombi diagnosed by computerized tomography (CT) angiography in patients with confirmed SARS-CoV-2 infection.

[Incidence of accidental exposure to blood and body fluids among healthcare professionals in a community hospital]. / Incidencia de exposiciones accidentales a sangre y fluidos biológicos en el personal sanitario de un hospital comarcal.

OBJECTIVE: To determine the annual incidence of healthcare professionals' accidental exposure to blood and body fluids in a community hospital and describe their characteristics, associated situations and follow-up. METHOD: A longitudinal, retrospective study of biological accidents voluntarily reported on a yearly basis by exposed healthcare professionals at Fundació Hospital de l'Esperit Sant (in Santa Coloma de Gramenet, Barcelona, Spain), between 2005 and 2014. A descriptive analysis of the variables related to the exposed professional, the exposure itself, its production mechanism and the source patient was conducted. The rate of exposure was calculated per 100 occupied beds and by job category. RESULTS: 318 exposures were reported; 89.62% were percutaneous and the remainder were non-intact skin or mucous contamination. The mean percutaneous exposure incidence rate from 2005 to 2014 was 17.6 per 100 occupied beds/year (limits 10.3 in 2013 and 24.5 in 2005). Doctors were exposed to the greatest risk (5.29 exposures per 100 doctors). Over 50% occurred in a surgical setting. 44.2% of exposed healthcare professionals had been working at the centre for 1 year or less on average. Puncture was the most common percutaneous lesion. No cases of occupational viral transmission were reported. CONCLUSIONS: The rate of percutaneous exposure reported in this hospital fluctuated significantly throughout the analysis period. Risk of exposure is related to job category, work experience, the setting and the activity performed.

[Effectiveness of lacosamide in the treatment of refractory neuropathic pain: an open observational trial]. / Efectividad de la lacosamida en el tratamiento del dolor neuropatico refractario: estudio observacional abierto.

INTRODUCTION: Although different treatments are available for neuropathic pain, these patients are often refractory, which makes it necessary to test treatments that, as they have proven useful in other pathologies, could be effective in neuropathic pain. PATIENTS AND METHODS: The study made use of the medical records of patients who had been treated with lacosamide for neuropathic pain in different hospitals in the central area of the peninsula and who fulfilled similar characteristics in terms of refractoriness to other standard treatments, in a follow-up that lasted at least six months, or who had had to stop treatment with that drug for some reason or another. A sample of 114 patients (61 males and 53 females) with a mean age of 60.5 years was obtained from the data. RESULTS: The most common causes of neuropathic pain were: diabetic polyneuropathy (31.6%), post-herpes neuralgia (22.8%), trigeminal neuralgia (17.5%), suboccipital and lumbar-radicular neuralgia (both 12.3%). Effectiveness was good/very good in most patients, with the mean score on the visual analogue scale after six months dropping from 7.7 to 4.8. No serious side effects were reported in any of the patients, but in 12 and 10 patients no recordings were made beyond six months, due to ineffectiveness and intolerance to the treatment, respectively. CONCLUSIONS: Treatment with lacosamide in neuropathic pain due to different causes could be considered an effective and well-tolerated alternative for patients who fail to respond to standard treatments.

TITLE: Efectividad de la lacosamida en el tratamiento del dolor neuropatico refractario: estudio observacional abierto.Introduccion. Aunque se dispone de diferentes tratamientos para el dolor neuropatico, en muchas ocasiones estos pacientes son refractarios, lo que hace necesario probar tratamientos que, por su utilidad en otras patologias, podrian ser eficaces en el dolor neuropatico. Pacientes y metodos. Se recogieron las historias clinicas de pacientes que hubieran sido tratados con lacosamida para el dolor neuropatico, en diferentes hospitales de la zona centro peninsular, y que cumplieran unas caracteristicas similares en cuanto a refractariedad a otros tratamientos estandares, en un seguimiento de al menos seis meses, o que hubiesen tenido que suspender el tratamiento con dicho farmaco por cualquier motivo. Se obtuvo una muestra de 114 pacientes, 61 varones y 53 mujeres, con una edad media de 60,5 años. Resultados. Las causas de dolor neuropatico mas frecuentes fueron: polineuropatia diabetica (31,6%), neuralgia postherpetica (22,8%), neuralgia del trigemino (17,5%), neuralgia suboccipital y lumbociatalgia (un 12,3% en ambas). La eficacia fue buena/muy buena en la mayoria de los pacientes, con un descenso medio en la escala analogica visual tras seis meses de 7,7 a 4,8. No se registraron efectos secundarios graves en ningun paciente, pero en 12 y 10 pacientes no hubo registro mas alla de seis meses, por ineficacia e intolerancia al tratamiento, respectivamente. Conclusiones. El tratamiento con lacosamida en el dolor neuropatico de diferentes causas podria considerarse como una alternativa efectiva y bien tolerada para aquellos pacientes que no respondan a los tratamientos estandares.