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.

[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.

[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.

[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.

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.