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Background: COVID-19 survivors who were hospitalised continue to experience long-term multisystemic sequelae and symptoms, impacting their health-related quality of life (HRQoL). The complexity of post-COVID-19 conditions underscores the importance of adopting a multidisciplinary, patient-centric approach to ensure ongoing care. This study aims to assess HRQoL and post-COVID symptoms in a cohort of severe COVID-19 survivors depending on their participation in a multidisciplinary programme. Methods: This prospective study was conducted in a post-COVID clinic staffed by a multidisciplinary team (physical rehabilitator, nutritionist, psychologist, including experts in pulmonary rehabilitation, nutrition, psychology and others). Subjects over 18 years old who were hospitalised due to severe COVID-19 during the acute phase and had attended the post-COVID clinic within the first 3 months following discharge were included. Subjects who were unable or unwilling to provide informed consent to participate in the protocol were excluded. Linear mixed-effect models were employed to examine changes in 12-Item Short-Form Health Survey (SF-12) component scores. The resolution of post-COVID symptom clusters was compared using the Cox model. Results: A total of 730 patients were included, with a mean±sd age of 55.78±15.43 years; 60.55% were male and 90.62% required mechanical ventilation during hospitalisation. Programme attendants demonstrated improved SF-12 physical and mental component scores at 3 and 12 months. A reduction in the prevalence of post-COVID symptoms was observed in both groups, with greater reductions in those attending the programme. Conclusion: Our study showed that patients enrolled on the multidisciplinary programme experienced improvements in fatigue, musculoskeletal, gastrointestinal, neuropsychiatric and respiratory symptoms, along with enhanced SF-12 mental and physical component scores.

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Resumen La proporción de usuarios de una sustancia de abuso que desarrolla problemas con su consumo (abuso o dependencia) representa solo una parte de esta población. En México, el 63.8 % de la población consume alcohol, y de ellos, el 15 % desarrolla algún trastorno por consumo de alcohol (TCA). Se ha observado una relación causal entre el trastorno por consumo de sustancias (TCS) y la falta de autocontrol. Es decir, satisfacer necesidades de manera impulsiva, v. gr., consumir una droga sin evaluar las consecuencias. La corteza prefrontal (CPF) es el principal sustrato neuroanatómico del autocontrol y característicamente la CPF alcanza la madurez alrededor de los 30 años, sugieriendo que el autocontrol se alcanza despues de esta edad. Se ha propuesto que todos los grupos etarios que no han consolidado el uso del autocontrol son vulnerables al TCS. Similarmente ocurre con aquellos sujetos que por algún trastorno psiquiátrico tienen como característica una limitada función prefrontal. La CPF coordina una red subcortical cuya interacción depende de distintos sistemas de neurotransmisión, entre ellos, endocanabinoides. En este trabajo se revisó la función de la CPF y del sistema de endocanabinoides (sECB) y su relación con la vulnerabilidad a la adicción y otros trastornos psiquiátricos.

Abstract The proportion of users of a substance of abuse who develop problems with its use (abuse or dependence) represents only a part of this population. In Mexico, 63.8% of the population consumes alcohol and only 15% of them develop an alcohol use disorder (AUD). A causal relation has been observed between substance use disorder (SUD) and the lack of self-control. Which means, satisfying needs in an impulsive way, v.gr. using a drug, without considering the consequences. The prefrontal cortex (PFC) is the main neuroanatomical substrate of self-control and characteristically reaches maturity around the age of 30, suggesting that self-control is reached after this age. We suggest that all age groups that have not consolidated the use of self-control are vulnerable to SUD. The same occurs with those who, due to a psychiatric disorder, have the characteristic of a limited prefrontal function. The PFC coordinates a subcortical network whose interaction depends on different neurotransmission systems among them, the endocannabinoids system (ECBs). In this work we will review the function of the PFC, the ECBs and its relationship with vulnerability to addiction and other psychiatric disorders.

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La enseñanza médica por simulación es un método eficaz para el aprendizaje; mejora la adquisición de competencias, la práctica repetitiva y elimina riesgos para el paciente. Los simuladores de paracentesis existentes, tienen un alto costo y bajo nivel de realismo, por lo que se diseñó y elaboró un simulador híbrido de bajo costo. Se realizó un video representativo de un escenario clínico apropiado, que demuestra la técnica completa de paracentesis. Veinte médicos especialistas observaron el video y realizaron el procedimiento en simulador, posteriormente se aplicó un cuestionario sobre el realismo del simulador, utilidad del video e importancia del procedimiento en la educación médica. Los resultados mostraron que el 85% de los participantes considera que el simulador favoreció la experiencia de aprendizaje. El 90% consideró la apariencia clínica muy adecuada. El 100% opina que la adquisición de la habilidad de paracentesis es relevante en alumnos de pregrado

Medical education by simulation is an effective method for learning; It improves competence acquisition, repetitive practice and eliminates risks for the patient. Existing paracentesis simulators have a high cost and low level of realism, so a low cost simulator was designed and developed. A representative video of a suitable clinical scenario was demonstrated, demonstrating the complete paracentesis technique. 20 medical specialists observed the video and performed the procedure in the simulator, later applied a questionnaire on the realism of the simulator, the utility of the video, and the importance of the procedure in medical education. The results show that 85% of the participants consider the simulator favored the learning experience. 90% considered the clinical appearance to be adequate. 100% believe that the acquisition of paracentesis ability is relevant in undergraduate students

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