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Rim , Laparoscopia , Humanos , Laparoscopia/economia , Rim/patologia , Biópsia/economia , Biópsia/efeitos adversos , Biópsia/métodos , Nefropatias/patologiaRESUMO
RESUMEN: Antecedentes: La enfermedad por el nuevo coronavirus ha acelerado el desarrollo de pautas terapéuticas para los pacientes en función de su estado de severidad. Hasta la fecha, se han estudiado múltiples fármacos, sin embargo, con el paso del tiempo, solo algunos de los grupos terapéuticos han demostrado ser efectivos y han evidenciado una reducción en la morbimortalidad de los pacientes. Métodos: Se realizó una búsqueda e identificación de artículos publicados en las siguientes bases de datos electrónicas: PubMed, Clinical Key, Web of Science y Scopus para su análisis y selección en inglés y español. La investigación bibliográfica enfatiza la búsqueda de lineamientos actuales sobre el tratamiento de la COVID-19, incluyendo todos los grados de severidad, buscando la efectividad del medicamento. Resultados: Para cada fármaco listado, se describe su farmacodinamia, farmacocinética y recomendaciones generales de uso en pacientes adultos con COVID-19. Conclusiones: Durante la pandemia de COVID-19 se han estudiado numerosos grupos farmacológicos, sin embargo, solo un grupo selecto ha demostrado tener un papel en el tratamiento de la enfermedad. La literatura y las guías respaldan el uso de estos manejos.
ABSTRACT: Background: The new coronavirus disease has accelerated the development of therapeutic guidelines for patients depending on their degree of severity. To date, many drugs have been studied. However, as time passed, only some of these therapeutic groups have been effective and have produced a reduction in patient mortality and morbidity. Methods: A search and identification of articles published in the following electronic databases was carried out: PubMed, Clinical Key, Web of Science, and Scopus; for their analysis and selection in English and Spanish. The literature research emphasizes the search for current guidelines on the treatment of COVID-19, including all degrees of severity, seeking the effectiveness of the medication. Results: For each listed drug, its pharmacodynamics, pharmacokinetics, and general recommendations for use in adult patients with COVID-19, are described. Conclusions: During the COVID-19 pandemic, numerous groups of drugs have been studied, however, only a select group have shown to have a role in the treatment of the disease. The literature and guidelines support the use of these treatments.
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Introduction/Background The COVID-19 pandemic has resulted in a large number of deaths and has caused a significant increase in population morbidity. This viral infection has been associated with different neurological symptoms and complications that do not have a clear pathophysiological mechanism and exact implications for these patients. Case Presentation A 40-year-old man with COVID-19 and co-infection with Klebsiella pneumoniae KPC presented extensive pulmonary involvement and required comprehensive management in the intensive care unit (ICU). During his hospitalization, he developed neurological symptoms with evidence of involvement of the corpus callosum, which was attributed to the cytotoxic lesion of the corpus callosum (CLOCC). After several months of interdisciplinary management in the ICU, there was a progressive improvement in his general condition, with discharge from the hospital without significant sequelae, with follow-up images showing complete involvement of the corpus callosum due to what was considered an atypical cytotoxic lesion of the corpus callosum. Conclusion Imaging features of CLOCCs are known to be temporary, but in the setting of COVID-19, it has not yet been determined if this is true and further studies are needed. Nonetheless, the one-year follow-up of our patient makes us believe that this atypical involvement of the corpus callosum described in severe SARS-CoV-2 infections is not transitory, even if there are no neurologic sequelae.
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INTRODUCTION: Traumatic spinal root injury caused by shoulder dislocation may involve the brachial plexus or, in some cases, a single nerve. The degree of severity of the injury depends on many patient-specific factors as well as the mechanism of injury. It is essential to suspect this type of lesion by means of a thorough physical examination in order to have better patient outcomes. CASE PRESENTATION: We presented the subtle magnetic resonance imaging (MRI) findings in a 35-yearold male with left shoulder trauma and dislocation after falling off a bicycle. He complained of decreased muscle strength and sensitivity in the C8 dermatome. Atrophy of the hypothenar region and flexion deformity of the 4th and 5th digits were noted. Magnetic resonance imaging findings were consistent with a partial preganglionic C8 motor root lesion. We found T2 increased signal intensity and thinning of the intradural segment of the C8 motor nerve root and low signal in the sequence of a multi- echo gradient recalled echo (GRE). CONCLUSION: MRI is a noninvasive tool that allows a detailed anatomical characterization of the nerves. In brachial plexus injuries, the use of the GRE sequence is useful to identify the lesions, even if they are subtle; however, some lesions may go unnoticed. It is important to note that these patients require an interdisciplinary group to reach a correct diagnosis, which is vital to establish the appropriate treatment and follow-up.
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Plexo Braquial , Ombro , Humanos , Masculino , Adulto , Ombro/diagnóstico por imagem , Ombro/inervação , Plexo Braquial/diagnóstico por imagem , Plexo Braquial/lesões , Plexo Braquial/patologia , Imageamento por Ressonância MagnéticaRESUMO
BACKGROUND: Persistent sciatic artery (PSA) is a congenital malformation due to incomplete involution during the embryonic period. Its etiology is unknown, with an estimated incidence of 0.02 - 0.04% in the whole population and a mean age of 60-65 years. Its presentation can be bilateral. It is asymptomatic in most cases and is usually detected accidentally; however, some symptoms may appear, such as claudication, sciatic neuralgia, and pain in the affected limb. It can also manifest as an aneurysmal dilatation or thrombosis that can generate distal embolism with ischemia. CASE REPORT: In this case study, a patient in her 90s with a suspected peripheral arterial disease, which required an angiotomography of the lower limb, showing a superficial femoral artery running to the middle and distal third of the thigh and a vascular structure running in the sciatic neurovascular bundle corresponding to a persistent sciatic artery presenting atherosclerotic changes and extensive occlusion, was presented. The patient's treatment was clinical with dual antiplatelet therapy and prophylactic anticoagulation. This was due to comorbidities and age. Moreover, the PSA occlusion was not critical and did not significantly impact the patient's quality of life. CONCLUSION: Most patients with this anatomical variant are asymptomatic all their lives, but some of them may present symptoms with serious consequences. It is important to suspect it by clinical presentation and perform diagnostic confirmation by angiotomography. Treatment has yielded excellent results with endovascular techniques. Certain patients only require conservative treatment with anticoagulants and antiplatelet agents.