Search

Background: The COVID-19 pandemic has affected the care of patients with other diseases. Difficulty in access to healthcare during these months has been especially relevant for persons with HIV infection (PWH). This study therefore sought to ascertain the clinical outcomes and effectiveness of the measures implemented among PWH in a region with one of the highest incidence rates in Europe., Methods: Retrospective, observational, pre-post intervention study to compare the outcomes of PWH attended at a high-complexity healthcare hospital from March to October 2020 and during the same months across the period 2016-2019. The intervention consisted of home drug deliveries and preferential use of non face-to-face consultations. The effectiveness of the measures implemented was determined by reference to the number of emergency visits, hospitalisations, mortality rate, and percentage of PWH with viral load >50copies, before and after the two pandemic waves., Results: A total of 2760 PWH were attended from January 2016 to October 2020. During the pandemic, there was a monthly mean of 106.87 telephone consultations and 2075 home deliveries of medical drugs dispensed to ambulatory patients. No statistically significant differences were found between the rate of admission of patients with COVID-HIV co-infection and that of the remaining patients (1172.76 admissions/100,000 population vs. 1424.29, p=0.401) or in mortality (11.54% vs. 12.96%, p=0.939). The percentage of PWH with viral load >50copies was similar before and after the pandemic (1.20% pre-pandemic vs. 0.51% in 2020, p=0.078)., Conclusion: Our results show that the strategies implemented during the first 8 months of the pandemic prevented any deterioration in the control and follow-up parameters routinely used on PWH. Furthermore, they contribute to the debate about how telemedicine and telepharmacy can fit into future healthcare models., (Copyright © 2021 Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. Published by Elsevier España, S.L.U. All rights reserved.)

Objective: To measure the benefits of a physical exercise program in a community, through the modifications in quality of life, and perimenopausal-menopausal women physical condition., Setting: The participants were recruited in PC consultations from two health centers in Molina de Segura (Murcia)., Participants: Women between 40 and 70 years old, or under 40 of age diagnosed with early menopause., Design: Quasi-experimental study, non-randomized, controlled, open and single-center with 2 parallel branches to study., Intervention: Experimental group: ACTIVA Bone Health Program for six months., Control: inactive., Main Measurements in Both Groups: The SF 36 questionnaire was used to measure the Quality of life., Physical Condition: Aerobic condition, flexibility, balance and strength measured with the mile, flamenco, flexibility box tests, and throwing the medicine ball, respectively. Physical activity level through the GPPAQ Questionnaire. Sociodemographic variables were collected and the adherence to the program was measured., Results: The quality of life improved in the intervention group compared to the control group, except «Body Pain» dimension (p = 0.412). As regards the intragroup level, all dimensions showed significant improvement except both «Physical Function» (p = 0.263) and «Body Pain» (p = 0.136). The physical capacities that benefited most were aerobic fitness, strength and balance., Conclusions: The Active Bone Health Physical Exercise Program piloting showed benefits on participants' physical and mental quality of life. In addition, it has been shown that performing a specific physical exercise for premenopausal-menopausal women improves their physical condition., (Copyright © 2021 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objectives: To review the cases of Kawasaki disease (KD) in a pediatric reference hospital, analyzing the associated radiologic findings in the lungs., Material and Methods: Retrospective study of the cases of KD diagnosed at our hospital in the last ten years. We reviewed the clinical histories and imaging studies (plain-film chest radiographs and chest CT scans) of 24 patients and analyzed the radiologic findings in the lungs during the acute phase of the disease., Results: Of the total of 24 cases reviewed, 5 (20.8%) showed alterations on plain-film chest radiographs. The mean age of onset of KD in these five patients was 2 years 5 months. Findings were interstitial pattern (n=3), alveolar infiltrates (n=3), subsegmental atelectasis (n=2), pleural effusion (n=1) and cardiomegaly (n=1). In one case, chest CT showed multiple pulmonary nodules. All findings appeared in the acute febrile phase and evolved favorably to complete resolution on radiologic studies., Conclusions: Radiologic findings in the lungs of patients with KD are uncommon. In our series, they were seen in 20.8% of the patients, in the acute febrile phase, due to inflammation of the lower respiratory tract or cardiac insufficiency. It is important to note that the pulmonary nodules observed in one patient are extremely rare. It is conceivable that more cases of KD presenting with small pulmonary nodules undetected at plain-film radiography might be seen as more children undergo CT.

Congenital heart disease occurs in about 0,8% of all newborns. Many cardiac malformations occur among relatives and have a polymorphic presentation. The origin of most congenital heart disease is thought to be multifactorial, implying both anomalous expression of genes and the influence of epigenetic factors. However, in a small number of cases, the origin of congenital heart disease has been directly related to chromosomal anomalies or to defects in a single gene. Curiously, defects in a single gene can explain a polymorphic presentation if the anomalous gene controls a basic embryonic process that affects different organs in time and space. Some of these genes appear to control the establishment of laterality. The establishment of the left-right asymmetry starts at the Hensen node. Here, the initial embryonic symmetry is broken by cascades of gene activation that confer specific properties on the left and right sides of the embryo. Although there are variations between species, some basic patterns of gene expression (Nodal, Pitx2) appear to be maintained along the phylogenetic scale. Anomalous expression of these genes induces the heterotaxia syndrome, which usually courses with congenital heart disease. The development of heart malformations is illustrated with the mouse mutant iv/iv, which is a model for the heterotaxia syndrome and the associated congenital heart disease.