Medicina
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Carpal tunnel syndrome is median nerve symptomatic compression at the level of the wrist, characterized by increased pressure within the carpal tunnel and decreased nerve function at the level. Carpal tunnel release decreases pressure in Guyon's canal, via open techniques, with symptom and two-point discrimination improvement in the ulnar nerve distribution. We hypothesize that endoscopic carpal tunnel release improves two-point discrimination in the ulnar nerve distribution as well. ⋯ There were significant post operative improvements in both the median (7.7 vs 4.4 mm, p < 0.001) and ulnar (5.7 vs 4.1 mm, p < 0.001) nerve territories. Smoking status, sex, age and diabetes did not significantly affect two-point discrimination outcomes. In conclusion the endoscopic release of the transverse carpal ligament decompresses the carpal tunnel and Guyon's canal, demonstrating improvement in two-point discrimination in both the ulnar and median nerve distributions.
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This study describes the incidence of early events supposedly attributable to vaccination or immunization (ESAVI) that occurred in healthcare workers who had been inoculated with the first component of the Sputnik V vaccine. Safety at 72 h post-immunization was analyzed based on a self-reported form. Between January 5 and January 20, 2021, in Buenos Aires, Argentina, a total of 707 healthcare workers (median age 35 yrs, female 67%) were vaccinated. ⋯ This study demonstrates high rates of early local and systemic reactions. However, serious events were rare. Studies on long-term safety, stratified by sex and age, are needed.
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Multicenter Study
[Descriptive analysis of 4776 patients admitted to medical clinic services for COVID-19. Results of the Argentine Multi-Center Registry - REMA-COVID-19].
A multicenter registry that included adults hospitalized for COVID-19 was carried out in various provinces of Argentina, from March to October 2020. The objectives were to describe the epidemiological characteristics, clinical manifestations, treatments, complications and risk factors, need for admission to critical care units and mortality. The registry included information on 4776 patients in 37 health centers in Argentina. ⋯ The most frequent complications in critical care were: cardiovascular events (54.1%), septic shock (33.3%), renal failure (9.7%) and pneumonia associated with mechanical ventilation (12.5%). Overall mortality was 12.3%. Old age, dementia and COPD behaved as independent predictors of mortality (p < 0.001, 0.007 and 0.002 respectively) in the multivariate analysis.
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The aim of this study was to determine the incidence of preservation fluids (PF) bacterial positive cultures, identify the germs involved, determine their correlation with infections in recipients during the postoperative period and compare outcomes in terms of morbidity, hospital stay and both patient and graft survival. We describe incidence and etiology of germs developed in PF cultures in our series and evaluate its impact on recipients. A prospective study in deceased donor liver transplants (LT) recipients was carried out from January 2014 to December 2017. ⋯ We found no differences in postoperative infections (p 0.840), ICU and total hospital stay (p 0.374 and 0.427) between both groups. Postoperative infections and hospital stay seem not to be infuenced by PF cultures positivity. Treatment of isolated pathogens could have prevented infections, therefore, those groups that perform PF cultures should consider treatment in these cases and conclude prophylaxis when PF is negative or contaminated.
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ANCA-associated vasculitis is a heterogeneous group of rare autoimmune conditions of unknown cause. Clinical characteristics and prognostic factors were analyzed in 47 patients: 20 (42.5%) with granulomatosis with polyangiitis, 17 (36.2%) with microscopic polyangiitis, 6 (12.8%) with renal-limited vasculitis, and 4 (8.5%) with eosinophilic granulomatosis with polyangiitis. Mean age at diagnosis was 53.5 ± 16.5 years and the median of BVAS (Birmingham Vasculitis Activity Score) was 14 (4-42). ⋯ Overall mortality was 3.5 deaths per 100 patient-year in the whole group. Those over 55 years old, the presence of alveolar hemorrhage, those with FFS (Five Factor Score) of 2, and patients with MPA had poor prognosis. Renal involvement, ANCA pattern and BVAS were not associated to a poorer prognosis.