Medicina
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Observational Study
[Cohort of pregnant and postpartum women with COVID-19. Comparative analysis between two pandemic waves].
The clinical presentation of pregnant women with COVID-19 varied according to the time of the pandemic. ⋯ These findings support the need for prioritize this group of patients to implement preventive strategies.
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To contribute to the study of the disease, data were recorded from all hospitalized patients in the Clinical Medicine room of Hospital Municipal Dr. Raúl Caccavo, Coronel Suárez, Buenos Aires province, diagnosed with COVID-19 in the first year of the pandemia (March 2020 to March 2021), the only health institution where patients were hospitalized in our city. A descriptive and retrospective transversal cut study was carried out with 178 patients (average age: 61 years old, range: 9 months -96 years), 90% of them hospitalized for a respiratory cause. ⋯ All patients hospitalized for respiratory causes were subjected to a thorax tomography, and 69% of them presented bilateral infiltration in ground glass. The laboratory tests revealed leucopenia in 15% of the patients and thrombocytopenia in 3% of them. These data could be an input for the development of COVID-19 clinical prediction models, although more evidence will be needed for that end.
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The use of positive airway pressure is the treatment of choice for obstructive sleep apnea. Since the beginning of SARS-CoV-2 virus pandemic the recommendations were to avoid the administration of this therapy in the sleep laboratory and to start treatment with autoadjustable continuous positive airway pressure devices. The objective was to evaluate access to these devices in the current epidemiological context. ⋯ The delay between the beginning of the procedure to access the device and the start of treatment was 31 ± 21 in patients who had medical insurance and 65 ± 35.2 in those who did not (p = 0.008). Access to auto-adjustable therapies during the COVID-19 pandemic was below our former experience and that described in other studies with fixed therapies. It is worth considering whether this decrease is a product of the pandemic and independent of the type of therapy or is directly related to the higher costs of self-adjustable devices or to a lack of coverage from the healthcare providers.
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Thoracic endometriosis syndrome (TES) is a rare disorder characterized by the presence of ectopic endometrial tissue in the chest cavity. The typical clinical manifestation is a spontaneous pneumothorax, which usually presents with chest pain, dyspnea, and/or cough. The diagnosis requires a high level of clinical suspicion and a complete gynecological history. ⋯ A VATS was performed where nodules in the parietal pleura and diaphragmatic orifices were identified. In the postoperative period, she continued with hormonal treatment. At 6 months of follow-up, she reported improvement in pain and did not present new episodes of pneumothorax.
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The aim of this study was to describe the long term prognosis of 34 patients with Takayasu arteritis and the results of surgical and endovascular treatment. A total of 5 central surgeries and 53 endovascular procedures were performed including 18 bypass surgeries (33.8%) and 35 angioplasties (66.2%). The median follow-up was 7.5 years, interquartile range [IQR] 2.6-12.5. ⋯ Surgery had higher mortality in patients with aortic and ascending aortic valve disease, combined coronary artery disease and carotid disease. In long term follow up Takayasu arteritis frequently requires revascularization and restenosis or new lesions are common. Surgical treatment had better results with less restenosis than angioplasty.