Fibrilación auricular en pacientes con COVID-19. Utilidad de la puntuación CHA2DS2-VASc: un análisis del registro internacional HOPE COVID-19

Introduction and objectivesCoronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2. Atrial fibrillation (AF) is common in acute situations, where it is associated with more complications and higher mortality.MethodsAnalysis of the international HOPE registry (NCT04334291). The objective was to assess the prognostic information of AF in COVID-19 patients. A multivariate analysis and propensity score matching were performed to assess the relationship between AF and mortality. We also evaluated the impact on mortality and embolic events of the CHA₂DS₂-VASc score in these patients.ResultsAmong 6217 patients enrolled in the HOPE registry, 250 had AF (4.5%). AF patients had a higher prevalence of cardiovascular risk factors and comorbidities. After propensity score matching, these differences were attenuated. Despite this, patients with AF had a higher incidence of in-hospital complications such as heart failure (19.3% vs 11.6%, P = .021) and respiratory insufficiency (75.9% vs 62.3%, P = .002), as well as a higher 60-day mortality rate (43.4% vs 30.9%, P = .005). On multivariate analysis, AF was independently associated with higher 60-day mortality (hazard ratio, 1.234; 95%CI, 1.003-1.519). CHA₂DS₂-VASc score acceptably predicts 60-day mortality in COVID-19 patients (area ROC, 0.748; 95%CI, 0.733-0.764), but not its embolic risk (area ROC, 0.411; 95%CI, 0.147-0.675).ConclusionsAF in COVID-19 patients is associated with a higher number of complications and 60-day mortality. The CHA₂DS₂-VASc score may be a good risk marker in COVID patients but does not predict their embolic risk.     

Surgical management of foramen magnum meningiomas

The objective of the study is to describe our experience in the surgical management of foramen magnum meningiomas with regard to the clinical-radiological findings, the surgical approach and the outcomes after mid-term follow up. Over a 5-year period, 15 patients presenting with meningiomas of the foramen magnum underwent surgical treatment. The medical records were reviewed in order to analyze the clinical-radiological aspects, as well as the surgical approach and the outcomes. Based on the preoperative magnetic resonance imaging exams, the tumors were classified as anterior or anterolateral in the axial slices and clivospinal or spinoclival in the sagittal slices. The lateral approach was used in all cases. However, the extent of bone removal and the management of the vertebral artery were tailored to each patient. Fourteen patients were females, and one was male, ranging in age from 42 to 74 years (mean 55,9 years). The occipital condyle was partially removed in eight patients, and in seven patients, removal was not necessary. Total removal of the tumor was achieved in 12 patients, subtotal in two, and partial resection in one patient. Postoperative complications occurred in two patients. Follow-up ranged from 6 to 56 months (mean 23.6 months).There was no surgical mortality in this series. The extent of the surgical approach to foramen magnum meningiomas must be based on the main point of dural attachment and tailored individually case-by-case. The differentiation between the clivospinal and spinoclival types, as well as anterior and anterolateral types, is crucial for the neurosurgical planning of foramen magnum meningiomas.     

Accelerated phase of idiopathic pulmonary fibrosis

The natural history of idiopathic pulmonary fibrosis is characterized by a slow progression resulting in respiratory failure and death. The progression to the fulminant form is rapid in a small percentage of cases, however. Within weeks or months, patients develop respiratory distress, and extensive ground-glass patterns can be seen in computed tomography scans and hyaline membranes in biopsy samples. This is described as an accelerated phase of idiopathic pulmonary fibrosis, in which elevated levels of acute-phase reactants and tumor markers have been reported. To date, the monoclonal tumor marker, CA 15/3 has not been associated with the accelerated phase.     

The capsid protein of infectious bursal disease virus contains a functional α4β1 integrin ligand motif

Infectious bursal disease virus (IBDV), a member of the dsRNA Birnaviridae family, is an important immunosuppressive avian pathogen. We have identified a strictly conserved amino acid triplet matching the consensus sequence used by fibronectin to bind the α4β1 integrin within the protruding domain of the IBDV capsid polypeptide. We show that a single point mutation on this triplet abolishes the cell-binding activity of IBDV-derived subviral particles (SVP), and abrogates the recovering of infectious IBDV by reverse genetics without affecting the overall SVP architecture. Additionally, we demonstrate that the presence of the α4β1 heterodimer is a critical determinant for the susceptibility of murine BALB/c 3T3 cells to IBDV binding and infectivity. Our data suggests that the IBDV might also use the α4β1 integrin as a specific binding receptor in avian cells.     

Preserved orbitofrontal function in first-episode schizophrenia: further evidence from the object alternation paradigm

Neuropsychological literature indicates that performance on Object Alternation Task (OAT) can be linked to the orbitofrontal cortex (OFC). Patients with chronic schizophrenia perform poorly on behavioral and neuropsychological tasks related to OFC functions. In a previous study using the Iowa Gambling Task, we found unimpaired performance in a sample of individuals with first-episode schizophrenia (FES) spectrum disorders. In this study, we aimed to extend our study of OFC functions by using the OAT paradigm, to determine whether there are abnormalities in the early phases of schizophrenia. We examined the performance of 70 patients with FES and 21 healthy controls on a computerized version of OAT. There were no significant differences between patients and control subjects with respect to the OAT. This finding suggests that the OFC function, as measured by decision-making tasks, is preserved in the early phases of schizophrenia.     

Interleukin-1 receptor antagonist genotype and brain morphometry in first-episode non-affective psychosis

Studies of schizophrenia that combine imaging and genetic approaches attempt to map structural brain anomalies associated with genetic risk variants. The aim of the present study was to investigate whether variations in the interleukin-1 receptor antagonist (IL-1RN) were associated with structural brain characteristics of 73 minimally medicated first-episode non-affective psychotic patients. We did not find evidence for association between genetic variation in the IL-1RN gene and brain morphometry at early phases of the illness.     

Lack of influence of COMT Val158Met genotype on cognition in first-episode non-affective psychosis

COMT gene is a logical candidate gene for schizophrenia. Moreover, variations in the COMT Val158Met functional polymorphism have been associated with prefrontal cognitive abnormalities among patients with schizophrenia, healthy relatives and controls. In this study, using an epidemiologically-based sample of 130 patients experiencing a first-episode of a non-affective psychosis, we examined whether COMT Val158Met genotype influenced cognitive performance on the phenotypic expression of psychosis. We found no significant differences in any cognitive measure according to COMT genotype. These findings, together with previously published research, put the relationship between COMT genotype and cognitive performance in doubt.     

Is advanced esophageal adenocarcinoma a distinct entity from intestinal subtype gastric cancer? Data from the AGAMENON-SEOM Registry

Gastric Cancer - Advanced esophageal adenocarcinoma (EAC) is generally treated similarly to advanced gastroesophageal junction (GEJ-AC) and gastric (GAC) adenocarcinomas, although GAC clinical...     

Working conditions of public health workers in the primary care in Catalonia, Spain

OBJECTIVE: To describe the working conditions and tasks of health workers in the health training unit of family medicine in Catalonia, Spain. METHODS: Cross-sectional study. RESULTS: Fifty-three public health workers were located. Forty responses were obtained, of which 29 were complete. More than half the health technicians in the Catalan Health Service had temporary contracts. Their main tasks were teaching, providing methodological assistance in research, and auditing healthcare services and healthcare workers. Health technicians wanted more precise job definition and better working conditions. Although a small proportion believed coordination of primary care and public health to be very difficult, most would take part in it. CONCLUSIONS: The main issues for public health workers were work instability, better salaries, and greater job definition. Coordination between primary care and public health was considered desirable.     

High prevalence of chigger mite infection in a forest-specialist frog with evidence of parasite-related granulomatous myositis

Parasitology Research - Amphibians are hosts for a wide variety of micro- and macro-parasites. Chigger mites from the Hannemania genus are known to infect a wide variety of amphibian species across...