Initial approach to irst-time seizures in pediatrics

Objective: Prove that conducting complementary studies at laboratories and imaging studies are unnecessary in irst-time unprovoked seizures, since there is no change in the evolution and prognosis of the disease, as well as the study of our population, the incidence rate and the proportion of our patients that have been studied and given maintenance treatment, so it can be determined whether or not our population should follow the suggestions of the American Academy of Pediatrics and the Spanish Pediatric Association. Methods: An observational study, including patients diagnosed with irst-time unprovoked seizures. They were followed up on by the emergency department and information was collected from their clinical history and compared with the results of the different studies between patients that suffered just one seizure and the ones that had recurrent seizures. Results: Thirty one patients were included, 14 males and 17 females. The average age was 5.5 years old. The 100% of patients were studied, and the groups were compared. The signiicant study was the electroencephalogram (EEG) with a p=0.02 (signiicance p<0.05), incidence of 41%. Conclusions: The study and diagnosis of irst-time unprovoked seizures is based on clinical manifestations. The EEG is important in the study and classiication of unprovoked seizures. Our population has an incidence and recurrence rate similar to that in the bibliography, and for that reason, this study suggests that the diagnostic and therapeutic guidelines of the American Academy of Pediatrics and the Spanish Pediatric Association should be followed

La teoría del desarrollo humano y sustentable: hacia el reforzamiento de la salud como un derecho y libertad universal

En el artículo se analizará la salud como un elemento constitutivo de la teoría del desarrollo humano, así como los entornos institucionales, políticos y sociales que permiten el acceso a la salud, como uno de los factores totales para avanzar hacia una sociedad sustentable. Asimismo, se analizan estos aspectos conceptuales desde la perspectiva de la medición de indicadores de salud en México y en el estado de Nuevo León. Los indicadores están considerados por estrategias mundiales como el Índice de Desarrollo Humano (IDH), la Agenda 21 y los Objetivos del Desarrollo del Milenio (ODM). Además, en el análisis se utiliza el Coeficiente de Gini, aplicado a indicadores de la salud, todo lo anterior para analizar el avance de la equidad y el desarrollo de las oportunidades de salud de la población

Astrocitoma subependimario de células gigantes asociado a complejo de esclerosis tuberosa: recomendaciones para el diagnóstico oportuno y tratamiento

El complejo de esclerosis tuberosa es una enfermedad genética poco frecuente, autosómica dominante con fenotipo y expresión clínica muy variables. Se caracteriza por alteraciones en la migración, diferenciación y proliferación celulares con formación de múltiples tumores benignos llamados hamartomas, las cuales afectan principalmente piel, encéfalo, riñón, ojo, corazón y pulmón. Los astrocitomas subependimarios de células gigantes son tumores benignos de crecimiento lento y son los más frecuentes en el sistema nervioso central de los pacientes con complejo de esclerosis tuberosa. Actualmente existen medicamentos indicados en pacientes con astrocitomas subependimarios de células gigantes asociados con complejo de esclerosis tuberosa y son una alternativa al tratamiento quirúrgico. Su mecanismo consiste en la inhibición el complejo 1 mTOR, acción que modula el defecto molecular que ocasiona al complejo de esclerosis tuberosa. Con su uso se han reportado disminución y estabilización de angiomiolipomas renales, linfangioleiomiomatosis, angiofibromas y de astrocitomas subependimarios de células gigantes asociados con complejo de esclerosis tuberos

Pathogenesis Coronavirus Disease 2019 (COVID-19): Narrative Literature Review

The pathogenesis of COVID-19 occurs in 3 phases according to the pathophysiology and clinical degree. The three phases are grouped into the initial phase of infection, the pulmonary phase, and the hyperinflammatory phase. The initial phase of infection begins with the inoculation of the virus into host cells. This virus infects cells in the airways that line the alveoli. SARS CoV-2 will bind to receptors found on the epithelium of the respiratory tract, gastrointestinal tract, and endothelium of blood vessels and make its way into cells. The second phase is the pulmonary phase. In this phase, there is viral multiplication and inflammation in the lungs. The binding of SARS-CoV-2 to the ACE2 receptor causes ACE2 deficiency and an imbalance of the renin-angiotensin system (RAS). In the third phase, namely hyper inflammation, excessive cytokine production after SARS-CoV-2 infection will increase the permeability of the capillary wall membrane around the infected alveoli, causing edema, pulmonary dyspnea, and hypoxemia. The presence of plasma fluid in the alveoli and loss of elasticity due to decreased surfactant function due to type 2 pneumocyte infection caused by SARS-CoV-2 infection causes acute respiratory distress syndrome in COVID-19 patients

Epilepsy as a Presenting Symptom of Covid-19 in a Tertiary Private Hospital in Northern Mexico

Background. Various manifestations of COVID-19 have been described in patients, including neurological. Few studies describe seizures as a presenting symptom. This study was aimed to identify clinical characteristics, type of epilepsy and electroencephalographic findings in patients with epilepsy as a presenting symptom of COVID-19 in a tertiary private hospital. Methods. Descriptive, retrospective, observational and cross-sectional study. Inclusion criteria were patients with epilepsy as a presenting symptom of COVID-19 confirmed with Polimerase Chain Reaction (PCR) for SARS-CoV2 by nasopharyngeal swab from March 2020-July 2021 in a tertiary private hospital. Study variables were age, gender, type of epilepsy, comorbidities and electroencephalographic findings. It was classified into three groups: acute symptomatic seizures, onset of epilepsy, and uncontrolled epilepsy. Information was captured in Excel and analyzed in SPSS. Results. Of 203,987 patientes with a confirmed diagnosis of COVID-19 in Nuevo León until July 2021, 10 patients (0.004%) were included with seizures. Two patients had acute symptomatic seizures (20%), four patients had onset seizures (40%) and four patients (40%) had uncontrolled epilepsy with an average epilepsy evolution time of 15.75 years. &nbsp;Focal seizures were predominant in 63%. Electroencephalogram was abnormal in 90% (50% focal frontotemporal sharp waves, 20% encephalopathic, 20% generalized spike wave). Two patients (20%) had status epilepticus. Conclusion. This study is important in order to carry out early detection in suspects or with a previous neurological history and to avoid the spread of the coronavirus

Astrocitoma subependimario de células gigantes asociado a complejo de esclerosis tuberosa: recomendaciones para el diagnóstico oportuno y tratamiento.

RESUMEN El complejo de esclerosis tuberosa es una enfermedad genética poco frecuente, autosómica dominante con fenotipo y expresión clínica muy variables. Se caracteriza por alteraciones en la migración, diferenciación y proliferación celulares con formación de múltiples tumores benignos llamados hamartomas, las cuales afectan principalmente piel, encéfalo, riñón, ojo, corazón y pulmón. Los astrocitomas subependimarios de células gigantes son tumores benignos de crecimiento lento y son los más frecuentes en el sistema nervioso central de los pacientes con complejo de esclerosis tuberosa. Actualmente existen medicamentos indicados en pacientes con astrocitomas subependimarios de células gigantes asociados con complejo de esclerosis tuberosa y son una alternativa al tratamiento quirúrgico. Su mecanismo consiste en la inhibición el complejo 1 mTOR, acción que modula el defecto molecular que ocasiona al complejo de esclerosis tuberosa. Con su uso se han reportado disminución y estabilización de angiomiolipomas renales, linfangioleiomiomatosis, angiofibromas y de astrocitomas subependimarios de células gigantes asociados con complejo de esclerosis tuberosa