Epilepsia catamenial. Principales neurotransmisores influenciados por los estrógenos y la progesterona. Enfoque terapéutico.

La epilepsia catamenial se define como: “La exacerbación de las crisis epilépticas en relación con el ciclo menstrual, caracterizadas por un incremento de por lo menos dos veces en su frecuencia” (1, 6). El incremento de las crisis epilépticas, puede atribuirse a las propiedades neuroactivas de las hormonas esteroideas, y a la variación cíclica de sus niveles plasmáticos durante el ciclo menstrual. Cabe destacar, que aproximadamente un tercio de las mujeres que padecen epilepsia tienen crisis relacionadas con la menstruación con mayor frecuencia (2). Este hecho, lleva a pensar que los esteroides sexuales femeninos tienen una implicación directa o indirecta en la aparición de las crisis a lo largo del ciclo menstrual, denominando a esta situación, epilepsia catamenial (catamenios significa menstrual) (3). Su estudio es de gran importancia, ya que las mujeres que sufren dicha patología ven afectadas sus actividades diarias, debido a que el ciclo menstrual se repite durante toda la edad fértil de la mujer, provocando en gran medida la pérdida de su calidad de vida. Por este motivo, se ha realizado una revisión bibliográfica acerca de la epilepsia catamenial, los neurotransmisores que intervienen en ella y que se ven afectados por los cambios de niveles de estrógenos y progesterona durante el ciclo menstrual. Además, se ha revisado también la información sobre los tratamientos hormonales y no hormonales que actualmente se utilizan y que pueden paliar la aparición y frecuencia de las crisis epilépticas en esta patología

Hypocalcemia: A key biomarker in hospitalized COVID-19 patients

BACKGROUND: At the end of 2019 a new respiratory syndrome emerged in China named Coronavirus disease 2019 (COVID-19). Considering the severity of the disease in adult subjects with one or more chronic pathologies, it was mandatory to find simple and effective biomarkers for negative prognosis of the disease easily available at the admission to the hospital. MATERIAL AND METHODS: To identify possible parameters showing association with the outcome in COVID-19 patients with previous chronic diseases, blood biochemical profiles of 511 patients, enrolled from March to June 2020, were retrospectively evaluated. The pathologies taken into consideration were diabetes, arterial hypertension, chronic kidney disease, cardiovascular diseases, chronic obstructive pulmonary disease, obesity, and cancer. All the data were collected upon admission to the emergency room (ER) during the indicated period. RESULTS AND DISCUSSION: In accord with previous studies, we observed that serum and ionized calcium were prevalently altered in our cohort. We determined that hypocalcemia was a major parameter associated with mechanical ventilation and poor prognosis, correlating also with the presence of comorbidities such as cardiovascular diseases, chronic kidney disease, and cancer. In addition, we found a positive correlation between hypocalcemia and clinical complications during hospitalizations, strengthening the relevance of calcium concentration as a useful prognostic biomarker in COVID-19 patients

Hypocalcemia: A key biomarker in hospitalized COVID-19 patients

Background: At the end of 2019 a new respiratory syndrome emerged in China named Coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection. Considering the severity of the disease in adult subjects with one or more chronic pathologies, it was mandatory to find simple and effective biomarkers for negative prognosis of the disease easily available at the admission to the hospital. Methods: To identify possible parameters showing association with the outcome in COVID-19 patients with pre-existing chronic diseases, blood biochemical profiles of 511 patients, enrolled from March to June 2020, were retrospectively evaluated. The pathological conditions taken into consideration were diabetes, arterial hypertension, chronic kidney disease, cardiovascular diseases, chronic obstructive pulmonary disease, obesity, and cancer. All the data were collected upon admission to the emergency room (ER) during the indicated period. Results: We observed that serum and ionized calcium were prevalently altered in our cohort. We determined that hypocalcemia was a major parameter associated with mechanical ventilation and poor prognosis, correlating also with the presence of comorbidities such as cardiovascular diseases, chronic kidney disease, and cancer. In addition, we found a positive correlation between hypocalcemia and clinical complications during hospitalizations. Conclusions: Our results strengthen the relevance of serum calcium concentration as a useful prognostic biomarker in hospitalized COVID-19 patients