Evolución tórpida de enfermedad de Fabry en tratamiento con agalsidasa alfa: Presentación de un caso

Fabry disease is characterized by the absence of activity of the lysosomal enzyme α-galactosidase A, which causes glycolipids, which should be broken down, to accumulate in the lysosomes of the cells of various tissues in the body, causing the signs and characteristic symptoms of this pathology. The severity of the disease depends on the level of mutation of the α-galactosidase A gene, which goes hand in hand with the age at presentation of symptoms, if we have a large mutation, we will have an earlier onset of it. For women, it is more frequent that the course of this condition is asymptomatic, most of them function as transmitters of Fabry disease, on the contrary, it has a predilection towards men. The most frequent clinical manifestations are angiokeratomas, acroparesthesias, anhidrosis, whorled cornea and in cases of death, they are related to kidney failure due to the progressive kidney failure it causes, heart failure or cerebrovascular disease. There is no cure for this deficiency, but we can stop its progress. For this purpose, two treatments have been developed: the first is enzyme replacement with agalsidase beta and the second with agalsidase alfa, whose effectiveness we will evaluate in a patient with Fabry disease compared to studies with enzyme replacement therapy with agalsidase beta.Fabry disease is characterized by the absence of activity of the lysosomal enzyme α-galactosidase A, which causes glycolipids, which should be broken down, to accumulate in the lysosomes of the cells of various tissues in the body, causing the signs and characteristic symptoms of this pathology. The severity of the disease depends on the level of mutation of the α-galactosidase A gene, which goes hand in hand with the age at presentation of symptoms, if we have a large mutation, we will have an earlier onset of it. For women, it is more frequent that the course of this condition is asymptomatic, most of them function as transmitters of Fabry disease, on the contrary, it has a predilection towards men. The most frequent clinical manifestations are angiokeratomas, acroparesthesias, anhidrosis, whorled cornea and in cases of death, they are related to kidney failure due to the progressive kidney failure it causes, heart failure or cerebrovascular disease. There is no cure for this deficiency, but we can stop its progress. For this purpose, two treatments have been developed: the first is enzyme replacement with agalsidase beta and the second with agalsidase alfa, whose effectiveness we will evaluate in a patient with Fabry disease compared to studies with enzyme replacement therapy with agalsidase beta

Evolución tórpida de enfermedad de Fabry en tratamiento con agalsidasa alfa: Presentación de un caso.

Fabry disease is characterized by the absence of activity of the lysosomal enzyme α-galactosidase A, which causes glycolipids, which should be broken down, to accumulate in the lysosomes of the cells of various tissues in the body, causing the signs and characteristic symptoms of this pathology. The severity of the disease depends on the level of mutation of the α-galactosidase A gene, which goes hand in hand with the age at presentation of symptoms, if we have a large mutation, we will have an earlier onset of it. For women, it is more frequent that the course of this condition is asymptomatic, most of them function as transmitters of Fabry disease, on the contrary, it has a predilection towards men. The most frequent clinical manifestations are angiokeratomas, acroparesthesias, anhidrosis, whorled cornea and in cases of death, they are related to kidney failure due to the progressive kidney failure it causes, heart failure or cerebrovascular disease. There is no cure for this deficiency, but we can stop its progress. For this purpose, two treatments have been developed: the first is enzyme replacement with agalsidase beta and the second with agalsidase alfa, whose effectiveness we will evaluate in a patient with Fabry disease compared to studies with enzyme replacement therapy with agalsidase betaLa enfermedad de Fabry se caracteriza por la ausencia de actividad de la enzima lisosomal α-galactosidasa A, lo cual provoca que los glucolípidos, los cuales deberían ser descompuestos, se acumulen en los lisosomas de las células de diversos tejidos en el cuerpo ocasionando los signos y síntomas característicos de esta patología. La gravedad de la enfermedad depende del nivel de mutación del gen de la α-galactosidasa A, lo cual va de la mano con la edad de presentación de los síntomas, si tenemos presencia de una gran mutación, tendremos un inicio más temprano de la misma. Para las mujeres es más frecuente que el curso de este padecimiento sea asintomático, en su mayoría actúan como transmisoras de la enfermedad de Fabry, por el contrario, tiene predilección hacia los hombres.  Las manifestaciones clínicas más frecuentes son angioqueratomas, acroparestesias, anhidrosis, córnea verticilada y en casos de fallecimiento, se relacionan con insuficiencia renal por el fallo renal progresivo que ocasiona, insuficiencia cardiaca o enfermedad cerebrovascular. Esta deficiencia no tiene cura, pero podemos frenar su avance, para ello se han desarrollado dos tratamientos principales: el primero la sustitución enzimática con agalsidasa beta y el segundo con agalsidasa alfa, del cual evaluaremos su efectividad en un paciente con enfermedad de Fabry en comparación a estudios con el tratamiento de reemplazo enzimático con agalsidasa bet

Superposición de hepatitis B a hepatitis autoinmune. Diagnóstico y tratamiento, presentación de un caso clínico y revisión de casos clínicos en la literatura internacional

The hepatitis B virus represents one of the most frequent viral infections worldwide due to its easy transmission, in addition to this, its association with autoimmune pathologies has been found. This work will allow us to know the best treatment and most appropriate diagnostic method for its favorable clinical resolution. This systematic review was prepared in the database of Latin American and Caribbean Literature in Health Sciences, PubMed, and Google Scholar. The search was limited to studies carried out in humans, full texts, regardless of the language of writing or restriction of country of origin. A total of 133 articles were retrieved in the bibliographic search, of which 11 were excluded because they were duplicates, 71 articles were discarded because they contained brief information or only an ephemeral mention of the topic was made, 15 more were dispensed with in the Full review phase Text, 5 more for not being studies in humans and, finally, 10 opinions and perspectives, from which it was concluded that the treatment should be administered encompassing both pathologies to avoid clinical exacerbationEl virus de la hepatitis B representa una de las infecciones virales más frecuentes a nivel mundial dada su fácil forma de transmisión, aunado a esto, se ha encontrado su asociación a patologías autoinmunes. Este trabajo nos permitirá conocer el mejor tratamiento y método diagnóstico más adecuado para su resolución clínica favorable. Esta revisión sistemática se elaboró en la base de datos de Literatura Latinoamericana y del Caribe en Ciencias de la Salud, PubMed y de Google Scholar. La búsqueda fue delimitada a estudios realizados en humanos, textos completos, sin importar el idioma de escritura ni restricción de país de procedencia. Se recuperaron un total de 133 artículos en la búsqueda bibliográfica, de los cuales se excluyeron 11 por estar duplicados, 71 artículos fueron descartados por contener breve información o solo se realiza una mención efímera del tema, se prescindieron 15 más en la fase de revisión Full Text, 5 más por no ser estudios en humanos y, por último, 10 opiniones y perspectivas, de los cuales se concluyó que el tratamiento se debe administrar englobando ambas patologías para evitar la exacerbación clínica

Evento cerebrovascular en pacientes post COVID-19

Objective: The present study aims to determine the association and the factors involved between had suffered a COVID-19 event with the development of a cerebrovascular event. Methods: This is an observational, case-control, analytical, retrospective study with a 1:2 relation. Applied in the population of the Emergency Department, Internal Medicine, and Family Medicine, of the General Hospital Zone with Family Medicine No. 32 of Minatitlan Veracruz. Results: A final sample of 111 cases and 222 controls was obtained. The average age is 58 years ±17.6. Of the total number of patients, 126 (37.8%) were men and 207 (62.2%) were women. 159 patients (47.74%) had a positive history of COVID-19. An Odds Ratio of 1.38 (95%; 0.876 – 2.186) was found. The age of the patients, the severity of the infection in its acute phase, the level of severity of the cerebrovascular event and the history of vaccination were statistically significant results. Conclusion: COVID-19 is associated as an independent factor with the development of a cerebrovascular event.Objetivo: El presente estudio pretende determinar la asociación y factores implicados entre haber padecido un evento de COVID-19 con el desarrollo de un evento cerebrovascular. Métodos: Es un estudio observacional, de casos y controles, analítico, retrospectivo, con relación 1:2. Aplicado en la población del servicio de Urgencias, Medicina interna y Medicina familiar, del Hospital General de Zona con Medicina Familiar N° 32 de Minatitlán Veracruz. Resultados: Se obtuvo una muestra final de 111 casos y 222 controles. El promedio de edad es de 58 años ±17.6. Del total de pacientes 126 (37.8%) son hombres y 207 (62.2%) son mujeres. 159 pacientes (47.74%) tuvieron antecedente positivo de COVID-19. Se encontró un Odds Ratio de 1.38 (95%; 0.876 – 2.186). La edad de los pacientes, la gravedad de la infección en su fase aguda, el nivel de gravedad del evento cerebrovascular y el antecedente de vacuna, fueron resultados estadísticamente significativos. Conclusión: El COVID-19 se encuentra asociado como factor independiente al desarrollo de evento cerebrovascular

Twitter as a Tool for Teaching and Communicating Microbiology: The #microMOOCSEM Initiative

Online social networks are increasingly used by the population on a daily basis. They are considered a powerful tool for science communication and their potential as educational tools is emerging. However, their usefulness in academic practice is still a matter of debate. Here, we present the results of our pioneering experience teaching a full Basic Microbiology course via Twitter (#microMOOCSEM), consisting of 28 lessons of 40-45 minutes duration each, at a tweet per minute rate during 10 weeks. Lessons were prepared by 30 different lecturers, covering most basic areas in Microbiology and some monographic topics of general interest (malaria, HIV, tuberculosis, etc.). Data analysis on the impact and acceptance of the course were largely affirmative, promoting a 330% enhancement in the followers and a >350-fold increase of the number of visits per month to the Twitter account of the host institution, the Spanish Society for Microbiology. Almost one third of the course followers were located overseas. Our study indicates that Massive Online Open Courses (MOOC) via Twitter are highly dynamic, interactive, and accessible to great audiences, providing a valuable tool for social learning and communicating science. This strategy attracts the interest of students towards particular topics in the field, efficiently complementing customary academic activities, especially in multidisciplinary areas like Microbiology.Versión del edito

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Política Internacional (no. 8 oct-dic 2020)

La Revista tiene el objetivo de contribuir al desarrollo de las ciencias políticas, así como difundir los logros en política internacional. Se dirige a los profesionales de las relaciones internacionales en Cuba y del resto del mundo

100 años investigando el mar. El IEO en su centenario (1914-2014).

Se trata de un libro que pretende divulgar a la sociedad las principales investigaciones multidisciplinares llevadas a cabo por el Instituto Español de Oceanografía durante su primer siglo de vida, y dar a conocer la historia del organismo, de su Sede Central y de los nueve centros oceanográficos repartidos por los litorales mediterráneo y atlántico, en la península y archipiélagos.Kongsberg 200Postprin