Browsing by Autor "Diego Bratta"

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    Focalidad del nervio oculomotor derecho asociado a SARS COV-2. Reporte de un caso
    (2021) Diego Bratta; Wilmer Peña; Oriana Newman
    Desde diciembre de 2019 surge en Wuhan un nuevo SARS-Coronavirus-2 (SARS-CoV-2) asociado a la enfermedad de COVID-19, un evento pandémico. Además de causar neumonía y síndrome respiratorio agudo severo, el SARS-CoV-2 es un agente neurotrópico que se une a la enzima convertidora de angiotensina 2 (ECA2) y utilizando los receptores ECA2 que se encuentran dentro del sistema nervioso central, ingresa causando manifestaciones neurológicas. Debido a que es una enfermedad de reciente aparición y su presentación clínica es bastante variable, su fisiopatología no está completamente dilucidada. Las alteraciones hematológicas como los estados procoagulantes se han asociado a peor pronóstico y a un alto riesgo de producción de eventos cardiovasculares y afecciones de tipo neurológicas. En este artículo se presenta un caso de ictus isquémico focal en un paciente con múltiples comorbilidades en el contexto de COVID-19. Se reporta la presencia de focalidad completa del nervio oculomotor derecho en un masculino de 64 años COVID-19 positivo, un hallazgo infrecuente, por lo que sugerimos realizar estudios seriados de neuroimagen en centros hospitalarios durante el manejo de casos graves de COVID-19 con manifestaciones neurológicas. Since December 2019 emerges in Wuhan a novel SARS-Coronavirus-2 (SARS-CoV-2) associated to COVID-19 disease, a pandemic event. In addition to COVID-19 pneumonia and severe acute respiratory syndrome, SARS-CoV-2 is a neurotropic agent that binds to angiotensin converting enzyme 2 (ACE2) and using ACE2 receptors found within the central nervous system, enters causing neurological manifestations. Because it is a recent-onset disease and its clinical presentation is quite variable, its pathophysiology is not fully understood. Hematological alterations such as procoagulant states have been associated with a worse prognosis and a high risk of cardiovascular events and neurological conditions. In this article presents a case of focal ischemic stroke in a patient with multiple comorbidities in the context of COVID-19. It is reported the presence of right nerve oculomotor complete focality in a COVID-19 positive 64-year-old male, an infrequent finding, so, we suggest conducting serial neuroimaging studies in hospital centers during the management of severe cases of COVID-19 with neurological manifestations.
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    Lesión pulmonar apical por SARS-COV-2 y manifestación de cuadro clínico leve. Reporte de un caso. Apical pulmonary injury by SARS-COV-2 and mild clinical profile manifestation. A case report
    (2021) Diego Bratta; Wilmer Peña; Oriana Newman
    The coronavirus is a viral agent, responsible for the current pandemic, declared a public health emergency by the WHO, which began in Wuhan, China. COVID-19 is causing severe lung involvement in some patients. Computerized axial tomography has proven to be a sufficiently sensitive diagnostic method to complement the diagnosis of coronavirus pneumonia, supporting the RT-CPR test. The compromise of the ventilation / perfusion ratio in some cases can help to guide the severity of the lung compromise, and in others, it can serve as a prognosis. The ventilation / perfusion relationship can be calculated through the formula of the Alveolar-arterial Oxygen Difference (DA-a02), together with this, the Kirby index is an indirect measure that allows evaluating the degree of respiratory failure as a product of a pulmonary inflammatory process, intrapulmonary shunt. The results of both calculations, added to the CT imaging findings and the semiological elements, can be indicative of the pulmonary functional status and the risk of having an unfavorable evolution. Applying these principles of lung physiology in the pathophysiological context of COVID-19 lung infection may be useful in medical practice. In our case, the distribution of the injuries observed in the CT scan by COVID-19 could be related to the areas of affectation in the lung parenchyma observed and the commitment that the pulmonary inflammatory process has in unbalancing the gas exchange zones, the ventilation ratio / perfusion (V / Q).