Anales de la Real Academia Nacional de Medicina最新文献_第10页

Nursing-home and Covid-19: What have we learnt? 幼儿园和新冠肺炎：我们学到了什么？

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-09-30 DOI: 10.32440/AR.2020.137.02.REV16

J. M. Casado

{"title":"Nursing-home and Covid-19: What have we learnt?","authors":"J. M. Casado","doi":"10.32440/AR.2020.137.02.REV16","DOIUrl":"https://doi.org/10.32440/AR.2020.137.02.REV16","url":null,"abstract":"People living in care-homes has been Covid-19 pandemia’s preferential victims. Our aim is to offer some reflexions about it: 1) Nursing-home problems related to Covid-19 were detected to late. Legal supervisors of these centers, CCAA, were, probably, negligent. 2) Residential centers are a very heterogeneus world from any point of view we should take into account: size, institutional dependency, number and qualification of health and non-health workers, resources, functional protocols, etc. We can not consider them as an unitariam group, 3) Health vulnerability is the rule. Many reasons help to understand it: high age (mean about 90 y,), presence of chronic diseases, rates of physical and mental dependency, need of intensive help for daily living’s activities, etc. They live in closed spaces, with many common activities, and difficulties for isolation. Social ageism has added another perverse factor. The result has been a very high rates of mortality. 4) A key point to understand the past and to prevent future similar events, would be to analyce the degree of medicalization each nursing-home needs. 5) We must learn from this experience and we must change many of our previous standard thoughts regarding the functional approach to this sort of setting.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45836923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Dermatologic manifestations of coronavirus disease 2019 (COVID-19) 2019冠状病毒病(COVID-19)的皮肤病学表现

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-09-30 DOI: 10.32440/ar.2020.137.02.rev15

D. Fernández-Nieto

{"title":"Dermatologic manifestations of coronavirus disease 2019 (COVID-19)","authors":"D. Fernández-Nieto","doi":"10.32440/ar.2020.137.02.rev15","DOIUrl":"https://doi.org/10.32440/ar.2020.137.02.rev15","url":null,"abstract":"The cutaneous manifestations associated with coronavirus disease 2019 (COVID-19) are frequent and varied. Knowing these manifestations facilitates the diagnosis of asymptomatic or mildly symptomatic cases, contributing to reduce the spread of the virus.\u0000There are 5 main presentation patterns: acral areas of erythema-oedema with vesicles or pustules (pseudo-perniosis), other vesicular eruptions, urticarial lesions, maculopapular eruptions and livedo or necrosis. Most patterns can be further subdivided. The prognosis depends on the age of the patient and the severity of the respiratory clinic, not on the skin manifestation itself.\u0000Pseudo-chilblain lesions and vesicular eruptions are considered suggestive of COVID-19, while the rest of manifestations are unspecific and could occur in the context of other diseases.\u0000The physiopathological mechanisms involved in the appearance of skin lesions have yet to be categorized. There are 3 main hypotheses: hyperactive immune response, activation of the complement pathway and alterations in the coagulation cascade. Different alterations in each pathway would justify the great variety in the way that the different skin manifestations are presented.\u0000The causal relationship between some of the skin manifestations and COVID-19 is not yet fully demonstrated, since there are other factors such as drugs or fever that could be confounding factors. The presence of viral particles has been demonstrated by immunohistochemical techniques in pseudo-chilblain lesions, purpuric maculopapular exanthema and erythema multiforme. However, polymerase chain reaction (PCR) techniques from the skin samples have been negative in every conducted study.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44503441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Towards the spanish vaccine against SARS-CoV-2, responsible for the pandemic Covid-19 对导致Covid-19大流行的西班牙SARS-CoV-2疫苗

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-09-30 DOI: 10.32440/AR.2020.137.02.REV18

M. Esteban, J. G. Arriaza

{"title":"Towards the spanish vaccine against SARS-CoV-2, responsible for the pandemic Covid-19","authors":"M. Esteban, J. G. Arriaza","doi":"10.32440/AR.2020.137.02.REV18","DOIUrl":"https://doi.org/10.32440/AR.2020.137.02.REV18","url":null,"abstract":"There is a general consensus that the only way to stop the pandemic caused by the coronavirus SARS-CoV-2 is through the development of an effective and safe vaccine. Various countries have move forward to develop a vaccine, and currently a number of preclinical and clinical trials phase I/II revealed that some of the vaccines triggered activation of humoral and cellular immune responses that could be relevant in protection against the coronavirus, but it remains yet to demonstrated efficacy in the population of any of the vaccines. Our group of Poxvirus and Vaccines at the CNB-CSIC started with the development of a vaccine immediately after the full genome (30.000 nucleotides) sequence of the SARS-CoV-2 was published in January 10, 2020. In this article we describe the steps that we have follow up to develop a vaccine candidate using as a vector (vehicle) an attenuated strain of modified vaccinia virus strain (MVA) expressing the full-length S (Spike) protein of SARS-CoV-2. We have demonstrated in cultured cells and in animals (mice) that the vaccine fulfills relevant criteria to be considered a candidate against COVID-19, like expression of the entire protein at the cell membrane, formation of oligomers (trimers), high stability and ability to induce neutralizing antibodies, a type of Th1 response and induction of a wide spectrum of SARS-CoV-2 specific T cells, like CD4+, CD8+, Tfh, Tregs and memory cells. We have programmed efficacy studies in animals (humanized mice and macaques) and phase I/II and III clinical trials. The GMP lot is under production by an Spanish company and a patent has been presented.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46770822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Neurological disorders in Covid-19: clinical involvement and pathophysiological mechanisms 新冠肺炎神经系统疾病的临床参与及病理生理机制

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-09-30 DOI: 10.32440/AR.2020.137.02.REV14

J. García-Moncó

引用次数: 0

COVID-19 crisis: epidemiological and social perspective of an unprecedented pandemic in our lives COVID-19危机:我们生活中前所未有的大流行的流行病学和社会视角

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-09-30 DOI: 10.32440/AR.2020.137.02.REV02

J. Martin-Moreno

{"title":"COVID-19 crisis: epidemiological and social perspective of an unprecedented pandemic in our lives","authors":"J. Martin-Moreno","doi":"10.32440/AR.2020.137.02.REV02","DOIUrl":"https://doi.org/10.32440/AR.2020.137.02.REV02","url":null,"abstract":"Increasing globalization drives complex human, biological and commercial interactions that affect the way we live and get sick. The pandemic risk that has appeared with the COVID-19 had already been anticipated by many institutions and experts, yet our governments and decision-makers have not prepared themselves sufficiently. This has meant that the devastating epidemic we have suffered has caught our entire system off guard. The SARS in 2003 and the MERS in 2012 were previous warnings of coronavirus mutations that presented a worrying infectivity and lethality, although they managed to be controlled with public health measures. On this occasion, the arrogance of many of our countries has meant that although the pandemic was coming progressively and announced, we did not do enough to prepare and strengthen the health system and public health.\u0000In this paper, we basically review the etiological agent, the incubation period, the mechanisms of transmission, the risk factors, the summarized clinical manifestations, the epidemiological analysis of the situation (including incidence or new cases, mortality and lethality, and estimating the excess mortality associated with the COVID-19), and the confinement and gradual stages of de-escalation. From the social point of view, the vulnerable groups that have been particularly affected by COVID-19 in Spain are identified. The article concludes by reviewing preventive medicine and public health measures in the face of COVID-19. This is articulated through the measures of basic hygiene and to investigate what we can expect from primary prevention through the mechanism of immunization that can provide us with vaccines. In the final part, the problem is discussed in order to develop, select, prioritize, and distribute these vaccines as a universal good, and it is emphasized that for now, and while we lack vaccines, our obligation is to continue insisting on hygiene and… on healthy behaviors. And to emphasize the importance of education for a better world.","PeriodicalId":75487,"journal":{"name":"Anales de la Real Academia Nacional de Medicina","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42751591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Account of a doctor who fell ill with COVID-19 一位感染COVID-19的医生的故事

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-09-30 DOI: 10.32440/AR.2020.137.02.CC02

A. C. Jentoft

引用次数: 0

Mechanical respiratory support. ECMO. Liquid ventilation 机械呼吸支持。医学界。液体通风

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-05-04 DOI: 10.32440/ar.2020.137.01.rev01

Gabriel Téllez-de-Peralta

引用次数: 0

Vida Académica 2019 2019年学术生活

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-05-04 DOI: 10.32440/ar.2020.137.01.supl01

引用次数: 0

Elder abuse and mistreatment 虐待和虐待老年人

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-03-05 DOI: 10.32440/ar.2019.136.03.rev07

J. Ribera-Casado, Montserrat Lázaro-Nogal

引用次数: 0

Chromatic vision 色视症

Anales de la Real Academia Nacional de Medicina Pub Date : 2020-03-05 DOI: 10.32440/ar.2019.136.03.rev05

Julián García-Sánchez

引用次数: 0