Dossier

There are four factors that can influence the development of the so-called Covid-19 prolonged or long-lasting, subject of research by different groups of scientists:
1) The patient’s viral load or the high level of SARS-CoV-2 RNA.
2) The presence of antibodies that mistakenly attack the body’s tissues as happens with autoimmune diseases.
3) The reactivation of the Epstein-Bar virus that we usually catch in our youth and remains latent in most people.
4) The presence of type 2 diabetes.

Some scientists suggest that the Covid-19 pandemic in both those who contracted the disease and those who were not infected but were affected by isolation is likely to have accelerated the aging process. The feeling of chronic stress should accelerate this process. They are based on that in many people they increased body weight and obesity, evidenced alopecia and referred to “deep fatigue”.

People who had SARS-CoV-2 infection have been shown to have cardiovascular pathology during the year after infection. Therefore, a clinical examination is recommended 6 months after suffering from the disease. In asymptomatic patients without previous heart disease, cardiological evaluation with electrocardiogram, echocardiogram and ergometry is not required, but in those who have a cardiovascular or cerebrovascular history. In those who present dyspnea or palpitations add to these studies the holter.

Tinnitus: a symptom that appeared with the Omni variant, which is often confused with the coriza or the flu.
In patients who report having this symptom an audiometry is recommended.

In the mute the number of infected and dead by Covid-19 is far from real. This often happens in both wars and pandemics. It is estimated that the dead in the world are three times those recorded (The Lancet).

The American Psychiatric Association (APA) has incorporated the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5), the Prolonged Grief Disorder or Syndrome, referring to those patients who after more than a year of affective loss continue to suffer. Detractors believe that grief is not a mental disorder but a fundamental aspect of the human experience that always happened in history; that there will be many false positive diagnoses; that having “nostalgia” or longing” for someone is different from having depression, although in some cases it may approach post-traumatic stress. One argument is that doctors need to categorize with recognized diagnostics in order to be able to bill insurers and prepaid. There are fears of “overdiagnosis” and “over-medication”, and that the pharmaceutical companies see in this diagnosis a thriving market.

On 14 April 2021, the WHO launched a new Global Diabetes Compact (Global Diabetes Compact), which aims to boost efforts to prevent the disease and treat all those in need, coinciding with the one hundred years of the discovery of insulin. The Global Compact is co-sponsored by WHO and the Government of Canada, with support from the University of Toronto.

About half of all adults with type 2 diabetes remain undiagnosed and 50% of people with type 2 diabetes do not receive the insulin they need, putting them at avoidable risk of debilitating and irreversible complications such as premature death, amputations of limbs and loss of vision.

There is a need to increase access to medicines and diagnostic tools for diabetes, particularly insulin, in low- and middle-income countries.

Currently, the insulin market is dominated by three companies (the American Eli Lilly, the Danish Novo Nordisk and the Franco-German Sanofi-Aventis).

Innovation will be a central component of the Compact with a focus on the development and evaluation of low-cost technologies and digital solutions for diabetes care.

The Global Compact will also focus on catalysing progress by setting global coverage targets for diabetes care. A “global price” will quantify the costs and benefits of achieving these new goals.

Médecins Sans Frontières (MSF) welcomed the new deal and stressed the need to accelerate the availability of more sources of guaranteed quality human insulin so that everyone in need can access a vital medicine.

It is the only non-communicable disease for which the risk of dying prematurely is increasing, rather than decreasing.

Anthony Fauci warned that the best way to combat the variants is to vaccinate as many people as possible soon as possible and continue with the social distancing and the use of chin. “Viruses cannot mutate unless they reproduce”, he added.

(Report in Spanish)

Dr. Franco Gustavo Amaro (Argentina)

Adult Still’s disease in an autoinflammatory disease of unknown etiology, there is little data on its incidence and prevalence in the population, although various genetic and environmental factors involved in its genesis have been reported. It is characterized by pharyngitis, high fever, leukocytosis, arthralgias and skin manifestations. It was first described in 1971 by Bywaters in 14 adult patients. The infant form called idiopathic juvenile arthritis was described by George Still in 1897.

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Dr. Adel Enrique Escobar García (Colombia) 

Spontaneous pneumomediastinum or spontaneous mediastinal emphysema is uncommon and is characterized by open air in the mediastinum not preceded by chest trauma, surgery, or any other medical procedure. It was first described by Louis Hamman in 1939, which is why it is also known as Hamman syndrome. The treatment is symptomatic and conservative, despite how impactful the images and the associated clinic may be. Evolution is equally favorable, self-limiting and recurrence is rare.

(Full text in Spanish)

Dr. Lucas Dolcemelo (Argentina) 

Anthony Fauci warned that the best way to combat the variants is to vaccinate as many people as possible soon as possible and continue with the social distancing and the use of chin. “Viruses cannot mutate unless they reproduce”, he added.

(Report in Spanish)

Entity first recognized by Ernest W. Goodpasture in 1919 in a patient who suffered hemoptysis and acute hematuria after recovering from a flu which has led to investigate its etiopathogenesis and treatment.

It is characterized by triad: alveolar hemorrhage, rapidly progressive glomerulonephritis and formation of glomerular basal antimembrane antibodies (Ac anti-MBG).

It is an autoimmune disease characterized by the linear deposition of basal antimembrane antibodies at the glomerular and alveolar levels, resulting in rapidly progressive alveolar hemorrhage and glomerulonephritis.

Renal biopsy is the primary tool for making the correct diagnosis in lung-kidney syndromes and is a prognostic study.

Despite being a rare disease, it presents a high morbidity and mortality, so it is important to have a high clinical suspicion, an early diagnosis and an adequate and intensive treatment.

(full text and bibliography in Spanish)

Dr. Nathalie Nazareth Abreu Francisconi (Venezuela)

Dengue, Zika and Chikungunya are three viral infectious diseases, which can become epidemic, and like Yellow Fever, among other infections, can be transmitted by Aedes aegypti.

Dengue is the most lethal arbovirosis, particularly during the acute phase of the disease. Faced with the doubt of diagnosis between Dengue, Chikungunya or Zika, it is recommended that the patient be treated as a case of Dengue and that a daily follow-up or at least every 48 hours be carried out to detect serious warning signs, especially during the critical phase of the disease (full text in Spanish)

To ask well is to know very much (Arabic proverb)

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