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Introduction: Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. Smell and/or taste disorders have emerged as a very frequent symptom as the disease has spread in Europe. Spain is one of the European countries with the highest number of infections. Objective: This study aimed to investigate the clinical progression of smell and taste disorders in Spanish patients with mild COVID-19. Methods: An online survey was used to conduct a cross-sectional study of patients who presented sudden smell and/or taste disorders during the 2 months of total lockdown due to COVID-19 in Spain. Results: In our sample, 91.18% of respondents with impaired smell and/or taste and who were able to undergo PCR testing were positive for SARS-CoV-2 infection. Anosmia and ageusia presented in isolation in 6.5% of participants. The remaining 93.5% presented other mild symptoms: headache (51.6%), cough (51.6%), myalgia (45.2%), asthaenia (38.7%), nasal congestion or rhinorrhoea (35.5%), fever (41.9%), low-grade fever (29.0%), odynophagia (25.8%), or diarrhoea (6.5%). The mean duration of anosmia was 8.33 days, with patients subsequently manifesting hyposmia; complete resolution occurred after a mean of 17.79 days. In 22.6% of respondents, olfactory deficits persisted. All participants recovered their sense of taste. Conclusions: Olfactory and gustatory disorders are prevalent symptoms in mild COVID-19. Most patients do not present associated nasal congestion or rhinorrhoea and a small group of patients present these alterations in isolation. Resumen: Introducción: La enfermedad por coronavirus-2019 (COVID-19), se ha expandido con gran rapidez en todo el mundo. Las alteraciones del olfato y/o gusto han emergido como un síntoma muy frecuente a medida que la enfermedad se propagó en Europa. Uno de los países con mayor número de contagios en este continente ha sido España. Objetivo: Investigar la evolución clínica de los trastornos del olfato y el gusto en la enfermedad leve por COVID-19 en pacientes españoles. Métodos: Se realizó un estudio transversal a través de encuesta on‐line, en pacientes que presentaron afección súbita del olfato y/o el gusto, durante los dos meses de confinamiento total por COVID-19 en España. Resultados: El 91,18% de los sujetos con afectación del olfato y/o el gusto, que tuvieron a acceso a la realización de PCR, fueron positivos para COVID-19. El 6,5% presentó anosmia y ageusia de forma aislada. El 93,5% manifestó otros síntomas leves asociados: cefalea (51,6%), tos (51,6%), mialgias (45,2%), astenia (38,7%), congestión nasal o rinorrea (35,5%), fiebre (41,9%), febrícula (29,0%), odinofagia (25.8%) y diarrea (6,5%). La duración media de la anosmia fue de 8,33 días, posteriormente los pacientes manifestaron hiposmia, con resolución completa en 17,79 días de media. En el 22,6% de los pacientes el déficit olfatorio persistió. Todos los sujetos recuperaron el sentido del gusto. Conclusiones: Los trastornos olfativos y gustativos son síntomas prevalentes en la infección leve por COVID-19. Gran parte de los pacientes no presentan congestión nasal o rinorrea asociada y un grupo reducido de pacientes los presentan de forma aislada.

Resumen: Introducción: La enfermedad por coronavirus-2019 (COVID-19) se ha expandido con gran rapidez en todo el mundo. Las alteraciones del olfato o gusto han emergido como un síntoma muy frecuente a medida que la enfermedad se propagó en Europa. Uno de los países con mayor número de contagios en este continente ha sido España. Objetivo: Investigar la evolución clínica de los trastornos del olfato y el gusto en la enfermedad leve por COVID-19 en pacientes españoles. Métodos: Se realizó un estudio transversal a través de encuesta on-line, en pacientes que presentaron afección súbita del olfato o el gusto, durante los 2 meses de confinamiento total por COVID-19 en España. Resultados: El 91,18% de los sujetos con afectación del olfato o el gusto, que tuvieron acceso a la realización de PCR, fueron positivos para COVID-19. El 6,5% presentó anosmia y ageusia de forma aislada. El 93,5% manifestó otros síntomas leves asociados: cefalea (51,6%), tos (51,6%), mialgias (45,2%), astenia (38,7%), congestión nasal o rinorrea (35,5%), fiebre (41,9%), febrícula (29,0%), odinofagia (25,8%) y diarrea (6,5%). La duración media de la anosmia fue de 8,33 días, posteriormente los pacientes manifestaron hiposmia, con resolución completa en 17,79 días de media. En el 22,6% de los pacientes el déficit olfatorio persistió. Todos los sujetos recuperaron el sentido del gusto. Conclusiones: Los trastornos olfativos y gustativos son síntomas prevalentes en la infección leve por COVID-19. Gran parte de los pacientes no presentan congestión nasal o rinorrea asociada y un grupo reducido de pacientes los presentan de forma aislada. Abstract: Introduction: Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. Smell and/or taste disorders have emerged as a very frequent symptom as the disease has spread in Europe. Spain is one of the European countries with the highest number of infections. Objective: This study aimed to investigate the clinical progression of smell and taste disorders in Spanish patients with mild COVID-19. Methods: An online survey was used to conduct a cross-sectional study of patients who presented sudden smell and/or taste disorders during the 2 months of total lockdown due to COVID-19 in Spain. Results: In our sample, 91.18% of respondents with impaired smell and/or taste and who were able to undergo PCR testing were positive for SARS-CoV-2 infection. Anosmia and ageusia presented in isolation in 6.5% of participants. The remaining 93.5% presented other mild symptoms: headache (51.6%), cough (51.6%), myalgia (45.2%), asthaenia (38.7%), nasal congestion or rhinorrhoea (35.5%), fever (41.9%), low-grade fever (29.0%), odynophagia (25.8%), or diarrhoea (6.5%). The mean duration of anosmia was 8.33 days, with patients subsequently manifesting hyposmia; complete resolution occurred after a mean of 17.79 days. In 22.6% of respondents, olfactory deficits persisted. All participants recovered their sense of taste. Conclusions: Olfactory and gustatory disorders are prevalent symptoms in mild COVID-19. Most patients do not present associated nasal congestion or rhinorrhoea and a small group of patients present these alterations in isolation.

Introduction: Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. Smell and/or taste disorders have emerged as a very frequent symptom as the disease has spread in Europe. Spain is one of the European countries with the highest number of infections., Objective: This study aimed to investigate the clinical progression of smell and taste disorders in Spanish patients with mild COVID-19., Methods: An online survey was used to conduct a cross-sectional study of patients who presented sudden smell and/or taste disorders during the 2 months of total lockdown due to COVID-19 in Spain., Results: In our sample, 91.18% of respondents with impaired smell and/or taste and who were able to undergo PCR testing were positive for SARS-CoV-2 infection. Anosmia and ageusia presented in isolation in 6.5% of participants. The remaining 93.5% presented other mild symptoms: headache (51.6%), cough (51.6%), myalgia (45.2%), asthaenia (38.7%), nasal congestion or rhinorrhoea (35.5%), fever (41.9%), low-grade fever (29.0%), odynophagia (25.8%), or diarrhoea (6.5%). The mean duration of anosmia was 8.33 days, with patients subsequently manifesting hyposmia; complete resolution occurred after a mean of 17.79 days. In 22.6% of respondents, olfactory deficits persisted. All participants recovered their sense of taste., Conclusions: Olfactory and gustatory disorders are prevalent symptoms in mild COVID-19. Most patients do not present associated nasal congestion or rhinorrhoea and a small group of patients present these alterations in isolation., (Copyright © 2020 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Cigarette smoking is a major risk factor in the development of chronic obstructive pulmonary disease (COPD). Serotonin levels have been associated with COPD and smoking has been as a significant modulator. Elevated levels of serotonin are responsible for bronchoconstriction and pulmonary vasoconstriction and also nicotine dependence, thus serotonin response could be affected by genetic polymorphisms in transporters and receptors of serotonin., Objectives: The aim of the current study was to analyze the effect of SLC6A4 (5HTT_LPR) (rs25531) and HTR2A-1438G/A (rs6311) genetic polymorphisms on the relation between smoking habits and COPD., Methods: The association between SLC6A4 (5HTT_LPR) (rs25531), HTR2A-1438G/A (rs6311), smoking degree and COPD was analyzed in a total of 77 COPD patients (active smokers) and 90 control subjects (active healthy smokers). The DNA was extracted of peripheral leukocytes samples and genotyping was performed using an allele specific polymerase chain reaction., Results: The distribution of SLC6A4 genotypes did not vary between healthy smokers and COPD patients (P=0.758). On the other hand, the A allele of HTR2A (rs6311) was significantly associated with COPD incidence in the trend model (P=0.02; 1.80 [1.04-3.11]). Among all smokers, this allele was also associated with the number of pack years smoked (P=0.02) and also, we observed a marginal association with FEV1/FVC values (P=0.06)., Conclusion: Our results point a possible role of the A allele of HTR2A (rs6311) in COPD pathogenesis, suggesting that this effect depends partly on tobacco consumption due to a gene-by-environment interaction., (Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)

Autoimmune diseases are a cluster of disorders characterized by a failure of the immune tolerance and a hyperactivation of the immune system that leads to a chronic inflammation state and the damage of several organs. The medications currently used to treat these diseases usually consist of immunosuppressive drugs that have significant systemic toxic effects and are associated with an increased risk of opportunistic infections. Recently, several studies have demonstrated that mesenchymal stem cells have immunomodulatory properties, a feature that make them candidates to be used in the treatment of autoimmune diseases. In the present study, we reviewed the role of this therapy in the treatment of systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, Crohn's disease and multiple sclerosis, as well as the potential risks associated with its use., (Copyright © 2013 Elsevier España, S.L.U. All rights reserved.)

Introduction: The objective of this investigation is to determine whether bispectral index (BIS®) monitoring during intravenous anaesthesia with spontaneous breathing for upper gastrointestinal endoscopy (UGE) in a pediatric population is useful for: a) decreasing the amount of drug, b) decreasing the time for awakening, and c) improving patient safety., Patients and Method: A quasi-experimental case-control prospective study was conducted in the setting of a second level hospital pediatric intensive care unit., Patients: Children aged 1-13 years., Case: ASA I patient who needed a diagnostic UGE; eligible, 36, participants, 30., Control: historical cohort of patients who needed UGE (years 2008-2010): 50 patients., Intervention: UGE performed with anaesthetic protocol, vital signs monitoring, sedation level (Ramsay scale) and BIS monitoring., Variables of Interest: propofol total dose (mg/kg), induction time, time in performing the UGE, awakening time (min); initial BIS (iBIS), and BIS during the UGE; adverse effects., Results: There were no significant differences in sex, age or weight between case (B) and control (C) population. No significant differences in total propofol doses: (B 4.9 ± 1.4 mg/kg; C 5.2 ± 1.6 mg/kg, P=.492), awakening time (B 12.2 ± 4.6 min; C 12.8 ± 4.4 min, P=.402), time for execution of UGE (B 9.5 ± 4.8 min; C 11.3 ± 6.5 min, P=.335) and induction time (B 11.1 ± 2.6 min; C 10.1 ± 4.2 min, P=.059), iBIS 55.4 ± 6.9. There were no significant differences in adverse effects: 2 patients suffered from mild desaturation in the control group., Conclusions: BIS monitoring for diagnostic UGE in spontaneous breathing in a pediatric population is feasible, but does not appear to decrease awakening time or the amount of propofol needed. Furthermore, there was no statistically significant decrease in the number of adverse effects., (Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.)

Acute peritoneal dialysis (APD) is still a useful tool in the critical pediatric patient. Acute kidney failure due to septic shock often requires invasive depuration procedures and although hemofiltration is very effective, not all pediatric Intensive Care Units have the equipment necessary to establish it. Pediatric APD is generally initiated with short dwell times, every hour exchanges and 10-20 ml/kg filling volumes. We present the evolution of two critical patients with kidney failure on APD who benefited from the measurement of dialysate-to-plasma (D/P) ratios for creatinine and urea, and dialysate-to-solution ratio for glucose (Dt/Do) to optimize APD prescription.

Introduction and Objectives: The predictive value of ECG abnormalities in patients with type-2 diabetes mellitus (DM2) has not been fully studied. Our objective was to assess the prognostic value of ECG abnormalities in patients with DM2 but without known cardiovascular disease., Methods: Overall, 412 patients with DM2 were identified at two primary care centers in the same city. Two hundred and twenty one patients younger 80 years without known cardiovascular disease were included in the study. An ECG was recorded at baseline and annually during follow-up. The ECGs were evaluated using a system based on the Minnesota code. The main study end-point during follow-up was the occurrence of a cardiovascular event, as defined in the Framingham study., Results: The mean follow-up duration was 5.9 years (1.1-8.5 years). At the beginning of the study, 24.9% of patients had ECG abnormalities; at the end, 44.3% had abnormalities. Cardiovascular events occurred in 65 patients (29.4%). The relative risk (RR) of a cardiovascular event in a patient with an ECG abnormality was 8.28 (95% confidence interval [CI], 3.36-20.42). Only hypertension (RR = 2.29; 95% CI, 1.24-4.22) and age were significantly related to the occurrence of a cardiovascular event. Multiple regression analysis that included classical risk factors and ECG findings showed that an ECG abnormality was a significant independent predictor, with adjusted RR = 5.95 (95% CI, 2.29-15.47)., Conclusions: The presence of an ECG abnormality can predict the occurrence of a future cardiovascular event in patients with DM2 more accurately than risk factors alone. This finding could be helpful in selecting subgroups of high-risk diabetic patients.

Utility of inhaled nitric oxide in the treatment of acute respiratory distress syndrome (ARDS) with pulmonary hypertension (PHT) is controversial and there are few studies in the literature that evaluate its effects during prolonged administration. We analyze the case of a 45 day old male patient with un-operated Fallot's tetralogy who developed ARDS and PHT with non-cardiac cause, that required prolonged mechanical ventilation (30 days) and administration of inhaled nitric oxide (INO). Before the INO, the oxygenation index was 19, and at a few minutes of its application it decreased to 15. The patient developed a dependence on INO, tolerating its gradual weaning. Administration could be interrupted at 27 days on onset. We did not observe toxic effects during the administration of INO.

Objective: Analyze the frequencies of genetic mutation in alcohol dehydrogenase (ADH), aldehyde dehydrogenase (ALDH) and cytochrome P450 2E1 (CYP2E1) and establish their possible association with the development of acute alcoholic hepatitis (AAH)., Methodology: Case-control study in a total of 85 Spanish patients. We distinguish three groups (one case group and two control groups) based on hepatic histological lesion and alcohol consumption: controls (group 1: teetotalers; group 2: drinkers without AAH; cases: group 3: drinkers with AAH). Case diagnosis was established based on the presence of polymorphonuclear leukocyte infiltrate in histological study. We analyzed the presence of the genetic mutations R47H and R369C (ADH2), E487K (ALDH2) and mutation Rsa I of CYP2E1 (allele c2) by polymerase chain reaction (PCR) and capillary electrophoresis., Results: The allele c2 of CYP2E1 was found in 10%, 16% and 50% of the groups 1, 2 and 3 patients, respectively. Presence of the mutation Rsa I showed influence on the development of AAH (odds ratio [OR]: 3.63; confidence interval (95% [CI]: 0.88-15.02)., Conclusions: The data suggest a possible association between the presence of the Rsa I of CYP2E1 and the development of AAH in patients with chronic alcohol consumption.

Presentation of a new case of high flow priapism in a patient with recent background of perineal traumatism. Diagnosis, already inferred through anamnesis, was later suspected from the results of blood gasometry in cavernous bodies, and eventually confirmed by Eco-Doppler. A revision of the related literature revealed a total of 20 patients in whom supraselective embolization has been used as the therapeutical approach, Bucrylate being used in only two of them. Finally, a few considerations are contributed on the therapeutical management of these patients and the relevance of a correct diagnosis of the two distinct groups of priapism, since they differ considerably in terms of treatment.