Acute neurological sequela in patients with COVID-19 infection include acute thromboembolic infarcts related to cytokine storm and post infectious immune activation resulting in a prothrombotic state. Radiologic imaging studies of the sinonasal tract and mastoid cavity in patients with COVID-19 infection are sparse and limited to case series. In this report, we investigate the radiologic involvement of nasal cavity, nasopharynx, paranasal sinuses, and mastoid cavity in patients with SARS-CoV-2 infection who presented with acute neurological symptoms.
 
  Retrospective review of medical records and neuroradiologic imaging in patients diagnosed with acute COVID-19 infection who presented with acute neurological symptoms to assess radiologic prevalence of sinus and mastoid disease and its correlation to upper respiratory tract symptoms.
 
  Of the 55 patients, 23 (42%) had partial sinus opacification, with no evidence for complete sinus opacification. The ethmoid sinus was the most commonly affected (16/55 or 29%). An air fluid level was noted in 6/55 (11%) patients, most commonly in the maxillary sinus. Olfactory recess and mastoid opacification were uncommon. There was no evidence of bony destruction in any of the studies, Cough, nasal congestion, rhinorrhea, and sore throat were not significantly associated with any radiological findings.
 
  In patients who present with acute neurological symptoms, COVID-19 infection is characterized by limited and mild mucosal disease within the sinuses, nasopharynx and mastoid cavity.
 
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 4.Dear editor, We present the case of a 69-year-old female undergoing esophagogastroduodenoscopy for iron-deficiency anemia investigation.  https://www.selleckchem.com/products/leupeptin-hemisulfate.html  She reported intermittent bloating, nausea and vomiting. A pedunculated polyp was identified arising from the greater curvature of the middle gastric body, with a long fibroelastic stalk (30mm) and a 60mm congestive head that prolapsed towards the pyloric ring, causing a complete gastric outlet obstruction (GOO). An en-block polypectomy was performed. An intraprocedural oozing bleeding from a large visible vessel at the residual stalk was managed using endoloop®. Histo-immunohistochemistry showed a R0-resection of a mixed-type gastric pyloric gland adenoma (PGA) positive for MUC-5AC and MUC-6 mucins, in a surrounding H. pylori-negative non-atrophic chronic gastritis. She became asymptomatic with anemia resolution. Adenomas account for up to 10% of gastric polyps. Histologically, they are categorized into intestinal, foveolar, pyloric and oxyntic types (1). PGA is a rare subt. This case illustrates a successful endoscopic resection as a minimally invasive procedure of a doubly complicated PGA.Aminosalicylates (5-ASA) are used as the first-line maintenance treatment in patients with mild-moderate ulcerative colitis (UC). Early identification of patients at high risk for 5-ASA non-response and appropriate therapeutic escalation are essential to avoid disease progression. However, the absence of a standardized definition for treatment success makes this a challenging task. The focus of the current review was to describe the risk factors and management strategies associated with 5-ASA non-response. Rates of 5-ASA failure can vary from 17 % to 75 % according to different success definitions, of which clinical relapse is the most prevalent and studied condition. Younger age and endoscopic activity at diagnosis, extensive colitis, early need for corticosteroids, elevated inflammatory markers and non-adherence are consistent risk factors of 5-ASA failure. Given the effectiveness, safety profile and tolerability of this medication, therapy optimization is critical before treatment escalation. Combined use of systemic and topical therapy at an appropriate dose in a once-daily administration and control of adherence could improve success rates.Alterations in liver function test have been described in 17-50% of patients COVID-19. The pathogenic mechanism remains obscure. With the occasion of a recent manuscript on the journal, we discuss the possible mechanisms.A 41-year-old caucasian female, with past medical history of pituitary adenoma medicated with cabergoline, presented with worsening dyspepsia and unintentional weight loss of 5%. Physical exam and laboratory results were unremarkable for pathological findings. Esophagogastroduodenoscopy revealed an oedematous and exuberant lymphangiectasia appearance in the duodenum, with no ulceration or suspected infiltration component (figure 1 - A/B). However, duodenal biopsies revealed infiltration by poorly differentiated carcinoma (figure 1 - C/D). In the meantime, infection and inflammatory/autoimmune causes were ruled out. A CT scan was performed revealing a thickened and enlarged pancreas with ill-defined limits and several intra-abdominal adenopathies, raising suspicion of pancreatic lymphoproliferative disease. EUS with FNB was performed with biopsy of the pancreas and one of the larger adenopathy. EUS also revealed an enlarged, non-nodular pancreas and a thickened duodenal wall. Mild ascites was detected. Both EUS-biopsies were concordant on the diagnosis of carcinoma with gastric or pancreatic-biliary origin, highly aggressive (Ki67>80%). Therefore, the diagnosis of pancreatic adenocarcinoma was assumed (cT4N1Mx). The patient is currently on palliative chemotherapy and remains paucisymptomatic.In response to the kind letter from Joaquin Cabezas et al. We agree that medical care in the COVID era has radically changed; using new mechanisms in the care of different diseases is undoubtedly now a priority to avoid contagion of both the patient and the medical staff, although the vaccine could protect the population, there are still many questions to answer; The model we use for the care of patients with a diagnosis of HCV in Mexico showed great benefits, as in other studies, since it significantly reduced costs, almost 50% of the patients were far from the center the third level but could be included, treated, monitored and cured using this model, with savings also in the complications that were avoided due to the non-progression of the disease and/or the stabilization of the already established liver disease, always based on guidelines international and national. This model could be used for other pathologies that require an evaluation and follow-up by specialists and subspecialists in populations far from tertiary hospitals.