Tuberculosis is a resurgent disease in most regions of the world, infecting one-third of the world's population and having a multisystemic involvement. Incidence of extra-pulmonary tuberculosis has increased in the last few decades as a result of the Human Immunodeficiency Virus (HIV) infection. The authors report a clinical case of the rare concomitant cutaneous and skeletal tuberculosis in an immunocompetent patient transferred from endemic area.

Case seriesPatient: Male, 71 • Female, 41 • Famale, 67Final Diagnosis: Diabetic neuropathy • meningioma • drug-induced diplopiaSymptoms: DiplopiaMedication: —Clinical Procedure: Clinical and imagiologic studySpecialty: OphthalmologyObjective:Challenging differential diagnosisBackground:Diplopia is a symptom with very different etiologies. It may be caused by pathology in the eye, orbit, extraocular muscles, neuromuscular junction, or in the central nervous system.Case Reports:Three clinical cases of hospitalization due to isolated diplopia are presented here, illustrating different etiologies.Conclusions:The present article aims to address the differential diagnosis of this clinical condition and to warn of less frequent causes of diplopia, such as adverse effects of commonly used drugs.

A pandemia do COVID-19, deflagrada no início de 2020, foi acompanhada por rápida disseminação, taxas de mortalidade sem barreiras sociais e uma corrida científica sem precedentes.Neste cenário mundial o Brasil tem lugar de destaque, pois é o 11º país que mais produziu artigos sobre o assunto. Este e-book tenho o objetivo de expor as pesquisas epidemiológicas, revisões científicas, estudos experimentais pré-clínicos, observacionais e clínicos sobre o assunto COVID-19 -O VÍRUS QUE MOVIMENTOU A CIÊNCIA.Esperamos que tenha uma leitura agradável e possa desfrutar ao máximo o conhecimento transmitido por nossos autores.

Introduction: With the increase in life expectancy, there is an increase in Alzheimer’s Disease (AD). Characterized by being a degenerative and irreversible neurological disease, that leads to developing a dependence for daily activities. Objective:To analyze the impact of AD on the quality of life and daily activities of the elderly. Methodology:Integrative literature review, with bibliographic survey carried out on an international basis (PUBMED). Criteria for the selection of articles was: be published in English, in the period 2018-2020, available in full, whose theme was “Impacts on the quality of life that AD causes in the elderly”. Results: For the sample of this review 59 articles were selected, of which 48 articles were not specific to the topic, leaving a final sample of 11 articles included in the review. Identifying that AD has a strong impact on patient’s quality of life, such as reduced autonomy and dependence on daily activities. Conclusion: It was observed that there is a reduction in the quality of life of patients with AD, related to loss of autonomy and dependence in daily activities. Mesh- Terms: Degenerative Disease, Aged, Insanity.

Background: Atrial fibrillation (AF) is the most common arrhythmia in older adults, increases with age and it is a well-established risk factor for stroke. Recent studies showed that up to 15% of stroke admissions present with AF. Furthermore, the number of patients with AF is expected to increase 2.5-fold in the next 50 years. Therefore, stroke prevention must constitute a priority in current health policies. Nonetheless, little is known about the prevalence of paroxysmal AF (PAF) in older adults. We aim to assess the prevalence of AF in stroke patients and to identify further paroxysmal events in patients with reported normal rhythm on admission. Methods: Observational study of routinely collected data over a 26-month period in a Stroke Unit within an Internal Medicine Department. All types of stroke were analyzed. AF diagnosis based on medical records, admission 12-lead electrocardiogram (ECG) or 24-hour Holter monitoring. Descriptive statistics were used. Results: A total of 332 consecutive patients were identified. Median age (IQR) was 77 (68-83) years; 53.0% women; 2.4% hemorrhagic stroke; 59.5% aged 75 years or older. Overall prevalence of AF on admission was 23.2%, of which 10.4% were newly diagnosed. 34.8% of the patients with known AF were on anticoagulation. Amongst the patients with reported normal rhythm on admission, a 1.9% of PAF was demonstrated on 24-hour Holter monitoring recorded during acute phase. In the 75 years or older cohort, we found higher prevalence of AF (31.3% vs 11.2%, p<.001) but no difference of that of PAF (2.2% vs 1.7%, p=NS). Cardioembolism was much more prevalent in the very old (33.0% vs 17.9%, p=.03). Conclusion: We report a higher prevalence of AF in patients presenting with stroke than published literature. Some patients were unaware of this condition. Surprisingly, only a third of patients with known AF were on anticoagulation. We were able to detect a high prevalence of PAF on 24-hour Holter monitoring during acute phase. However, PAF is as prevalent in the very old as it is in younger patients. Cardioembolic stroke is more frequent in the very old; therefore exhaustive investigation to detect AF in this cohort should be sought, so an effective secondary prophylaxis can be offered.