Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

Objective: To evaluate the epidemiological surveillance system for Covid-19 in the canton of Parrita, province of Puntarenas, Costa Rica, during the years 2020 and 2021. Methodology: An evaluation of the epidemiological surveillance system was carried out using the methodology proposed by the Center for Disease Control. The following attributes were evaluated: data quality, sensitivity, positive predictive value, representativeness and timeliness. Results: The database presented 85.9% of complete records (95% CI 84.8 - 87.2). The system has a sensitivity of 96.1 % (95 % CI 95.2 - 96.9) and a positive predictive value of 49.5 % (95 % CI 47.9 - 51.2). 95.6 % of Covid-19 positive cases were reported in less than 24 hours (95% CI 94.7 - 96.4). 95.6% of health orders for home isolation of patients were reported in less than 24 hours (95% CI 94.6 - 96.4). The behavior of the epidemic curve was congruent with that observed at the national level. Conclusion: The epidemiological surveillance system for Covid-19 implemented in the canton of Parrita, Costa Rica has very good information quality, high sensitivity, timeliness and representativeness.

A tuberculoma is a conglomerate of foci of caseous necrosis in the brain parenchyma produced by hematogenous dissemination. Tuberculosis of the central nervous system has an incidence of 0.06 per million inhabitants, corresponding to 1% of all cases of tuberculosis and 6-10% of extrapulmonary forms in immunocompetent patients. We present the case of a 57-year-old patient with headache of 48 hours of evolution, holocranial, prosopagnosia and psychomotor agitation with tendency to violence. At the same time, he reported unquantified fever, predominantly at night, with the same evolution. CBC with normal findings, serology: HBV, HCV, HIV negative. Chest X-ray showed pleural thickening. CT and MRI showed lesion with ring enhancement pattern in cerebellum. Lumbar puncture was performed reporting: protein: 456mg/dL, glucose: 10mg/dL, cells: 105mm3, mononuclear: 100%, ADA: 23.84U/L, GeneXpert: positive. Antipyretic treatment and steroids were given. Patient evolved satisfactorily.

Tres años después de su aparición en la provincia de Wuhan en China, la pandemia retrocede en casi todos los frentes, luego de dejarnos friolera de 668´613.487 de casos, al momento de escribir esta líneas (05/1/23) y de 6´713.586 de muertes en todo el mundo1, aunque en realidad, las cifras reales como mínimo, resulten ser dos o tres veces mayores en ambos casos, haciéndonos recordar épocas pasadas terribles,  que en ocasiones llegaron a poner en peligro la misma existencia de la humanidad. En Costa Rica, para la misma fecha, podemos mencionar la nefasta herencia de 1´171.802 casos y 9.104 hogares que lloran la pérdida de uno de sus seres queridos como consecuencia de la acción del SARS CoV-2. Pero retroceder no significa desaparecer. El mundo científico está muy claro al afirmar que nadie puede descartar el surgimiento de nuevas variantes que den origen a otras olas pandémicas, o bien, la aparición de novedosos agentes causales, que desaten en el mundo, epidemias y pandemias, quizás más contagiosas y aún, más letales que las actuales.  

Perioral dermatitis is a chronic inflammatory dermatosis characterized by multiple papules and pustules in a periorificial distribution, predominantly around the mouth. It mainly affects women aged 15 to 45 years. It may be related to the use of topical steroids, although other factors have also been implicated in its pathogenesis. We describe the case of a long-standing facial dermatitis in a young 38-year-old woman with poor response to isotretinoin, as well as to the indiscriminate and self-medicated use of combined creams and topical steroids; she was managed with azelaic acid, topical metronidazole and oral minocycline, obtaining a significant improvement of her condition. Perioral dermatitis represents a diagnostic challenge for the treating physician, in general, it has a good prognosis, but early identification and timely management is the key in the evolution of this disease.

Epilepsy is a chronic disease characterized by recurrent unprovoked seizures due to aberrant enlargement or synchronization of a group of neurons. Drug-resistant epilepsy is when despite using two or more drugs at their therapeutic dose, the person continues to have recurrent seizures, affecting approximately one third of patients. There are multiple hypotheses of resistance mechanisms, usually variable and multifactorial. They can be divided into three groups: disease-related mechanisms, drug-related mechanisms and genetic mechanisms. There are still many studies to be done to better understand these mechanisms and to generate different treatment proposals.

This article focuses on body dysmorphic disorder, its prevalence, diagnosis and treatment, as well as the degree of introspection and the eventual presence of muscle dysmorphia. In addition, it addresses the underdiagnosis of this pathology and its clinical implications for the patient and the treating physician.

Epilepsy is a common neurological disorder worldwide that affects more than 50 million people, from children to elderly adults. There are different risk factors that may contribute to the development of epilepsy, such as environmental factors, organic factors, factors associated with the newborn or the pregnant woman. Therefore, it is necessary to recognize these factors in order to provide adequate comprehensive care to the patient, with appropriate diagnosis and treatment. In addition, by identifying modifiable factors, measures can be taken to prevent the onset of epilepsy in individuals.