Evaluation of Polysaccharide Typhim Vi Antibody Response as a predictor of Humoral Immunodeficiency in Haematological Malignancies.

An increasing healthcare challenge in the management of haematological malignancy (HM) is secondary immunodeficiency. From January 2019, the EMA included the evaluation of specific antibody (Ab) responses to better select patients for immunoglobulin replacement therapy (IgRT). We evaluated Ab responses to pneumococcal and Salmonella typhi pure polysaccharide immunization in a cohort of 42 HM patients and 24 healthy-controls. Pre-post specific Ab concentrations were measured by ELISA at 4 weeks. Globally, significantly lower Typhim Vi (TV) seroprevalence (9%) compared to 23-valent pneumococcal polysaccharide vaccine (PPV) (76%) (p <0.001) was observed. TV non responders (88%) were higher than PPV non responders (62%) (p <0.0001) and correlated better to infectious history. By ROC analysis, pre-post 5-fold TV increase was the best cut-off to discriminate HM with recurrent infections and controls (sensitivity 91%, specificity 100%). Despite the small sample cohort, our results suggest that specific anti-S typhi Ab response is a useful complementary assay in the diagnosis and management decision of SID to HM.

[Neurological complications in critical patients with COVID-19]. / Complicaciones neurológicas en pacientes críticos por SARS-CoV-2.

Introduction: We analysed the neurological complications of patients with severe SARS-CoV-2 infection who required intensive care unit (ICU) admission. Patients and methods: We conducted a retrospective, observational, descriptive study of consecutive patients admitted to the ICU due to severe respiratory symptoms secondary to SARS-CoV-2 infection between 1 April and 1 June 2020. Results: We included 30 patients with neurological symptoms; 21 were men (72.40%), and mean age (standard deviation [SD]) was 57.41 years (11.61). The mean duration of ICU stay was 18.83 days (14.33). The neurological conditions recorded were acute confusional syndrome in 28 patients (93.33%), neuromuscular disease in 15 (50%), headache in 5 (16.66%), cerebrovascular disease in 4 (13.33%), and encephalopathies/encephalitis in 4 (13.33%). CSF analysis results were normal in 6 patients (20%). Brain MRI or head CT showed alterations in 20 patients (66.6%). EEG was performed in all patients (100%), with 8 (26.66%) showing abnormal findings. In 5 of the 15 patients with clinical myopathy, diagnosis was confirmed with electroneuromyography. We found a correlation between older age and duration of ICU stay (P = .002; 95% CI: 4.032-6.022; OR: 3,594). Conclusions: Severe COVID-19 mainly affects men, as observed in other series. Half of our patients presented acute myopathy, and almost all patients left the ICU with acute confusional syndrome, which fully resolved; no correlation was found with EEG or neuroimaging findings. Older age is associated with longer ICU stay.

Kaposi sarcoma secondary to endogenous adrenocorticotropic hormone-dependent Cushing syndrome.

Kaposi sarcoma (KS) is an angioproliferative tumour that develops as a result of an infection by human herpesvirus 8, which is considered a necessary cause but not sufficient. Other factors - genetic, immunological and environmental - might play a role in the development of the disease. We report a case of KS secondary to endogenous Cushing syndrome (ECS) due to a pituitary adenoma, an association that has been reported only once. We also conducted a search through the Medline and PubMed databases for cases involving KS and ECS, finding only three additional cases that shared common clinical and prognostic features with ours. ECS might favour the development of KS due to immunosuppression. Dermatologists and other clinicians should be aware of this association, as it might be an underdiagnosed condition. It also has an important impact on the management of KS, and based on this review it relies on a good prognosis when ECS is well controlled.

[Commercial devices for monitoring symptoms in Parkinson's disease: benefits, limitations and trends]. / Dispositivos comerciales para la monitorización de síntomas en la enfermedad de Parkinson: beneficios, limitaciones y tendencias.

Parkinson's disease (PD) is a neurodegenerative disorder that significantly affects patients' quality of life. Treatment of PD requires accurate assessment of motor and non-motor symptoms, which is often complicated by subjectivity in reporting symptoms, and the limited availability of neurologists. Commercial wearable devices, which monitor PD symptoms continuously and outside the clinical setting, have appeared to address these challenges. These devices include PKG™, Kinesia 360™, Kinesia U™, PDMonitor™ and STAT-ON™. These devices use advanced technologies, including accelerometers, gyroscopes and specific algorithms to provide objective data on motor symptoms, such as tremor, dyskinesia and bradykinesia. Despite their potential, the adoption of these devices has been limited, due to concerns about their accuracy, complexity of use and the lack of independent validation. The correlation between the measurements obtained from these devices and traditional clinical observations varies, and their usability and patient adherence are critical areas for improvement. Validation and usability studies with a sufficient number of patients, standardised protocols and integration with hospitals' IT systems are essential to optimise their usefulness and improve patient outcomes.

TITLE: Dispositivos comerciales para la monitorización de síntomas en la enfermedad de Parkinson: beneficios, limitaciones y tendencias.Resumen. La enfermedad de Parkinson (EP) es un trastorno neurodegenerativo que afecta significativamente a la calidad de vida de los pacientes. El tratamiento de la EP requiere una evaluación precisa de los síntomas motores y no motores, que a menudo se complica por la subjetividad en el informe de síntomas y la limitada disponibilidad de neurólogos. Para abordar estos desafíos han surgido dispositivos comerciales vestibles que monitorizan los síntomas de la EP de manera continua y fuera del entorno clínico. Entre los principales dispositivos se encuentran PKG™, Kinesia 360™, Kinesia U™, PDMonitor™ y STAT-ON™. Estos dispositivos utilizan tecnologías avanzadas, como acelerómetros, giroscopios y algoritmos específicos, para proporcionar datos objetivos sobre síntomas motores, como temblores, discinesia y bradicinesia. A pesar de su potencial, la adopción de estos dispositivos es limitada, debido a preocupaciones sobre su precisión, la complejidad de su uso y la falta de validación independiente. La correlación entre las mediciones de estos dispositivos y las observaciones clínicas tradicionales varía, y la usabilidad y la adhesión del paciente son áreas críticas de mejora. Para optimizar su utilidad y mejorar los resultados para los pacientes, es esencial realizar estudios de validación y usabilidad con un número suficiente de pacientes, desarrollar protocolos estandarizados y asegurar la integración con sistemas informáticos hospitalarios.

Assessment of the diagnostic utility of the electroencephalogram in pediatric emergencies.

INTRODUCTION: We analyze the diagnostic utility of urgent EEG (electroencephalogram) performed in children under 16 years of age in our center. MATERIAL AND METHODS: Descriptive, retrospective, observational study of consecutive patients from 0 to 16 years of age, who underwent an urgent EEG for any reason, from January to December 2022. RESULTS: Of the 388 patients, 70 were children: 37 (52.85%) women, and 33 (47.14%) men. Average age: 6.27 ±â€¯4.809. Of the 70 patients, 6 (8.57%) had previous epilepsy. Reasons for consultation: 17 febrile seizures, 10 first focal seizures, 10 first TCG seizures, 6 paroxysmal episodes, 6 absences, 3 myoclonus of extremities, 3 syncope, 2 SE, 2 visual alterations, 2 low level of consciousness, 2 cyanosis, 2 suspected meningitis or encephalitis, 1 choking, 1 atypical headache, 1 chorea, 1 presyncope, 1 language delay. Of the 70 patients, 47 had a normal EEG (67.14%). Of the 47 patients with a normal EEG, 10 were diagnosed with epilepsy, and 3 of them began receiving antiepileptic treatment upon discharge. None of the patients with suspected syncope or paroxysmal disorder (17 patients, 24.28%) had EEG abnormalities. Of the 17 patients with atypical febrile seizures, 3 had EEG abnormalities. CONCLUSIONS: A third of the EEG records performed in the Emergency Department showed alterations, probably due to the time taken. Almost half of the patients with suspected epilepsy or EE showed EEG abnormalities, which confirmed the diagnosis in these cases and encouraged the clinician to start drug treatment. No case with a high suspicion of epilepsy was dismissed due to the normality of the EEG recording in our series. No patient diagnosed with syncope or paroxysmal disorder had EEG abnormalities. Nearly a quarter of patients with atypical febrile seizures showed EEG abnormalities. We barely register cases of status epilepticus, probably due to the degree of complexity of our center.

[Translated article] Risk factors associated with periprosthetic infection in patients with femoral neck fracture: A case-control study.

BACKGROUND: Infection is one of the most important local complications in the patient with femoral neck fracture treated with arthroplasty. The aim of the present study is to describe and analyze possible risk factors that could be involved in periprosthetic infection in the patient with femoral neck fracture. METHODS: A retrospective case-control study was performed including patients with femoral neck fractures treated with arthroplasty in the period between January 2015 and December 2017. Cases were defined as patients with femoral neck fracture who after undergoing arthroplasty (hemiarthroplasty or total hip arthroplasty) had a periprosthetic infection, whose diagnosis was carried out according to the major and minor criteria described in the International Consensus on Musculoskeletal Infections (Philadelphia 2018). In order to mitigate the influence of variables that could be considered confounding variables, a multivariate analysis was carried out. OUTCOMES: A statistically significant association was found between periprosthetic infection and certain variables present at the time of admission, including the presence of moderate or severe anaemia (OR: 10.91; 95% CI: 1.07-111.50; P = .007), thrombocytopenia (OR: 27.72;95% CI: 3.48-221.01; P = .002), history of thromboembolism event (OR: 8.80; 95% CI: 1.31-59.38; P = .026), anxious-depressive disorder in treatment with two or three drugs (OR: 21.36; 95% CI: 3.65-125.12; P = .001) and liver disease (OR: 32.04; 95% CI: 2.59-396.29; P = .007). CONCLUSIONS: Periprosthetic infection in the patient with femoral neck fracture treated with arthroplasty could be related to the presence of certain variables at the time of hospital admission, including moderate or severe anaemia, thrombocytopenia, history of thromboembolic event, anxious-depressive disorder in treatment with two or three drugs or liver disease.

Risk factors associated with periprosthetic infection in patients with femoral neck fracture: A case-control study. / Factores de riesgo asociados a infección periprotésica en el paciente con fractura del cuello femoral: estudio de casos y controles.

BACKGROUND: Infection is one of the most important local complications in the patient with femoral neck fracture treated with arthroplasty. The aim of the present study is to describe and analyze possible risk factors that could be involved in periprosthetic infection in the patient with femoral neck fracture. METHODS: A retrospective case-control study was performed including patients with femoral neck fractures treated with arthroplasty in the period between January 2015 and December 2017. Cases were defined as patients with femoral neck fracture who after undergoing arthroplasty (hemiarthroplasty or total hip arthroplasty) had a periprosthetic infection, whose diagnosis was carried out according to the major and minor criteria described in the International Consensus on Musculoskeletal Infections (Philadelphia 2018). In order to mitigate the influence of variables that could be considered confounding variables, a multivariate analysis was carried out. OUTCOMES: A statistically significant association was found between periprosthetic infection and certain variables present at the time of admission, including the presence of moderate or severe anaemia (OR: 10.91; 95%CI: 1.07-111.50; P=.007), thrombocytopenia (OR: 27.72; 95%CI: 3.48-221.01; P=.002), history of thromboembolism event (OR: 8.80; 95%CI: 1.31-59.38; P=.026), anxious-depressive disorder in treatment with two or three drugs (OR: 21.36; 95%CI: 3.65-125.12; P=.001) and liver disease (OR: 32.04; 95%CI: 2.59-396.29; P=.007). CONCLUSIONS: Periprosthetic infection in the patient with femoral neck fracture treated with arthroplasty could be related to the presence of certain variables at the time of hospital admission, including moderate or severe anaemia, thrombocytopenia, history of thromboembolic event, anxious-depressive disorder in treatment with two or three drugs or liver disease.

Traumatic brain injury in the new millennium: new population and new management.

INTRODUCTION: Traumatic brain injury (TBI) is one of the leading causes of death and disability globally. We present a study describing epidemiological changes in severe TBI and the impact these changes have had on management and analysing alternatives that may improve outcomes in this new population. MATERIALS AND METHODS: We performed a retrospective, descriptive, cross-sectional analysis of patients presenting severe TBI at our hospital in the period of 1992-1996 and 2009-2013. We analysed demographic data, including age, sex, mortality, aetiology, anticoagulation, treatment, and functional outcome. RESULTS: We reviewed data from 220 patients. In the second cohort, there were 40% fewer patients, mean age was 12 years older, patients were more frequently receiving anticoagulation therapy, and the percentage of interventions was halved. Aetiology varied, with traffic accidents being the main cause in the first group, and accidental falls and being hit by cars in the second group. There were no intergroup differences for mortality or functional outcomes. CONCLUSION: The age of patients admitted due to severe TBI has increased. As a result of this, the main cause of severe TBI in our population is accidental falls in elderly, anticoagulated patients. Despite the low-energy nature of trauma, patients in the second cohort presented a poorer baseline status, and were less frequently eligible for surgery, with no improvement in mortality or functional outcomes.

Role of pituitary stalk and gland radiological status on endocrine function and outcome after endoscopic transsphenoidal surgery for non-functioning pituitary adenomas.

PURPOSE: To investigate endocrine function changes after non-functioning pituitary adenomas (NFPA) transsphenoidal surgery and to search for predictors of hypopituitarism resolution and development. METHODS: We included 117 patients with NFPA who underwent endoscopic transsphenoidal surgery from 2005 to 2019 by two neurosurgeons. Twenty-one patients were excluded because of previous pituitary surgery or radiotherapy. We assessed symptoms at diagnosis, tumour volume, tumour removal, hormonal status at diagnosis, hormonal outcomes at 2- and 12-month follow-up, and complications. Pituitary stalk and gland MRI status (visible or not) were included, and it theirs association to hormonal function was studied for the first time, to our knowledge. RESULTS: Pituitary gland visualization was more frequent in those patients who showed a smaller number of axes affected at 12 months (p = 0.011). Pituitary stalk status showed no association to hormonal function. The hormonal normalization rate at 12 months was 13%. The endocrine improvement rate at 12 months was 16.7%. Worsening of hormonal function occurred in 19.8% of patients. Younger age was associated to hormonal improvement (p = 0.004). Higher preoperative tumour volume (p = 0.015) and absence of gross total resection (GTR) (p = 0.049) were associated with worsening in at least one hormonal axis after surgery. CONCLUSIONS: Pituitary gland visibility was higher in those patients who showed better hormonal outcomes. Assessment of initial hormonal function and outcome after surgery regarding pituitary stalk status showed no significant association. Higher preoperative tumour volumes and absence of GTR were associated to postoperative endocrine function worsening, while younger age was associated to its improvement.

[Non-functioning pituitary adenomas: epidemiology, clinical and postoperative outcome]. / Adenomas hipofisarios no funcionantes: epidemiología, clínica y evolución posquirúrgica.

INTRODUCTION: Non-functioning pituitary adenomas are the most frequent tumor group in the sellar region. They are usually benign neoplasms diagnosed after visual or hormonal symptoms, although it is not uncommon to detect them as a casual finding. AIM: To analyze the clinical aspects found in this disease and its response after surgical treatment. PATIENTS AND METHODS: In a series of 100 cases, epidemiological, clinical, endocrinological, visual and radiological data were analyzed before and after surgical treatment, as well as the complications related to surgery and long-term follow-up. RESULTS: The most frequent symptom at the time of diagnosis was visual field involvement (62%), and only the 7% of adenomas were a casual finding. The most common hormonal deficit was hypogonadotropic hypogonadism (48%). After surgery, complete recovery of the visual field defect was observed in 54.8% of the patients, only 1% worsening after surgery, and the incidence of diabetes insipidus was 4%. The resection was superior to 95% in 63% of cases, although the percentage of adenomas with invasion of the cavernous sinus in Knosp grades 3 and 4 it was high (45%). CONCLUSIONS: Although the most frequent symptom of non-functioning pituitary adenomas is campimetric involvement, it has an excellent response to surgery if it is performed within the appropriate time. The grade of invasion of the cavernous sinus is the most limiting factor for a complete surgical resection.

TITLE: Adenomas hipofisarios no funcionantes: epidemiología, clínica y evolución posquirúrgica.Introducción. Los adenomas hipofisarios no funcionantes son el grupo tumoral más frecuente en la región selar. Suelen ser neoplasias benignas diagnosticadas por síntomas visuales u hormonales, aunque no es infrecuente detectarlos como un hallazgo casual. Objetivo. Analizar los aspectos clínicos hallados en esta enfermedad y su respuesta tras el tratamiento quirúrgico. Pacientes y métodos. En una serie de 100 casos, se analizaron datos epidemiológicos, clínicos, endocrinológicos, visuales y radiológicos antes y después del tratamiento quirúrgico, y se recogen las complicaciones relacionadas con la cirugía y el seguimiento a largo plazo. Resultados. El síntoma más frecuente en el momento del diagnóstico fue la afectación del campo visual (62%), y sólo el 7% de los adenomas se trataba de un hallazgo casual. El déficit hormonal más frecuente era el hipogonadismo hipogonadótropo (48%). Tras la cirugía se observó recuperación completa del defecto campimétrico en el 54,8% de los pacientes, con sólo un 1% de empeoramiento tras la cirugía, y la incidencia de diabetes insípida fue del 4%. La resección fue superior al 95% en el 63% de los casos, a pesar de que el porcentaje de adenomas con invasión del seno cavernoso en grados altos fue elevado (45%). Conclusiones. Aunque el síntoma más frecuente de los adenomas hipofisarios no funcionantes es la afectación campimétrica, ésta tiene una excelente respuesta a la cirugía si se realiza dentro del tiempo adecuado. El grado de invasión del seno cavernoso parece el factor más limitante para una resección quirúrgica completa.

Neurological complications in critical patients with COVID-19. / Complicaciones neurológicas en pacientes críticos por SARS-CoV-2.

INTRODUCTION: We analysed the neurological complications of patients with severe SARS-CoV-2 infection who required intensive care unit (ICU) admission. PATIENTS AND METHODS: We conducted a retrospective, observational, descriptive study of consecutive patients admitted to the ICU due to severe respiratory symptoms secondary to SARS-CoV-2 infection between 1 April and 1 June 2020. RESULTS: We included 30 patients with neurological symptoms; 21 were men (72.40%), and mean age (standard deviation [SD]) was 57.41 years (11.61). The mean duration of ICU stay was 18.83 days (14.33). The neurological conditions recorded were acute confusional syndrome in 28 patients (93.33%), neuromuscular disease in 15 (50%), headache in 5 (16.66%), cerebrovascular disease in 4 (13.33%), and encephalopathies/encephalitis in 4 (13.33%). CSF analysis results were normal in 6 patients (20%). Brain MRI or head CT showed alterations in 20 patients (66.6%). EEG was performed in all patients (100%), with 8 (26.66%) showing abnormal findings. In 5 of the 15 patients with clinical myopathy, diagnosis was confirmed with electroneuromyography. We found a correlation between older age and duration of ICU stay (P=.002; 95%CI: 4.032-6.022; OR: 3,594). CONCLUSIONS: Severe COVID-19 mainly affects men, as observed in other series. Half of our patients presented acute myopathy, and almost all patients left the ICU with acute confusional syndrome, which fully resolved; no correlation was found with EEG or neuroimaging findings. Older age is associated with longer ICU stay.

Update on the pathophysiology and management of syringomyelia unrelated to Chiari malformation. / Siringomielia no secundaria a Chiari. Actualización en fisiopatología y manejo.

INTRODUCTION: Much has been published on syringomyelia related to Chiari malformation. In contrast, little is known about the condition when it is not associated with this malformation, but this presentation of syringomyelia constitutes a different entity and therefore requires specific management. We conducted a literature review to summarise the most accepted and widespread ideas about the pathophysiology, management and other aspects of syringomyelia unrelated to Chiari malformation. DEVELOPMENT: We reviewed the most relevant literature on this condition, focusing on the pathophysiology, clinical presentation, diagnosis, and treatment. CONCLUSIONS: Syringomyelia unrelated to Chiari malformation is a distinct entity that must be well understood to guarantee correct diagnosis, monitoring, and management. When the disease is suspected, a thorough study should be conducted to identify its aetiology. Treatment must aim to eliminate the cause of the disease; symptomatic treatment should remain a second-line option.

Traumatic brain injury in the new millennium: A new population and new management. / El traumatismo craneoencefálico severo en el nuevo milenio. Nueva población y nuevo manejo.

INTRODUCTION: Traumatic brain injury (TBI) is one of the leading causes of death and disability globally. We present a study describing epidemiological changes in severe TBI and the impact these changes have had on management and analysing alternatives that may improve outcomes in this new population. MATERIALS AND METHODS: We performed a retrospective, descriptive, cross-sectional analysis of patients presenting severe TBI at our hospital in the period of 1992-1996 and 2009-2013. We analysed demographic data, including age, sex, mortality, aetiology, anticoagulation, treatment, and functional outcome. RESULTS: We reviewed data from 220 patients. In the second cohort, there were 40% fewer patients, mean age was 12years older, patients were more frequently receiving anticoagulation therapy, and the percentage of interventions was halved. Aetiology varied, with traffic accidents being the main cause in the first group, and accidental falls and being hit by cars in the second group. There were no intergroup differences for mortality or functional outcomes. CONCLUSION: The age of patients admitted due to severe TBI has increased. As a result of this, the main cause of severe TBI in our population is accidental falls in elderly, anticoagulated patients. Despite the low-energy nature of trauma, patients in the second cohort presented a poorer baseline status, and were less frequently eligible for surgery, with no improvement in mortality or functional outcomes.

Factores de riesgo asociados a infección periprotésica en el paciente con fractura del cuello femoral: estudio de casos y controles / Risk factors associated with periprosthetic infection in patients with femoral neck fracture: A case-control study

Antecedentes y objetivo: La infección es una de las complicaciones locales más importantes en el paciente con fractura del cuello femoral tratada con una artroplastia. El objetivo del presente estudio es describir y analizar posibles factores de riesgo que podrían estar implicados en la infección periprotésica del paciente con fractura del cuello femoral. Material y métodos: Se realizó un estudio de casos y controles retrospectivo que incluye a pacientes con fractura del cuello femoral tratada con una artroplastia en el periodo comprendido entre enero de 2015 y diciembre de 2017. Se definieron como casos a los pacientes con fractura del cuello femoral que tras someterse a una artroplastia (hemiartroplastia o artroplastia total de cadera) tuvieron como desenlace una infección periprotésica, cuyo diagnóstico se llevó a cabo atendiendo a los criterios mayores y menores descritos en el Consenso Internacional de Infecciones Musculoesqueléticas (Philadelphia 2018). Con la intención de atenuar la influencia de variables que podrían considerarse confusoras, se realizó un análisis multivariante. Resultados: Se apreció una asociación estadísticamente significativa entre infección periprotésica y determinadas variables presentes en el momento del ingreso, entre las que se encuentran la presencia de anemia moderada o severa (OR: 10,91; IC95%: 1,07-111,50; p=0,007), trombocitopenia (OR: 27,72; IC95%: 3,48-221,01; p=0,002), el antecedente tromboembólico (OR: 8,80; IC95%: 1,31-59,38; p=0,026), el trastorno ansioso-depresivo en tratamiento con 2 o 3 fármacos (OR: 21,36; IC95%: 3,65-125,12; p=0,001) y la hepatopatía (OR: 32,04; IC95%: 2,59-396,29; p=0,007). Conclusiones: La infección periprotésica en el paciente con fractura del cuello femoral tratado con una artroplastia podría relacionarse con la presencia de determinadas variables en el momento del ingreso hospitalario, entre las que se encuentran la anemia moderada o severa...(AU)

Background: Infection is one of the most important local complications in the patient with femoral neck fracture treated with arthroplasty. The aim of the present study is to describe and analyze possible risk factors that could be involved in periprosthetic infection in the patient with femoral neck fracture. Methods: A retrospective case-control study was performed including patients with femoral neck fractures treated with arthroplasty in the period between January 2015 and December 2017. Cases were defined as patients with femoral neck fracture who after undergoing arthroplasty (hemiarthroplasty or total hip arthroplasty) had a periprosthetic infection, whose diagnosis was carried out according to the major and minor criteria described in the International Consensus on Musculoskeletal Infections (Philadelphia 2018). In order to mitigate the influence of variables that could be considered confounding variables, a multivariate analysis was carried out. Outcomes: A statistically significant association was found between periprosthetic infection and certain variables present at the time of admission, including the presence of moderate or severe anaemia (OR: 10.91; 95%CI: 1.07-111.50; P=.007), thrombocytopenia (OR: 27.72; 95%CI: 3.48-221.01; P=.002), history of thromboembolism event (OR: 8.80; 95%CI: 1.31-59.38; P=.026), anxious-depressive disorder in treatment with two or three drugs (OR: 21.36; 95%CI: 3.65-125.12; P=.001) and liver disease (OR: 32.04; 95%CI: 2.59-396.29; P=.007). Conclusions: Periprosthetic infection in the patient with femoral neck fracture treated with arthroplasty could be related to the presence of certain variables at the time of hospital admission, including moderate or severe anaemia, thrombocytopenia, history of thromboembolic event, anxious-depressive disorder in treatment with two or three drugs or liver disease.(AU)

[Translated article] Risk factors associated with periprosthetic infection in patients with femoral neck fracture: A case–control study / Factores de riesgo asociados a infección periprotésica en el paciente con fractura del cuello femoral: estudio de casos y controles

Antecedentes y objetivo: La infección es una de las complicaciones locales más importantes en el paciente con fractura del cuello femoral tratada con una artroplastia. El objetivo del presente estudio es describir y analizar posibles factores de riesgo que podrían estar implicados en la infección periprotésica del paciente con fractura del cuello femoral. Material y métodos: Se realizó un estudio de casos y controles retrospectivo que incluye a pacientes con fractura del cuello femoral tratada con una artroplastia en el periodo comprendido entre enero de 2015 y diciembre de 2017. Se definieron como casos a los pacientes con fractura del cuello femoral que tras someterse a una artroplastia (hemiartroplastia o artroplastia total de cadera) tuvieron como desenlace una infección periprotésica, cuyo diagnóstico se llevó a cabo atendiendo a los criterios mayores y menores descritos en el Consenso Internacional de Infecciones Musculoesqueléticas (Philadelphia 2018). Con la intención de atenuar la influencia de variables que podrían considerarse confusoras, se realizó un análisis multivariante. Resultados: Se apreció una asociación estadísticamente significativa entre infección periprotésica y determinadas variables presentes en el momento del ingreso, entre las que se encuentran la presencia de anemia moderada o severa (OR: 10,91; IC95%: 1,07-111,50; p=0,007), trombocitopenia (OR: 27,72; IC95%: 3,48-221,01; p=0,002), el antecedente tromboembólico (OR: 8,80; IC95%: 1,31-59,38; p=0,026), el trastorno ansioso-depresivo en tratamiento con 2 o 3 fármacos (OR: 21,36; IC95%: 3,65-125,12; p=0,001) y la hepatopatía (OR: 32,04; IC95%: 2,59-396,29; p=0,007). Conclusiones: La infección periprotésica en el paciente con fractura del cuello femoral tratado con una artroplastia podría relacionarse con la presencia de determinadas variables en el momento del ingreso hospitalario, entre las que se encuentran la anemia moderada o severa...(AU)

Background: Infection is one of the most important local complications in the patient with femoral neck fracture treated with arthroplasty. The aim of the present study is to describe and analyze possible risk factors that could be involved in periprosthetic infection in the patient with femoral neck fracture. Methods: A retrospective case-control study was performed including patients with femoral neck fractures treated with arthroplasty in the period between January 2015 and December 2017. Cases were defined as patients with femoral neck fracture who after undergoing arthroplasty (hemiarthroplasty or total hip arthroplasty) had a periprosthetic infection, whose diagnosis was carried out according to the major and minor criteria described in the International Consensus on Musculoskeletal Infections (Philadelphia 2018). In order to mitigate the influence of variables that could be considered confounding variables, a multivariate analysis was carried out. Outcomes: A statistically significant association was found between periprosthetic infection and certain variables present at the time of admission, including the presence of moderate or severe anaemia (OR: 10.91; 95%CI: 1.07-111.50; P=.007), thrombocytopenia (OR: 27.72; 95%CI: 3.48-221.01; P=.002), history of thromboembolism event (OR: 8.80; 95%CI: 1.31-59.38; P=.026), anxious-depressive disorder in treatment with two or three drugs (OR: 21.36; 95%CI: 3.65-125.12; P=.001) and liver disease (OR: 32.04; 95%CI: 2.59-396.29; P=.007). Conclusions: Periprosthetic infection in the patient with femoral neck fracture treated with arthroplasty could be related to the presence of certain variables at the time of hospital admission, including moderate or severe anaemia, thrombocytopenia, history of thromboembolic event, anxious-depressive disorder in treatment with two or three drugs or liver disease.(AU)

The impact of increasing energy crop addition on process performance and residual methane potential in anaerobic digestion.

In a full-scale agricultural biogas plant, the changes in process performance connected with the increasing energy crop addition were monitored. The substrates applied were pig manure, solid energy crops and agricultural residues. During the study, the organic loading rate and the volume-related biogas productivity were doubled to 4.2 kg VS/(m(.3)d) and 2.83 Nm(3)/(m(3).d) respectively, by means of increasing the energy crop ratio in the feedstock to 96.5% (volatile solids). This resulted in an increase of the electrical capacity on a level twice as high as before. At the same time, methane yield and organic degradation rate decreased slightly to 0.35 Nm(3)/kg VS(added) and 87.4%, respectively. The strongest impact observed was on the transfer of partly degraded organic material into the digestate storage and with this, an increase of the residual methane potential of the digestate. A maximum theoretical methane load in the digestate of 14.4% related to total methane production of the biogas plant was observed. This maximum level could be reduced to 5.5%.

[Solitary fibrous tumors of the meninges: report of three cases and literature review]. / Tumor fibroso solitario meníngeo: descripción de tres casos y revisión de la literatura.

We report 3 patients with fibrous solitary tumor of meningeal location where we described the histological study, as well as evolution after the surgical treatment. The described patients presented ages of 37, 52 and 65 years, after the resection has not appeared an objective sign of recurrence in any case after 4, 6 and 7 years of follow-up respectively. Checking the literature the tumor is indistinguishable clinical and radiolocally of the typical meningioma, doing necessary the use of inmunohistochemistry to do the differential diagnosis, where positiveness for CD34 and the negativeness for EMA define the fibrous solitary tumor. It is about a benign tumor, where total removing is the principal factor in prognosis, nevertheless there are cases of local recurrences and long-distance metastasis. We can find all these characteristics in the showed cases of the present article, having the uncertainty of its local or systemic relapse ability in the future.