Frecuencia y tipología del segundo conducto mesiovestibular en primeros molares superiores / Frequency and typology of the second mesiobuccal canal in maxillary first molars

Objetivos: Evaluar mediante microscopia quirúrgica la presencia del segundo conducto mesiovestibular (MV2) en el piso de la cámara pulpar de los primeros molares superiores, determinar su abordabilidad, establecer el calibre de lima que llegó al tercio apical y tipificar radiovisiográficamente su morfología se-gún la clasificación de Weine. Materiales y métodos: Se utilizaron 48 primeros molares superiores huma-nos extraídos. Sé tomaron radiovisografías preope-ratorias (Carestream 5200) en sentido orto radial y mesio-distal. Se realizó apertura y se localizó entra-da del MV2 con microscopio quirúrgico (Newton MEC XXI, Argentina) a 16 x. Se cateterizó MV1 y MV2 con limas tipo K #10 y #15 (Dentsply Maillefer). Se cortó raíz distovestibular para mejorar visualización ra-diovisográfica. Se tomó conductometria en sentido mesio-distal para establecer la tipología. Se compa-raron frecuencias y porcentajes mediante test de Chi-cuadrado con corrección de Yates, prueba exac-ta de Fisher y test z para diferencia de proporcio-nes. Se calcularon intervalos de confianza 95% para porcentajes mediante método score de Wilson. Re-sultados: El 54% (26 casos) presentó MV2. De los 26 MV2, el 77% (20 casos) fueron abordables, porcen-taje significativamente mayor al 23% no abordable (z=3,62; P<0,05). Al hacer cateterismo, hubo asocia-ción significativa entre tipo de conducto (MV1 y MV2) y calibre de lima que llegó al tercio apical (Chi-cua-drado=29,12; gl=1; P<0,05). La tipología I (58%) fue significativamente mayor que las tipologías II (21%) y III (21%) (P<0,05 para ambas comparaciones). Con-clusión: El alto porcentaje de piezas que presentó MV2 evidencia la importancia clínica de detectarlo y tratarlo correctamente. Dado el alto porcentaje de piezas donde fue abordable, se concluye que el clíni-co debe tener conocimiento, destreza y la tecnología necesaria para poder abordarlo. Si bien la tipología I (58%) fue la más encontrada, cuando el MV2 termina en foramen independiente (tipo III), su omisión puede conducir al fracaso del tratamiento (AU))

Objectives: To evaluate by surgical microscopy the presence of second mesiobuccal canal (MB2) in the pulp chamber floor of the maxillary first molars, determine its approachability, establish the caliber of the file that reached the apical third, and radiographically typify its morphology according to Weine ́s classification. Materials and methods: 48 extracted human maxillary first molars were used. Preoperative radiovisographies (Carestream 5200) were taken in ortho-radial and mesio-distal direction. Coronal access was made and the entrance of MB2 was located with a surgical microscope (Newton MEC XXI, Argentina) at 16x. MB1 and MB2 were catheterized with K files #10 and #15 (Dentsply Maillefer). Distobuccal root was cut to improve radiovisographic visualization. Conductometry was taken in mesio-distal direction to establish the typology. Frequencies and percentages were compared using Chi-square test with Yates correction, Fisher's exact test and z test for difference in proportions. 95% confidence intervals were calculated for percentages using Wilson score method. Results: 54% (26 cases) presented MB2. Of the 26 MB2, 77% (20 cases) were approachable, a significantly higher percentage than those not approachable (z=3.62; P<0.05). When performing catheterization, there was a significant association between type of canal (MB1 and MB2) and file caliber that reached the apical third (Chi-square=29.12; df=1; P<0.05). Typology I (58%) was significantly higher than typologies II (21%) and III (21%) (P<0.05 for both comparisons). Conclusion: The high percentage of specimens that showed MB2 evidence the clinical importance of detecting and treating it correctly. Given the percentage of pieces where it was approachable (77%), it is concluded that the clinician must have the knowledge, skill and necessary technology to be able to approach it. Although typology I (58%) was the most found, when MB2 ends an independent foramen (type III), its omission can lead to treatment failure (AU)

Large-scale real-life analysis of survival and usage of therapies in multiple myeloma.

Survival in multiple myeloma has improved significantly in recent years, especially in young patients. We reviewed the evolution of the survival of patients with MM in three groups based on age at MM diagnosis over three time periods between 1999 and 2020 at our 12 de Octubre Hospital institution (H12O). Then, to confirm our results, we used data from TriNetx, a global health research platform that includes patients from Europe to US. Finally, we analysed differences in the patterns of treatment between networks across the world. Kaplan‒Meier analysis was used to estimate survival probabilities, and between-group differences were tested using the log-rank test and hazard ratio. For patients from H12O, the median OS was 35.61, 55.59 and 68.67 months for the 1999-2009, 2010-2014 and 2015-2020 cohorts, respectively (p = 0.0001). Among all patients included in the EMEA network, the median OS was 20.32 months versus 34.75 months from 1999-2009 versus 2010-2014. The median OS from the 2010-2014 versus 2015-2020 time cohorts was 34.75 months versus 54.43 months, respectively. In relation to the US cohort, the median OS from before 2010 versus 2010-2014 was not reached in either time cohort and neither when comparing the 2010-2014 versus 2015-2019 time cohorts. Bortezomib is the most commonly used drug in the EMEA cohort, while lenalidomide is the most commonly used drug in the US cohort. This large-scale study based on real-world data confirms the previous finding that MM patients have increased their survival in the last two decades.

Influencia de la inteligencia emocional percibida, la ansiedad y el estrés sobre la presencia de síntomas depresivos en estudiantes de medicina chilenos/as

Introducción: La inteligencia emocional facilita la gestión de emociones displacenteras, no obstante, su rol respecto de síntomas depresivos en estudiantes de medicina está aún en estudio y no está claro el peso que la inteligencia emocional tiene sobre este tipo de sintomatología. Objetivo: Analizar la relación entre los factores de la inteligencia emocional percibida y la sintomatología depresiva, ansiosa y estrés, en estudiantes de primer y sexto año de medicina. Método: con un diseño transversal expostfacto y un análisis Rlog hacia atrás, se observó la asociación entre la inteligencia emocional con la depresión en los estudiantes. Resultados: el único factor de la inteligencia emocional que explicó la presencia de síntomas depresivos fue la regulación emocional (Exp B= ,258: IC= 95%; ,128-,519; p=,000). También se identificó que la ansiedad y el estrés explicaron una proporción importante de la varianza de los síntomas depresivos (R2 Nagelkerke=,426) y que la presencia de cada uno de ellos aumentaba la probabilidad de presentar esta sintomatología. Conclusiones: Los datos muestran la importancia de la regulación emocional, la ansiedad y el estrés como predictores en la intensidad de la sintomatología depresiva en estudiantes de medicina, así como la diferenciación por sexo en la presencia de síntomas depresivos.

Introduction: Emotional intelligence facilitates the management of unpleasant emotions, however, emotional intelligence's role regarding the presence of depressive symptoms in medical students is still being studied, and it is not clear the relevance of emotional intelligence might have on this type of symptomatology. Objective: Analyze the relationship between factors of the perceived emotional intelligence and the presence of depressive and anxious symptoms and stress in first- and sixth-year medical students. Methods: Using a ex post facto design and a log-backward analysis the association between emotional intelligence factors and depression in students was observed. Results: The only emotional intelligence factor that explained the presence of depressive symptoms was emotional regulation (Exp B= ,258: CI= 95%; ,128-,519; p=,000). It was also identified that anxiety and stress explained a significant proportion of the variance of depressive symptoms (R2 Nagelkerke=,426) and that the presence of each of them increased the probability of presenting this symptomatology. Conclusions: The data show the importance of the emotional regulation, as a predictor of the intensity of depressive symptomatology in medical student. Also, of other variables included in the model such as: stress and anxiety symptoms and gender differentiation in the presence of depressive symptoms.

Metabolomics Highlights Different Life History Strategies of White and Brown Rot Wood-Degrading Fungi.

White and brown rot fungi efficiently deconstruct lignocellulose in wood, Earth's largest pool of aboveground biotic carbon and an important natural resource. Despite its vital importance, little is known about the metabolomic signatures among fungal species and nutritional modes (rot types). In this study, we used GC-MS metabolomics in solid wood substrates (in planta) to compare brown rot fungi (Rhodonia placenta and Gloeophylum trabeum) and white rot fungi (Trametes versicolor and Pleurotus ostreatus) at two decay stages (earlier and later), finding identifiable patterns for brown rot fungi at later decay stages. These patterns occurred in highly reducing environments that were not observed in white rot fungi. Metabolomes measured among the two white rot fungi were notably different, but we found a potential biomarker compound, galactitol, that was characteristic to white rot taxa. In addition, we found that white rot fungi were more efficient at catabolizing phenolic compounds that were originally present in wood. Collectively, white rot fungi were characterized by measured sugar release relative to higher carbohydrate solubilization by brown rot fungi, a distinction in soluble sugar availability that might shape success in the face of "cheater" competitors. This need to protect excess free sugars may explain the differentially high brown rot fungal production of pyranones and furanones, likely linked to an expansion of polyketide synthase genes. IMPORTANCE Despite the ecological and economic importance of wood-degrading fungi, little is known about the array of metabolites that fungi produce during wood decomposition. This study provides an in-depth insight into the wood decomposition process by analyzing and comparing the changes of >100 compounds produced by fungi with metabolic distinct nutritional modes (white and brown rot fungi) at different decay stages. We found a unique pattern of metabolites that correlated well with brown rot (carbohydrate selective mode) in later decay. These compounds were in line with some of the physiochemical and genetic features previously seen in these fungi such as a faster sugar release, lower pH, and the expansion of polyketide-synthase genes compared to white rot fungi (lignin-degrading mode). This study provides spatiotemporally resolved mechanism insights as well as critical groundwork that will be valuable for studies in basic biology and ecology, as well as applied biomass deconstruction and bioremediation.

[Impact of social network use on anorexia and bulimia in female adolescents: a systematic review].

Systematic review of published studies on the impact of social networks (SN) use on anorexia and bulimia in female adolescents. We selected articles published over the past 10 years, written in English, Spanish or Portu-guese found in The Cochrane Library Plus, PubMed, WOS, PsycINFO, and Scopus databases and with enough methodological quality. Nine studies were included in this review with a sample of 2,069 adolescents; 75.3% were female, mean age was 18 years, and mostly used Facebook and Instagram. Despite some positive aspects, SNs promote beauty standards in terms of thinness, allow comparisons between peers increasing concerns about weight, and create spaces that encourage anorexia and bulimia. Therefore, SN use plays a role in the development of eating disorders. The promotion of extreme thinness in girls makes this population more vulnerable.

Predictores de discapacidad en una cohorte con espectro de neuromielitis óptica / Predictors of disability in a cohort with neuromyelitis optica spectrum

Introducción: La discapacidad en el espectro de neuromielitis óptica (NMOSD) es frecuente y puede ser grave. Objetivo: Determinar factores asociados a mayor discapacidad en el NMOSD. Pacientes y métodosEstudio observacional, analítico, ambispectivo, en una cohorte de pacientes con NMOSD entre enero de 2015 y julio de 2021, utilizando una fuente secundaria para la revisión de variables y la escala extendida de discapacidad (EDSS) después del inicio y una fuente primaria, con una encuesta telefónica para la EDSS final y los datos faltantes. Se definió la discapacidad mayor cuando la puntuación de la EDSS era = 6. El análisis se realizó por medio de regresión logística con SPSS 25®. Resultados: Se analizó a 125 pacientes. La edad promedio de inicio fue 41 (desviación estándar: 14) años, con una relación mujer:hombre de 8:1. El 87% (109) era positivo para anticuerpos antiacuaporinas. La neuritis óptica (44,8%) y la mielitis transversa (39,2%) fueron las manifestaciones clínicas más frecuentes en el inicio. El 71,2% de los pacientes recibió tratamiento agudo en la primera recaída. La mediana de inicio del tratamiento crónico fue de 12 meses (rango intercuartílico: 3-60) y el 44% tuvo dificultades en el cumplimiento de la inmunosupresión. El 80,8% presentó recaídas y el 44% tenía una puntuación en la EDSS final = 6. La mediana de EDSS basal-final fue de 1 (rango intercuartílico, 0-3), con frecuencia hacia la acumulación de discapacidad. Se encontró asociación entre el curso con recaídas (odds ratio = 3,73; p = 0,011) y la EDSS basal alta (odds ratio = 1,54; p = 0,001) con una mayor discapacidad. En el análisis multivariado, una mayor EDSS basal y un curso con recaídas presentaron una probabilidad de discapacidad 1,6 y 5,3 veces mayor, respectivamente. Conclusiones: Las recaídas de la enfermedad y la EDSS alta después del primer episodio son predictores de discapacidad en el NMOSD.(AU)

Introduction: Disability in neuromyelitis optica spectrum disorder (NMOSD) is common and can be severe. Aim: To determine factors associated with increased disability in NMOSD. Patients and methods. Observational, analytical, ambispective study in a cohort of patients with NMOSD between January 2015 and July 2021, using a secondary source to review variables and the expanded disability status scale (EDSS) after onset and a primary source, with a telephone survey for the final EDSS and missing data. Major disability was defined as occurring when the EDSS score was ≥ 6. The analysis was performed by means of logistic regression with SPSS 25®. Results: A total of 125 patients were analysed. The average age at onset was 41 (standard deviation: 14) years, with a female-to-male ratio of 8:1. Of the total sample, 87% (109) were positive for anti-aquaporin antibodies. Optic neuritis (44.8%) and transverse myelitis (39.2%) were the most frequent clinical manifestations at onset. Altogether 71.2% of patients received acute treatment at their first relapse. Mean chronic treatment initiation was 12 months (interquartile range: 3-60) and 44% had difficulties with immunosuppression compliance. Of the total number of patients, 80.8% had relapses and 44% had a final EDSS score = 6. The median baseline-to-final EDSS score was 1 (interquartile range: 0-3), often towards disability accumulation. An association was found between a relapsing course (odds ratio = 3.73; p = 0.011) and a high baseline EDSS (odds ratio = 1.54; p = 0.0001) with increased disability. In the multivariate analysis, with a higher baseline EDSS and a relapsing course disability was 1.6 and 5.3 times more likely to occur, respectively. Conclusions: Disease relapses and high EDSS after the first episode are predictors of disability in NMOSD.(AU)

Influencia de las redes sociales sobre la anorexia y la bulimia en las adolescentes: una revisión sistemática / Impact of social network use on anorexia and bulimia in female adolescents: a systematic review

Se realizó una revisión sistemática de los estudios que han investigado la influencia de las redes sociales (RRSS) sobre las adolescentes en relación a la anorexia y bulimia nerviosa. Se seleccionaron artículos publicados en inglés, español o portugués en las bases de datos The Cochrane Library Plus, PubMed, WOS, PsycINFO y Scopus en los diez últimos años, con calidad suficiente. Se incluyeron nueve estudios con una muestra de 2.069 adolescentes (75,3% mujeres) de edad media 18 años, que utilizaban principalmente Facebook e Instagram. A pesar de algunos aspectos positivos, las RRSS promueven cánones de belleza basados en la delgadez, permiten la comparación entre iguales incrementando la preocupación por el peso, y crean espacios que fomentan los trastornos de la conducta alimentaria. Por tanto, las RRSS influyen en el desarrollo de trastornos de la conducta alimentaria y al promover la extrema delgadez en las chicas, las hace más vulnerables.(AU)

Systematic review of published studies on the impact of social networks (SN) use on anorexia and bulimia in female adolescents. We selected articles published over the past 10 years, written in English, Spanish or Portuguese found in The Cochrane Library Plus, PubMed, WOS, PsycINFO, and Scopus databases and with enough methodological quality. Nine studies were included in this review with a sample of 2,069 adolescents; 75.3% were female, mean age was 18 years, and mostly used Facebook and Instagram. Despite some positive aspects, SNs promote beauty standards in terms of thinness, allow comparisons between peers increasing concerns about weight, and create spaces that encourage anorexia and bulimia. Therefore, SN use plays a role in the development of eating disorders. The promotion of extreme thinness in girls makes this population more vulnerable.(AU)

[Predictors of disability in a cohort with neuromyelitis optica spectrum]. / Predictores de discapacidad en una cohorte con espectro de neuromielitis óptica.

INTRODUCTION: Disability in neuromyelitis optica spectrum disorder (NMOSD) is common and can be severe. AIM: To determine factors associated with increased disability in NMOSD. PATIENTS AND METHODS: Observational, analytical, ambispective study in a cohort of patients with NMOSD between January 2015 and July 2021, using a secondary source to review variables and the expanded disability status scale (EDSS) after onset and a primary source, with a telephone survey for the final EDSS and missing data. Major disability was defined as occurring when the EDSS score was = 6. The analysis was performed by means of logistic regression with SPSS 25®. RESULTS: A total of 125 patients were analysed. The average age at onset was 41 (standard deviation: 14) years, with a female-to-male ratio of 8:1. Of the total sample, 87% (109) were positive for anti-aquaporin antibodies. Optic neuritis (44.8%) and transverse myelitis (39.2%) were the most frequent clinical manifestations at onset. Altogether 71.2% of patients received acute treatment at their first relapse. Mean chronic treatment initiation was 12 months (interquartile range: 3-60) and 44% had difficulties with immunosuppression compliance. Of the total number of patients, 80.8% had relapses and 44% had a final EDSS score = 6. The median baseline-to-final EDSS score was 1 (interquartile range: 0-3), often towards disability accumulation. An association was found between a relapsing course (odds ratio = 3.73; p = 0.011) and a high baseline EDSS (odds ratio = 1.54; p = 0.0001) with increased disability. In the multivariate analysis, with a higher baseline EDSS and a relapsing course disability was 1.6 and 5.3 times more likely to occur, respectively. CONCLUSIONS: Disease relapses and high EDSS after the first episode are predictors of disability in NMOSD.

TITLE: Predictores de discapacidad en una cohorte con espectro de neuromielitis óptica.Introducción. La discapacidad en el espectro de neuromielitis óptica (NMOSD) es frecuente y puede ser grave. Objetivo. Determinar factores asociados a mayor discapacidad en el NMOSD. Pacientes y métodos. Estudio observacional, analítico, ambispectivo, en una cohorte de pacientes con NMOSD entre enero de 2015 y julio de 2021, utilizando una fuente secundaria para la revisión de variables y la escala extendida de discapacidad (EDSS) después del inicio y una fuente primaria, con una encuesta telefónica para la EDSS final y los datos faltantes. Se definió la discapacidad mayor cuando la puntuación de la EDSS era = 6. El análisis se realizó por medio de regresión logística con SPSS 25®. Resultados. Se analizó a 125 pacientes. La edad promedio de inicio fue 41 (desviación estándar: 14) años, con una relación mujer:hombre de 8:1. El 87% (109) era positivo para anticuerpos antiacuaporinas. La neuritis óptica (44,8%) y la mielitis transversa (39,2%) fueron las manifestaciones clínicas más frecuentes en el inicio. El 71,2% de los pacientes recibió tratamiento agudo en la primera recaída. La mediana de inicio del tratamiento crónico fue de 12 meses (rango intercuartílico: 3-60) y el 44% tuvo dificultades en el cumplimiento de la inmunosupresión. El 80,8% presentó recaídas y el 44% tenía una puntuación en la EDSS final = 6. La mediana de EDSS basal-final fue de 1 (rango intercuartílico, 0-3), con frecuencia hacia la acumulación de discapacidad. Se encontró asociación entre el curso con recaídas (odds ratio = 3,73; p = 0,011) y la EDSS basal alta (odds ratio = 1,54; p = 0,001) con una mayor discapacidad. En el análisis multivariado, una mayor EDSS basal y un curso con recaídas presentaron una probabilidad de discapacidad 1,6 y 5,3 veces mayor, respectivamente. Conclusiones. Las recaídas de la enfermedad y la EDSS alta después del primer episodio son predictores de discapacidad en el NMOSD.

Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study.

OBJECTIVE: The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. DESIGN: Prospective descriptive multicenter cohort study. SETTING: 26 Intensive care units (ICU) from Andalusian region in Spain. PATIENTS OR PARTICIPANTS: Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. INTERVENTIONS: None. VARIABLES: Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. RESULTS: 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor. CONCLUSION: Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.

Impact of COVID-19 in patients with multiple myeloma based on a global data network.

The COVID-19 pandemic has represented a major cause of morbidity/mortality worldwide, overstressing health systems. Multiple myeloma (MM) patients show an increased risk for infections and they are expected to be particularly vulnerable to SARS-CoV-2 infection. Here we have obtained a comprehensive picture of the impact of COVID-19 in MM patients on a local and a global scale using a federated data research network (TriNetX) that provided access to Electronic Medical Records (EMR) from Health Care Organizations (HCO) all over the world. Through propensity score matched analyses we found that the number of new diagnoses of MM was reduced in 2020 compared to 2019 (RR 0.86, 95%CI 0.76-0.96) and the survival of newly diagnosed MM cases decreased similarly (HR 0.61, 0.38-0.81). MM patients showed higher risk of SARS-CoV-2 infection (RR 2.09, 1.58-2.76) and a higher excess mortality in 2020 (difference in excess mortality 9%, 4.4-13.2) than non-MM patients. By interrogating large EMR datasets from HCO in Europe and globally, we confirmed that MM patients have been more severely impacted by COVID-19 pandemic than non-MM patients. This study highlights the necessity of extending preventive measures worlwide to protect vulnerable patients from SARS-CoV-2 infection by promoting social distancing and an intensive vaccination strategies.

Estancia hospitalaria y funcionalidad en pacientes con retraso en el inicio de tratamiento de fisioterapia / Length of hospital stay and functional status in patients with delayed start of physical therapy

Objetivo Evaluar la asociación entre la estancia hospitalaria, funcionalidad alcanzada y el tiempo hasta el inicio del tratamiento fisioterapéutico en los pacientes admitidos a un servicio de cirugía de un hospital de alta complejidad. Materiales y métodos Estudio observacional, analítico de corte transversal. Se incluyeron 279 personas (124 mujeres). Los días de retraso en el inicio de fisioterapia, los días cama, la estancia hospitalaria prolongada (percentil 75 de días cama), y el nivel funcional fueron registrados para investigar la influencia del retraso en el inicio de atención fisioterapéutica sobre estas variables. Resultados El número de días de retraso de atención fisioterapéutica estuvo altamente relacionado con el número de días cama (r2 = 0,74, p < 0,05). A su vez, un retraso mayor a cinco días en el inicio de atención fisioterapéutica se asocia al desarrollo de estancias hospitalarias prolongadas (p < 0,05). Sin embargo, la fisioterapia tuvo efectos similares sobre el nivel funcional, aun con retraso en su inicio (p > 0,05). Conclusiones Retrasos en el inicio de atención fisioterapéutica se asociaron con estancias hospitalarias prolongadas en pacientes admitidos a un servicio de cirugía de un hospital de alta complejidad. Futuros estudios deberían investigar los factores asociados a este fenómeno (AU)

Objective To evaluate the association between hospital stay, functional status and physical therapy delay (PT delay) in patients admitted to a surgery unit of a high complexity hospital. Materials and methods Observational, analytic and cross-sectional study. We included 279 patients (124 women). Days of PT delay (calculated as the difference between hospital admission and start of PT), days of bed rest, prolonged hospital stay (75th percentile of bed rest days), and functional status were registered to investigate the influence of PT delay on these variables. Results The number of days of PT delay was strongly associated with the number of bed rest days (r2 = 0.74, p < 0.05). Moreover, a PT delay of five days or more was associated with extended lengths of stay in our sample (p < 0.05). However, physical therapy had similar effects on functional status, even when there were PT delays (p > 0.05). Conclusions PT delay is associated with extended length of stay in patients admitted to a surgery unit of a high complexity hospital. Future studies should investigate the associated factors that could explain the occurrence of PT delays in surgical patients (AU)

Predictive factors of six-week mortality in critically ill patients with SARS-CoV-2: A multicenter prospective study.

OBJECTIVE: The objective of the study is to identify the risk factors associated with mortality at six weeks, especially by analyzing the role of antivirals and munomodulators. DESIGN: Prospective descriptive multicenter cohort study. SETTING: 26 Intensive care units (ICU) from Andalusian region in Spain. PATIENTS OR PARTICIPANTS: Consecutive critically ill patients with confirmed SARS-CoV-2 infection were included from March 8 to May 30. INTERVENTIONS: None. VARIABLES: Variables analyzed were demographic, severity scores and clinical condition. Support therapy, drug and mortality were analyzed. An univariate followed by multivariate Cox regression with propensity score analysis was applied. RESULTS: 495 patients were enrolled, but 73 of them were excluded for incomplete data. Thus, 422 patients were included in the final analysis. Median age was 63 years and 305 (72.3%) were men. ICU mortality: 144/422 34%; 14 days mortality: 81/422 (19.2%); 28 days mortality: 121/422 (28.7%); 6-week mortality 152/422 36.5%. By multivariable Cox proportional analysis, factors independently associated with 42-day mortality were age, APACHE II score, SOFA score at ICU admission >6, Lactate dehydrogenase at ICU admission >470U/L, Use of vasopressors, extrarenal depuration, %lymphocytes 72h post-ICU admission <6.5%, and thrombocytopenia whereas the use of lopinavir/ritonavir was a protective factor. CONCLUSION: Age, APACHE II, SOFA>value of 6 points, along with vasopressor requirements or renal replacement therapy have been identified as predictor factors of mortality at six weeks. Administration of corticosteroids showed no benefits in mortality, as did treatment with tocilizumab. Lopinavir/ritonavir administration is identified as a protective factor.

Granulomas in Dermatopathology: Principal Diagnoses - Part 1. / Granulomas en dermatopatología: principales entidades. Parte I.

This series of 2 articles on dermatopathologic diagnoses reviews conditions in which granulomas form. Part 1 clarifies concepts, discusses the presentation of different types of granulomas and giant cells, and considers a large variety of noninfectious diseases. Some granulomatous diseases have a metabolic origin, as in necrobiosis lipoidica. Others, such as granulomatous mycosis fungoides, are related to lymphomas. Still others, such as rosacea, are so common that dermatologists see them nearly daily in clinical practice.

Granulomas in Dermatopathology: Principal Diagnoses - Part 2. / Granulomas en dermatopatología: principales entidades. Parte II.

Part 2 of this series on granulomatous diseases focuses on skin biopsy findings. Whereas the first part treated noninfectious conditions (metabolic disorders and tumors, among other conditions), this part mainly deals with various types of infectious disease along with other conditions seen fairly often by clinical dermatologists.

Dermatopatología de la oclusión intraluminal vascular: parteII (coagulopatías, émbolos y miscelánea) / Clinical and Histopathologic Characteristics of the Main Causes of Vascular Occusion - Part II: Coagulation Disorders, Emboli, and Other

La patología vascular oclusiva es causante de diversas y variadas manifestaciones clínicas, algunas de ellas con catastróficas consecuencias para el paciente. Dado que las causas de tal oclusión son muy variadas, hemos abordado en un artículo previo reciente en esta misma revista las causas trombóticas. En el presente artículo recopilamos diversas causas adicionales de oclusión intravascular

Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. It also has a wide variety of causes, including thrombi, which we recently addressed in part I of this review. In this second part, we look at additional causes of vascular occlusion

Dermatopatología de la oclusión intraluminal vascular: parte I (trombos) / Clinical and Histopathologic Characteristics of the Main Causes of Vascular Occlusion - Part I: Thrombi

La patplogía vascular oclusiva es causante de diversas y variadas manifestaciones clínicas, algunas de las cuales son de catastróficas consecuencias para el paciente. Sin embargo, las causas de tal oclusión son muy variadas, extendiéndose desde trombos por acción descontrolada de los mecanismos de coagulación, hasta anomalías de los endotelios de los vasos u oclusión por materiales extrínsecos. En una serie de dos artículos hacemos una revisión de las principales causas de oclusión vascular, resumiendo sus manifestaciones clínicas principales y los hallazgos histopatológicos fundamentales. Esta primera parte corresponde a las oclusiones vasculares que cursan con trombos

Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. The causes of vascular occlusion are also highly variable, ranging from thrombi triggered by the uncontrolled activation of coagulation mechanisms, on the one hand, to endothelial dysfunction or occlusion by material extrinsic to the coagulation system on the other. In a 2-part review, we look at the main causes of vascular occlusion and the key clinical and histopathologic findings. In this first part, we focus on vascular occlusion involving thrombi