Effectiveness of thromboprophylaxis with low molecular weight heparin in critically ill patients with COVID-19. An observational prospective, multicenter study.

INTRODUCTION: COVID-19 induces coagulopathy associated with an increase of thromboembolic events. Due to the lack of agreement on recommendations for thromboprophylactic management, the aim of this study was to study the dosages of LMWH used in critically ill COVID-19 patients assessing the effect on their outcome. METHODS: We evaluated data of the Reg-COVID19. According to LMWH dose two groups were analyzed: prophylaxis and treatment. Primary outcome was the relationship of LMWH dosage with mortality. Secondary outcomes included the incidence of thrombotic and bleeding events, length of ICU stay, invasive mechanical ventilation, and thrombotic and inflammatory parameters. RESULTS: Data of 720 patients were analyzed, 258 in the prophylaxis group and 462 in the treatment group. C Reactive Protein, invasive mechanical ventilation, tocilizumab and corticosteroid treatments were related with the choice of LMWH dose. Hemorrhagic events (66/720, 9.2%) and thrombotic complications (69/720, 9.6%) were similar in both groups (p = .819 and p = .265), as was the time course of the thrombotic events, earlier than hemorrhagic ones (9 [3-18] and 12 [6-19] days respectively). Mortality was lower in prophylaxis group (25.2% versus 35.1%), but once an inverse probability weighting model was applied, we found no effect of LMWH dose. CONCLUSION: We found no benefit or harm with the administration of therapeutic or prophylactic LMWH dose in COVID19 critically ill patients. With a similar rate of hemorrhagic or thrombotic events, the LMWH dose had no influence on mortality. More studies are needed to determine the optimal thromboprophylaxis protocol for critically ill patients.

[Effectiveness of thromboprophylaxis with low molecular weight heparin in critically ill patients with COVID-19. An observational prospective, multicenter study]. / Eficacia de la tromboprofilaxis con heparina de bajo peso molecular en pacientes críticos con COVID-19: estudio observacional, prospectivo y multicéntrico.

Introduction: COVID-19 induces coagulopathy associated with an increase of thromboembolic events. Due to the lack of agreement on recommendations for thromboprophylactic management, the aim of this study was to study the dosages of LMWH used in critically ill COVID-19 patients assessing the effect on their outcome. Metohds: We evaluated data of the Reg-COVID19. According to LMWH dose two groups were analyzed: prophylaxis and treatment. Primary outcome was the relationship of LMWH dosage with mortality. Secondary outcomes included the incidence of thrombotic and bleeding events, length of ICU stay, invasive mechanical ventilation, and thrombotic and inflammatory parameters. Results: Data of 720 patients were analyzed, 258 in the prophylaxis group and 462 in the treatment group. C Reactive Protein, invasive mechanical ventilation, tocilizumab and corticosteroid treatments were related with the choice of LMWH dose. Hemorrhagic events (66/720, 9.2%) and thrombotic complications (69/720, 9.6%) were similar in both groups (P=.819 and P=.265), as was the time course of the thrombotic events, earlier than hemorrhagic ones (9 [3-18] and 12 [6-19] days respectively). Mortality was lower in prophylaxis group (25.2% versus 35.1%), but once an inverse probability weighting model was applied, we found no effect of LMWH dose. Conclusion: We found no benefit or harm with the administration of therapeutic or prophylactic LMWH dose in COVID19 critically ill patients. With a similar rate of hemorrhagic or thrombotic events, the LMWH dose had no influence on mortality. More studies are needed to determine the optimal thromboprophylaxis protocol for critically ill patients.

Características, evolución clínica y factores asociados a la mortalidad en UCI de los pacientes críticos infectados por SARS-CoV-2 en España: estudio prospectivo, de cohorte y multicéntrico / Patient characteristics, clinical course and factors associated to ICU mortality in critically ill patients infected with SARS-CoV-2 in Spain: a prospective, cohort, multicentre study

ANTECEDENTES: No se ha reportado plenamente la evolución clínica de los pacientes críticos de COVID-19 durante su ingreso en la unidad de cuidados intensivos (UCI), incluyendo las complicaciones médicas e infecciosas y terapias de soporte, así como su asociación con la mortalidad en ICU. OBJETIVO: El objetivo de este estudio es describir las características clínicas y la evolución de los pacientes ingresados en UCI por COVID-19, y determinar los factores de riesgo de la mortalidad en UCI de dichos pacientes. MÉTODOS: Estudio prospectivo, multi-céntrico y de cohorte, que incluyó a los pacientes críticos de COVID-19 ingresados en 30 UCIs de España y Andorra. Se incluyó a los pacientes consecutivos de 12 de Marzo a 26 de Mayo de 2020 si habían fallecido o habían recibido el alta de la UCI durante el periodo de estudio. Se reportaron los datos demográficos, síntomas, signos vitales, marcadores de laboratorio, terapias de soporte, terapias farmacológicas, y complicaciones médicas e infecciosas, realizándose una comparación entre los pacientes fallecidos y los pacientes dados de alta. RESULTADOS: Se incluyó a un total de 663 pacientes. La mortalidad general en UCI fue del 31% (203 pacientes). Al ingreso en UCI los no supervivientes eran más hipoxémicos [SpO2 sin mascarilla de no reinhalación, de 90 (RIC 83-93) vs 91 (RIC 87-94); p < 0,001] y con mayor puntuación en la escala SOFA - Evaluación de daño orgánico secuencial - [SOFA, 7 (RIC 5-9) vs 4 (RIC 3-7); p < 0,001]. Las complicaciones fueron más frecuentes en los no supervivientes: síndrome de distrés respiratorio agudo (SDRA) (95% vs 89%; p = 0,009), insuficiencia renal aguda (IRA) (58% vs 24%; p < 10−16), shock (42% vs 14%; p < 10−13), y arritmias (24% vs 11%; p < 10−4). Las súper-infecciones respiratorias, infecciones del torrente sanguíneo y los shock sépticos fueron más frecuentes en los no supervivientes (33% vs 25%; p = 0,03, 33% vs 23%; p = 0,01 y 15% vs 3%, p = 10−7), respectivamente. El modelo de regresión multivariable reflejó que la edad estaba asociada a la mortalidad, y que cada año incrementaba el riesgo de muerte en un 1% (95%IC: 1-10, p = 0,014). Cada incremento de 5 puntos en la escala APACHE II predijo de manera independiente la mortalidad [OR: 1,508 (1,081, 2,104), p = 0,015]. Los pacientes con IRA [OR: 2,468 (1,628, 3,741), p < 10−4)], paro cardiaco [OR: 11,099 (3,389, 36,353), p = 0,0001], y shock séptico [OR: 3,224 (1,486, 6,994), p = 0,002] tuvieron un riesgo de muerte incrementado. CONCLUSIONES: Los pacientes mayores de COVID-19 con puntuaciones APACHE II más altas al ingreso, que desarrollaron IRA en grados II o III y/o shock séptico durante la estancia en UCI tuvieron un riesgo de muerte incrementado. La mortalidad en UCI fue del 31%

BACKGROUND: The clinical course of COVID-19 critically ill patients, during their admission in the intensive care unit (UCI), including medical and infectious complications and support therapies, as well as their association with in-ICU mortality has not been fully reported. OBJECTIVE: This study aimed to describe clinical characteristics and clinical course of ICU COVID-19 patients, and to determine risk factors for ICU mortality of COVID-19 patients. METHODS: Prospective, multicentre, cohort study that enrolled critically ill COVID-19 patients admitted into 30 ICUs from Spain and Andorra. Consecutive patients from March 12th to May 26th, 2020 were enrolled if they had died or were discharged from ICU during the study period. Demographics, symptoms, vital signs, laboratory markers, supportive therapies, pharmacological treatments, medical and infectious complications were reported and compared between deceased and discharged patients. RESULTS: A total of 663 patients were included. Overall ICU mortality was 31% (203 patients). At ICU admission non-survivors were more hypoxemic [SpO2 with non-rebreather mask, 90 (IQR 83-93) vs 91 (IQR 87-94); p < 0.001] and with higher sequential organ failure assessment score [SOFA, 7 (IQR 5-9) vs 4 (IQR 3-7); p < 0.001]. Complications were more frequent in non-survivors: acute respiratory distress syndrome (ARDS) (95% vs 89%; p = 0.009), acute kidney injury (AKI) (58% vs 24%; p < 10−16), shock (42% vs 14%; p < 10−13), and arrhythmias (24% vs 11%; p < 10−4). Respiratory super-infection, bloodstream infection and septic shock were higher in non-survivors (33% vs 25%; p = 0.03, 33% vs 23%; p = 0.01 and 15% vs 3%, p = 10−7), respectively. The multivariable regression model showed that age was associated with mortality, with every year increasing risk-of-death by 1% (95%CI: 1-10, p = 0.014). Each 5-point increase in APACHE II independently predicted mortality [OR: 1.508 (1.081, 2.104), p = 0.015]. Patients with AKI [OR: 2.468 (1.628, 3.741), p < 10−4)], cardiac arrest [OR: 11.099 (3.389, 36.353), p = 0.0001], and septic shock [OR: 3.224 (1.486, 6.994), p = 0.002] had an increased risk-of-death. CONCLUSIONS: Older COVID-19 patients with higher APACHE II scores on admission, those who developed AKI grades II or III and/or septic shock during ICU stay had an increased risk-of-death. ICU mortality was 31%

Patient characteristics, clinical course and factors associated to ICU mortality in critically ill patients infected with SARS-CoV-2 in Spain: A prospective, cohort, multicentre study. / Características, evolución clínica y factores asociados a la mortalidad en UCI de los pacientes críticos infectados por SARS-CoV-2 en España: estudio prospectivo, de cohorte y multicéntrico.

BACKGROUND: The clinical course of COVID-19 critically ill patients, during their admission in the intensive care unit (UCI), including medical and infectious complications and support therapies, as well as their association with in-ICU mortality has not been fully reported. OBJECTIVE: This study aimed to describe clinical characteristics and clinical course of ICU COVID-19 patients, and to determine risk factors for ICU mortality of COVID-19 patients. METHODS: Prospective, multicentre, cohort study that enrolled critically ill COVID-19 patients admitted into 30 ICUs from Spain and Andorra. Consecutive patients from March 12th to May 26th, 2020 were enrolled if they had died or were discharged from ICU during the study period. Demographics, symptoms, vital signs, laboratory markers, supportive therapies, pharmacological treatments, medical and infectious complications were reported and compared between deceased and discharged patients. RESULTS: A total of 663 patients were included. Overall ICU mortality was 31% (203 patients). At ICU admission non-survivors were more hypoxemic [SpO2 with non-rebreather mask, 90 (IQR 83 to 93) vs. 91 (IQR 87 to 94); P<.001] and with higher sequential organ failure assessment score [SOFA, 7 (IQR 5 to 9) vs. 4 (IQR 3 to 7); P<.001]. Complications were more frequent in non-survivors: acute respiratory distress syndrome (ARDS) (95% vs. 89%; P=.009), acute kidney injury (AKI) (58% vs. 24%; P<10-16), shock (42% vs. 14%; P<10-13), and arrhythmias (24% vs. 11%; P<10-4). Respiratory super-infection, bloodstream infection and septic shock were higher in non-survivors (33% vs. 25%; P=.03, 33% vs. 23%; P=.01 and 15% vs. 3%, P=10-7), respectively. The multivariable regression model showed that age was associated with mortality, with every year increasing risk-of-death by 1% (95%CI: 1 to 10, P=.014). Each 5-point increase in APACHE II independently predicted mortality [OR: 1.508 (1.081, 2.104), P=.015]. Patients with AKI [OR: 2.468 (1.628, 3.741), P<10-4)], cardiac arrest [OR: 11.099 (3.389, 36.353), P=.0001], and septic shock [OR: 3.224 (1.486, 6.994), P=.002] had an increased risk-of-death. CONCLUSIONS: Older COVID-19 patients with higher APACHE II scores on admission, those who developed AKI grades ii or iii and/or septic shock during ICU stay had an increased risk-of-death. ICU mortality was 31%.

Benign Bilateral Adenomyoepithelioma of the Mammary Gland in a Ring-tailed Lemur (Lemur catta).

Naturally occurring mammary tumours are uncommon in prosimians. A 20-year-old female ring-tailed lemur (Lemur catta) developed bilateral enlargement of the mammary glands. Surgical removal revealed that both masses were comprised of multiple nodules and cystic areas that entirely replaced the normal glands. Histologically, a benign neoplastic biphasic cellular proliferation, composed of luminal-epithelial and basal-myoepithelial components, was identified. Immunohistochemical analysis for expression of cytokeratin (CK) AE1/AE3, CK7, CK5 + 8, CK14, vimentin, p63 and 14-3-3σ highlighted the biphasic nature of the neoplasm. A low mitotic count, low Ki67 labelling index, expression of oestrogen receptor-α, lack of expression of human epidermal growth factor receptor and a 3-year disease-free period without recurrence supported the benign nature of the tumour. Macroscopically, histologically and immunohistochemically this neoplasm resembled benign adenomyoepithelioma of the breast in women. This is the first complete report of a naturally occurring mammary tumour in a ring-tailed lemur.

High-grade astrocytoma (Glioblastoma Multiforme) in an Atlantic spotted dolphin (Stenella frontalis).

This report describes the gross, microscopical and immunohistochemical features of a high-grade astrocytoma (glioblastoma multiforme) in an adult male Atlantic spotted dolphin (Stenella frontalis). On necropsy examination, a 5 × 2.5 × 2 cm, poorly demarcated, red, friable and locally expansile mass effaced the thalamus and the left periventricular region and extended to the left lateral ventricle of the brain. Microscopically, the mass consisted of haphazardly arranged bundles and rows of interweaving polygonal to spindle-shaped cells. These often palisaded along serpentine foci of necrosis and were surrounded by prominent vessels. Immunohistochemically, the neoplastic cells expressed glial fibrillary acidic protein, but not vimentin, S100 protein, neuron-specific enolase or neurofilament protein. A diagnosis of high-grade astrocytoma was made and this represents the first description of a glioma in a cetacean species.

Primary central nervous system T-cell lymphoma in a common dolphin (Delphinus delphis).

This report describes the pathological findings in an adult female short-beaked common dolphin (Delphinus delphis) stranded alive in the Canary Islands. Necropsy examination revealed the presence of a nodular neoplastic growth in the central nervous system (CNS) at the level of the thalamus. Microscopical examination revealed the mass to be a lymphoma and immunohistochemical labelling demonstrated a T-cell origin. No significant lesions were observed in other organs, including lymphoid organs. This is the first report of a primary T-cell lymphoma in the CNS in cetaceans.

[Mortality in patients with multiple injuries: analysis using the trauma and injury severity score in a referral hospital]. / Análisis de la mortalidad en los pacientes politraumatizados según la metodología TRISS en un hospital traumatológico de referencia.

BACKGROUND AND OBJECTIVES: A growing number of patients with multiple injuries are being treated. Injury severity scales can be used to assess outcomes objectively. This study aimed to assess our hospital's cases on the basis of the Trauma and Injury Severity Score (TRISS) and compare outcomes to those reported in the Major Trauma Outcome Study, as well as to determine preventable mortality and analyze causes of death and associated factors. PATIENTS AND METHODS: Data were extracted from the records of patients admitted with multiple injuries in 2005 and were used to calculate the Revised Trauma Score (RTS), the Injury Severity Score (ISS), and the TRISS or probability of survival. Hospital mortality was also calculated. A TRISS between 25 and 50 was considered to indicate a preventable avoidable death; a TRISS over 50 indicated a preventable death. Logistic regression analysis was used to identify factors associated with mortality. RESULTS: We studied the cases of 198 patients with a mean (SD) age of 43.9 (19) years. Ninety-three percent had suffered blunt trauma. The mean ISS, the prehospital RTS, and the TRISS were 16.9 (11.2), 10.8 (2.5), and 0.95 (0.2), respectively. Twenty-five patients died. Fifteen deaths were classified as preventable or potentially preventable. Factors related to exitus were head injury and age (odds ratios, 4.6 and 4.0, respectively). CONCLUSIONS: The rate of preventable death in our hospital was higher than expected. Mortality was strongly associated with head injury and age. The TRISS model can identify preventable deaths objectively.

[Combined regional-general anesthesia with use of the Proseal laryngeal mask during prolonged peripheral plastic surgery]. / Anestesia regional combinada con mascarilla laríngea proseal en cirugía plástica periférica prolongada.

The ProSeal laryngeal mask offers a better interface for controlled ventilation than does a traditional mask because of the ProSeal's improved airway seal and the possibility of draining the digestive tract. Limb reconstructive surgery is normally a long procedure involving the use of grafts or flaps located at a distance from the lesion. Regional anesthesia is therefore of limited use. We report a series of 24 adult patients who underwent peripheral plastic surgery under combined regional and general intravenous anesthesia and in whom the ProSeal mask was used. Data recorded included assessment of the airway and intubation difficulty, disease and duration of the procedure, type of regional anesthesia, respiratory and hemodynamic variables, patient satisfaction, laryngeal complications, and postoperative analgesia. All patients were adequately ventilated. One episode of bradycardia was controlled with atropine. In the immediate postoperative period, no patient presented laryngeal complications and only 1 patient reported significant pain (8 on a visual analog scale). The ProSeal mask was a good choice for use with combined regional-general anesthesia, ensuring control of the airway without causing complications. Analgesia was adequate in most cases.

Análisis de la mortalidad en los pacientes politraumatizados según la metodología TRISS en un hospital traumatológico de referencia / Mortality in patients with multiple injuries: analysis using the Trauma and Injury Severity Score in a referral hospital

OBJETIVOS: Los pacientes politraumatizados representanun grupo creciente. Las escalas de gravedad permitenuna valoración objetiva de los resultados. El objetivode este estudio ha sido comparar la evaluación de lospacientes atendidos en nuestro centro mediante la metodologíadel Trauma and Injury Severity Score (TRISS),con la Major Trauma Outcome Study (MTOS) y determinarla mortalidad evitable, analizando las causas demuerte y los factores asociados con la mortalidad.PACIENTES Y MÉTODOS: Mediante una base de datos delos pacientes politraumatizados ingresados en el año 2005se calculó de manera retrospectiva el Revised Trauma Score(RTS), el Injury Severity Score (ISS), el TRISS o probabilidadde supervivencia (Ps) y la mortalidad hospitalaria.Un valor de TRISS entre 25-50 se consideró “mortalidadpotencialmente evitable” y un valor mayor de 50 “mortalidadevitable”. Se aplicó el análisis de regresión logísticapara ver qué factores se asociaban a la mortalidad.RESULTADOS: Se estudiaron 198 pacientes con una edadpromedio de 43,9 ± 19. El 93% fueron traumatismos cerrados.El ISS, el RTS prehospitalario y el TRISS medio fueronde 16,9 ± 11,2; 10,8 ± 2,5 y 0,95 ± 0,2 respectivamente.Hubo 25 muertes de las cuales 15 se clasificaron como mortalidadevitable o potencialmente evitable. Los factoresrelacionados con el exitus fueron el traumatismo craneoencefálico(Odds ratio 4,6) y la edad (Odds ratio 4,0).CONCLUSIONES: Hallamos una mortalidad evitablemayor de la esperada y una fuerte asociación del traumatismocraneoencefálico y la edad con la mortalidad.El modelo TRISS puede definir de manera objetiva lamortalidad evitable(AU)

BACKGROUND AND OBJECTIVES: A growing number ofpatients with multiple injuries are being treated. Injuryseverity scales can be used to assess outcomesobjectively. This study aimed to assess our hospital’scases on the basis of the Trauma and Injury SeverityScore (TRISS) and compare outcomes to those reportedin the Major Trauma Outcome Study, as well as todetermine preventable mortality and analyze causes ofdeath and associated factors.PATIENTS AND METHODS: Data were extracted from therecords of patients admitted with multiple injuries in2005 and were used to calculate the Revised TraumaScore (RTS), the Injury Severity Score (ISS), and theTRISS or probability of survival. Hospital mortality wasalso calculated. A TRISS between 25 and 50 wasconsidered to indicate a preventable avoidable death; aTRISS over 50 indicated a preventable death. Logisticregression analysis was used to identify factorsassociated with mortality.RESULTS: We studied the cases of 198 patients with amean (SD) age of 43.9 (19) years. Ninety-three percenthad suffered blunt trauma. The mean ISS, theprehospital RTS, and the TRISS were 16.9 (11.2), 10.8(2.5), and 0.95 (0.2), respectively. Twenty-five patientsdied. Fifteen deaths were classified as preventable orpotentially preventable. Factors related to exitus werehead injury and age (odds ratios, 4.6 and 4.0,respectively).CONCLUSIONS: The rate of preventable death in ourhospital was higher than expected. Mortality wasstrongly associated with head injury and age. TheTRISS model can identify preventable deathsobjectively(AU)

Anestesia regional combinada con mascarilla laríngea Proseal encirugía plástica periférica prolongada / Combined regional-general anesthesia with use of the ProSeal laryngeal mask during prolonged peripheral plastic surgery

La mascarilla laríngea Proseal (MLP) supone unamejoría respecto a la clásica (LM) para la ventilacióncontrolada porque mejora el sellado de la vía aérea yposibilita el drenaje de la vía digestiva. La cirugía plásticareconstructiva de extremidades, normalmente esprolongada e implica la utilización de injertos o colgajosa distancia de la lesión, lo que limita que se lleve a cabosólo con anestesia regional. Presentamos 24 pacientesadultos programados para cirugía plástica periférica,sometidos a anestesia regional y general endovenosa conMLP. Recogimos: valoración y dificultad de abordaje dela vía aérea, patología y duración del procedimiento,tipo de anestesia regional, datos ventilatorios y hemodinámicos,satisfacción de los pacientes, morbilidad laríngeay analgesia postoperatorias.Todos los pacientes se ventilaron correctamente, unopresentó bradicardia puntual que se controló con atropina.En el postoperatorio inmediato, ningún pacientemanifestó morbilidad laríngea y sólo uno tuvo dolorimportante con un EVA de 8.La anestesia combinada regional y general con MLPsupuso una buena opción en esta cirugía ya que aseguróel control de la vía aérea sin provocar morbilidad y logróuna analgesia postoperatoria correcta en la mayoría decasos (AU)

The ProSeal laryngeal mask offers a better interface forcontrolled ventilation than does a traditional maskbecause of the ProSeal’s improved airway seal and thepossibility of draining the digestive tract. Limbreconstructive surgery is normally a long procedureinvolving the use of grafts or flaps located at a distancefrom the lesion. Regional anesthesia is therefore of limiteduse. We report a series of 24 adult patients who underwentperipheral plastic surgery under combined regional andgeneral intravenous anesthesia and in whom the ProSealmask was used. Data recorded included assessment of theairway and intubation difficulty, disease and duration ofthe procedure, type of regional anesthesia, respiratory andhemodynamic variables, patient satisfaction, laryngealcomplications, and postoperative analgesia. All patientswere adequately ventilated. One episode of bradycardiawas controlled with atropine. In the immediatepostoperative period, no patient presented laryngealcomplications and only 1 patient reported significant pain(8 on a visual analog scale). The ProSeal mask was a goodchoice for use with combined regional-general anesthesia,ensuring control of the airway without causingcomplications. Analgesia was adequate in most cases (AU)

Vincristine impairs platelet aggregation in dogs with lymphoma.

Platelet aggregation before and after administration of 0.5 mg/m2 of vincristine (VCR) was evaluated in 7 dogs with spontaneously occuring lymphoma. Aggregation on platelet-rich plasma separated from blood collected in 3.8% sodium citrate was performed using adenosine diphosphate (ADP), arachidonic acid (AA), and collagen (COL) as agonists. The slope for aggregation in response to ADP was significantly lower after administration of VCR (P = .032). Maximal aggregation after administration of VCR was significantly lower in response to ADP, COL, and AA (P = .03, P = .04, and P = .03, respectively).

[Technical considerations for the massive practice of hair transplantation]. / Consideraciones técnicas para la práctica masiva de los trasplantes de cabello

Based upon his broad experience of over 2.000 transplant operations, the author notes the frequent patients refusals of multiple sessions and suggests adaptations of the Orentreich technique, to obtain a new modified single session operation allowing insertion of up to 250 to 300 hair plugs. After giving a detailed description of the technical modifications related to the anesthesia, hemostasis, biological integrity of the transplants, local blood supply and other problems, which had to be solved in order to obtain valid results within a record time, the author presents his final results.

[Experimental studies on seborrheic alopecia. II. Determination of the structural differences between testosterone transported cytosol protein of the bald and hairy areas]. / Estudios experimentales sobre la alopecia seborreica. II. Determinación de las diferencias estructurales entre la proteína citosol transportadora de la testosterona de las zonas pilosas y alopécicas

By previous isolation of the testosterone transport cytosol protein in bald and hairy areas in patients with male pattern baldness, the author studies the differences concerning the protein citosol-testosterone complex, after fixation by means of labelled testosterone and electrophoresis, measuring the corresponding radioactivity curves. The results show that there are important structural differences for the cytosol protein between the hairy and bald regions.

[Experimental studies on seborheric alopecia. III. Localization of testosterone receptors in human hairy follicles]. / Estudios experimentales sobre la alopecia seborréica. III. Localización de los receptores de la testosterona en folículos pilosos humanos

The author studies the location of the testosterone receptors in huamn hair follicles, by means of the isolation of the two most outstanding fractions of the pilosebaceous follicle, i.e., hair follicle and sebaceous gland. The two fractions were obtained by micro-dissection, homogenisation by separate, and isolation of the correspondig cytosol fraction. It was demonstrated that the two fractions possess the same binding activity against the andreogen tested.