BCGitis con afectación de aneurisma aortoilíaco: aportación de dos casos y revisión de la literatura / BCGitis with aortoiliac aneurysm involvement: Report of two cases and review of the literature

La BCGitis es una complicación infrecuente del tratamiento intravesical con Bacillus Calmette-Guérin para el cáncer superficial de vejiga de alto grado y el carcinoma in situ. Puede causar afectación vascular. Presentamos 2 casos y una revisión de la literatura de series de casos publicadas en los 10 años previos a la finalización de este trabajo en abril de 2022, que describiesen un caso de aneurisma micótico aortoilíaco tras recibir este tratamiento. De los 51 casos incluidos (49 revisados y 2 originales), el 100% eran hombres, 82% tenían más de 65 años. La mediana del período de latencia fue de 15 meses (RIQ 18). La localización más frecuente fue la aorta abdominal, documentándose rotura en el 45,1%. El síntoma más frecuente fue dolor abdominal o lumbar (61%), seguido de síndrome general (49%). Asoció absceso retroperitoneal un 39,2%. La mortalidad atribuible fue de 13,6%. La BCGitis debería incluirse como diagnóstico diferencial de pacientes que hayan recibido terapia con BCG y presenten afectación vascular, incluso años tras el tratamiento.(AU)

BCGitis is a rare complication after intravesical administration of Bacillus Calmette-Guérin for high-grade superficial bladder cancer and carcinoma in situ. May cause vascular involvement. We present two cases and a review of the literature of the case reports published on the 10 years prior to April of 2022, when this project was finished, which described a case of aortoiliac mycotic aneurysm after receiving this treatment. Of the 51 cases included (49 revised and 2 original), 100% were men, 82% were older than 65 years. The median latency period was 15 months (IQR 18). The most frequent location was the abdominal aorta, rupture occurred in 45.1% of patients. The most frequent symptom was abdominal or lumbar pain (61%), followed by general syndrome (49%). In 39.2% cases, it was associated with retroperitoneal abscesses. Attributable mortality was 13.6%. BCGitis should be included in the differential diagnosis in patients who have received BCG therapy and present vascular involvement, even years after being treated.(AU)

BCGitis with aortoiliac aneurysm involvement: Report of two cases and review of the literature.

BCGitis is a rare complication after intravesical administration of Bacillus Calmette-Guérin for high-grade superficial bladder cancer and carcinoma in situ. May cause vascular involvement. We present 2 cases and a review of the literature of the case reports pubished on the 10 years prior to April of 2022, when this proyect was finished, which described a case of aortoiliac mycotic aneurysm after receiving this treatment. Of the 51 cases included (49 revised and 2 original), 100% were men, 82% were older than 65 years. The median latency period was 15 months (IQR 18). The most frequent location was the abdominal aorta, rupture occurred in 45,1% of patients. The most frequent symptom was abdominal or lumbar pain (61%), followed by general syndrome (49%). In 39,2% cases, it was associated with retroperitoneal abscesess. Attributable mortality was 13,6%. BCGitis should be included in the differential diagnosis in patients who have received BCG therapy and present vascular involvement, even years after being treated.

Assessment of Post-COVID Symptoms Using the C19-YRS Tool in a Cohort of Patients from the First Pandemic Wave in Northwestern Spain.

Introduction: The emergence or persistence of symptoms after acute SARS-CoV-2 infection has made it necessary to develop tools to detect them and assess their impact on patients' quality of life. One of these tools is the COVID-19 Yorkshire Rehabilitation Screening (C19-YRS) scale. We present the results of this tool in a cohort of first pandemic wave patients. Methods: A cross-sectional study of patients with confirmed SARS-CoV-2 infection from March to May 2020 in Lugo (northwestern Spain). C19-YRS was administered via phone 10 months after the acute infection to both former inpatients and outpatients. Electronic medical records were reviewed and relevant data from the acute episode were collected. The main outcome was the presence of impairment in different areas measured by the C19-YRS scale. Results: The answer rate was 63.2%. The mean age was 54 ± 16 years, 38.4% were male and 190 (42.9%) had some comorbidity. Eighty-seven patients (19.6%) required hospitalization and 10 (2.3%) required intensive care unit admission. Ten (3.5%) patients lost their job due to the pandemic. Two hundred seventy-six patients (62.3%) related any symptoms; fatigue (37.2%) and exertional dyspnea (33.4%) were the most common with significant worsening in both cases compared with the situation before the infection. Subgroup analysis showed that more symptom domains were impaired in women than men. Older patients, those with comorbidity and those who needed hospital admission, demanded more health resources after the acute infection. Discussion: C19-YRS is useful for the detection and quantification of symptoms after COVID-19 and provides relevant social, health, and occupational information.

Acute recurrent autoinflammatory myopericarditis: from pathophysiology to practice / Miopericarditis autoinflamatoria aguda recurrente: de la fisiopatología a la clínica

Recurrent myopericarditis is the acute inflammation of the pericardium and myocardium that relapses after a symptom-free interval of 4 to 6 weeks. A thorough differential diagnosis is necessary to identify uncommon causes that may have therapeutic and prognostic importance. These include autoinflammatory diseases, which can present as recurrent myopericarditis in genetically predisposed or impaired-immunity individuals.We present a 33-year-old male with polyclonal hypogammaglobulinemia and six episodes of myopericarditis, in which the diagnosis of a probable autoinflammatory syndrome was established. Targeted treatment based on the pathophysiological mechanismswas started with immunoglobulins and anakinra, with favourable clinical and serological outcome with no relapses.Organ-specific autoinflammatory diseases with myocardial involvement may be associated with life-threatening complications. The role of multidisciplinary care and a diagnostic approach focused on the pathophysiology of the disease could be the most important thing for early treatment to improve the prognosis and quality of life of our patients. (AU)

La miopericarditis recurrente es la inflamación aguda del pericardio yel miocardio que recidiva tras un periodo libre de síntomas de 4 a 6semanas. Es necesario realizar un diagnóstico diferencial exhaustivopara identificar causas poco comunes que puedan tener importanciaterapéutica y pronóstica. Entre ellas se encuentran las enfermedadesautoinflamatorias, que pueden presentarse como miopericarditis recurrente en individuos genéticamente predispuestos o una inmunidadalterada.Presentamos el caso de un varón de 33 años con hipogammaglobulinemia policlonal y seis episodios de miopericarditis, en el que seestableció el diagnóstico de un probable síndrome autoinflamatorio.Se inició un tratamiento dirigido con inmunoglobulinas y anakinra basado en los mecanismos fisiopatológicos de la enfermedad, con unresultado clínico y serológico favorable en ausencia de recaídas.Las enfermedades autoinflamatorias con afectación cardíaca órgano-específica pueden asociarse a complicaciones potencialmentemortales. El papel de la atención multidisciplinar y un enfoque diagnóstico centrado en la fisiopatología de la enfermedad, resultan devital importancia para instaurar un tratamiento precoz que mejore elpronóstico y la calidad de vida de nuestros pacientes. (AU)

Evaluación a los dos meses del alta hospitalaria tras la primera ola de COVID-19: presencia de síntomas persistentes / Assessment of hospitalized covid-19 patients two month after discharge: characterization of persistent symptoms

Introduction: a series of symptoms have been reported after COVID-19, which have been encompassed in the so-named “postCOVID syndrome”. PostCOVID syndrome is a heterogeneous disorder with an uncertain pathophysiology. The aim of this study is to describe the characteristics and frequence of symptoms after COVID-19 discharge and to analyze the possible implicated factors. Methods: this is an observational propective study with COVID-19 patients hospitalized from March to April 2020. Patients were assessed in an outpatient clinic two months after discharge, and serological, radiological and laboratory workup was conducted. Previous medical history, length of stay (LOS) and intensive care unit (ICU) admission were recorded. Persistent symptons (PS) were defined as those appearing after the acute infection and present at follow-up. Results: 74 patients were included. Mean age was 66±13 years, and 54.4% patients were men. Six (8.1%) patients needed ICU admission, and median LOS was 8 (6-12) days. Forty (54.8%) patients presented PS, the most frequent being fatigue and dyspnea (20.3% each). 77% patients presented laboratory abnormalities but just in 11 cases (15.1%) were they severe. Ten (13.5%) had radiological abnormalities. 71 (95.9%) had positive IgG serology. There were no differences between patients with and without PS regarding previous medical history or acute infection course. PS patients had a higher heart rate 83 (75-93) vs 76 65-85) bpm; p=0.038) at assessment. Conclusion: symptoms and laboratory abnormalities are frequent two months after COVID-19, although usually mild. No predictors... (AU)

Introducción: se han notificado tras el alta por COVID-19 una serie de síntomas englobados dentro del llamado “síndrome post-COVID”, un cuadro heterogéneo cuya fisiopatología es incierta. Nuestro objetivo es describir las características y frecuencia de síntomas tras el alta y analizar los posibles factores relacionados. Métodos: estudio observacional prospectivo con pacientes ingresados por COVID-19 durante marzo-abril de 2020. Se evaluó en consulta a los dos meses tras el alta con valoración clínica, analítica, serología y radiografía de tórax. Se recogieron los antecedentes, la estancia hospitalaria y la necesidad de UCI. Se definieron síntomas persistentes (SP) como síntomas que aparecieron desde la infección aguda y que se mantenían al seguimiento. Resultados: se revisaron 74 pacientes. La edad media fue 66±13 años, siendo un 51,4% hombres. Seis (8,1%) ingresaron en UCI, y la mediana de estancia fue 8 (6-12) días. Cuarenta (54,8%) presentaron SP, siendo los más frecuentes astenia y disnea (20,3% ambos). Un 77% tenía alteraciones analíticas pero solo en 11 (15,1%) fueron relevantes. Diez (13,5%) presentaban alteraciones radiológicas y 71 (95,9%) tenían IgG positiva. No hubo diferencias entre los pacientes con y sin SP en sus antecedentes o evolución hospitalaria. Los pacientes con SP estaban más taquicárdicos [83 (75-93) lpm vs 76 (65-85) lpm; p=0,038], no existiendo diferencias significativas en el resto de variables... (AU)