Fractura de cadera en el anciano e infección por COVID-19. Descripción de 3 casos / Hip fracture in elderly and COVID-19 infection. Report of 3 cases

La pandemia COVID-19 y su diseminación desde la descripción de los primeros casos en China en enero de 2020, ha condicionado la organización sanitaria y la asistencia convencional, tanto en sala de hospitalización como en unidades de cuidados intensivos (UCI), o consultas y actividad quirúrgica. Los pacientes con fractura de cadera, habitualmente ancianos y pluripatológicos, se benefician de una intervención precoz, sin embargo, la cirugía en presencia de infección SARS-CoV-2 activa, parece condicionar una morbimortalidad elevada. Presentamos 3 casos de pacientes ancianos con COVID-19 y fractura de cadera, intervenidos tras 3 semanas de evolución y con presencia de PCR positiva. A pesar de factores pronósticos de gravedad (edad, hipertensión arterial y marcadores de inflamación elevados) el postoperatorio fue el habitual y fueron dados de alta del hospital.(AU)

Since its first description in china in January 2020, COVID-19 pandemia outbreak has affected health organization and conventional care in all settings as wards, intensive care and surgery. Hip fracture patients usually are older and have a lot of comorbidities. This type of patientes benefit from early surgery. However, surgery in COVID-19 patients with active infection is associate with bad outcomes and mortality. We present three patients with COVID infection undergoing hip fracture surgery. Surgery was performed tree weeks after admission. Despite have risk factor (old age, arterial hypertension, elevated inflammatory parameters) the outcome was good and were discharged from hospital without events.(AU)

Hip fracture in elderly and COVID-19 infection. Report of 3 cases. / Fractura de cadera en el anciano e infección por COVID-19. Descripción de 3 casos.

Since its first description in china in January 2020, COVID-19 pandemia outbreak has affected health organization and conventional care in all settings as wards, intensive care and surgery. Hip fracture patients usually are older and have a lot of comorbidities. This type of patientes benefit from early surgery. However, surgery in COVID-19 patients with active infection is associate with bad outcomes and mortality. We present three patients with COVID infection undergoing hip fracture surgery. Surgery was performed tree weeks after admission. Despite have risk factor (old age, arterial hypertension, elevated inflammatory parameters) the outcome was good and were discharged from hospital without events.

[Hip fracture in elderly and COVID-19 infection. Report of 3 cases]. / Fractura de cadera en el anciano e infección por COVID-19. Descripción de 3 casos.

Since its first description in china in January 2020, COVID-19 pandemia outbreak has affected health organization and conventional care in all settings as wards, intensive care and surgery. Hip fracture patients usually are older and have a lot of comorbidities. This type of patientes benefit from early surgery. However, surgery in COVID-19 patients with active infection is associate with bad outcomes and mortality. We present three patients with COVID infection undergoing hip fracture surgery. Surgery was performed tree weeks after admission. Despite have risk factor (old age, arterial hypertension, elevated inflammatory parameters) the outcome was good and were discharged from hospital without events.

Linfoma de células NK/T extranodal nasal / Nasal-type extranodal Natural Killer T-cell lymphoma

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Urticaria vasculitis: estudio retrospectivo de 15 casos / Urticarial Vasculitis: A Retrospective Study of 15 Cases

Introducción: La urticaria vasculitis (UV) es un subtipo de vasculitis caracterizada clínicamente por lesiones de tipo urticarial e histológicamente por vasculitis necrotizante. Objetivo: El objetivo de este trabajo es el estudio de los pacientes con urticaria vasculitis que han sido atendidos en el Servicio de Dermatología del Hospital Universitario Virgen del Rocío (Sevilla, España) para determinar las características de presentación clínicas e histológicas, así como el despistaje de hipocomplementemia, en estrecha relación con enfermedad sistémica asociada. Material y métodos: Se han extraído de la base de datos de nuestro servicio los casos de urticaria vasculitis confirmados histológicamente durante un período de 10 años. Resultados: Quince pacientes fueron diagnosticados de urticaria vasculitis (9 mujeres y 6 hombres, con una mediana de edad de 51 años). En 14 pacientes (93%) las lesiones persistían más de 24 horas. En 9 pacientes (60%) las lesiones se resolvían con púrpura e hiperpigmentación residual. Siete pacientes (47%) presentaron niveles disminuidos de complemento en sangre, 12 pacientes (80%) asociaron síntomas extracutáneos y 8 pacientes (53%) asociaban enfermedad sistémica, siendo la entidad más frecuente el lupus eritematoso sistémico. Conclusiones: La urticaria vasculitis constituye a menudo una entidad infradiagnosticada, con una variable respuesta al tratamiento y en la que la existencia de niveles de complemento disminuidos y de síntomas extracutáneos puede ser indicativa de enfermedad sistémica asociada (AU)

Introduction: Urticarial vasculitis is a subtype of vasculitis characterized clinically by urticarial lesions and histologically by necrotizing vasculitis. Objective: To study the clinical and histologic features of urticarial vasculitis in patients seen in the dermatology department of Hospital Universitario Virgen de Rocío in Seville, Spain, and to examine the association between hypocomplementemia and systemic disease. Material and methods: We performed a chart review of histologically confirmed cases of urticarial vasculitis in the database of our department covering a period of 10 years. Results: Fifteen patients (9 women and 6 men with a median age of 51 years) were included. In 14 patients (93%), the lesions persisted for more than 24 hours, and in 9 cases (60%) the lesions resolved leaving residual purpura or hyperpigmentation. Seven patients (47%) had low complement levels in the blood, 12 (80%) had extracutaneous symptoms, and 8 (53%) had associated systemic disease, the most common of which was systemic lupus erythematosus. Conclusions: Urticarial vasculitis may be underdiagnosed. Response to treatment is variable, and hypocomplementemia and extracutaneous symptoms may indicate the presence of associated systemic disease (AU)

Urticarial vasculitis: a retrospective study of 15 cases.

INTRODUCTION: Urticarial vasculitis is a subtype of vasculitis characterized clinically by urticarial lesions and histologically by necrotizing vasculitis. OBJECTIVE: To study the clinical and histologic features of urticarial vasculitis in patients seen in the dermatology department of Hospital Universitario Virgen de Rocío in Seville, Spain, and to examine the association between hypocomplementemia and systemic disease. MATERIAL AND METHODS: We performed a chart review of histologically confirmed cases of urticarial vasculitis in the database of our department covering a period of 10 years. RESULTS: Fifteen patients (9 women and 6 men with a median age of 51 years) were included. In 14 patients (93%), the lesions persisted for more than 24hours, and in 9 cases (60%) the lesions resolved leaving residual purpura or hyperpigmentation. Seven patients (47%) had low complement levels in the blood, 12 (80%) had extracutaneous symptoms, and 8 (53%) had associated systemic disease, the most common of which was systemic lupus erythematosus. CONCLUSIONS: Urticarial vasculitis may be underdiagnosed. Response to treatment is variable, and hypocomplementemia and extracutaneous symptoms may indicate the presence of associated systemic disease.

[Nelson syndrome: a rare cause of generalized hyperpigmentation of the skin]. / Síndrome de Nelson: una causa infrecuente de hiperpigmentación cutánea generalizada.

Nelson syndrome is a rare cause of generalized mucocutaneous hyperpigmentation. Its clinical manifestations are due to excessive secretion of adrenocorticotropic hormone from a pituitary adenoma, which develops after bilateral therapeutic adrenalectomy. As this operation has fallen into disuse, Nelson syndrome is now extremely rare and difficult to recognize. We present a very severe case of generalized hyperpigmentation due to Nelson syndrome in a 37-year-old woman.