[Castellón Field Hospital: comprehensive analysis of its use during the SARS-CoV-2 pandemic.] / Hospital de Campaña de Castellón: análisis integral de su uso durante la pandemia por SARS-CoV-2.

OBJECTIVE: Field hospitals, also known as alternative care sites, have been an important healthcare reinforcement during the SARS-CoV-2 pandemic worldwide. In the Valencian Community, three of these hospitals were opened, one for each province. Our study aimed to make a comprehensive analysis of this resource in Castellon. METHODS: A retrospective observational study was carried out with an analytical and statistical component of 3 aspects: infrastructure, satisfaction and clinical data from COVID-positive hospitalized patients. The sources of information were primary, institutional for the infrastructure and personal for the satisfaction surveys and clinical data. RESULTS: A set of 6x3 metres polyvalent tents was chosen, which joined formed a single-floor area of about 3.500 m2. Although hospital opened for approximately a year and a half with multiple uses, most in relation to the COVID pandemic (vaccination center, emergency room observation, hospital assistance, warehouse...), reception of positive patients for the virus began during the third wave of the pandemic, remaining active for eleven days. A total of thirty-one patients with a mean age of 56 years were admitted. 41.9% did not have any comorbidity and 54.8% needed treatment with oxygen therapy. Furthermore, the length of stay was three days, finding a significant relationship between this one, the oxygen flow required during admission and the age. Satisfaction was measured by a survey of seventeen questions where an average satisfaction of 8.33/10. CONCLUSIONS: This is one of the few studies in the literature in which a field hospital is analyzed from such different points of view. After this analysis, it is concluded that it is an extraordinary and temporary resource whose use is useful without reflecting an increase of morbidity/mortality among our patients and with a very favorable subjective assessment.

OBJETIVO: Los hospitales de campaña, también conocidos como alternative care sites, han supuesto un refuerzo sanitario importante durante la pandemia por SARS-CoV-2 a nivel mundial. En la Comunidad Valenciana se abrieron tres de estos hospitales, uno por cada provincia. Nuestro estudio pretendió hacer un análisis integral de dicho recurso en la provincia de Castellón. METODOS: Se realizó un estudio observacional retrospectivo con un componente analítico y estadístico de tres aspectos: la infraestructura, la satisfacción de los pacientes atendidos y los datos o características clínicas de los pacientes ingresados positivos por COVID. Las fuentes de información fueron primarias, institucionales para el apartado de la infraestructura y personales para las encuestas de satisfacción y los datos clínicos. RESULTADOS: El tipo de infraestructura que se eligió fue un conjunto de tiendas modulares polivalentes de 6x3 metros que unidas formaban una superficie de una sola planta de unos 3.500 m2. Aunque el hospital permaneció abierto durante aproximadamente año y medio con diversas funciones, la mayoría en relación con la pandemia por COVID (centro de vacunación, observación de Urgencias, asistencia hospitalaria, almacén…), inició su acogida de pacientes positivos debido al virus durante la tercera ola de la pandemia, ejerciendo este papel durante once días. En el hospital ingresaron un total de 31 pacientes con una edad media de 57 años, de los que un 41,9% no tenían ninguna comorbilidad y un 54,8% necesitaron oxigenoterapia. La estancia media hospitalaria fue de tres días, encontrándose una relación estadísticamente significativa entre ésta, el flujo de oxígeno requerido durante el ingreso y la edad. La satisfacción se midió mediante una encuesta de diecisiete preguntas donde se obtuvo una media de 8,33/10. CONCLUSIONES: Este es uno de los pocos estudios de la literatura en los que se abarca, desde puntos tan distintos, cómo funciona un hospital de campaña. Tras el análisis se concluye que se trata de un recurso extraordinario y temporal cuyo empleo es útil sin reflejar un aumento de la morbi/mortalidad de nuestros pacientes y con una valoración subjetiva del mismo muy favorable.

Hospital de Campaña de Castellón: análisis integral de su uso durante la pandemia por SARS-CoV-2 / Castellón Field Hospital: comprehensive analysis of its use during the SARS-CoV-2 pandemic

Fundamentos: Los hospitales de campaña, también conocidos comoalternative care sites, han supuesto un refuerzo sanitarioimportante durante la pandemia por SARS-CoV-2 a nivel mundial. En la Comunidad Valenciana se abrieron tres de estos hospitales,uno por cada provincia. Nuestro estudio pretendió hacer un análisis integral de dicho recurso en la provincia de Castellón.Métodos: Se realizó un estudio observacional retrospectivo con un componente analítico y estadístico de tres aspectos: lainfraestructura, la satisfacción de los pacientes atendidos y los datos o características clínicas de los pacientes ingresados positivospor COVID. Las fuentes de información fueron primarias, institucionales para el apartado de la infraestructura y personales para lasencuestas de satisfacción y los datos clínicos.Resultados: El tipo de infraestructura que se eligió fue un conjunto de tiendas modulares polivalentes de 6x3 metros que unidasformaban una superficie de una sola planta de unos 3.500 m 2. Aunque el hospital permaneció abierto durante aproximadamente añoy medio con diversas funciones, la mayoría en relación con la pandemia por COVID (centro de vacunación, observación de Urgencias,asistencia hospitalaria, almacén...), inició su acogida de pacientes positivos debido al virus durante la tercera ola de la pandemia,ejerciendo este papel durante once días. En el hospital ingresaron un total de 31 pacientes con una edad media de 57 años, de losque un 41,9% no tenían ninguna comorbilidad y un 54,8% necesitaron oxigenoterapia. La estancia media hospitalaria fue de tres días,encontrándose una relación estadísticamente significativa entre ésta, el flujo de oxígeno requerido durante el ingreso y la edad. Lasatisfacción se midió mediante una encuesta de diecisiete preguntas donde se obtuvo una media de 8,33/10.Conclusiones: Este es uno de los pocos estudios de la literatura en los que se abarca, desde puntos tan distintos, cómo funciona...(AU)

Background: Field hospitals, also known asalternative care sites, have been an important healthcare reinforcement during theSARS-CoV-2 pandemic worldwide. In the Valencian Community, three of these hospitals were opened, one for each province. Our studyaimed to make a comprehensive analysis of this resource in Castellon.Methods: A retrospective observational study was carried out with an analytical and statistical component of 3 aspects: infrastruc-ture, satisfaction and clinical data from COVID-positive hospitalized patients. The sources of information were primary, institutional for theinfrastructure and personal for the satisfaction surveys and clinical data.Results: A set of 6x3 metres polyvalent tents was chosen, which joined formed a single-floor area of about 3.500 m2. Althoughhospital opened for approximately a year and a half with multiple uses, most in relation to the COVID pandemic (vaccination center,emergency room observation, hospital assistance, warehouse...), reception of positive patients for the virus began during the thirdwave of the pandemic, remaining active for eleven days. A total of thirty-one patients with a mean age of 56 years were admitted.41.9% did not have any comorbidity and 54.8% needed treatment with oxygen therapy. Furthermore, the length of stay was threedays, finding a significant relationship between this one, the oxygen flow required during admission and the age. Satisfaction wasmeasured by a survey of seventeen questions where an average satisfaction of 8.33/10.Conclusions: This is one of the few studies in the literature in which a field hospital is analyzed from such different points ofview. After this analysis, it is concluded that it is an extraordinary and temporary resource whose use is useful without reflecting anincrease of morbidity/mortality among our patients and with a very favorable subjective assessment.(AU)

Current clinical spectrum of common variable immunodeficiency in Spain: The multicentric nationwide GTEM-SEMI-CVID registry.

Common variable immunodeficiency (CVID) constitutes a heterogenic group of primary immunodeficiency disorders with a wide-ranging clinical spectrum. CVID-associated non-infectious morbidity constitutes a major challenge requiring a full understanding of its pathophysiology and its clinical importance and global variability, especially considering the broad clinical, genetic, and regional heterogeneity of CVID disorders. This work aimed to develop a nationwide, multicenter, retrospective study over a 3-year period describing epidemiological, clinical, laboratory, therapeutic, and prognostic features of 250 CVID patients in Spain. The mean diagnostic delay was around 10 years and most patients initially presented with infectious complications followed by non-infectious immune disorders. However, infectious diseases were not the main cause of morbimortality. Non-infectious lung disease was extraordinarily frequent in our registry affecting approximately 60% of the patients. More than one-third of the patients in our cohort showed lymphadenopathies and splenomegaly in their follow-up, and more than 33% presented immune cytopenias, especially Evans' syndrome. Gastrointestinal disease was observed in more than 40% of the patients. Among biopsied organs in our cohort, benign lymphoproliferation was the principal histopathological alteration. Reaching 15.26%, the global prevalence of cancer in our registry was one of the highest reported to date, with non-Hodgkin B lymphoma being the most frequent. These data emphasize the importance of basic and translational research delving into the pathophysiological pathways involved in immune dysregulation and diffuse lymphocytic infiltration. This would reveal new tailored strategies to reduce immune complications, and the associated healthcare burden, and ensure a better quality of life for CVID patients.

Síndrome cerebeloso secundario a metronidazol / Cerebellar syndrome caused by metronidazole

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Melanoma esofágico primario: descripción de un caso / Primary esophageal melanoma: report of a case

Introducción: el melanoma esofágico primario es un tumor muy poco frecuente que constituye únicamente el 0,1-0,2% de las enfermedades malignas del esófago. El objetivo del estudio fue presentar el manejo de un nuevo caso clínico diagnosticado y tratado en nuestro centro. Caso clínico: paciente de 67 años que presentaba clínica de disfagia a sólidos sin otros antecedentes ni lesiones cutáneas asociadas. Se le realizó una gastroscopia, apreciándose una formación polipoide en tercio distal esofágico sugestiva de neoplasia. La biopsia fue positiva para melanoma con marcadores inmunohistoquímicos S100 y HMB45 positivos; citoqueratinas y CEA negativos. La tomografía computarizada (TC) y la tomografía por emisión de positrones (PET) no mostraron infiltración local ni metástasis a distancia. Se practicó una esofaguectomía de Ivor-Lewis con linfadenectomía regional. La estancia postoperatoria fue de tres semanas sin producirse complicaciones postoperatorias reseñables. El estudio anatomopatológico de la pieza confirmó el diagnóstico de melanoma esofágico primario. Discusión: el pronóstico del melanoma primario de esófago es infausto, debido a que se trata de un tumor agresivo que suele diagnosticarse en fases avanzadas de la enfermedad, con presencia de invasión local y metástasis. El tratamiento de elección actualmente es la cirugía, obteniéndose resultados limitados con el resto de terapias adyuvantes (AU)

Introduction: Primary malignant melanoma of the esophagus is a rare tumor representing only 0.1-0.2% of esophageal malignancies. The goal of the study was to report on the management of a new case diagnosed and treated in our site. Case report: A 67-year-old patient presented with dysphagia to solids with no other remarkable history or associated skin lesions. He underwent gastroscopy, which revealed a polypoid mass suggestive of neoplasm in the distal third of the esophagus. Biopsy indicated melanoma with positive immunohistochemical markers S100 and HMB45, and negative cytokeratins and CEA. Computerized tomography (CT) and positron-emission tomography (PET) scans showed no local infiltration or distant metastases. An Ivor-Lewis esophagectomy procedure was performed with regional lymphadenectomy. Postoperative stay lasted for three weeks, and no remarkable postsurgical complications arose. The pathological study of the specimen confirmed the diagnosis of primary esophageal melanoma. Discussion: Primary malignant melanoma of the esophagus has an unfortunate prognosis as it is an aggressive tumor usually diagnosed at an advanced stage, with local invasion and metastatic disease. Currently, surgery is the treatment of choice, with the remaining adjuvant therapies obtaining limited results (AU)

Primary esophageal melanoma: report of a case.

INTRODUCTION: Primary malignant melanoma of the esophagus is a rare tumor representing only 0.1-0.2% of esophageal malignancies. The goal of the study was to report on the management of a new case diagnosed and treated in our site. CASE REPORT: A 67-year-old patient presented with dysphagia to solids with no other remarkable history or associated skin lesions. He underwent gastroscopy, which revealed a polypoid mass suggestive of neoplasm in the distal third of the esophagus. Biopsy indicated melanoma with positive immunohistochemical markers S100 and HMB45, and negative cytokeratins and CEA. Computerized tomography (CT) and positron-emission tomography (PET) scans showed no local infiltration or distant metastases. An Ivor-Lewis esophagectomy procedure was performed with regional lymphadenectomy. Postoperative stay lasted for three weeks, and no remarkable postsurgical complications arose. The pathological study of the specimen confirmed the diagnosis of primary esophageal melanoma. DISCUSSION: Primary malignant melanoma of the esophagus has an unfortunate prognosis as it is an aggressive tumor usually diagnosed at an advanced stage, with local invasion and metastatic disease. Currently, surgery is the treatment of choice, with the remaining adjuvant therapies obtaining limited results.