Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

La inhibición de la Poli (ADP-RIBOSA) POLIMERASA-1 mediante nanopartículas poliméricas funcionalizadas con ABT-888 potencia la citotoxicidad de temozolomida en líneas celulares de hepatocarcinoma

El carcinoma hepatocelular (CHC), o hepatocarcinoma, es el tumor primario de hígado más frecuente (85-90%) y constituye un problema de salud mundial. Es el sexto cáncer más frecuente y la tercera causa de muerte relacionada con el cáncer, representando el 7% del cáncer global. En fases tempranas, la resección quirúrgica, el trasplante hepático y la ablación percutánea, pueden considerarse como tratamiento curativo; pero en fases avanzadas, existe un pobre pronóstico a largo plazo. Poli (ADP-ribosa)-1 (PARP-1) es una proteína de detección de daños en el ADN y es capaz de unirse a roturas de cadena producidas por agentes genotóxicos, así como señalizar el daño en el ADN a los complejos de reparación. Se ha observado un incremento de expresión de PARP-1 en líneas celulares de hepatocarcinoma, y en tejido hepático tumoral, en comparación con tejido hepático sano peritumoral. El uso de inhibidores de PARP ha demostrado incrementar la sensibilidad celular frente a agentes citotóxicos, como es el caso de la Temozolamida (alquilantes). Por otro lado, la Nanoterapia ha surgido como una innovadora alternativa a la quimioterapia convencional, con el objetivo de vehiculizar el fármaco de forma selectiva hacia el tumor y evitar los fenómenos de resistencia a fármacos antitumorales. El empleo de NP magnéticas permite evadir estos mecanismos de resistencia antitumoral, permitiendo incrementar la concentración intracelular del fármaco, mejorando así su efecto citotóxico. El hepatocarcinoma (CHC) es un tumor con un pobre pronóstico cuando se diagnostica en estadios avanzados, siendo escaso el arsenal terapéutico, con bajas tasas de respuesta y elevados efectos adversos. Por otro lado, se ha estudiado la inhibición enzimática de la actividad de PARP-1 en un amplio rango de enfermedades, incluyendo el infarto, daño por isquemia-reperfusión, diabetes, shock y otras formas de inflamación, demostrando mejorar distintas formas de daño hepático. Además, se están utilizando varios inhibidores de PARP-1 en ensayos clínicos en el campo de fármacos antitumorales en diversos tipos de tumores, incluido el hepatocarcinoma celular. En este contexto, hemos decidido evaluar la nanotecnología como vehículos transportadores de fármacos, (inhibidor de PARP-1 conocido como ABT-888 y la Temozolomida como agente inductor de daños en el ADN), en el tratamiento del carcinoma hepatocelular. Pensamos que esta propuesta puede constituir una aproximación terapéutica efectiva del CHC.Tesis Univ. Granada. Programa Oficial de Doctorado en: Medicina Clínica y Salud Públic

Biliary bleeding due to a hepatic artery pseudoaneurysm rupture.

Hepatic artery pseudoaneurysm is a rare cause of upper gastrointestinal bleeding. Traumatic etiology is frequent (vascular anastomosis or iatrogenesisia), although it is also related to infectious or inflammatory diseases. We report the case of a 65-year-old patient, with hematemesis due to hepatic artery branch pseudoaneurysm rupture, in the context of infectious endocarditis. The diagnosis was made by angioTC, using arteriography for embolization

Carcinosarcoma of the extrahepatic bile duct: an unusual cause of obstructive jaundice.

In relation to the article published in this journal by Guzmán describing a case of ampulla of Vater carcinosarcoma, we present a case of extrahepatic bile duct carcinosarcoma. A neoplasm described in different anatomical locations with an exceptional origin in the bile duct

A large perforated gastric ulcer due to cocaine use.

Juxtapyloric perforation is one of the most common digestive tract complications associated with cocaine use. We present the case of an habitual user of cocaine who goes to the Emergency Department due to epigastric pain due and intolerance of days of evolution. An endoscopic finding of a large antral ulcer with an ischemic appearance; in which it is not possible to show pylorus

Eosinophilic cholecystitis: an infrequent cause of acute cholecystitis

Eosinophilic cholecystitis (EC) is a rare disease that is characterised by eosinophilic infiltration of the gallbladder. Its pathogenesis is unknown, although many hypotheses have been made. Clinical and laboratory manifestations do not differ from those of other causes of cholecystitis. Diagnosis is histological and usually performed after analysis of the surgical specimen. We report the case of a woman aged 24 years, with symptoms of fever, vomiting and pain in the right upper quadrant. When imaging tests revealed acalculous cholecystitis, an urgent cholecystectomy was performed. Histological examination of the surgical specimen revealed eosinophilic cholecystitis. No cause of the symptoms was found