Trombosis venosa superficial extensa y síndrome de Behçet

Superficial venous thrombosis is frequent; its main risk factor is variceal veins’ presence in lower limbs, although it can occur in other prothrombotic states. Behçet syndrome is a chronic disease characterized by recurrent oral and genital aphthous and ocular involvement; vascular involvement may also appear, which is a diagnostic criterion. A 62-year-old woman, with recurrent oral and ocular involvement (uveitis) was admitted in the emergency room because of superficial venous thrombosis, meeting diagnostic criteria for Behçet syndrome. The treatment of vein thrombosis in Behçet syndrome is immunosuppression. We started azathioprine, and no recurrences were registered.La trombosis venosa superficial es frecuente; su principal factor de riesgo es la presencia de venas varicosas en miembros inferiores, aunque también puede ocurrir en otros estados protrombóticos. El síndrome de Behçet es una enfermedad crónica, caracterizada por aftas orales y genitales y afectación ocular, que también puede aparecer con manifestaciones vasculares, actual criterio diagnóstico. Mujer de 62 años, con antecedentes de episodios de aftas orales y uveítis, acude a Urgencias por trombosis venosa superficial; cumple los criterios para el diagnóstico de síndrome de Behçet. El tratamiento de las trombosis venosas en el síndrome de Behçet es la inmunosupresión. Se inició tratamiento con azatioprina sin recurrencias posteriores.

Hacia una paridad de desempeño académico en la competencia cuantitativa a partir del Modelo Pedagógico CEIPA

After the emergence of new training and / or training demands, the need arose to evaluate the academic performance of CEIPA, Business School students, after the incorporation of their own pedagogical model focused on constructivism; with the purpose of providing you with the necessary skills to reason, do calculations and solve numerical operations quickly and systematically within the competitive and globalized labor market. In principle, a comparative study is developed on academic performance in quantitative competence within the university environment and then, a quantitative methodology of an exploratory and explanatory type is followed, taking as a sample 543 students. For the results, tables prepared by the SPSS Software were made according to each type of evaluation: debates, exams and assignments. The results show that there are no statistically significant differences under the face-to-face and virtual study regimes, mainly in the evaluation of learning from exams and assignments. However, in the debates there is not the same symmetry, on the contrary, a higher performance is shown in the virtual mode.Tras el surgimiento de nuevas demandas de formación y/o capacitación, nace la necesidad de evaluar el desempeño académico de los estudiantes de CEIPA, Business School, tras la incorporación de su propio modelo pedagógico centrado en el constructivismo con el propósito de brindarle las habilidades necesarias para razonar, hacer cálculos y resolver operaciones numéricas de manera rápida y sistemática dentro del competitivo y globalizado mercado laboral. En principio, se desarrolló un estudio comparativo sobre el desempeño académico en la competencia cuantitativa dentro del ámbito universitario y luego, se implementó una metodología cuantitativa de tipo exploratoria y explicativa, tomando como muestra 543 estudiantes. Para los resultados, se hicieron tablas elaboradas por el Software SPSS de acuerdo con cada tipo de evaluación: debates, exámenes y trabajos. Los resultados muestran que no existen diferencias estadísticamente significativas bajo los regímenes de estudio presencial y virtual, principalmente en la evaluación de los aprendizajes a partir de los exámenes y trabajos. Sin embargo, en los debates no existe la misma simetría, pues se muestra un mayor desempeño en la modalidad virtual

Mid-Regional Pro-Adrenomedullin, Methemoglobin and Carboxyhemoglobin as Prognosis Biomarkers in Critically Ill Patients with COVID-19: An Observational Prospective Study

Depto. de MedicinaFac. de MedicinaTRUEpu

Inflammatory Biomarkers in the Short-Term Prognosis of Venous Thromboembolism: A Narrative Review

The relationship between inflammation and venous thrombosis is not well understood. An inflammatory response may be both the cause and consequence of venous thromboembolism (VTE). In fact, several risk factors of VTE modulate thrombosis through inflammatory markers. Acute pulmonary embolism (PE) is burdened by a remarkable mortality rate, up to 34% in severely ill patients presenting with hemodynamic instability. Initial mortality risk stratification is based on hemodynamic instability. Patients with a situation of hemodynamic stability require immediate further risk assessment based on clinical, imaging, and circulating biomarkers, as well as the presence of comorbidities. Some inflammatory biomarkers have shown potential usefulness in the risk stratification of patients with VTE, especially acute PE. C-reactive protein on admission is associated with 30-day mortality and bleeding in VTE patients. P-selectin is associated with right ventricle dysfunction in PE patients and might be associated with VTE recurrences and the extension of thrombosis. Tissue factor microparticles are associated with VTE recurrence in cancer-associated thrombosis. Other inflammatory biomarkers present scarce evidence (inflammatory cytokines, erythrocyte sedimentation rate, fibrinogen, leukocyte count). In this manuscript, we will review the prognostic role of different inflammatory biomarkers available both for clinical practice and research in VTE patients

A rare case of stroke as a complication after percutaneous mechanical thrombectomy in a patient with intermediate-high risk pulmonary embolism and patent foramen ovale

We present an extremely rare case of a patient with intermediate-high risk pulmonary embolism treated with percutaneous mechanical thrombectomy, complicated with stroke as a form of paradoxical embolism through a previously unknown patent foramen ovale. We reviewed the literature for indications, efficacy, and safety of this procedure, as well as for experience on this technique in patients with patent foramen ovale

The Fluid Aspect of the Mediterranean Diet in the Prevention and Management of Cardiovascular Disease and Diabetes: The Role of Polyphenol Content in Moderate Consumption of Wine and Olive Oil

A growing interest has emerged in the beneficial effects of plant-based diets for the prevention of cardiovascular disease, diabetes and obesity. The Mediterranean diet, one of the most widely evaluated dietary patterns in scientific literature, includes in its nutrients two fluid foods: olive oil, as the main source of fats, and a low-to-moderate consumption of wine, mainly red, particularly during meals. Current mechanisms underlying the beneficial effects of the Mediterranean diet include a reduction in inflammatory and oxidative stress markers, improvement in lipid profile, insulin sensitivity and endothelial function, as well as antithrombotic properties. Most of these effects are attributable to bioactive ingredients including polyphenols, mono- and poly-unsaturated fatty acids. Polyphenols are a heterogeneous group of phytochemicals containing phenol rings. The principal classes of red wine polyphenols include flavonols (quercetin and myricetin), flavanols (catechin and epicatechin), anthocyanin and stilbenes (resveratrol). Olive oil has at least 30 phenolic compounds. Among them, the main are simple phenols (tyrosol and hydroxytyrosol), secoroids and lignans. The present narrative review focuses on phenols, part of red wine and virgin olive oil, discussing the evidence of their effects on lipids, blood pressure, atheromatous plaque and glucose metabolism

Venous Thrombosis within 30 Days after Vaccination against SARS-CoV-2 in a Multinational Venous Thromboembolism Registry

Background: Venous thromboembolism (VTE)—including deep vein thrombosis, pulmonary embolism, and cerebral venous sinus thrombosis (CVST)—may occur early after vaccination against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We sought to describe the site, clinical characteristics, and outcomes of VTE after vaccination against SARS-CoV-2. Methods: In a prospective study using the Registro Informatizado de Enfermedad TromboEmbólica (RIETE) platform, patients with VTE 4–30 days after vaccination against SARS-CoV-2 (1 February 2021 through 30 April 2021) were included. VTE patients recruited from the same centers into RIETE in the same months in 2018–2019 were selected as the reference group. All-cause mortality and major bleeding were the main study outcomes. Results: As of 30 April 2020, 102 patients with post-vaccination VTEs had been identified (28 after adenovirus-based vaccination [ChAdOx1 nCov-19; AstraZeneca] and 74 after mRNA-based vaccination [mRNA-1273; Moderna, and BNT162b2; Pfizer]). Compared with 911 historical controls, patients with VTE after adenovirus-based vaccination more frequently had CVST (10.7% vs. 0.4%, p < 0.001) or thrombosis at multiple sites (17.9% vs. 1.3%, p < 0.001), more frequently had thrombocytopenia (40.7% vs. 14.7%, p < 0.001), and had higher 14-day mortality (14.3% vs. 0.7%; odds ratio [OR]: 25.1; 95% confidence interval [CI]: 6.7–94.9) and major bleeding rates (10.3% vs. 1.0%, OR: 12.03, 95% CI: 3.07–47.13). The site of thrombosis, accompanying thrombocytopenia, and 14-day mortality rates were not significantly different for patients with VTE after mRNA-based vaccination, compared with historical controls. Conclusions: Compared with historical controls, VTE after adenovirus-based vaccination against SARS-CoV-2 is accompanied by thrombocytopenia, occurs in unusual sites, and is associated with worse clinical outcomes

Association Between Preexisting Versus Newly Identified Atrial Fibrillation and Outcomes of Patients With Acute Pulmonary Embolism

Background Atrial fibrillation (AF) may exist before or occur early in the course of pulmonary embolism (PE). We determined the PE outcomes based on the presence and timing of AF. Methods and Results Using the data from a multicenter PE registry, we identified 3 groups: (1) those with preexisting AF, (2) patients with new AF within 2 days from acute PE (incident AF), and (3) patients without AF. We assessed the 90-day and 1-year risk of mortality and stroke in patients with AF, compared with those without AF (reference group). Among 16 497 patients with PE, 792 had preexisting AF. These patients had increased odds of 90-day all-cause (odds ratio [OR], 2.81; 95% CI, 2.33-3.38) and PE-related mortality (OR, 2.38; 95% CI, 1.37-4.14) and increased 1-year hazard for ischemic stroke (hazard ratio, 5.48; 95% CI, 3.10-9.69) compared with those without AF. After multivariable adjustment, preexisting AF was associated with significantly increased odds of all-cause mortality (OR, 1.91; 95% CI, 1.57-2.32) but not PE-related mortality (OR, 1.50; 95% CI, 0.85-2.66). Among 16 497 patients with PE, 445 developed new incident AF within 2 days of acute PE. Incident AF was associated with increased odds of 90-day all-cause (OR, 2.28; 95% CI, 1.75-2.97) and PE-related (OR, 3.64; 95% CI, 2.01-6.59) mortality but not stroke. Findings were similar in multivariable analyses. Conclusions In patients with acute symptomatic PE, both preexisting AF and incident AF predict adverse clinical outcomes. The type of adverse outcomes may differ depending on the timing of AF onset.info:eu-repo/semantics/publishedVersio

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

Predicción de mortalidad y sangrado precoces en pacientes con enfermedad tromboembólica venosa aguda mediante medición de proteína C reactiva

Objetivos. La asociación de la medición de la proteína C reactiva (PCR) al diagnóstico y complicaciones precoces en la enfermedad tromboembólica venosa (ETV) aguda no ha sido evaluada. Nuestra hipótesis es que los niveles elevados de PCR al diagnóstico podrían estar asociados con complicaciones precoces (mortalidad, hemorragia, recurrencia) en pacientes con ETV aguda. Material y métodos. Estudio observacional prospectivo, en el que se incluyeron pacientes consecutivos con diagnóstico de ETV aguda en los que se midió la PCR en las primeras 24 horas del diagnóstico. La mortalidad, sangrado y recurrencia fueron registrados durante el seguimiento a 30 días..