Sacrolistesis postraumática sin lesión neurológica

Las fracturas transversas de sacro son raras pero aún lo son más aquellas en las que hay un desplazamiento o listeis de una vértebra sacra sobre otra. El sentido de desplazamiento viene condicionado por el mecanismo causante, pudiendo ser en flexión o en extensión. En las verdaderas listesis el sentido del traumatismo es en extensión, llevando a colocarse total o parcialmente la vértebra sacra superior por delante de la inferior. En determinados casos como pueden ser los politraumatizados, el diagnóstico puede ser difícil, por lo que es necesario realizar un estudio radiológico meticuloso. En estas fracturas ocurre frecuentemente una lesión de raíces lumbosacras de mayor o menor gravedad, aunque suele existir algún tipo de recuperación, incluso espontánea, con el transcurso del tiempo. Se presenta el caso de una mujer que presentó una sacrolistesis de S1 sobre S2 por haber sufrido caída de nalgas, sin existir ninguna lesión neurológica.Transverse fractures of the sacrum are rare, but fractures with displacement or listhesis of one sacral vertebra over another are even more infrequent. The direction of the displacement is conditioned by the causing mechanism and may occur in flexion or extension, in true listhesis, trauma occurs in extension, placing the superior sacral vertebra totally or partially in from of the inferior vertebra. In some cases, such as multiple traumas, the diagnosis can be difficult, and a careful radiologic study is required. A more or less severe injury of th lumbosacral roots frequently occurs in these fractures, although a certain degree of recovery takes place, even spontaneously, over time. We present the case of a 69 years old woman suffering from a sacrolisthesis of S1 over S2 after a fall on the buttocks with no neurological lesion

Location, Clinical Presentation, Diagnostic Algorithm and Open vs. Arthroscopic Surgery of Knee Synovial Haemangioma: A Report of Four Cases and a Literature Review

Objective: The aim was to report 4 patients with intra-articular knee synovial haemangioma (KSH) and to perform a systematic review to describe the patient characteristics, patterns of tumor location, clinical presentation, usefulness of imaging examinations, pros and cons of arthroscopic vs. open resection, and follow-up in the literature. Design: From 1996 to 2016, four patients with KSH were retrospectively reviewed. A literature search was conducted in PubMed from 2000/01 to 2020/06 using the search terms "synovial haemangioma" and "knee." Fifty full-text articles that included a total of 92 patients were included for further discussion. Results: Four adults (20-40 years) were diagnosed with KSH. Three lesions located in the suprapatellar pouch, two eroding the patella and one the supratrochlear bone, and one in the posterior compartment. Persistent anterior knee pain was the main complain. MRI revealed a benign tumor mass in all cases except one. Open excisional biopsy and regional synovectomy were performed in three patients, and by arthroscopy of the posterior compartment in the fourth. Histological type was arteriovenous in three cases and capillary in one. A pain-free knee without recurrence was achieve in all cases except one, which was successfully reoperated. Average follow-up time was 3.5 years. A literature review showed that KSH appears most frequently in children and teenagers (64.6%) and does not differ by gender. The suprapatellar and patella-femoral joint compartment was the most frequent location (47.9%). The bony tissue of the knee was rarely affected (13.5%). Pain, swelling and haemarthrosis were frequently reported (88.2, 66.7, and 47.1%). MRI was the most commonly used imaging test (98%). Treatment consisted of regional synovectomy by open surgery or arthroscopy in 66.7 and 15.6% of cases, respectively. Conclusions: KSH should be considered in the differential diagnosis of adult patients with chronic low-intensity knee pain. MRI is the most useful exam because it establishes the location, extent and benign characteristics of the tumor. Definitive diagnosis requires histological examination. We believe excisional biopsy and regional synovectomy by arthroscopy should be the treatments of choice for intra-articular tumors, but we recommend open surgery when the lesion extends to the tendons, muscle or bone

Organ-specific allergen challenges in airway allergy: Current utilities and future directions

Atopy has been long used as the screening method for airway allergy. Nevertheless, aeroallergens can trigger respiratory symptoms not only in atopic patients (atopic res piratory allergy, ARA), but also in non-atopic subjects (local respiratory allergy, LRA). Moreover, ARA and LRA can coexist in the same patient, and this clinical scenario has been called dual respiratory allergy (DRA). When the clinical history cannot determine the relevance of sensitizations in ARA patients, nasal, conjunctival or bronchial aller gen challenges (NAC, CAC, and BAC, respectively) should be conducted. Moreover, these tests are required to identify patients with LRA and DRA. The clarification of the allergic triggers of airway diseases has a profound impact on the management strategies the patients can be offered. Importantly, allergen immunotherapy (AIT) remains as the only disease-modifying intervention for ARA. Recent data indicate that AIT might have a similar effect on LRA patients. Nevertheless, AIT success relies largely on the correct phenotyping of allergic individuals, and NAC, CAC, and BAC are very helpful tools in this regard. In this review, we will summarize the main indications and methodology of CAC, NAC, and BAC. Importantly, the clinical implementation of these tests might translate into precision medicine approaches and better health outcomes for patients with airway allergy.Consejería de Salud, Junta de Andalucía, Grant/Award Number: P20_00405; Instituto de Salud Carlos III, Grant/Award Number: PI20/01715, RD21/0002/0008, CM21/00262, CM20/00160, JR22/00048 and JR19/00029. Funding for open access charge: Universidad de Málaga / CBUA

ERCP and splenic injury

Abstractendoscopic Retrograde Colangiopancreatography (eRCP) is an invasive procedure with important complications that occurs in 5%-10% of the cases. The most frequent procedure related complications are: acute pancreatitis, hemorrhage, perforation and infection. an infrequent but potentially life threatening eRCP complication is the splenic injury, with very few cases reported in the literature. We report a patient with cholecholithiasis and biliary pancreatitis who was diagnosed with a subcapsular splenic laceration a few hours after an eRCP. Clinicians should be alerted to this potential post-procedure complication associated with eRCP

Superficial radiotherapy as haemostatic treatment in breast cancer

Poster Session [EP-1661] Purpose or Objective Breast cancer is a common pathology in which o = 25% in tumor size and absence of bleeding was observed. Conclusion Surface radiotherapy is a treatment modality that should be taken into account in patients with breast cancer who present bleeding as a consequence of local tumor growth, given that this is a treatment comfortable for the patient, non invasive and increases the quality of patient’s life

Isolation of Neisseria meningitidis strains with increase of penicillin minimal inhibitory concentrations

We report the isolation and characterization of ten strains showing an increase in the minimal inhibitory concentrations to penicillin (MICs > 0·1 μg/ml), and describe the epidemiological, clinical and microbiological features. The susceptibility of 3432 meningococcal strains isolated from patients in the recent epidemic wave (1978–86) in Spain, to several antimicrobial agents used in the treatment and chemoprophylaxis of meningococcal infection has been tested. Most were resistant to sulphadiazine but sensitive to other antibiotics. The possible existence of a new pattern of behaviour of meningococcal to penicillin is discussed

Assessing the variability in transmission of bovine tuberculosis within Spanish cattle herds

In Spain, despite years of efforts to eradicate bovine tuberculosis (bTB), the disease is still endemic, with some areas of high prevalence. In this context, the surveillance and control plans may need to be re-evaluated, and understanding the dynamics of bTB spread within Spanish herds may help to develop new strategies for reducing the time for detection of infected herds and for the elimination of bTB from the herds already infected. Here, we developed a compartmental stochastic model to simulate bTB within-herd transmission, fed it with epidemiological data from 22 herds (obtained from a previous work) and carried out parameter inference using Approximate Bayesian Computing methods We also estimated the “Within-herd transmission potential Number” (Rh), i.e. the average number of secondary cases generated by a single animal infected introduced into a totally susceptible herd, considering different scenarios depending on the frequency of controls. The median global values obtained for the transmission parameters were: for the transmission coefficient (β), 0.014 newly infected animals per infectious individual per day (i.e. 5.2 per year), for the rate at which infected individuals become infectious (α), 0.01 per day (equivalent to a latent period of 97 days), and for the rate at which infected individuals become reactive to the skin test (α1), 0.08 per day (equivalent to a period of 12 days for an infected animal to become reactive). However, the results also evidenced a great variability in the estimates of those parameters (in particular β and α) among the 22 herds. Considering a 6-month interval between tests, the mean Rh was 0.23, increasing to 0.82 with an interval of 1 year, and to 2.01 and 3.47 with testing intervals of 2 and 4 years, respectively.info:eu-repo/semantics/publishedVersio