Infección de quiste de uraco en adulto

The pathology of the urachus is rare and it is caused by the permeabilization of the urachal remnant. Among the most important complications are infection and neoplasia of the urachus. We showcase a 50-year-old woman who was diagnosed and treated for an urinary tract infection without improvement. The computerized tomography showed a prevesical collection compatible with an infected urachal cyst diagnosis. The treatment was favorable after a course of antibiotics and drainage of the lesion. Later, the patient had an excision surgery and a partial cystectomy with a favorable outcome.La patología del uraco es infrecuente y se produce por la permeabilización del remanente de uraco. Aunque la mayoría de los casos son asintomáticos, se puede dar el caso de ciertas complicaciones, siendo las más importantes la infección y las neoplasias de uraco. Presentamos el caso de una mujer de 50 años diagnosticada y tratada de infección de orina con mala evolución por lo que se realizó una tomografía computarizada que mostró colección prevesical compatible con un diagnóstico de quiste de uraco sobreinfectado. La paciente evolucionó favorablemente con drenaje y antibioterapia. Más adelante también se realizó cirugía de exéresis y cistectomía parcial con un resultado favorable

Aspectos productivos y educativos de realidades mixtas

En las últimas décadas, y particularmente en los últimos años, hemos asistido a un notable desarrollo de la electrónica que ha propiciado no sólo un crecimiento casi exponencial en la potencia de cómputo, de almacenamiento y de comunicación, sino que además ha permitido crear un gran número de dispositivos de hardware que posibilitan interacciones mucho más naturales y ricas entre los humanos y la tecnología en sí misma. De la misma forma, ha impulsado la creación de más y mejores aplicaciones de Realidad Mixta (RM), concepto relacionado a lo continuo de la virtualidad, donde en un extremo tenemos el mundo físico y real y, en el otro, a la realidad virtual. La realidad mixta es la tecnología que se encuentra entre los dos extremos del continuo de la virtualidad. Dentro de éste podemos encontrar a la Realidad Aumentada (RA), que consiste en adicionar información y objetos del mundo virtual al mundo real para complementarlo. Esta línea de investigación, desarrollo e innovación comprenderá el estudio de los diferentes aspectos de las realidades mixtas con el propósito de diseñar e implementar nuevas aplicaciones enfocadas en aspectos educativos y productivos de la región de influencia de esta Universidad.Eje: Innovación en Sistemas de SoftwareRed de Universidades con Carreras en Informática (RedUNCI

Aspectos productivos y educativos de realidades mixtas

En las últimas décadas, y particularmente en los últimos años, hemos asistido a un notable desarrollo de la electrónica que ha propiciado no sólo un crecimiento casi exponencial en la potencia de cómputo, de almacenamiento y de comunicación, sino que además ha permitido crear un gran número de dispositivos de hardware que posibilitan interacciones mucho más naturales y ricas entre los humanos y la tecnología en sí misma. De la misma forma, ha impulsado la creación de más y mejores aplicaciones de Realidad Mixta (RM), concepto relacionado a lo continuo de la virtualidad, donde en un extremo tenemos el mundo físico y real y, en el otro, a la realidad virtual. La realidad mixta es la tecnología que se encuentra entre los dos extremos del continuo de la virtualidad. Dentro de éste podemos encontrar a la Realidad Aumentada (RA), que consiste en adicionar información y objetos del mundo virtual al mundo real para complementarlo. Esta línea de investigación, desarrollo e innovación comprenderá el estudio de los diferentes aspectos de las realidades mixtas con el propósito de diseñar e implementar nuevas aplicaciones enfocadas en aspectos educativos y productivos de la región de influencia de esta Universidad.Eje: Innovación en Sistemas de SoftwareRed de Universidades con Carreras en Informática (RedUNCI

High-dose benznidazole in a 62-year-old Bolivian kidney transplant recipient with Chagas central nervous system involvement

There is little published data on benznidazole dosing, or levels in cerebrospinal fluid. In this report, we describe the clinical course of an immunosuppressed patient with Chagas central nervous system involvement. He was treated successfully with larger benznidazole doses than are recommended, in order to reach therapeutically effective concentrations in the brain

COVID-19 in elderly kidney transplant recipients

The SARS-Cov-2 infection disease (COVID-19) pandemic has posed at risk the kidney transplant (KT) population, particularly the elderly recipients. From March 12 until April 4, 2020, we diagnosed COVID-19 in 16 of our 324 KT patients aged ≥65 years old (4.9%). Many of them had had contact with healthcare facilities in the month prior to infection. Median time of symptom onset to admission was 7 days. All presented with fever and all but one with pneumonia. Up to 33% showed renal graft dysfunction. At infection diagnosis, mTOR inhibitors or mycophenolate were withdrawn. Tacrolimus was withdrawn in 70%. The main treatment combination was hydroxychloroquine and azithromycin. A subset of patients was treated with anti-retroviral and tocilizumab. Short-term fatality rate was 50% at a median time since admission of 3 days. Those who died were more frequently obese, frail, and had underlying heart disease. Although a higher respiratory rate was observed at admission in nonsurvivors, symptoms at presentation were similar between both groups. Patients who died were more anemic, lymphopenic, and showed higher D-dimer, C-reactive protein, and IL-6 at their first tests. COVID-19 is frequent among the elderly KT population and associates a very early and high mortality rate

Clinical profiles in renal patients with COVID-19

The COVID-19 pandemic has led to frequent referrals to the emergency department on suspicion of this infection in maintenance hemodialysis (MHD) and kidney transplant (KT) patients. We aimed to describe their clinical features comparing confirmed and suspected non-confirmed COVID-19 cases during the Spanish epidemic peak. Confirmed COVID-19 ((+)COVID-19) corresponds to patient with positive RT-PCR SARS-CoV-2 assay. Non-confirmed COVID-19 ((-)COVID-19) corresponds to patients with negative RT-PCR. COVID-19 was suspected in 61 patients (40/803 KT (4.9%), 21/220 MHD (9.5%)). Prevalence of (+)COVID-19 was 3.2% in KT and 3.6% in MHD patients. Thirty-four (26 KT and 8 MHD) were (+)COVID-19 and 27 (14 KT and 13 MHD) (-)COVID-19. In comparison with (-)COVID-19 patients, (+)COVID-19 showed higher frequency of typical viral symptoms (cough, dyspnea, asthenia and myalgias), pneumonia (88.2% vs. 14.3%) and LDH and CRP while lower phosphate levels, need of hospital admission (100% vs. 63%), use of non-invasive mechanical ventilation (36% vs. 11%) and mortality (38% vs. 0%) (p < 0.001). Time from symptoms onset to admission was longer in patients who finally died than in survivors (8.5 vs. 3.8, p = 0.007). In KT and MHD patients, (+)COVID-19 shows more clinical severity than suspected non-confirmed cases. Prompt RT-PCR is mandatory to confirm COVID-19 diagnosis

Bioavailability of once-daily tacrolimus formulations used in clinical practice in the management of De Novo kidney transplant recipients: the better study.

Multicenter, prospective, observational study to compare the relative bioavailability of once-daily tacrolimus formulations in de novo kidney transplant recipients. De novo kidney transplant recipients who started a tacrolimus-based regimen were included 14 days post-transplant and followed up for 6 months. Data from 218 participants were evaluated: 129 in the LCPT group (Envarsus) and 89 in the PR-Tac (Advagraf) group. Patients in the LCPT group exhibited higher relative bioavailability (Cmin /total daily dose [TDD]) vs. PR-Tac (61% increase; P

Influence of the length of hospitalisation in post-discharge outcomes in patients with acute heart failure: Results of the LOHRCA study.

To investigate the relationship between length of hospitalisation (LOH) and post-discharge outcomes in acute heart failure (AHF) patients and to ascertain whether there are different patterns according to department of initial hospitalisation. Consecutive AHF patients hospitalised in 41 Spanish centres were grouped based on the LOH (15 days). Outcomes were defined as 90-day post-discharge all-cause mortality, AHF readmissions, and the combination of both. Hazard ratios (HRs), adjusted by chronic conditions and severity of decompensation, were calculated for groups with LOH >6 days vs. LOH 6 days vs. LOH We included 8563 patients (mean age: 80 (SD = 10) years, 55.5% women), with a median LOH of 7 days (IQR 4-11): 2934 (34.3%) had a LOH 15 days. The 90-day post-discharge mortality was 11.4%, readmission 32.2%, and combined endpoint 37.4%. Mortality was increased by 36.5% (95%CI = 13.0-64.9) when LOH was 11-15 days, and by 72.0% (95%CI = 42.6-107.5) when >15 days. Conversely, no differences were found in readmission risk, and the combined endpoint only increased 21.6% (95%CI = 8.4-36.4) for LOH >15 days. Stratified analysis by hospitalisation departments rendered similar post-discharge outcomes, with all exhibiting increased mortality for LOH >15 days and no significant increments in readmission risk. Short hospitalisations are not associated with worse outcomes. While post-discharge readmissions are not affected by LOH, mortality risk increases as the LOH lengthens. These findings were similar across hospitalisation departments