Apendicitis aguda y teratoma: ¿causalidad o consecuencia?

La enfermedad ginecológica puede cursar con gran variedad de manifestaciones clínicas. La coexistencia de teratoma y apendicitis aguda supone un porcentaje inusual de enfermedad abdominal en mujeres jóvenes, aunque no de forma exclusiva. Apenas hay revisiones o casos documentados en la literatura, por lo que se desconoce si existe causalidad entre ambas o simplemente es una coincidencia. Exponemos el caso de una paciente joven cuyo síntoma guía fue un dolor abdominal difuso con gran discordancia clinicorradiológica, que precisó intervención quirúrgica y confirmó la presencia de ambas entidades tras el estudio anatomopatológico. Gynaecological disorders can have a wide variety of clinical manifestations. The coexistence of teratoma and acute appendicitis accounts for unusual, but not exclusive, percentage of abdominal pathology in young women. There are virtually no reviews or documented cases in the literature, so it is unknown whether there is causality between the 2 or simply a coincidence. The case is presented of a young patient whose main symptom was diffuse abdominal pain with great clinical and radiological discordance. Surgical intervention was required to confirm the presence of both pathologies after the completion of the histopathology study

Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%