Multifocal pyoderma gangrenosum secondary to subclinical diverticulitis: case report and brief literature review

Pyoderma gangrenosum is characteristically associated with inflammatory bowel disease. However, the association between this neutrophilic dermatosis and diverticular disease is scarcely mentioned in the literature. Diverticulitis should be included in the differential diagnosis in patients with pyoderma gangrenosum and gastrointestinal complaints, or even in asymptomatic patients, particularly in the elderly. Misdiagnosis can lead to inadequate treatments and serious complications

Deterioro de la integridad cutánea por Pioderma Gangrenoso.

Pyoderma Gangrenosum (P.G), is an infrequent inflammatory skin disorder with a probably autoimmune etiology. P.G. is characterized by the appearance of necrotic skin ulcers and their progress is usually torpid, chronic and often destructive with spread to large areas. These lesions can appear anywhere on the body, but they are mainly located in legs, buttocks, abdomen and arms. It can occur spontaneously or in areas that have suffered minor trauma or surgeryEl pioderma gangrenoso (PG), es un trastorno inflamatorio de la piel poco frecuente de etiología probablemente autoinmune. P.G. se caracteriza por la aparición de úlceras cutáneas necróticas y su progreso es generalmente tórpido, crónico y a menudo destructivo con propagación a grandes áreas. Estas lesiones pueden aparecer en cualquier parte del cuerpo, pero se encuentran principalmente en las piernas, glúteos, abdomen y brazos. Puede ocurrir de forma espontánea o en zonas que han sufrido un traumatismo menor o cirugía

High medium-term incidence of major cardiovascular events in discharged patients with unstable angina

The introduction of high-sensitivity troponin (hsTn) assays has reduced the diagnosis of unstable angina (UA) in favor of non-ST elevation myocardial infarction (NSTEMI) in the context of non-ST elevation acute coronary syndrome (NSTEACS). It is unclear whether the detection of these hsTn levels affects the prognosis and therefore whether a different therapeutic approach is warranted. This study aims to determine whether using hsTn results in medium-term prognostic differences in patients with UA and NSTEMI. Methods: This multicenter, prospective registry study included consecutive patients who underwent hsTn assays and were discharged with a diagnosis of NSTEACS. Patients were followed for two years. Outcomes were the occurrence of major adverse cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, and non-fatal ischemic stroke), major bleeding, and all-cause mortality. Results: Patients with UA and NSTEMI did not show differences in terms of the invasive interventions received, the coronary artery disease diagnosed, the type of revascularization performed, or the proportion presenting MACE (UA 18.1% vs. NSTEMI 18.9%; p = 0.79). However, patients with NSTEMI had higher cardiovascular mortality at two years (UA 4% vs. NSTEMI 9.2%; p = 0.012), as well as, all-cause mortality (UA vs. 7.9% vs. NSTEMI 16.4%; p = 0.002). Conclusions: Medium-term incidence of MACE was similar in patients with UA and NSTEMI, but cardiovascular and all-cause mortality in NSTEMI patients was over twice that of patients with UA