Strategy for the Conservative Treatment of Type-III Camptodactyly in Children with Beals-Hecht Syndrome / Estratégia para o tratamento conservador da camptodactilia de tipo III em criança com síndrome de Beals-Hecht

Abstract The authors present a successful case in the conservative treatment of type-III camptodactyly in a patient with Beals-Hecht syndrome. Camptodactyly is a flexion deformity of the proximal interphalangeal (PIP) joint, in the anteroposterior direction, painless and bilateral in 2/3 of the cases. Type-III is the most severe and disabling form, as it usually affects several fingers and is associated with syndromes and other malformations. The case herein reported had the correction achieved with the systematic use of static orthoses started at 7 months of age and completed after 23 and a half months of the intervention.

Resumo Os autores apresentam um caso bem-sucedido no tratamento conservador da camptodactilia de tipo III em paciente com síndrome de Beals-Hecht. A camptodactilia é uma deformidade em flexão da articulação interfalangeana proximal (IFP), no sentido anteroposterior, indolor, e bilateral em 2/3 dos casos. A de tipo III é a forma mais grave e incapacitante, pois geralmente acomete vários dedos e está associada a síndromes e outras malformações. O caso apresentado teve a correção alcançada com o uso sistemático de órteses estáticas iniciado aos 7 meses de idade e concluído após 23 meses e meio de intervenção.

Dynamic computed tomography angiography for noninvasive diagnosis of bow Hunter's syndrome: a case report

ABSTRACT The focus of this case report is to technically describe a noninvasive diagnostic evaluation of bow Hunter's syndrome using a dynamic computed tomography angiography protocol and discuss its advantages. In addition, we aimed to exemplify the quality of the study by presenting images of a 3D-printed model generated to help plan the surgical treatment for the patient. The dynamic computed tomography angiography protocol consisted of a first image acquisition with the patient in the anatomic position of the head and neck. This was followed by a second acquisition with the head and neck rotated to the side that triggered the symptoms, with technical parameters similar to the first acquisition. The acquired images were used to print a 3D model to better depict the findings for the surgical team. The dynamic computed tomography angiography protocol developed in this study helped visualize the vertebrobasilar arterial anatomy, detect vertebral artery stenosis produced by head and neck rotation, depict the structure responsible for artery stenosis (e.g., bony structure or membranes), and study possible complications of the disease (e.g., posterior cerebral circulation infarction). Additionally, the 3D-printed model better illustrated the findings of stenosis, aiding in surgical planning. In conclusion, dynamic computed tomography angiography for the evaluation of bow Hunter's syndrome is a feasible noninvasive technique that can be used as an alternative to traditional diagnostic methods.

Polidocanol-foam treatment of varicose veins: Quality-of-life impact compared to conventional surgery

Abstract Background and objective: Lower limb varicose veins are a prevalent disease associated with several available treatment options, including conventional surgery and polidocanol foam sclerotherapy. However, few studies have analyzed therapeutic modality outcomes based on Patient-Reported Outcome Measures (PROMs). This large sample-size study was designed to evaluate the outcomes of polidocanol foam sclerotherapy compared to conventional surgery based on an analysis of PROMs. Methods: This was a prospective, observational, and qualitative study of 205 patients who underwent varicose vein treatment with either polidocanol foam sclerotherapy (57 patients, 90 legs) or conventional surgery (148 patients, 236 legs). Patients were preoperatively assessed and re-evaluated 30 days after the procedure using the Venous Disease Severity Score (VCSS) and specific venous disease quality-of-life questionnaires (VEINES-QoL/Sym). Results: Both treatments significantly improved VCSS and VEINES results 30 days after the procedure (p < 0.05). However, surgery promoted greater improvements in VCSS (on average 4.02-points improvement, p < 0.001), VEINES-QoL (average 8-points improvement, p < 0.001), and VEINES-Sym (average 11.66 points improvement, p < 0.001) than did sclerotherapy. Postoperative pain and aesthetic concerns about the legs were the domains of the questionnaires in which the results varied the most between the treatment modalities, with worse results for sclerotherapy. Conclusion: Both polidocanol foam sclerotherapy and conventional surgery positively impact patients' quality of life after 30 days, but the improvement is more significant for patients who undergo conventional surgery.

Retrospective analysis of 1,203 cases of referral to a quaternary vascular surgery outpatient clinic within the Unified Health System, São Paulo, Brazil

ABSTRACT Objective Consequently, in this study, we aimed to evaluate 1,203 cases of referral to a quaternary vascular surgical service, in São Paulo, Brazil, over a 6-year period, to assess the appropriate need for referral; in addition to the prevalence of surgical indications. Methods In this retrospective analysis, we reviewed the institutional records of participants referred from Basic Healthcare Units to a vascular surgical service inside the Brazilian Unified Health System, between May 2015 and December 2020. Demographic and clinical data were collected. The participants were stratified, as per the reason for referral to the vascular surgical service, previous imaging studies, and surgical treatment indications. Referral appropriateness and complementary examinations were evaluated for each disease cohort. Finally, the prevalence of cases requiring surgical treatment was defined as the outcome measure. Results Of the 1,203 referrals evaluated, venous disease was the main reason for referral (53%), followed by peripheral arterial disease (19.4%). A considerable proportion of participants had been referred without complementary imaging or after a long duration of undergoing an examination. Referrals were regarded as inappropriate in 517 (43%) cases. Of these, 32 cases (6.2%) had been referred to the vascular surgical service, as the incorrect specialty. The percentage of referred participants who ultimately underwent surgical treatment was 39.92%. Carotid (18%) and peripheral arterial diseases (18.4%) were correlated with a lower prevalence of surgical treatments. Conclusion The rate of referral appropriateness to specialized vascular care from primary care settings was low. This may represent a subutilization of quaternary surgical services, with low rates of surgical treatment.

Proposed public policies to improve outcomes in vascular surgery: an experts' forum

ABSTRACT Objective To evaluate outcomes of vascular surgeries and identify strategies to improve public vascular care. Methods This was a descriptive, qualitative, and cross-sectional survey involving 30 specialists of the Hospital Israelita Albert Einstein via Zoom. The outcomes of vascular procedures performed in the Public Health System extracted through Big Data analysis were discussed, and 53 potential strategies to improve public vascular care to improve public vascular care. Results There was a consensus on mandatory reporting of some key complications after complex arterial surgeries, such as stroke after carotid revascularization and amputations after lower limb revascularization. Participants agreed on the recommendation of screening for diabetic feet and infrarenal abdominal aortic aneurysms. The use of Telemedicine as a tool for patient follow-up, auditing of centers for major arterial surgeries, and the concentration of complex arterial surgeries in reference centers were also points of consensus, as well as the need to reduce the values of endovascular materials. Regarding venous surgery, it was suggested that there should be incentives for simultaneous treatment of both limbs in cases of varicose veins of the lower limbs, in addition to the promotion of ultrasound-guided foam sclerotherapy in the public system. Conclusion After discussing the data from the Brazilian Public System, proposals were defined for standardizing measures in population health care in the area of vascular surgery.

Application of telesimulation in a medical undergraduate course during the SARS-CoV-2 pandemic: a quantitative and retrospective study

ABSTRACT BACKGROUND: Because of the social isolation and distancing measures that were imposed to stop the spread of coronavirus disease 19 (COVID-19), new ways of teaching were implemented. OBJECTIVES: To describe the implementation of telesimulation and seek to assess students' perceptions regarding telesimulation. DESIGN AND SETTING: Retrospective quantitative study conducted within the hospital simulation at a private medical school in São Paulo, Brazil. METHODS: After telesimulation training, students answered a questionnaire that provided an overall assessment of this activity, self-assessment and assessments of the facilitators and infrastructure provided by the University. RESULTS: Among the students, 50% reported that the activity was below expectations and 45% reported that it was in line with their expectations. The strong points of the activity were the clinical cases, workload and teachers. The main challenge was students' difficulty in reflecting on their learning and the infrastructure. CONCLUSIONS: Since students have less experience and fewer clinical encounters than residents or professionals, they also face more difficulty. Although telesimulation may have provided a valid alternative to replace simulation training during the COVID-19 pandemic, more face-to-face activities should be offered to students, when possible.

Focal incidental upper abdominal findings on unenhanced chest computed tomography that do not require further imaging: a roadmap for the thoracic radiologist / Achados incidentais focais no abdome superior encontrados na tomografia computadorizada de tórax sem contraste que não requerem investigação adicional: roteiro para o radiologista torácico

Abstract Chest scans usually include the upper abdomen, leading radiologists to evaluate the upper abdominal structures. The aim of this article is to summarize the most common incidental upper abdominal findings that do not require further imaging or management in patients undergoing unenhanced computed tomography of the chest for the investigation of thoracic symptoms or diseases. We review common incidental findings of the liver, gallbladder, spleen, adrenal glands, kidney, and retroperitoneum, as well as findings that mimic other lesions. Thoracic radiologists should be aware of such typical findings and report when no further investigation is needed, thus avoiding unnecessary imaging examinations, protecting patients from additional medical interventions, and allaying patient concerns.

Resumo As tomografias de tórax geralmente incluem o abdome superior, o que implica a avaliação das estruturas abdominais superiores. Nosso objetivo é resumir os achados incidentais mais comuns do abdome superior que não requerem imagem ou tratamento adicional em pacientes submetidos a tomografia computadorizada de tórax sem contraste para investigar sintomas ou doenças torácicas. Achados incidentais comuns do fígado, vesícula biliar, baço, glândulas adrenais, rins, retroperitônio e alterações que podem mimetizar lesões nesses órgãos serão revisados. O radiologista torácico deve estar ciente de tais achados e relatar quando nenhuma investigação adicional for necessária, para evitar excesso de exames, especialmente com radiação ionizante, proteger os pacientes de intervenções médicas e de preocupações.

Larvas de helmintos no solo de praças públicas de Caxias, Maranhão, Brasil / Helminth larvae in the soil of public squares in Caxias, Maranhão, Brazil / Larvas de helmintos en el suelo de plazas públicas en Caxias, Maranhão, Brasil

Solos de praças públicas são comumente contaminados por helmintos devido ao fácil acesso de cães e gatos infectados. Esses animais ao defecarem podem liberar ovos desses parasitos e, em condições ambientais favoráveis, tornam-se ovos embrionados ou larvas infectantes. O objetivo deste trabalho foi investigar a existência de larvas de helmintos no solo de duas praças públicas do município de Caxias, Maranhão, Brasil, durante a estação chuvosa e seca na região. A pesquisa foi realizada em março de 2018, considerado período chuvoso, e em outubro do mesmo ano, período seco, sendo que foram coletadas trinta amostras de areia, quinze de cada praça, nos dois períodos do ano. O material foi coletado e levado para o Laboratório de Parasitologia do Departamento de Parasitologia e Microbiologia da Universidade Federal do Piauí para análise. Na estação chuvosa, das quinze amostras analisadas na praça A, cinco foram positivas para larvas de ancilostomídeos e das quinze na praça B, três estavam contaminadas com os mesmos helmintos. No período seco, na praça A havia apenas uma amostra com essas larvas e na praça B não foram encontrados parasitos. Os resultados revelaram a presença de larvas de helmintos de caráter zoonótico no solo de praças públicas de Caxias, Maranhão, principalmente no período chuvoso, servindo de alerta à população local.(AU)

Soil in public squares is commonly contaminated by helminths due to the easy access of infected dogs and cats. These animals, when defecating, can release helminth eggs and, under favorable environmental conditions, those eggs can become embryonated or infective larvae. The purpose of this work was to investigate the existence of helminth larvae in the soil of two public squares in the city of Caxias, in the state of Maranhão, Brazil, during the rainy and dry seasons in the region. The study was carried out in March 2018, which is considered the rainy season, and in October of the same year, the dry season. A total of thirty sand samples were collected, fifteen from each square, in both periods of the year. The material was collected and taken to the Parasitology Laboratory of the Department of Parasitology and Microbiology of the Federal University of Piauí for analysis. In the rainy season, from the fifteen samples analyzed in square A, five were positive for hookworm larvae; and from the fifteen samples collected from square B, three were contaminated with the same helminths. During the dry period, only one sample from square A presented these larvae while no parasites were found in square B. The results revealed the presence of zoonotic helminth larvae in the soil of public squares in Caxias, Maranhão, mainly in the rainy season, which can be used as a warning sign to the local population.(AU)

Los suelos de las plazas públicas son comúnmente contaminados por helmintos debido al fácil acceso de perros y gatos infectados. Esos animales, al defecar, pueden liberar huevos de esos parásitos y, en condiciones ambientales favorables, convertirse en huevos embrionados o larvas infectantes. El objetivo de este trabajo fue investigar la existencia de larvas de helmintos en el suelo de dos plazas públicas de la ciudad de Caxias, Maranhão, Brasil, durante la estación lluviosa y seca de la región. La investigación se realizó en marzo de 2018, considerada época de lluvias, y en octubre del mismo año, época seca, y se recolectaron treinta muestras de arena, quince de cada plaza, en ambos períodos del año. El material fue recolectado y llevado al Laboratorio de Parasitología del Departamento de Parasitología y Microbiología de la Universidad Federal de Piauí para su análisis. En época de lluvias, de las quince muestras analizadas en la plaza A, cinco resultaron positivas a larvas de anquilostomiasis y de las quince de la plaza B, tres estaban contaminadas con los mismos helmintos. En el período poco lluvioso, en la plaza A solo hubo una muestra con esas larvas y en la plaza B no se encontraron parásitos. Los resultados revelaron la presencia de larvas de helmintos zoonóticos en el suelo de las plazas públicas de Caxias, Maranhão, principalmente en la época de lluvias, sirviendo de alerta a la población local.(AU)

Interobserver agreement regarding the Fleischner Society diagnostic criteria for usual interstitial pneumonia patterns on computed tomography / Concordância interobservador nas categorias diagnósticas de pneumonia intersticial usual propostas pela Fleischner Society na tomografia computadorizada

Abstract Objective: To assess interobserver agreement among radiologists regarding the current Fleischner Society diagnostic criteria for usual interstitial pneumonia (UIP) patterns on computed tomography (CT). Materials and Methods: Using the Fleischner Society criteria for UIP CT patterns, five raters, working independently, categorized the high-resolution CT (HRCT) scans of 44 patients with interstitial lung disease who underwent lung biopsy. The raters also evaluated the presence, extent, and distribution of the most relevant imaging findings, as well as indicating their level of confidence in the most likely diagnosis and in up to three diagnostic hypotheses. Results: There was moderate to substantial interobserver agreement regarding the UIP patterns on HRCT—kappa statistic (κ) = 0.59-0.61. Interobserver agreement for the binary scores was substantial (κ = 0.77-0.79), whereas that for the presence of honeycombing was almost perfect (κ = 0.81-0.96). There was agreement regarding at least one of the three diagnostic hypotheses in only 36.4% of the cases. For the level of confidence in the most likely diagnosis, there was only slight to fair agreement (κ = 0.19-0.21). Conclusion: Interobserver agreement regarding the current Fleischner Society CT criteria for UIP was moderate to substantial among raters with varying levels of experience. There was only slight to fair agreement regarding the diagnostic hypotheses and for the level of confidence in the most likely diagnosis.

Resumo Objetivo: Avaliar a concordância interobservador entre radiologistas para os critérios atuais da Fleischner Society para categorias diagnósticas de pneumonia intersticial usual (PIU) em tomografia computadorizada (TC). Materiais e Métodos: Cinco observadores categorizaram independentemente as imagens de TC de 44 pacientes com doença pulmonar intersticial que foram submetidos a biópsia pulmonar empregando as últimas categorias de diagnóstico da Sociedade Fleischner para UIP. Também foram avaliadas presença, extensão e distribuição dos achados de imagem mais relevantes, bem como a confiança no diagnóstico mais provável e em até três hipóteses diagnósticas. Resultados: Houve concordância moderada a alta para as categorias diagnósticas entre os observadores (κ = 0,59-0,61). A concordância interobservador para a pontuação binária foi alta (κ = 0,77-0,79), enquanto para a presença de faveolamento foi considerada de alta a muito alta (κ = 0,81-0,96). Houve concordância em uma das três hipóteses diagnósticas em apenas 36,4% dos casos. Baixa concordância foi encontrada para o diagnóstico mais provável (κ = 0,19-0,21). Conclusão: A concordância entre observadores para os critérios atuais de TC da Fleischner Society para UIP foi moderada a alta entre observadores com diferentes níveis de experiência. Houve baixa concordância nas hipóteses diagnósticas e quanto ao grau de confiança no diagnóstico primário.

Development and content validation of a mobile application for monitoring latent tuberculosis treatment

ABSTRACT Background: Non-compliance with latent tuberculosis infection (LTBI) treatment is a reality. The objective of this study was to develop and validate an mobile device application for monitoring the treatment of LTBI. Methods: We defined the requirements, elaborated on the application's conceptual map, generated implementation and prototyping alternatives, and validated content. Results: Feedback on the validity of content were: "usefulness, consistency, clarity, objectivity, vocabulary, and precision" from professionals, and "clarity" from patients. Conclusions: The application proved to be easy to understand, according to the assessment of both professionals and people undergoing treatment for LTBI.

O-JMeSH: creating a bilingual English-Japanese controlled vocabulary of MeSH UIDs through machine translation and mutual information

Previous approaches to create a controlled vocabulary for Japanese have resorted to existing bilingual dictionary and transformation rules to allow such mappings. However, given the possible new terms introduced due to coronavirus disease 2019 (COVID-19) and the emphasis on respiratory and infection-related terms, coverage might not be guaranteed. We propose creating a Japanese bilingual controlled vocabulary based on MeSH terms assigned to COVID-19 related publications in this work. For such, we resorted to manual curation of several bilingual dictionaries and a computational approach based on machine translation of sentences containing such terms and the ranking of possible translations for the individual terms by mutual information. Our results show that we achieved nearly 99% occurrence coverage in LitCovid, while our computational approach presented average accuracy of 63.33% for all terms, and 84.51% for drugs and chemicals.

Constructing Japanese MeSH term dictionaries related to the COVID-19 literature

The coronavirus disease 2019 (COVID-19) pandemic has led to a flood of research papers and the information has been updated with considerable frequency. For society to derive benefits from this research, it is necessary to promote sharing up-to-date knowledge from these papers. However, because most research papers are written in English, it is difficult for people who are not familiar with English medical terms to obtain knowledge from them. To facilitate sharing knowledge from COVID-19 papers written in English for Japanese speakers, we tried to construct a dictionary with an open license by assigning Japanese terms to MeSH unique identifiers (UIDs) annotated to words in the texts of COVID-19 papers. Using this dictionary, 98.99% of all occurrences of MeSH terms in COVID-19 papers were covered. We also created a curated version of the dictionary and uploaded it to PubDictionary for wider use in the PubAnnotation system.

Training in healthcare during and after COVID-19: proposal for simulation training

SUMMARY INTRODUCTION: The challenge of facing COVID-19 falls under all health care structures, and without specific training to health care professionals they are probably the professionals with the highest level of exposure. Regardless of the level of health care, the training of professionals aims to optimize resources and attend patients while assuring quality and security. POINT OF VIEW: This report proposes simulation training for health care professionals to update professionals for attending patients during the pandemic. This training was built with five simulated stations, considering different stages of a patient with COVID-19. This report takes advantage of different simulation techniques, such as skills training, standardized patient, medium- and high-fidelity simulator, rapid cycle of deliberate practice, and in situ simulation. DISCUSSION: Medical procedures for COVID-19 patients offer additional risk for health care professionals, especially considering exposure to procedures that generate aerosols, such as compression, mask ventilation, and orotracheal intubation. Thus, finding educational strategies that allow training is essential to simulate the evolution of COVID-19 patients in a safe manner. CONCLUSION: Simulation has proven to be a useful and effective form of training around the world for training health teams on the front lines for patient care in COVID-19.

Embolization of renal tumor bone metastasis: case report / Embolização de metástase óssea de tumor renal: relato de caso

Abstract Primary or secondary bone tumors can manifest in different ways, from simple bone pain to possible pathological fractures. Hypervascularized tumors are of greatest concern, with increased incidence of complications. Preoperative embolization of the bone tumor is an effective measure for reducing blood loss during open surgery to excise the tumor. With appropriate experience, the risks of the procedure are minimal and final outcomes are highly satisfactory. The purpose of this paper is to describe the case of a 43-year-old male patient with a metastatic renal cell tumor in the left proximal femur (seen on lower limb computed tomography) who underwent selective preoperative embolization. The procedure resulted in a remarkable absence of bleeding and successful response to subsequent onco-orthopedic surgery.

Resumo Os tumores ósseos, primários ou secundários, podem se manifestar de várias formas, desde dor óssea até fraturas patológicas. A preocupação maior repousa sobre tumores hipervascularizados, com maior incidência de complicações. A embolização pré-operatória do tumor ósseo é uma medida eficaz para reduzir a perda sanguínea durante a exérese tumoral em cirurgia aberta. Com uma experiência apropriada, os riscos do procedimento são mínimos, com resultados finais bastante satisfatórios. O presente artigo tem por finalidade descrever o caso de um paciente do sexo masculino, de 43 anos, com tumor metastático de células renais em fêmur proximal esquerdo (visualizado por angiotomografia de membro inferior), submetido à embolização arterial seletiva pré-operatória. O procedimento resultou em ausência de sangramento e ótima resposta à cirurgia onco-ortopédica realizada.

Clinical simulation strategies for knowledge integration relating to initial critical recognition and management of COVID-19 for use within continuing education and health-related academia in Brazil: a descriptive study

ABSTRACT BACKGROUND: The COVID-19 pandemic has led to an immense need to develop training on case recognition and management, with a focus on patients' and health professionals' safety at several levels of healthcare settings in Brazil. Different simulation strategies can be included in the diverse clinical care phases for these patients. OBJECTIVE: To suggest a complete simulation-based training program for Brazilian hospitals and/or academic institutions at this moment of the pandemic. DESIGN AND SETTING: Descriptive analysis on possible simulated clinical cases using different methodologies, thereby supporting suspected or confirmed COVID-19 patients. METHODS: This was a reflective theoretical descriptive study on an educational program based on clinical simulation, with four practical phases at different performance and complexity levels. Wearing, handling and adequately disposing of personal protective equipment, along with specific respiratory procedures in different healthcare settings up to intensive care for seriously infected patients were addressed. RESULTS: This program was designed for application at different Brazilian healthcare levels through different clinical simulation strategies. Summaries of expected performance were suggested in order to standardize technical capacity within these simulation settings, so as to serve these levels. CONCLUSIONS: Developing training programs for situations such as the current COVID-19 pandemic promotes safety not only for patients but also for healthcare workers. In the present context, clear definition of which patients need hospital outpatient or inpatient care will avoid collapse of the Brazilian healthcare system. Institutions that do not have simulated environments can, through the examples described, adopt procedures to promote didactic information in order to help healthcare professionals during this time.

SciBabel: a system for crowd-sourced validation of automatic translations of scientific texts

Scientific research is mostly published in English, regardless of the researcher's nationality. However, this growing practice impairs or hinders the comprehension of professionals who depend on the results of these studies to provide adequate care for their patients. We suggest that machine translation (MT) can be used as a way of providing useful translation for biomedical articles, even though the translation itself may not be fluent. To tackle possible mistranslation that can harm a patient, we resort to crowd-sourced validation of translations. We developed a prototype of MT validation and edition, where users can vote for that translation as valid, or suggest modifications (i.e., post-editing the MT). A glossary match system is also included, aiming at terminology consistency.

SciBabel: a system for crowd-sourced validation of automatic translations of scientific texts

Scientific research is mostly published in English, regardless of the researcher's nationality. However, this growing practice impairs or hinders the comprehension of professionals who depend on the results of these studies to provide adequate care for their patients. We suggest that machine translation (MT) can be used as a way of providing useful translation for biomedical articles, even though the translation itself may not be fluent. To tackle possible mistranslation that can harm a patient, we resort to crowd-sourced validation of translations. We developed a prototype of MT validation and edition, where users can vote for that translation as valid, or suggest modifications (i.e., post-editing the MT). A glossary match system is also included, aiming at terminology consistency.

PharmacoNER Tagger: a deep learning-based tool for automatically finding chemicals and drugs in Spanish medical texts

Automatically detecting mentions of pharmaceutical drugs and chemical substances is key for the subsequent extraction of relations of chemicals with other biomedical entities such as genes, proteins, diseases, adverse reactions or symptoms. The identification of drug mentions is also a prior step for complex event types such as drug dosage recognition, duration of medical treatments or drug repurposing. Formally, this task is known as named entity recognition (NER), meaning automatically identifying mentions of predefined entities of interest in running text. In the domain of medical texts, for chemical entity recognition (CER), techniques based on hand-crafted rules and graph-based models can provide adequate performance. In the recent years, the field of natural language processing has mainly pivoted to deep learning and state-of-the-art results for most tasks involving natural language are usually obtained with artificial neural networks. Competitive resources for drug name recognition in English medical texts are already available and heavily used, while for other languages such as Spanish these tools, although clearly needed were missing. In this work, we adapt an existing neural NER system, NeuroNER, to the particular domain of Spanish clinical case texts, and extend the neural network to be able to take into account additional features apart from the plain text. NeuroNER can be considered a competitive baseline system for Spanish drug and CER promoted by the Spanish national plan for the advancement of language technologies (Plan TL).