Lejía en tiempos de COVID-19 y falsa hematuria / Bleach in COVID's 19 time and spurious hematuria

La hematuria es un motivo de consulta frecuente. Una adecuada historia clínica y exploración física permiten una aproximación diagnóstica inicial en la mayoría de los casos. Lo primero es reconocer y confirmar la hematuria, descartando otras circunstancias que pueden teñir falsamente la orina. El análisis del aspecto macroscópico de la orina es clave para determinar el origen glomerular o extraglomerular de la hematuria. Presentamos el caso de una niña con falsa hematuria por agente externo, efectuándose el diagnóstico a través de una exhaustiva historia clínica

Hematuria is a frequent reason for consultation. An adequate medical history and physical examination allow an initial diagnostic approach in most cases. The first thing is to recognize and confirm hematuria, ruling out other circumstances that can falsely stain urine. The analysis of the macroscopic appearance of urine is key to determine the glomerular or extraglomerular origin of hematuria. In this paper, the case of a girl with false hematuria from an external agent in which the diagnosis is reached through an exhaustive medical history

La Asociación Catalana de Salud Laboral (@SCSL) ante el gran reto de la COVID-19 / L'Associació Catalana de Salut Laboral (@SCSL) davant el gran repte de la COVID-19 / The Catalan Society of Occupational Health (@SCSL) facing the big challenge of COVID-19

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Hoyuelo cutáneo occipital en una recién nacida / Occipital skin dimple in a new-born girl

El seno dérmico es un defecto congénito de cierre del tubo neural que se produce entre la tercera y la cuarta semana de gestación. Es una variedad de disrafismo que permite una potencial comunicación entre la piel y el sistema nervioso central. Se localiza preferentemente en línea media posterior, desde el occipucio hasta la región lumbosacra; la localización occipital es la segunda más frecuente. La clínica es muy variable, desde pacientes asintomáticos hasta el desarrollo de meningitis o abscesos por comunicación con el sistema nervioso central como primera manifestación clínica. La resonancia magnética es la prueba de imagen diagnóstica más adecuada, ya que permite determinar la extensión de las lesiones y descartar lesiones a otros niveles. Se recomienda exéresis quirúrgica profiláctica total en todos los casos. Presentamos un caso de una recién nacida con un hoyuelo cutáneo en la región occipital visualizado en la primera exploración física

The dermal sinus is a congenital neural tube closure defect that occurs between the 3rd -4th week of gestation. It is a variety of dysraphism that allows a potential communication between the skin and the central nervous system. It often is located in the posterior midline, from occipital to lumbosacral region, the occipital location is the second most frequent. The clinic is very variable, from asymptomatic patients to development of meningitis or abscesses due to a communication with the central nervous system as the first clinical manifestation. Magnetic resonance imaging is the most appropriate diagnostic imaging test, it allows to determine the lenght of the fistulous path and rule out injuries at other levels. Total prophylactic surgical excision is recommended in all cases. We present a case of a newborn with a skin dimple in occipital region visualized in the first physical examination

Brown tumor of the cervical spine: a case report and review of the literature.

Brown tumors (BT) are benign focal bone lesions that may appear in the context of primary and secondary hyperparathyroidism (HPT). Involvement of the spine is exceedingly rare. We present a case of brown tumor involving the cervical spine, the third reported in the literature. In the literature review (until August 2010), we found nine cases of spinal BT in primary HPT and 14 cases in secondary HPT. Fifteen patients (65%) had evidence of spinal cord compression. A 34-year-old woman on long-term hemodialysis, with secondary HPT, presented with a 9-month history of persistent neck pain. Radiographs of the cervical spine revealed an expansive osteolytic lesion in the posterior arch of the second cervical vertebra. MR imaging revealed an expansive mass on C2 affecting the vertebral body, odontoid process, right pedicle, laminas, and spinous process; there were no signs of spinal edema. A CT-guided needle biopsy of the lesion showed destruction of trabecular bone, infiltration of the fibroblastic cells, and abundant osteoclast-like multinucleated giant cells with hemorrhage and hemosiderin pigment, and the diagnosis of brown tumor was made. Cervical pain disappeared within a few days of parathyroidectomy, and rapid remineralization of C2 was evident within a few months. BT must always be considered in the context of hyperparathyroidism and osteolytic lesions. Vertebral BT can be particularly devastating due to medullar compression symptoms. Regression or complete disappearance of these lesions after parathyroidectomy is common, but prompt surgical decompression is necessary in case of medullar compression symptoms.

Conocimientos y creencias de las enfermeras sobre el cuidado de las úlceras por presión: revision sistemática de la literatura / Nurses’ knowledge and beliefs about pressure ulcers care: a systematic review of literature

Objetivos: Determinar el estado actual del conocimiento sobre las medidasde prevención y tratamiento de las upp en los profesionales de enfermería.Diseño: Revisión sistemática. Fuentes de datos: Se han utilizado 14 bases dedatos bibliográficas. Database of Abstracts of Reviews of Effectiveness (DARE);Cinahl; Medline; Currents Contents: Clinical Medicine, Social and BehavioralSciences, Life Sciences; Índice médico español (IME); Cuiden; CentroLatinoamericano y del Caribe de Información en Ciencias de la Salud (LILACS);Cochrane Library; EBSCO; ScienceDirect; Springer; InterSciencia;ProQuest y Pascal. Métodos de revisión: Se han incluido artículos de encuestasde conocimientos sobre úlceras por presión que estuvieran publicadosen español, inglés, francés y portugués, y un estudio cuasi-experimental,para ver la influencia en los conocimientos de una sesión educativa específicasobre upp. Se han excluido aquellos estudios sobre conocimientos que utilizanmetodologías que impiden su comparación. Resultados: Se han incluido18 artículos. La mayoría utilizaron un muestreo por conveniencia. Losparticipantes de los estudios eran enfermeras tituladas, auxiliares de enfermeríay estudiantes. El índice global de conocimientos se sitúa en un 70%como media; con un rango entre 73 y 85% para la prevención y de 56 a 78%para tratamiento. El nivel de formación influye sobre el índice de conocimientos.Los factores de riesgo mejor conocidos son la incontinencia, la inmovilidad,presión mantenida o la desnutrición. Las intervenciones de enfermeríamejor conocidas son cuidados de la piel, mantener la cama limpia y los cambios posturales. El uso de superficies de alivio de la presión, la educaciónal paciente y la clasificación de la upp están entre las intervenciones enfermerasconocidas por un menor número de profesionales. Conclusiones:Existe un aceptable nivel de conocimientos de las recomendaciones para laprevención y cuidados de las upp, siendo superior el índice de conocimientosde factores de riesgo y prevención al de tratamiento. La formación específicasobre upp mejora este índice de conocimientos

Aim: To determine the current knowledge about prevention and treatment ofpressure ulcers (PU) in nurses. Design: Systematic review. Data source: Fourteenbibliographic databases: Database of Abstracts of Reviews of Effectiveness (DARE);Cinahl; Medline; Currents Contents: Clinical Medicine, Social and BehavioralSciences, Life Sciences; Índice médico español (IME); Cuiden; Centro Latinoamericanoy del Caribe de Información en Ciencias de la Salud (LILACS);Cochrane Library; EBSCO; ScienceDirect; Springer; InterSciencia; ProQuest yPascal. Methods: Papers about surveys of knowledge on PU published in Spanish,English, French and Portuguese were included. Also a quasi-experimentalstudy about the effect of a formation session on PU knowledge was included. Studiesabout knowledge using non comparable methodology were excluded. Results:Eighteen papers were included in the review. Most of them have used a conveniencesample. Participants were registered nurses, licensed nurses and nurse students.As average, the overall index of knowledge was 70%; with a range between73 and 85% for prevention, and between 56 and 78% for treatment. Risk factorsbest known were: incontinence, immobility, pressure or malnutrition. Thenursing interventions best known were: skin care, maintain clean the bed and repositioning.On contrary, the use of pressure-relief surfaces, patient education andPU classification were the nursing interventions kwon by a fewer number of nurses.Conclusions: Overall the level of knowledge about PU care is acceptable.The knowledge about risk factors and prevention measures is better than that oneabout treatment. Education and specific training about PU improve the knowledge index

Resonancia magnética en el diagnóstico y el seguimiento de la fascitis eosinofílica / Role of the nuclear magnetic resonance in the diagnosis and follow up of eosinophilic fascitis

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Analysis of ionic ratios in myocardial tissue and their relation to cardiac damage.

The authors evaluated the usefulness of the postmortem biochemical analysis of ionic ratios in different parts of the heart and their relation to cardiac damage caused by chest trauma, as observed by anatomopathologic study. Fifty-nine 59 cases were studied, selected from routine necropsies, and samples were taken from different sites of cardiac tissue. The cause of death was trauma in 40 cases and nontraumatic causes in 19 cases. The object of this study was to analyze the levels of Na+, K+, Ca+2, Mg+2, and Zn+2 in different zones of the heart, and the relationship between intracellular and extracellular ion ratios and the different causes of death and any anatomopathologic alterations observed. The biochemical tests revealed a possible relation between the ionic values and cause of death. Alterations in cell membrane permeability and corresponding modification of the ionic ratios were produced earlier than histologic alterations, which need longer to establish themselves whether or not they follow a traumatic process.