Country-report pattern corrections of new cases allow accurate 2-week predictions of COVID-19 evolution with the Gompertz model.

Accurate short-term predictions of COVID-19 cases with empirical models allow Health Officials to prepare for hospital contingencies in a two-three week window given the delay between case reporting and the admission of patients in a hospital. We investigate the ability of Gompertz-type empiric models to provide accurate prediction up to two and three weeks to give a large window of preparation in case of a surge in virus transmission. We investigate the stability of the prediction and its accuracy using bi-weekly predictions during the last trimester of 2020 and 2021. Using data from 2020, we show that understanding and correcting for the daily reporting structure of cases in the different countries is key to accomplish accurate predictions. Furthermore, we found that filtering out predictions that are highly unstable to changes in the parameters of the model, which are roughly 20%, reduces strongly the number of predictions that are way-off. The method is then tested for robustness with data from 2021. We found that, for this data, only 1-2% of the one-week predictions were off by more than 50%. This increased to 3% for two-week predictions, and only for three-week predictions it reached 10%.

Cambios en el control postural y la marcha en pacientes con ictus en fase subaguda tras recibir rehabilitación interdisciplinar y factores relacionados: estudio retrospectivo / Postural control and gait changes in subacute stroke patients after receiving interdisciplinary rehabilitation and related factors: a retrospective study

Introducción: La rehabilitación precoz tras el ictus resulta fundamental para optimizar la recuperación, pero sus efectos y los factores pronósticos están aún en discusión. Objetivo: Evaluar los cambios en el control postural y la marcha en los pacientes con ictus que reciben rehabilitación interdisciplinar en fase subaguda y valorar los posibles factores relacionados. Pacientes y métodos: Estudio observacional retrospectivo que analizó datos sociodemográficos y clínicos, incluyendo el control postural y la capacidad de marcha, mediante las escalas Trunk Impairment Scale (TIS), Postural Assessment Scale for Stroke (PASS), Functional Ambulation Categories (FAC) y de Tinetti, tanto en el inicio como a los dos meses de rehabilitación. Resultados: Se recogieron datos de 63 pacientes con ictus en fase subaguda. La rehabilitación interdisciplinar tuvo un impacto clínico moderado (p < 0,01; d > 0,5) y relevante sobre el control postural y la marcha. Los factores asociados moderadamente (p < 0,05; d > 0,5) a una mayor evolución en el control postural evaluado con la TIS y la PASS fueron la rehabilitación ambulatoria, la ausencia de medicación psicótropa y la ausencia de dislipidemia. La TIS en el inicio se asoció significativamente (p < 0,05) con los valores de todas las escalas tras dos meses de rehabilitación, excepto con la PASS movilidad. Conclusiones: La rehabilitación interdisciplinar favorece cambios moderados y clínicamente relevantes en la recuperación del control postural y la marcha de pacientes con ictus subagudo tras dos meses de tratamiento. La rehabilitación ambulatoria y la ausencia de dislipidemia y de medicación psicótropa se asocian con la evolución, pero son necesarios más estudios para confirmar su influencia en muestras mayores.(AU)

Introduction: Although early post-stroke rehabilitation is essential to optimize recovery, its effects and prognostic factors are yet under discussion. Objective: To assess postural control and gait changes in post-stroke patients who underwent interdisciplinary rehabilitation in subacute phase and evaluate potential associated factors. Patients and methods: An observational retrospective study that analyzed sociodemographic and clinical data, including Trunk Impairment Scale (TIS), Postural Assessment Scale for Stroke (PASS), Functional Ambulatory Categories (FAC) and Tinetti scale, at admission and two months after rehabilitation. Results: Data were collected from 63 patients with stroke in subacute phase. Interdisciplinary rehabilitation had a moderate and relevant clinical impact (p < 0,01; d > 0,5) in postural control and gait. Ambulatory rehabilitation, psychotropic medication absence and dislipemia absence were moderate associated factors (p < 0,05; d > 0,5) with a greater evolution in postural control measured with TIS and PASS. TIS at admission showed significant association with all scales’ results at two months after rehabilitation, except with PASS changing posture subscale. Conclusions: Interdisciplinary rehabilitation promotes moderate and clinically relevant changes in postural control and gait recovery in subacute stroke patients, after two-month rehabilitation period. Ambulatory rehabilitation, dyslipidemia absence and psychotropic medication absence were associated with patients’ evolution, but further research is required to confirm their actual influence in larger samples.(AU)

[Postural control and gait changes in subacute stroke patients after receiving interdisciplinary rehabilitation and related factors: a retrospective study]. / Cambios en el control postural y la marcha en pacientes con ictus en fase subaguda tras recibir rehabilitación interdisciplinar y factores relacionados: estudio retrospectivo.

INTRODUCTION: Although early post-stroke rehabilitation is essential to optimize recovery, its effects and prognostic factors are yet under discussion. OBJECTIVE: To assess postural control and gait changes in post-stroke patients who underwent interdisciplinary rehabilitation in subacute phase and evaluate potential associated factors. PATIENTS AND METHODS: An observational retrospective study that analyzed sociodemographic and clinical data, including Trunk Impairment Scale (TIS), Postural Assessment Scale for Stroke (PASS), Functional Ambulatory Categories (FAC) and Tinetti scale, at admission and two months after rehabilitation. RESULTS: Data were collected from 63 patients with stroke in subacute phase. Interdisciplinary rehabilitation had a moderate and relevant clinical impact (p < 0,01; d mayor de 0,5) in postural control and gait. Ambulatory rehabilitation, psychotropic medication absence and dislipemia absence were moderate associated factors (p < 0,05; d mayor de 0,5) with a greater evolution in postural control measured with TIS and PASS. TIS at admission showed significant association with all scales' results at two months after rehabilitation, except with PASS changing posture subscale. CONCLUSIONS: Interdisciplinary rehabilitation promotes moderate and clinically relevant changes in postural control and gait recovery in subacute stroke patients, after two-month rehabilitation period. Ambulatory rehabilitation, dyslipidemia absence and psychotropic medication absence were associated with patients' evolution, but further research is required to confirm their actual influence in larger samples.

TITLE: Cambios en el control postural y la marcha en pacientes con ictus en fase subaguda tras recibir rehabilitación interdisciplinar y factores relacionados: estudio retrospectivo.Introducción. La rehabilitación precoz tras el ictus resulta fundamental para optimizar la recuperación, pero sus efectos y los factores pronósticos están aún en discusión. Objetivo. Evaluar los cambios en el control postural y la marcha en los pacientes con ictus que reciben rehabilitación interdisciplinar en fase subaguda y valorar los posibles factores relacionados. Pacientes y métodos. Estudio observacional retrospectivo que analizó datos sociodemográficos y clínicos, incluyendo el control postural y la capacidad de marcha, mediante las escalas Trunk Impairment Scale (TIS), Postural Assessment Scale for Stroke (PASS), Functional Ambulation Categories (FAC) y de Tinetti, tanto en el inicio como a los dos meses de rehabilitación. Resultados. Se recogieron datos de 63 pacientes con ictus en fase subaguda. La rehabilitación interdisciplinar tuvo un impacto clínico moderado (p menor de 0,01; d mayor de 0,5) y relevante sobre el control postural y la marcha. Los factores asociados moderadamente (p menor de 0,05; d > 0,5) a una mayor evolución en el control postural evaluado con la TIS y la PASS fueron la rehabilitación ambulatoria, la ausencia de medicación psicótropa y la ausencia de dislipidemia. La TIS en el inicio se asoció significativamente (p menor de 0,05) con los valores de todas las escalas tras dos meses de rehabilitación, excepto con la PASS movilidad. Conclusiones. La rehabilitación interdisciplinar favorece cambios moderados y clínicamente relevantes en la recuperación del control postural y la marcha de pacientes con ictus subagudo tras dos meses de tratamiento. La rehabilitación ambulatoria y la ausencia de dislipidemia y de medicación psicótropa se asocian con la evolución, pero son necesarios más estudios para confirmar su influencia en muestras mayores.

[Effectiveness of motor imagery in patients with multiple sclerosis: a systematic review]. / Eficacia de la imagen motora en la esclerosis múltiple: revisión sistemática.

INTRODUCTION: Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Motor imagery (MI) has been proposed as a treatment to improve gait, fatigue and quality of life in these dysfunctions. AIM: To assess the effectiveness of MI, action observation therapy or mirror therapy approaches compared to other rehabilitation modality or no intervention, in MS. DEVELOPMENT: A systematic review of randomized controlled trials was conducted. Studies published in the last ten years investigating MI versus other interventions or no intervention in patients with MS were included. PEDro scale was used to assess methodological quality of included studies. Eight studies met the eligibility criteria. For fatigue, the MI and its combination with relaxation seem to be superior compared with other types of interventions or no intervention. The MI combined with music also showed significant improvements in gait and quality of life (QoL). CONCLUSIONS: MI and its combination with relaxation exercises have been shown to be effective in the treatment of fatigue, gait, balance, depression and QoL in patients with MS. The action observation therapy is useful in upper limb rehabilitation and improvement in attention, executive control and activation of sensorimotor networks. Further research with high methodological quality is needed to support these findings and to evaluate their effectiveness in long term.

TITLE: Eficacia de la imagen motora en la esclerosis múltiple: revisión sistemática.Introducción. La esclerosis múltiple (EM) es una enfermedad inflamatoria desmielinizante del sistema nervioso central. Se ha propuesto la imagen motora (IM) como tratamiento para mejorar la marcha, la fatiga y la calidad de vida en esta patología. Objetivo. Evaluar la eficacia del abordaje mediante IM, terapia de observación de acciones (AOT) o terapia en espejo, en comparación con una modalidad diferente de rehabilitación o la no intervención en la EM. Desarrollo. Se realizó una revisión sistemática de ensayos controlados aleatorizados. Se incluyeron estudios de los últimos 10 años que comparasen la IM frente a otras intervenciones o la no intervención en pacientes con EM. Se utilizó la escala PEDro para evaluar la calidad metodológica de los estudios incluidos. Ocho estudios cumplieron los criterios de elegibilidad. Para la fatiga, la IM y su combinación con la relajación parecen ser superiores en comparación con otros tratamientos o la no intervención. La IM combinada con música también mostró mejoras significativas en la marcha y en la calidad de vida. Conclusiones. La IM combinada con ejercicios de relajación ha demostrado eficacia en el tratamiento de la fatiga, la marcha, el equilibrio, la depresión y la calidad de vida en personas con EM. La AOT resulta útil en la rehabilitación del miembro superior y en la mejora de la atención, el control ejecutivo y la activación de las redes sensoriomotoras. Son necesarios estudios de mayor calidad metodológica que respalden estos resultados y valoren su efectividad a largo plazo.

Myofascial pain, widespread pressure hypersensitivity, and hyperalgesia in the face, neck, and shoulder regions, in survivors of head and neck cancer.

PURPOSE: Medical treatment for head and neck cancer may induce the presence of inflammation, pain, and dysfunction. The purpose of the current study was to assess the presence of myofascial trigger points (TrPs) and their relationship with widespread pressure hypersensitivity and hyperalgesia in survivors of head and neck cancer (sHNC). METHODS: TrPs and pressure-pain thresholds (PPTs) were quantified in different muscles/joints in the head and neck of 30 sHNC (59.45 ± 13.13 years) and 28 age- and sex-matched controls (58.11 ± 12.67 years). RESULTS: The sHNC had more TrPs in all muscles on the affected side (p < 0.05) than did the healthy controls, and in the temporalis, masseter, and suboccipitalis muscles on the unaffected side (p < 0.05). They also had lower PPTs in all places (p < 0.05) except for the temporalis muscle (p = 0.114) and C5-C6 joint (p = 0.977). The intensity of cervical pain correlated positively with the presence of upper trapezius TrPs. CONCLUSIONS: sHNC suffering cervical and/or temporomandibular joint pain have multiple active TrPs and experience widespread pressure hypersensitivity and hyperalgesia, suggestive of peripheral and central sensitization.

Plasmocitoma solitario de costilla como presentación inicial de mieloma múltiple: reporte de un caso / Lone rib plasmacytoma as a presentation of initial multiple myeloma: a case report

Resumen Introducción: El 50% de los tumores de pared torácica son malignos, dentro de los que destaca el plasmocitoma de costilla. Objetivo: Presentar un caso clínico que debutó inicialmente como un plasmocitoma de costilla, y que terminó presentándose como mieloma múltiple. Materiales y Método: Registro clínico de un paciente sometido a resección de tumor de parrilla costal. Resultados: Paciente masculino de 58 años, con un año de dolor costal, asociado a aumento de volumen a nivel de la octava costilla derecha en línea media axilar, indurada. TC de tórax que demuestra imagen sugerente de plasmocitoma de 79 × 44 mm. Se realiza resección quirúrgica, con instalación de malla de prolene en el defecto. Biopsia diferida con compromiso neoplásico por lesión monoclonal de células plasmáticas. Se complementa estudio con biopsia de médula ósea confirmando mieloma múltiple. Se inicia tratamiento con quimioterapia adyuvante. Conclusiones: El plasmocitoma óseo solitario es una entidad de baja frecuencia, que se asocia a la presencia de mieloma múltiple. Es por esto que al momento de la sospecha se hace necesario descartar su presencia, con el fin de mejorar el pronóstico del paciente.

Introduction: Up to 50% of chest wall tumors are malignant; among which rib plasmocytoma stand out. Aim: Showcase a clinical case that debuted as a rib plasmacytoma, and that ended up presenting as Multiple Myeloma. Materials and Method: Records of a patient with resection of chest wall tumor. Results: Male patient of 58 years, with one year of costal pain, associated with an indurated increase in volume at the level of the eighth right rib in the mid-axillary line. Chest CT scan demonstrated a suggestive image of plasmacytoma of 79 × 44 mm. Surgical resection was performed, with prolene mesh installation in the defect. Biopsy showed neoplastic compromise due to monoclonal lesion of plasma cells. Study is complemented with bone marrow biopsy confirming multiple myeloma. The patient was treated with adjuvant chemotherapy. Conclusions: Solitary bone plasmacytoma is a low frequency entity, which is associated with the presence of multiple myeloma. At the moment of suspicion, it is necessary to rule out their presence, in order to improve the patient's prognosis.

Diagnostic Approach for Suspected Allergic Cutaneous Reaction to a Permanent Tattoo.

The last few decades have seen a notable increase in the number of people who have a tattoo. This practice is not free from complications. Most adverse effects appear early and are temporary, although they can occasionally develop later and be permanent and serious. Recent research has generated new knowledge on the composition of inks, their degradation over time, the immune activity that is stimulated, and the various clinical disorders that can arise. This information enables better approaches to diagnosis and management when complications arise. Diagnosing allergic reactions to permanent tattoo ink can be very challenging. This review aims to identify clinical and histological clues to help practitioners differentiate allergic reactions from other complications. We discuss the yield and appropriateness of skin tests and biopsies and propose an algorithm to guide the diagnostic process.

Diagnostic approach for suspected allergic cutaneous reaction to a permanent tattoo

The last few decades have seen a notable increase in the number of people who have a tattoo. This practice is not free from complications. Most adverse effects appear early and are temporary, although they can occasionally develop later and be permanent and serious. Recent research has generated new knowledge on the composition of inks, their degradation over time, the immune activity that is stimulated, and the various clinical disorders that can arise. This information enables better approaches to diagnosis and management when complications arise. Diagnosing allergic reactions to permanent tattoo ink can be very challenging. This review aims to identify clinical and histological clues to help practitioners differentiate allergic reactions from other complications. We discuss the yield and appropriateness of skin tests and biopsies and propose an algorithm to guide the diagnostic process

En las últimas décadas ha aumentado ostensiblemente el número de personas que se realiza un tatuaje en la piel. Esta técnica no está exenta de complicaciones. La mayoría son precoces y transitorias, pero, en ocasiones, son tardías, permanentes y graves. En los últimos años, los avances en el conocimiento de la composición de tintas, de los procesos de degradación de las mismas tras el tatuado, de la actividad inmunitaria que se desencadena y la descripción de una clasificación en patrones clínicos, nos han permitido realizar un mejor enfoque diagnóstico y manejo terapéutico de estas complicaciones. El diagnóstico de las reacciones alérgicas a las tintas de los tatuajes permanentes supone un verdadero reto. En esta revisión intentaremos dar claves clínicas e histológicas que nos ayudan a diferenciar las reacciones alérgicas del resto de complicaciones. Discutiremos la rentabilidad e idoneidad de las pruebas epicutáneas y de la biopsia cutánea, y propondremos un algoritmo diagnóstico

Validación y fiabilidad de la versión española de la escala autoadministrada de Evaluación de Signos y Síntomas Neuropáticos de Leeds (S-LANSS) / Validity and reliability of the Spanish-language version of the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale

INTRODUCCIÓN: La escala autoadministrada de Evaluación de Signos y Síntomas Neuropáticos de Leeds (S-LANSS) es un instrumento diseñado para identificar a pacientes con dolor de características neuropáticas. OBJETIVO: Evaluar la validez y fiabilidad de la versión española del S-LANSS. MÉTODOS: Se incluyó un total de 182 pacientes con dolor crónico para evaluar la validez discriminante y convergente del S-LANSS, incrementándose la muestra hasta 321 pacientes para valorar la validez de constructo y la fiabilidad de la escala. Se utilizó como variable criterio la versión validada al español del ID-Pain. Todos los participantes cumplimentaron el cuestionario ID-Pain, el S-LANSS, y la Escala Numérica del Dolor. La validez discriminante se evaluó mediante el análisis del área bajo la curva de características operativas para el receptor, y la sensibilidad y especificidad. La validez de constructo se evaluó mediante un análisis factorial y mediante el análisis del odds-ratio de cada ítem del S-LANSS respecto a la puntuación total. La validez convergente y la fiabilidad se valoraron con la R de Pearson y el alfa de Cronbach respectivamente. RESULTADOS: El punto de corte óptimo del S-LANSS fue ≥ 12 puntos (área bajo la curva = 0,89; sensibilidad = 88,7; especificidad = 76,6). El S-LANSS presentó un factor y, además, cada ítem contribuyó significativamente a la puntuación total positiva del S-LANSS (p < 0,05). El S-LANSS mostró una relación significativa con el ID-Pain (R = 0,734) y un alfa de Cronbach de 0,71. CONCLUSIÓN: La versión española del S-LANSS es válida y fiable para identificar pacientes con dolor crónico con características neuropáticas

INTRODUCTION: The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale is a tool designed to identify patients with pain with neuropathic features. OBJECTIVE: To assess the validity and reliability of the Spanish-language version of the S-LANSS scale. METHODS: Our study included a total of 182 patients with chronic pain to assess the convergent and discriminant validity of the S-LANSS; the sample was increased to 321 patients to evaluate construct validity and reliability. The validated Spanish-language version of the ID-Pain questionnaire was used as the criterion variable. All participants completed the ID-Pain, the S-LANSS, and the Numerical Rating Scale for pain. Discriminant validity was evaluated by analysing sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Construct validity was assessed with factor analysis and by comparing the odds ratio of each S-LANSS item to the total score. Convergent validity and reliability were evaluated with Pearson's r and Cronbach's alpha, respectively. RESULTS: The optimal cut-off point for S-LANSS was ≥12 points (AUC = .89; sensitivity = 88.7; specificity = 76.6). Factor analysis yielded one factor; furthermore, all items contributed significantly to the positive total score on the S-LANSS (P < .05). The S-LANSS showed a significant correlation with ID-Pain (r = .734, alfa = .71). CONCLUSION: The Spanish-language version of the S-LANSS is valid and reliable for identifying patients with chronic pain with neuropathic features

¿Qué procedimientos diagnósticos deberíamos realizar ante una sospecha de reacción alérgica a un tatuaje? Propuesta basada en nuestra casuística / Diagnostic Tools to Use When We Suspect an Allergic Reaction to a Tattoo: A Proposal Based on Cases at Our Hospital

INTRODUCCIÓN: Los tatuajes se han convertido en una práctica muy popular en los países occidentales, sobre todo entre los más jóvenes. Las complicaciones asociadas a esta técnica incluyen procesos infecciosos, alérgicos, reacciones a cuerpo extraño e incluso procesos inflamatorios sistémicos. PACIENTES Y MÉTODOS: Se ha realizado un estudio retrospectivo de todos los pacientes que acudieron a la consulta de Alergia cutánea por manifestar complicaciones en un tatuaje desde enero de 2002 a diciembre de 2016. RESULTADOS: Se han incluido a 23 pacientes. De ellos, 9 presentaron complicaciones de forma precoz y en todos ellos la etiología fue infecciosa. De los 14 pacientes con reacciones tardías, 10 fueron diagnosticados de probable dermatitis de contacto alérgica a la tinta, sin embargo solo en 3 de los casos se pudo apuntar al alérgeno probablemente culpable y tan solo en uno de ellos se pudo demostrar. Se detectaron dos casos de sarcoidosis cutánea, uno de reacción granulomatosa a cuerpo extraño, y un caso de reacción neuropática en una paciente. CONCLUSIONES: Las complicaciones asociadas a los tatuajes son un motivo de consulta relativamente frecuente en las consultas de Dermatología. Proponemos un algoritmo diagnóstico basado en nuestra casuística, que ayude a orientar las distintas reacciones a tatuaje y con ello a iniciar las medidas terapéuticas oportunas

INTRODUCTION: Tattooing has become a popular practice in western countries, particularly among younger populations. Tattoos, however, can cause complications, such as infections, allergic or foreign-body reactions, and even systemic inflammatory responses. PATIENTS AND METHODS: We conducted a retrospective study of all patients seen for tattoo-related complications at our skin allergy unit between January 2002 and December 2016. RESULTS: We studied 23 patients. Nine of these experienced early complications, all related to infection. The other 14 patients developed late reactions. Ten were diagnosed with probable allergic contact dermatitis to ink, but the suspect allergen was identified in just 3 cases and confirmed in just 1 of these. There were 2 cases of cutaneous sarcoidosis, 1 case of foreign body granuloma, and 1 case of neuropathy. CONCLUSIONS: Complications resulting from tattoos are relatively common dermatology complaints. Drawing from our experience, we propose a diagnostic algorithm designed to guide dermatologists in evaluating different reactions to tattoos and prescribing appropriate treatment

Validity and reliability of the Spanish-language version of the self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) pain scale. / Validación y fiabilidad de la versión española de la escala autoadministrada de Evaluación de Signos y Síntomas Neuropáticos de Leeds (S-LANSS).

INTRODUCTION: The self-administered Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) scale is a tool designed to identify patients with pain with neuropathic features. OBJECTIVE: To assess the validity and reliability of the Spanish-language version of the S-LANSS scale. METHODS: Our study included a total of 182 patients with chronic pain to assess the convergent and discriminant validity of the S-LANSS; the sample was increased to 321 patients to evaluate construct validity and reliability. The validated Spanish-language version of the ID-Pain questionnaire was used as the criterion variable. All participants completed the ID-Pain, the S-LANSS, and the Numerical Rating Scale for pain. Discriminant validity was evaluated by analysing sensitivity, specificity, and the area under the receiver operating characteristic curve (AUC). Construct validity was assessed with factor analysis and by comparing the odds ratio of each S-LANSS item to the total score. Convergent validity and reliability were evaluated with Pearson's r and Cronbach's alpha, respectively. RESULTS: The optimal cut-off point for S-LANSS was ≥12 points (AUC=.89; sensitivity=88.7; specificity=76.6). Factor analysis yielded one factor; furthermore, all items contributed significantly to the positive total score on the S-LANSS (P<.05). The S-LANSS showed a significant correlation with ID-Pain (r=.734, α=.71). CONCLUSION: The Spanish-language version of the S-LANSS is valid and reliable for identifying patients with chronic pain with neuropathic features.

Diagnostic Tools to Use When We Suspect an Allergic Reaction to a Tattoo: A Proposal Based on Cases at Our Hospital. / ¿Qué procedimientos diagnósticos deberíamos realizar ante una sospecha de reacción alérgica a un tatuaje? Propuesta basada en nuestra casuística.

INTRODUCTION: Tattooing has become a popular practice in western countries, particularly among younger populations. Tattoos, however, can cause complications, such as infections, allergic or foreign-body reactions, and even systemic inflammatory responses. PATIENTS AND METHODS: We conducted a retrospective study of all patients seen for tattoo-related complications at our skin allergy unit between January 2002 and December 2016. RESULTS: We studied 23 patients. Nine of these experienced early complications, all related to infection. The other 14 patients developed late reactions. Ten were diagnosed with probable allergic contact dermatitis to ink, but the suspect allergen was identified in just 3 cases and confirmed in just 1 of these. There were 2 cases of cutaneous sarcoidosis, 1 case of foreign body granuloma, and 1 case of neuropathy. CONCLUSIONS: Complications resulting from tattoos are relatively common dermatology complaints. Drawing from our experience, we propose a diagnostic algorithm designed to guide dermatologists in evaluating different reactions to tattoos and prescribing appropriate treatment.

Recuento en saliva de Streptococcus mutans en niños de 6 a 12 años con y sin tinciones cromógenas / Counting of Streptococcus mutans in saliva of 6 to 12 years old children with and without black stain

Introducción: Las tinciones cromógenas o 'Black Stain' (BS) se han asociado a una baja experiencia de caries y un menor recuento de bacterias cariogénicas. El objetivo es determinar si existe diferencia en el número de pacientes que presenten un alto recuento de S. mutans (>105 UFC/ml saliva) entre niños con BS y sin ellas. Material y métodos: Estudio observacional analítico de corte transversal. Se incluyeron 158 escolares entre 6 y 12 años de establecimientos educacionales de la ciudad de Valdivia, Chile. Luego de un examen clínico se determinó la prevalencia de individuos con BS y se conformó un grupo con ausencia de tinciones para comparar el recuento de S. mutans. Se calculó la proporción del número de pacientes con valores >105 UFC/ ml en ambos grupos para establecer los sujetos con alto riesgo cariogénico, evaluando si las diferencias fueron significativas (p<0,05) mediante el test exacto de Fisher. Resultados: Se diagnosticó BS en 15 niños (6 hombres y 9 mujeres), estimando una prevalencia de 9,5% del total de examinados. De esta forma, los grupos de estudio se conformaron por 15 niños con BS y 30 sin la tinción. No hubo diferencia estadísticamente significativa (p=0,538) en la proporción de niños con recuento >105 UFC/ml de S. mutans entre los grupos. Discusión: La presencia de BS en pacientes de 6 a 12 años no se asocia a mayor o menor riesgo cariogénico (AU)

Introduction: Chromogenic staining or 'Black Stain'(BS) has been associated with a low caries frequency and less cariogenic bacteria count. The aim of the study was to determine the difference in the number of patients who have a high count of S. mutans (>105 CFU/ml saliva) among children with BS and without them. Material and methods: Analytical observational cross-sectional study. In this study were included 158 children between 6 and 12 years old, from educational establishments in the city of Valdivia, Chile. After clinical muexamination, the prevalence of individuals with BS was determined and a group was formed with no stains to compare the count of S. mutans. We calculate the ratio of patients with values> 105 CFU/ml in the two groups to identify the patients with high cariogenic risk. Statistical differences were evaluated by Fisher’s test (p <0.05). Results: BS was diagnosed in 15 children (6 men and 9 women), estimating a prevalence of 9.5% of all examined. Thus, the groups studied were formed by 15 children with BS and 30 without staining. There was no statistically significant difference (p=0.538) in the proportion of children with >105 CFU/ml of S. mutans between groups. Discussion: The presence of BS in patients aged 6 to 12 years is not associated with cariogenic risk (AU)

Valoración de la calidad de vida, el estado musculoesquelético y del dolor en pacientes recién diagnosticados de cáncer de colon / Assessment of quality of life, the musculoskeletal state and pain in recently diagnosed colon cancer patients

Objetivo: Determinar la calidad de vida, el estado musculoesquelético y el dolor en pacientes diagnosticados de cáncer de colon, previamente a cirugía. Material y métodos: Un total de 15 pacientes con cáncer de colon y 15 controles sanos formaban la muestra del estudio transversal. La calidad de vida se evaluó a través del cuestionario QLQ-C30. El resto de variables se valoró mediantes el test de McQuade, dinamometría de tronco, algometría para los umbrales de dolor a la presión y una escala visual analógica. Se realizó un análisis principal mediante la covarianza ANCOVA. Resultados: Se encontraron diferencias significativas en la calidad de vida entre pacientes diagnosticados con cáncer de colon y los controles sanos en la función física (p < 0,01), tareas (p < 0,01), función emocional (p = 0,046), fatiga (p < 0,01), dolor (p = 0,05), insomnio (p = 0,04), apetito (p = 0,01), diarrea (p = 0,01) y salud global (p < 0,01). Mediante las imágenes ecográficas se encontró una disminución del grosor de los músculos oblicuo interno (p = 0,02) y del transverso del abdomen (p = 0,02) entre ambos grupos de estudio. No hubo cambios significativos en el resto de variables estudiadas. Conclusiones: Los pacientes diagnosticados de cáncer de colon presentan, previamente a la cirugía, un deterioro de la calidad de vida y alteraciones musculoesqueléticas de la musculatura profunda estabilizadora del abdomen. Los grupos de estudio no presentan cambios significativos con relación al dolor

Objectives: To investigate the quality of life and musculskeletal state and pain in colorectal diagnosed cancer patients prior to the surgical intervention. Material and methods: A total of 15 patients with colorectal cancer and 15 healthy control patients made up this cross-sectional study. Quality of life was assessed with EORTC QLQ_C30 questionnaire. The remaining variables were measured with the McQuade test, digital dynamometer, algometry for pressure pain threshold and the Visual Analogue Scale. The main analysis was made using the ANCOVA. Results: Significant differences were found in quality of life among patients diagnosed with colon cancer and healthy controls in physical function (P < .01), role functioning (P < .01), emotional functioning (P = .046), fatigue (P < .01), pain (P = .05), insomnia (P = .04), appetite loss (P = .01), diarrhea (P = .01) and global health status (P < .01). Ultrasound imaging showed a decrease in the thickness of both muscles: internal oblique (P = .02) and transversus abdominis (P = .02) between the 2 study groups. There were no significant changes in the rest of the variables studied. Conclusions: The patients diagnosed with colorectal cancer show deterioration of quality of life and musculoskeletal disorders in the stabilizing muscles in the abdomen prior to the surgery. The study groups did not show significant changes related to pain

Physical impairments and quality of life of colorectal cancer survivors: a case-control study.

The aim of the study is to determine the physical performance, quality of life and fatigue in colorectal cancer survivors compared with healthy controls. Twenty-three colorectal cancer survivors and 22 matched controls were recruited for this case-control study. Fitness level (muscle trunk flexor endurance test, 6-min walk test, chair sit and reach test and flamingo test) was assessed in both groups. Participants completed the European Organization of Research and Treatment of Cancer, the Quality of Life Questionnaire (QLQ-C30), the Piper Fatigue Scale (PFS) and the International Fitness Scale (IFIS). Significant differences between groups were found for all fitness parameters (P < 0.05). In addition, the anova revealed significant differences in all of the IFIS scores (P < 0.001), PFS (P < 0.01) and functioning scores of the QLQ-C30 (P < 0.05) between colorectal cancer survivors and the control group. The Mann-Whitney U-test showed a significant increase in symptom scores such as fatigue, dyspnoea and diarrhoea in the cancer survivors (P < 0.05). This study shows the existence of perceived and objective deterioration of health-related fitness level, presence of moderate cancer fatigue and reduced perceived quality of life in colorectal cancer survivors compared with healthy controls.

Carcinoma Seroso Papilar Peritoneal Primario: serie de casos Hospital Clínico Universidad de Chile 2010-2015 / Primary Serous Papillary Carcinoma: Case Report, Hospital Clinico Universidad de Chile 2010-2015

Los cánceres peritoneales primarios son una patología de baja prevalencia, dentro de los cuales el carcinoma seroso papilar primario de peritoneo es el más frecuente con una incidencia de 6,78 casos por millón de habitantes. Predomina en el sexo femenino y su principal diagnóstico diferencial es el carcinoma papilar seroso de ovario avanzado, para lo cual la inmunohistoquímica, junto a sus clasificaciones clínicas y anatomopatológicas son la forma de diferenciar en base a la clasificación de la Organización Mundial de la salud para lesiones tumorales. Objetivo: Describir los resultados inmuno-histoquímicos de una serie de casos estudiados en el Hospital Clinico de la Universidad de Chile y compararlos con la literatura médica. Material y Método: Estudio retrospectivo, descriptivo en base a análisis de 12 biopsias entre Enero 2010 y Marzo 2015 clasificándolos según edad, sexo y registro de biopsia. Se realizó técnica histológica rutinaria además de las tinciones inmunohistoquímicas para WT1, citoqueratinas y otros reactivos de acuerdo a los diagnósticos diferenciales. Resultados: La distribución etaria fue de 47 a los 75 años, media de 60 años, el 100% de los casos de sexo femenino. Los reactivos de Inmunohistoquímica predominantes fueron WT1 (53,8%), Citoqueratina-7 (38,5%). Conclusiones: Este carcinoma es una entidad poco común en la clínica, con similitudes al carcinoma seroso ovárico. Existe consenso sobre el diagnóstico de esta patología, el cual se debe orientar, según los criterios de la Gynecologic Oncology Group. Ante la sospecha clínica, el patólogo puede realizar el estudio inmunohistoquímico dirigido y así tener un diagnóstico preciso para determinar la conducta terapéutica del cirujano.

The primary peritoneal cancer is a low prevalence disease, within which primary papillary serous carcinoma of the peritoneum is the most frequent with an incidence of 6.78 cases per million inhabitants. Predominates in females and its main differential diagnosis is advanced ovarian papillary serous carcinoma, for which immunohistochemistry and clinical and pathological classifications are the way to differentiate base on the World Health Organization classification for tumor lesions. Objective: Describe the immunohistochemical results of a series of cases studied in Universidad de Chile Clinical Hospital and to compare them with the literature. Material and Methods: Descriptive retrospective study based on analysis of biopsies from 12 cases between January 2010 and March 2015 classifying them according to age, sex and biopsy register. Routine histological technique was performed in addition to the immunohistochemical staining for WT1, cytokeratin and other reagents according to the differential diagnoses. Results: The age distribution was 47 to 75 years, mean 60 years, 100% of cases female. Immunohistochemical reagents were predominant WT1 (53.8%) and cytokeratin-7 (38.5%). Conclusion: This carcinoma is a rare entity in routine clinical practice, with similarities to ovarian serous carcinoma.There is consensus on the diagnosis of this condition, which must be oriented according to the criteria of the Gynecologic Oncology Group. Clinical suspicion can lead the pathologist to perform immunohistochemical study and thus have an accurate diagnosis to determine the therapeutic approach of the surgeon.

Hallazgos histológicos gástricos en obesos mórbidos sometidos a gastrectomía vertical laparoscópica / Pathological findings in resected gastric segments after laparoscopic sleeve gastrectomy

Background: Laparoscopic sleeve gastrectomy (LSG) is used for the treatment of obesity and may provide gastric tissue for pathological studies. The association of obesity with dyslipidemias, diabetes and cardiovascular disease is of common knowledge. However its association with gastrointestinal diseases and gastritis is less well known. Aim: To analyze the pathological findings of the resected gastric segment during LSG. Material and Methods: Two hundred fifty patients aged 37 +/- 12 years and with a body mass index of 37.7 +/- 3.1 kg/m² (189 women), subjected to LSG, were included in a prospective protocol. Resected gastric segments were sent for a pathological study. Results: A gastric disease was identified in 220 (88 percent) cases. Chronic follicular gastritis was diagnosed in 117 patients (46.8 percent), chronic superficial gastritis in 76 (30.4 percent), chronic nonspecific gastritis in 38 (15.2 percent), intestinal metaplasia in 14 percent (5.6 percent) and in one case (0.4 percent) an early gastric carcinoma. Helicobacterpylori was present in 34 (13.6 percent) patients. Conclusions: This study shows a high prevalence of histopathological gastric lesions detected after the LSG, reaffirming the need for detection of these lesions before surgery.

Introducción: La gastrectomía vertical laparoscópica (GVL) es un procedimiento quirúrgico efectivo en el tratamiento de la obesidad. La obesidad está asociada con algunas comorbilidades como diabetes, dislipidemia y enfermedad cardiovascular, pero también se ha demostrado que tiene efectos potenciales sobre la gastritis y diversas enfermedades gastrointestinales. El objetivo de este estudio es determinar los hallazgos histológicos del segmento gástrico resecado durante la GVL realizada en una serie de pacientes obesos. Material y Método: Entre enero de 2006 y diciembre de 2008, 250 pacientes consecutivos a los que se realizó GVL, fueron incluídos en un protocolo prospectivo. La serie consistió en 189 mujeres (75,6 por ciento) y 61 hombres (24,4 por ciento), con edad promedio de 37,5 +/- 12,1 años. El Índice de Masa Corporal (IMC) promedio fue 37,7 +/- 3,1 kg/m². Resultados: Los resultados histológicos identificaron 220 casos (88 por ciento) con patología gástrica. Se diagnosticó gastritis crónica folicular en 117 pacientes (46,8 por ciento), gastritis crónica superficial en 76 (30,4 por ciento), gastritis crónica inespecífica en 38 (15,2 por ciento), metaplasia intestinal en 14 percent (5,6 por ciento) y en un caso (0,4 por ciento) adenocarcinoma in situ. Helicobacter pylori (HP) estuvo presente en 34 pacientes (13,6 por ciento). Conclusiones: Los hallazgos de este estudio, muestran una prevalencia incrementada de lesiones gástricas histopatológicas detectadas posterior a la GVL, reafirmando la necesidad de una detección de estas lesiones antes de la cirugía.