Convalescent plasma treatment for patients of 80 years and older with COVID-19 pneumonia.

BACKGROUND: Older patients, frequently with multiple comorbidities, have a high mortality from COVID-19 infection. Convalescent plasma (CP) is a therapeutic option for these patients. Our objective is to retrospectively evaluate the efficacy and adverse events of CP treatment in this population group. METHODS: Forty one patients over 80 years old with COVID-19 pneumonia received CP added to standard treatment, 51.2% with high anti-SARS-CoV-2 IgG titers and 48.8% with low titers. Median time between the onset of symptoms and the infusion of plasma was 7 days (IQR 4-10). A similar group of 82 patients who received only standard treatment, during a period in which CP was not available, were selected as a control group. RESULTS: In-hospital mortality was 26.8% for controls and 14.6% for CP patients (P = 0.131) and ICU admission was 8.5% for controls and 4.9% for CP patients (P = 0.467). Mortality tended to be lower in the high-titer group (9.5%) than in the low-titer group (20%), and in patients transfused within the first 7 days of symptom onset (10%) than in patients transfused later (19.1%), although the differences were not statistically significant (P = 0.307 and P = 0.355 respectively). There was no difference in the length of hospitalization. No significant adverse events were associated with CP treatment. CONCLUSIONS: Convalescent plasma treatment in patients over 80 years old with COVID-19 pneumonia was well tolerated but did not present a statistically significant difference in hospital mortality, ICU admission, or length of hospitalization. The results should be interpreted with caution as only half the patients received high-titer CP and the small number of patients included in the study limits the statistical power to detect significant differences. TRIAL REGISTRATION: CEIm Cantabria # 2020.127.

Atherogenic index of plasma is associated with the severity of Hidradenitis Suppurativa: a case-control study.

BACKGROUND: Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with several comorbidities and vascular risk factors, such as dyslipidemia. The present study aimed to assess the possible associations between the lipid profile and atherogenic indexes and the severity of HS. METHODS: This case-control study enrolled 78 HS patients and 62 healthy controls. Classic lipid profile and lipoprotein ratios, including the atherogenic index of plasma (AIP), were evaluated. The severity of HS was measured by the HS Physician Global Assessment (PGA). RESULTS: HS-patients had lower serum total cholesterol and HDL-C levels and higher AIP than the control group. AIP was positively correlated to BMI, waist circumference, systolic and diastolic blood pressure, LDL-C, triglycerides, non-HDL-C, ApoB, HOMA, and hs-CRP and negatively to HDL-C and ApoA1. For the overall lipid profile, only AIP was related to a more severe HS (PGA ≥ 3) after controlling for age, sex, BMI, insulin resistance (IR), active smoking, and statin use (r = 0.268; p = 0.023). Multiple logistic regression adjusted for age, sex, BMI, IR, smoking status and statin use, showed that AIP ≥ 0.11 was significantly associated with the severity of HS (OR, 4.38; CI 95%, 1.09-17.50; p = 0.037). CONCLUSIONS: In conclusion, these results showed that AIP is significantly and independently associated with HS severity.

Estenosis cervical: descompresión, fijación y artrodesis vía anterior / Cervical stenosis: decompression, anterior fixation and fusion

Diseño del estudio: descriptivo, serie de casos, prospectivo, multicéntrico. Objetivo: revisar la experiencia de la descompresión, artrodesis y fijación de la estenosis cervical. Marco conceptual: la estenosis cervical es causa de cervicobraquialgia asociada o no a déficit neurológico, cuya presentación es frecuente en la consulta externa de ortopedia y neurocirugía. El propósito de este estudio es revisar y describir la experiencia en los pacientes afectados con esta patología, así como los resultados derivados de su manejo. Todos los pacientes incluidos en el estudio fueron seguidos de manera ambulatoria por consulta externa, iniciando su manejo con fármacos, analgésicos y fisioterapia, sin que existiera una adecuada respuesta a éstos, por lo cual se consideró la cirugía. Materiales y método: se analizaron 30 pacientes, promedio de edad 57,2 años (35-92), promedio de seguimiento 62 meses (6-138). Se consideraron dos tipos de diagnóstico: hernia discal y canal estrecho degenerativo, valorando su compromiso neurológico pre y posquirúrgico con la escala de la Asociación Japonesa de Ortopedia (calificación máxima 17/17). Resultados: hernia discal 53% de casos siendo los niveles más comprometidos C5-C6 y C6-C7; canal estrecho degenerativo 47% de casos, con mayor afectación en C4-C5 y C5-C6. Neurológicamente presentaban mielorradiculopatía (50%), radiculopatía (40%) y mielopatía (10%). Se observó mejoría neurológica en el posoperatorio en 1 punto para hernia discal y 3 puntos para canal estrecho degenerativo en promedio. Complicaciones mínimas acordes con la literatura. Recomendaciones: la técnica descrita se considera indicada puesto que los resultados posoperatorios son favorables.