Costilla accesoria cervical como causa de síndrome de apertura torácica superior. Nuestra experiencia de los últimos diez años / Cervical accessory rib, as a cause of thoracic oulet syndrome (tos): our experience of the last ten years

El síndrome de apertura torácica superior por costilla cervical, es una patología no muy frecuente, ocasionada por la persistencia después del nacimiento de la última costilla cervical que debería haberse reabsorbido. La patología que origina, es comprensiva de las estructuras vecinas en especial nerviosas, pero también vasculares. Se manifiesta en pacientes jóvenes después de la adolescencia con una especial incidencia en el sexo femenino. El diagnóstico es sencillo si se piensa en esta causa como la etiológica del síndrome, con la realización de una simple radiografía de base de cuello para evidenciar su presencia, aunque es posible realizar otras complementarias. El tratamiento es la simple extirpación de la costilla que en la mayoría de las ocasiones resuelve el cuadro clínico. Se analiza en la publicación la experiencia de nuestro servicio hospitalario en los últimos diez años, analizando aspectos demográficos, diagnósticos, terapéuticos y los resultados obtenidos

The syndrome of superior thoracic opening due to cervical rib is a not very frequent pathology, caused by the persistence after birth of the last cervical rib that should have been reabsorbed. The pathology that it originates is comprehensive of neighboring structures, especially nervous, but also vascular. It manifests itself in young patients after adolescence with a special incidence in the female sex. The diagnosis is simple if we think of this cause as the etiological cause of the syndrome, with a simple neck base X-ray to show its presence, although it is possible to perform other complementary ones. Treatment is the simple removal of the rib, which in most cases resolves the clinical picture. The experience of our Hospital Vascular Service in the last ten years is analyzed in the publication, analyzing demographic, diagnostic and therapeutic aspects and the results obtained

Isquemia arterial aguda bilateral de extremidades inferiores y estado protrombótico en infección por SARS-COV-2. A propósito de un caso / Bilateral acute lower limbs ischaemia and prothrombotic status in SARS-COV-2 infection. A case report

La infección por SARS-COV-2 se ha convertido en una emergencia sanitaria internacional. Junto con la infección respiratoria, se pueden presentar complicaciones derivadas de un estado de hipercoagulabilidad, ensombreciendo el pronóstico. Se presenta el caso clínico de un paciente con neumonía vírica por SARS-COV-2, en el que se produce una isquemia arterial bilateral de extremidades inferiores

SARS-COV-2 infection has become an international health emergency. Apart from the respiratory disease, complications arising from an hypercoagulable state may occur, overshadowing the prognostic. The clinical case of a patient with SARS-COV-2 viral pneumonia is presented, in which bilateral arterial ischemia of the lower extremities occurs

Aneurismas de la arteria poplítea. experiencia de un centro en un periodo de 10 años / Aneurisms of popliteal artery. experience of a center in a period of 10 years

Los aneurismas de la arteria poplítea son una patología relativamente frecuente al constituir los de mayor incidencia y prevalencia dentro de los periféricos. Este tipo de patología, presenta una serie de peculiaridades de acuerdo a datos demográficos y también con respecto a formas y tipos de presentación. La clínica se centra especialmente en su perfil de bultoma que late y expande y en las complicaciones de frecuente presentación. Su tratamiento quirúrgico está basado en opciones terapéuticas de cirugía abierta y cirugía convencional. Se presenta la experiencia de un solo centro durante diez años en la atención de esta patología

Popliteal artery aneurysms are a relatively frequent pathology as they are those with the highest incidence and prevalence within the peripherals. This type of pathology presents a series of peculiarities according to demographic data and also with respect to forms and types of presentation. The clinic focuses especially on its profile of beating and expanding lump and on complications that frequently appear. His surgical treatment is based on therapeutic options of open surgery and conventional surgery. The experience of a single center for ten years in the care of this pathology is presented

Outcomes by sex following treatment initiation with darunavir/cobicistat in a large Spanish cohort of the CODAR study (GeSIDA 9316).

BACKGROUND: Few women have been included in darunavir/cobicistat clinical development studies, and hardly any of them were antiretroviral experienced or treated with anything other than triple-based therapies. OBJECTIVES: Our aim was to increase our knowledge about women living with HIV undergoing darunavir/cobicistat-based regimens. METHODS: A multicentre (21 hospitals), retrospective study including a centrally selected random sample of HIV-1 patients starting a darunavir/cobicistat-based regimen from June 2014 to March 2017 was planned. Baseline characteristics, 24 and 48 week viral load response (<50 copies/mL), CD4+ lymphocyte count increase, time to change darunavir/cobicistat and adverse event occurrence were all compared by sex. The study was approved by each of the 21 ethics committees, and patients signed informed consent. RESULTS: Out of 761 participants, 193 were women. Similar characteristics were found for both sexes, except that the women had a longer duration of HIV infection (P = 0.001), and were less frequently pre-treated with darunavir/cobicistat in their previous regimen (P = 0.02). The main reason for using a darunavir/cobicistat-based regimen was simplification, without differences by sex, while monotherapy seems to be more frequently prescribed in women than in men (P = 0.067). The main outcomes, HIV viral load response, CD4+ lymphocyte count increase at 24 or 48 weeks, occurrence of adverse events, main reasons for changing and time to the modify darunavir/cobicistat regimen, did not show differences between the sexes. CONCLUSIONS: No sex disparities were found in the main study outcomes. These results support the use of a darunavir/cobicistat-based regimen in long-term pre-treated women. Clinical Trial.gov No. NCT03042390.