Resultados del tratamiento médico de la embolia de pulmón en una unidad de corta estancia de un hospital de tercer nivel: ¿es el lugar adecuado? / Results of pulmonary embolism treatment in a tertiary hospital short stay unit. Is this the right place?

Objetivo. Describir la estancia media (EM) de la embolia de pulmón (EP) en una unidad de trombosis (UT) dependiente de una unidad de corta estancia (UCE) de un hospital de tercer nivel. Comparar estos datos con el resto de hospitales de nuestra región, con los del resto de comunidades autónomas (CCAA) y con el mismo hospital durante un año previo a nuestra existencia. Material y método. Estudio observacional retrospectivo descriptivo en el que se incluyeron los pacientes con diagnóstico de EP en el Hospital Clínico Universitario Virgen de la Arrixaca (HCUVA) durante el año 2012. Clasificamos estos datos por servicio hospitalario, calculando la EM. Comparamos esta con la del resto de hospitales de nuestra región, con el resto de CCAA y con nuestros datos en el año 2007, cuando no existía aun la UT. Resultados. Se incluyeron 113 pacientes: 60 (53%) ingresaron en la UT, siendo la EM de 4,39 días, en Oncología, de 7,45, y en Medicina Interna (MI), de 15,38. No hubo ningún fallecido en la UT y solo se produjeron 3 reingresos (5%). Los datos publicados mostraron que la EM en todos los hospitales de nuestra región fue de 8,25 días; en nuestro hospital fue de 5,18 días y en el resto de hospitales, mayor. La CCAA con mejor EM fue el País Vasco con 6,85 días. En el año 2007, hubo 70 pacientes con EP en el HCUVA: 34 (49%) en MI con una EM de 8,50 días, 11 (31%) en Oncología con una EM de 9,64 días y 3 (4,3%) en Neumología, con una EM de 19 días; la mortalidad global fue del 11% y la tasa de reingresos en MI, del 6%. Conclusión. La EM de la EP en la UT en una UCE fue menor que en el resto de servicios de nuestro hospital, menor que en el resto de hospitales de nuestra comunidad, menor que en el resto de CCAA y menor que en cualquier servicio de nuestro hospital en una época anterior a nuestra existencia, sin aumentar la tasa de reingreso ni la mortalidad (AU)

Objectives. To determine the mean stay (MS) of patients with pulmonary embolism (PE) in a thrombosis unit (TU) with a short stay unit (SSU) in a tertiary hospital. To compare the data collected with those of other hospitals in the same region, of other regions (Autonomous Communities [AACC]), and within the same hospital in the year before the SSU opened. Material and methods. A descriptive retrospective observational study that included patients with a diagnosis of PE in the University Hospital Virgen de la Arrixaca (HCUVA) in 2012. These data were classified by hospital department, and used for calculating the mean stay. This was then compared with that of other hospitals in our region, with the rest of the regions, and with the data in 2007 (the last year without a TU). Results. A total of 113 patients with PE were included, 60 (53%) in the TU with an MS of 4.39, in Oncology, 7.45, and Internal Medicine (IM), 15.38 days. There were no deaths in the TU and only 3 (5%) readmissions. Published data showed that the MS in all hospitals in our region was 8.25, 5.18 in our hospital, and higher in the rest of hospitals. The best AACC was the Basque Country with an MS of 6.85 days. In 2007, there were 70 patients with PE in the HCUVA, 34 (49%) in IM, with an MS of 8.50, Oncology 11 (31%) with an MS 9.64, and Chest Diseases 3 (4.3%) with an MS 19 days, and with an overall mortality of 11% and a rate of readmissions in IM of 6%. Conclusion. The mean stay for a PE in the SSU of a TU was lower than in the rest of the hospital departments, lower than the rest hospitals of our region, lower than the rest of the regions, and lower than any department of our hospital before the SSU existed, without increasing the readmission or mortality rate (AU)

[Results of pulmonary embolism treatment in a tertiary hospital short stay unit. Is this the right place?]. / Resultados del tratamiento médico de la embolia de pulmón en una unidad de corta estancia de un hospital de tercer nivel: ¿es el lugar adecuado?

OBJECTIVES: To determine the mean stay (MS) of patients with pulmonary embolism (PE) in a thrombosis unit (TU) with a short stay unit (SSU) in a tertiary hospital. To compare the data collected with those of other hospitals in the same region, of other regions (Autonomous Communities [AACC]), and within the same hospital in the year before the SSU opened. MATERIAL AND METHODS: A descriptive retrospective observational study that included patients with a diagnosis of PE in the University Hospital Virgen de la Arrixaca (HCUVA) in 2012. These data were classified by hospital department, and used for calculating the mean stay. This was then compared with that of other hospitals in our region, with the rest of the regions, and with the data in 2007 (the last year without a TU). RESULTS: A total of 113patients with PE were included, 60 (53%) in the TU with an MS of 4.39, in Oncology, 7.45, and Internal Medicine (IM), 15.38days. There were no deaths in the TU and only 3 (5%) readmissions. Published data showed that the MS in all hospitals in our region was 8.25, 5.18 in our hospital, and higher in the rest of hospitals. The best AACC was the Basque Country with an MS of 6.85days. In 2007, there were 70patients with PE in the HCUVA, 34 (49%) in IM, with an MS of 8.50, Oncology 11 (31%) with an MS 9.64, and Chest Diseases 3 (4.3%) with an MS 19days, and with an overall mortality of 11% and a rate of readmissions in IM of 6%. CONCLUSION: The mean stay for a PE in the SSU of a TU was lower than in the rest of the hospital departments, lower than the rest hospitals of our region, lower than the rest of the regions, and lower than any department of our hospital before the SSU existed, without increasing the readmission or mortality rate.

[Intermediate uveitis due to human T-cell lymphotropic virus type 1]. / Uveítis intermedia por virus linfotropo humano de células T Tipo 1.

CASE REPORT: The case of a 66-year-old woman with intermediate uveitis in both eyes and progressive weakness of lower limbs is reported. A human T-lymphotropic virus type 1 (HTLV-1) infection was detected in the serological study, with the patient being diagnosed with tropical spastic paraparesis and HTLV-1 intermediate uveitis. The patient made good progress with oral steroid treatment. DISCUSSION: The clinical and epidemiological aspects of HTLV-1 infection are discussed. We recommend a serological determination of the virus in intermediate uveitis of unknown origin in people from endemic areas or with neurological symptoms.

Uveítis intermedia por virus linfotropo humano de células T Tipo 1 / Intermediate uveitis due to human T-cell lymphotropic virus type 1

Caso Clínico: Se presenta el caso de una mujer de 66 años con uveítis intermedia bilateral y debilidad progresiva de miembros inferiores. En estudio serológico se detecta infección por virus linfotropo humano de células T tipo 1 (VLHT-1), siendo diagnosticada la paciente de paraparesia espástica tropical y uveítis intermedia por VLHT-1. La paciente evolucionó favorablemente con tratamiento corticoideo oral. Discusión: Se comenta la clínica y la epidemiología de la infección por VLHT-1. Se recomienda la realización de serología para el virus en uveítis intermedias no filiadas en inmigrantes de áreas endémicas o con síntomas neurológicos(AU)

Case Report: The case of a 66-year-old woman with intermediate uveitis in both eyes and progressive weakness of lower limbs is reported. A human T-lymphotropic virus type 1 (HTLV-1) infection was detected in the serological study, with the patient being diagnosed with tropical spastic paraparesis and HTLV-1 intermediate uveitis. The patient made good progress with oral steroid treatment. Discussion: The clinical and epidemiological aspects of HTLV-1 infection are discussed. We recommend a serological determination of the virus in intermediate uveitis of unknown origin in people from endemic areas or with neurological symptoms(AU)

Resultados de la punción aspiración con aguja fina y la biopsia por punción con estudio anatomopatológico definitivo en lesiones mamarias / No disponible

Objetivo: Valorar los resultados de la punción aspiración con aguja fina (PAAF) y la biopsia por punción (BPP) de lesiones mamarias con estudio anatomopatológico de la pieza quirúrgica. Pacientes y métodos: Estudio retrospectivo y observacional de 144 pacientes durante dos años con PAAF, BPP y pieza quirúrgica. Resultados: Del total de 144 lesiones el diagnóstico anatomopatológico fue: 17 de benigno, 10 de hiperplasia, 7 de carcinomas in situ, 108 de carcinoma y 2 otros. En 2 de los 17 casos benignos la PAAF y la BPP diagnosticaron un carcinoma. Eran casos sometidos a quimioterapia neoadyuvante con respuesta total. En otro caso de hiperplasia por PAAF y carcinoma por BPP, la lesión se extirpó en su totalidad con esta técnica. De los 108 carcinomas, 10 casos fueron falsos negativos por BPP. En 8 el diagnóstico fue benigno y en 2 de hiperplasia. En 4 casos la PAAF indicó un carcinoma, en 2 fue sospechosa, 1 benigna y en otra no se obtuvo material celular. En la PAAF se detectaron 3 falsos negativos. En 2 de ellos la BPP diagnosticó carcinoma y en otro benignidad. El caso que fue diagnosticado de benigno por ambas técnicas era un carcinoma en glándula mamaria axilar. Conclusión: En el estudio hay un número bajo de lesiones benignas controladas por imagen y de hiperplasias y carcinomas in situ al no tener citología por presentarse con microcalcificaciones. En la casuística analizada, la PAAF y la BPP son técnicas complementarias para el diagnóstico de lesiones mamarias(AU)

Objective: To evaluate the results of fine needle aspiration (FNA) and core biopsy (CB) of breast lesions with pathologic diagnosis. Patients and methods: A retrospective, observational study of 144 patients in two years with FNA, CB and surgical specimen. Results: Pathological diagnosis of the 144 lesions were: 17 benign, 10 hyperplasia, 7 carcinoma in situ, 108 carcinoma and 2 others. In 2 of 17 benign cases, FNA and CB diagnosed carcinoma. These cases were treated with neoadjuvant chemotherapy with a complete response. In other case of hyperplasia in FNA and carcinoma in CB was totally excised by this technique. Ten of the 108 carcinomas were false negatives in CB (8 benign, 2 hyperplasia). In 4 cases FNA diagnosed carcinoma, 2 were suspicious of malignancy, 1 benign and in other there was no material for a diagnosis. In FNA there were 3 false negatives, 2 of them were diagnosed of carcinoma and benign by CB. The case diagnosed of benign by both techniques was a carcinoma arising in a mammary axillary gland. Conclusion: In this study the number of benign lesions is low because they were followed by image techniques. Also there are few hyperplasias and carcinomas in situ which are diagnosed by mammography for microcalcifications and they do not have cytological study. In the cases studied, FNA and CB are complementary techniques for the diagnosis of breast lesions(AU)

Tumor de células granulares de la mama / No disponible

El tumor de células granulares es una lesión poco frecuente y que ocasionalmente puede afectar a la glándula mamaria. Se presenta el caso de una mujer de 31 años con un nódulo en la mama derecha, mamográficamente benigno y ecográficamente sospechosa. La punción citológica y el estudio histológico demostraron un tumor de células granulares de la mama. Su extirpación completa fue curativa(AU)

Granular cell tumor is an infrequent lesion that can occur in the breast. Herein is presented a case of a 31-year-old female with a mammographically benign nodule but ultrasonographically suspicious in the right breast. Fine needle aspiration and histologic study revealed a granular cell tumor of the breast. The complete excision was curative(AU)