Particulate wear debris osteolysis, acute urinary retention and delirium as late complications of hip arthroplasty.

Intrapelvic mass formation as a result of particulate wear debris induced osteolysis is a recognised late complication of cementless total hip arthroplasty. Clinical presentation typically involves hip and/or leg pain resulting in functional impairment, and obstructive urinary symptoms developing 3-20 years after surgery. An acute confusional state has never been described in this scenario. We report the case of an 86-year-old gentleman with a diagnosis of dementia brought to our emergency department with an acute confusional state. Abdominal imaging revealed a distended bladder, a large pelvic mass and a lytic lesion within his right acetabulum. Cytological and microbiological examination of fluid obtained with radiologically guided aspiration of the mass was negative for neoplasia and infection.

Body composition assessed by anthropometry and bioelectric impedance analysis in older persons recovering from cerebrovascular accident.

We investigated body composition in older patients who had experienced a cerebrovascular accident (CVA) and were participating in a recovery program that included physical exercise. We studied 61 persons in two groups. One group consisted of 13 men and 12 women (mean age, 68 years) who were receiving day center care to recover from a CVA that had occurred from six months to one year previously. The second group (control) consisted of 20 men and 16 women (mean age, 68 years) in good health, residing in a retirement home. Most subjects in both groups were able to perform normal activities of daily living without help and showed a high degree of independence (> 60 on the Barthel scale). Bioelectric impedance and anthropometric methods were used to measure the magnitude of changes in fat-free mass and fat mass. Percentage total body fat measured with bioelectric impedance was higher in both groups than when measured anthropometrically. The anthropometric values and bioelectric impedance results in patients who participated in a physical exercise program were similar to the findings in control subjects. The anticipated loss in muscle mass and gain in body fat as a result of inactivity associated with illness was not seen, possibly because of the personalized program of continuous physical exercise. Our comparison of older people recovering from CVA and apparently healthy older people illustrates the benefits of physical exercise in compensating for changes in body composition as a result of immobility during convalescence.

Mujer de 36 años de edad, sometida a trasplante autogénico de sangre periférica por neoplasia de mama, con fiebre y lesiones cutáneas generalizadas / Thirty-six-year-old woman submitted to autogenic transplantation of peripheral blood due to breast neoplasm with fever and generalized cutaneous lesions

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Infección pulmonar por Aspergillus Fumigatus y nocardia asteroides como complicación del tratamiento con glucocorticoides / Concomitant pulmonary infection by Aspergillus Fumigatus and nocardia asteroides as a complication of corticosteroid therapy

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