Riesgo de exposición a la Covid-19 en auxiliares de enfermería, enfermeras y médicos de un hospital universitario ante la pandemia / Risk of exposure to Covid-19 in nursing assistants, nurses, and physicians in a university hospital in the face of pandemic

Objetivo principal: Los profesionales sanitarios fueron los trabajadores más afectados por Covid-19, especialmente durante las primeras oleadas. El objetivo del estudio es evaluar la percepción del riesgo de exposición al Covid-19, información recibida y participación laboral entre enfermeros, médicos y auxiliares de enfermería. Metodología: Se realizó un estudio transversal mediante una encuesta epidemiológica entre enfermeras, médicos y auxiliares de enfermería de un hospital universitario. Se realizó una validación de aspecto y contenido, un pretest cognitivo y un pilotaje de la encuesta epidemiológica con treinta sujetos. Se realizó un análisis descriptivo utilizando media y desviación estándar (DE) para las variables cuantitativas y las frecuencias absolutas (n) y relativas (%) para variables cualitativas. Se aplicó el test chi-cuadrado y el test ANOVA para evaluar la asociación de las respuestas con las variables: sexo, tipo de trabajador, área de trabajo y actividad en Unidades Covid-19. Resultados principales: Las enfermeras, médicos y auxiliares de enfermería trabajaban principalmente en áreas asistenciales y en unidades de alto riesgo de exposición. Los auxiliares de enfermería y las enfermeras tenían una mayor percepción de riesgo. Las enfermeras estaban menos implicadas en la organización, pero se sentían más apoyadas por sus compañeros. Los médicos se sentían más apoyados por sus superiores y mejor atendidos cuando tenían problemas de salud. Conclusión principal: Las enfermeras y auxiliares de enfermería presentaron mayor percepción de riesgo, las enfermeras se implicaron menos en la organización de la atención sanitaria, mientras que los médicos se sintieron más apoyados por sus superiores.(AU)

Objective: Healthcare professionals were the workers most affected by Covid-19, especially during the first waves of the pandemic. Thus, the aim of this study is to evaluate the perceived risk of exposure to Covid-19, the information received and the work participation between nurses, physicians and nursing assistants. Method: A cross-sectional study was conducted using an epidemiological survey among nurses, physicians and nursing assistants in a university hospital. Aspect and content validation, cognitive pretest, and piloting of the epidemiological survey was carried out with thirty subjects. A descriptive analysis was performed using mean and standard deviation (SD) for quantitative variables and absolute (n) and relative (%) frequencies for qualitative variables. The chi-square test and the ANOVA test were applied to assess the association of the responses with the variables: sex, type of worker, area of work and activity in Covid-19 Units. Results: Nurses, physicians and nursing assistants worked mainly in assistance areas and high risk of exposure units. Nursing assistants and nurses had a higher perception of risk. Nurses were less involved in the organization, but felt more supported by their colleagues. However, physicians felt more supported by their superiors and better care when they had a health problem. Conclusions: Nursing assistants and nurses presented higher risk perception, nurses were less involved in the organization of health care, while physicians felt more supported by their superiors.(AU)

Osificación heterotópica de las piernas en un varón / Report of a man with heterotopic ossification of the legs

La osificación heterotópica es un trastorno infrecuente que consiste en el depósito de tejido óseo extraesquelético. En la piel, puede ser primario, en el contexto de síndromes genéticos, o secundario a trastornos muy diversos. Dentro de las formas secundarias, la osificación subcutánea de las piernas por insuficiencia venosa crónica es una complicación infrecuente y poco reportada. Presentamos un paciente con osificación subcutánea de las piernas secundaria a insuficiencia venosa y revisamos la literatura

Heterotopic ossification is an uncommon disorder that consists of deposition of ectopic bone outside the extraskeletal tissues. In the skin, it can be primary, in association with genetic syndromes, or be secondary to different disorders. The latter include subcutaneous ossification of the legs in chronic venousinsufficiency, an infrequent and unrecognized complication. We report the case of a patient with subcutaneous ossification of both legs secondary to venous insufficiency and review the literature

Ceftazidime-avibactam in the treatment of infections caused by KPC-producing Klebsiella pneumoniae: factors associated with clinical efficacy in a single-center cohort.

BACKGROUND: Infections caused by KPC-producing Klebsiella pneumoniae (KPC-Kp) are not well represented in pivotal trials with ceftazidime-avibactam (CAZ-AVI). This study aimed to investigate its efficacy in a single-centre cohort of patients infected with KPC-Kp. METHODS: A retrospective observational study was conducted of consecutive patients treated for > 72 hours with CAZ-AVI for KPC-Kp infections. Fourteen-day clinical response was considered when none of these criteria were present: i) the patient died before day 14, ii) treatment with CAZ-AVI at day 14 for persistence of symptoms or signs of infection, iii) recurrence. A multivariate logistic regression model was used to identify factors predictive of 14-day clinical failure. A propensity score to receive targeted initial treatment with CAZ-AVI was used as a covariate of the analysis. RESULTS: Forty-seven patients were included. The median age was 70 years and the median Charlson index was 4. The most frequent sources of infection were intraabdominal (n = 18; 38.3%) followed by pneumonia (n = 14; 29.8%). Twenty-five patients (53.2%) had septic shock. CAZ-AVI was used as monotherapy in 34 (72.3%) of the cases. CAZ-AVI resistance was detected after CAZ-AVI therapy in six of 47 (12.7%) patients. Thirty-day crude mortality was 23.4% (n = 11). The 14-day clinical response rate was 59.6% (n = 28). Pneumonia (OR 7.57; 95% CI 1.45-39.43; P = 0.01), and INCREMENT-CPE score > 7 points (OR 6.73; 95% CI 1.39-34.94; P = 0.02) were associated with 14-day clinical failure. CONCLUSIONS: CAZ-AVI offers an advance for the treatment of KPC-Kp infections. In patients with pneumonia or an INCREMENT-CPE score > 7 points it may be reasonable to use CAZ-AVI in combination.

Lupus eritematoso cutáneo, morfea profunda y psoriasis en una paciente / Cutaneous lupus erythematosus, morphea profunda and psoriasis: a case report

La psoriasis es una frecuente dermatosis inflamatoria que puede asociarse a diversas enfermedades. Estudios recientes señalan que la presencia de enfermedades autoinmunes es mayor, pero es rara la asociación con enfermedades del tejido conectivo. La coexistencia con lupus es infrecuente. Por otra parte, la morfea raramente se ha reportado en pacientes con lupus o psoriasis. Presentamos a una paciente con lupus cutáneo y morfea profunda que posteriormente desarrolló psoriasis, con excelente respuesta a metotrexato y revisamos la literatura

Psoriasis is a common inflammatory dermatosis that may be associated with a number of diseases. Recent studies provide evidence that there is a greater frequency of autoimmune diseases, but association with autoimmune connective tissue diseases is uncommon. The coexistence of psoriasis and lupus erythematosus is rare. Besides, the occurrence of morphea has rarely been reported in patients with lupus or psoriasis. We report a woman with cutaneous lupus and morphea profunda associated with psoriasis, with an excellent response to methotrexate, and review the literature

Cutaneous lupus erythematosus, morphea profunda and psoriasis: A case report. / Lupus eritematoso cutáneo, morfea profunda y psoriasis en una paciente.

Psoriasis is a common inflammatory dermatosis that may be associated with a number of diseases. Recent studies provide evidence that there is a greater frequency of autoimmune diseases, but association with autoimmune connective tissue diseases is uncommon. The coexistence of psoriasis and lupus erythematosus is rare. Besides, the occurrence of morphea has rarely been reported in patients with lupus or psoriasis. We report a woman with cutaneous lupus and morphea profunda associated with psoriasis, with an excellent response to methotrexate, and review the literature.

Report of a man with heterotopic ossification of the legs. / Osificación heterotópica de las piernas en un varón.

Heterotopic ossification is an uncommon disorder that consists of deposition of ectopic bone outside the extraskeletal tissues. In the skin, it can be primary, in association with genetic syndromes, or be secondary to different disorders. The latter include subcutaneous ossification of the legs in chronic venousinsufficiency, an infrequent and unrecognized complication. We report the case of a patient with subcutaneous ossification of both legs secondary to venous insufficiency and review the literature.

Angiofibromas múltiples faciales en dermatitis atópica grave. Estudio de dos pacientes / Multiple facial angiofibromas in severe atopic dermatitis. Study of two patients

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Asociación entre melanoma, linfoma y cáncer de tiroides. Descripción de un caso y revisión de la literatura / Association between melanoma, lymphoma and thyroid cancer. Case report and review of the literature

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Neoplasia de celulas dendriticasblastica plasmocitoide.

Plasmacytoid blast dendritic cell neoplasia (NCDBP) is an uncommon malignant neoplasm, presenting clinically with cutaneous involvement and subsequent lymph node and bone marrow extension. It characteristically expresses the markers: CD56, CD4, and CD123. There is no optimal treatment, relapses are frequent, and the survival time is short. We present the case of an elderly patient with NCDBP who initially presented with cutaneous lesions, but experienced rapid systemic progression and did not, respond to treatment.

Frontal fibrosing alopecia and extrafacial lichen planus pigmentosum in a caucasian woman.

We present the case of a 72-year-old Caucasian woman with frontal fibrosing alopecia of one year's duration. Eighteen months later, she presented with sudden hyperpigmentation on the submental area, neck and upper chest. Histopathological examination was consistent with lichen planus pigmentosus. This is the report of a unique case of a FFA and extrafacial lichen planus pigmentosus.

Dermatosis neutrofílica de las manos / Neutrophilic dermatosis of the hands

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Dermatosis papular acantolítica de la vulva con buena respuesta a tacrólimus tópico.

Papular acantholytic dermatosis of the vulva is a rare, chronic disorder and is an entity that remains to be fully understood. It shares clinical and histopathological overlap with Darier disease and Hailey-Hailey disease. We describe a 30-year-old woman with papular acantholytic dermatosis of the vulva. The lesions consisted of whitish papules and erosions on the labia majora. Histologically, there was hyperkeratosis and focal parakeratosis with acantholytic and dyskeratotic cells. She did not respond completely to topical steroids but clinical improvement occurred after the use of topical tacrolimus.