Cervical spine trauma.

Cervical spine trauma encompasses a wide of injuries, ranging from stable, minor lesions to unstable, complex lesions that can lead to neurologic sequelae or vascular involvement. The Canadian C-Spine Rule and the NEXUS criteria aim to identify individuals with a low risk of cervical spine trauma who can safely forgo imaging tests. In high-risk patients, an imaging test is indicated. In adult patients the imaging test of choice is multidetector computed tomography. Complementary imaging tests such as CT angiography of the supra-aortic vessels and/or magnetic resonance imaging are occasionally necessary. It can be challenging for radiologists to diagnose and classify these lesions, because some of them can be subtle and difficult to detect. This paper aims to describe the most important imaging findings and the most widely used classification systems.

Peliosis hepatis due to disseminated tuberculosis in a patient with AIDS.

Peliosis hepatis is a rare histopathological entity of unknown etiology. We present a case of peliosis hepatis in a 44-year-old man with disseminated tuberculosis and acquired immunodeficiency syndrome. The diagnosis of peliosis hepatis was based on liver biopsy results which were suggestive of tuberculous etiology. Diagnosis of tuberculosis was confirmed by auramine stain, rRNA amplification and culture of Mycobacterium tuberculosis from synovial fluid of the elbow joint. The patient responded favourably to tuberculostatic treatment with four drugs and the early initiation of highly active antiretroviral therapy. Histopathological evidence of peliosis hepatis, without an obvious cause, makes it necessary to rule out tuberculosis, especially in the context of immunodeficiency diseases and immigrants from endemic areas.

Síndrome de Cushing iatrogénico por corticoides tópicos en dos adultos / Iatrogenic Cushing’s syndrome caused by topical steroid therapy in two adults

Los corticoides tópicos representan el escalón principal en el tratamiento de muchas enfermedades dermatológicas no infecciosas. Si se usan de forma apropiada son seguros y efectivos, pero sin una supervisión médica adecuada pueden producir efectos secundarios graves, tanto locales como sistémicos. Presentamos dos pacientes adultos diagnosticados de síndrome de Cushing iatrogénico en nuestro hospital. Aunque es una complicación poco frecuente, se debe tener en cuenta en pacientes con dermatosis inflamatorias de larga evolución, ya que puede ser de difícil diagnóstico si no se sospecha (AU)

Topical corticosteroids are the mainstay of treatment for many non- infectious dermatoses. If used appropriately they are a safe and effective therapy, but without medical supervision severe local and systemic adverse effects may occur. We report two patients followed at our Dermatology unit that developed iatrogenic Cushing's syndrome after using topical corticosteroids. Although it's an extremely rare complication in adults, we must be aware of this adverse effect in patients with chronic inflammatory dermatoses, as diagnosis requires a high grade of suspicion (AU)

Embolismos sépticos cutáneos tras angioplastia / Septic Emboli to the Skin Following Angioplasty

Los procedimientos vasculares invasivos son en el momento actual ampliamente utilizados para el diagnóstico y tratamiento de muchas patologías del sistema cardiovascular, con un buen perfil de seguridad y eficacia, aunque entrañan potenciales complicaciones que ocasionalmente pueden comprometer la vida del paciente. Presentamos un nuevo caso de pseudoaneurisma infeccioso postangioplastia complicado con embolismos sépticos cutáneos. Se trata de una entidad infrecuente caracterizada por bacteriemia persistente, sepsis sin foco aparente y embolismos sépticos regionales. El análisis histopatológico de las lesiones cutáneas habitualmente permite evidenciar la presencia de cocobacilos Gram positivos y de vasculitis séptica. Es una entidad con una importante morbimortalidad, por lo que el diagnóstico precoz resulta esencial. Por ello, ante lesiones cutáneas tras procedimientos vasculares invasivos deben considerarse en el diagnóstico diferencial no solo los embolismos de colesterol, sino también los embolismos sépticos (AU)

Invasive vascular procedures have good efficacy and safety profiles and are now widely used for the diagnosis and treatment of many cardiovascular disorders. However, they do have potential complications that can occasionally be life-threatening. We present a new case of infectious pseudoaneurysm following percutaneous transluminal coronary angioplasty and complicated by septic emboli to the skin. It is a rare condition characterized by persistent bacteremia, sepsis of unknown origin, and regional septic emboli. Histopathology of the skin lesions typically reveals gram-positive coccobacilli and septic vasculitis. The condition carries a significant morbidity and mortality, making early diagnosis essential. Both cholesterol and septic emboli should be considered in the differential diagnosis of skin lesions after invasive vascular procedures (AU)

[Septic emboli to the skin following angioplasty]. / Embolismos sépticos cutáneos tras angioplastia.

Invasive vascular procedures have good efficacy and safety profiles and are now widely used for the diagnosis and treatment of many cardiovascular disorders. However, they do have potential complications that can occasionally be life-threatening. We present a new case of infectious pseudoaneurysm following percutaneous transluminal coronary angioplasty and complicated by septic emboli to the skin. It is a rare condition characterized by persistent bacteremia, sepsis of unknown origin, and regional septic emboli. Histopathology of the skin lesions typically reveals gram-positive coccobacilli and septic vasculitis. The condition carries a significant morbidity and mortality, making early diagnosis essential. Both cholesterol and septic emboli should be considered in the differential diagnosis of skin lesions after invasive vascular procedures.