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Philadelphia negative myeloproliferative neoplasms [MPN Ph (-)] and monoclonal gammopathies (MG) stem from different hematopoietic progenitor lines. The association between both has a frequency between 3 to 14%, and it has been associated with a higher risk of thrombosis. This study aimed to describe the clinical characteristics of patients with both entities at our center., Methods: Retrospective observational study of case series. The MPN Ph (-) database of our center between 2015 and 2020 was consulted. The clinical records were reviewed, obtaining demographic, clinical, and management determinants. Descriptive statistical analysis was performed., Results: Among 144 patients, 6 patients diagnosed with MG and MPN were found, all of them female. The median age was 71 years at diagnosis of MPN Ph (-) and 70 years at diagnosis of MG. Two were diagnosed concomitantly with both pathologies, in 2 the MG preceded the MPN, and in 2 the MPN was previously diagnosed. No patient has progressed to acute leukemia or myelofibrosis. Regarding the treatments received, all received Hydroxicarbamide, some with aspirin and one with anticoagulation. Of the MGs, one patient with solitary bone plasmacytoma progressed to multiple myeloma, requiring treatment after 2 years. Two had a thrombotic event, both arterials., Conclusion: The observed MG frequency of 4% was similar to what was expected for the age of the patients. Although it is noteworthy that 2 had thrombotic events, further studies are needed to evaluate this association.

Objective: Explore the use of two abortion care models in Argentina over the period 2016-2019: pro-rights private medical service providers and abortion accompaniment (via self-management and via health institutions); and compare the profile of who accesses these models and when., Methods: We used data from accompaniment collectives in the Socorristas en Red and private service providers. We estimated annual abortion rates via these service models and compared the profile of the populations by type of service and gestational age (2019) using descriptive statistics and chi-square tests., Results: In 2016, 37 people per 100,000 women of reproductive age obtained accompanied self-managed abortions, and the number increased to 111 per 100,000 in 2019, a threefold increase. The rate of abortions via care providers was 18 per 100,000 in 2016 and 33 in 2019. Higher proportions of those who obtained abortion via care providers were 30 years or older. A higher proportion of those accompanied were 19 years or younger; 11% of those who obtained accompanied self-managed abortions were more than 12 weeks gestation compared with 7% among those who had accompanied abortions via health institutions and 0.2% among those who had abortions with private providers. A higher proportion of those who accessed accompanied abortions after 12 weeks gestation had lower educational levels, did not work or have social security coverage, had more past pregnancies, and attempted to terminate their pregnancies prior to contacting the Socorristas compared to those who had accompanied abortions at 12 weeks or earlier., Conclusions: In Argentina, prior to Law 27.610 models of care guaranteed access to safe abortion. It is important to continue making visible and legitimizing these models of care so that all those who decide to have an abortion, whether inside or outside health institutions, have safe and positive experiences.

Introduction: the rupture of the extensor pollicis longus (EPL) tendon is a rare pathology and usually occurs in adult women in relation to distal radius fractures., Material and Methods: we present the case of an adolescent female patient who, after conservative treatment with splinting of a Peterson type I physeal fracture of the radius, suffered an acute extension deficit of the thumb at six weeks, diagnosed with clinical radiological examination as spontaneous rupture of the extensor pollicis longus (EPL). She was treated with extensor pollicis indicis propius (EIP) transfer with satisfactory results and recovering her usual activity one month after surgery., Conclusion: this kind of injuries are infrequent in pediatric ages and rarely described in a pediatric patient with immature skeleton, what makes this case something exceptional. It is necessary considering these complications in patients of low ages even with no other risk factors. The most frequent treatment applied in adults as in children is the EIP transference with good results in the long term.

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Since the first report in 1954, abdominal pseudocysts have been recognized as a particularly uncommon complication of ventriculoperitoneal shunts of CSF, so their etiology, diagnosis, and therapeutic management remain very controversial. Our objective is to offer a critical and updated systematic review of those controversial points, using a thorough search and review of the most relevant literature available. The clinical presentation of pseudocysts is normally through non-specific abdominal symptoms. The most validated etiology consists on the existence of a concomitant infection of the CSF shunt system, and so, treatment needs of antibiotherapy and total or partial substitution of the system. However, the pseudocyst itself doesn't need an active treatment, except for some specific cases. This management, algorithmically presented in the present work, achieves a lower recurrence rate than other options, but this one is still important, and is also associated with other complications of those shunts related with several other factors which need to be taken in account., (Copyright © 2020 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Neurocryptococcosis is an opportunistic fungal infection that represents a high cost in human lives and for the economy of countries. Its causative agent, the Cryptococcus neoformans/Cryptococcus gattii species complex, has a sexual and an asexual phase, four major serotypes and seven molecular varieties with phenotypic, clinical-epidemiological and antifungal susceptibility differences., Objective: To characterize by molecular methods clinical isolates of C. neoformans from Guayaquil, Ecuador., Materials and Methods: We determined mating types, serotypes and molecular varieties by PCR and RFLP in 27 yeast isolates previously identified as C. neoformans by conventional methods. The isolates were recovered from cerebrospinal fluid of HIV seropositive patients with neurological syndrome admitted at "Dr. José Daniel Rodríguez Maridueña" Hospital from December, 2013, to January, 2015., Results: We established a wide prevalence of C. neoformans serotype A, MATα and genotype VNI among the studied isolates., Conclusions: These data are similar to those obtained in other countries and the first identified by molecular characterization in Guayaquil, Ecuador. Therefore, they constitute an important contribution to the knowledge on cryptococcosis in this country.

A total of 249 persons living in the northwest part of Ecuador with a clinical diagnosis of malaria confirmed by thick blood films were treated with chloroquine and primaquine according to the therapeutical system in force in the National Service for Eradication of Malaria. New clinical assessment and thick blood film were applied after 4 days in P. falciparum (n = 120) cases and after 8 days in P. vivax (n = 129) cases; patients were questioned about the compliance or non-compliance with the treatment, and the reasons for their acting in either way were studied. EPI-INFO 6.04 and SPSS PC 7.0 packages served to process the information: "kind adjustment test" (bondad de ajuste) abd factorial analysis of correspondences were used. The patient who daily took his/her pills for the number of days indicated, at the established intervals and at the right time was defined as a patient complying with the drug therapy. For every 3 patients complying with treatment, there were 2 who did not; non-compliance was not significantly related to age, sex, educational level, ethnic group, urban or rural setting or level of income, but learning about seriousness of the infection did help to compliance with the therapy. The reasons for non-compliance were mainly associated with drugs (side effects/reluctancy to take drugs), with the fact of forgetting to take them and of "getting cured quickly". The profile of the patient who did not comply with treatment corresponded to male, teenager, mixed race, poor and rural setting.