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Pelvic-abdominal injuries caused by goring are serious lesions which require rapid diagnosis and urgent treatment in the context of a polytraumatized patient. The simultaneous rupture of both the bladder and the prostatic-membranous urethra occurs in 10%-29% of males with pelvic fractures but bladder neck injuries in adults are rarer. Unstable pelvic fractures, bilateral fractures of the ischiopubic branches (also referred to as fractures from falling astride) and the diastasis of the pubic symphysis are those that have the greatest likelihood of injuring both the posterior urethra and the bladder. We present a case of perineal bull horn injury with muscle laceration, bone fractures, scrotal avulsion and rupture of the bladder neck involving the right ureter which required two operations to be repaired.

Resumen: Introducción: Estudio que describe la experiencia en el uso del electroencefalograma urgente (EEGurg) por la guardia de neurología ante la sospecha de estatus epiléptico no convulsivo (EENC) y en otras indicaciones en un hospital terciario. Sujetos y métodos: Estudio observacional retrospectivo de los registros de EEG de 8 canales realizados con carácter urgente en pacientes hospitalizados y en Urgencias e interpretados por la guardia de neurología entre julio del 2013 y mayo del 2015. Se recogieron las siguientes variables: sexo, edad, síntomas, diagnóstico inicial, epilepsia previa y causa, ictus previo, neoplasia, tomografía computarizada cerebral urgente, diagnóstico tras EEGurg, actitud terapéutica, evolución, EEG convencional (EEGc) de control y diagnóstico definitivo. Se analizaron los datos de frecuencia, así como la sensibilidad y especificidad en el diagnóstico de EENC. Resultados: Se recogieron 135 registros de EEGurg realizados a 129 pacientes, el 51,4% hombres, edad mediana 69 años. En 112 casos (83%) la indicación fue descartar EENC por alteración del nivel de consciencia 42 (37,5%), del comportamiento 38 (33,9%) y del lenguaje 32 (28,5%). En 37 (33%) registros se informó como EENC, siendo este el diagnóstico definitivo en 35 (94,6%). En otros 3 casos, el EENC se diagnosticó en el EEGc de control tras pasar desapercibido en la valoración del EEGurg por la guardia. El EEGurg en el diagnóstico del EENC presenta una sensibilidad del 92,1%, una especificidad del 97,2%, un valor predictivo positivo del 94,6% y un valor predictivo negativo del 96% tomando como referencia el diagnóstico al alta. Conclusiones: En nuestra experiencia, en un contexto clínico adecuado, el EEGurg utilizado por la guardia de neurología es una herramienta sensible y específica en el diagnóstico del EENC. Abstract: Introduction: We aim to describe the use of emergency electroencephalogram (EmEEG) by the on-call neurologist when nonconvulsive status epilepticus (NCSE) is suspected, and in other indications, in a tertiary hospital. Subjects and methods: Observational retrospective cohort study of emergency EEG (EmEEG) recordings with 8-channel systems performed and analysed by the on-call neurologist in the emergency department and in-hospital wards between July 2013 and May 2015. Variables recorded were sex, age, symptoms, first diagnosis, previous seizure and cause, previous stroke, cancer, brain computed tomography, diagnosis after EEG, treatment, patient progress, routine control EEG (rEEG), and final diagnosis. We analysed frequency data, sensitivity, and specificity in the diagnosis of NCSE. Results: The study included 135 EEG recordings performed in 129 patients; 51.4% were men and their median age was 69 years. In 112 cases (83%), doctors ruled out suspected NCSE because of altered level of consciousness in 42 (37.5%), behavioural abnormalities in 38 (33.9%), and aphasia in 32 (28.5%). The EmEEG diagnosis was NCSE in 37 patients (33%), and this was confirmed in 35 (94.6%) as the final diagnosis. In 3 other cases, NCSE was the diagnosis on discharge as confirmed by rEEG although the EmEEG missed this condition at first. EmEEG performed to rule out NCSE showed 92.1% sensitivity, 97.2% specificity, a positive predictive value of 94.6%, and a negative predictive value of 96%. Conclusions: Our experience finds that, in an appropriate clinical context, EmEEG performed by the on-call neurologist is a sensitive and specific tool for diagnosing NCSE. Palabras clave: Estatus epiléptico, Estatus epiléptico no convulsivo, Electroencefalograma, Urgencias neurológicas, Epilepsia, Síndrome confusional agudo, Keywords: Status epilepticus, Non-convulsive status epilepticus, Electroencephalogram, Neurological emergencies, Epilepsy, Acute confusional state

Introduction: We aim to describe the use of emergency electroencephalogram (EmEEG) by the on-call neurologist when nonconvulsive status epilepticus (NCSE) is suspected, and in other indications, in a tertiary hospital. Subjects and methods: Observational retrospective cohort study of emergency EEG (EmEEG) recordings with 8-channel systems performed and analysed by the on-call neurologist in the emergency department and in-hospital wards between July 2013 and May 2015. Variables recorded were sex, age, symptoms, first diagnosis, previous seizure and cause, previous stroke, cancer, brain computed tomography, diagnosis after EEG, treatment, patient progress, routine control EEG (rEEG), and final diagnosis. We analysed frequency data, sensitivity, and specificity in the diagnosis of NCSE. Results: The study included 135 EEG recordings performed in 129 patients; 51.4% were men and their median age was 69 years. In 112 cases (83%), doctors ruled out suspected NCSE because of altered level of consciousness in 42 (37.5%), behavioural abnormalities in 38 (33.9%), and aphasia in 32 (28.5%). The EmEEG diagnosis was NCSE in 37 patients (33%), and this was confirmed in 35 (94.6%) as the final diagnosis. In 3 other cases, NCSE was the diagnosis on discharge as confirmed by rEEG although the EmEEG missed this condition at first. EmEEG performed to rule out NCSE showed 92.1% sensitivity, 97.2% specificity, a positive predictive value of 94.6%, and a negative predictive value of 96%. Conclusions: Our experience finds that, in an appropriate clinical context, EmEEG performed by the on-call neurologist is a sensitive and specific tool for diagnosing NCSE. Resumen: Introducción: Estudio que describe la experiencia en el uso del electroencefalograma urgente (EEGurg) por la guardia de neurología ante la sospecha de estatus epiléptico no convulsivo (EENC) y en otras indicaciones en un hospital terciario. Sujetos y métodos: Estudio observacional retrospectivo de los registros de EEG de 8 canales realizados con carácter urgente en pacientes hospitalizados y en Urgencias e interpretados por la guardia de neurología entre julio del 2013 y mayo del 2015. Se recogieron las siguientes variables: sexo, edad, síntomas, diagnóstico inicial, epilepsia previa y causa, ictus previo, neoplasia, tomografía computarizada cerebral urgente, diagnóstico tras EEGurg, actitud terapéutica, evolución, EEG convencional (EEGc) de control y diagnóstico definitivo. Se analizaron los datos de frecuencia, así como la sensibilidad y especificidad en el diagnóstico de EENC. Resultados: Se recogieron 135 registros de EEGurg realizados a 129 pacientes, el 51,4% hombres, edad mediana 69 años. En 112 casos (83%) la indicación fue descartar EENC por alteración del nivel de consciencia 42 (37,5%), del comportamiento 38 (33,9%) y del lenguaje 32 (28,5%). En 37 (33%) registros se informó como EENC, siendo este el diagnóstico definitivo en 35 (94,6%). En otros 3 casos, el EENC se diagnosticó en el EEGc de control tras pasar desapercibido en la valoración del EEGurg por la guardia. El EEGurg en el diagnóstico del EENC presenta una sensibilidad del 92,1%, una especificidad del 97,2%, un valor predictivo positivo del 94,6% y un valor predictivo negativo del 96% tomando como referencia el diagnóstico al alta. Conclusiones: En nuestra experiencia, en un contexto clínico adecuado, el EEGurg utilizado por la guardia de neurología es una herramienta sensible y específica en el diagnóstico del EENC. Keywords: Status epilepticus, Non-convulsive status epilepticus, Electroencephalogram, Neurological emergencies, Epilepsy, Acute confusional state, Palabras clave: Estatus epiléptico, Estatus epiléptico no convulsivo, Electroencefalograma, Urgencias neurológicas, Epilepsia, Síndrome confusional agudo

Resulta paradójico que a pesar de las enormes ventajas que supone en muchas aplicaciones de construcción el empleo del hormigón ligero estructural (HLE) frente a un hormigón convencional (HC), su uso todavía no se haya generalizado. Muy posiblemente, el desconocimiento de su comportamiento físico y mecánico contribuye de forma decisiva a la utilización de un HC en muchas ocasiones en las que su sustitución por HLE sería totalmente competitivo y ventajoso. Este trabajo pretende ampliar el conocimiento del comportamiento del HLE para contribuir a su utilización en todas las situaciones en donde su empleo supone una clara ventaja frente al HC. Abstract It is a paradox that despite of the huge advantages of the Lightweight Concrete (LWC) over the Normal Concrete (NC) in a number of construction applications, its use has not been widespread. Quite sure, the lack of knowledge about LWC mechanical behavior leds to the use of NC in many occasion when a the use of LWC will be totally competitive and beneficial. This paper aims to expand the knowledge about LWC behavior to contribute to its use at any situation when its use is an obvious advantage against NC.

Parkinson's disease, a major neurodegenerative disorder in humans whose etiology is unknown, may be associated with some environmental factors. Nocardia otitidiscaviarum (GAM-5) isolated from a patient with an actinomycetoma produced signs similar to Parkinson's disease following iv injection into NMRI mice. NMRI mice were infected intravenously with a non-lethal dose of 5 x 10(6) colony forming units of N. otitidiscaviarum (GAM-5). Fourteen days after bacterial infection, most of the 60 mice injected exhibited parkinsonian features characterized by vertical head tremor, akinesia/bradykinesia, flexed posture and postural instability. There was a peak of nocardial growth in the brain during the first 24 h followed by a decrease, so that by 14 days nocardiae could no longer be cultured. At 24 h after infection, Gram staining showed nocardiae in neurons in the substantia nigra and occasionally in the brain parenchyma in the frontal and parietal cortex. At 21 days post-infection, tyrosine hydroxylase immunolabeling showed a 58% reduction of tyrosine hydroxylase in the substantia nigra, and a 35% reduction of tyrosine hydroxylase in the ventral tegmental region. Dopamine levels were reduced from 110 ± 32.5 to 58 ± 16.5 ng/mg protein (47.2% reduction) in brain from infected mice exhibiting impaired movements, whereas serotonin levels were unchanged (191 ± 44 protein in control and 175 ± 39 ng/mg protein in injected mice). At later times, intraneuronal inclusion bodies were observed in the substantia nigra. Our observations emphasize the need for further studies of the potential association between Parkinson's disease or parkinsonism-like disease and exposure to various nocardial species.