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Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis, is a vasculitis that primarily affects the respiratory tract and kidneys(1). Known as a rare disease, predominantly affects Caucasian adults aged between 45 and 60 years(2). While the specific cause remains unclear, it is believed that environmental factors play a role in triggering the condition in individuals who are genetically predisposed(3). There is a wide range of clinical manifestations, comprising both general nonspecific symptoms(4) and organ-specific symptoms, with lung involvement in nearly 90% of patients(5). The diagnosis relies on clinical and imaging criteria, along with histopathological confirmation(2). Treatment consists of an induction phase, followed by a maintenance phase, utilizing glucocorticoids and immunosuppressants, which has greatly enhanced the prognosis for these patients(6). The objective of this paper is to illustrate the complexity of GPA through the presentation of a clinical case. The patient is a 59-year-old man with a professional background involving exposure to respiratory toxins who presented to the clinic with intermittent mucopurulent cough, episodes of hemoptysis, nonspecific chest pain, bilateral knee pain, weight loss, and excessive nocturnal sweating. The imaging findings indicated significant polymorphic lesions in the lungs, and the diagnosis of GPA was confirmed via transthoracic biopsy. Using a therapeutic strategy of immunosuppression and oral corticosteroid therapy, the patient's clinical condition showed a modest improvement. The particularity of this case lies in the need to revise the treatment strategy for a patient identified as a non-responder to cyclophosphamide, given the imaging, functional and biological decline observed under the initial immunosuppressive therapy. [ABSTRACT FROM AUTHOR]

Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant, that is, a hip prosthesis. A total hip replacement (total hip arthroplasty or THA) consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head. Hip replacement is currently one of the most common orthopaedical operations, though patient satisfaction short- and long-term varies widely. In this paper we present the case of a 75-year-old woman, with classic uncemented hip prosthesis intervention, from the preoperative preparation stage to 1 year after the intervention and the recovery phases and their evolution. Due to a quality management of the intervention and good hygiene and nutrition, the lack of osteoporosis and the absence of paleopathology, the patient recovered in a fast and correct manner, returning to a good functionality and state of health. Also, the cooperation between the patient, family, therapist, doctor and psychologist had a decisive role in the success of both the intervention and the postoperative period with optimal results for the age and possibilities of the patient. [ABSTRACT FROM AUTHOR]