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Purpose: Both venous and arterial thrombotic events (VTE/AT) can be associated with Immune Checkpoint Inhibitors (ICI). However, there is a paucity of information apropos patients in routine clinical practice., Methods: /Patients. This retrospective, multicenter study was promoted by the Thrombosis and Cancer Section of the Spanish Society of Medical Oncology (SEOM). Individuals with head and neck cancer who initiated ICI between 01/01/2015 and 31/12/2021 were recruited. Minimum follow-up was 6 months (except in cases of demise). The primary objective was to calculate the incidence of ICI-associated VTE/AT, with secondary objectives including the analysis of their impact on survival and the identification of variables predictive of VTE/AT., Results: A total of 143 patients with head and neck cancer were enrolled. The incidence of VTE/AT during follow-up (median 8.6 months) was 2.8%. Survival analysis showed no significant differences (p = 0.644) between the group that developed VTE/AT (median 7.13 months, 95% CI 0-22.9) and the group that did not (median 9.86 months, 95% CI 6.3-13.4). The presence of liver metastases was predictive of VTE/AT (p < 0.05)., Conclusions: Thromboembolic disease associated with immunotherapy in patients with head and neck neoplasia does not significantly impact survival. The presence of liver metastases can predict these events., (© 2024. The Author(s).)

Competing Interests: Declaration of competing interest The authors have no conflicts of interest in relation to this article.

Cyanacrylate is not free of complications and a more commonly used alternative in clinical practice are prostheses that have the disadvantage of migrating in these cases where there is no stenosis; however, with their fixation using a specific device, migrations are greatly reduced. A good alternative to cyanacrylate, especially in cases of orifices or large tracts in which complications may appear, are the prostheses, which are also easier to handle in clinical practice. Sometimes cancer patients have upper gastrointestinal complications no subsidiary to surgical treatment, like a tumor fistula, that contraindicate chemotherapy. In situations like this, endoscopic intervention can be a potentially profitable alternative that impacts the patient's prognosis.

Thrombosis may be included in the profile of side effects associated with CDK4/6 inhibitors. Its significance might be greater than reported in randomized clinical trials. To investigate this, a retrospective, multicenter study was conducted. The primary objective was to calculate the incidence of thrombosis associated with CDK4/6 inhibitors. Secondary objectives included examining the impact of thrombosis on survival and identifying predictor variables for the development of venous thromboembolism (VTE) or arterial thrombosis (AT). A total of 986 patients were recruited. The incidence of VTE/AT associated with CDK4/6 inhibitor treatment during the follow-up period was 5.48 %. Survival analysis did not indicate that the development of VTE/AT during CDK4/6 inhibitor treatment significantly impacted patient survival (p = 0.133). In our analysis, two variables were found to be statistically significant (p < 0.05) as predictors of VTE/AT in breast cancer patients receiving CDK4/6 inhibitor therapy. These variables were the presence of central nervous system (CNS) metastasis with an odds ratio (OR) of 3.68 (95 % CI 1.18 - 11.49) and the use of abemaciclib with an OR of 2.3 (95 % CI 1.16 - 4.57)., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest related to this article., (Copyright © 2024. Published by Elsevier B.V.)

Purpose: Both venous and arterial thrombotic events (VTE/AT) can be associated with immune checkpoint inhibitors (ICI). However, there is a paucity of information apropos patients in routine clinical practice., Methods/patients: Retrospective, multicenter study promoted by the Thrombosis and Cancer Section of the Spanish Society of Medical Oncology (SEOM). Individuals with kidney or bladder cancer who initiated ICI between 01/01/2015 and 12/31/2020 were recruited. Minimum follow-up was 6 months (except in cases of demise). The primary objective was to calculate the incidence of ICI-associated VTE/AT and secondary objectives included to analyze their impact on survival and identify variables predictive of VTE/AT., Results: 210 patients with kidney cancer were enrolled. The incidence of VTE/AT during follow-up (median 13 months) was 5.7%. Median overall survival (OS) was relatively lower among subjects with VTE/AT (16 months, 95% CI 0.01-34.2 vs. 27 months, 95% CI 22.6-31.4; p = 0.43). Multivariate analysis failed to reveal predictive variables for developing VTE/ AT. 197 patients with bladder were enrolled. There was a 9.1% incidence rate of VTE/AT during follow-up (median 8 months). Median OS was somewhat higher in patients with VTE/AT (28 months, 95% CI 18.4-37.6 vs 25 months, 95% CI 20.7-29.3; p = 0.821). Serum albumin levels < 3.5 g/dl were predictive of VTE/ AT (p < 0.05)., Conclusions: There appears to be no association between developing VTE/AT and ICI use in patients with renal or bladder cancer. Serum albumin levels are a predictive factor in individuals with bladder cancer., (© 2023. The Author(s).)

Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Osteonevus of Nanta is a rare histopathologic variant of melanocytic nevus that results from ossification of the dermis between dermal nests of melanocytes. Most cases described in the literature have been associated with long-standing intradermal nevi and were often located in the upper part of the body. We report a lesion on the shoulder of an elderly man showing the association of a common blue nevus and osteoma cutis, an exceptional feature which has been previously reported in 2 instances. We also describe for the first time the dermoscopic appearance of this "blue osteonevus."

Juvenile xanthogranuloma is the most common form of non-Langerhans cell histiocytosis in childhood. The clinical differential diagnosis of a solitary juvenile xanthogranuloma includes molluscum contagiosum, Spitz nevus, and melanoma. Lesions larger than 2 cm in diameter may be misdiagnosed as hemangiomas, but this is not typical of smaller juvenile xanthogranuloma. We report a case of solitary juvenile xanthogranuloma in a 10-year-old boy with angiomatous appearance and peculiar immunophenotype., (© 2017 Wiley Periodicals, Inc.)

Background: Paraneoplastic syndromes consist of a group of disorders that are not related to the extension of the primary tumor or its metastases and that might be the first manifestation of a hidden neoplasm. It is a well-known association between dermatomyositis (DM) and cancer, especially gynecological tumors in women and lung cancer in men., Methods: We describe the case of a 67-year-old male who developed muscular weakness and pruritic skin lesions. Skin biopsies were performed and histologic findings were consistent with DM., Results: Skin biopsy showed interface dermatitis with vacuolar degeneration of the basal layer, dermal mucin deposits, and necrotic keratinocytes in the acrosyringia, a finding that has been previously reported in lupus erythematous but not in DM. Autoimmunity tests showed positivity for antinuclear antibodies and anti-NXP2, a recently described antibody associated with juvenile DM and, more rarely, with paraneoplastic DM., Conclusion: We present the first case in the literature with histopathologic changes of DM affecting the acrosyringia. Besides, our patient autoimmunity results support the utility of the new myositis-specific autoantibodies and its relation with a clinical phenotype.

During the 2009 to 2010 corn-growing (Zea mays L. cv. Alexandria) seasons, severely stunted and yellowing corn plants in several commercial fields at Aldearrubia (Salamanca Province) were observed in western Spain. The disease incidence ranged from 80 to 100%. Early symptoms consisted of severely reduced growth of the plants coupled with extensive leaf yellowing. Occurrence of the disease was estimated to cause near complete loss of the crop yields since the corn produced in affected fields was unmarketable. Disease surveys revealed high parasitism in the main and feeder roots and a large soil population of the root-knot nematode Meloidogyne spp. The nematode population was extracted and quantified from soil and root samples according to Barker (1). It was identified as the southern root-knot nematode M. incognita race 1, by female perineal pattern, host-differential test, and multiplex PCR using forward primers H-18S, CF-ITS, I-ITS, and reverse primer HCFI-28S (3,4). ITS products cloned and assayed using the ABI PRISM 3100 Genetic Analyzer (Applied Biosystems, Salamanca, Spain) were subjected to a database search using BLAST (National Centre for Biotechnology Information) to confirm the identification. These sequences exhibited 99.0% similarity with that of an M. incognita isolate from France (GenBank Accession No. AF402309.1). M. incognita was found in 80% of soil samples collected from the areas where the disease was observed and 83.5% of root samples with nematode population densities ranging from 26 to 269 eggs and second-stage juveniles (J2s) per 100 cm 3 of soil and 234 to 1,634 eggs and J2s per 5 g of fresh roots. In glasshouse proofs of pathogenicity, a mix of 1,500 eggs and J2s of these populations of M. incognita were inoculated in 20-cm-diameter pots with 10 replicates with a single pregerminated seed of corn cv. Alexandria as host plant; another 10 replicates without inoculation were established as control plants. After 6 weeks, all plants inoculated were severely stunted and yellowing; infected roots showed galls on root tips and secondary feeder roots. Galling of root tips that cause stubby root symptoms prevented further root growth into deeper soil layers and induced proliferation of secondary roots, which confirmed the nematodes' pathogenicity. The severe infections in roots of corn plants suggest that parasitism of corn roots by the root-knot nematode must contribute to stunting, yellowing, and decline of corn, reducing yield by restricting access to water and nutrients that are needed for plant growth and development, and can result in the death of younger plants as previously reported (2). To our knowledge, this is the first report of M. incognita infecting corn in Spain. References: (1) K. R. Barker. Nematode extraction and bioassays. Page 19 in: An Advanced Treatise on Meloidogyne. Vol. II, Methodology. K. R. Barker et al., eds. North Carolina State University Graphics, Raleigh, 1985. (2) T. P. Heffes et al. Nematropica 22:139, 1992. (3) L. Robertson et al. Crop Prot. 25:440, 2006. (4) C. Zijlstra. Fund. Appl. Nematol. 20:505, 1997.

Soil and root samples were collected from May to October 2010 from cultivated and wild plants during a survey for hop cyst nematodes. Cyst nematodes were detected in roots of common nettle (Urtica dioica L.) with severe plant yellowing in four natural areas of León and Burgos provinces, Spain, where common nettle is grown in organic farming systems as a substrate for pharmaceutical products. Cysts were isolated by flotation and sieving methods. Cysts and juveniles were analyzed by morphological and molecular methods. The cyst nematodes obtained from soil and plant samples from all four locations had uniform morphological and molecular characteristics that differed from those of Heterodera humuli. Cysts (n = 25) had the following characteristics: lemon shaped, yellow to pale brown; cyst wall with ridges forming an irregular zigzag pattern; young cysts covered by subcrystalline layer; vulval cone bifenestrate with circular or subcircular fenestrae; bullae absent; underbridge weak; body length (not including the neck) ranging from 295 to 489 μm (mean of 418 μm); body width ranging from 208 to 375 μm (mean of 310 μm); fenestrate length of 39 to 58 μm (mean of 46.5 μm) and width of 25.2 to 30.9 μm (mean of 25.1 μm); underbridge length from 51 to 90 μm (mean of 69.2 μm); and vulval slit length from 26 to 40 μm (mean of 33 μm). J2 (n = 20) had the following characteristics: body length ranging from 338 to 380 μm (mean of 359.3 μm); stylet length from 21 to 24 μm (mean of 22.1 μm) with knobs rather wide and slightly projecting anteriorly; tail conical with a length of 41 to 52.5 μm (mean of 45.6 μm) and hyaline part of tail ranging from 18 to 25 μm (mean of 23.3 μm); lateral field with four lines. All morphological data and characters were consistent with those of H. ripae (1). DNA from single cysts was extracted to amplify the internal transcribed spacer (ITS) region of rDNA by PCR with forward primer TW81 (5'-GTTTCCGTAGGTGAACCTGC-3') and reverse primer AB28 (5'-ATATGCTTAAGTTCAGCGGGT-3') (2). The PCR product was digested by restriction enzymes (AluI, CfoI, HaeI, HinfI, PstI, RsaI, TaqI, and Tru9I) to obtain restriction fragment length polymorphism profiles (2). ITS products cloned and assayed using the ABI PRISM 3100 Genetic Analyzer (Applied Biosystems, Salamanca, Spain) were subjected to a database search using BLAST (National Centre for Biotechnology Information) to confirm the identification. These sequences exhibited 99.0% similarity with that of a H. ripae isolate from Germany (GenBank Accession No. AF274407.1). In glasshouse proofs of pathogenicity with these populations of H. ripae, 25 full cysts placed in nylon net bags were inoculated in 9-cm-diameter pots with 10 replicates per plant. After 12 weeks, soil from each pot was dried and cysts extracted. Cysts did not develop on roots of common hop (Humulus lupulus L.) and hemp (Cannabis sativa L.), but in common nettle there was an increase in nematode populations, with all plants severely stunted and yellowing, which confirmed the nematodes' pathogenicity. H. ripae has been previously reported in Russia, Estonia, Latvia, Armenia, Moldova, Ukraine, Bulgaria, Slovakia, Germany, and Belgium (1). To our knowledge, this is the first report of H. ripae in Spain. The identification of H. ripae in nettle fields is important in this region where it could cause large yield reductions if not properly managed. References: (1) S. A. Subbotin et al. Russ. J. Nematol. 5:143, 1997. (2) S. A. Subbotin et al. Nematology 5:515, 2003.

A 68-year-old man underwent hip surgery under subarachnoid anesthesia with bupivacaine and fentanyl to replace an acetabular component. Two days after surgery the patient developed unilateral cauda equina syndrome, affecting five nerve roots (L4 to S3), with no sphincter involvement. Two and a half years later, the lesion had become permanent. We discuss the possible origin of the condition, suggesting differential diagnoses such as mechanical problems (position-mobilization) and anesthetic toxicity.

Objectives: To compare the clinical efficacy of hyperbaric 0.5% ropivacaine and 0.5% bupivacaine in subarachnoid blockade for ambulatory surgery., Material and Method: Randomized double-blind study of 90 patients undergoing lower abdominal surgery. Subarachnoid blockade was achieved with 0.5% ropivacaine (12.5 mg) or 0.5% bupivacaine (12.5 mg) in 10% glucose. We recorded age, sex, weight, latency, extension of motor and sensory blocks, duration of surgery, side effects and quality as perceived by the surgeon and the patient., Results: The two groups were similar with respect to latency time and extension of sensory block. Durations of motor (68.9 +/- 22.9 min) and sensory (127.0 +/- 24.3 min) blocks were significantly shorter with ropivacaine than with bupivacaine (133.3 +/- 29.4 and 174.9 +/- 25.5 min, respectively). Patients in the ropivacaine group also experienced a less intense motor block (Bromage 1, 11.1% vs. 93.3%) and fewer episodes of hypotension 0% vs. 17.7%) or bradycardia (4.4% vs. 8.8%) than those in the bupivacaine group. No neurotoxic effects or instances of postdural puncture headache were recorded., Conclusions: Hyperbaric 0.5% ropivacaine offers certain advantages over hyperbaric 0.5% bupivacaine for subarachnoid block in outpatient surgery. Duration and intensity of the sensory-motor blockade is less with ropivacaine and fewer cardiovascular side effects develop.

By means of the present study, we compare the variations in the cardiovascular response to the orotracheal intubation while using midazolam or etomidate during the anesthetic induction. For this purpose, we studied 2 groups of 10 patients each one which were premedicated with fentanyl and atropine, and succinylcholine as muscle relaxant. We took the data at a basal state, 10 minutes after premedication and 0, 1, 2, 3, 4, 5 and 10 minutes after the intubation handling. As hemodynamic data we registered heart rate, systolic and diastolic blood pressure and the rate product (PRP). In both groups, the peak response occurred two minutes after intubation in all the studied parameters. Systolic and diastolic blood pressure as well as PRP were significantly lower with midazolam. We conclude that midazolam and etomidate do not prevent the cardiovascular response to the intubation handling, although midazolam smooths pressure response.