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Objetivo Determinar los tiempos de asistencia, características extrahospitalarias e intrahospitalarias y supervivencia de las paradas cardiacas atendidas por una UVI móvil, al igual que los factores implicados en la supervivencia al ingreso y al alta hospitalaria. Diseño Estudio observacional retrospectivo desde el 1 de enero de 2010 al 31 de diciembre de 2010, con un seguimiento de un año desde la PCR. Ámbito Área sanitaria IV del Principado de Asturias, con 342.020 habitantes en 2010.PacientesSe incluyeron todos los pacientes que sufrieron una PCR en 2010 y fueron atendidos por la UVI móvil. Variables principales Datos demográficos, causa de la PCR, intervención por testigos, tiempos de asistencia y supervivencia al ingreso, al alta y un año después. Resultados Se atendieron un total de 177 paradas cardiacas. En 120 se indicó el soporte vital avanzado (SVA), siendo 66 de ellas (55%) de causa presumiblemente cardiaca. Recuperaron el pulso 63 pacientes (52,5%), llegando 51 de ellos con vida al hospital (42,5%). Se les dio el alta a 13 pacientes (10,8%). Al año 11 (9,2%) seguían vivos y 9 de ellos (7,5%) tenían una cerebral performance category (CPC) de 1. El ritmo inicial de fibrilación ventricular (FV) y los tiempos cortos en la asistencia se relacionaron con la supervivencia. Conclusiones La supervivencia fue superior a la publicada al ingreso al hospital y similar a la del alta. Como factores relacionados se encontraron los tiempos de asistencia y el ritmo inicial. La reanimación por el testigo fue escasa y no se usaron desfibriladores semiautomáticos (DEA) públicos (AU)

Objective To evaluate attendance timings, out- and in-hospital characteristics, and survival of cardiac arrests attended by an advanced life support unit in Asturias (Spain) in 2010. Factors related to survival upon admission and at discharge were also analyzed. Design A retrospective, observational trial was carried out involving a cohort of out-hospital cardiac arrests (OHCA) occurring between 1 January 2010 and 31 December 2010, with one year of follow-up from OHCA. Setting Health Care Area IV of the Principality of Asturias, with a population of 342,020 in 2010.PatientsAll patients with OHCA and attended by an advanced life support unit were considered. Main variables Demographic data, the etiology of cardiac arrest, bystander cardiopulmonary resuscitation (CPR), attendance timings and survival upon admission, at discharge and after one year. Results A total of 177 OHCA were included. Of these, 120 underwent CPR by the advanced life support team. Sixty-six of these cases (55%) were caused by presumed heart disease. A total of 63 patients (52.5%) recovered spontaneous circulation, and 51 (42.5%) maintained circulation upon admission to hospital. Thirteen patients (10.8%) were discharged alive. After one year, 11 patients were still alive (9.2%) - 9 of them (7.5%) with a Cerebral Performance Category (CPC) score of 1. Ventricular fibrillation and short attendance timings were related to increased survival. Conclusions The survival rate upon admission was better than in other series and similar at discharge. Initial rhythm and attendance timings were related. Public automated external defibrillators (AED) were not used, and bystander CPR was infrequent (AU)

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OBJECTIVE: To evaluate attendance timings, out- and in-hospital characteristics, and survival of cardiac arrests attended by an advanced life support unit in Asturias (Spain) in 2010. Factors related to survival upon admission and at discharge were also analyzed. DESIGN: A retrospective, observational trial was carried out involving a cohort of out-hospital cardiac arrests (OHCA) occurring between 1 January 2010 and 31 December 2010, with one year of follow-up from OHCA. SETTING: Health Care Area IV of the Principality of Asturias, with a population of 342,020 in 2010. PATIENTS: All patients with OHCA and attended by an advanced life support unit were considered. MAIN VARIABLES: Demographic data, the etiology of cardiac arrest, bystander cardiopulmonary resuscitation (CPR), attendance timings and survival upon admission, at discharge and after one year. RESULTS: A total of 177 OHCA were included. Of these, 120 underwent CPR by the advanced life support team. Sixty-six of these cases (55%) were caused by presumed heart disease. A total of 63 patients (52.5%) recovered spontaneous circulation, and 51 (42.5%) maintained circulation upon admission to hospital. Thirteen patients (10.8%) were discharged alive. After one year, 11 patients were still alive (9.2%) - 9 of them (7.5%) with a Cerebral Performance Category (CPC) score of 1. Ventricular fibrillation and short attendance timings were related to increased survival. CONCLUSIONS: The survival rate upon admission was better than in other series and similar at discharge. Initial rhythm and attendance timings were related. Public automated external defibrillators (AED) were not used, and bystander CPR was infrequent.

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Presentamos un linfoma testicular en un paciente que acude a urgencias con un cuadro similar al de un escroto agudo, al que se le realiza una ecografía convencional y doppler. Los hallazgos sugieren un tumor, probablemente linfoma dada la edad del paciente y la imagen radiológica. No obstante, es la falta de respuesta al tratamiento antibiótico lo que indica la orquiectomia biópsica. Destacamos la similitud entre la orquitis y el linfoma testicular, el tumor mas frecuente en varones mayores de 50 años. El diagnóstico por ecografía es sugestivo, pero no definitivo; suelen ser masas hipoecogénicas e hipervasculares si son mayores de 15 mm. La no afectación de epidídimo sugiere con mayor fuerza la naturaleza tumoral. El tratamiento debe ser quirúrgico y quimioterapia. El pronostico es malo con una supervivencia a los 5 años entre el 5-20 por ciento (AU)

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