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Introducción: Las infecciones respiratorias son las enfermedades respiratorias con mayor mortalidad en el mundo. Las causadas por Streptococcus pneumoniae, virus de influenza, Bordetella pertussis, SARS-CoV-2 y el Virus Sincitial Respiratorio, cuentan hoy día con vacunas seguras y efectivas. Este documento representa una guía de práctica clínica (GPC) de la Asociación Latinoamericana de Tórax (ALAT), elaborada por iniciativa de los departamentos de enfermedades infecciosas y pediatría, con el objetivo de establecer recomendaciones sobre vacunas respiratorias, utilizando la evidencia disponible. Método: Se estableció un grupo de desarrollo de las guías conformado por cinco médicos responsables globales del proyecto, se crearon cinco subgrupos de trabajo, uno por cada vacuna, con expertos neumólogos de adulto, pediatras e infectólogos invitados, que generaron preguntas clínicas. Se trabajó con un grupo de expertos metodólogos que transformaron preguntas clínicas en preguntas PICO, seleccionándose nueve preguntas por método DELPHI. Luego, se utilizó el sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation) para evaluar la evidencia disponible. Resultados: Se obtuvieron recomendaciones para población adulta y pediátrica de las vacunas de neumococo, influenza, tos ferina, COVID-19 y Virus Respiratorio Sincitial basadas en preguntas PICO. También se agregaron recomendaciones basadas en preguntas narrativas relacionadas al uso de vacunas respiratorias en población con enfermedades respiratorias crónicas como asma, EPOC y fibrosis pulmonar.

Introduction: Respiratory infections are the leading cause of respiratory disease-related mortality worldwide. Infections caused by Streptococcus pneumoniae, influenza virus, Bordetella pertussis, SARS-CoV-2 and Respiratory Syncytial Virus (RSV) now have safe and effective vaccines available.This document represents a Clinical Practice Guideline (CPG) by the Latin American Thoracic Association (ALAT), developed through the initiative of the departments of in-fectious diseases and pediatrics, with the goal of establishing recommendations on respiratory vaccines using the available evidence. Method: A guideline development group was established, composed of five lead physicians responsible for the overall project. Five working subgroups were created, one for each vaccine, involving invited experts in adult pulmonology, pediatrics, and infectious diseases, who formulated clinical questions. A group of expert methodologists then transformed these clinical questions into PICO questions, with nine questions selected using the DELPHI method. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) system was then used to assess the available evidence. Results: Recommendations were obtained for the adult and pediatric populations for pneumococcal, influenza, pertussis, COVID-19 and Respiratory Syncytial Virus vaccines based on PICO questions. Additionally, recommendations based on narrative questions related to the use of respiratory vaccines in populations with chronic respiratory diseases such as asthma, COPD, and pulmonary fibrosis were included.

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LGBTQ+ people tend to experience prejudice, stigma, and discrimination, which increases their risk of developing mental health difficulties. Support networks, including companion animals, can be used to cope with these challenges. We performed a systematic review of studies related to the effects of human-animal interactions on the LGBTQ+ population. The review included 18 empirical studies; the findings showed that participants tended to view companion animals as family members, as well as providers of love, acceptance, and social support. Thus, companion animals could alleviate stress and increase resilience. However, certain costs were also cited and, under some circumstances, poorer health was observed. The results are discussed considering three unique aspects of the "LGBTQ+ people-animal bond": (1) it promotes self-acceptance, (2) provides a sense of protection against sexuality-based stigma and social acts of aggression based on sex or gender, and (3) exposes animal guardians requesting animal care services to potential discrimination. By characterizing the LGBTQ+ people-animal bond, more effective responses to meet their needs and promote inclusion may be achieved.

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Cassava witches' broom disease (CWBD) is a devastating disease of cassava in Southeast Asia (SEA), of unknown etiology. Affected plants show reduced internodal length, proliferation of leaves and weakening of stems. This results in poor germination of infected stem cuttings (i.e., planting material) and significant reductions in fresh root yields and starch content, causing economic losses for farmers and processors. Using a metagenomic approach, we identified a fungus belonging to the Ceratobasidium genus, sharing more than 98.3-99.7% nucleotide identity at the Internal Transcribed Spacer (ITS), with Ceratobasidium theobromae a pathogen causing similar symptoms in cacao. Microscopy analysis confirmed the identity of the fungus and specific designed PCR tests readily showed (1) Ceratobasidium sp. of cassava is strongly associated with CWBD symptoms, (2) the fungus is present in diseased samples collected since the first recorded CWBD outbreaks in SEA and (3) the fungus is transmissible by grafting. No phytoplasma sequences were detected in diseased plants. Current disease management efforts include adjustment of quarantine protocols and guarantee the production and distribution of Ceratobasidium-free planting material. Implications of related Ceratobasidium fungi, infecting cassava, and cacao in SEA and in other potential risk areas are discussed.

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Introducción: El SARS-CoV-2 causa graves neumonías. Las gestantes experimentan cambios inmunológicos y fisiológicos, que pueden hacerlas más susceptibles a las infecciones respiratorias virales, incluida la COVID-19. Objetivo: Exponer las características de una serie de casos de muertes maternas, confirmadas con la COVID-19. Métodos: Se realizó un estudio de serie de autopsias parciales, a las puérperas confirmadas al SARS-CoV-2, revisadas por el grupo especial de trabajo de anatomía patológica para la COVID-19, en el año 2021. Se analizaron las variables edad, historia obstétrica y causas de muerte, en el Hospital Militar Central "Dr. Luis Díaz Soto". Resultados: En el 2021 fueron atendidas 425 gestantes confirmadas al SARS-CoV-2, de ellas 16 fallecieron (3,8 %). A todas se les realizó cesárea, por beneficio materno-fetal e ingresaron en la unidad de cuidados intensivos, con comorbilidades entre las cuales la obesidad y la diabetes fueron más frecuentes. La media de fecha de inicio de los síntomas fue 5,18 días, todas contacto de casos positivos; en las causas de muerte la hipoxia sistémica afectó a un tercio de las fallecidas; el edema pulmonar de permeabilidad se presentó en el 100 % de las puérperas y en todas las muertes maternas hubo daño múltiple de órganos. Conclusiones: El edema pulmonar de permeabilidad afecta a todos los casos, con impacto importante como causa de muerte, así como en la expresión de la hipoxia y la respuesta inflamatoria sistémica. La COVID-19 es la causa básica de muerte en todos los casos.

Introduction: SARS-CoV-2 causes severe pneumonias. Pregnant women experience immunological and physiological changes, which may make them more susceptible to viral respiratory infections, including COVID-19. Objective: To present the characteristics of a case series of maternal deaths confirmed with COVID-19. Methods: A serial study of partial autopsies of postpartum women confirmed with SARS-CoV-2, reviewed by the special working group of pathological anatomy for COVID-19, in the year 2021, was carried out. The variables age, obstetric history and causes of death were analyzed at the Central Military Hospital "Dr. Luis Díaz Soto". Results: In 2021, 425 pregnant women with confirmed SARS-CoV-2 were attended, 16 of them died (3.8%). All of them underwent cesarean section for maternal-fetal benefit and were admitted to the intensive care unit, with comorbidities among which obesity and diabetes were more frequent. The mean date of symptom onset was 5.18 days, all contact positive cases; in the causes of death systemic hypoxia affected one third of the deceased; permeability pulmonary edema was present in 100 % of the puerperal women and in all maternal deaths there was multiple organ damage. Conclusions: Permeability pulmonary edema affects all cases, with important impact as a cause of death, as well as in the expression of hypoxia and systemic inflammatory response. COVID-19 is the basic cause of death in all cases.

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Cassava witches' broom disease (CWBD) is one of the main diseases of cassava in Southeast Asia (SEA). Affected cassava plants show reduced internodal length and proliferation of leaves (phyllody) in the middle and top part of the plant, which results in reduced root yields of 50% or more. It is thought to be caused by phytoplasma; however, despite its widespread distribution in SEA still little is known about CWBD pathology. The overarching goal of this study was to review and corroborate published information on CWBD biology and epidemiology considering recent field observations. We report the following: (1) CWBD symptoms are conserved and persistent in SEA and are distinct from what has been reported as witches' broom in Argentina and Brazil. (2) In comparison with cassava mosaic disease, another major disease of cassava in SEA, symptoms of CWBD develop later. (3) Phytoplasma detected in CWBD-affected plants belong to different ribosomal groups and there is no association study available indicating phytoplasma as the causing agent of CWBD. These findings are essential clues for designing surveillance and management strategies and for future studies to better understand the biology, tissue localization and spatial spread of CWBD in SEA and other potential risk areas.

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Introducción : los reportes de caso son un tipo de publicación biomédica que nos permiten compartir experiencias tanto de la etiología, diagnostico, terapéutica y pronóstico de eventos anecdóticos que ocurren tanto en uno como en varios pacientes durante la práctica clínica. Objetivo : elaborar recomendaciones metodológicas para la elaboración de la discusión de un reporte de caso clínico. Métodos : se realizó una revisión narrativa de lineamientos internacionales y evidencia disponible. Resultados: se ubicaron un total de 411 227 artículos, seleccionándose finalmente a 10 artículos de revisión narrativa. Discusión : la discusión es la sección más relevante del reporte de caso pese a considerarse por algunas revistas como un aporte opcional. Recomendamos para la elaboración de la discusión, seguir los siguientes cuatro pasos: a) hallazgo y comparación con la evidencia actual, b) fundamentación de la causalidad de los hallazgos, c) limitaciones y fortalezas en el manejo del caso expuesto e d) implicaciones clínicas y perspectivas para el futuro. Conclusión: se recomienda seguir los cuatro pasos secuenciales para la elaboración de la discusión y evaluar su impacto en la producción científica en estudiantes de pregrado y postgrado.

Introduction: Case reports are a type of biomedical publication that allow us to share experiences regarding the etiology, diagnosis, therapeutics, and prognosis of anecdotal events that occur both in one and in several patients during clinical practice. Objetivo: To elaborate methodological recommendations for the elaboration of the discussion of a clinical case report. Methods: A narrative review of international guidelines and available evidence was carried out. Results: A total of 411,227 articles were located, finally selecting 10 narrative review articles. Discussion: The discussion is the most relevant section of the case report despite being considered by some journals as an optional contribution. We recommend for the elaboration of the discussion, to follow the following four steps: a) finding and comparison with the current evidence, b) justification of the causality of the findings, c) limitations and strengths in the management of the exposed case and d) clinical implications and prospects for the future. Conclusion: It is recommended to follow the four sequential steps for the elaboration of the discussion and to evaluate its impact on the scientific production in undergraduate and postgraduate students.

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Although the consumption of carbohydrates is needed for survival, their potent reinforcing properties drive obesity worldwide. In turn, sugar overconsumption reveals a major role for brain reward systems in regulating sugar intake. However, it remains elusive how different cell types within the reward circuitries control the initiation and termination of sugary meals. Here, we identified the distinct nucleus accumbens cell types that mediate the chemosensory versus postprandial properties of sweet sugars. Specifically, D1 neurons enhance sugar intake via specialized connections to taste ganglia, whereas D2 neurons mediate the termination of sugary meals via anatomical connections to circuits involved in appetite suppression. Consistently, D2, but not D1, neurons partially mediate the satiating effects of glucagon-like peptide 1 (GLP-1) agonists. Thus, these nucleus accumbens cell types function as a behavioral switch, enabling positive versus negative control over sugar intake. Our study contributes to unveiling the cellular and circuit substrates of sugar overconsumption.

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This paper presents the results of an observational and retrospective study on the therapeutic effects of Jusvinza, an immunomodulatory peptide with anti-inflammatory properties for critically ill COVID-19 patients. This peptide induces regulatory mechanisms on the immune response in experimental systems and in patients with Rheumatoid Arthritis. Exploratory research in COVID-19 patients revealed that Jusvinza promotes clinical and radiological improvement. The aim of this study is to describe the clinical outcome and variations of several inflammatory biomarkers in a cohort of critically ill COVID-19 patients, divided into two groups during the observational research: one group received Jusvinza and the other did not. Research physicians extracted the patients´ data from their hospital's clinical records. The study analyzed 345 medical records, and 249 records from critically ill patients were included. The data covered the demographic characteristics, vital signs, ventilatory parameters and inflammatory biomarkers. Survival outcome was significantly higher in the group receiving Jusvinza (90.4%) compared to the group without Jusvinza (39.5%). Furthermore, in patients treated with Jusvinza there was a significant improvement in ventilatory parameters and a reduction in inflammation and coagulation biomarkers. Our findings show that Jusvinza could control the extent of inflammation in COVID-19 patients. This study indicates that Jusvinza is a helpful drug for the treatment of diseases characterized by hyperinflammation.

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The Peruvian Amazon is a geographical area with great biodiversity, where the main economic activities are agricultural crops and grazing animals. The evaluation of sustainability in production systems is based on the analysis of economic, environmental and social components, which are variable between production units or livestock farms. The classification of livestock farms based on their characteristics of similarity and differences can contribute to the most appropriate assessment of their level of sustainability. The objective of this research was to determine the level of sustainability of livestock farms in the district of Moyobamba, San Martín, Peru, based on environmental, economic and social criteria. The research was carried out from November 2018 to February 2019 with a survey of a sample of 60 livestock farms out of a population of 2220. A survey-type form and data collection in the field were applied, adapting a methodology that proposes inferring on 33 indicators grouped into six criteria: three environmental criteria (soil quality, pasture health and animal quality), two economic criteria (farm system and farm economy), and a social criterion of the farm. A scale from 1 to 10 was used to assess the condition of each indicator. The typification of farms was carried out through a Conglomerate Analysis. To analyze the level of sustainability, Amoeba graphs were constructed for each defined farm group. Qualitative variables were analyzed with contingency tables and quantitative variables using the T test (p < 0.05). Three types of livestock farms were identified, differentiated by level of education, farm size, years in cattle raising and number of cattle heads (p < 0.05), where Group 1 is less experienced, Group 1 has more area and cattle, and Group 3 only have older years in livestock. There were significant differences between the evaluated criteria and the sustainability index. From the typification of livestock farms, Group 2 (13 farms) presented a higher level of sustainability as did Group 3 (16 farms), while Group 1 (31 farms) presented unsustainable conditions. The environmental indicators based on animal quality and farm system show unsustainability in all farms the District of Moyobamba, as they fail to exceed the threshold of sustainability (5).

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Acetylcholine (ACh), as a ligand of nicotinic acetylcholine receptors (nAChRs), plays a key role in the cholinergic anti-inflammatory pathway; however, its role in the immunoglobulin A (IgA) response remains unknown. Therefore, the present study aimed to investigate the role of ACh in the intestinal biomarkers involved in IgA synthesis and the polymeric immunoglobulin receptor (pIgR) involved in IgA transcytosis. Groups of mice were administered GTS-21 (an α7nAChR agonist) or mecamylamine (a non-selective nAChR antagonist) intraperitoneally for 7 days. Intestinal fluids were used for antibody concentration assessment by ELISA, cell suspensions from Peyer's patches and the lamina propria were obtained for flow cytometric analysis of plasma cells, and CD4+ T-cells expressing intracellular transforming growth factor (TGF)-ß and IgA-producing interleukin (IL)-4, -5, -6 and -10, and isolated epithelial cells to determine the levels of pIgR mRNA using reverse transcription-quantitative PCR. Regarding to the untreated control group, the concentration of IgA was reduced in the mecamylamine group and unaltered in the GTS-21 group while IgM levels exhibited no differences; the percentage of IgA+ plasma cells from Peyer's patches and the lamina propria, and the percentage of TGF-ß+/CD4+ T-cells from Peyer's patches were greater in the GTS-21-group. In both treatment groups, the percentages of IgM+ plasma cells and IL-6+/IL-10+ CD4+ T cells were greater in both compartments; pIgR mRNA expression levels decreased in epithelial cells. The percentage of IL-4 CD4+ T-cells were greater in Peyer's patches and lower in the lamina propria in the mecamylamine group, and the percentage of IL-5 CD4+ T-cells in the lamina propria were decreased in both treatment groups. These findings require further examination to address the impact of cholinergic modulation on IgA-transcytosis via pIgR. The present study may be an experimental reference for clinical trials that address the role of nicotinic system in intestinal dysfunctions as postoperative ileus.

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Cambiar, o no, la patela ha sido motivo de controversia durante muchos años. Las complicaciones asociadas al aparato extensor y el dolor anterior de rodilla representan un problema recurrente en la cirugía protésica de rodilla. En prótesis total de rodilla (PTR) nos encontramos con tres principales posibilidades: siempre cambiar la patela, nunca cambiarla, o hacer un recambio selectivo dependiendo de las características del paciente. En caso de no realizar recambio, se han descripto procedimientos asociados como la pateloplastia o la denervación de la patela. Y los autores que postulan recambio selectivo han evidenciado diversos factores que ayudarían a tomar la decisión, tales como el índice de masa corporal, grado de artrosis, edad, o anatomía patelar, entre otros. Existe una vasta cantidad de publicaciones científicas en torno al recambio patelar. En esta revisión de la literatura se discutirá qué dice la evidencia respecto de las opciones descriptas (recambio selectivo, siempre o nunca) y se concluirá con la opinión de los autores sobre lo más adecuado según la evidencia

Whether to change the patella, or not, has been a matter of controversy for many years. Complications associated with the extensor apparatus and anterior knee pain represent a recurring problem in knee replacement surgery.In total knee prosthesis (TKP) we find three main possibilities: always change the patella, never change it, or make a selective replacement depending on the patient characteristics. If replacement is not performed, associated procedures such as patelloplasty or patella denervation have been described. And the authors who postulate selective replacement have evidenced various factors that would help to make the decision, such as: body mass index, osteoarthritis degree, age, or patellar anatomy, among others.There is a vast number of scientific publications on patellar turnover. In this review of the literature, we will discuss what the evidence says regarding the options described (selective replacement, always or never) and it will conclude with the opinion of the authors on what is most appropriate according to the evidence

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Cassava Mosaic Disease (CMD) caused by Sri Lankan cassava mosaic virus (SLCMV), has rapidly spread in Southeast Asia (SEA) since 2016. Recently it has been documented in Lao PDR. Previous reports have identified whitefly species of B. tabaci as potential vectors of CMD in SEA, but their occurrence and distribution in cassava fields is not well known. We conducted a countrywide survey in Lao PDR for adult whiteflies in cassava fields, and determined the abundance and genetic diversity of the B. tabaci species complex using mitochondrial cytochrome oxidase I (mtCOI) sequencing. In order to expedite the process, PCR amplifications were performed directly on whitefly adults without DNA extraction, and mtCOI sequences obtained using nanopore portable-sequencing technology. Low whitefly abundances and two cryptic species of the B. tabaci complex, Asia II 1 and Asia II 6, were identified. This is the first work on abundance and genetic identification of whiteflies associated with cassava in Lao PDR. This study indicates currently only a secondary role for Asia II in spreading CMD or as a pest. Routine monitoring and transmission studies on Asia II 6 should be carried out to establish its potential role as a vector of SLCMV in this region.

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During acute SARS-CoV-2 infection, there is persistent deregulation of the immune system that can last up to 8 months after the acute condition is controlled. This, added to other factors, is possibly associated with an increased risk of the appearance and concurrence of autoimmune diseases. The simultaneous occurrence of GBS and ITP has been rarely reported in the literature, and GBS is rarely associated with another autoimmune disease. We present the case of a man who, one month after his recovery from acute moderate COVID-19, presented concurrent GBS and ITP with an adequate response to treatment.

Durante la infección aguda por el SARVS-CoV-2 se produce una desregulación del sistema inmune que puede durar hasta ocho meses después de controlado el cuadro agudo. Esto, sumado a otros factores, posiblemente este asociado con un aumento del riesgo de aparición y concurrencia de enfermedades autoinmunes. La aparición simultanea del síndrome de Guillain-Barré (SGB) y púrpura trombocitopénica (PTI) se ha reportado poco en la literatura, y el SGB raramente se asocia con otra enfermedad autoinmune. Presentamos el caso de un varón que luego de un mes de tener un cuadro agudo de COVID-19 moderado, presentó concurrentemente SGB y PTI con respuesta adecuada al tratamiento.

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RESUMEN Durante la infección aguda por el SARVS-CoV-2 se produce una desregulación del sistema inmune que puede durar hasta ocho meses después de controlado el cuadro agudo. Esto, sumado a otros factores, posiblemente este asociado con un aumento del riesgo de aparición y concurrencia de enfermedades autoinmunes. La aparición simultanea del síndrome de Guillain-Barré (SGB) y púrpura trombocitopénica (PTI) se ha reportado poco en la literatura, y el SGB raramente se asocia con otra enfermedad autoinmune. Presentamos el caso de un varón que luego de un mes de tener un cuadro agudo de COVID-19 moderado, presentó concurrentemente SGB y PTI con respuesta adecuada al tratamiento.

ABSTRACT During acute SARS-CoV-2 infection, there is persistent deregulation of the immune system that can last up to 8 months after the acute condition is controlled. This, added to other factors, is possibly associated with an increased risk of the appearance and concurrence of autoimmune diseases. The simultaneous occurrence of GBS and ITP has been rarely reported in the literature, and GBS is rarely associated with another autoimmune disease. We present the case of a man who, one month after his recovery from acute moderate COVID-19, presented concurrent GBS and ITP with an adequate response to treatment.

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El trasplante de médula ósea, conocido actualmente como trasplante de progenitores hematopoyéticos (TPH), implica la infusión de células progenitoras hematopoyéticas sanas a pacientes con médula ósea disfuncional, disminuida o comprometida por neoplasias hematológicas. Desde su primera exploración en seres humanos en la década de 1950 basados en los resultados obtenidos en modelos animales, en la actualidad, en Europa y países colaboradores se han realizado más de un millón de procedimientos, gracias además a una red internacional de registro de donantes de medula ósea y al avance de la tecnología en cuanto al tratamiento de soporte, la detección temprana de complicaciones y la tipificación de la histocompatibilidad (HLA) con las que se puede seleccionar mejor a los donante potenciales.

Bone marrow transplantation, currently known as hematopoietic stem cell transplant (HSCT), involves the infusion of stem cells healthy hematopoietic cells to patients with dysfunctional bone marrow, diminished or compromised by hematological neoplasms. Since its rst exploration in humans in the 1950s based on the results obtained in animal models, more than one million procedures have now been performed in Europe and collaborating countries. Early detection of complications and histocompatibility typing (HLA) with which potential donors can be better-selected thanks to an international donor registry network of bone marrow and the advancement of technology in terms of support treatment.

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Muscarinic-acetylcholine-receptors (mAChRs) modulate intestinal homeostasis, but their role in inflammation is unclear; thus, this issue was the focus of this study. BALB/c mice were treated for 7 days with muscarine (mAChR/agonist), atropine (mAChR/antagonist) or saline. Small-intestine samples were collected for histology and cytofluorometric assays in Peyer's patches (PP) and lamina propria (LP) cell-suspensions. In LP, goblet-cells/leukocytes/neutrophils/MPO+ cells and MPO/activity were increased in the muscarine group. In PP, IFN-γ+/CD4+ T or IL-6+/CD4+ T cell numbers were higher in the muscarine or atropine groups, respectively. In LP, TNF-α+/CD4+ T cell number was higher in the muscarine group and lower in the atropine.

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Introducción: El objetivo de este trabajo es comparar los resultados clínicos y complicaciones de la artroplastia total de rodilla bilateral (ATRB) con los de la artroplastia total de rodilla unilateral (ATRU).Materiales y métodos: estudio caso control. Se analizaron quince pacientes (treinta rodillas) con ATRB y ciento dos con ATRU, operados entre marzo del 2016 a agosto del 2018 por un mismo equipo quirúrgico, centro y modelo de prótesis. Se excluyeron artroplastias con componentes constreñidos. Se analizaron los datos demográficos, estadía hospitalaria (EH), caída del hematocrito, necesidad de transfusión sanguínea, días con drenaje, complicaciones postoperatorias, mortalidad, tiempo de isquemia y rango de movilidad (ROM). Se utilizó la encuesta KOOS Jr. para medir resultados funcionales y otra para valorar satisfacción. El análisis estadístico se realizó con t de Student, prueba exacta de Fisher y modelos mixtos (p <0.05).Resultados: ambos grupos fueron comparables en edad, IMC, tabaquismo, riesgo anestésico según la Sociedad Americana de Anestesiología (ASA), depresión y hematocrito. El grupo ATRB presentó una EH, días de drenaje, descenso del hematocrito postoperatorio y necesidad de transfusiones significativamente mayor. No hubo diferencias significativas en cuanto a tiempo de isquemia, complicaciones postoperatorias, mortalidad y en el ROM logrado a corto y mediano plazo. Se observó una tendencia a lograr antes el ROM objetivo (0-120°) en las ATRB. No hubo diferencias significativas en los resultados funcionales ni en satisfacción. Conclusión: en nuestro centro y en pacientes seleccionados, la ATRB es un procedimiento seguro sin una mayor tasa de complicaciones ni mortalidad asociada, con resultados clínicos similares a la ATRU. Nivel de Evidencia: III

Introduction: The aim of this study is to compares the clinical results and complications of bilateral total knee arthroplasty (BTKA) with unilateral total knee arthroplasty (UTKA).Materials and methods: case control study. Fifteen patients (thirty knees) with BTKA and hundred two patients with UTKA were analyzed, operated from March 2016 to August 2018 by the same surgical team, center and prosthetic model. Arthroplasties with constrained components were excluded. Demographic data, length of hospital stay (LOS), hematocrit drop, need for blood transfusion, days with drainage, post-operative complications, mortality, tourniquet time and range of motion (ROM) were analyzed. KOOS Jr. survey was answered, and satisfaction was reported. Statistical analysis was performed with t-Student, Fisher's test and mixed models (p <0.05).Results: the groups were comparable (age, BMI, smoking, anesthetic risk according to the classification system of the American Society of Anesthesiology (ASA), depression, hematocrit). The BTKA group presented LOS, drainage days, decrease in post operative hematocrit and need for transfusions significantly higher. There were no significant differences in terms of tourniquet time, post-operative complications, mortality and ROM achieved at short term. There is a tendency to achieve the target ROM (0-120 °) earlier on the BTKA group. There were no significant differences in functional results or satisfaction.Conclusion: In our center and in selected patients, the BTKA is a safe procedure without a higher rate of complications or associated mortality, with clinical results similar to the UTKA. Level of Evidence: III

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