Hospital de La Ribera

Ocular syphilis in the Iberian Peninsula shows a wide clinical spectrum and frequent posterior segment involvement. Most patients achieved favourable serological and visual outcomes. These findings support the effectiveness of standard therapies and highlight the need for early diagnosis, especially in high-risk populations.

Atopic dermatitis (AD) involving special areas such as the hands, head and neck, and genital region poses important therapeutic challenges owing to distinct barrier fragility, environmental exposure, and mixed Th1/Th2/Th17 activation. These sites often drive treatment escalation despite limited overall body surface involvement. Evidence on the real-world effectiveness of upadacitinib in these anatomical locations remains limited. A retrospective, observational multicenter study was conducted across five Spanish dermatology departments (November 2024 to November 2025). Adults and adolescents with moderate-to-severe AD and involvement of at least one special area treated with upadacitinib (15 or 30 mg) for ≥ 16 weeks were included. Disease severity was assessed using the Eczema Area and Severity Index (EASI), body surface area (BSA), pruritus numeric rating scale (NRS), Dermatology Life Quality Index (DLQI), Investigator's Global Assessment (IGA), and local 0-4 Physician Global Assessment (PGA). Minimal disease activity (MDA) was defined as EASI ≤ 3 plus pruritus-NRS 0-1. Descriptive statistics were applied. Distribution-shift plots were used to analyze categorical changes in special areas. Overall, 57 patients were included (mean age 47.9 ± 17.6 years, 59.6% women). Facial/neck, hand, and genital involvement were present in 73.7%, 61.4%, and 21.1% of patients, respectively; 31.9% had ≥ 2 special areas affected. Upadacitinib induced rapid improvement, with EASI decreasing from 18.9 to 2.7 at week 16 and 2.4 at week 52. MDA was reached by 61% at week 16 and 69% at week 52. Special-area PGA improved markedly across all sites. Upadacitinib provided rapid, sustained, and clinically meaningful improvement in AD involving special areas, supporting its use in anatomically sensitive areas.

Angiomatous meningioma (AM) is a rare histological variant of meningioma characterized by prominent vascular proliferation, often posing intraoperative hemostatic challenges. We report the case of a 42-year-old man presenting with recurrent generalized tonic-clonic seizures and postictal right hemiparesis. CT imaging revealed a large, enhancing left parietal mass with marked perilesional edema and mass effect. In this rural setting, MRI and cerebral angiography were unavailable, requiring surgical planning to rely solely on CT findings. The patient underwent a wide left parietal craniotomy, where a highly vascular lesion was encountered. Early devascularization of dural feeders, stepwise debulking, and meticulous microsurgical dissection achieved gross total resection (Simpson grade II) with effective hemostasis. Histopathology confirmed AM. Postoperatively, the patient showed progressive neurological improvement, remained seizure-free, and was discharged on oral levetiracetam; follow-up imaging confirmed complete resection. This case underscores the need to consider AM in patients with seizure-related hemiparesis and demonstrates that, even without advanced vascular imaging, careful CT-based planning and precise microsurgical technique can yield excellent outcomes in resource-limited environments.

Background: The arcuate foramen (AF) is a bony bridge formed by the ossification of the atlantooccipital ligament that covers the groove of the vertebral artery (VA). It contains the VA, the suboccipital nerve and the vertebral venous plexus. Objectives: We aimed to assess and compare the frequency of the complete AF in a Chalcolithic and a contemporary Iberian Peninsula sample. Methods: We analyzed in situ the presence or absence of the AF in 34 adult Iberian Peninsula Chalcolithic skeletons and in 120 Iberian Peninsula adult present-day subjects that underwent a computed tomography study. Results: The AF prevalence was 11.6% for the current subjects and 11.8% for Chalcolithic remains (p = 0.927). No significant difference was observed in AF presence between males and females in both the present-day (p = 0.757) and Chalcolithic samples (p = 0.580). Conclusions: There were no AF prevalence differences between the Iberian Peninsula Chalcolithic and the present-day Iberian Peninsula samples analyzed. This information will serve to provide pertinent knowledge regarding the presence of the AF in Iberian Peninsula Chalcolithic samples in comparison to Iberian Peninsula present-day subjects.