After an allergological work-up, over 90% of the children evaluated were finally confirmed as tolerant to BLs. Most reactions were of the non-immediate type, and DPT was an essential tool for diagnosis.

In these children, CI hypersensitivity to NSAIDs was the most frequent type of hypersensitivity reaction. Ibuprofen was the drug most often involved, angio-oedema the most common entity, and frequently associated with atopy. DPT proved a safe approach for diagnosing these patients.

Purpose The optimal management of pyogenic discitis is not agreed on. We conducted a retrospective, cross-sectional, observational study in which all patients with discitis who attended Hospital San Carlos Madrid from January 1999 to January 2009 were included. Methods We identified 108 consecutive adult patients with infectious discitis. There were 49 men and 59 women with an average age of 67,5 (+/-16,89) years in the study group. Mean follow-up interval was 6,06 (12,5-2) years. 78 patients had spontaneous discitis and 30 patients had postoperative discitis. Inclusion criteria for the review were illness compatible with vertebral infection and / or evidence of spinal involvement on magnetic resonance imaging (MRI). Results In 56 percutaneous discal biopsy (52% patients) were positive in 28 cases. A single disc was infected in 100 patients. The segments involved were the cervical spine in four, the thoracic spine in 38 and the lumbar spine in 66. One or more comorbid diseases were present in 73 (68%) of 108 patients. Diabetes mellitus was the most common disease. Comorbid disease was rapidly fatal in four patients, ultimately fatal in seven patients, and nonfatal or not present in 97 patients (90 %). Conclusion Early diagnosis is a major challenge. Heightened awareness and the prompt use of MRI are necessary to avoid diagnostic delay. Prolonged antimicrobial therapy and the judicious application of timely surgical intervention are essential for an optimal outcome. Introduction and epidemiology

These data indicate that both etoricoxib and meloxicam are good alternatives for treatment in older children with hypersensitivity to NSAIDs.

Purpose We used the Optetrak Condylar Constrained (CCK) implant, a modular and constrained knee implant as replacement for a failed primary arthroplasty, to assess the survivorship, the complications, the clinical, radiological, and functional situation, and the quality of life of those patients in whom a CCK had been implanted in recent years in order to find predictive pre-operative conditions of survival and clinical outcomes. Methods We performed a retrospective study of 125 CCK implanted between 1999 and 2005. The mean follow-up was nine years (range, seven to 13). Mean age was 73.6 years. A total of 78 % of the revised TKA were cemented and 66 % were CR. We assessed the pre-operative, the operative and the postoperative conditions studying the medical files of all the patients. In order to study the functional and clinical situation we used the Hospital for Special Surgery (HSS) score and the Knee Society score (KSS), both clinical and functional. We analysed all the X-rays using the Knee Society Roentgenographic evaluation. The quality of life was studied using the Oxford knee score (OKS). Results The mean results of the KSS clinical and the KSS functional were 68.24 and 63.85, respectively. There were not any conditions associated with poor results of the knees (p>0.05). The global survival at 24 months was 92.7 %, at 60 months 87.8 % and at 96 months it was 87.8 %. There were some conditions associated with poor survival of the knees, e.g. patients were younger than 70 years old, rheumatic diseases, kidney faliure, tibial tuberosity osteotomy, PS primary arthroplasty, revision before five years and septic loosening.Conclusions Based on these results there are some preoperative factors that change the survival of the total knee replacement revision.