El Hibernoma o lipoma de grasa parda, es un tumor benigno extremadamente infrecuente. Presentamos el caso, de un paciente femenino de 12 años de edad con una tumoración gigante en región dorsal, de origen congénito, con una extensión desde la región cervical baja hasta el sacro, presentaba con ausencia de los músculos de la región glútea, se realizó estudios de imagen, así como química sanguínea, donde se evidencio anemia severa y desnutrición proteico energética, se organizó un equipo multidisciplinario centrado al tratamiento definitivo de la lesión, la cual provocaba además seria deformidad de la columna lumbar (cifoescoliosis), se logró la resección completa de la lesión, con un peso total de 12 Kg, con reconstrucción de los bordes anales sin afectar el esfínter anal, se mantuvo bajo seguimiento durante 1 años sin presentar ninguna recidiva de la lesión.

Purpose: To identify clinical phenotypes and biomarkers for best mortality prediction considering age, symptoms and comorbidities in COVID-19 patients with chronic neurological diseases in intensive care units (ICUs). Subjects and Methods: Data included 1252 COVID-19 patients admitted to ICUs in Cuba between January and August 2021. A k-means algorithm based on unsupervised learning was used to identify clinical patterns related to symptoms, comorbidities and age. The Stable Sparse Classifiers procedure (SSC) was employed for predicting mortality. The classification performance was assessed using the area under the receiver operating curve (AUC). Results: Six phenotypes using a modified v-fold cross validation for the k-means algorithm were identified: phenotype class 1, mean age 72.3 years (ys)—hypertension and coronary artery disease, alongside typical COVID-19 symptoms; class 2, mean age 63 ys—asthma, cough and fever; class 3, mean age 74.5 ys—hypertension, diabetes and cough; class 4, mean age 67.8 ys—hypertension and no symptoms; class 5, mean age 53 ys—cough and no comorbidities; class 6, mean age 60 ys—without symptoms or comorbidities. The chronic neurological disease (CND) percentage was distributed in the six phenotypes, predominantly in phenotypes of classes 3 (24.72%) and 4 (35,39%); χ² (5) 11.0129 p = 0.051134. The cerebrovascular disease was concentrated in classes 3 and 4; χ² (5) = 36.63, p = 0.000001. The mortality rate totaled 325 (25.79%), of which 56 (17.23%) had chronic neurological diseases. The highest in-hospital mortality rates were found in phenotypes 1 (37.22%) and 3 (33.98%). The SSC revealed that a neurological symptom (ageusia), together with two neurological diseases (cerebrovascular disease and Parkinson’s disease), and in addition to ICU days, age and specific symptoms (fever, cough, dyspnea and chilliness) as well as particular comorbidities (hypertension, diabetes and asthma) indicated the best prediction performance (AUC = 0.67). Conclusions: The identification of clinical phenotypes and mortality biomarkers using practical variables and robust statistical methodologies make several noteworthy contributions to basic and experimental investigations for distinguishing the COVID-19 clinical spectrum and predicting mortality.

Objective: To evaluate the results of endoscopic approach versus the conventional approach in the surgical treatment of pontocerebellar angle tumors. Methods: An observational, comparative, ambispective and cross-sectional study was carried out in 105 patients with tumors of the pontocerebellar angle, approached at the Neurology and Neurosurgery Institute (NNI) in the period between January 2015 and December 2019. They used clinical, surgical, pathological, auditory and imaging variables.Results: 28.6% of the cases and 30% of the controls were between 50 and 59 years old. 60% of the cases and 57.1% of the controls were women. The tumor was on the right side in 68.6% of the cases and 67.1% of the controls.Hearing loss was found in 80% and 84.3% of cases and controls, respectively. Schwannoma was found in 82.9% of cases and 85.7% of controls. Postoperative facial function was classified as grade I in 60% and 48.6% of cases and controls, respectively, while auditory was classified as class I in 74.3% and 61.4% for both groups, respectively. The frequency of complications was 40% in cases and 51.4% in controls. Conclusions:The age group of 50-59 years prevails in the study, female sex, hearing loss and headache as a clinical picture and schwannoma as a histological variant. The retrosigmoid endoscopic keyhole achieves a greater degree of tumoral resection, postoperative facial and auditory function compared to the conventional approach. Facial paralysis is identified as the most frequent complication.