RESUMO
AIMS: To estimate if chronic anticoagulant (CAC) treatment is associated with morbidity and mortality outcomes of patients hospitalized for SARS-CoV-2 infection. METHODS: In this European multicentric cohort study, we included 1186 patients of whom 144 were on CAC (12.1%) with positive coronavirus disease 2019 testing between 1 February and 30 July 2020. The average treatment effect (ATE) analysis with a propensity score-matching (PSM) algorithm was used to estimate the impact of CAC on the primary outcomes defined as in-hospital death, major and minor bleeding events, cardiovascular complications (CCI), and acute kidney injury (AKI). We also investigated if different dosages of in-hospital heparin were associated with in-hospital survival. RESULTS: In unadjusted populations, primary outcomes were significantly higher among CAC patients compared with non-CAC patients: all-cause death (35% vs. 18% Pâ<â0.001), major and minor bleeding (14% vs. 8% Pâ=â0.026; 25% vs. 17% Pâ=â0.014), CCI (27% vs. 14% Pâ<â0.001), and AKI (42% vs. 19% Pâ<â0.001). In ATE analysis with PSM, there was no significant association between CAC and primary outcomes except for an increased incidence of AKI (ATE +10.2%, 95% confidence interval 0.3-20.1%, Pâ=â0.044). Conversely, in-hospital heparin, regardless of dose, was associated with a significantly higher survival compared with no anticoagulation. CONCLUSIONS: The use of CAC was not associated with the primary outcomes except for the increase in AKI. However, in the adjusted survival analysis, any dose of in-hospital anticoagulation was associated with significantly higher survival compared with no anticoagulation.
Assuntos
Injúria Renal Aguda , COVID-19 , Injúria Renal Aguda/induzido quimicamente , Injúria Renal Aguda/epidemiologia , Anticoagulantes/efeitos adversos , COVID-19/complicações , Teste para COVID-19 , Estudos de Coortes , Mortalidade Hospitalar , Hospitais , Humanos , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2RESUMO
Lymphangioleiomyomatosis is a rare disorder of unknown origin that usually presents pulmonary symptoms. Retroperitoneal lymphangioleiomyomatosis without lung involvement has rarely been reported. We present a 38-year-old woman, the fourth case reported of retroperitoneal lymphangioleiomyomatosis with endosalpingiosis in the literature.
RESUMO
Malignant pheochromocytoma is a rare disease and surgical resection is the only curative treatment. There are no definitive histological or cytological criteria of malignancy, as it is impossible to determine this condition in the absence of advanced locoregional disease or metastases. We report a case of a patient with a giant retroperitoneal tumour, the second largest to be published, which was diagnosed as a malignant pheochromocytoma; it was treated with surgery. The literature is reviewed to evaluate tumour features and criteria to distinguish between benign and malignant pheochromocytomas.