RESUMEN
A 49-year-old male was involved in an accident and an abdominal computer tomographic examination revealed papillary renal cell carcinoma of the right kidney. During hospitalization, the patient was infected with COVID-19. In the following COVID-19 treatment, a black dot developed on the right side of the head and face. Antifungal therapy and surgical debridement were initiated and gradual improvement was observed.
RESUMEN
OBJECTIVE: To evaluate the predictive value of some biochemical markers in the outcome of extremity vascular trauma. METHODS: This study comprised 30 patients with traumatic arterial injury and acute limb ischemia referred to Namazi hospital affiliated with Shiraz University of Medical Ssciences, over a period of 8 months, from Sep 2009 to Jul 2010. Venous blood samples were drawn from distal ischemic limb to determine pH, HCO3, PCO2, PO2, Na and K before definitive surgical intervention. Comparable samples were also obtained from veins of non-ischemic upper extremities. The biochemical assays were compared after monitoring the revasculurized limbs and evaluation of viability during a period of 7 days. RESULTS: The mean age of the patients was 28.3 ± 7.8 (range: 18-56) years. Two (6.6%) patients underwent amputation because of developing irreversible limb ischemia after vascular reconstruction. Both patients had blunt traumatic knee injury accompanied by nerve, vein and soft tissue damage. The statistical analysis showed correlations between parameters, except for Na of local (ischemic limb) and systemic samples. In this context, the highest correlation was observed in regard to HCO3. CONCLUSION: The correlation was most pronounced with respect to HCO3. Ischemic limbs exhibited reduction in pH and PO but, PCO2 and K increased after ischemia of injured limbs. PO2 reflects tissue perfusion and is of value in predicting the outcome. We believe that blunt trauma and associated nerve, vein and soft tissue injuries pose negative prognostic effects on limb survival postoperatively.