Risk factors associated with acute kidney injury in a cohort of hospitalized patients with COVID-19.

BACKGROUND: Patients with COVID-19 have a high incidence of acute kidney injury (AKI), which is associated with mortality. The objective of the study was to determine the factors associated with AKI in patients with COVID-19. METHODOLOGY: A retrospective cohort was established in two university hospitals in Bogotá, Colombia. Adults hospitalized for more than 48 h from March 6, 2020, to March 31, 2021, with confirmed COVID-19 were included. The main outcome was to determine the factors associated with AKI in patients with COVID-19 and the secondary outcome was estimate the incidence of AKI during the 28 days following hospital admission. RESULTS: A total of 1584 patients were included: 60.4% were men, 738 (46.5%) developed AKI, 23.6% were classified as KDIGO 3, and 11.1% had renal replacement therapy. The risk factors for developing AKI during hospitalization were male sex (OR 2.28, 95% CI 1.73-2.99), age (OR 1.02, 95% CI 1.01-1.03), history of chronic kidney disease (CKD) (OR 3.61, 95% CI 2.03-6.42), High Blood Pressure (HBP) (OR 6.51, 95% CI 2.10-20.2), higher qSOFA score to the admission (OR 1.4, 95% CI 1.14-1.71), the use of vancomycin (OR 1.57, 95% CI 1.05-2.37), piperacillin/tazobactam (OR 1.67, 95% CI 1.2-2.31), and vasopressor support (CI 2.39, 95% CI 1.53-3.74). The gross hospital mortality for AKI was 45.5% versus 11.7% without AKI. CONCLUSIONS: This cohort showed that male sex, age, history of HBP and CKD, presentation with elevated qSOFA, in-hospital use of nephrotoxic drugs and the requirement for vasopressor support were the main risk factors for developing AKI in patients hospitalized for COVID-19.

Abdominoplasty in Hemodialysis Patients Before Transplant.

Morbid obesity in patients with chronic kidney disease is a contraindication for inclusion on the kidney transplant waitlist.Despite intentional weightloss,the persistence of the abdominal adipose panniculus poses postoperative risks, such as infection of the surgical site and seromas. We describe 2 cases of patients on hemodialysis who had a body mass index greater than 35 kg/m² who underwent abdominoplasty before transplant without perioperative complications. One patient received a living-related kidney transplant (donor was the brother) without complications.

Anti-Leptospira spp. antibodies in meat dealers in Tunja, Boyacá, Colombia / Anticorpos anti-Leptospira spp. em distribuidores de carne na cidade de Tunja, Boyacá, Colômbia

ABSTRACT Leptospirosis is a zoonotic disease distributed worldwide, which is emerging as a public health problem in tropical and subtropical countries. Traditionally, it has been considered as an occupational disease. The objective of this study was to determine the serological prevalence of anti-Leptospira antibodies in meat dealers in the city of Tunja, Boyacá, Colombia. An observational, cross-sectional and descriptive study was carried out in a population of 186 operators from meat establishments in the city of Tunja. The samples were analyzed using the microagglutination test in order to determine the serovar that causes the infection. Each participant answer a survey with important questions about socio-demographic, epidemiological and occupational factors. A seroprevalence of 43% [n = 80; 95% confidence interval (CI): 36%-50%] was found. According to the serovar analysis, the distribution was: L. bratislava 30% (n = 24; 95%IC: 20%-40%), L. hardjo 21.25% (n = 17; 95%IC: 12%-30%), L. pomona 20% (n = 16; 95%IC: 11%-29%), L. icterohaemorragiae 17.5% (n = 14; 95%IC: 9%-26%), L. grippotyphosa 16.25% (n = 13; 95%IC: 8%-24%), L. canicola 16.25% (n = 13; 95%IC: 8%-24%), and L. tarassovi 11.25% (n = 9; 95%IC: 4%-18%). The prevalence rate found in this study confirms the circulation of the microorganism in these operators, which may suggest the need to reinforce hygienic-sanitary, biosecurity and prevention measures as well as the control of the disease in this population.

RESUMEN La leptospirosis es una zoonosis de distribución mundial como un problema de salud pública, en países tropicales y subtropicales. Tradicionalmente ha sido considerada como una enfermedad profesional. El objetivo de este estudio fue determinar la prevalencia serológica de anticuerpos anti-Leptospira en expendedores de carne en la ciudad de Tunja, Boyacá, Colombia. Se realizó un estudio observacional, transversal y descriptivo en una población de 186 trabajadores de expendios de carne en la ciudad de Tunja. Las muestras fueron analizadas mediante la técnica de microaglutinación para determinar el serovar que causa la infección. A cada participante se aplicó una encuesta con preguntas importantes respecto a factores sociodemográficos, epidemiológicos y laborales. Se encontró seroprevalencia del 43% [n = 80; intervalo de confianza (IC) 95%: 36%-50%]. Según el análisis por serovar, la distribución fue: L. bratislava 30% (n = 24; IC95%: 20%-40%), L. hardjo 21,25% (n = 17; IC95%: 12%-30%), L. pomona 20% (n = 16; IC95%: 11%-29%), L. icterohaemorragiae 17,50% (n = 14; IC95%: 9%-26%), L. grippotyphosa 16,25% (n = 13; IC95%: 8%-24%), L. canicola 16,25% (n = 13; IC95%: 8%-24%) y L. tarassovi 11,25% (n = 9; IC95%: 4%-18%). La prevalencia hallada en este estudio confirma la circulación del microorganismo en aquellos trabajadores, lo cual exige reforzar las medidas higiénicas, de bioseguridad y de prevención y control de la enfermedad en esa población.

RESUMO A leptospirose é uma zoonose de distribuição mundial que está emergindo como um problema de saúde pública em países tropicais e subtropicais. Tradicionalmente, tem sido considerada uma doença ocupacional. O objetivo deste estudo foi determinar a prevalência sorológica de anticorpos anti-Leptospira em distribuidores de carne na cidade de Tunja, Boyacá, Colômbia. Realizou-se um estudo observacional, transversal e descritivo em uma população de 186 trabalhadores de estabelecimentos de carne na cidade de Tunja. As amostras foram analisadas pela técnica de microaglutinação para determinar o sorovar que causa a infecção. Cada participante respondeu a um questionário com questões importantes sobre fatores sociodemográficos, epidemiológicos e trabalhistas. Foi encontrada soroprevalência de 43% [n = 80; intervalo de confiança (IC)95%: 36%-50%]. De acordo com a análise por sorovar, a distribuição foi: L. bratislava 30% (n = 24; IC95%: 20%-40%), L. hardjo 21,25% (n = 17; IC95%: 12%-30%), L. pomona 20% (n = 16; IC95%: 11%-29%), L. icterohaemorragiae 17,50% (n = 14; IC95%: 9%-26%), L. grippotyphosa 16,25% (n = 13; IC95%: 8%-24%), L. canicola 16,25% (n = 13; IC95%: 8%-24%) e L. tarassovi 11,25% (n = 9; IC95%: 4%-18%). A prevalência encontrada neste estudo confirma a circulação do microrganismo nesses trabalhadores, o que sugere a necessidade de reforçar medidas higiênicas, de biossegurança e de prevenção e controle da doença nessa população.

Utilidad de la tomografia por emisión de positrones - tomografia computada para el diagnóstico de neurosarcoidosis. A propósito de un caso / Positron emission tomography/CT scanning in the diagnosis of neurosarcoidosis

Resumen El diagnóstico de la neurosarcoidosis es difícil por su polimorfismo clínico y radiológico, y cualquier parte del sistema nervioso central puede estar afectado. Presentamos el caso de una paciente joven con cefalea, meningitis linfocitaria subaguda, en quien a pesar de estudios bioquímicos e imagenológicos no se identificó la etiología. La tomografia por emisión de positrones con 18 fluorodeoxiglucosa permitió la identificación de un ganglio mediastinal hipermetabólico, con informe de patología de granulomas no caseificantes, hallazgos sugestivos de sarcoidosis, reflejando la utilidad de la tomografía por emisión de positrones con 18 fluorodeoxiglucosa para el diagnóstico y estadificación de la enfermedad, especialmente en las situaciones en las que no hay evidencia mediante otros estudios imagenológicos de enfermedad extraneural.

Abstract The diagnosis of neurosarcoidosis is difficult because of its clinical and radiological polymorphism. Any part of the central nervous system may be affected, and imaging studies are usually inconclusive. The case is presented of a young patient with headache, bilateral facial paralysis, and subacute lymphocytic meningitis in whom, despite biochemical and imaging studies the origin was not identified. Using 18-PET-FDG helped to identify a hypermetabolic mediastinal adenopathy, with pathology reporting non-caseating granulomas, findings suggestive of sarcoidosis. This reflects its usefulness for the diagnosis and staging of the disease, especially in situations where there is no evidence from other imaging studies of extra-neural disease.