COVID-19 in CKD Patients: Lessons from 553 CKD Patients with Biopsy-Proven Kidney Disease.

INTRODUCTION: Chronic kidney disease (CKD) patients infected with COVID-19 are at risk of serious complications such as hospitalization and death. The prognosis and lethality of COVID-19 infection in patients with established kidney disease has not been widely studied. METHODS: Data included patients who underwent kidney biopsy at the Vall d'Hebron Hospital between January 2013 and February 2020 with COVID-19 diagnosis during the period from March 1 to May 15, 2020. RESULTS: Thirty-nine (7%) patients were diagnosed with COVID-19 infection. Mean age was 63 ± 15 years and 48.7% were male. Hypertension was present in 79.5%, CKD without renal replacement therapy in 76.9%, and cardiovascular disease in 64.1%. Nasopharyngeal swab was performed in 26 patients; older (p = 0.01), hypertensive (p = 0.005), and immunosuppressed (p = 0.01) patients, those using RAS-blocking drugs (p = 0.04), and those with gastrointestinal symptoms (p = 0.02) were more likely to be tested for CO-VID-19. Twenty-two patients required hospitalization and 15.4% died. In bivariate analysis, mortality was associated with older age (p = 0.03), cardiovascular disease (p = 0.05), chronic obstructive pulmonary disease (p = 0.05), and low hemoglobin levels (p = 0.006). Adjusted Cox regression showed that low hemoglobin levels at admission had 1.81 greater risk of mortality. CONCLUSIONS: Patients with CO-VID-19 infection and kidney disease confirmed by kidney biopsy presented a mortality of 15.4%. Swab test for COVID-19 was more likely to be performed in older, hypertensive, and immunosuppressed patients, those using RAS-blocking drugs, and those with gastrointestinal symptoms. Low hemoglobin is a risk factor for mortality.

Carcinoma en tejido mamario ectópico axilar con diferenciación neuroendocrina: reporte de un caso / Carcinoma in ectopic axillary breast tissue with neuroendocrine differentiation: case report

Presentar un caso de carcinoma en tejido mamario ectópico axilar. Paciente femenina de 38 años de edad, quien consultó por aumento de volumen y nódulo en región axilar de un año de evolución y punción aspiración por aguja fina previa no diagnóstica. En la evaluación se observó mamas axilares bilaterales, palpando en la derecha tumor duro de superficie irregular, se realizó mamografía, C y biopsia por aguja gruesa. Por el diagnóstico de la biopsia por aguja gruesa, se practicaron estudios de extensión y se trató con neoadyuvancia y cirugía. El estudio histopatológico de la pieza quirúrgica concluyó carcinoma ductal infiltrante con patrón neuroendocrino y metástasis en 2 de 18 ganglios, recibió adyuvancia y se mantiene libre de enfermedad

A case of female patient 38 years of age, who consulted for increased volume and axillary node in a year of evolution and prior non-diagnostic FNA. The evaluation noted bilateral axillary breasts, feeling hard lump on the right an irregular surface, we performed mammography, PAAF and core needle biopsy. For the diagnosis of the biopsy needle, extension studies were performed and treated with neoadjuvant therapy and surgery. Histopathological examination of the surgical specimen concluded infiltrating ductal carcinoma neuroendocrine pattern and metastatic in 2 of 18 nodes, received adjuvant therapy and remains free of disease