ABSTRACT
Introduction: There are no data on the association of type of pneumonia and long-term mortality by the type of pneumonia (COVID-19 or community-acquired pneumonia [CAP]) on long-term mortality after an adjustment for potential confounding variables. We aimed to assess the type of pneumonia and risk factors for long-term mortality in patients who were hospitalized in conventional ward and later discharged. Methods: Retrospective analysis of two prospective and multicentre cohorts of hospitalized patients with COVID-19 and CAP. The main outcome under study was 1-year mortality in hospitalized patients in conventional ward and later discharged. We adjusted a Bayesian logistic regression model to assess associations between the type of pneumonia and 1-year mortality controlling for confounders. Results: The study included a total of 1,693 and 2,374 discharged patients in the COVID-19 and CAP cohorts, respectively. Of these, 1,525 (90.1%) and 2,249 (95%) patients underwent analysis. Until 1-year follow-up, 69 (4.5%) and 148 (6.6%) patients from the COVID-19 and CAP cohorts, respectively, died (p = 0.008). However, the Bayesian model showed a low probability of effect (PE) of finding relevant differences in long-term mortality between CAP and COVID-19 (odds ratio 1.127, 95% credibility interval 0.862-1.591; PE = 0.774). Conclusion: COVID-19 and CAP have similar long-term mortality after adjusting for potential confounders.
ABSTRACT
El síndrome antifosfolipídico se caracteriza por abortos o fenómenos trombóticos asociado a anticuerpos específicos. El tratamiento se basa en la anticoagulación con los antagonistas de la vitamina K. Presentamos 2 casos en los que el empleo del rivaroxabán ha logrado controlar la enfermedad tras su fracaso con acenocumarol
Antiphospholipid syndrome is characterized by abortions or thrombotic phenomena associated with specific antibodies. Anticoagulant therapy is based on vitamin K antagonists. We present two cases in which the use of rivaroxaban achieved control of the disease after the failure of acenocoumarol
Subject(s)
Humans , Male , Adult , Acenocoumarol/therapeutic use , Anticoagulants/therapeutic use , Antiphospholipid Syndrome/drug therapy , Factor Xa Inhibitors/therapeutic use , Rivaroxaban/therapeutic use , Carotid Artery Thrombosis/diagnostic imaging , International Normalized Ratio , Treatment Outcome , Venous Thromboembolism/drug therapyABSTRACT
Antiphospholipid syndrome is characterized by abortions or thrombotic phenomena associated with specific antibodies. Anticoagulant therapy is based on vitamin K antagonists. We present two cases in which the use of rivaroxaban achieved control of the disease after the failure of acenocoumarol.
Subject(s)
Acenocoumarol/therapeutic use , Anticoagulants/therapeutic use , Antiphospholipid Syndrome/drug therapy , Factor Xa Inhibitors/therapeutic use , Rivaroxaban/therapeutic use , Adult , Carotid Artery Thrombosis/diagnostic imaging , Humans , International Normalized Ratio , Male , Treatment Outcome , Venous Thromboembolism/drug therapyABSTRACT
Objetivos: Análisis clínico-epidemiológico asistencial, de pacientes afectos de Trombosis venosa, controlados en consulta monográfica. Diseño: Observacional, Serie de casos consecutivos, longitudinal, sin intervención farmacológica. Resultados: Se recogieron 313 casos de Enfermedad Tromboembólica Venosa (ETEV), procedentes de los municipios de la provincia, compuestos por 134 varones (42,8%) con edad media 59,92 años y 179 mujeres (57,2%),edad media 57,65 años. De los diagnósticos fueron: TVP 153 (48,9%), EP 51 (16,3%) y TVS 51(16,3%) siendo asociados TVP+EP 48 (15,6%).Los principales factores de riesgo fueron la movilidad reducida, varices, cirugía previa y cáncer. La incidencia anual por principales poblaciones fue: Carrión de Calatrava con 3,66 x1.000 habitantes, Ciudad Real y Daimiel con 0,7x1000, Villarubia de los Ojos 0,67 x 1.000, Almagro con 0,55 y Miguelturra 0,445 x1.000 hab. Conclusiones: a) La incidencia de pacientes controlados, se situaría en 30 x 100.000 habitantes/año, centrada en localidades de mayor población a excepción Carrión de Calatrava, lo que supondría una incidencia media-baja, presentándose clínicamente de forma similar a otras series, y siendo mayor en mujeres. b) Los factores de riesgo principales fueron inmovilidad, varices, cirugía previa ortopédica, general y cáncer cuya asociación con trombosis ha de ser considerada, así como la presencia de trombofilia congénita y anticuerpos relacionados con síndrome antifosfolípido. c) Los medios actuales técnicos de los que disponemos en nuestra Gerencia Única actual, creemos se adecua al estándar asistencial óptimo, no realizándose un exceso de las mismas, si bien la carga asistencial implica coordinar
Goals: Clinical and epidemiological analysis of patients with venous thrombosis, controlled in a monographic consultation. Design: Observational, consecutive case series, longitudinal, without pharmacological intervention. Results: 313 cases of VTE were collected from 48 municipalities in the region, consisting on 134 males (42.8%) with mean age 59.92 years and 179 women (57.2%), mean age 57.65 years. The diagnoses were: TVP 153 (48.9%), EP 51 (16.3%) and IC 51 (16.3%) being associated DVT + EP 48 (15.6%). The main risk factors were reduced mobility, varicose veins, previous surgery and cancer. The annual incidence in the main populations was: 3.66x1.000 hab. in Carrión de Calatrava, Ciudad Real and Daimiel with 0.7 x1.000, Villarrubia de los Ojos x1.000, 0.67, and 0.55x1.000 in Calatrava and Almagro x1.000 hab=0.445. Conclusions: a) The incidence of controlled patients, would be at 30x100.000 inhabitants / year, focusing on population locations, presenting clinically similar to other series, and was higher in women. b) The main risk factors were immobility, varicose veins, previous orthopedic surgery, general and cancer whose association with thrombosis must be considered along with congenital thrombophilia. c) Current technicians that we have in our current single management means we think fits the best standard of care, not performing too much the same, although the burden of care involves properly coordinate follow-up in consultation with complementary tests required
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Venous Thromboembolism/epidemiology , Venous Thrombosis/etiology , Pulmonary Embolism/etiology , Thrombophilia/complications , Spain/epidemiology , Prevalence , Risk Factors , Age and Sex Distribution , Diagnostic ImagingABSTRACT
Primary pulmonary artery sarcoma is a rare tumor that is highly fatal. It can be misdiagnosed as acute or chronic pulmonary thromboembolic disease. Herein, we report the case of a 22-year-old woman with a preoperative diagnosis of pulmonary embolism and superior vena caval thrombosis. Intraoperatively, an extensive sarcoma was seen to extend retrograde from the pulmonary artery, past the right ventricle and right atrium, and into the superior vena cava. Surgical resection of the tumor and reconstruction of the central pulmonary arteries, followed by adjuvant chemotherapy, relieved the clinical symptoms. The patient remained free of cancer at 14 months postoperatively. We believe that this is the 1st report of a primary pulmonary artery sarcoma that extended retrograde into the superior vena cava.
Subject(s)
Pulmonary Artery/pathology , Sarcoma/diagnosis , Superior Vena Cava Syndrome/diagnosis , Vascular Neoplasms/diagnosis , Vena Cava, Superior/pathology , Cardiac Surgical Procedures , Chemotherapy, Adjuvant , Diagnostic Errors , Echocardiography, Doppler , Echocardiography, Transesophageal , Female , Humans , Neoplasm Invasiveness , Pulmonary Artery/surgery , Pulmonary Embolism/diagnosis , Sarcoma/complications , Sarcoma/pathology , Sarcoma/therapy , Superior Vena Cava Syndrome/etiology , Superior Vena Cava Syndrome/therapy , Tomography, X-Ray Computed , Treatment Outcome , Vascular Neoplasms/complications , Vascular Neoplasms/pathology , Vascular Neoplasms/therapy , Vascular Surgical Procedures , Vena Cava, Superior/surgery , Young AdultABSTRACT
En un pequeño grupo de hipertensos puede identifi carse una causa, responsable del aumento de las cifras de presión arterial, como el Síndrome de Cushing, que supone el 0,2-0,6% de los casos. Presentamosel caso de un paciente diagnosticado de hipertensión secundaria a Síndrome de Cushing
In a small group of hypertensive patients a cause of elevated blood pressure levels can be identifi ed,such as Cushing syndrome, which corresponds to 0.2-0.6% of cases. We present the case of a patient diagnosed with hypertension secondary to Cushing Syndrome
