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1.
G Ital Nefrol ; 38(4)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34469082

RESUMO

COVID-19 has a wide spectrum of clinical presentation, ranging from asymptomatic or mild symptoms to severe multiorgan failure. In Portugal, the first cases affecting patients on a chronic hemodialysis program arose in the city of Oporto. The authors report here two cases of COVID-19 infection in patients incident in renal replacement therapy in the Alentejo region and hypothesise that the high serum concentration of urea may decapitate the appearance of typical symptoms of the SARS-CoV-2 infection. The fact that the hemodialysis population can present active infection without fever may lead to a delayed diagnosis and consequently an increased risk of mortality.


Assuntos
COVID-19/diagnóstico , Falência Renal Crônica/terapia , Terapia de Substituição Renal , Idoso , COVID-19/sangue , COVID-19/terapia , Evolução Fatal , Feminino , Humanos , Falência Renal Crônica/sangue , Masculino , Portugal , Respiração Artificial , SARS-CoV-2/isolamento & purificação
2.
BMC Pulm Med ; 21(1): 278, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465321

RESUMO

BACKGROUND: There are various reasons for delayed positive nasopharyngeal PCR tests for coronavirus disease 2019 (COVID19) in not only asymptomatic but also severely diseased patients. The pathophysiological attributes are not known. We explore this possibility through a case report. CASE PRESENTATION: A 64-year-old male with history of pulmonary fungal infection, asthma and chronic pulmonary obstructive disease (COPD), diabetes, coronary artery disease presented with shortness of breath, fever and chest image of ground opacity, reticular interstitial thickening, highly suspicious for COVID19. However, nasopharyngeal swab tests were discordantly negative for four times in two weeks, and IgG antibody for COVID19 was also negative. However, serum IgE level was elevated. No other pathogens are identified. His symptoms deteriorated despite corticosteroid, antibiotics and bronchodilator treatment. Bronchoalveolar lavage (BAL) and open lung wedge biopsy were performed for etiology diagnosis. They demonstrated COVID19 viral RNA positive fibrosing organizing pneumonia with respiratory tract damage characterized by suspicious viral cytopathic effect, mixed neutrophilic, lymphoplasmacytic, histiocytic and eosinophilic inflammation and fibrosis besides expected asthma and COPD change. One week later, repeated COVID19 nasopharyngeal tests on day 40 and day 49 became positive. CONCLUSION: Our case and literature review indicate that allergic asthma and associated high IgE level together with corticosteroid inhalation might contribute to the delayed positive nasopharyngeal swab in upper airway; COPD related chronic airways obstruction and the addition of fibrosis induced ventilator dependence and poor prognosis in COVID19 pneumonia, and should be therapeutically targeted besides antiviral therapy.


Assuntos
Teste de Ácido Nucleico para COVID-19 , COVID-19/diagnóstico , Diagnóstico Tardio , Nasofaringe/virologia , SARS-CoV-2/isolamento & purificação , Administração por Inalação , Corticosteroides/uso terapêutico , Asma/complicações , Asma/tratamento farmacológico , Asma/patologia , Lavagem Broncoalveolar , COVID-19/complicações , COVID-19/terapia , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Doença Pulmonar Obstrutiva Crônica/patologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa
3.
Pan Afr Med J ; 39: 95, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34466197

RESUMO

Limbic encephalitis (LE) is a rare disease often of paraneoplastic origin. It is frequently associated with bronchopulmonary cancer. Diagnosis is based on brain magnetic resonance imaging (MRI). We here report the case of a 54-year-old female patient with a history of active smoking, presenting with chronic dry cough. Chest X-ray showed suspicious right lung opacity. Bronchial fibroscopy and bronchial biopsies were not contributory. Thoraco-abdomino-pelvic computed tomography (CT)-scan and brain CT-scan showed a mass in the right upper lobe classified as T4N2M1a. CT-guided lung biopsy confirmed the diagnosis of bronchopulmonary adenocarcinoma. The patient had reported a recent history of memory disturbances associated with depressed mood, anxiety and paroxysmal confusion. Metabolic screening and tests for detecting infection were normal and brain MRI suggested limbic encephalitis. The evolution was characterized by rapid disease progression; the patient died in about ten days.


Assuntos
Adenocarcinoma de Pulmão/diagnóstico por imagem , Encefalite Límbica/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Adenocarcinoma de Pulmão/complicações , Progressão da Doença , Evolução Fatal , Feminino , Humanos , Encefalite Límbica/etiologia , Neoplasias Pulmonares/complicações , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
4.
Bol Med Hosp Infant Mex ; 78(4): 335-340, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34351888

RESUMO

INTRODUCCIÓN: La COVID-19 se ha convertido en una amenaza para la salud pública mundial. Sin embargo, las formas graves en niños son poco frecuentes. Se presenta el caso de un lactante con síndrome inflamatorio multisistémico relacionado con COVID-19. CASO CLÍNICO: Lactante de 8 meses que estuvo en contacto con adultos positivos para COVID-19. El lactante inició con una forma leve de la enfermedad que progresó con rapidez a una forma crítica de presentación inicialmente con estado epiléptico, y a su ingreso con evidencia de inflamación en laboratorios, afección sistémica grave con falla multiorgánica y prueba de reacción en cadena de la polimerasa para SARS-CoV-2 nasofaríngea positiva. El lactante falleció 7 días después de su ingreso. CONCLUSIONES: El espectro de presentación de la COVID-19 en niños menores de 1 año es variable y aún no se cuentan con criterios consensuados para el diagnóstico y el tratamiento. Todo lactante con enfermedad grave con compromiso multiorgánico al ingreso en tiempos de pandemia obliga a realizar una meticulosa historia clínica y considerar la infección por SARS-CoV-2 hasta su confirmación. BACKGROUND: COVID-19 has become a threat to global public health. However, severe forms of COVID-19 presentation in children are rare. We present the case of an infant with COVID 19-related multisystem inflammatory syndrome. CASE REPORT: We describe the case of an 8-month-old infant who had contact with COVID-19 positive adults. The infant began with mild symptoms of the disease but rapidly progressed to a critical form of presentation:initially with epileptic status, and upon admission with laboratory evidence of inflammation, severe systemic condition with multiple organ failure, and a positive nasopharyngeal SARS-CoV-2 PCR test. The infant died 7 days after admission. CONCLUSIONS: The spectrum of COVID-19 presentation in children under one year of age is variable, and there are still no established criteria for diagnosis and treatment. All infants presenting a severe disease with multiple organ involvement at admission in times of pandemic require a thorough medical history to consider SARS-CoV-2 infection until proven otherwise.


Assuntos
COVID-19 , Síndrome de Resposta Inflamatória Sistêmica , COVID-19/diagnóstico , COVID-19/terapia , Estado Terminal , Evolução Fatal , Humanos , Lactente , Masculino , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico , Síndrome de Resposta Inflamatória Sistêmica/terapia
5.
J Med Microbiol ; 70(8)2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34448689

RESUMO

Following prolonged hospitalization that included broad-spectrum antibiotic exposure, a strain of Providencia rettgeri was cultured from the blood of a patient undergoing extracorporeal membrane oxygenation treatment for hypoxic respiratory failure due to COVID-19. The strain was resistant to all antimicrobials tested including the novel siderophore cephalosporin, cefiderocol. Whole genome sequencing detected ten antimicrobial resistance genes, including the metallo-ß-lactamase bla NDM-1, the extended-spectrum ß-lactamase bla PER-1, and the rare 16S methyltransferase rmtB2.


Assuntos
Antibacterianos/farmacologia , COVID-19/terapia , Farmacorresistência Bacteriana , Infecções por Enterobacteriaceae/mortalidade , Pneumonia Associada à Ventilação Mecânica/mortalidade , Providencia/efeitos dos fármacos , Idoso , COVID-19/complicações , Infecções por Enterobacteriaceae/sangue , Infecções por Enterobacteriaceae/etiologia , Infecções por Enterobacteriaceae/microbiologia , Oxigenação por Membrana Extracorpórea , Evolução Fatal , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pneumonia Associada à Ventilação Mecânica/etiologia , Pneumonia Associada à Ventilação Mecânica/microbiologia , Providencia/genética , Providencia/isolamento & purificação
8.
Adv Emerg Nurs J ; 43(3): 194-197, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34397495

RESUMO

COVID-19 is a major health issue, and patients with underlying conditions are more susceptible to catastrophic outcomes. Toxic epidermal necrolysis (TEN) is a severe systemic disease caused by an immune system hypersensitive reaction. We present a case of TEN induced following sulfasalazine administration that later on complicated with COVID-19, deep vein thrombosis, pulmonary emboli, and eventually death.


Assuntos
Antirreumáticos/efeitos adversos , Artrite Reumatoide/tratamento farmacológico , COVID-19/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Síndrome de Stevens-Johnson/etiologia , Sulfassalazina/efeitos adversos , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2
9.
Medicine (Baltimore) ; 100(32): e26911, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34397927

RESUMO

RATIONALE: With the recent advancements in molecular biology research, epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) have emerged as excellent therapies for patients with EGFR-mutant cancers. However, these patients inevitably develop cross-acquired resistance to EGFR-TKIs. Transformation to small-cell lung cancer (SCLC) is considered a rare resistance mechanism against EGFR-TKI therapy. Here, we report a case of TKI resistance due to SCLC transformation and demonstrate its mechanisms and clinical features. PATIENT CONCERNS: A 54-year-old Chinese man with a history of smoking for 40 years complained of an intermittent cough in March 2019. DIAGNOSIS: Transbronchial lung biopsy was performed on the basal segment of the left lower lobe, which confirmed lung adenocarcinoma. In January 2020, repeat biopsy was performed, and the results of immunohistochemistry (IHC) staining showed TTF-1 (+), CK7 (+), napsin A (+), syn (+), and CD56 (+), with a Ki-67 (+) index 80% of small cell carcinomas. Infiltrating adenocarcinomas and small cell carcinomas were observed. INTERVENTIONS: Icotinib (125 mg thrice daily) was administered as a first-line treatment from June 2019. We subsequently administered a chemotherapy regimen consisting of etoposide (180 mg, days 1-3) plus cisplatin (45 mg, days 1-3) every 3 weeks for 1 cycle after recurrence. As the patient could not tolerate further chemotherapy, he continued taking icotinib orally and received whole-brain radiotherapy 10 times to a total dose of 30 Gy after brain metastases. OUTCOMES: The patient relapsed after successful treatment with icotinib for 9 months. A partial response was achieved after 4 cycles of chemotherapy, and despite the brief success of chemotherapy, our patient exhibited brain metastasis and metastases of the eleventh thoracic spine and the second lumbar vertebra with pathological fracture. The patient eventually died of aggressive cancer progression. LESSONS: Our case highlights the possibility of SCLC transformation from EGFR-mutant adenocarcinoma and the importance of repeat biopsy for drug resistance. Serum neuron-specific enolase levels may also be useful for detecting early SCLC transformation.


Assuntos
Adenocarcinoma de Pulmão/genética , DNA de Neoplasias/genética , Neoplasias Pulmonares/genética , Mutação , Carcinoma de Pequenas Células do Pulmão/genética , Adenocarcinoma de Pulmão/metabolismo , Adenocarcinoma de Pulmão/patologia , Biópsia , Transformação Celular Neoplásica , Análise Mutacional de DNA , Receptores ErbB/genética , Receptores ErbB/metabolismo , Evolução Fatal , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/metabolismo , Masculino , Pessoa de Meia-Idade , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Carcinoma de Pequenas Células do Pulmão/metabolismo , Tomografia Computadorizada por Raios X
10.
Pan Afr Med J ; 39: 56, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34422179

RESUMO

Severe Combined Immunodeficiency (SCID) involves the lymphocyte lineage and mimics Human Immunodeficiency Virus (HIV) disease common in our region, making it difficult to diagnose and manage effectively. SCID in East Africa stands underdiagnosed because of lack of awareness and diagnostic resources. A case series of three SCID patients admitted to a Tertiary Paediatric Centre in Kenya between 2016 and 2019. The clinical presentations, laboratory findings, management and outcome for each were studied. Three cases were diagnosed between the ages of 4 to 15 months. Two of them were male and one was a female. All had a history of previous sibling death. There was no parental consanguinity. All presented with pneumonia. One of them had vaccine acquired Rotavirus infection and a persistent generalised maculopapular rash. The T, B cell profile was T- B- in two and T- B+ in one case and the immunoglobulins were reduced in all. All the cases were fatal. Thus, Primary immunodeficiency disorders are prevalent in East Africa. A proper clinical history, examination and laboratory tests like a haemogram, peripheral blood film can aid to suspect and diagnose SCID even with limited resources.


Assuntos
Pneumonia/diagnóstico , Imunodeficiência Combinada Severa/diagnóstico , Evolução Fatal , Feminino , Hospitais Pediátricos , Humanos , Lactente , Quênia , Masculino , Pneumonia/imunologia , Imunodeficiência Combinada Severa/imunologia , Índice de Gravidade de Doença
11.
Rheumatol Int ; 41(10): 1839-1843, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34409510

RESUMO

The outcomes of COVID-19 in patients treated with biologic agents are a subject of intense investigation. Recent data indicated that patients under rituximab (RTX) may carry an increased risk of serious disease. We performed an electronic search in Medline and Scopus using the keywords rituximab and COVID-19. We present a rare case of severe, protracted COVID-19 pneumonia in a patient with mixed connective tissue disease (MCTD) who was infected a few days following RTX treatment. In a relevant literature search, we identified 18 cases of patients with rheumatic diseases (6 RA, 8 ANCA vasculitis, 3 systemic sclerosis and 1 polymyositis) treated with RTX who experienced an atypical and/or prolonged course of COVID-19 pneumonia with no evidence of cytokine storm. Our case indicates that RTX may unfavorably affect outcomes following SARS-CoV-2 infection. B cell depletion may dampen the humoral response against the virus; we may hypothesize that B cell-depleted patients may be protected from cytokine storm but on the other hand may have difficulties in virus clearance leading to a protracted course. Taking into account that COVID-19 vaccines are available we may consider delaying RTX infusions at least in patients without life threatening disease, until vaccination is completed.


Assuntos
Antirreumáticos/efeitos adversos , COVID-19/imunologia , Contraindicações de Medicamentos , Doença Mista do Tecido Conjuntivo/tratamento farmacológico , Rituximab/efeitos adversos , Idoso , Antirreumáticos/administração & dosagem , COVID-19/diagnóstico , Evolução Fatal , Feminino , Humanos , Infusões Intravenosas , Masculino , Rituximab/administração & dosagem , SARS-CoV-2
12.
Biomed Res Int ; 2021: 3890681, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34337007

RESUMO

The entire H5N1 highly pathogenic avian influenza viral genomes were identified in the frozen autopsy specimens: the trachea, lung, colon, and intestinal feces from a patient who died of the disease in 2006. Phylogenetic analysis of the viral genomes showed that these viruses belonged to clade 1 and were the reassortants generated from the reassortment of the viruses within the same clade. The sequencing data from the autopsy specimens revealed at least 8 quasispecies of the H5N1 viruses across all 4 specimen types. These sequences were compared to those derived from the virus isolates grown in Madin Darby canine kidney (MDCK) cells. The virus isolates from the trachea, lung, and fecal specimens showed 27 nucleotide substitutions, leading to the changes of 18 amino acid residues. However, there was no change in the amino acid residues that determined the viral virulence. The changes were more commonly observed in the lung, particularly in the HA and NA genes. Our study suggested that the adaptation changes for the viral fitness to survive in a new host species (MDCK cells) might involve many genes, for example, the amino acid substitution 177G or 177W adjacent to the receptor-binding residues in the HA1 globular head and the substitution M315I in PB2. However, a mutation changes near the receptor binding domain may play an important role in determining the cell tropism and is needed to be further explored.


Assuntos
Adaptação Fisiológica , Autopsia , Técnicas de Cultura de Células , Variação Genética , Genoma Viral , Virus da Influenza A Subtipo H5N1/crescimento & desenvolvimento , Virus da Influenza A Subtipo H5N1/genética , Adaptação Fisiológica/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Cães , Evolução Fatal , Glicoproteínas de Hemaglutininação de Vírus da Influenza/química , Glicoproteínas de Hemaglutininação de Vírus da Influenza/genética , Humanos , Células Madin Darby de Rim Canino , Masculino , Pessoa de Meia-Idade , Filogenia , Virulência/genética
13.
Cell Death Dis ; 12(8): 762, 2021 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-34344867

RESUMO

While vaccination is the single most effective intervention to drastically reduce severe disease and death following SARS-CoV-2 infection, as shown in UK and Israel, some serious concerns have been raised for an unusual adverse drug reaction (ADR), including vaccine-induced immune thrombotic thrombocytopenia (VITT) with concurrent low platelets as well as capillary leak syndrome. In fact, the overall safety of the vaccine is highlighted by the low frequency of ADR considering that in UK, by the early June, 40 million first doses and 29 million second doses have been injected; nonetheless, 390 thrombotic events, including 71 fatal events have been reported. Interestingly, the cases reported low platelet counts with the presence of anti-platelet factor-4 (PF4) antibodies, indicating an abnormal clotting reaction. Here, out of three referred cases, we report a post-vaccine clinical case of fatal thrombosis with postmortem examination and whole exome sequencing (WES) analysis, whose pathogenesis appeared associated to a preexisting condition of thrombocytopenia due to myelodysplasia.


Assuntos
Vacinas contra COVID-19/efeitos adversos , Trombocitopenia/complicações , Tromboembolia/etiologia , Medula Óssea/patologia , COVID-19/prevenção & controle , Evolução Fatal , Feminino , Humanos , Pulmão/patologia , Pessoa de Meia-Idade , Síndromes Mielodisplásicas/complicações , Síndromes Mielodisplásicas/diagnóstico , Síndromes Mielodisplásicas/patologia , SARS-CoV-2/imunologia , Trombocitopenia/diagnóstico , Trombocitopenia/patologia
14.
Cir Cir ; 89(4): 435-442, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34352870

RESUMO

INTRODUCCIÓN: en la actual pandemia de COVID-19, existe evidencia creciente que ha identificado el neurotropismo del virus SARS-CoV-2 y sus complicaciones neurológicas, incluida la enfermedad cerebrovascular isquémica y escasamente hemorragia cerebral (HC). OBJETIVO: describir las características clínicas, radiológicas, de laboratorio y pronósticas de los pacientes con HC asociada al SARS-CoV-2. MÉTODOS: se incluyeron pacientes consecutivos con prueba de PCR confirmatoria para infección por SARS-CoV-2 y HC. RESULTADOS: en un período de 90 días, en un centro de referencia COVID-19 en México, de 1108 pacientes con infección por SARS-CoV-2, se encontraron 4 pacientes (0.36%) con HC. Tenían una edad de 71(±12.2) años, 2 eran mujeres. Se encontró que dos tenían factores de riesgo cardiovascular previos. En dos casos se encontró el origen en el núcleo dentado mientras que los otros dos correspondieron al tálamo. Tres de los cuatro pacientes murieron. Postulamos que el descontrol hipertensivo, coagulopatía, trombocitopenia y la respuesta inmune inducida por el virus SARS-CoV-2 podrían desencadenar HC en un paciente con riesgo previo. CONCLUSIONES: la HC se asocia a la infección por SARS-CoV-2 con mal pronóstico cuando se presenta. Los equipos de neurocirugía deben estar preparados para el tratamiento oportuno de estos pacientes. INTRODUCTION: In the current COVID-19 pandemic, there is a growing body of evidence that has identified the neurotropism of the SARS-CoV-2 virus and its neurological complications, including cerebrovascular disease, focusing mainly in ischemic and scarcely about hemorrhagic stroke (HS). OBJECTIVE: The objective of the study was to describe clinical, radiological, laboratory tests, and prognostic characteristics of patients with SARS-CoV-2 associated HS. METHODS: Consecutive patients with a confirmatory PCR test for SARS-CoV-2 infection and a HS demonstrated by head CT were included in the study. RESULTS: Over a period of 90 days, in a COVID-19 reference center in Mexico, out of a total of 1108 patients with SARS-CoV-2 infection, it found 4 patients (0.36%) who meet criteria. They had an age of 71 (±12.2) years, 2 were women. It was found that two had prior cardiovascular risk factors. Two of the HS originated in the dentate nucleus while the other two corresponded to the thalamus. Three of the four patients died. We suggest that catastrophic uncontrolled blood pressure, coagulopathy, thrombocytopenia, and immune response induced by SARS-CoV-2 could in a specific patient trigger HS. CONCLUSIONS: HS is associated to SARS-CoV-2 infection with poor prognosis when it presented. Neurosurgery teams should prepare for the timely and appropriate treatment of this patients.


Assuntos
COVID-19/complicações , AVC Hemorrágico/etiologia , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , Teste de Ácido Nucleico para COVID-19 , Evolução Fatal , Feminino , Fatores de Risco de Doenças Cardíacas , AVC Hemorrágico/diagnóstico , AVC Hemorrágico/diagnóstico por imagem , Hospitais Gerais , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , SARS-CoV-2 , Tomografia Computadorizada por Raios X
15.
Medicine (Baltimore) ; 100(31): e26844, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397857

RESUMO

RATIONALE: Primary signet ring cell carcinoma of the uterine cervix is extremely rare and the clinical characteristics and prognosis are not well known and there are no specific guidelines for treatment. PATIENT CONCERNS: A 43-year-old woman was referred to our hospital for abnormal uterine bleeding lasting 1 month. DIAGNOSES: Histological examination revealed a signet ring cell carcinoma of the uterine cervix. After evaluation of extragenital origin, the patient was diagnosed International Federation of Gynecology and Obstetrics stage IIIC1 primary signet ring cell carcinoma or the uterine cervix. INTERVENTION: The patient was prescribed concomitant chemo-radiation followed by intracavitary brachytherapy. OUTCOMES: She showed no evidence of disease after treatment but, it recurred after 7 months of last treatment. LESSONS: Different approaches to diagnosis and treatment of this rare disease are needed and molecular pathological studies related to the onset of the disease are required.


Assuntos
Carcinoma de Células em Anel de Sinete , Colo do Útero , Quimiorradioterapia/métodos , Cisplatino/administração & dosagem , Neoplasias do Colo do Útero , Esfregaço Vaginal/métodos , Adulto , Antineoplásicos/administração & dosagem , Biópsia/métodos , Braquiterapia/métodos , Carcinoma de Células em Anel de Sinete/patologia , Carcinoma de Células em Anel de Sinete/fisiopatologia , Carcinoma de Células em Anel de Sinete/terapia , Colo do Útero/diagnóstico por imagem , Colo do Útero/patologia , Evolução Fatal , Feminino , Humanos , Recidiva Local de Neoplasia/patologia , Papillomaviridae/isolamento & purificação , Retratamento/métodos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/fisiopatologia , Neoplasias do Colo do Útero/terapia , Hemorragia Uterina/diagnóstico , Hemorragia Uterina/etiologia
16.
J Radiol Case Rep ; 15(4): 7-16, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34276871

RESUMO

Extraskeletal osteosarcoma is a highly aggressive malignant osteoid forming mesenchymal neoplasm arising from soft tissues which accounts for 1% of all soft tissue sarcomas. We report the case of a 46-year-old female with no significant past medical history presenting to an emergency department with a right lateral thigh mass following minor trauma. She was eventually found to have high grade extraskeletal osteosarcoma with rapid progression of disease resulting in patient demise. Differentiation of these lesions from alternative processes relies on specific imaging and pathologic features. Differential diagnoses include both benign and malignant etiologies such as myositis ossificans, soft tissue hemangiomas, and other malignant soft tissue neoplasms such as epithelial and synovial sarcoma.


Assuntos
Osteossarcoma/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Diagnóstico Diferencial , Evolução Fatal , Feminino , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica , Osteossarcoma/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem
17.
BMC Infect Dis ; 21(1): 678, 2021 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256733

RESUMO

BACKGROUND: In this case report, we presented a rare case of maternal death with massive vulvar edema and Covid-19 diagnosis. CASE PRESENTATION: The case was a 20-year-old woman who was referred to with pain and massive vulvar edema by passing 7 days from her labor. The laboratory tests showed leukocytosis, lymphopenia, and elevated C-reactive protein levels. The high-resolution computed tomography was in favor of Covid-19 changes. Finally, she died because of respiratory distress, ON the 8th day postpartum. CONCLUSION: Given the increasing prevalence of Covid-19, it is important and vital to be aware of its potential complications and then to try prevent and manage them, especially during high-risk periods such as pregnancy and postpartum.


Assuntos
COVID-19/complicações , Edema/complicações , Edema/diagnóstico por imagem , Morte Materna , Período Pós-Parto , SARS-CoV-2/genética , Doenças da Vulva/complicações , Doenças da Vulva/diagnóstico por imagem , COVID-19/sangue , COVID-19/virologia , Teste para COVID-19/métodos , Evolução Fatal , Feminino , Humanos , Linfopenia , Gravidez , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tomografia Computadorizada por Raios X/métodos , Adulto Jovem
19.
Mayo Clin Proc ; 96(7): 2005-2007, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34218872
20.
J Autoimmun ; 123: 102688, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34225251

RESUMO

Unprecedented loss of life due to the COVID pandemic has necessitated the development of several vaccines in record time. Most of these vaccines have received approval without being extensively whetted for their adverse effect and efficacy profiles. Most adverse effects have been mild, nonetheless, more serious thromboembolic events have also been reported. Autoimmune hepatitis (AIH) can occur in predisposed individuals where an immune mediated reaction against hepatocytes is triggered by environmental factors. Vaccines are a very rare cause of AIH. We report two such cases of AIH triggered by COVID (Covishield) vaccination. While one patient made an uneventful recovery, another succumbed to the liver disease. Ours is the first report of Covishield vaccination related AIH and second ever after any form of COVID vaccination. We hope that our report does not deter COVID vaccination drives. However, we also hope to raise awareness of its potential side effects and the increased role of pharmacovigilance in guiding treatment.


Assuntos
Vacinas contra COVID-19/efeitos adversos , COVID-19/prevenção & controle , Hepatite Autoimune/etiologia , Pandemias , SARS-CoV-2/imunologia , Vacinação/efeitos adversos , Adulto , Evolução Fatal , Feminino , Hepatite B Crônica/complicações , Hepatite Autoimune/imunologia , Hepatite Autoimune/patologia , Humanos , Hipotireoidismo/complicações , Icterícia/etiologia , Masculino , Pessoa de Meia-Idade , Modelos Imunológicos , Farmacovigilância
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