Phase 2 randomized study on chloroquine, hydroxychloroquine or ivermectin in hospitalized patients with severe manifestations of SARS-CoV-2 infection.

Objective: Given the urgent need for strategies to minimize the damage caused by this pandemic, this study performed a randomized, double-blind phase 2 study to assess the safety of the effectiveness of chloroquine (CQ), hydroxychloroquine (HCQ) or ivermectin in severe forms of COVID-19, in addition to identifying predictors of mortality in this group of patients.Methods: Phase 2, double-blind, randomized study to assess the safety and efficacy of enteral CQ, HCQ or ivermectin in patients hospitalized for SARS-CoV-2 infection, admitted to a Reference Hospital in Roraima (Brazil) in may 2020. Patients were randomized in a 1:1:1 ratio. The endpoints were need of supplemental O2, invasive ventilation, admission in ICU and death. The study was approved by an independent IRB.Results: 168 patients were randomized. The mean age was 53.4 years (±15.6), most participants were male (n = 95; 58.2%). Therapy with corticosteroid, anticoagulant or antibiotics was a decision of the attending physicians, and there was no difference between the groups. The mortality was similar in three groups (22.2%; 21.3% and 23.0%) suggesting ineffectiveness of the drugs. No difference in the incidence of serious adverse events were observed. To be older than 60 years of age, obesity, diabetes, extensive pulmonary involvement and low SaO2 at hospital admission due to independent risk factors for mortality.Conclusion: Although CQ, HCQ or ivermectin revealed a favorable safety profile, the tested drugs do not reduce the need for supplemental oxygen, ICU admission, invasive ventilation or death, in patients hospitalized with a severe form of COVID-19.

Angioma de canal endocervical: relato de caso e revisão de literatura / Angioma of the Endocervical Canal: Case Report and Literature Review / Angioma del canal endocervical: un caso y revisión de la literatura

Introdução: O angiomixoma é um tumor raro, agressivo, de origem mesenquimal, que geralmente acomete a pelvee o períneo, sendo na vulva a apresentação mais comum. Seu pico de incidência ocorre na quarta década. Tem como principais características o crescimento lento e indolor com formação de grandes massas com altas taxas de recorrência local sem, no entanto, apresentar metástases tumorais. Relato de caso: Mulher, 52 anos, com sangramento vaginal napós-menopausa decorrente de pólipo endocervical de 2,0 cm simulando mioma cervical. Apesar da citologia oncótica sem anormalidades, o estudo histológico revelou angiomixoma agressivo. A paciente foi submetida à histerectomia radical tipo II de Piver sem linfadenectomia há 42 meses e não apresenta evidências de recorrência local ou metástases a distância. Essa condição incomum raramente apresenta manifestação clínica de sangramento genital. Conclusão: O angiomixoma agressivo é doença rara e pouco compreendida. O tratamento cirúrgico continua sendo a modalidadeterapêutica de escolha