Revista do Instituto de Medicina Tropical de São Paulo
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Rev. Inst. Med. Trop. Sao Paulo · Jan 2020
Meta AnalysisPrevalence of comorbidities in patients and mortality cases affected by SARS-CoV2: a systematic review and meta-analysis.
The new coronavirus, COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020. Risk factors associated with this disease are age, sex, and the presence of comorbidities, the most common being hypertension, diabetes, and heart disease. The aim of this meta-analysis was to calculate the prevalence and geographical distribution of comorbidities in all patients admitted to intensive care units (ICUs), and the mortality rate of COVID-19. ⋯ Hypertension was the most prevalent comorbidity in all three groups studied, accounting for 32%, 26%, and 35%, respectively. The odds ratio of death for a patient with a comorbidity compared to one with no comorbidity was 2.4 (P < 0.0001). The higher the prevalence of comorbidities the higher the odds that the COVID-19 patient will need intensive care or will die, especially if the pre-existing disease is hypertension, heart disease, or diabetes.
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Rev. Inst. Med. Trop. Sao Paulo · Jan 2020
Review Case ReportsSpontaneous pneumomediastinum, pneumothorax and subcutaneous emphysema in COVID-19: case report and literature review.
Coronavirus Disease 2019 (COVID-19) has rapidly spread worldwide. Numerous studies have shown its typical and atypical CT findings. ⋯ The probable cause of SP in COVID-19 was alveolar damage. Once pneumothorax and SP were present, the patient should be carefully monitored to prevent respiratory deterioration, especially when lung lesions are severe.
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Rev. Inst. Med. Trop. Sao Paulo · Jan 2018
Review Case ReportsAcute kidney injury and pancreatitis due to scorpion sting: case report and literature review.
Despite the high number of accidents due to scorpion stings in Brazil, severe cases in adults are seldomly reported. In the Northeast region of Brazil, Tityus stigmurus is the most prevalent species. A 69 year-old woman who was stung by a scorpion attended the emergency room 5 hours after envenomation. ⋯ Intensive supportive therapy was adopted. In the follow-up, 3 months later, she was completely recovered. This report is being brought to recommend the thorough management of victims of scorpion accidents, enabling early diagnosis of severe complications, which could lead to death if aggressive supportive measures are not early and adequately taken.
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Rev. Inst. Med. Trop. Sao Paulo · Jan 2014
Review Case ReportsBiopsy proven acute tubular necrosis due to rhabdomyolysis in a dengue fever patient: a case report and review of literature.
Renal histology results are very scarce in dengue-associated rhabdomyolysis patients developing acute kidney injury (AKI). We report a case of dengue fever-induced AKI associated to rhabdomyolysis with a renal biopsy showing acute tubular necrosis (ATN) and renal deposition of myoglobin. A 28-year-old patient who presented dengue fever (DF) complicated by severe AKI and rhabdomyolysis is described. ⋯ The patient was discharged with recovered renal function. In conclusion, this case report described a biopsy proven ATN associated to DF-induced rhabdomyolysis, in which renal deposition of myoglobin was demonstrated. We suggest that serum creatine phosphokinase should be monitored in DF patients to allow for an early diagnosis of rhabdomyolysis and the institution of renal protective measures.
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Rev. Inst. Med. Trop. Sao Paulo · Jul 1993
Review Case Reports[Cryptococcal meningitis in pregnancy. Review of the literature. Report of 2 cases].
Two cases of neurocryptococcosis were diagnosed during pregnancy in São Paulo (Brazil). Amphotericin B was used in the second trimester in one patient. The other, received amphotericin B during the first trimester of pregnancy and 5-fluorocytosine was added in the second trimester. ⋯ The therapy used to treat pregnant women with cryptococcal meningitis is commented. The newborn follow-up is discussed. A review of the literature concerning neurocryptococcosis during pregnancy is presented.