To analyze the clinical characteristics and outcomes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with sarcoidosis from a large multicenter cohort from Southern Europe and to identify the risk factors associated with a more complicated infection. We searched for patients with sarcoidosis presenting with SARS-CoV-2 infection (defined according to the European Centre for Disease Prevention and Control guidelines) among those included in the SarcoGEAS Registry, a nationwide, multicenter registry of patients fulfilling the American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders 1999 classification criteria for sarcoidosis. A 2:1 age-sex-matched subset of patients with sarcoidosis without SARS-CoV-2 infection was selected as control population. Forty-five patients with SARS-CoV-2 infection were identified (28 women, mean age 55 years). Thirty-six patients presented a symptomatic SARS-CoV-2 infection and 14 were hospitalized (12 required supplemental oxygen, 2 intensive care unit admission and 1 mechanical ventilation). Four patients died due to progressive respiratory failure. Patients who required hospital admission had an older mean age (64.9 vs. 51.0 years, p = 0.006), a higher frequency of baseline comorbidities including cardiovascular disease (64% vs. 23%, p = 0.016), diabetes mellitus (43% vs. 13%, p = 0.049) and chronic liver/kidney diseases (36% vs. 0%, p = 0.002) and presented more frequently fever (79% vs. 35%, p = 0.011) and dyspnea (50% vs. 3%, p = 0.001) in comparison with patients managed at home. Age- and sex-adjusted multivariate analysis identified the age at diagnosis of SARS-Cov-2 infection as the only independent variable associated with hospitalization (adjusted odds ratio 1.18, 95% conficence interval 1.04–1.35). A baseline moderate/severe pulmonary impairment in function tests was associated with a higher rate of hospitalization but the difference was not statistically significant (50% vs. 23%, p = 0.219). A close monitoring of SARS-CoV-2 infection in elderly patients with sarcoidosis, especially in those with baseline cardiopulmonary diseases and chronic liver or renal failure, is recommended. The low frequency of severe pulmonary involvement in patients with sarcoidosis from Southern Europe may explain the weak prognostic role of baseline lung impairment in our study, in contrast to studies from other geographical areas.

Neutrophilic dermatoses encompass a wide spectrum of diseases characterized by a dense infiltration mainly composed of neutrophils. Neutrophilic dermatosis of the dorsal hands is currently considered a localized variant of Sweet syndrome. Cocaine abuse has been related to a wide range of mucocutaneous manifestations, including neutrophilic dermatoses such as pyoderma gangrenosum. The authors of this study present a patient with neutrophilic dermatosis of the dorsal hands, in which cocaine abuse was identified as a probable trigger.

Recent evidence suggests that obese people are hypohydrated and that water consumption may be a useful indicator for the prevention and treatment of obesity. Nevertheless, there is no agreement regarding the best hydration status indicators and there are few data about the relationship between hydration and body weight. In the present study, we aim to analyze the correlation among hydration status with obesity measured by three different methods (plasma osmolarity, urinary specific gravity (USG) and urinary osmolarity) in a hospital-based outpatient population. We have carried out a cross-sectional study to evaluate the association between obesity and hydration status in 260 patients, average 56.5±15.7 years. Hydration status was estimated by means of plasma osmolarity, urine osmolarity and USG. We did show significant trend of higher urine osmolarity (P=0.03), USG (P=0.000) and plasma osmolarity (P=0.000) with an increase of weight status categories, more accurate in the case of plasma osmolarity. In a multivariate analysis, after controlled by confounders, we found that obesity was associated with plasma osmolarity (OR 1.09; 95% CI 1.02 to 1.17, P=0.009), urine osmolarity (OR 1.00; 95% CI 1.00 to 1.01, P=0.05) and USG (OR 1.02; 95% CI 1.00 to 1.04, P=0.05). Our results have shown a more accurate relationship between plasma osmolarity with all body mass index categories. This finding may have clinical implications that must be confirmed in further studies.

Bronconeumonia bilateral por Rothia mucilaginosa

Embolismo tumoral pulmonar microvascular en paciente con tumor urotelial