Since the outbreak of novel coronavirus in 2019, SARS-CoV-2 has spread worldwide at an unexpected rate, becoming a major global health concern. Although respiratory tract infections represent typical clinical presentation, recently, numerous cases of acute arterial thrombosis and thromboembolic disease have been reported due to COVID-19 infection. Renal artery embolism is a condition that is easily missed due to its infrequent and nonspecific presentation. In this paper, we reported a case of a 63-year-old, previously healthy, male patient who has developed multiple right kidney infarctions due to COVID-19 infection without any respiratory or other typical clinical manifestations. Consecutive RT-PCR tests were negative and the diagnosis was set finally by serological screening. Our presentation has emphasized the necessity of clinical, laboratory, microbiological, and radiological integration in diagnostic approach to this novel and challenging disease with often unusual clinical presentations to avoid false negative discrimination.
Given high risk of infection-related mortality due to impaired immunity, elderly patients are at increased risk with COVID-19. In its diagnostic procedure clinical laboratory medicine has a pivotal role. The aim of this study was to investigate clinical and laboratory specificities in Croatian population of nursing home residents affected by coronavirus. One hundred and six residents of nursing homes that were hospitalized due to COVID-19 infection, were included in this retrospective study. Clinical and laboratory findings at three time points were extracted from medical records. There were 86 females and 20 males, with median of age 84 (min-max: 47–97) years. Patients were divided into three groups: Survivors (S), patients who are still alive (N=65), In-Hospital Non-Survivors (IHNS), patients who died from coronavirus during hospitalization (N=31) and Out-of-Hospital Non-Survivors (OHNS), patients who recovered from infection but died during the period of three months of the follow-up (N=10). We have established differences between these three groups in laboratory findings (p<0.05). At the admission, survivors had lower values of lactate dehydrogenase, aspartate transaminase, sedimentation ratio, ferritin and C-reactive protein, OHNS were in the middle, and IHNS had the highest values. Leukocytes and absolute lymphocyte count were greater in OHNS group, and same between survivors and IHNS. After 7 days, we noticed increase in leukocyte and neutrophils count among IHNS. Assessing of complete blood count, differential blood count, reactants of acute infection and combination of their ratios might predict worse outcome in nursing home residents due to coronavirus infection.
Approximately 60% of patients with squamous cell carcinoma (LSCC) have regional occult metastatic disease/distant metastases at the time of diagnosis, putting them at higher risk for disease progression. Therefore, biomarkers are needed for early prognostic purpose. The aim of this study was to analyze the expression pattern of connexins (Cx) 37, 40 and 45, pannexin1 (Panx1) and vimentin in LSCC and correlate with tumor grade (G) and outcome. Methods: Thirty-four patients who underwent (hemi-)laryngectomy and regional lymphadenectomy due to LSCC from 2017 to 2018 in University Hospital Split, Croatia, were studied. Samples of tumor tissue and adjacent normal mucosa embedded in paraffin blocks were stained using the immunofluorescence method and were semi-quantitatively analyzed. Results: The expression of Cx37, Cx40, and Panx1 differed between cancer and adjacent normal mucosa and between histological grades, being the highest in well-differentiated (G1) cancer and low/absent in poorly differentiated (G3) cancer (all p < 0.05). The expression of vimentin was the highest in G3 cancer. Expression of Cx45 was generally weak/absent, with no significant difference between cancer and the controls or between grades. Lower Panx1 and higher vimentin expression were found to be prognostic factors for regional metastatic disease. Lower Cx37 and 40 expressions were present in patients with disease recurrence after the three-year follow-up period. Conclusion: Cx37 and Cx40, Panx1, and vimentin have the potential to be used as prognostic biomarkers for LSCC.
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