A 74-year-old woman was admitted to our hospital with a history of episodes of left-sided hemiparesis and numbness for few minutes. A brain MRI showed cortical subarachnoid blood and diffuse cortical microbleeds, compatible with a diagnosis of cerebral amyloid angiopathy, according to modified Boston criteria 1. Other possible causes of the MRI findings, such as coagulopathy and traumatic brain injury, were excluded. Cerebral amyloid angiopathy, a common cause of lobar hemorrhage in older patients, can also present with transient focal neurological episodes, which are sometimes known as ' amyloid spells'. These are stereotyped, recurrent, transient episodes of numbness or weakness and may mimic a transient ischemic attack 1,2,3,4,5 .
Since the first cases of coronavirus disease 2019 in December 2019, in the city of Wuhan, China, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was responsible for the death of more than 3.6 million people, as of June 2021. It has a lethality rate of around 2.15% worldwide, with 171 million people infected, according to data from the World Health Organization. 1,2 In view of the absence of proven effective therapy for the disease, numerous studies have been developed seeking to identify the determining factors for the development of more severe forms of COVID-19, in order to direct efforts to avoid the worst outcomes in patients with possible profiles of development of severe conditions. 3 Several comorbidities have been associated with the most complicated forms of COVID-19, 4 including systemic arterial hypertension (SAH), a disease that has a prevalence of around 26% in the world's adult population 5 and a prevalence of 24.5% in Brazilian capital cities. 6 Furthermore, several studies have pointed to SAH as the most frequent comorbidity in patients diagnosed with COVID-19 worldwide.
Introduction: The pathological status of obesity can influence COVID-19 from its initial clinical presentation, therefore, the identification of clinical and laboratory parameters most affected in the presence of obesity can contribute to improving the treatment of the disease. Objective: To identify the clinical, laboratory, and tomographic characteristics associated with obesity and BMI at t hospital admission in adult patients with COVID-19. Methods: This is a cross-sectional observational study with a total of 315 participants with COVID-19 confirmed by rt-PCR. The participants were divided into non-Obese (n=203) and Obese (n=112). Physical examinations, laboratory tests, and computed tomography of the chest were performed during the first 2 days of hospitalization. Results: Patients with obesity were younger, and they had higher systolic and diastolic blood pressure, higher frequency of alcoholism, fever, cough, and headache, higher ALT, LDH, and red blood cell count (RBC), hemoglobin, hematocrit, and percentage of lymphocytes. Also, they presented a lower value of leukocyte count and Neutrophil/Lymphocyte Ratio (RNL). The parameters positively correlated with BMI were alcoholism, systolic and diastolic blood pressure, fever, cough, sore throat, number of symptoms, ALT in men, LDH, magnesium, RBC, hemoglobin, hematocrit, and percentage of lymphocytes. The parameters negatively correlated with the BMI were: age and RNL. Conclusion: Several parameters were associated with obesity at hospital admission, revealing better than expected results. However, these results should be interpreted with great caution, as there may be some influence of a phenomenon called the Obesity Paradox that can distort the severity and prognosis of the patient.
Background: Cerebral amyloid angiopathy (CAA) is a cerebrovascular disorder caused by progressive deposition of β-amyloid peptides in the walls of small and medium-sized cortical and leptomeningeal vessels. Until today, the prevalence of CAA is unknown in our region. Objective: This study aims to analyze the prevalence of this entity in a specific elderly population in a tertiary hospital in Northeastern Brazil. Methods: A cross-sectional, retrospective study with the enrollment of patients aged 65 or older followed in the neurological outpatient service of the Universidade Federal do Piauí, Brazil, who underwent brain magnetic resonance imaging (MRI) from July 2016 to June 2018. Results: One hundred and seventy-four patients were enrolled, of whom 100 were women (57.4%) and 74, men (42.6%), aged from 65 to 91 years old (median age 73.27). Nine patients were excluded from the study due to unavailability of MRI sequences needed for an appropriate analysis. Out of the 165 remaining patients, 12 (7.2%) had established the diagnosis of CAA, according to the modified Boston criteria. Conclusion: The prevalence of CAA in our study was like those of medical literature, with a progressive age-related increase.
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