Clinical, laboratory and tomographic characteristics associated with obesity and BMI at hospital admission in adult patients with COVID-19: a cross-sectional study / Características clínicas, laboratoriais e tomográficas associadas à obesidade e IMC na admissão hospitalar em pacientes adultos com COVID-19: um estudo transversal

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.

Análise histopatológica e imuno-histoquímica (antígeno nuclear de proliferaçäo celular) de pacientes com carcinoma cervical invasor antes e após radioterapia e cirurgia / Histopathological and immunohistochemical analysis (proliferating cell nuclear antigen) of patients with invasor cervical carcinoma before and radiotherapy and surgery

OBJETIVO: Avaliar a existência de tumor residual e o índice de proliferaçäo celular (PCNA) em pacientes com carcinoma espinocelular do colo uterino, tratadas com a combinaçäo de radioterapia e cirurgia. MÉTODOS: Avaliamos 16 pacientes com carcinoma do colo uterino atendidas no período de abril de 1986 a agosto de 1998, tratadas com irradiaçäo pré-operatória e cirurgia. Após revisäo histopatológica do material das biópsias e peças cirúrgicas, procedeu-se ao exame imuno-histoquímico para avaliar a expressäo do PCNA. A imuno-expressäo do PCNA foi analisada através do programa de análise gráfica por computador IMAGELAB 2.3. RESULTADOS: Em oito (50 por cento) casos detectou-se persistência de neoplasia e em outros oito (50 por cento) houve ausência de neoplasia residual. O valor médio do índice de PCNA anterior à radioterapia nos casos com tumor residual foi de 61,56 por cento e, nos casos sem tumor residual, de 60 por cento. A avaliaçäo da expressäo do PCNA nas 16 biópsias prévias à radioterapia mostrou valor médio de 60 por cento. Nas peças de histerectomia com neoplasia residual a expressäo do PCNA foi, em média, 74 por cento. CONCLUSÖES: A associaçäo de radioterapia pré-operatória e cirurgia no carcinoma do colo uterino permite adequada terapêutica em pacientes sem condiçöes para a cirurgia radical. Outrossim, a radioterapia exclusiva apresenta percentagem relevante de insucessos detectados pela cirurgia e pela análise do PCNA