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Background Most COVID-19-related deaths have occurred in older persons with comorbidities. Specific patterns of comorbidities related to COVID-19 deaths have not been investigated. Methods A random sample of 6085 individuals in Italy who died in-hospital with confirmed COVID-19 between February and December 2020 were included. Observed to expected (O/E) ratios of disease pairs were computed and logistic regression models were used to determine the association between disease pairs with O/E values ≥ 1.5. Results Six pairs of diseases exhibited O/E values ≥ 1.5 and statistically significant higher odds of co-occurrence in the crude and adjusted analyses: (1) ischemic heart disease and atrial fibrillation, (2) atrial fibrillation and heart failure, (3) atrial fibrillation and stroke, (4) heart failure and COPD, (5) stroke and dementia, and (6) type 2 diabetes and obesity. Conclusion In those deceased in-hospital due to COVID-19 in Italy, disease combinations defined by multiple cardio-respiratory, metabolic, and neuropsychiatric diseases occur more frequently than expected. This finding indicates a need to investigate the possible role of these clinical profiles in the chain of events that lead to death in individuals who have contracted SARS-CoV-2.

Background Among the unknowns posed by the coronavirus disease 2019 (COVID-19) outbreak, the role of biological sex to explain disease susceptibility and progression is still a matter of debate, with limited sex-disaggregated data available. Methods A retrospective analysis was performed to assess if sex differences exist in the clinical manifestations and transitions of care among hospitalized individuals dying with laboratory-confirmed SARS-CoV-2 infection in Italy (February 27–June 11, 2020). Clinical characteristics and the times from symptoms’ onset to admission, nasopharyngeal swab, and death were compared between sexes. Adjusted multivariate analysis was performed to identify the clinical features associated with male sex. Results Of the 32,938 COVID-19-related deaths that occurred in Italy, 3517 hospitalized and deceased individuals with COVID-19 (mean 78 ± 12 years, 33% women) were analyzed. At admission, men had a higher prevalence of ischemic heart disease (adj-OR = 1.76, 95% CI 1.39–2.23), chronic obstructive pulmonary disease (adj-OR = 1.7, 95% CI 1.29–2.27), and chronic kidney disease (adj-OR = 1.48, 95% CI 1.13–1.96), while women were older and more likely to have dementia (adj-OR = 0.73, 95% CI 0.55–0.95) and autoimmune diseases (adj-OR = 0.40, 95% CI 0.25–0.63), yet both sexes had a high level of multimorbidity. The times from symptoms’ onset to admission and nasopharyngeal swab were slightly longer in men despite a typical acute respiratory illness with more frequent fever at the onset. Men received more often experimental therapy (adj-OR = 2.89, 95% CI 1.45–5.74) and experienced more likely acute kidney injury (adj-OR = 1.47, 95% CI 1.13–1.90). Conclusions Men and women dying with COVID-19 had different clinical manifestations and transitions of care. Identifying sex-specific features in individuals with COVID-19 and fatal outcome might inform preventive strategies.

The clinical and pathological characteristics of a myoblastoma of the orbital are described. The tumor presented as a painless hard mass in the left orbit of a 56-year-old caucasian male, causing diplopia and hypertrophy of the left eye in the primary visual position. Light microscopy studies revealed a typical granular cell tumor with PAS-positive intracytoplasmic granules. Immunoperoxidase studies showed positivity for S-100 protein and desmin. Electron microscopy studies showed numerous intracellular myelin degenerative bodies. The patient developed an epidermoid cyst at the site of initial surgery, but has no signs of local or distant disease two years after initial treatment.

Objetivo: Comunicar dos casos de metástasis tardías de carcinoma renal de células claras. Métodos: Dos pacientes, hombre y mujer, con historia de nefrectomía previa hacía 17 y 16 años respectivamente, presentaron nuevos tumores en tiroides y páncreas, que se extirparon. Resultados: La histopatología de ambas lesiones correspondió a tumores de células claras y el estudio inmunohistoquímico fue compatible con metástasis de carcinoma renal de células claras. Conclusiones: 1º) Ante nodulos en tiroides o páncreas, en pacientes con historia previa de cualquier tipo de carcinoma, se debe considerar la posibilidad de una metástasis. 2º) Los pacientes con carcinoma renal de células claras y nefrectomía (resección), deben tener un seguimiento de por vida, con una actitud de alerta a la aparición de nódulos en tiroides o en páncreas. 3º) En presencia de un tumor de células claras en tiroides o en páncreas, se debe incluir la posibilidad de un carcinoma renal metastático en el diagnóstico diferencial. 4º) El tratamiento de elección es la resección quirúrgica.

In fifty non selected ductal carcinomas of the breast we found that a marked tumoral inflammatory infiltrate (P less than 0.025), perinodal tumoral infiltrate (P less than 0.01), sinus catarrh (P less than 0.05), follicular hyperplasia (P less than 0.025), mixed pattern in lymph nodes (P less than 0.01) and with 54 years of age or younger (P less than 0.01) correlated significantly with lymph node metastases and/or high histologic grade. On the contrary, elastosis (P less than 0.05), scanty or absent inflammatory infiltrate (P less than 0.01), sinus histiocytosis (P less than 0.001) and endothelial hyperplasia were statistically related to low histologic grade and/or lack of metastases. Elastosis is considered a defensive host response. Groups of lymphocytes in the perinodal fat is usually found in metastasized lymph nodes and may indicate metastasis should be sought in a lymph node which otherwise seems to be tumor-free.