Objective : Given the urgent need for strategies to minimize the damage caused by this pandemic, this study performed a randomized, double-blind phase 2 study to assess the safety of the effectiveness of chloroquine (CQ), hydroxychloroquine (HCQ) or ivermectin in severe forms of COVID-19, in addition to identifying predictors of mortality in this group of patients. Methods : Phase 2, double-blind, randomized study to assess the safety and efficacy of enteral CQ, HCQ or ivermectin in patients hospitalized for SARS-CoV-2 infection, admitted to a Reference Hospital in Roraima (Brazil) in may 2020. Patients were randomized in a 1:1:1 ratio. The endpoints were need of supplemental O 2 , invasive ventilation, admission in ICU and death. The study was approved by an independent IRB. Results : 168 patients were randomized. The mean age was 53.4 years (±15.6), most participants were male ( n = 95; 58.2%). Therapy with corticosteroid, anticoagulant or antibiotics was a decision of the attending physicians, and there was no difference between the groups. The mortality was similar in three groups (22.2%; 21.3% and 23.0%) suggesting ineffectiveness of the drugs. No difference in the incidence of serious adverse events were observed. To be older than 60 years of age, obesity, diabetes, extensive pulmonary involvement and low SaO 2 at hospital admission due to independent risk factors for mortality. Conclusion : Although CQ, HCQ or ivermectin revealed a favorable safety profile, the tested drugs do not reduce the need for supplemental oxygen, ICU admission, invasive ventilation or death, in patients hospitalized with a severe form of COVID-19.

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Introdução: O angiomixoma e um tumor raro, agressivo, de origem mesenquimal, que geralmente acomete a pelve e o períneo, sendo na vulva a apresentação mais comum. Seu pico de incidência ocorre na quarta década. Tem como principais características o crescimento lento e indolor com formação de grandes massas com altas taxas de recorrência local sem, no entanto, apresentar metástases tumorais. Relato de caso: Mulher, 52 anos, com sangramento vaginal na pós-menopausa decorrente de polipo endocervical de 2,0 cm simulando mioma cervical. Apesar da citologia oncótica sem anormalidades, o estudo histológico revelou angiomixoma agressivo. A paciente foi submetida a histerectomia radical tipo II de Pi ver sem linfadenectomia há 42 meses e não apresenta evidências de recorrência local ou metástases a distância. Essa condição incomum raramente apresenta manifestação clínica de sangramento genital. Conclusão: O angiomixoma agressivo é doença rara e pouco compreendida. O tratamento cirúrgico continua sendo a modalidade terapêutica de escolha.  

Objective: to perform a review and descriptive analysis of 24 cases of COVID-19 associated with pulmonary thromboembolism seen in the public service in the State of Roraima in 2021. Methods: retrospective review of 24 selected cases of patients who presented with COVID-19 pneumonia and developed pulmonary thromboembolism (PTE) in the year 2021. All patients selected for this study had a confirmed diagnosis of COVID-19 -either by SWAB-RT-PCR or by clinicalepidemiological diagnosis + imaging testsand a diagnosis of PTE within a period of up to 3 months after the date of hospitalization/ diagnosis. Results: the predominant age range among research participants was patients older than 60 years. There was a predominance of obesity (58.3%) and hypertension (50%) as the main comorbidities among patients in the selected group, followed by diabetes mellitus (41.6%). About 75% of the patients required intensive care and of these, 61.1% were admitted to the intensive care unit for a period of more than 10 days. Most study subjects were on prophylaxis with regular use of enoxaparin at a dose appropriate for their weight (79.2% of participants). Conclusion: there is an association between Covid-19 and the presence of coagulopathies, especially in the most critically ill patients.