Angiomyolipomas (AMLs) are the most common benign renal tumours. Most of these neoplasms are found incidentally on imaging. However, symptomatic presentation does exist.Renal AMLs are typically composed of smooth muscle, blood vessels, and adipose tissue. Because of the abundant fat tissue, they give a characteristic appearance on imaging and are therefore easily diagnosed. However, sometimes they contain too little fat to be detected. This increases the difficulty in differentiating them from renal cell carcinoma (RCC).Management of AML is based on clinical presentation and should be individualized for every patient. Treatment modalities range from active surveillance to more invasive approaches.

BackgroundLong-term outcome data of COVID-19 survivors are needed to understand their recovery trajectory and additional care needs.MethodsA prospective observational multi-centre cohort including adults hospitalised with COVID-19 from March through May 2020. Work-up at 3 and 12 months following admission consisted of clinical review, pulmonary function testing, 6-min walking distance (6MWD), muscle strength, chest computed tomography (CT), and quality of life questionnaires. We evaluated factors correlating with recovery by linear mixed effects modelling.ResultsOf 695 patients admitted, 299 and 226 returned at 3 and 12 months, respectively (median age 59 years, 69% male, 31% severe disease). About 1/2 and 1/3 reported fatigue, dyspnoea and/or cognitive impairment at 3 and 12 months, respectively. Reduced 6MWD and quadriceps strength were present in 20% and 60% at 3 months versus 7% and 30% at 12 months. A high anxiety score and body mass index correlated with poor functional recovery. At 3 months, diffusing capacity for carbon monoxide (DLCO) and total lung capacity were below the lower limit of normal in 35% and 18%, decreasing to 21% and 16% at 12 months; predictors of poor DLCO recovery were female sex, pre-existing lung disease, smoking, and disease severity. Chest CT improved over time; 10% presented non-progressive fibrotic changes at 1 year.ConclusionMany COVID-19 survivors, especially with severe disease, experienced limitations at 3 months. At 1 year, the majority showed improvement to almost complete recovery. To timely identify additional care or rehabilitation needs, we recommend a multidisciplinary follow-up visit following COVID-19 admission.

Summary In 214 cases of severe dystocia in mares, of which 141 (66 per cent) were Draught horses, deviation of the head and neck, with or without torticollis, malformed head and limbs were found to be the cause of dystocia. No evidence of a genetic lethal factor was found and torticollis was often combined with scoliosis of the head and, frequently, with malformation of one or more limbs. This is considered evidence of a common aetiology and pathogenesis of the syndrome of malformation. The malformations were found to be associated with an increased incidence of caudal and, particularly, transverse presentations. These findings are presented as evidence to support the hypothesis that, during the second half of pregnancy, the narrow tip of the uterine horns provides only limited space for the developing cranial half of the foetus. The surprisingly rapid and complete anatomical and functional recovery of severe malformations of the bones of the neck, head and limbs of surviving foals, born by caesarian section, is taken as further evidence that these malformations have no genetic basis, but originate from unfavourable intrauterine conditions.

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