Amiloidose AL em um adulto jovem: remissão clínica e laboratorial com transplante autólogo de células tronco

Transplante autólogo de células tronco é uma das formas de tratamento da amiloidose primária ou AL. Os autores relatam um paciente de 46 anos com hematomas periorbitais bilaterais, macroglossia, em quem, na investigação, se constatou a presença de paraproteínas IgG Kappa no soro. O diagnóstico de amiloidose primária ou AL foi confirmado, e o tratamento proposto com condicionamento com doses altas de Melfalan, seguido de transplante autólogo de células tronco, determinou a remissão completa da doença com desaparecimento de sinais clínicos e ausência do componente monoclonal

Mobility restrictions during the COVID-19 pandemic and reduced outpatient HIV and syphilis testing in Brazil

Background: In the initial phases of the COVID-19 pandemic, strategies adopted to reduce the dissemination of SARS-CoV-2 relied on non-pharmacological interventions, including physical distancing. Mobility restrictions affected the availability and quality of care for many health conditions, including sexually transmitted infections. Objective: To investigate the impact of the COVID-19 pandemic mobility restriction on syphilis and HIV testing in outpatient settings. Methods: In this study, we collected the weekly number of syphilis and HIV tests performed in a referent laboratory in São Paulo, Brazil, as well as the percentage of positive tests between January 2019 and December 2021. We also retrieved data on retail and recreation mobility in São Paulo city using Google COVID-19 Community Mobility Reports. We explored the association between populational mobility and the number of weekly tests and the association between the number of weekly tests and the percentage of positive results during the pandemic period. The analyses were conducted separately for syphilis and HIV tests. Results: We found that mobility restrictions during the COVID-19 pandemic have been associated with a significant decrease in both syphilis and HIV tests performed in outpatient settings. We also observed that the number of tests performed was inversely associated with the percentage of positive results for syphilis; this association was also apparent for HIV tests in the first wave of the pandemic in the graphic analysis. Conclusion: Taken together, our findings suggest an indirect impact of COVID-19 pandemic-related mobility restrictions on the uptake of diagnostic tests for HIV and syphilis and the potential adoption of targeted-testing strategies. Understanding the extent and complexity of COVID-19 aftermaths on specific conditions and communities is essential to build strategies to mitigate the long-term consequences of COVID-19

Anti-C1q, anti-chromatin/nucleosome, and anti-dsDNA antibodies in juvenile systemic lupus erythematosus patients

OBJETIVO: Avaliar a presença de anticorpos anti-C1q, anticromatina/nucleossomo e anti-DNA de duplo filamento (dsDNA) em pacientes com lúpus eritematoso sistêmico juvenil (LESJ) e controles. MÉTODOS: Foram analisados 67 pacientes com LESJ e 34 controles saudáveis para presença de anticorpos anti-C1q, anticromatina/nucleossomo e anti-dsDNA pelo método ELISA. Os níveis de C1q foram avaliados por imunodifusão radial. RESULTADOS: Na época, a média de idade era similar entre os pacientes com LESJ e os controles (14,6 ± 3,86 vs. 13,6 ± 2,93 anos; P = 0,14). Foram observadas frequências mais altas de anticorpos anti-C1q, anticromatina/nucleossomo e anti-dsDNA em pacientes com LESJ em relação aos controles (20% vs. 0%; P = 0,0037; 48% vs. 0%; P < 0,0001 e 69% vs. 3%; P < 0,0001, respectivamente). A mediana dos anticorpos anti-C1q, anticromatina/nucleossomo e anti-dsDNA também foi significativamente mais alta em pacientes com LESJ em relação aos controles [9,6 (5,5-127) vs. 7,5 (5-20) unidades, P = 0,0006; 18 (1,9-212) vs. 3,2 (1,7-17) unidades, P < 0,0001; e 111 UI/mL (6-741) vs. 14 (6-33) UI/mL, P < 0,0001, respectivamente]. A sensibilidade para os anticorpos anti-C1q, anticromatina/nucleossomo e anti-dsDNA foi: 21% (IC: 11-33), 49% (IC: 36-62) e 70% (IC: 57-81). A especificidade foi de 100% (IC: 88-100), 100% (88-100) e 97% (IC: 83-99), respectivamente. Foi observada uma correlação positiva entre os níveis de anti-dsDNA e tanto anticorpos anti-C1q (r = 0,51; IC: 0,29-0,68; P < 0,0001) como anticromatina/nucleossomo (r = 0,87; IC: 0,79-0,92; P < 0,0001). Foi observada uma correlação negativa entre os níveis de anti-C1q e C1q (r = -0,33; IC: -0,56-0,05; P = 0,018). A frequência de anti-dsDNA foi mais alta em pacientes com SLEDAI-2K &gt; 1 (P = 0,0047), e não foram observadas diferenças nas frequências desses três autoanticorpos e nefrite (P &gt; 0,05). CONCLUSÃO: Nosso estudo demonstrou elevada especificidade para diagnóstico de lúpus envolvendo os três autoanticorpos, especialmente anti-C1q e anticromatina/nucleossomo

Seasonal fluctuation of soil carbon dioxide emission in differently managed pastures

Soil carbon dioxide emission (ECO2) is a process determined by biotic and abiotic factors influenced by land use and management practices. In grassland ecosystems, grazing intensity may affect C input from plants into soil, and thus may also change soil respiration rate. Indeed, limited information is available regarding the effects of grazing management on ECO2. This study was conducted to evaluate ECO2 seasonal variation, and its relationship to soil temperature (Tsoil) and precipitation, in an area with different pasture heights of Marandu palisade grass [Brachiaria brizantha (A. Rich.) Stapf.]. The pasture heights (15, 25, and 35 cm) were distributed in a completely randomized design with 12 repetitions in each area. The evaluations of ECO2 and Tsoil occurred from January 2011 to February 2013, totaling 73 d of observation that were distributed according to climatic seasons. The results showed that seasonal variation of ECO2 was directly related to variations in precipitation and Tsoil. Soil CO2 emission was higher in summer and lower in winter. The data variability of ECO2 was higher in rainy, hot summers than in dry, cold winters. A positive linear association between ECO2 and Tsoil was observed in summer and autumn. In most seasons measured, ECO2 reduced with increasing pasture height. Accordingly, 2-yr data indicated that accumulated ECO2 decreased with increasing pasture height. Thus to better understand the effect of pasture height on ECO2, a shorter period of measurements is not suitable since a different result was observed in the first year of evaluation.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES

Anti-C1q, anti-chromatin/nucleosome, and anti-dsDNA antibodies in juvenile systemic lupus erythematosus patients (vol 52, pg 971, 2012)

HCFMUSP, Sao Paulo, BrazilHosp Abreu Sodre AACD, Sao Paulo, BrazilHosp Israelita Albert Einstein, Sao Paulo, BrazilHC FMUSP, Dept Pediat, Sao Paulo, BrazilHC FMUSP, Pediat Rheumatol Unit, Sao Paulo, BrazilWeb of Scienc