ASIA and BIA-ALCL as adverse reactions to silicone breast implants

Adjuvant-induced autoimmune/inflammatory syndrome leads to capsular contracture and fibrosis from the oxidation that takes place in silicone. Anaplastic large cell lymphoma occurs through the development of a seroma, with the formation of a periprosthetic effusion, or through the infiltration of the condition itself. To analyze these conditions, a review of the literature was carried out on the symptoms and pathophysiology of the autoimmune/inflammatory syndrome induced by adjuvants and anaplastic large cell lymphoma, searched using the terms “ASIA breast silicone,” “Lymphoma,” “Adjuvants” “Immunologic” “ Breast Implants” on the PubMed platform. Analyzing the data obtained, it was noted that the symptoms of the autoimmune/inflammatory syndrome induced by adjuvants are nonspecific, such as fatigue, myalgia, arthralgia, morning stiffness, and night sweats, and therefore need attention. Anaplastic large cell lymphoma presents with breast pain, periprosthetic effusion, and palpable mass, among other characteristics. Because of these aspects, it is concluded that a good investigation should be carried out when nonspecific symptoms appear, regardless of the time the surgery was performed since these complications can occur years later

Clinical, Pathophysiological and Electrodiagnostic Aspects of Lambert-Eaton Myasthenic Syndrome

Lambert-Eaton myasthenic syndrome (LEMS) is characterized by an autoimmune disorder of the neuromuscular junction, which, through a reduction in nerve terminal acetylcholine release mediated by antibodies against functional voltage-gated calcium channels (VGCCs) of the P/Q in presynaptic nerve terminals, leads to proximal muscle weakness, in addition to autonomic dysfunction and areflexia, constituting the classic triad of symptoms. The syndrome presents itself in two forms: the paraneoplastic form—resulting mainly from small cell lung carcinoma—and the underlying autoimmune form. With clinical suspicion of the disease, the diagnosis can be made through serological and electrophysiological tests, which present typical findings and reflect the existence of a presynaptic transmission defect. Treatment is based on early screening and removal of the etiological agent, which in the most common case is the treatment of the underlying cancer. In patients whose symptoms affect their daily activities, some medications can intervene in the search for a better quality of life, such as amifampridine, pyridostigmine and 3,4-diaminopyridine (3,4-DAP). It must be remembered, however, that LEMS has a significant impact on the patient’s quality of life and ability to perform daily activities and therefore warrants timely diagnosis and adequate treatment in itself

Incidence of cardioembolic stroke related to atrial fibrillation in Joinville, Brazil

Background Atrial fibrillation (AF) is an important cause of cardioembolic stroke, and population aging has increased its prevalence. Objective To evaluate the incidence of cardioembolic stroke caused by AF in the city of Joinville, Brazil, as well as previous diagnoses and use of medication. Methods Between 2017 and 2020 we extracted data from the population-based Joinville Stroke Registry. Demographic characteristics, diagnosis of AF, and patterns of medication use were collected, and the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) system was used to classify the etiology. Results There were 3,303 cases of ischemic stroke, 593 of which were cardioembolic, and 360 had AF. Of the patients with AF, 258 (71.6%) had a previous diagnosis of the disease, and 102 (28.3%) were newly diagnosed after the stroke. Among patients with a previously-diagnosed AF, 170 (47.2%) were using anticoagulants, and 88 (24.4%) were using other medications. Conclusion During the analyzed period, ischemic stroke caused by AF was a significant burden on the population of Joinville, and a considerable number of patients had undiagnosed or untreated AF