Electromyoneurography and laboratory findings in a case of Guillain-Barré syndrome after second dose of Pfizer COVID-19 vaccine

Guillain-Barre syndrome (GBS) is an acute immune-mediated disease of the peripheral nerves and nerve roots (polyradiculoneuropathy) that is usually elicited by various infections. We present a case of GBS after receiving the second dose of Pfizer-COVID 19 vaccine. Diagnosis was made after performing an accurate clinical examination, electromyoneurography and laboratory tests. In particular, anti-ganglioside antibo-dies have tested positive. During this pandemic with ongoing worldwide mass vaccination campaign, it is critically important for clinicians to rapidly recognize neurological complications or other side effects associated with COVID-19 vaccinatio

Multiple sites of thrombosis without thrombocytopenia after a second dose of Pfizer-BioNTech COVID-19 vaccine

In the current international scientific panorama, rare cases of venous thrombotic complications following mRNA vaccine administration have been reported, consisting mainly of cerebral sinus thromboses and acute venous thromboembolism. The present paper describes the case of a 75-year-old woman in good health who developed cerebral venous thrombosis, deep venous thrombosis, and bilateral pulmonary emboli after receiving a second dose of Pfizer-BioNTech COVID-19 vaccine. A series of laboratory tests performed during hospitalization yielded interesting results, allowing us to exclude thrombophilic risk factors and to certify the absence of thrombocytopenia in the patient. Although COVID-19 vaccination is the most important tool in stopping the pandemic, pharmacovigilance is crucial for detecting potential multisystem thrombotic events, even for mRNA vaccines

Improving Medical Research in the United Kingdom

Peer reviewedPublisher PD

Honorarios odontologicos : aspectos eticos, legais e economicos

Orientador: Ivana Aparecida GilDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O presente estudo tem por objetivo racionalizar os procedimentos dos trabalhos do Cirurgião Dentista no sentido de concientizar o mesmo sobre o valor a ser cobrado para cada ato operatório realizado em seu consultório. Tem por finalidade orientar estes profissionais sob a realidade de seus custos e lhes permitir um ganho real pré determinado. Foram considerados os principais critérios do código de ética odontológico e da Lei Civil para se estimar o ganho real pré determinando que um Cirurgião Dentista deve alcançar. Para atingir esses objetivos, o profissional deve, inicialmente, levar em consideração os seguintes itens: 1. Deve Conhecer seus custos (fixos e variáveis, diretos e indiretos) e aplicá-Ios em uma fórmula pré determinada. 2. Avaliar o peso de cada ítem que compõe tabela de preços em odontologia, 3. Mostrar como, mesmo mantendo o preço final inalterável, aumentar a margem de ganho real, 4. Mostrar que ítens devem ser alterados para chegar a preços pré determinados. Desta forma o presente trabalho, foi dividido didaticamente em 10 passos, para que um profissional, mesmo sem formação em economia ou pouco afeito a números, possa facilmente avaliar detalhadamente os custos fixos e variáveis, diretores e indiretos, e aplicar numa formula para calcular o seu ganho real pré determinadoAbstract: The present study has by objective to rationalize the conducts of the Dentist Surgeon's works to become conscious himself about to value to be charge to each operated act made in his surgery. It has by concludes to guide these professional about the reality of his cost and to permit them a gain before. They were considered the main criterions of the dentist ethics code and curl law to appreciate the real gain before that an Dentist Surgeon must obtain. To attain these objectives, the professional must initialIy, to take into account the following item: 1. To know his costs (permanent and variable, direct and indirect) and to apply them in this formula before. 2. To value the importance of each item that consists of the price- list in dentistry. 3. To demonstrate like to increase the along side of real gain, same keeping the final unaltered price. 4. To demonstrate that item must be altered to reach to prices before. Of this the present work was divided didacticly on ten steps, in order to the professional, same without training in Economics or few accustomed to numbers he can value easily and detailly the permanent and variable direct and indirect costs and to apply in the formula to calculate his real gain beforeMestradoOdontologia Legal e DeontologiaMestre em Ciência

La desigualdad detrás de las cámaras: análisis de las producciones cinematográficas de Netflix y Amazon Prime Video (2017-2021)

La mujer siempre se ha encontrado bajo la sombra del hombre, pero la evolución de la sociedad le ha permitido salir de ella y dejarse ver en cualquier ámbito laboral, o eso es lo que se piensa actualmente. Con este Trabajo de Fin de Grado se quiere observar y analizar si la presencia femenina, dentro del mundo cinematográfico, sigue estando bajo el techo de cristal, es decir, ligada al departamento de maquillaje, peluquería y vestuario, o ha conseguido hacerse un hueco en los cargos de mayor responsabilidad. Para ello, se realizó un análisis cualitativo de las 50 películas más vistas, desde 2017 hasta mayo de 2021, de las dos plataformas de streaming con más seguidores: Netflix y Amazon Prime Video. Además, se realizó una encuesta, dirigida a la sociedad, para comprobar que la mayoría de las personas que respondieron a la encuesta sí creen que la mujer se encuentra bajo el techo de cristal, piensan que es menos conocida en el mundo cinematográfico y que no tiene la misma facilidad a la hora de optar a presupuestos más altos.Women have always lived under men's shadow, but society's evolution has allowed them to get out of it and can now be seen in any kind of workplace, at least thats what we think nowadays. This final degree project's objective is to observe and analyse that if women presence, inside the film industry, is still under the glass ceiling, that is, bound to the make up, hairstyle, and clothing department, or if it has made it's way into a more important position. Therefore, a qualitative analysis was made about the 50 most watched films, from 2017 until May 2021, on the two streaming platforms with the most followers: Netflix and Amazon Prime Video. Furthermore, a survey was conducted, aimed towards society, to verify that the majority of people who answered the survey do think that women that are under the glass ceiling, are less known in the film industry and that they don't have as much ease when it comes to having higher budgets.Departamento de Historia Moderna, Contemporánea y de América, Periodismo y Comunicación Audiovisual y PublicidadGrado en Periodism

Expressão de claudina, paxilina e FRA-1 em lesões mamárias não nodulares associadas a microcalcificações

CONTEXT AND OBJECTIVE The possible role of adhesion molecules in early breast carcinogenesis has been shown in the literature. We aimed to analyze early adhesion imbalances in non-nodular breast lesions and their association with precursor lesions, in order to ascertain whether these alterations exist and contribute towards early carcinogenesis. DESIGN AND SETTING Retrospective cross-sectional study based on medical records at a private radiological clinic in São Paulo, Brazil. METHODS We retrospectively reviewed the medical records of all consecutive women attended between August 2006 and July 2007 who presented mammographic evidence of breast microcalcifications classified as Breast Imaging Reporting and Data System Atlas (BI-RADS) type 4. These women underwent stereotaxic biopsy. Clinical, radiological and pathological data were collected, and immunohistochemical assays searched for claudin, paxillin, FRA-1 and HER-2. RESULTS Over this period, 127 patients were evaluated. Previous BI-RADS diagnoses showed that 69 cases were in category 4A, 47 in 4B and 11 in 4C. Morphological assessment showed benign entities in 86.5%. Most of the benign lesions showed preserved claudin expression, associated with paxillin (P < 0.001). Paxillin and HER-2 expressions were correlated. FRA-1 expression was also strongly associated with HER-2 expression (P < 0.001). CONCLUSIONS Although already present in smaller amounts, imbalance of adhesion molecules is not necessarily prevalent in non-nodular breast lesions. Since FRA-1 expression reached statistically significant correlations with radiological and morphological diagnoses and HER-2 status, it may have a predictive role in this setting.CONTEXTO E OBJETIVO A literatura tem mostrado a importância de moléculas de adesão na carcinogênese precoce de mama. Objetivamos analisar desequilíbrios precoces de adesão em lesões não nodulares da mama e associação com lesões precursoras, a fim de verificar se essas alterações existem e contribuem com a carcinogênese. TIPO DE ESTUDO E LOCAL Estudo retrospectivo baseado em prontuários médicos, numa clínica radiológica privada em São Paulo, Brasil. MÉTODOS Revisamos retrospectivamente prontuários de todas as mulheres consecutivamente atendidas com evidência mamográfica de microcalcificações mamárias, classificadas como tipo 4 do Breast Imaging Reporting and Data System Atlas (BI-RADS) entre agosto de 2006 e julho de 2007. Elas foram submetidas a biópsia estereotáxica. Dados clínicos, radiológicos e histopatológicos foram coletados e ensaios de imunoistoquímica procuraram por claudina, paxilina, HER-2 e FRA-1. RESULTADOS No período, 127 pacientes foram avaliadas. Diagnósticos de BI-RADS anteriores tinham 69 casos na categoria 4A, 47 em 4B, e 11 em 4C. A avaliação morfológica mostrou entidades benignas em 86,5%. A maioria das lesões benignas mostrou expressão preservada de claudina, associada a paxilina (P < 0,001). Expressões de paxilina e HER-2 foram correlacionadas. Expressão de FRA-1 associou-se à de HER-2 (P < 0,001). CONCLUSÕES Embora já presente em menor quantidade, o desequilíbrio de moléculas de adesão não é necessariamente prevalente em lesões mamárias nodulares e talvez a expressão de FRA-1 possa ter um papel preditivo neste cenário, uma vez que atingiu correlações estatisticamente significativas com o diagnóstico radiológico e morfológico e com o status de HER-2.Universidade Federal de São Paulo (UNIFESP) Researcher in the Department of Morphology Department in CURA LaboratoryUniversidade Federal de São Paulo (UNIFESP) Department of PathologyUniversidade Federal de São Paulo (UNIFESP) Department of RadiologyUniversidade Federal de São Paulo (UNIFESP) Department of MorphologyUNIFESP, Researcher in the Department of Morphology Department in CURA LaboratoryUNIFESP, Department of PathologyUNIFESP, Department of RadiologyUNIFESP, Department of MorphologySciEL

Immunoglobulin Treatment in Polymyositis and Dermatomyositis

Polymyositis (PM) and dermatomyositis (DM) are systemic autoimmune diseases of unknown aetiology in which the skeletal muscles are the main targets. Despite the improvement obtained in the last years with new therapeutic options, their prognosis remains poor, with higher rates of morbidity and mortality. Due to the rarity of the disease, few well-designed studies have been published and, to the best of our knowledge, only five randomised controlled trials. The low incidence of the disease, the characteristic relapsing/remitting or chronic and persistently active course, the lack of agreed standardised criteria for diagnosis and for assessment of disease activity makes difficult to carry and to compare studies. Among the treatment options, the use of intravenous immunoglobulin (IVIg) is still matter of debate. In this chapter we describe the use of IVIg in PM and DM, revising the literature and reporting our experience. We analyse our series of 74 subjects with PM or DM diagnosed according to the Bohan and Peter criteria. Usually, IVIg is given in case of refractory or relapsed disease, steroid resistance or dependency. In a previous revision of our data related to 63 patients, we documented that subjects treated with IVIg achieve a clinical and functional remission in a high percentage of cases, that is maintained at long follow-up period (a mean of five years), as compared to control group. The revision of the literature and our data confirm that IVIg is effective alone or as add on therapy in the treatment of inflammatory myopathies, even in refractory or relapsed disease. Most of the patients with PM or DM receive an immunosuppressant such as cyclosporine A (CSA) or mycophenolate mofetil (MMF). We want to verify if the use of IVIg as add-on treatment with CSA or MMF could improve the outcome or could reduce the rate of side effects that are usually linked to the immunosuppressant. We thus revise the literature and our data related to the use of CSA and MMF in PM or DM. The subcutaneous administration (SCIg) could be considered as an alternative to IVIg. In primary immunodeficiency, SCIg has been demonstrated to be linked to a lower incidence of adverse reactions, with reliable efficacy and improvement of the quality of life of treated subjects. We have been the first to publish about a series of seven patients with autoimmune myopathies treated with SCIg. We could document the feasibility and the good tolerance of SCIg, with relevant improvement of the clinical and laboratory features. We here present data related to a larger series. Finally, we review the data related to the mechanisms of action of immunoglobulin administration in autoimmune mediated diseases, in particular underlying the different proposed mechanism of IVIg and SCIg