Diffuse skin rash in tropical areas: Dengue fever or COVID-19? Pastor Bandeira, Isabelle; Sordi Chara, Beatriz; Meneguzzi de Carvalho, Giovani ...
Anais brasileiros de dermatologia/Anais Brasileiros de Dermatologia,
01/2021, Letnik:
96, Številka:
1
Journal Article
Recenzirano
Odprti dostop
There have been several clinical manifestations associated with SARS-CoV-2 infection since 2019, including dermatological signs and symptoms. In this article, the authors report a case of a ...previously healthy patient with COVID-19 who was mistakenly diagnosed with dengue fever due to a skin rash. By the time the patient's investigation was initiated, Joinville (Santa Catarina, Brazil) had approximately 5,000 confirmed cases of dengue fever and 1,700 cases of COVID-19 in 2020. Thus, the authors emphasize that in endemic regions such as Brazil, the two diseases must be considered until proven otherwise. Finally, the authors warn of the possibility of co-infection with these two viruses in regions that are facing both epidemics at the same time.
MicroRNAs (miRNAs) are a family of non-translated small ribonucleic acids (RNAs) measuring 21–25 nucleotides in length that play various roles in multiple sclerosis (MS). By regulating gene ...expression via either mediating translational repression or cleavage of the target RNA, miRNAs can alter the expression of transcripts in different cells, such as B lymphocytes, also known as B cells. They are crucial in the pathogenesis of MS; however, they have not been extensively studied during the treatment of some drugs such as natalizumab (NTZ). NTZ is a humanized immunoglobulin G4 antibody antagonist for integrin alpha 4 (α4) used in the treatment of MS. The drug reduces the homing of lymphocytes to inflammation sites. Integrin α4 expression on the cell surface of B cells is related to MS severity, indicating a critical component in the pathogenesis of the disease. NTZ plays an important role in modifying the gene expression in B cells and the levels of miRNAs in the treatment of MS. In this review, we have described changes in gene expression in B cells and the levels of miRNAs during NTZ therapy in MS and its relapse. Studies using the experimental autoimmune encephalomyelitis (EAE) model and those involving patients with MS have described changes in the levels of microRNAs in the regulation of proteins affected by specific miRNAs, gene expression in B cells, and certain functions of B cells as well as their subpopulations. Therefore, there is a possibility that some miRNAs could be studied at different stages of MS during NTZ treatment, and these specific miRNAs can be tested as markers of therapeutic response to this drug in future studies. Physiopathology, gene expression in B cells and their subpopulations can help understand this complex puzzle involving miRNAs and the therapeutic response of patients with MS.
MicroRNA; Natalizumab; Multiple sclerosis; B lymphocyte; Therapy.
Dissection of cervical arteries constitutes a medical emergency. Although relatively rarely, activities classified as sports and recreation may be a cause of arterial dissection independently of neck ...or head trauma. The purpose of the present paper was to present a series of cases of cerebrum-cervical arterial dissection in individuals during or soon after the practice of these sports activities.
Retrospective data on patients with arterial dissection related to sports and recreation.
Forty-one cases were identified. The most frequently affected vessel was the vertebral artery. A large variety of activities had a temporal relationship to arterial dissection, and jogging was the most frequent of these. This is the largest case series in the literature.
Arterial dissection may be a complication from practicing sports.
The treatment of multiple sclerosis (MS) with disease-modifying-drugs (DMDs) is evolving and new drugs are reaching the market. Efficacy and safety aspects of the drugs are crucial, but the patients' ...satisfaction with the treatment must be taken into consideration.
Individual interview with patients with MS regarding their satisfaction and points of view on the treatment with DMDs.
One hundred and twenty eight patients attending specialized MS Units in five different cities were interviewed. Over 80% of patients were very satisfied with the drugs in use regarding convenience and perceived benefits. The only aspect scoring lesser values was tolerability.
Parameters for improving treatment in MS must include efficacy, safety, and patient satisfaction with the given DMD.
Series of cases collected from Brazilian centers.
We studied 13 cases of patients presenting with progressive histories of neurological dysfunction caused by SS-CNS. The most frequent clinical ...findings in these patients were progressive gait ataxia, hearing loss, hyperreflexia and cognitive dysfunction. The diagnoses of SS-CNS were made seven months to 30 years after the disease onset.
SS-CNS is a rare disease that may remain undiagnosed for long periods. Awareness of this condition is essential for the clinician.
Treatment options for multiple sclerosis (MS) have changed over the last few years, bringing about a new category of drugs with more efficient profiles. However, these drugs have come with a whole ...new profile of potential adverse events that neurologists have to learn well and quickly. One of the most feared complications of these MS treatments is progressive multifocal leukoencephalopathy caused by the reactivation of the John Cunningham virus (JCV).
To identify the serologic profile of JCV in patients with MS.
Data on serum antibodies for JCV were obtained using the enzyme-linked immunosorbent assay provided by the STRATIFY-JCV program.
A total of 1,501 blood tests were obtained from 1,102 patients with MS. There were 633 patients (57.1%) who were positive for antibodies for JCV and 469 patients who were negative (42.9%). Twenty-three patients became positive after initially having negative JCV antibody status. The rate of seroconversion was 18.5% over 22 months.
The JCV serologic profile and seroconversion in Brazilian patients were similar to those described in other countries.
The recently emerged coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causal agent of COVID-19, is the newest threat to human health. It has already infected more ...than 54.5 million people worldwide, currently leading to more than 1.3 million deaths. Although it causes a mild flu-like disease in most patients, lethality may increase to more than 20% in elderly subjects, especially in those with comorbidities, like hypertension, diabetes, or lung and cardiac disease, and the mechanisms are still elusive. Common symptoms at the onset of illness are fever, cough, myalgia or fatigue, headache, and diarrhea or constipation. Interestingly, respiratory viruses have also placed themselves as relevant agents for central nervous system (CNS) pathologies. Conversely, SARS-CoV-2 has already been detected in the cerebrospinal fluid. Here, we discuss several clinical features related to CNS infection during COVID-19. Patients may progress from headaches and migraines to encephalitis, stroke, and seizures with leptomeningitis. However, the pathway used by the virus to reach the brain is still unknown. It may infect the olfactory bulb by retrograde neuronal transportation from olfactory epithelium, or it could be transported by the blood. Either way, neurological complications of COVID-19 add greatly to the complex pathophysiology of the disease. Neurological signs and symptoms must alert physicians not only to worst outcomes but also to future possible degenerative diseases.
Multiple Sclerosis (MS) is a chronic, autoimmune, demyelinating disease of the central nervous system (CNS). Currently, several protocols are described for the different phases of MS. In this ...longitudinal study, we aim to quantify the concentration of plasma cytokines of MS patients treated with Fingolimod alone or after Glatiramer Acetate (GA) or Interferon-beta (IFN-β), in order to compeer both treatments and describes if it is possible to use them as biomarkers.
Compare the two different types of drug treatment and describes possible immune biomarkers in RRMS patients treated with Fingolimod alone or after GA or IFN-β.
This is a controlled, non-randomized clinical trial. Plasma concentrations of IL-31, sCD40L and nine others cytokines were evaluated in two groups of patients with a one-year follow-up. Group 1 (n = 12): RRMS patients treated with GA or IFN-β for at least six months before the study who changed therapy to Fingolimod after six months, and Group 2 (n = 12): naïve RRMS patients who started treatment with Fingolimod. We used ANOVA two-way to analyze the cytokines and Spearman coefficient to evaluate the correlation.
Although Group 2 started with a greater number of relapses per disease duration, Fingolimod treatment was effective in decreasing this parameter, as well as EDSS over 12 months. However, the treatment with GA or IFN-β on Group 1 showed a tendency to increase the number of relapses after 6 months of follow-up, which decrease when the therapy was changed to Fingolimod. After the evaluation of 11 cytokines in one year, we found that IL-31 and sCD40L were the biomarkers that demonstrated a more difference when compared to the classical ones, following the clinical pattern over the treatment period.
Our study describes the existence of two promising plasmatic biomarkers (IL-31 and sCD40L), which reduced plasmatic levels in RRMS patients followed the treatment time of Fingolimod, despite that more studies are needed to prove their efficiency.
•This is a controlled, non-randomized clinical trial. A longitudinal study for twelve months, compare between two different types of drug treatment.•A longitudinal follow-up of eleven plasma cytokines were evaluated in two groups of patients. Group 1: RRMS patients treated with GA or IFN-β who changed therapy to Fingolimod after six months, and Group 2: naïve RRMS patients who started treatment with Fingolimod.•After the evaluation of one year, we found that IL-31 and sCD40L were the biomarkers that demonstrated a more difference when compared to the classical ones.•Plasma concentrations of IL-31 and sCD40L, which reduced plasmatic levels in RRMS patients followed the treatment time of Fingolimod, despite that more studies are needed to prove their efficiency.
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