Articles

Purpose: Real-time reverse-transcription polymerase chain reaction (RT-PCR)-based testing remains the gold standard for the diagnosis of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to the high diagnosis demand of SARS-CoV-2 and the limited resources for RT-PCR testing, especially in Low-Income Countries (LICs), antigen-based methods are being considered as an option. The aim of this study was to assess the performance of LumiraDx SARS-CoV-2 antigen assay for large population screening compared to RT-PCR.Methods: This evaluation was conducted on 4146 participants including travelers and participants under household survey and vaccine evaluation studies before injection of the first dose. Oropharyngeal and nasopharyngeal swaps were collected from each participant into 2 mL of viral transport medium (VTM) and 400 μl of VTM were used to assess the performance of LumiraDx SARS-CoV-2 antigen assay, compared to RT-PCR. Results: The prevalence of SARS-CoV-2 of the cohort was 4.5% with RT-PCR and 4.1% with LumiraDx antigen test. Compared to the RT-PCR, the sensitivity and specificity of the LumiraDx antigen SARS-CoV-2 test were 82,7% [95% CI 74.1-89,7] and 99.9% [95% CI 99.6-99.9] respectively. Given the RT-PCR threshold cycle (Ct) range, the sensitivity was 92.1% [95% CI 84.6-96.3] when the Ct value was below or equal 33 cycles, and 38.1% [95% CI 18.9-61.3] when it was above 33 cycles. The inter-rater reliability showed a kappa coefficient of 0.88 when considering all the patients and 0.94 for Ct values below 33 cycles. Conclusion: Our data have shown that the LumiraDx platform can be considered for large-scale testing of SARS-CoV-2.

Background and objectives: Brainstem gliomas are tumors of the central nervous system which have varying presentations and clinical courses. This study aims to analyze the frequency, clinical and therapeutic aspects of brainstem glioma.Methods: We retrospectively analyzed the data from the record of the patients treated for brainstem glioma under the age of 20 between January 2007 and July 2020 in the Radiation Oncology department of the Ibn Rochd UHC.Results: There were fifteen patients (10 males and 5 females). The mean age of onset was 12 years (range 8 - 14 years). The duration of symptoms varied from 1 month to 2 years. Nine of the patients had intracranial hypertension due to hydrocephalus, six had cranial nerve deficits at presentation, and five patients had cerebellar signs. The lesion was pontine in 12 cases. None of the patients had a tumoral resection, nine had a ventriculo-peritoneal shunt insertion for the hydrocephalus and three had a Stereotactic biopsy that revealed one astrocytoma grade 1, one low grade glioma and one glioblastoma. The radiotherapy was indicated in all the cases but only nine patients had a 3D radiotherapy with a total dose of 54 Gy. Three patients received chemotherapy. Six patients are still alive, two are lost to follow up and seven patients are dead with a mean survival period of 8 months.Conclusion: Brainstem glioma is a devastating disease with a bad prognosis. The clinical presentation is variable and the management is multidisciplinary. Our study illustrates the importance of treatment by radiation.

This article addresses, in an integrated way, the main aspects of the by-products obtained from sugarcane processing summarizing their most important and economic characteristics, their composition, and most relevant uses as options for industrial diversification, all taken as a review.

Brimonidine tartrate eye drops are a topical agent used to treat glaucoma in children over 2 years of age and adults. It is banned for children younger than 2 years of age because post-marketing studies have shown serious side effects. Colic is common in infants, which worries parents. And parents often use herbal and chemical medicines to solve this problem. We present a 12-day-old newborn with brimonidine eye drop intoxication, in which the drug was mistakenly administered orally to treat the colic problem.

Treatment options in multiple myeloma (MM) based on novel agents are often limited by dose-related neurotoxicity. Bortezomib, a highly active reversible proteasome inhibitor, frequently causes peripheral neuropathy (PN). Bortezomib-induced PN (BIPN) is characterized by a length-dependent, sensory, axonal polyneuropathy (PNP) with predominant small fiber-affection. Following dose reduction or drug discontinuation, BIPN resolves within 3-4 months in the majority of patients. The pathophysiological mechanisms of BIPN are unclear. Rare cases of a severe demyelinating or mixed BIPN with prominent motor involvement have been attributed to autoimmune or inflammatory reactions. A case report, including nerve pathology, is presented of a 59-year-old man with stage III IgG-κ MM who was treated with bortezomib on the occurrence of progressive disease. After the fourth cycle, he developed a painful distal symmetric sensory PNP followed by gait instability and muscle weakness increasing over 3 months despite early cessation of bortezomib.Neurological examination revealed a distal flaccid tetraparesis mainly of the lower limbs with sensory loss and severe ataxia, electrophysiological features of a mixed axonal-demyelinating PNP, and pathomorphological evidence of neuritis. Steroid treatment was initiated, and partial recovery of the neurological symptoms within 6 months was observed. While a neurotoxic effect may explain the initial distal sensory disturbances, the worsening of neurological dysfunction after bortezomib withdrawal and the clinical pattern with steroid-responsive muscle weakness predominantly of the legs are consistent with an immune-mediated mechanism. This is in line with the sural nerve biopsy findings. Toxic BIPN followed by an immune-mediated BIPN in the same patient has not been reported before.

Purpose: To evaluate the presentation and outcome of periocular capillary hemangioma treated with low-dose oral propranolol.Method: Thirty cases of periocular capillary hemangioma prospectively studied from 1st June 2015 to 31st May 2017 who received oral propranolol on an outpatient basis. Hemangioma causing any threat to vision or disfigurement was included and age below 3 months and multiple lesions were excluded. Starting dose of propranolol was 1 mg/kg and increased to 2 mg/kg after 2 weeks as a maintenance dose. The tapering dose was 1 mg/kg of body weight before discontinuing the medication. Treatment was continued till the child is 1 year of age or no further change in color or size of the lesion in two successive follow-ups. Results: Presenting age was 6.36 ± 3.36 months (ranged 3–24 months) with female predominance (70%). In 86.6% of cases, the vision was Central Steady and Maintained and cycloplegic refraction showed marked astigmatism in 3 children which resolved after treatment. Forty-six percent of children showed color change as an initial response to treatment. Most children (33.3%) responded completely within 5 months after starting the treatment. One third patients (33.3%) showed 100% resolution, 50% showed 90% to 70% resolution. Pretreatment and post-treatment lesion size was1.60 ± 0.86 cm2 and 0.30 ± 0.40 cm2 respectively (p - value < 0.0005). None showed any significant adverse effect of oral propranolol.Conclusion: Low-dose oral propranolol is an effective and cost-effective treatment modality for periocular capillary hemangioma and is safe as an outpatient basis. 

A 69-year-old man presented with a one-month history of a painful mass in the right breast. Pathologic evaluation of the excision of the mass revealed a proliferation of both glandular and stromal elements consistent with gynecomastia. In addition, histologic examination revealed peripheral nerves in the deep portion of the specimen were entrapped in the proliferative changes associated with gynecomastia. It is proposed that the expansile proliferation led to compressive pressure on the nerves and caused the pain associated with gynecomastia.

The article shows that the current level of physiology does not disclose the biological mechanisms of the organism’s transition from one range to adapt to a higher one with an increase in the regular forces of the stimulus above sub-extreme. A new trend in the physiology of adaptation - proqredient adaptation, explains the mechanism of increasing the tolerance of the organism, with dependence on psychoactive substances (PAS). Scientific has reasonably shown that depending on the organism from PAS - not the disease, and the states like proqredient adaptation.

Cancer, as a disease, has found a place in the social imaginary. Individuals construct ideas based on pre-established discourses—be they medical, media, or popular—which often hinder its prevention. Educational interventions have tended to focus on spreading information about the disease, ignoring its social connotations. The objective of the present study is to investigate the concept of cancer prevention in 980 adolescents, aged between 12 and 18 years, attending primary and secondary school in three public schools and one private school in the metropolitan region of São Paulo and the municipality of Dom Viçoso, Minas Gerais. The notion of prevention implies the dominant feeling of performing medical examinations from a symptom, against the idea of preventing, even when there is no clinical manifestation of the body. The majority of students emphasize the advantages of early diagnosis and that the decisive factor for the cure corresponds to the moment of detection: "cancer must be discovered in time". This is a solid belief within the body of knowledge about the disease that can be used as a starting point in prevention messages.However, even when the importance of early detection of cancer is understood as an essential element for its cure, care practices do not accompany the set of principles that regulate prevention or its demands.

Pseudofungus structures in lymph node tissues have been reported on multiple occasions. Despite a variety of investigative tests including histochemical special stains and energy dispersive spectral analysis, the underlying nature and origin of these pseudofungus structures has never been clearly defined. The most common hypothesis suggests that they represent collagen fibers that become coated with iron and calcium. Herein, evidence is given that the pseudofungus structures identified in the lymph node tissues represent fragments of polyurethane catheters. The evidence includes both a comparison of these pseudofungus structures to fragments of polyurethane well documented in the literature and a comparison of polyurethane catheter scrapings to the pseudofungus structures identified in the literature. In both of these comparisons, the morphology of the polyurethane fragments are identical to the pseudofungus structures. This is the first definitive report identifying polyurethane catheter fragments as representing the true nature and etiology of pseudofungus structures in lymph node tissues.