Seroconversion of JCV antibodies is strongly associated to natalizumab therapy.

Previous infection with John Cunningham virus (JCV) increases the risk of progressive multifocal leukoencephalopathy in patients with multiple sclerosis (MS) undergoing treatment with natalizumab. Patients who test negative for JCV antibodies must be assessed every six months due to the risk of seroconversion. Data from the United States of America, Portugal, Holland, France, United Kingdom and Sweden have shown a strong correlation between the use of natalizumab and JCV seroconversion. The authors present now data on patients from Brazil, as there are no data from Latin American countries published on this subject yet. A group of 86 patients with MS with negative results for antibodies against JCV were included in this analyses with at least two JCV antibodies testing. Twenty-five patients (29% of the total group) did not use natalizumab at any time, while the remaining 71% used natalizumab for a median period of 800 days (equivalent to 28 monthly infusions). Seroconversion was observed in 19 patients (22.1%). There was no association of seroconversion with gender, age, previous pulses of corticosteroid or specific MS-modifying drugs. The use of natalizumab was strongly associated to seroconversion (p < 0.0001). The present results confirm the influence of natalizumab therapy on JCV antibodies in several countries and continents.

Comparative study of the nutritional status of vitamin A in pregnant women and in women who became pregnant or did not after Roux-en-Y gastric bypass / Estudio comparativo del estado nutricional de la vitamina A en mujeres embarazadas y en mujeres que quedaron embarazadas o no tras el bypass gástrico en Y de Roux

Introduction: the changes in digestive physiology after Roux-en-Y gastric bypass (RYGB), as well as pregnancy, maximizes the risk of vitamin A deficiency (VAD) and both can result in harm to the mother and child health. Objective: to compare the nutritional status of vitamin A among women who became pregnant or did not after RYGB and in pregnant women who did not undergo surgery, and to assess the impact of VAD on the mother and child health. Methods: this is a cross-sectional study of the analytical type. The women were divided into: group 1 (G1) with 80 pregnant women; group 2 (G2) with 40 pregnant women who had previously undergone RYGB, both in their third trimester of pregnancy; and group 3 (G3) with 77 non-pregnant women who had previously undergone RYGB. Serum concentrations of retinol and β-carotene, night blindness (NB), gestational and neonatal intercurrences were investigated. The significance level adopted was p < 0.05. Results: RYGB, per se, had a greater impact on the inadequacy of retinol, β-carotene, and on the increased percentage of NB when compared to non-surgical pregnant women. When surgery was associated with pregnancy, more than 75% of inadequacy of retinol and β-carotene was noted, as well as a higher percentage of individuals with NB. G2 also showed increased prevalence ratio for developing gestational and neonatal intercurrences, when compared to G1. Conclusion: RYGB provides greater negative impact on the nutritional status of vitamin A compared to pregnancy, and surgery associated with pregnancy can create even greater risks

Introducción: los cambios en la fisiología digestiva después del bypass gástrico en Y de Roux (BGYR), así como la gestación, maximizan el riesgo de deficiencia de vitamina A (DVA), ambos pueden resultar dañinos para la salud materna e infantil. Objetivo: comparar el estado nutricional de la vitamina A entre las mujeres que quedaron embarazadas o no después del BGYR y en embarazadas que no se sometieron a cirugía, y evaluar el impacto del DVA en la salud de la madre y el niño. Métodos: se trata de un estudio transversal del tipo analítico. La cohorte se dividió en: grupo 1 (G1) 80 mujeres embarazadas; grupo 2 (G2) 40 mujeres embarazadas que habían sido sometidas anteriormente a BGYR, ambos en su tercer trimestre de gestación; y grupo 3 (G3), 77 mujeres no embarazadas que habían previamente sometido a BGYR. Se investigaron las concentraciones séricas de retinol y β-caroteno, ceguera nocturna (CN), intercurrencias gestacionales y neonatales. Resultados: BGYR, por sí mismo, tuvo un mayor impacto en la inadecuación de retinol, β-caroteno y en el aumento del porcentaje de CN en comparación con las mujeres embarazadas no quirúrgicas. Cuando la cirugía se asoció con el embarazo, se observó más del 75% de la inadecuación de retinol y β-caroteno, así como un mayor porcentaje de individuos con CN. El G2 también mostró una mayor proporción de prevalencia para desarrollar intercurrencias, en comparación con el G1. Conclusión: BGYR proporciona un mayor impacto negativo sobre el estado nutricional de la vitamina A en comparación con el embarazo; la cirugía asociada con el embarazo puede proporcionar aún mayores riesgos