The specific metabolome profiling of patients infected by SARS-COV-2 supports the key role of tryptophan-nicotinamide pathway and cytosine metabolism.

The biological mechanisms involved in SARS-CoV-2 infection are only partially understood. Thus we explored the plasma metabolome of patients infected with SARS-CoV-2 to search for diagnostic and/or prognostic biomarkers and to improve the knowledge of metabolic disturbance in this infection. We analyzed the plasma metabolome of 55 patients infected with SARS-CoV-2 and 45 controls by LC-HRMS at the time of viral diagnosis (D0). We first evaluated the ability to predict the diagnosis from the metabotype at D0 in an independent population. Next, we assessed the feasibility of predicting the disease evolution at the 7th and 15th day. Plasma metabolome allowed us to generate a discriminant multivariate model to predict the diagnosis of SARS-CoV-2 in an independent population (accuracy > 74%, sensitivity, specificity > 75%). We identified the role of the cytosine and tryptophan-nicotinamide pathways in this discrimination. However, metabolomic exploration modestly explained the disease evolution. Here, we present the first metabolomic study in SARS-CoV-2 patients which showed a high reliable prediction of early diagnosis. We have highlighted the role of the tryptophan-nicotinamide pathway clearly linked to inflammatory signals and microbiota, and the involvement of cytosine, previously described as a coordinator of cell metabolism in SARS-CoV-2. These findings could open new therapeutic perspectives as indirect targets.

Fatal outcome after reactivation of inherited chromosomally integrated HHV-6A (iciHHV-6A) transmitted through liver transplantation.

HHV-6A and HHV-6B are found as inherited and chromosomally integrated forms (iciHHV-6A and -6B) into all germinal and somatic cells and vertically transmitted in a Mendelian manner in about 1% of the population. They were occasionally shown to be horizontally transmitted through hematopoietic stem cell transplantation. Here, we present a clinical case of horizontal transmission of iciHHV-6A from donor to recipient through liver transplantation. Molecular analysis performed on three viral genes (7.2 kb) in the recipient and donor samples supports transmission of iciHHV-6A from the graft. Transmission was followed by reactivation, with high viral loads in several compartments. The infection was uncontrollable, leading to severe disease and death, despite antiviral treatments and the absence of resistance mutations. This case highlights the fact that physicians should be aware of the possible horizontal transmission of iciHHV-6 and its consequences in case of reactivation in immunocompromised patients.

Experimental determination of time of intracranial hemorrhage by spectrophotometric analysis of cerebrospinal fluid.

A method for determining the time elapsed after a cerebrovascular accident by examination of the cerebrospinal fluid (CSF) is described. Hemorrhagic intracranial trauma was simulated in dogs by injecting blood into the subarachnoid space. Daily samples of cerebrospinal fluid were gathered during the subsequent 14 days, and the concentrations of oxyhemoglobin and bilirubin were measured using spectrophotometric methods. The hemoglobin coefficient (HC), defined as the ratio of the oxyhemoglobin concentration to the sum of the concentrations of the cerebrospinal fluid pigments, and the hemoglobin-bilirubin index (HBI), the ratio of the oxyhemoglobin and the bilirubin concentrations, are found to permit accurate calculation of the time elapsed after the hemorrhage.

[Family planning in Brazil]. / Planejamento familiar no Brasil.

PIP: In 1970, 41.6% of the Brazilian population was represented by children aged 0-14, and by 21.3% of women in fertile age; the birth rate was 36.9/1000. Without an appropriate national program of family planning, Brazil will have in the year 2000, 218.8 million inhabitants. The need for family planning services in Brazil is evident, even more so since abortion is forbidden, unless for therapeutic reasons. A national family planning program should include a complete range of maternal and child services, and screening for high-risk women; in other words, family planning should be thought of and used as preventive medicine. Family planning is not so much a right as a duty of the couple. The Catholic church, largely prevalent in Brazil, approves of family planning when practiced with the means allowed by the church itself.^ieng

Inqueritos sobre deformidade em um hospital para doente de hanseniase / Inquiry on deformity in a hospital for sick people of leprosy

A hanseníase tem sido conceituada como moléstia incapacitante. Para alguns aqui estariam as raízes do temos despertados pela doença. Os autores discordam de tais conceitos e propugnam pela separação de deformidade passível de ser causada pela moléstia, da incapacidade para o trabalho. Em 727 pacientes internados e asilados em Hospital de Dermatologia Sanitária (Santo Angelo, São Paulo, Brasil) foram pesquisadas 62 alterações físicas, denominadas no texto de deformidades, e primária ou secundariamente ligadas à hanseníase. Os resultados encontrados permitem afirmar que a limitação ou incapacitação ao trabalho estão fundamentalmente ligadas às deformidades secundárias. Estas, no consenso geral, são perfeitamente evitáveis. Os achados foram relacionados com o descobrimento tardio da doença e a existência de um programa de atenções básicas, elementares, de prevenção de deformidades, associado ao diagnóstico e tratamento.

[Total proteins of the cerebrospinal fluid obtained by punction of the cisterna magna: normal values. Variations related to sex]. / Proteinas totais do liquido cefalorraqueano obtido por punção da cisterna magna: valores normais. Variações ligadas ao sexo

The total protein content of CSF collected from the cisterna magna (cisternal fluid) of 98 patients (58 males and 40 females) with no neurological diseases was determined by the colorimetric method devised by Lowry and co-workers. This method has been previously chosen based mainly on it's sensitivity, accuracy and low fluid consumption. The CSF samples were normal with regard to pressure, color, citology and it's content in glucose, chloride and urea. Complement fixation tests for syphilis and cisticercosis, as well as the globulin tests (Pandy, Nonne--Appelt and Takata-Ara) were negative. The average value and the normal range of cisternal fluid total protein was calculated for the mixed population (males and females). The mean protein value was 26.78 mg/100 ml, the lower and upper limits were respectively 13.20 and 40.36 mg/100 ml. These data are higher than those stated in some publications, and factors that could interfere in the different results mentioned in the literature are briefly discussed. Since the statistical analysis of the results showed that the mean total protein concentration in males (28.76 mg/100 ml) was higher than in females (23.91 mg/100 ml), normal limits for each sex were established: 16.96 to 47.13 mg/100 ml for males and 14.76 to 42.76 mg/100 ml for females.

Esperancas de sobrevida na hanseniase / Hopes of supervened in leprosy

Calculam-se as tábuas de sobrevida adaptadas às moléstias crônicas segundo técnica de Chiang, de 5000 hansenianos do Estado de São Paulo, diagnosticados entre 1947 e 1950. As esperanças de sobrevida de cada uma das três modalidades clínicas da moléstia são comparadas entre si e com as da população brasileira em 1950. Conclui-se que as modalidades indeterminadas e virchovianas têm esperanças de sobrevida parecidas e que o tipo tuberculóide em termos de sobrevida, é a mais grave.