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Little is known about the efficacy of COVID-19 vaccines during acute lymphoblastic leukemia therapy (ALL); data for COVID-19 vaccine immune responses in pediatric leukemia remain sparse. We conducted a single center study of patients aged 5-25 years undergoing ALL chemotherapy who received COVID-19 vaccination. Twenty-one patients were enrolled; efficacy was evaluable in 20. Twenty were vaccinated while receiving chemotherapy. Twenty received the BNT162b2 mRNA vaccine. Spike reactive antibodies (S-IgG) and/or T-cells (SRT) were detected in 16 of 20 (80%) vaccinated patients; 13 (65%) and 9 (45%) were positive for S-IgG and SRT, respectively. Six (30%) showed both spike reactive B and T-cell responses. Eleven of the 13 with S-IgG positivity were negative for anti-Nucleocapsid IgG, an antibody profile consistent with a vaccine induced immune response. All 13S-IgG+ patients showed neutralizing antibodies. SRT included CD4+ (7) and CD8+ (6) T-cells; both CD4+ and CD8+ SRT were seen in 4. SRT were multifunctional (producing multiple cytokines) in most patients (8 of 9); 4 showed SRT with triple cytokine and B-cell co-stimulatory responses, indicating a multimodal adaptive immune response. Immune responses were seen among patients vaccinated in the settings of lymphopenia (6 of 12) intensive chemotherapy (3 of 4), and Peg allergy (6 of 8). Sequencing revealed public CD4+ and CD8+ TCR sequences reactive to epitopes across the spike protein. In conclusion, COVID-19 vaccination induced B and/or T-cell responses in a majority of children and young adults undergoing ALL chemotherapy.
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Microglial cells are recognized as very dynamic brain cells, screening the environment and sensitive to signals from all other cell types in health and disease. Apolipoprotein D (ApoD), a lipid-binding protein of the Lipocalin family, is required for nervous system optimal function and proper development and maintenance of key neural structures. ApoD has a cell and state-dependent expression in the healthy nervous system, and increases its expression upon aging, damage or neurodegeneration. An extensive overlap exists between processes where ApoD is involved and those where microglia have an active role. However, no study has analyzed the role of ApoD in microglial responses. In this work, we test the hypothesis that ApoD, as an extracellular signal, participates in the intercellular crosstalk sensed by microglia and impacts their responses upon physiological aging or damaging conditions. We find that a significant proportion of ApoD-dependent aging transcriptome are microglia-specific genes, and show that lack of ApoD in vivo dysregulates microglial density in mouse hippocampus in an age-dependent manner. Murine BV2 and primary microglia do not express ApoD, but it can be internalized and targeted to lysosomes, where unlike other cell types it is transiently present. Cytokine secretion profiles and myelin phagocytosis reveal that ApoD has both long-term pre-conditioning effects on microglia as well as acute effects on these microglial immune functions, without significant modification of cell survival. ApoD-triggered cytokine signatures are stimuli (paraquat vs. Aß oligomers) and sex-dependent. Acute exposure to ApoD induces microglia to switch from their resting state to a secretory and less phagocytic phenotype, while long-term absence of ApoD leads to attenuated cytokine induction and increased myelin uptake, supporting a role for ApoD as priming or immune training factor. This knowledge should help to advance our understanding of the complex responses of microglia during aging and neurodegeneration, where signals received along our lifespan are combined with damage-triggered acute signals, conditioning both beneficial roles and limitations of microglial functions.
Assuntos
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos , COVID-19 , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/induzido quimicamente , Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/tratamento farmacológico , Vacinas contra COVID-19 , ChAdOx1 nCoV-19 , Humanos , SARS-CoV-2 , VacinaçãoRESUMO
Introducción: La recesión gingival es uno de los defectos estético-funcionales más comunes en la cavidad oral. Se caracteriza por la exposición de la superficie de la raíz debido a un desplazamiento del margen gingival apical a la unión amelocementaria. La literatura reporta un porcentaje de recubrimiento de la raíz favorable en recesiones gingivales clases I y II de Miller; sin embargo, varios estudios no lograron el recubrimiento total, lo que ha sido asociado a varios factores. Objetivo: Identificar los factores asociados al recubrimiento total de recesiones gingivales clases I y II de Miller en dientes tratados con colgajo de reposición coronal. Métodos: Se consultaron las bases de datos PubMed SciELO, Redalyc, Lilacs y Scopus. De 105 investigaciones, se analizaron 7 que cumplieron los criterios de inclusión. Análisis e integración de las informaciones: El metaanálisis dio resultados no concluyentes, debido a la alta heterogeneidad de los estudios. Sin embargo, se detectaron los siguientes factores: el uso de ácido etilendiaminotetraacético (p < 0,0001), la presencia de tejido queratinizado adjunto ≥ 2 mm (p = 0,019), una profundidad de recesión gingival inicial > 3 mm (p = 0,020) y pacientes que fumaban más de 10 cigarrillos diarios (p < 0,05). Conclusiones: Se identificaron el uso de ácido etilendiaminotetracético, la presencia de tejido queratinizado, la profundidad de la recesión y pacientes fumadores como posibles factores que intervienen el recubrimiento total de recesiones gingivales clases I y II de Miller en dientes tratados con colgajo de reposición coronal(AU)
Introduction: Gingival recession is one of the most common esthetic-functional defects of the oral cavity. It is characterized by exposure of the root surface due to displacement of the apical gingival margin to the cementoenamel junction. The literature about the topic reports a percentage of favorable root coverage of Miller class I and II gingival recessions. However, several studies do not report complete coverage, which has been associated to a number of factors. Objective: Identify the factors associated to complete coverage of Miller class I and II gingival recessions in teeth treated with coronally repositioned flap. Methods: A search was conducted in the databases PubMed, SciELO, Redalyc, Lilacs and Scopus. Of a total 105 studies retrieved, seven met the inclusion criteria. Data analysis and integration: The meta-analysis did not achieve conclusive results, due to the high heterogeneity of the studies. However, the following factors were identified: use of ethylenediaminetetraacetic acid (p < 0.0001), presence of adjacent keratinized tissue ≥ 2 mm (p = 0.019), initial gingival recession depth > 3 mm (p = 0.020) and patients who smoked more than 10 cigarettes a day (p < 0.05). Conclusions: Use of ethylenediaminetetraacetic acid, presence of keratinized tissue, recession depth and smoker patients were identified as possible factors involved in the complete coverage Miller class I and II gingival recessions in teeth treated with coronally repositioned flap(AU)
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Humanos , Fatores de Risco , Fumantes , Retração Gengival/epidemiologia , Bases de Dados BibliográficasRESUMO
A high proportion of children with Attention problems (ADHD) experience motor competence problems. The present study sought to compare the motor competence between a group of ADHD students and a normative sample before and after controlling for motor coordination problems, and check if there are differences between the group with ADHD and the group with DT, depending on the presence or not of the DCD concurrent with the ADHD. A total of 22 children with ADHD combined type (ADHD-CT; 12-13 years, SD 0.7, 16 males, 6 females) and 23 age-matched typically developing children with no movement difficulties (12-13 years, SD 0.7 16 males, 7 females) participated in this study. Motor coordination was measured using the Movement Assessment Battery for Children-2nd Edition (MABC-2). ADHD symptoms were assessed by the school's Department of Psychology.The ADHD diagnosis is based on diagnostic criteria established by the Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5), and the application of the following behavioral scales and evaluation of executive functions have been followed: Child Behavior Checklist for ages; Behavior Ratting Inventory of Executive Functions (BRIEF); Scales for the Evaluation of ADHD (EDAH). Based on the MABC-2 score (percentile score ≤ 5th), ADHD children were classified into two groups: co-occurring DCD/ADHD and ADHD group. Results showed that children with ADHD and typically developing (TD) children showed big individual differences on all motor skill areas and on overall percentile scores. Thirteen children with ADHD were delayed, and three were at risk for motor delays. Only four TD children were at risk for motor delays. DCD/ADHD group scored significantly lower than the TD group across all motor skill areas, while ADHD group scored lower than the TD group only on manual dexterity
Existe una alta proporción de niños en los que coexisten los problemas de atención e hiperactividad, con bajos niveles de competencia motriz. El presente estudio, busca comparar los niveles de competencia motriz entre un grupo de niños con diagnóstico por Trastorno por Déficit de Atención e Hiperactividad (TDAH) y un grupo con desarrollo típico (DT), y comprobar si hay diferencias entre el grupo con TDAH y el grupo con DT, en función de la presencia o no del TDC concurrente con el TDAH. Un total de 22 niños con TDAH, subtipo combinado (TDAH-TC; 12 a 13 años,DT0.7 16 varones, 6 mujeres) y 23 niños con desarrollo típico, sin dificultades de movimiento (12 a 13 años, DT0.7,16 hombres y 7 mujeres), participaron en este estudio. La coordinación motora o competencia motriz, fue evaluada a través de la Batería de Evaluación del Movimiento para niños ABC-Movement, en su 2ª edición (MABC-2). El diagnóstico de TDAH, procede del Departamento de Orientación y Psicología del Centro Educativo del que proceden los niños evaluados. Para ello, se han seguido los criterios de diagnóstico que establece el Manual diagnóstico y estadístico de los trastornos mentales, quinta edición (DSM-5),y la aplicación de las siguientes escalas de comportamiento, y de evaluación de las funciones ejecutivas: Child Behavior Checklist for ages; Behavior Ratting Inventory of Executive Functions (BRIEF); Escalas para la Evaluación del TDAH (EDAH). Los resultados mostraron que, aquellos niños con TDAH, obtuvieron valores más bajos en el test de evaluación, que aquellos que mostraban un desarrollo típico. Además, en el grupo de niños con TDAH, se determinó que 13 de ellos, presentaban problemas en el desarrollo de la coordinación
Uma alta proporção de crianças com problemas de atenção (TDAH) tem problemas de competênciamotora. O presente estudo buscou comparar a competência motora entre um grupo de alunos com TDAH e uma amostra normativa antes e após o controle de problemas de coordenação motora, e verifique se há diferenças entre o grupo com TDAH e o grupo com DT, dependendo da presença ou não do TDC concomitante ao TDAH.Um total de 22 crianças com TDAH do tipo combinado (ADHD-CT; 12-13 anos,DT0.7, 16 homens, 6 mulheres) e 23 crianças com idade de desenvolvimento típico sem dificuldades de movimento (12-13 anos, DT0.7, 16 homens, 7 mulheres) participaram deste estudo. A coordenação motora foi medida usando a Bateria de Avaliação de Movimento para Crianças -2ª Edição (MABC-2). Sintomas de TDAH foram avaliados pelo Departamento de Psicologia da escola. Para tanto, foram seguidos os critérios diagnósticos estabelecidos no Manual Diagnóstico e Estatístico de Transtornos Mentais, quinta edição (DSM-5), e a aplicação das seguintes escalas comportamentais e avaliação das funções executivas: Comportamento Infantil Lista de verificação para idades; Comportamento Ratting Inventory of Executive Functions (BRIEF); Escalas para a avaliação do TDAH (EDAH). Com base no escore MABC-2 (escore percentual ≤ 5), as crianças com TDAH foram classificadas em dois grupos: grupo com DCD / TDAH e TDAH. Os resultados mostraram que crianças com TDAH e crianças com desenvolvimento típico (DT) apresentaram grandes diferenças individuais em todas as áreas de habilidades motoras e nos escores percentuais gerais. Treze crianças com TDAH foram atrasadas e três correram risco de atrasos motores. Apenas quatro crianças com DT estavam em risco de atrasos motores. DCD / ADHD grupo marcou significativamente menor do que o grupo TD em todas as áreas de habilidades motoras, enquanto o grupo TDAH marcou menos do que o grupo TD apenas na destreza manual
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Humanos , Masculino , Feminino , Criança , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Atividade Motora/fisiologia , Destreza Motora/fisiologia , Teste de Esforço , Estudos de Casos e ControlesRESUMO
Introducción. La hipomielinización con atrofia de ganglios basales y de cerebelo (H-ABC) es una rara entidad descrita recientemente. Se presentan dos nuevos casos pertenecientes a una misma familia. Casos clínicos. Caso 1: niño de 17 meses con retraso grave en todas las áreas, ausencia de lenguaje y de contacto visual. En la exploración destacaba una microcefalia con tetraparesia espástica. En la resonancia magnética cerebral se apreciaba atrofia cerebelosa de predominio vermiano con pérdida de volumen de ambos núcleos del putamen y la cabeza del caudado, y patrón de hipomielinización de la sustancia blanca. En la electromiografía se objetivó un patrón de polineuropatía crónica de predominio motor. Presentó un descenso de los valores de ácido homovalínico y de ácido 5-hidroxindolacético. El tratamiento con levodopa/carbidopa no fue efectivo. Caso 2: niña de 11 meses, hermana del caso anterior. Presentaba un retraso grave en todas las áreas y en la exploración clínica se detectó una microcefalia con tetraparesia espástica. La resonancia magnética cerebral mostró hallazgos superponibles a los del hermano, con hipomielinización, atrofia cerebelosa y afectación putaminal y de ambos caudados; en la electromiografía, hallazgos compatibles con polineuropatía motora de carácter desmielinizante. Presentó un descenso de los valores de ácido homovalínico y ácido 5-hidroxindolacético en el líquido cefalorraquídeo. El tratamiento con levodopa/carbidopa resultó ineficaz. Conclusiones. Estos dos nuevos casos ayudan a caracterizar mejor esta entidad y refuerzan la hipótesis del origen genético del síndrome, dado que se trata de dos casos pertenecientes a una misma familia (AU)
Introduction. Hypomyelination with atrophy of the basal ganglia and cerebellum (H-ABC) is a rare condition that has only recently been reported. Here we present two new cases belonging to the same family. Case reports. Case 1: 17-month-old boy with severe underdevelopment in all areas, absence of language and eye contact. The examination revealed microcephaly with spastic tetraparesis. A magnetic resonance imaging scan showed predominantly vermian atrophy of the cerebellum with loss of volume of both nuclei of the putamen and the head of the caudate, and a pattern of hypomyelination of the white matter. Electromyography recording highlighted the presence of a predominantly motor pattern of chronic polyneuropathy. Homovallinic acid and 5-hydroxyindoleacetic acid values were lower than usual. Treatment with levodopa/carbidopa was not effective. Case 2: 11-month-old girl, the sister of the boy in the previous case. The patient presented severe underdevelopment in all areas and microcephaly with spastic tetraparesis was detected in the clinical examination. Magnetic resonance imaging of the head showed findings that could be superimposed upon those of the brother, with hypomyelination, cerebellar atrophy and involvement of the putamen and both caudates; electromyography findings were consistent with motor polyneuropathy of a demyelinating nature. Homovallinic acid and 5-hydroxyindoleacetic acid values in cerebrospinal fluid were lower than usual. Treatment with levodopa/carbidopa was ineffective. Conclusions. These two new cases help characterise this condition better and reinforce the hypothesis of the genetic origin of the syndrome, given that the two cases occurred in the same family (AU)
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Humanos , Masculino , Feminino , Lactente , Leucoencefalopatias/diagnóstico , Doenças dos Gânglios da Base/diagnóstico , Dissinergia Cerebelar Mioclônica/diagnóstico , Polineuropatias/diagnósticoRESUMO
Como parte del Programa de Encuestas Comparativas de Fecundidad en América Latina, iniciado por CELADE en 1962, se presentan los análises de los datos proporcionados por dicha encuesta, para áreas rurales de Costa Rica, México, Colombia y Perú. Esta investigación comparativa, integrada por un conjunto de artículos, abarca tanto los mecanismos utilizados por las poblaciones rurales para el control voluntario de la fecundidad, como los problemas metodológicos involucrados en su estudio. La mayoría de los artículos abordam tópicos referidos a la adopción de la anticoncepción en América Latina, considerando variables antecedentes y las que posibilitan la práctica del fenómeno. (1- Motivación para limitar la procreación; 2- Conocimientos de técnicas anticonceptivas; 3- Legitimidad de la práctica anticonceptiva; 4- Comunicación y adopción conjunta de decisiones por parte de la pareja para limitar su fecundidad). En todos los artículos que configuran el libro se aborda la influencia de los 4 tipos de variables en la anticoncepción, así como las características socio-económicas (individuales y comunitarias) de la población estudiada