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  1. Article ; Online: A brief history of antiphospholipid antibodies and antiphospholipid syndrome = Uma breve história dos anticorpos antifosfolípides e da síndrome antifosfolípide

    Staub, Henrique Luiz / Staub, Lia Portell

    Scientia Medica, Vol 28, Iss 3, p ID

    2018  Volume 31097

    Abstract: OBJETIVOS: Revisar os relatos históricos sobre anticorpos antifosfolípides (aAF) dos primeiros anos do século XX; delinear as características cardinais da síndrome antifosfolípide (SAF) a partir de 1983, incluindo critérios clínicos, etiopatogênese e ... ...

    Abstract OBJETIVOS: Revisar os relatos históricos sobre anticorpos antifosfolípides (aAF) dos primeiros anos do século XX; delinear as características cardinais da síndrome antifosfolípide (SAF) a partir de 1983, incluindo critérios clínicos, etiopatogênese e terapia atual. MÉTODOS: Revisão de literatura utilizando o PubMed. Foram selecionados artigos com foco na história dos aAF e da SAF. RESULTADOS: Os aAF foram originalmente descritos em pacientes com sífilis ainda em 1906 por Wassermann. Uma primeira definição do anticoagulante lúpico foi proposta em 1963, enquanto o anticorpo anticardiolipina (aCL) foi descrito 20 anos mais tarde. A SAF, inicialmente reportada por Hughes em 1985 como chr(38)quot;síndrome do aCLchr(38)quot; é uma das mais prevalentes trombofilias adquiridas. Tromboses arteriais e venosas, associadas ou não à morbidade gestacional, compreendem os achados principais. É uma nova entidade, tendo sido primeiramente associada ao lupus eritematoso sistêmico. Uma forma primária de SAF foi reconhecida em1989, e muitas variantes de SAF são modernamente conhecidas. A terapia-padrão para a SAF trombótica é a anticoagulação plena e ininterrupta. Na SAF obstétrica, a combinação de ácido acetil-salicílico com enoxaparina tem-se mostrado altamente efetiva. CONCLUSÕES: A caracterização sequencial dos aAF desde Wasserman em 1906, e mais tarde da SAF nos anos 1980, é um interessante exemplo de como uma nova entidade é concebida passo a passo. A SAF é uma nova e intrigante causa de trombofilia autoimune, com uma complexa patogênese e uma pletora de manifestações clínicas e laboratoriais. O tratamento é baseado em anticoagulação contínua
    Keywords trombose ; complicações na gravidez ; anticorpos antifosfolípides ; medicina ; Medicine (General) ; R5-920
    Language English
    Publishing date 2018-01-01T00:00:00Z
    Publisher Editora da Pontifícia Universidade Católica do Rio Grande do Sul (EDIPUCRS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Neurological syndromes and potential triggers associated with antibodies to neuronal surface antigens.

    Klein da Costa, Bruna / de Oliveira Pinto, Paula / Staub, Lia / Hansel, Gisele / Vanik Pinto, Guilherme / Porcello Schilling, Lucas / Rodrigues Dos Passos, Giordani / Alves Martins, William / Becker, Jefferson / Machado Castilhos, Raphael / Palmini, André / Sato, Douglas Kazutoshi

    Multiple sclerosis and related disorders

    2023  Volume 80, Page(s) 105022

    Abstract: Background: Autoantibodies against surface neuronal antigens have been associated with specific neurological presentations including autoimmune encephalitis (AE), with variable association with neoplasia and infections.: Methods: We described the ... ...

    Abstract Background: Autoantibodies against surface neuronal antigens have been associated with specific neurological presentations including autoimmune encephalitis (AE), with variable association with neoplasia and infections.
    Methods: We described the phenotype and environmental associations of patients with neurological syndromes associated with antibodies against neuronal surface antigens who were referred to a tertiary center in the South of Brazil. All patients were tested for neuronal autoantibodies using cell-based assays. Clinical, radiological, and laboratory findings were retrospectively reviewed.
    Results: We identified 16 patients, 15 had subacute, and one had a progressive disease course. Among patients with subacute onset, 11 (73 %) were N-Methyl-d-Aspartate receptor (NMDAr-IgG)+, 3 (20 %) were Leucine-rich Glioma-Inactivated-1 (LGI1-IgG)+, and 1 (6 %) was positive for Glycine receptor-IgG. The patient with a progressive disease course had antibodies against IgLON5. Most patients had disease onset in spring and summer suggesting environmental factors for the development of AE. Also, we observed a different pattern of brain lesions when NMDAr-IgG encephalitis followed herpes encephalitis and a previously unreported association with Rosai-Dorfman-Destombe disease. All patients with encephalopathy met criteria for possible AE and all proven NMDAr-IgG+ met criteria for NMDAr-IgG encephalitis. However, only one LGI1-IgG+ patient fulfilled clinical criteria for limbic encephalitis. All but one received high-dose intravenous methylprednisolone, 11 also had intravenous human immunoglobulin, and 4 plasma exchange. Furthermore, all patients received second-line immunotherapy. Importantly, most patients improved with immunotherapy, even when initiated later in the disease course.
    Conclusion: We identified seasonal variability associated with neuronal surface antibodies suggesting environmental triggers. Also, we described the coexistence of NMDAr-IgG encephalitis with histiocytosis. In our series, most patients received second-line immunotherapy. We observed neurologic improvement after treatment even in cases of delayed diagnosis. Increasing the recognition and availability of tests and treatments for these conditions is of paramount importance in low- and middle-income countries.
    MeSH term(s) Humans ; Retrospective Studies ; Antigens, Surface ; Autoantibodies ; Syndrome ; Encephalitis, Herpes Simplex ; Immunoglobulin G ; Anti-N-Methyl-D-Aspartate Receptor Encephalitis ; Cell Adhesion Molecules, Neuronal
    Chemical Substances Antigens, Surface ; Autoantibodies ; Immunoglobulin G ; IgLON5 protein, human ; Cell Adhesion Molecules, Neuronal
    Language English
    Publishing date 2023-09-29
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 2645330-7
    ISSN 2211-0356 ; 2211-0348
    ISSN (online) 2211-0356
    ISSN 2211-0348
    DOI 10.1016/j.msard.2023.105022
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Quality indicators in prolonged hemodialysis with regional citrate anticoagulation with the genius system: retrospective cohort of critical patients with acute kidney injury.

    Vieira, Jorge Alberto Menegasso / Reinheimer, Isabel Cristina / Dos Santos, Amanda Corrêa / Halperin, Fernando Kowarick / Susin, Luiza Aguirre / Staub, Lia Portella / Ribeiro, Raquel Jaqueline Eder / da Silveira, Julia Braga / Fontoura, Lucas Friedrich / de Souza, Diego Candido / Nunes, Karen Patrícia / de Souza, Vandrea Carla / da Silva Selistre, Luciano / Poli-de-Figueiredo, Carlos Eduardo

    BMC nephrology

    2023  Volume 24, Issue 1, Page(s) 353

    Abstract: Background: Prolonged hemodialysis (HD) is performed from 6 to 12 h and can last up to 24 h. To prevent system clotting some studies suggest that Regional Citrate Anticoagulation (RCA) use reduces bleeding rates relative to systemic heparin. However, ... ...

    Abstract Background: Prolonged hemodialysis (HD) is performed from 6 to 12 h and can last up to 24 h. To prevent system clotting some studies suggest that Regional Citrate Anticoagulation (RCA) use reduces bleeding rates relative to systemic heparin. However, there may be difficulties in the patient's clinical management and completing the prescribed HD with Genius system using RCA.
    Objective: To analyze safety Quality Indicators (IQs) and follow up on prolonged HD with 4% sodium citrate solution in a Genius® hybrid system.
    Methods: This is a retrospective cohort conducted in an intensive care unit.
    Results: 53 random sessions of prolonged HD with 4% sodium citrate solution of critically ill patients with AKI assessed. Evaluated safety indicators were dysnatremia and metabolic alkalosis, observed in 15% and 9.4% of the sessions, respectively. Indicators of effectiveness were system clotting which occurred in 17.3%, and the minimum completion of the prescribed HD time, which was 75.5%.
    Conclusion: The assessment of the indicators showed that the use of RCA with a 4% sodium citrate solution in prolonged HD with the Genius system in critically ill patients with AKI can be performed in a simple, safe, and effective way.
    MeSH term(s) Humans ; Acute Kidney Injury/therapy ; Anticoagulants/therapeutic use ; Citrates/therapeutic use ; Citric Acid/therapeutic use ; Critical Illness/therapy ; Heparin/adverse effects ; Quality Indicators, Health Care ; Renal Dialysis ; Retrospective Studies ; Sodium Citrate
    Chemical Substances Anticoagulants ; Citrates ; Citric Acid (2968PHW8QP) ; Heparin (9005-49-6) ; Sodium Citrate (1Q73Q2JULR)
    Language English
    Publishing date 2023-11-30
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-023-03342-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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