C5a Serum Levels in Patients with Endometriosis: A Cross-Sectional Study.

Endometriosis (EM) is a gynecological disorder that presents significant immune dysregulation in its pathophysiology. Recent studies indicate that the Complement System may play a significant role in the immune processes involved in peritoneal clearance and inflammation in EM patients. C5a is a potent anaphylatoxin molecule of complement associated with the development of inflammatory disorders, however its possible impact on EM development requires further investigation. The aim of this study was to determine the concentration of serum C5a in women with EM and to investigate its possible association with severity, symptoms, age and the timing of infertility. Ninety-four patients with EM (from stage I to IV) and 50 healthy controls were assessed for C5a serum levels. Clinical and demographic data were included in the analysis. C5a serum levels were higher in patients with EM than in controls (39.5 ng/mL vs. 26.0 ng/mL; p < .0001), but not different between the EM stages. No association was observed between C5a serum concentration and the presence of symptoms, age, symptom time or infertility time. The C5a serum levels were higher in patients with EM than in controls but not associated with the severity or clinical findings.

Antinuclear antibodies in patients with endometriosis: A cross-sectional study in 94 patients.

Markers of autoimmunity, such as autoantibodies, have been found in patients with endometriosis. These include the antinuclear antibodies (ANA). We aimed to evaluate the prevalence of ANA in a sample of patients with endometriosis and its possible clinical associations. Ninety-four patients with endometriosis and 91 controls were studied for ANA and extractable nuclear antigen (ENA; anti-Ro, anti-La, anti-Sm, and anti-RNP) profiles and anti-dsDNA. Epidemiological, clinical, and staging data in endometriosis were obtained. Patients with autoimmune disorders were excluded. Patients with endometriosis had a 21.2% prevalence of positive ANA vs. 5.4% in controls (P = 0.001). The ENA profile and anti-dsDNA were negative. Patients with positive ANA were more asymptomatic (P = 0.03) and had less dysmenorrhea. No associations with disease duration, patient age, or endometriosis stage were found. We found a high prevalence of positive ANA in patients with endometriosis. The presence of this autoantibody may be linked to a milder clinical expression of the disease.

Hemothorax after oocyte retrieval in a patient with a history of COVID-19: a case report.

Spontaneous hemothorax is a rare disorder characterized by pleural fluid hematocrit greater than 50% of the peripheral blood hematocrit without natural or iatrogenic trauma to the lungs or pleural space. Since the first case of COVID-19, more than 85 million cases have been confirmed and most patients have sustained symptoms after more than six months of acute infection. This paper reports the case of a 38-year-old woman without signs of endometriosis and a history of COVID-19 infection who developed spontaneous hemothorax after oocyte retrieval. Three months before undergoing assisted reproductive technology (ART) treatment, the patient had a symptomatic COVID-19 infection with a negative PCR test and a positive IgG test four weeks after the onset of symptoms. Controlled ovarian stimulation and oocyte retrieval were conducted uneventfully. Two hours after oocyte retrieval, the patient developed nausea and mild hypogastric pain. Ten hours after the procedure, the patient went to the emergency department with abdominal pain. Chest computed tomography scans revealed moderate right pleural effusion and laminar left pleural effusion. Since the patient had respiratory symptoms, the choice was made to drain the pleural fluid. Fluid analysis confirmed the patient had right hemothorax (400 mL). After drainage, the patient's clinical and imaging signs improved gradually without complications. The patient was asymptomatic one week after the procedure.

Insights into the role of complement system in the pathophysiology of endometriosis.

Endometriosis (EM) is a gynecologic disorder characterized by the presence of endometrium-like tissue outside of normal location that affects up to 10 % of all women in reproductive age. The pathogenesis of endometriosis is not completely known. The relationship between complement and EM has already been demonstrated in some studies, indicating an important role in the pathophysiology of the disease, however, researches are scarce and sometimes controversial. The objective of this review is to bring state-of-the-art knowledge on the subject and promote better understanding of the complement system role in the pathophysiology of EM. We searched in databases up to December 2020 and found 1213 articles that were screened, from which were selected 54 articles from title and abstract. We found that there is a dysfunction of the immune system on endometriosis, including the complement system. Apparently, the complement system is dysregulated in endometriosis and several proteins of the three complement pathways presented serum levels altered in women with endometriosis compared with those without the disease. The most studied protein is C3. Future investigations on the innate immune response and complement system could offer a further understanding on the inflammatory pathogenesis of EM, which will support a new therapeutic plan.

Zika virus testing of asymptomatic patients undergoing assisted reproduction in Curitiba, Brazil.

OBJECTIVE: The objective is to report recent data on the infection and detection of Zika virus in infertile couples and to discuss the need to make disease surveillance compulsory in this population in order to decrease the burden on the healthcare system and expedite treatment onset. METHODS: We collected and analyzed the results of Zika virus infection screening tests of infertile couples in a private clinic in the low-incidence region of Curitiba - Brazil. RESULTS: Among the 1189 serologies performed, 98.5% were negative for Zika virus, 0.75% were positive, and 0.75% were inconclusive. The twenty-one reverse transcription polymerase chain reaction tests performed for confirmation of infection were negative. CONCLUSION: Zika virus infection screening for asymptomatic patients may lead to delayed fertility treatment initiation in addition to excessive expenses for the patients. Based on our results, we challenge the validity of mandatory screening, especially in low-incidence regions.

Estudo e avaliação comparativa da incidência de doença meningocócica em Curitiba antes e depois da introdução da vacina antimeningocócica C ao calendário / Vacinal study and evaluation of incidence of meningococcal disease in Curitiba before and after the introduction in the calendar meningococcal C vaccine

Avaliar e comparar a incidência da meningite meningocócica antes e após a introdução da vacinação antimeningocócica C no município de Curitiba. Analisar a validade da prevenção e comparar com os resultados obtidos em outros países. Estudo quantitativo retrospectivo epidemiológico, no qual foram utilizados dados do SINAN (Sistema de Informação de Agravos de Notificação) por meio do DATASUS. Dividido em um período de 12 meses antes e após a implantação da vacina para comparação da incidência da doença meningocócica em crianças menores de 1 ano e entre 1 e 4 anos em Curitiba. Bibliografia pesquisada na base de dados MEDLINE, LILACS, IBECS e SciELO, entre 1997 e 2012. No período anterior à vacinação, a incidência foi de 26 casos em crianças menores que 4 anos e, após a vacinação, foi de 17 casos, tendo uma redução de 34,62% na incidência da doença meningocócica em Curitiba. A vacinação de crianças com a vacina antimeningocócica C realmente é efetiva na redução da incidência da doença meningocócica, tanto em Curitiba quanto em outros lugares do mundo onde foi utilizada a vacinação em massa da população.

To evaluate and compare the incidence of meningococcal meningitis before and after the introduction of the meningococcal C vaccination in Curitiba. To evaluate the validity of the prevention and compared with the results obtained in other countries. A quantitative retrospective epidemiological study which was used data from SINAN (Sistema de Informação de Agravos de Notificação) through DATASUS. It was divided into a 12-month period before and after the deployment of the vaccine to compare the incidence of meningococcal disease in children under one year and between one and four years in Curitiba. Bibliography was searched through MEDLINE, LILACS, SciELO and IBECS, between 1997 and 2012. In the period prior to vaccination, the incidence were 26 cases in children younger than four years, and after vaccination were 17 cases, with a reduction of 34.62% in the incidence of meningococcal disease in Curitiba. The children's vaccination with meningococcal C vaccine is actually effective in reducing the incidence of meningococcal disease, both in Curitiba, as elsewhere in the world, where mass vaccination of the population was done.