RESUMO
We evaluated the safety and viral rebound, after analytical treatment interruption (ATI), of vedolizumab and ART in recent HIV-1 infection. We used this model to analyze the impact of α4ß7 on the HIV-1 reservoir size. Participants started ART with monthly Vedolizumab infusions and ATI was performed at week 24. Biopsies were obtained from ileum and caecum at baseline and week 24. Vedolizumab levels, HIV-1 reservoir, flow cytometry and cell-sorting and antibody competition experiments were assayed. Vedolizumab was safe and well-tolerated. No participant achieved undetectable viremia off ART 24 weeks after ATI. Only a modest effect on the time to achieve >1000 HIV-RNA copies/mL and the proportion of participants off ART was observed, being higher compared to historical controls. Just before ATI, α4ß7 expression was associated with HIV-1 DNA and RNA in peripheral blood and with PD1 and TIGIT levels. Importantly, a complete blocking of α4ß7 was observed on peripheral CD4+ T-cells but not in gut (ileum and caecum), where α4ß7 blockade and vedolizumab levels were inversely associated with HIV-1 DNA. Our findings support α4ß7 as an important determinant in HIV-1 reservoir size, suggesting the complete α4ß7 blockade in tissue as a promising tool for HIV-cure combination strategies.
RESUMO
Surgical ciliated cysts are rare benign cystic lesions that generally occur a number of years after invasive surgical procedures or trauma involving the maxilla. The appearance of this cyst after orthognathic surgery is a complication that has rarely been reported. It usually shows as a well-defined radiolucency in the maxilla in young adults mimicking other maxillary cysts. Therefore, an exhaustive clinical-radiological diagnosis is needed to establish its differential diagnosis and appropriate treatment. The present study describes the case of a surgical ciliated cyst that appeared 20 years after LeFort I orthognathic surgery. Treatment consisted of complete enucleation with primary closure and removal of osteosynthesis material. Histopathological examination confirmed the diagnosis of a maxillary cyst lined with pseudostratified ciliated columnar cells. Clinicians should be aware of this rare type of cyst in patients with a history of maxillary surgery or trauma to establish a differential diagnosis and ensure appropriate management.
RESUMO
No disponible
Assuntos
Humanos , Masculino , Adulto , Insuficiência Renal Crônica/cirurgia , Hiperparatireoidismo Secundário/cirurgia , Glomerulonefrite/cirurgia , Transplante de Rim , SíndromeAssuntos
Distúrbio Mineral e Ósseo na Doença Renal Crônica/diagnóstico , Diálise/efeitos adversos , Ossos Faciais/anormalidades , Falência Renal Crônica/complicações , Adulto , Distúrbio Mineral e Ósseo na Doença Renal Crônica/etiologia , Distúrbio Mineral e Ósseo na Doença Renal Crônica/patologia , Diálise/métodos , Ossos Faciais/diagnóstico por imagem , Humanos , Hiperparatireoidismo Secundário/complicações , Hiperparatireoidismo Secundário/patologia , Hiperparatireoidismo Secundário/terapia , Falência Renal Crônica/patologia , Falência Renal Crônica/terapia , Transplante de Rim/métodos , Masculino , Má Oclusão/diagnóstico , Má Oclusão/etiologia , Paratireoidectomia/métodos , Síndrome , Cooperação e Adesão ao Tratamento , Resultado do TratamentoRESUMO
Pregnancy pyogenic granuloma is considered a benign common growth that usually develops on the gingiva in the second and third trimester of gestation, in response to local irritation, trauma or hormonal factors. Here, the authors report a case of a primigravida who presented an extragingival pyogenic granuloma with a rapid progression in the post-partum. The occurrence on the lower lip in the first few days after delivery was a relatively rarity in the present case which provoked a meaningful state of anxiety and cancerophobia to the female. Complete excision was curative and brought immediate relief of pain and discomfort. This clinical report highlights the possibility of pyogenic granuloma presenting like a rapid-growing mass on the lip and the importance of clinical differential diagnosis of such presentation in this atypical location.
Assuntos
Gengiva , Granuloma Piogênico , Doenças Labiais , Procedimentos Cirúrgicos Bucais/métodos , Transtornos Fóbicos , Complicações na Gravidez , Adulto , Diagnóstico Diferencial , Feminino , Gengiva/patologia , Gengiva/cirurgia , Granuloma Piogênico/diagnóstico , Granuloma Piogênico/fisiopatologia , Granuloma Piogênico/psicologia , Granuloma Piogênico/cirurgia , Humanos , Doenças Labiais/diagnóstico , Doenças Labiais/fisiopatologia , Doenças Labiais/psicologia , Doenças Labiais/cirurgia , Transtornos Fóbicos/etiologia , Transtornos Fóbicos/fisiopatologia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/fisiopatologia , Complicações na Gravidez/psicologia , Complicações na Gravidez/cirurgia , Resultado do TratamentoRESUMO
No disponible