Pre-procedural antibody testing for SARS-CoV-2 in the routine endoscopic practice.

METHODS: a retrospective multicenter cohort study was performed of all endoscopic procedures performed between April 27 and June 15, 2020. A screening questionnaire (SQ) was performed with patients three days prior to the procedure and 14 days after. Furthermore, a serologic SARS-CoV-2 test was performed 48 hours before. RESULTS: two hundred and eleven consecutive patients with endoscopic procedures were included. No patients had a positive SQ, either on entry to the study or 14 days later. Only four patients (1.9 % [95 % CI: 0.07-4.8 %]) were positive for antibodies. CONCLUSION: the pre-endoscopy seroprevalence of SARS-CoV-2 is low in this cohort. Pre-procedural SARS-CoV-2 antibody testing does not add any benefit over clinical SQ to identify active COVID-19 patients.

Restrictive Use of Oral Glucocorticoids in Systemic Lupus Erythematosus and Prevention of Damage Without Worsening Long-Term Disease Control: An Observational Study.

OBJECTIVE: To analyze the influence of 2 different treatment strategies on general and specific damage accrual in patients with systemic lupus erythematosus (SLE). METHODS: Two cohorts were identified according to the responsible physicians: patients treated at the autoimmune diseases unit (ADU), and patients treated by other members of the internal medicine (IM) department. Members of the ADU worked with a protocol including the universal prescription of hydroxychloroquine (HCQ), the use of maximum oral prednisone dosages ≤30 mg/day and maintenance therapy with ≤5 mg/day, by using methylprednisolone pulses and/or early immunosuppressive (IS) drugs. We analyzed the influence of these 2 treatment strategies on damage accrual, both general and domain specific, attributed to glucocorticoids, cardiovascular (CV) disease, SLE, and unclassified, since the diagnosis of disease in patients with a followup ≥5 years. RESULTS: A total of 74 patients were included in the ADU group and 213 in the IM group. They were comparable for most demographic and lupus-related variables. ADU patients received prednisone later and at lower doses, more methylprednisolone pulses, earlier IS drugs and more HCQ (P < 0.05 for all comparisons). The Systemic Lupus Erythematosus Disease Activity Index score decreased similarly in both cohorts (P = 0.4). Patients in the ADU group were less likely to accrue any damage (P = 0.007). They accrued less glucocorticoid-related (adjusted hazard ratio [HR] 0.23 [95% confidence interval (95% CI) 0.07-0.80]), CV disease (adjusted HR 0.28 [95% CI 0.08-0.95]), and unclassified damage (adjusted HR 0.58 [95% CI 0.3-1.1]). Both groups accrued similar SLE-related damage (adjusted HR 0.84 [95% CI 0.40-1.75]). CONCLUSION: The use of reduced oral prednisone doses, which was possible by combining different therapies, reduced glucocorticoid-related damage and improved CV prognosis without increasing damage caused by SLE.

Population genomics of parallel hybrid zones in the mimetic butterflies, H. melpomene and H. erato.

Hybrid zones can be valuable tools for studying evolution and identifying genomic regions responsible for adaptive divergence and underlying phenotypic variation. Hybrid zones between subspecies of Heliconius butterflies can be very narrow and are maintained by strong selection acting on color pattern. The comimetic species, H. erato and H. melpomene, have parallel hybrid zones in which both species undergo a change from one color pattern form to another. We use restriction-associated DNA sequencing to obtain several thousand genome-wide sequence markers and use these to analyze patterns of population divergence across two pairs of parallel hybrid zones in Peru and Ecuador. We compare two approaches for analysis of this type of data-alignment to a reference genome and de novo assembly-and find that alignment gives the best results for species both closely (H. melpomene) and distantly (H. erato, ∼15% divergent) related to the reference sequence. Our results confirm that the color pattern controlling loci account for the majority of divergent regions across the genome, but we also detect other divergent regions apparently unlinked to color pattern differences. We also use association mapping to identify previously unmapped color pattern loci, in particular the Ro locus. Finally, we identify a new cryptic population of H. timareta in Ecuador, which occurs at relatively low altitude and is mimetic with H. melpomene malleti.

Glucocorticoids and irreversible damage in patients with systemic lupus erythematosus.

OBJECTIVE: The aim of this study was to analyse the relationship between glucocorticoids and damage accrual in SLE. METHODS: We report an observational cohort study including 230 patients with SLE enrolled at diagnosis with 5 years of follow-up. Damage was calculated using the SLICC damage index. Glucocorticoid-related damage was defined as avascular osteonecrosis, osteoporotic fractures, diabetes mellitus or cataracts. Prednisone doses were calculated at the end of the fourth year of follow-up (prednisone-4). A categorical prednisone-4 variable was constructed: no prednisone, ≤7.5 mg/day (low dose), >7.5 mg/day (medium-high dose). The relationship between methylprednisolone pulses and damage was also tested. RESULTS: By the fifth year, 188 patients (82%) had been treated with prednisone. Eighty-seven patients (37.8%) had accrued damage at 5 years. Patients with damage at year 5 had received a higher mean daily prednisone-4 dose (10.4 vs 6 mg/day, P < 0.001). The mean daily prednisone-4 dose was higher in patients accruing glucocorticoid-attributable damage (11 vs 7 mg/day, P = 0.04). Patients taking medium-high doses of prednisone-4 had a higher risk of accruing damage than those taking no prednisone [adjusted odds ratio (OR) 5.39, 95% CI 1.59, 18.27]. Patients taking medium-high doses of prednisone-4 were more likely to develop glucocorticoid-related damage than those on no prednisone (adjusted OR 9.9, 95% CI 1.1, 84). No differences were seen between patients on low doses and those on no prednisone. The cumulative dose of i.v. methylprednisolone-4 was not associated with global or glucocorticoid-related damage. CONCLUSION: Prednisone causes damage in SLE. Doses <7.5 mg/day and methylprednisolone pulses are not associated with damage accrual.

Measuring individual locomotor rhythms in honey bees, paper wasps and other similar-sized insects.

Circadian rhythms in social insects are highly plastic and are modulated by multiple factors. In addition, complex behaviors such as sun-compass orientation and time learning are clearly regulated by the circadian system in these organisms. Despite these unique features of social insect clocks, the mechanisms as well as the functional and evolutionary relevance of these traits remain largely unknown. Here we show a modification of the Drosophila activity monitoring (DAM) system that allowed us to measure locomotor rhythms of the honey bee, Apis mellifera (three variants; gAHB, carnica and caucasica), and two paper wasps (Polistes crinitus and Mischocyttarus phthisicus). A side-by-side comparison of the endogenous period under constant darkness (free-running period) led us to the realization that these social insects exhibit significant deviations from the Earth's 24 h rotational period as well as a large degree of inter-individual variation compared with Drosophila. Experiments at different temperatures, using honey bees as a model, revealed that testing the endogenous rhythm at 35°C, which is the hive's core temperature, results in average periods closer to 24 h compared with 25°C (23.8 h at 35°C versus 22.7 h at 25°C). This finding suggests that the degree of tuning of circadian temperature compensation varies among different organisms. We expect that the commercial availability, cost-effectiveness and integrated nature of this monitoring system will facilitate the growth of the circadian field in these social insects and catalyze our understanding of the mechanisms as well as the functional and evolutionary relevance of circadian rhythms.

La placenta en el embarazo normal y de alto riesgo / Placenta in normal and high risk pregnancy

Se propuso una investigación para conocer las diferencias existentes entre placentas provenientes de embarazos normales y de alto riesgo desde el punto de vista de características morfológicas macroscópicas. Se corelacionaron clínico- morfológicamente , 19 embarazos incluyendo estados hipertensivos asociados al embarazo e incompatibilidad Rh y 23 embarazos supuestamente normales. Se encontró que en los embarazos normales hay relación directa entre pesos fetales y placentarios, hay peso promedio mayor de los recien nacidos y sus placentas y edad gestacional media mayor. En los embarazos de alto rieso hay tendencia a producir recien nacidos pre-término con bajo peso para su edad gestacional y placentas pequeñas. En los embarazos con pre-eclampsia se encontró aumento de la relación peso placentario / peso fetal sugiriendo que ante un medio materno desfavorable la placenta se hipertrofía compensatoriamente. Se sugiere para estudios posteriores hacer una investigación utilizando la microscopía de contraste de fase y la inmunofluorescencia