Anti-neutrophil cytoplasmic antibody-associated vasculitides (AAV) are rare autoimmune disorders typically involving the lungs and kidneys. A few case reports have described an association with hematopoietic stem cell transplant (HSCT). We present a case of myeloperoxidase-positive AAV with predominant renal involvement in a 49-year-old male with a history of acute myeloid leukemia treated with allogenic HSCT and complicated by chronic graft-versus-host disease (GVHD). He presented with rapidly progressive glomerulonephritis, and kidney biopsy revealed pauci-immune necrotizing crescentic glomerulonephritis. Treatment with methylprednisolone pulses followed by oral prednisolone, rituximab, and plasmapheresis led to improved kidney function and a tailored rituximab maintenance regimen was followed. However, a renal-limited relapse occurred at 15 months, requiring repeat induction therapy. Dialysis was avoided, but renal function only partially recovered. This case suggests that AAV can develop after HSCT and GVHD and highlights the importance of long-term follow-up and further research into underlying mechanisms.

Purpose: The Cow’s Milk-related Symptom Score (CoMiSS) improves the recognition of cow milk allergy (CMA) symptoms. A score of ≥10 should raise awareness of CMA. The median CoMiSS in healthy European infants aged <6 months is 3. This study aimed to determine the impact of different regions on CoMiSS in healthy infants aged <12 months to evaluate regional and age-related differences. Methods: A prospective cross-sectional study was conducted at one hospital each in Indonesia (Jakarta) and Brazil (Sergipe). CoMiSS was assessed in healthy infants aged –12 months old. Results: In Jakarta, a total of 286 infants (50.7% boys) were included. The median (interquartile range) CoMiSS was 1.5 (0–4); the 95th percentile was 7. In Sergipe, 101 infants (60.4% boys) were included. The median (interquartile range) CoMiSS was 4 (4–6); the 95th centile was 10.9. Age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94–0.99;p<0.001) and country (OR, 2.40; 95% CI, 2.06–2.79; p<0.001) were significant independent predictors of changes in mean CoMiSS in a linear regression model (r2 =0.27). Conclusion Median CoMiSS in healthy infants differed between Jakarta and Sergipe (1.5 vs. 4.0).These findings highlight that the perceived normality of parents may be region-dependent.

Purpose: The Cow’s Milk-related Symptom Score (CoMiSS) improves the recognition of cow milk allergy (CMA) symptoms. A score of ≥10 should raise awareness of CMA. The median CoMiSS in healthy European infants aged <6 months is 3. This study aimed to determine the impact of different regions on CoMiSS in healthy infants aged <12 months to evaluate regional and age-related differences. Methods: A prospective cross-sectional study was conducted at one hospital each in Indonesia (Jakarta) and Brazil (Sergipe). CoMiSS was assessed in healthy infants aged –12 months old. Results: In Jakarta, a total of 286 infants (50.7% boys) were included. The median (interquartile range) CoMiSS was 1.5 (0–4); the 95th percentile was 7. In Sergipe, 101 infants (60.4% boys) were included. The median (interquartile range) CoMiSS was 4 (4–6); the 95th centile was 10.9. Age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94–0.99;p<0.001) and country (OR, 2.40; 95% CI, 2.06–2.79; p<0.001) were significant independent predictors of changes in mean CoMiSS in a linear regression model (r2 =0.27). Conclusion Median CoMiSS in healthy infants differed between Jakarta and Sergipe (1.5 vs. 4.0).These findings highlight that the perceived normality of parents may be region-dependent.

Purpose: The Cow’s Milk-related Symptom Score (CoMiSS) improves the recognition of cow milk allergy (CMA) symptoms. A score of ≥10 should raise awareness of CMA. The median CoMiSS in healthy European infants aged <6 months is 3. This study aimed to determine the impact of different regions on CoMiSS in healthy infants aged <12 months to evaluate regional and age-related differences. Methods: A prospective cross-sectional study was conducted at one hospital each in Indonesia (Jakarta) and Brazil (Sergipe). CoMiSS was assessed in healthy infants aged –12 months old. Results: In Jakarta, a total of 286 infants (50.7% boys) were included. The median (interquartile range) CoMiSS was 1.5 (0–4); the 95th percentile was 7. In Sergipe, 101 infants (60.4% boys) were included. The median (interquartile range) CoMiSS was 4 (4–6); the 95th centile was 10.9. Age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94–0.99;p<0.001) and country (OR, 2.40; 95% CI, 2.06–2.79; p<0.001) were significant independent predictors of changes in mean CoMiSS in a linear regression model (r2 =0.27). Conclusion Median CoMiSS in healthy infants differed between Jakarta and Sergipe (1.5 vs. 4.0).These findings highlight that the perceived normality of parents may be region-dependent.

Purpose: The Cow’s Milk-related Symptom Score (CoMiSS) improves the recognition of cow milk allergy (CMA) symptoms. A score of ≥10 should raise awareness of CMA. The median CoMiSS in healthy European infants aged <6 months is 3. This study aimed to determine the impact of different regions on CoMiSS in healthy infants aged <12 months to evaluate regional and age-related differences. Methods: A prospective cross-sectional study was conducted at one hospital each in Indonesia (Jakarta) and Brazil (Sergipe). CoMiSS was assessed in healthy infants aged –12 months old. Results: In Jakarta, a total of 286 infants (50.7% boys) were included. The median (interquartile range) CoMiSS was 1.5 (0–4); the 95th percentile was 7. In Sergipe, 101 infants (60.4% boys) were included. The median (interquartile range) CoMiSS was 4 (4–6); the 95th centile was 10.9. Age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94–0.99;p<0.001) and country (OR, 2.40; 95% CI, 2.06–2.79; p<0.001) were significant independent predictors of changes in mean CoMiSS in a linear regression model (r2 =0.27). Conclusion Median CoMiSS in healthy infants differed between Jakarta and Sergipe (1.5 vs. 4.0).These findings highlight that the perceived normality of parents may be region-dependent.

Purpose: The Cow’s Milk-related Symptom Score (CoMiSS) improves the recognition of cow milk allergy (CMA) symptoms. A score of ≥10 should raise awareness of CMA. The median CoMiSS in healthy European infants aged <6 months is 3. This study aimed to determine the impact of different regions on CoMiSS in healthy infants aged <12 months to evaluate regional and age-related differences. Methods: A prospective cross-sectional study was conducted at one hospital each in Indonesia (Jakarta) and Brazil (Sergipe). CoMiSS was assessed in healthy infants aged –12 months old. Results: In Jakarta, a total of 286 infants (50.7% boys) were included. The median (interquartile range) CoMiSS was 1.5 (0–4); the 95th percentile was 7. In Sergipe, 101 infants (60.4% boys) were included. The median (interquartile range) CoMiSS was 4 (4–6); the 95th centile was 10.9. Age (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94–0.99;p<0.001) and country (OR, 2.40; 95% CI, 2.06–2.79; p<0.001) were significant independent predictors of changes in mean CoMiSS in a linear regression model (r2 =0.27). Conclusion Median CoMiSS in healthy infants differed between Jakarta and Sergipe (1.5 vs. 4.0).These findings highlight that the perceived normality of parents may be region-dependent.

A 53-year-old female presented with a 2-year history of an enlarging hyperpigmented plaque on her left foot, which was later accompanied by yellowish, foul-smelling discharge, tenderness, and pain (5/10). A biopsy in Thailand confirmed acral lentiginous melanoma. Following surgical site dehiscence and lesion recurrence, she underwent further examination at Southern Philippines Medical Center. A skin punch biopsy revealed atypical melanocytes, leading to Mohs micrographic surgery. After confirming negative tumor margins, a successful skin punch graft was performed, resulting in full wound healing with no recurrence.

Acral lentiginous melanoma, though rare, is most common in Asians and often presents in areas like the soles, palms, and subungual regions. Mohs micrographic surgery, offering precise margin control, ensures cure rates comparable to traditional excision while sparing more tissue, crucial for areas like the foot. Skin punch grafting, in this case, provided faster wound healing and a high graft survival rate, highlighting its effectiveness in dermatologic surgery.

In conclusion, acral lentiginous melanoma’s subtle presentation often delays diagnosis, but combining Mohs surgery with skin punch grafting offers significant therapeutic benefits—ensuring tissue preservation, faster recovery, and improved graft outcomes.

Purpose: This study aimed to describe the growth, body protein status, and micronutrient biomarkers of Brazilian infants with cow’s milk allergy (CMPA) at baseline and at 18 months of follow-up in comparison with their healthy peers. Methods: Thirty infants with CMPA younger than six months of age were included in this longitudinal study, and their nutritional status was compared with that of 24 non-allergic age-matched children. Anthropometric measurements were used to assess growth, and blood and urine samples were analyzed for protein and micronutrient status. Mixed linear models adjusted for birth weight, socioeconomic status, infant feeding at baseline, weightfor-age, C-reactive protein, serum albumin, micronutrient dietary supplementation, and salt consumption were employed to evaluate the evolution of nutritional parameters throughout the follow-up period. Results: Overall, the mean age of the children at enrolment was 2.9 (standard deviation 1.7) months, and 29 children (53.7%) were male. Infants with CMPA showed a higher prevalence of functional iron depletion (transferrin saturation <20) (p=0.027), lower serum ferritin (p=0.009), and lower urinary iodine (p=0.034) levels than non-allergic children at baseline.Patients with CMPA showed a higher increment in weight-for-age and length-for-age over time than those in the control group (p<0.01). Mixed linear analyses showed a significantly lower increase in serum vitamin B12 (s-B12) (p=0.001) and urinary iodine (p<0.001) concentrations over time compared to the control group. Conclusion Infants with CMPA on a cow’s milk elimination diet had a higher weight and length at 18 months of follow-up but showed signs of inadequate iron, iodine, and B-12 vitamin status.

Background: and Purpose Visual hallucinations (VH) and subjective cognitive complaints (SCC) are associated with cognitive impairment (CI) in Parkinson’s disease. Our aims were to determine the association between VH and SCC and the risk of CI development in a cohort of patients with Parkinson’s disease and normal cognition (PD-NC). Methods: Patients with PD-NC (total score of >80 on the Parkinson’s Disease Cognitive Rating Scale [PD-CRS]) recruited from the Spanish COPPADIS cohort from January 2016 to November 2017 were followed up after 2 years. Subjects with a score of ≥1 on domain 5 and item 13 of the Non-Motor Symptoms Scale at baseline (V0) were considered as “with SCC” and “with VH,” respectively. CI at the 2-year follow-up (plus or minus 1 month) (V2) was defined as a PD-CRS total score of <81. Results: At V0 (n=376, 58.2% males, age 61.14±8.73 years [mean±SD]), the frequencies of VH and SCC were 13.6% and 62.2%, respectively. VH were more frequent in patients with SCC than in those without: 18.8% (44/234) vs 4.9% (7/142), p<0.0001. At V2, 15.2% (57/376) of the patients had developed CI. VH presenting at V0 was associated with a higher risk of CI at V2 (odds ratio [OR]=2.68, 95% confidence interval=1.05–6.83, p=0.039) after controlling for the effects of age, disease duration, education, medication, motor and nonmotor status, mood, and PD-CRS total score at V0. Although SCC were not associated with CI at V2, presenting both VH and SCC at V0 increased the probability of having CI at V2 (OR=3.71, 95% confidence interval=1.36–10.17, p=0.011). Conclusions VH were associated with the development of SCC and CI at the 2-year follow-up in patients with PD-NC.