Renal damage was not observed in ANCA-positive patients with ulcerative colitis even after 1 year of follow-up, suggesting that the ANCA found in these patients do not share the antigenic targets with the ANCA commonly found in renal vasculitis. Therefore the potential of ANCA of inducing renal lesions (if any) is dependent on their own antigenic specificity.

No abstract

CONTEXT: The term pulmonary-renal syndrome has been used frequently to describe the clinical manifestations of a great number of diseases in which pulmonary hemorrhage and glomerulonephritis coexist. The classic example of this type of vasculitis is Goodpasture´s syndrome, a term used to describe the association of pulmonary hemorrhage, glomerulonephritis and the presence of circulating antiglomerular basement membrane antibodies (anti-GBM). Among the several types of systemic vasculitides that can present clinical manifestations of the pulmonary-renal syndrome, we focus the discussion on two types more frequently associated with antineutrophil cytoplasm antibodies (ANCA), microscopic polyangiitis and Wegener´s granulomatosis, concerning a 10 year old girl with clinical signs and symptoms of pulmonary-renal syndrome, with positive ANCA and rapidly progressive evolution. CASE REPORT: We describe the case of a 10-year-old girl referred to our hospital for evaluation of profound anemia detected in a primary health center. Five days before entry she had experienced malaise, pallor and began to cough up blood-tinged sputum that was at first attributed to dental bleeding. She was admitted to the infirmary with hemoglobin = 4 mg/dL, hematocrit = 14%, platelets = 260,000, white blood cells = 8300, 74% segmented, 4% eosinophils, 19% lymphocytes and 3% monocytes. Radiographs of the chest revealed bilateral diffuse interstitial alveolar infiltrates. There was progressive worsening of cough and respiratory distress during the admission day, when she began to cough up large quantities of blood and hematuria was noted. There was rapid and progressive loss of renal function and massive lung hemorrhage. The antineutrophil cytoplasm antibody (ANCA) test with antigen specificity for myeloperoxidase (anti-MPO) was positive and the circulating anti-GBM showed an indeterminate result.

No abstract

Global value chains are undergoing a revolution in the Industry 4.0 environment, which is driving changes in organizations, as well as in business models, which have also experienced pressure derived from the COVID-19 pandemic, however, in this context a greater digitalization has been detonated which should generate value. The objective of the present research has been to analyze the main scientific contributions applying a regional segmentation related to global value chains in the scope of industry 4.0, in this sense the present study included a systematic review of contributions from the academic, scientific and business fields, with the collection of 50 articles of which 25 complied with the study area, in a period between the years 2016 to 2022, allowing to identify factors and variables that influence as fundamental pieces for digital transformation. The findings of this research found that it is necessary to promote models, frameworks or action plans by governments, as well as organizations seeking to embrace Industry 4.0 in which the cornerstone is the human factor. It was concluded that it is necessary to understand the challenges that will arise in the coming years, looking for strategies by applying models on technology adoption to facilitate joining the digital transformation, which promises to optimize various activities, strengthening global chains with greater value for related parties.