Candida auris in US Correctional Facilities.

Candida auris is an emerging fungal pathogen that typically affects patients in healthcare settings. Data on C. auris cases in correctional facilities are limited but are needed to guide public health recommendations. We describe cases and challenges of providing care for 13 patients who were transferred to correctional facilities during January 2020-December 2022 after having a positive C. auris specimen. All patients had positive specimens identified while receiving inpatient care at healthcare facilities in geographic areas with high C. auris prevalence. Correctional facilities reported challenges managing patients and implementing prevention measures; those challenges varied by whether patients were housed in prison medical units or general population units. Although rarely reported, C. auris cases in persons who are incarcerated may occur, particularly in persons with known risk factors. Measures to manage cases and prevent C. auris spread in correctional facilities should address setting-specific challenges in healthcare and nonhealthcare correctional environments.

Th17 cells sense microbiome to promote depressive-like behaviors.

BACKGROUND: Microbiome alterations have been associated with depression, and fecal transfer of depressed patients' microbiomes is sufficient to enhance despair behaviors in rodents. Yet little is known about the potential mechanisms, whereby microbes modulate depressive-like behaviors. RESULTS: In this study, we showed that certain bacteria known to induce Th17 cells are increased in depressed patients and mice exhibiting learned helplessness. Fecal transfers of human depressed patients' microbiomes into germ-free-like mice were sufficient to decrease sociability and increased susceptibility to the learned helplessness paradigm, confirming that the microbiome is sufficient to confer depressive-like behaviors. This microbial effect was dependent on the presence of Th17 cells in the recipient, as germ-free-like recipient mice deficient in Th17 cells were resistant to the behavioral changes induced by the microbiome of depressed patients. CONCLUSION: Altogether, these findings suggest a crucial role of the microbiome/Th17 cell axis in regulating depressive-like behaviors. Video Abstract.

Life expectancy after 2015 of adults with HIV on long-term antiretroviral therapy in Europe and North America: a collaborative analysis of cohort studies.

BACKGROUND: The life expectancy of people with HIV taking antiretroviral therapy (ART) has increased substantially over the past 25 years. Most previous studies of life expectancy were based on data from the first few years after starting ART, when mortality is highest. However, many people with HIV have been successfully treated with ART for many years, and up-to-date prognosis data are needed. We aimed to estimate life expectancy in adults with HIV on ART for at least 1 year in Europe and North America from 2015 onwards. METHODS: We used data for people with HIV taking ART from the Antiretroviral Therapy Cohort Collaboration and the UK Collaborative HIV Cohort Study. Included participants started ART between 1996 and 2014 and had been on ART for at least 1 year by 2015, or started ART between 2015 and 2019 and survived for at least 1 year; all participants were aged at least 16 years at ART initiation. We used Poisson models to estimate the associations between mortality and demographic and clinical characteristics, including CD4 cell count at the start of follow-up. We also estimated the remaining years of life left for people with HIV aged 40 years who were taking ART, and stratified these estimates by variables associated with mortality. These estimates were compared with estimates for years of life remaining in a corresponding multi-country general population. FINDINGS: Among 206 891 people with HIV included, 5780 deaths were recorded since 2015. We estimated that women with HIV at age 40 years had 35·8 years (95% CI 35·2-36·4) of life left if they started ART before 2015, and 39·0 years (38·5-39·5) left if they started ART after 2015. For men with HIV, the corresponding estimates were 34·5 years (33·8-35·2) and 37·0 (36·5-37·6). Women with CD4 counts of fewer than 49 cells per µL at the start of follow-up had an estimated 19·4 years (18·2-20·5) of life left at age 40 years if they started ART before 2015 and 24·9 years (23·9-25·9) left if they started ART after 2015. The corresponding estimates for men were 18·2 years (17·1-19·4) and 23·7 years (22·7-24·8). Women with CD4 counts of at least 500 cells per µL at the start of follow-up had an estimated 40·2 years (39·7-40·6) of life left at age 40 years if they started ART before 2015 and 42·0 years (41·7-42·3) left if they started ART after 2015. The corresponding estimates for men were 38·0 years (37·5-38·5) and 39·2 years (38·7-39·7). INTERPRETATION: For people with HIV on ART and with high CD4 cell counts who survived to 2015 or started ART after 2015, life expectancy was only a few years lower than that in the general population, irrespective of when ART was started. However, for people with low CD4 counts at the start of follow-up, life-expectancy estimates were substantially lower, emphasising the continuing importance of early diagnosis and sustained treatment of HIV. FUNDING: US National Institute on Alcohol Abuse and Alcoholism and UK Medical Research Council.

Impact of nicotine-induced green tobacco sickness on DNA damage and the relation with symptoms and alterations of redox status in tobacco farmers.

During the harvest period, tobacco workers are exposed to nicotine and it is known that absorption of the alkaloid via the leaves causes green tobacco sickness (GST). We investigated if GST and its symptoms are associated with DNA damage and alterations of the redox status. DNA damage was measured in lymphocytes of tobacco workers and controls (n = 40/group) in single cell gel electrophoresis assays. Exposure to nicotine was determined by plasma cotinine measurements, alterations of the redox status by quantification of the total antioxidant capacity (TEAC) and of thiobarbituric acid reactive substances (TBARS). The symptoms of GTS included nausea, abdominal cramps, headache, vomiting and dizziness, and 50% of the workers had more than one symptom. Cotinine levels were enhanced in the workers (111 ng/mL); furthermore, the extent of DNA damage was ca. 3-fold higher than in the controls. This effect was more pronounced in participants with GST compared to healthy nicotine exposed workers and increased in individuals with specific symptoms (range 22-36%). TBARS levels did not differ between workers and unexposed controls, while TEAC values were even increased (by 14.3%). Contact with nicotine present in tobacco leaves causes GTS and leads to damage of the DNA; this effect is more pronounced in workers with GTS symptoms and is associated with alterations of the redox status. Damage of the genetic material which was found in the workers may lead to adverse long-term effects that are caused by genomic instability such as cancer and accelerated ageing.

Effectiveness of a multifaceted intervention to reduce night-time sedative use in a rehabilitation unit: a pre-post intervention study.

Background: night-time sedation prescribed during a hospital stay can result in long-term use of such medications in older people. We examined the effectiveness of a multifaceted intervention to reduce night time sedation in an inpatient rehabilitation unit. Methods: an initial retrospective survey of night-time sedative use was followed by prospective re-evaluation after a number of changes were made including education of staff and of patients regarding the potential hazards of sedative medications, measures to promote sleep hygiene and facilitate a 'quiet time' after 10 pm and development of a withdrawal protocol for patients on long-term night sedation. The primary outcome measures were the proportions of patients started on night sedation in the unit and the proportion of those using night sedation where a dose reduction was attempted before and after the intervention. Results: night sedation was prescribed for 22/68 (32.4%) subjects in the pre- and 23/169 (13.6%) subjects in the post-intervention surveys (P = 0.001); medication started while in the unit dropped from 10 (14.7%) to 1 (0.6%) (P < 0.0001). There was an improvement in the proportion of patients using night sedation where an attempt was made to reduce the dosage of or eliminate sedative drug use prior to discharge after the intervention was introduced (3/22 (13.6%) vs 14/23 (60.9%) (P = 0.001)). Conclusions: a multifaceted intervention, including ongoing education, audit and feedback and changes to unit practices to promote a 'quiet time' at night, leads to a substantial reduction in the use of night sedation in inpatients.

Chemical and toxicological effects of medicinal Baccharis trimera extract from coal burning area.

The entire process of power generation, extraction, processing and use of coal strongly impact water resources, soil, air quality and biota leads to changes in the fauna and flora. Pollutants generated by coal burning have been contaminating plants that grow in area impacted by airborne pollution with high metal contents. Baccharis trimera is popularly consumed as tea, and is widely developed in Candiota (Brazil), one of the most important coal burning regions of the Brazil. This study aims to investigate the phytochemical profile, in vivo genotoxic and mutagenic potential of extracts of B. trimera collected from an exposed region to pollutants generated by coal burning (Candiota City) and other unexposed region (Bagé City), using the Comet assay and micronucleus test in mice and the Salmonella/microsome short-term assay. The HPLC analyses indicated higher levels of flavonoids and phenolic acids for B. trimera aqueous extract from Bagé and absence of polycyclic aromatic hydrocarbons for both extracts. The presence of toxic elements such as cobalt, nickel and manganese was statistically superior in the extract from Candiota. For the Comet assay and micronucleus test, the mice were treated with Candiota and Bagé B. trimera aqueous extracts (500-2000 mg/kg). Significant genotoxicity was observed at higher doses treated with B. trimera aqueous extract from Candiota in liver and peripheral blood cells. Micronuclei were not observed but the results of the Salmonella/microsome short-term assay showed a significant increase in TA98 revertants for B. trimera aqueous extract from Candiota. The extract of B. trimera from Candiota bioacumulated higher levels of trace elements which were associated with the genotoxic effects detected in liver and peripheral blood cells.

Effects of quercetin on polychlorinated biphenyls-induced liver injury in rats.

INTRODUCTION: Polychlorinated biphenyls (PCBs), used as pesticides in agriculture, can lead to irreversible injuries in living organisms, particularly in liver. Oxidative stress has been implicated in the liver pathogenesis induced by different molecules, including PCBs. It has been demonstrated that quercetin, an antioxidant flavonoid found in the diet, exhibits a potent antioxidant effect in different liver pathologies. OBJECTIVE: To evaluate oxidative stress caused by PCBs in liver and the antioxidant activity of quercetin. METHODOLOGY: We used male Wistar rats (n = 36), divided in 4 groups: control, quercetin (50 mg/kg/day), PCBs (0.4 ml/kg/day), and rats treated with both PCBs and quercetin. On day 25 blood was collected to assess liver integrity (enzymes AST, ALT and ALP), and liver samples to measure oxidative stress (TBARS), activity of antioxidant enzymes (SOD, CAT, GPx) and DNA damage (micronucleus assay), and histological damage. RESULTS: TBARS concentration and SOD activity were significantly higher in PCBs animals as compared to the PCB group receiving quercetin. CAT and GPx decreased in PCBs and increased when quercetin was added. The histological analysis showed damage to hepatocytes in PCBs, but quercetin was able to afford protection against such damage. The micronucleus test showed there was an increase in the production of microclenucleus compared to control, and quercetin was able to reduce this effect. CONCLUSION: Contamination with PCBs led to increased lipid peroxidation and DNA damage, and the use of antioxidant quercetin was effective in reducing PCBs-induced liver injury.

Introducción: los bifenilospoliclonados (PCBs) son pesticidas ampliamente usados en agricultura que pueden inducir daños irreversibles particularmente en el hígado. El estrés oxidativo ha sido implicado en diversas patogénesis hepáticas, incluidas las relacionadas conPCBs. La quercetina, un flavonoide de la dieta, ha demostrado tener un potente efecto antioxidante en diversos modelos de patología hepática. Objetivo: Evaluar el estrés oxidativo hepático inducido por PCBs y la actividad antioxidante de la quercetina. Metodología: Se usaron ratas macho de raza Wistar (n = 36), divididas en cuatro grupos: control, quercetina (50 mg/kg/día), PCBs (0,4 ml/kg/día) y ratas tratadas tanto con PCBs como con quercetina. Transcurridos 25 días de tratamiento se recogieron muestras de sangre, para evaluar la integridad hepática (AST, ALT y ALP), y de tejido para cuantificar el estrés oxidativo (TBARS), actividad antioxidante (SOD, CAT, GPx), daño al DNA (ensayo de micronúcleos) y daño histológico. Resultados: la concentración de TBARS y la actividad SOD fueron significativamente mayores en los animales que recibieron PCBs que en los que recibían quercetina. La actividad de CAT y GPx se redujo con los PCBs y se incrementó al administrar quercetina. Los análisis histológicos y de micronúcleos mostraron daño hepático y al DNA respectivamente inducido por PCBs que eran revertidos con el tratamiento con quercetina. Conclusion: La contaminación con PCBs induce un incremento en la peroxidación lipídica, modificación en la actividad de enzimas antioxidantes, daño histológico y al DNA en el hígado, siendo el antioxidante quercetina es capaz de reducir dichos cambios.

Use of buccal micronucleus assay to determine mutagenicity induced by amfepramone in humans and the protective effects of vitamin C.

The abusive use of amfepramone in Brazilian population has grown in recent years. Few studies have been conducted on amphetamine with respect to DNA damage, and there have been no apparent investigations examining the influence of amfepramone on humans. The aim of this study was to determine the possible mutagenic actions of amfepramone on humans using the micronucleus (MN) assay with buccal cells and the effects of supplementation with vitamin C as a potential protective agent. The study included 108 females with 52 as control and 56 taking amfepramone at 120 mg/d for at least the whole previous month. All women were intentionally selected to be nonsmokers and nondrinkers. After 30 d of amfepramone women were given amfepramone plus vitamin C use at 1000 mg/d for another month. Results showed a marked increase in the number of MN in amfepramone users in both basal and differentiated cells, indicating a mutagenic action. After vitamin C supplementation, a significant decrease in the frequency of MN and apoptosis was observed. Evidence indicates that the main mechanism of action of amfepramone in inducing DNA damage occurs through formation of reactive oxygen species (ROS), intercalation and topoisomerase binding, attributed to the presence of an N-dialkyl group. In addition, data demonstrated that vitamin C effectively inhibited amfepramone-induced DNA damage.

Genetic and oxidative damage of peripheral blood lymphocytes in workers with occupational exposure to coal.

Coal is an important fossil fuel used to generate energy. Coal dust is constituted primarily of hydrocarbons and metals. During coal extraction, large quantities of coal dust particles are emitted, contributing to environmental pollution. Coal miners are constantly exposed to coal dust and its derivatives. The goal of this study was to evaluate the potential genotoxic effects of coal and oxidative stress in individuals from Candiota who were exposed to coal as part of their occupation. The comet assay and micronucleus (MN) test were used to assess these effects. This study involved 128 male participants of whom 71 reported work that included exposure to coal (exposed group) and 57 reported working at different jobs (unexposed group). The exposed group had a significantly increased damage index and damage frequency, as assessed using the comet assay, and increased MN and nucleoplasmic bridge frequencies, as assessed using the MN assay, compared with unexposed individuals. Significant and positive correlations between MN frequencies in the lymphocytes and buccal cells of control and exposed individuals were observed. The exposed individuals presented lower average levels of thiobarbituric acid reactive substances (TBARS) and catalase activity (CAT), while the mean superoxide dismutase activity (SOD) levels were higher in this group. The exposed group also had higher hematocrit levels. No correlation between DNA damage and inorganic elements, as identified using PIXE, was found; however, there was a correlation between the damage index and zinc. The evidence that exposure to coal and its derivatives presents a genetic hazard demonstrates the need for protective measures and educational programs for coal miners.

Baccharis trimera (Less.) DC as genotoxicity indicator of exposure to coal and emissions from a thermal power plant.

During coal combustion, hazardous elements are discharged that impair environmental quality. Plant cover is the first available surface for the atmospheric pollutants in terrestrial ecosystems. The aim of this study was to evaluate genotoxicity in the aqueous extract of the native plant, Baccharis trimera, exposed to coal and emissions from a thermal power plant (coal-fired power plant in Candiota, Brazil), correlating seasonality, wind tunnel predominance, and presence of inorganic elements. The presence of inorganic elements in the aerial parts of B. trimera was analyzed by particle-induced X-ray emission (PIXE) spectrometry, and genotoxicity was evaluated by ex vivo comet assay. The genotoxic effects of aqueous extracts of B. trimera from four sites located in the area around power plant were analyzed by comet assay in peripheral human lymphocytes. Winter samples showed greater levels of metals than summer samples. Genotoxicity was detected in B. trimera extracts collected from the region exposed to extraction and burning coal. Extracts from the site impacted by the dominant wind induced more damage to DNA than those from other sites. Based on our data, we can suggest that in winter the inorganic elements from extraction and burning of coal and carried through the wind tunnel were responsible for the genotoxicity observed in aqueous extract of B. trimera.

Mitigation by vitamin C of the genotoxic effects of nicotine in mice, assessed by the comet assay and micronucleus induction.

Nicotine has been reported to cause acute toxicity and to present long-term risks, such as chromosomal damage and genetic instability. The genotoxicity of nicotine may be mediated partly by an oxidative mechanism. We have evaluated the effects of the antioxidant vitamin C on nicotine-induced genotoxicity in mice. The comet assay and the micronucleus test were used to assess the effects of nicotine (15mg/kg) at different exposure times (2, 4, and 24h in the comet assay; 24h in the micronucleus test). Pretreatment with vitamin C 24h before nicotine exposure strongly protected mice against nicotine-induced DNA damage.

Effect of the substrate and catalyst chirality on the diastereoselective epoxidation of limonene using Jacobsen-type catalysts.

Chiral and achiral Jacobsen's catalysts in their homogeneous form or immobilized on Al-MCM-41 exhibit similar catalytic activity during diastereoselective epoxidation of limonene when in situ generated dimethyldioxirane is used as oxidizing agent. Experimental observations suggest that not only the catalyst chiral center but also the substrate chiral center participates in the preferential formation of most diastereomers. Remarkable turnover numbers (TON), up to 288, was achieved over the heterogeneous catalysts in comparison to their homogeneous counterparts (TON up to 46). Catalyst leaching rather than catalyst oxidative degradation was identified as the main source of catalyst deactivation during reutilization tests.

Efecto de la rehabilitación física en pacientes hemofílicos con hamartrosis en codo y rodilla

Se realizó un estudio epidemiológico descriptivo retrospectivo en el área de rehabilitación del Hospital Regional Simón Bolívar de Bogotá, con el propósito de describir el efecto de la terapia física en los pacientes hemofílicos con hemartrosis recurrente de codo y rodilla. Se tomó una muestra representativa de treinta y nueve (39) pacientes sin límite de edad que acudieron al programa de rehabilitación durante dieciocho (18) meses (enero 1989-junio 1990) encontrandose que el 48.7 por ciento de los pacientes tenían una edad promedio de 16.8 años, 87,2 por ciento presentaban hemofilia tipo A y el 53.8 por ciento con menos del 1 por ciento de actividad del factor circulante. Los hallazagos para las articulaciones estudiadas demostraron que las respuestas al tratamiento son significativamente diferentes entre los menores de 10 años y mayores de 20 años, pero globalmente no se demuestra efectividad en la terapia física recomendada. De acuerdo al grado de severidad de la enfermedad no inidicaron un comportamiento diferente para los movimientos de flexión y extensión de los codos y rodillas