Capsaicin attenuates immunosuppression induced by chronic stress in BALB/C mice.

Although acute stress generally exerts positive effects on the immune system, chronic stress typically causes immunosuppression via the hypothalamic-pituitary-adrenal (HPA) axis. In this study, the effects of capsaicin (1.28 mg/kg intraperitoneally [i.p.] for 7 days) on immune parameters were evaluated under conditions of chronic stress. Capsaicin treatment significantly increased the immune response as evaluated by the delayed-type hypersensitivity (DTH) reaction to dinitrofluorobenzene (DNFB) and splenocyte proliferation assays- It also is able to rescue the splenocytes of the apoptosis induced by stress. The capsaicin treatment increased the production of Th1 cytokines and decreased the production of Th2 cytokines and TGF-ß1 in the plasma and culture supernatants of immunosuppressed mice, which is associated with the modulation of Th2 induced by stress cells. Moreover, the production of corticosterone significantly decreased in capsaicin-treated animals as compared to control groups. The capsaicin treatment further attenuated the immunosuppression induced by the corticosterone treatment (40 mg/kg i.p. for 7 days), albeit less potently, as exhibited in the DTH response. Intriguingly, the capsaicin treatment decreased the induction of IL-10, IL-4, and TGF-ß1 through high doses of corticosterone, indicating direct cellular immunomodulation. These results show, that capsaicin is able to modulate chronic stress-induced immunosuppression, mediating corticosterone released inhibition, but also, that capsaicin significantly modulates the pharmacological action of corticosterone in vivo.

Pathogens and fecal indicators in waste stabilization pond systems with direct reuse for irrigation: Fate and transport in water, soil and crops.

Wastewater use for irrigation is expanding globally, and information about the fate and transport of pathogens in wastewater systems is needed to complete microbial risk assessments and develop policies to protect public health. The lack of maintenance for wastewater treatment facilities in low-income areas and developing countries results in sludge accumulation and compromised performance over time, creating uncertainty about the contamination of soil and crops. The fate and transport of pathogens and fecal indicators was evaluated in waste stabilization ponds with direct reuse for irrigation, using two systems in Bolivia as case studies. Results were compared with models from the literature that have been recommended for design. The removal of Escherichia coli in both systems was adequately predicted by a previously-published dispersed flow model, despite more than 10years of sludge accumulation. However, a design equation for helminth egg removal overestimated the observed removal, suggesting that this equation may not be appropriate for systems with accumulated sludge. To assess the contamination of soil and crops, ratios were calculated of the pathogen and fecal indicator concentrations in soil or on crops to their respective concentrations in irrigation water (termed soil-water and crop-water ratios). Ratios were similar within each group of microorganisms but differed between microorganism groups, and were generally below 0.1mLg(-1) for coliphage, between 1 and 100mLg(-1) for Giardia and Cryptosporidium, and between 100 and 1000mLg(-1) for helminth eggs. This information can be used for microbial risk assessments to develop safe water reuse policies in support of the United Nations' 2030 Sustainable Development Agenda.

Effects of the fluoride on the central nervous system.

INTRODUCTION: Fluoride (F) is a toxic and reactive element, and exposure to it passes almost unnoticed, with the consumption of tea, fish, meat, fruits, etcetera and articles of common use such as: toothpaste additives; dental gels, non-stick pans and razor blades as Teflon. It has also been used with the intention of reducing the dental cares. DEVELOPMENT: Fluoride can accumulate in the body, and it has been shown that continuous exposure to it causes damaging effects on body tissues, particularly the nervous system directly without any previous physical malformations. BACKGROUND: Several clinical and experimental studies have reported that the F induces changes in cerebral morphology and biochemistry that affect the neurological development of individuals as well as cognitive processes, such as learning and memory. F can be toxic by ingesting one part per million (ppm), and the effects they are not immediate, as they can take 20 years or more to become evident. CONCLUSION: The prolonged ingestion of F may cause significant damage to health and particularly to the nervous system. Therefore, it is important to be aware of this serious problem and avoid the use of toothpaste and items that contain F, particularly in children as they are more susceptible to the toxic effects of F.

Depth of focus increase by multiplexing programmable diffractive lenses.

A combination of several diffractive lenses written onto a single programmable liquid crystal display (LCD) is proposed for increasing the Depth of Focus (DOF) of the imaging system as a whole. The lenses are spatially multiplexed in a random scheme onto the LCD. The axial irradiance distribution produced by each lens overlaps with the next one producing an extended focal depth. To compare the image quality of the multiplexed lenses, the Modulation Transfer Function (MTF) is calculated. Finally we obtain the experimental Point Spread Functions (PSF) for these multiplexed lenses and experimental results in which an extended object is illuminated under spatially incoherent monochromatic light. We compare the images obtained in the focal plane and in some defocused planes with the single lens and with three multiplexed lenses. The experimental results confirm that the multiplexed lenses produce a high increase in the depth of focus.

Cognitive and affective disorders associated to HIV infection in the HAART era: findings from the NeuroICONA study. Cognitive impairment and depression in HIV/AIDS. The NeuroICONA study.

OBJECTIVE: To assess the natural story of HIV-associated affective and cognitive disorders and the relationship with clinical, pharmacological, immunological and behavioural factors. METHOD: A total of 395 HIV-positive patients, naive to Highly Active Antirectroviral therapy (HAART), with no severe psychiatric disorders have been enrolled in the Neuro-ICONA Study. All participants were administered a comprehensive data collection instrument including an addiction behaviour survey, a medical problem list, a psychiatric assessment, a validated neuropsychological test battery. RESULTS: The global prevalence of cognitive impairment and of prominent depressive symptomatology were 17.9 and 15.5%, respectively. A significant difference in the prevalence of prominent depressive symptomatology was observed between patients in HAART and those not taking HAART(14.1 vs. 23.8%; P = 0.05). CONCLUSION: Depressive and cognitive disorders affect a substantial proportion of HIV-seropositive subjects. The prevalence of prominent depressive symptomatology appears to significantly vary in relationship to the therapeutic protocol.

Flavobacterium spp. organisms as opportunistic bacterial pathogens during advanced HIV disease.

OBJECTIVE: To assess the role of Flavobacterium spp. infection in patients with HIV disease. METHODS: Clinical charts of 2412 consecutive HIV-infected patients hospitalized in a 8-year period were retrospectively reviewed, to identify all cases of Flavobacterium spp. infections, and to evaluate their occurrence and outcome according to several epidemiological, clinical, and laboratory parameters. RESULTS: Six patients out of 2412 (0.25%), developed Flavobacterium spp. complications: septicaemia in five cases, and pneumonia in the remaining patient, with F. meningosepticum and F. odoratum isolated in two cases and one case, respectively, and unnamed Flavobacterium spp. organisms in the remaining three cases. Flavobacterium spp. organisms were responsible for six out of 1939 overall episodes of non-mycobacterial bacterial diseases observed in our patient group (0.31%). All patients were severely immunocompromised, showing a prior diagnosis of AIDS, a mean CD4+ lymphocyte count of 64.2 (range 12-187) cells/microl, and a mean neutrophil count of 1.143 (range 700-1600) cells (range 700-1600) cells/microl. Antibiotic, corticosteriod, or cotrimoxazole treatment was carried out during the month preceding disease onset by three, two and five patients, respectively. Community-acquired and nosocomial Flavobacterium spp. disease were equally frequent, but the latter occurred with a significantly lower mean neutrophil and CD4+ cell count. Antimicrobial susceptibility assays showed complete sensitivity to ciprofloxacin, and variable resistance to ureidopenicillins, ceftazidime, imipenem, aztreonam, and aminoglycosides. An appropriate antimicrobial regimen obtained clinical and microbiological cure in all cases, in absence of related mortality or relapses. CONCLUSIONS: Since only one episode of HIV-associated F. (Sphingobacterium) multivorum complication has been described to date, our series represents the largest one dealing with Flavobacterium spp. infection in the setting of HIV disease. Our experience suggests that Flavobacterium spp. organisms may play a pathogenic role in patients with advanced HIV disease, even when some commonly recognized risk factors are lacking (i.e. indwelling catheters, instrumentation, IV drug abuse), while a very low CD4+ lymphocyte count, leukopaenia-neutropaenia, and concurrent AIDS-related infectious complications may act as important predisposing factors. In view of the infrequent occurrence of these infections, early suspicion is essential for both clinicians and microbiologists facing immunocompromised patients at risk for invasive bacterial complications. Flavobacterium spp. organisms should be taken into consideration as nosocomial- or community-acquired opportunistic pathogens, due to their relationship with advanced immunodeficiency and their elevated resistance to many antimicrobial agents commonly used against Gram-negative bacterial pathogens.

Emerging gram-negative pathogens in the immunocompromised host: Agrobacterium radiobacter septicemia during HIV disease.

Three out of 2,412 consecutive HIV-infected patients hospitalized since 1990, developed Agrobacterium radiobacter septicemia. All patients were severely immunocompromised, showing a prior diagnosis of AIDS, concurrent opportunistic infections, a mean CD4+ lymphocyte count below 100 cells/microL, and neutropenia. Nosocomial A. radiobacter sepsis occurred in two cases of three, and was related to a lower neutrophil and CD4+ cell count. Antibiotic and cotrimoxazole treatment were carried out during the month preceding disease onset by two and three patients, respectively. Antimicrobial susceptibility assays showed resistance to ureidopenicillins and aztreonam, and complete sensitivity to carbapenems, amikacin, and ciprofloxacin. A therapeutic regimen including amikacin plus ceftriaxone or ceftazidime obtained clinical and microbiological cure in all cases, in the absence of related mortality or relapses. Only two episodes of HIV-associated A. radiobacter complications have been described to date: one case of sepsis and one patient with pneumonia. Despite their low frequency, gram-negative non-fermenting bacilli should be considered in HIV-infected patients with a suspected bacterial complication, because of their cumbersome identification procedures, and their unpredictable antibiotic susceptibility, with elevated resistance to many compounds expected to be effective against gram-negative organisms. A. radiobacter may play a pathogenic role in patients with advanced HIV disease, even when some commonly recognized risk factors are lacking (in-dwelling catheters and instrumentation), while a very low CD4+ lymphocyte count, leukopenia-neutropenia, hospitalization, and concurrent AIDS-related infectious complications, may act as predisposing factors.

Bacterial esophagitis in patients with HIV disease.

The authors carried out a retrospective study by reviewing all patients with HIV disease presenting esophageal symptoms who were evaluated by upper endoscopy. Three cases of bacterial esophagitis are reported and discussed according to literature data.

Pulmonary Kaposi's sarcoma in AIDS patients treated with combined chemotherapy and recombinant human granulocyte colony-stimulating factor.

Optimal delivery of chemotherapy in AIDS patients with Kaposi's sarcoma (KS) is frequently limited by hematological toxicity, mainly neutropenia. We have conducted an open-label study to investigate the safety and efficacy of recombinant human granulocyte colony-stimulating factor (filgrastim, r-metHuG-CSF) administration in 25 AIDS patients with pulmonary KS treated with Adriamycin, bleomycin, and vincristine (ABV) combination. The patients were assigned to receive r-metHuG-CSF (Neupogen, Dompé, Biotec, 5 mg/kg of body weight per day) injected subcutaneously for 3-5 days before chemotherapy until the absolute neutrophil count was higher than 25 x 10(9); r-metHuG-CSF was then discontinued 5 days before chemotherapy. Patients were eligible to resume r-metHuG-CSF 3 days after completing the anticancer regimen until normalization of the absolute neutrophil count occurred, for a maximum of 10 days. The cytotoxic regimen included vincristine 1.4 mg/m2, bleomycin 10 mg/m2, and doxorubicin 20 mg/m2, every 2 weeks. The overall response rate was 58% with a complete response rate of 18%. Median survival was 11 months and median response duration was 6 months. Adverse effects consisted of transient nausea and vomiting in 48% of patients, and moderate headache in 43%. Hematologic toxicities included anemia in 27%, and mild to moderate neutropenia (grade II-III) in 38%. The mean leukocyte and neutrophil nadirs were 1920 and 850 mm3. The mean duration of neutropenia was 3.2 days. The combination of r-metHuG-CSF and ABV chemotherapy was well tolerated. Administration of r-metHuG-CSF within 5 days before chemotherapy appears to be an acceptable treatment with important clinical implications. We stress that further studies are needed to determine the maximum tolerable doses of combination chemotherapy supported by G-CSF in AIDS-associated KS patients.

AZT plus methotrexate in HIV-related non-Hodgkin's lymphomas.

AZT is a thymidine analogue useful in the treatment of AIDS. It has been demonstrated that this compound can possess a significant antineoplastic activity when combined with de novo thymidylate synthesis inhibitors, such as 5-fluorouracil (5FU) and methotrexate (MTX). Here we report a review of our data concerning the efficacy and tolerance of the combination AZT + MTX in HIV-related non Hodgkin's lymphomas (NHL). Twenty-nine patients were treated, at weekly intervals, with three (patient 1 to 10) or six (patient 11 to 29) consecutive courses of MTX 1g/m2 and increasing doses of oral AZT (2, 4 and 6g/m2) with leucovorin rescue. Of 26 evaluable patients, a total (complete + partial) response rate of 77% was obtained. The median complete response duration was 16.8 months. There was one therapy-related death due to septic shock. Grade III-IV neutropenia was observed after 19% of the courses, but was prevented by G-CSF administration in 82/119 courses. Grade III-IV anemia was observed after 9% of the courses. In conclusion, the combination AZT + MTX was effective and well tolerated in our series of HIV-related NHL patients.

Imported tropical diseases in subjects with HIV infection.

The authors report a case of Plasmodium falciparum malaria and a case of lymphatic filariasis caused by Brugia malayi, imported by HIV-infected patients during trips in endemic countries. The clinical and laboratory picture, as well as treatment response of imported malaria and filariasis did not differ significantly in patients with HIV infection compared with immunocompetent subjects. The exposition to tropical diseases during exotic travels has to be taken into account, in the differential diagnosis of infectious disorders complicating the course of HIV disease.

Input-image homogenization as a method to improve a correlator's discrimination capability.

We propose an input-image preprocessing method consisting of homogenization of the image to improve the discrimination capability of a correlation-based recognition process. This method is an approximation of the optimal filter. It offers the advantage that correlation with the preprocessed images can easily be implemented in an optical correlator working with phase-only spatial light modulators.

[Smectite in AIDS-associated chronic idiopathic diarrhea]. / Diosmectite nella diarrea cronica idiopatica in corso di AIDS.

BACKGROUND: A prospective clinical survey was carried out in order to determine the effects of Smectite in patients with AIDS-associated chronic idiopathic diarrhea. METHODS: A total of 22 patients has been included in this study. All patients received smectite, 3 g orally three times daily far from meals for a period of 10-21 days. The outcome of chronic diarrhea has been evaluated during treatment. RESULTS: A significant reduction of duration of diarrhea, of frequency of stool number, and of the amount of liquid stools, has been recorded in all patients after the third and the fourth day of treatment. No major adverse effects and drug interactions have been documented in all treated patients. CONCLUSIONS: Smectite may be considered as adjuvant therapy in patients with AIDS-associated chronic idiopathic diarrhea by virtue of its efficacy and tolerability.

Quantitative cytomegalovirus (CMV) antigenaemia during antiviral treatment of AIDS-related CMV disease.

In order to assess the value of quantitative measurement of cytomegalovirus (CMV) antigenaemia as a marker for the guidance of antiviral chemotherapy in the AIDS setting, 33 patients with CMV complications and showing at least 20 pp65-positive polymorphonuclear leucocytes per 2 x 10(5) cells, received either ganciclovir or foscarnet as induction and maintenance therapy. Antigenaemia was assessed every 1-4 weeks. During acute-phase antiviral therapy, a significant decrease of CMV antigenaemia (>50% of pretreatment levels) paralleled clinical improvement in 2-7 weeks in 32 of 33 subjects. In ten of 24 evaluable patients followed up during a further 4-12 months, disease relapses occurred concurrently with an increase of CMV antigenaemia in seven cases, while three cases of relapsing retinitis did not show a significant increase in antigenaemia. All patients with recurrent disease had a favourable response to further treatment, including halted clinical progression and significant decrease in antigenaemia. In HIV-related CMV disease, periodic monitoring of quantitative CMV antigenaemia proves useful in evaluating response to antivirals, in guiding therapeutic management and in predicting disease relapses.

Recurrent 'migrainelike' episodes in patients with HIV disease.

Recurrent transient neurological deficits have been described in human immunodeficiency virus (HIV)-infected subjects, but their frequency, pathogenesis, and outcome are still unsettled. We describe 10 HIV-infected patients with transient neurological deficits (0.8% of all patients followed in our department during the last decade). All patients were in the advanced stage of immunological disease. None of the clinical or special investigations performed outside of the attacks indicated an underlying structural lesion of the central nervous system. In 80% of these patients, anticardiolipin antibodies were present. The final outcome was unrelated to these transient neurological deficits which, per se, had a benign course. We discuss the possible etiopathogenetic mechanisms of such episodes and suggest that they may be "migrainelike" events, possibly related to transient functional circulatory abnormalities secondary to an immunological antiphospholipid antibody-dependent mechanism.