RESUMO
The management of anorexia nervosa (AN) remains complex with insufficient success rates. Based on clinical and empirical observations implicating neuropsychological difficulties in AN, cognitive remediation (CR) therapy appears to show positive effects. Nevertheless, these results remain subject to debate as some studies do not show this improvement, or in the case of positive improvements, a smaller effect size on cognitive performance. A possible explanation could lie in the cognitive tests used to assess CR. The aim of this study is to propose a new protocol for the evaluation of cognitive remediation for patients suffering from ED through the presentation of a case study.
Assuntos
Anorexia Nervosa , Terapia Cognitivo-Comportamental , Remediação Cognitiva , Humanos , Anorexia Nervosa/complicações , Anorexia Nervosa/terapia , Anorexia Nervosa/psicologia , Terapia Cognitivo-Comportamental/métodos , Testes NeuropsicológicosRESUMO
Mercury (Hg) is a widespread pollutant across estuarine and coastal areas, raising concern on its potential impact on aquatic organisms. Hg may origin from natural and anthropogenic sources, being persistent and potentially toxic to biota, ultimately representing a serious risk to human health. Hg accumulation and toxicity may also induce reactive oxygen species (ROS) production in marine organisms, responsible for cell and tissue damage. Additionally, the temperature is undoubtedly an important environmental factor to consider regarding accumulation, due to its marked influence on the physiology and ecology of aquatic organisms. This study aimed to investigate the effect of different temperature scenarios (15, 20 and 25 °C) on the Hg accumulation in Pomatoschistus microps (Krøyer, 1838) liver and muscle, as well as on oxidative stress responses and energy metabolism, after short-term exposure to a naturally contaminated sediment with an environmentally relevant [Hg] (1.2 µg g-1). The results showed that Hg accumulation tends to increase along the temperature gradient with higher values of Hg accumulated in liver than in muscle tissue. The action of antioxidant enzymes and stress proteins seems to be effective in combating oxidative stress in the liver. Despite the action of antioxidant defences in the muscle, oxidative damage was observed at the protein level concomitantly with a decrease in aerobic energy production after exposure to Hg at higher temperatures. These findings are ecologically relevant and highlight the importance of further investigation of combined effects of Hg and other stressors, especially in a scenario of a changing climate where events leading to rapid alterations on water parameters are more frequent.
Assuntos
Mercúrio , Poluentes Químicos da Água , Animais , Humanos , Mercúrio/toxicidade , Estresse Oxidativo , Temperatura , Água , Poluentes Químicos da Água/toxicidadeRESUMO
Shiga toxin-producing Escherichia coli (STEC) infections are a significant public health issue, with foodborne transmission causing >1 million illnesses worldwide each year. We conducted a systematic review and meta-analysis (PROSPERO registry # CRD42017074239), to determine the relative association of different food types with sporadic illnesses caused by STEC. Searches were conducted from 01 August to 30 September 2017, using bibliographic and grey literature databases, websites and expert consultation. We identified 22 case-control studies of sporadic STEC infection in humans, from 10 countries within four World Health Organization subregions, from 1985 to 2012. We extracted data from 21 studies, for 237 individual measures in 11 food categories and across three status types (raw or undercooked, not raw and unknown). Beef was the most significant food item associated with STEC illness in the Americas and Europe, but in the Western Pacific region, chicken was most significant. These findings were not significantly moderated by the raw or cooked status of the food item, nor the publication year of the study. Data from the African, South-East Asian and Eastern Mediterranean subregions were lacking and it is unclear whether our results are relevant to these regions.
Assuntos
Surtos de Doenças , Infecções por Escherichia coli/epidemiologia , Doenças Transmitidas por Alimentos/epidemiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , América/epidemiologia , Estudos de Casos e Controles , Infecções por Escherichia coli/transmissão , Europa (Continente)/epidemiologia , Feminino , Doenças Transmitidas por Alimentos/prevenção & controle , Humanos , Incidência , Masculino , Sistema de Registros , Medição de Risco , Organização Mundial da SaúdeRESUMO
Microbial subtyping approaches are commonly used for source attribution of human salmonellosis. Such methods require data on Salmonella in animals and humans, outbreaks, infection abroad and amounts of food available for consumption. A source attribution model was applied to 24 European countries, requiring special data management to produce a standardized dataset. Salmonellosis data on animals and humans were obtained from datasets provided by the European Food Safety Authority. The amount of food available for consumption was calculated based on production and trade data. Limitations included different types of underreporting, non-participation in prevalence studies, and non-availability of trade data. Cases without travel information were assumed to be domestic; non-subtyped human or animal records were re-identified according to proportions observed in reference datasets; missing trade information was estimated based on previous years. The resulting dataset included data on 24 serovars in humans, broilers, laying hens, pigs and turkeys in 24 countries.
Assuntos
União Europeia/estatística & dados numéricos , Infecções por Salmonella/epidemiologia , Animais , Galinhas/microbiologia , Surtos de Doenças/estatística & dados numéricos , Europa (Continente)/epidemiologia , Microbiologia de Alimentos/estatística & dados numéricos , Humanos , Gado/microbiologia , Vigilância da População/métodos , Salmonella/classificação , Intoxicação Alimentar por Salmonella/epidemiologia , Intoxicação Alimentar por Salmonella/etiologia , Intoxicação Alimentar por Salmonella/microbiologia , Infecções por Salmonella/etiologia , Infecções por Salmonella/microbiologia , Salmonelose Animal/epidemiologia , Salmonelose Animal/etiologia , Salmonelose Animal/microbiologia , Sorotipagem , Suínos/microbiologia , Perus/microbiologiaRESUMO
A Bayesian modelling approach comparing the occurrence of Salmonella serovars in animals and humans was used to attribute salmonellosis cases to broilers, turkeys, pigs, laying hens, travel and outbreaks in 24 European Union countries. Salmonella data for animals and humans, covering the period from 2007 to 2009, were mainly obtained from studies and reports published by the European Food Safety Authority. Availability of food sources for consumption was derived from trade and production data from the European Statistical Office. Results showed layers as the most important reservoir of human salmonellosis in Europe, with 42·4% (7 903 000 cases, 95% credibility interval 4 181 000-14 510 000) of cases, 95·9% of which was caused by S. Enteritidis. In Finland and Sweden, most cases were travel-related, while in most other countries the main sources were related to the laying hen or pig reservoir, highlighting differences in the epidemiology of Salmonella, surveillance focus and eating habits across the European Union.
Assuntos
Reservatórios de Doenças/microbiologia , União Europeia/estatística & dados numéricos , Intoxicação Alimentar por Salmonella/epidemiologia , Animais , Galinhas/microbiologia , Surtos de Doenças/estatística & dados numéricos , Reservatórios de Doenças/estatística & dados numéricos , Europa (Continente)/epidemiologia , Humanos , Vigilância da População , Intoxicação Alimentar por Salmonella/etiologia , Intoxicação Alimentar por Salmonella/microbiologia , Intoxicação Alimentar por Salmonella/transmissão , Salmonelose Animal/epidemiologia , Processos Estocásticos , Suínos/microbiologia , Viagem/estatística & dados numéricos , Perus/microbiologiaRESUMO
BACKGROUND: Although polypharmacy may be justified in elderly patients with multiple diseases, it may be dangerous, especially when it includes potentially inappropriate medications (PIM). AIM: To identify inappropriate medication and factors associated with the most relevant prescriptions among older people. MATERIAL AND METHODS: Cross-sectional observational analysis of drugs prescribed during the first trimester of 2010 to 179 older adults aged 77 ± 8 years (98 women), living in a geriatric reference hospital in Argentina. The use of potentially inappropriate medications (PIM) in elderly patients was analyzed using Beers Criteria updated to 2012. RESULTS: The mean number of drugs prescribed per individual was 6.1 ± 2.7. The most commonly used drugs were anti-ulcer agents (58.1%), agents acting on the renin-angiotensin system (54.2%), antithrombotic medications (50.8%) and benzodiazepines (50.8 %). The use of antacids and anti-ulcer agents, psychotropic drugs and PIM was significantly higher among patients using six or more drugs daily, compared to the less medicated group (odds ratio (OR) = 6.8, 95% confidence intervals (CI) 3.5-13.2; OR=15.0, 95%CI 5.9-38.4; OR=5.0; 95%IC 2.6-9.8, respectively). Thirty one percent of participants using non-steroidal anti-inflammatory drugs, were not receiving medications for gastric protection. One to four drugs included in the Beers list were prescribed to 66% of participants. CONCLUSIONS: Despite the high prevalence of use of antacids and anti-ulcer agents, these drugs were not prescribed to a significant proportion of patients using non-steroidal anti-inflammatory drugs. Strategies to optimize pharmacotherapy in the elderly population are urgently required.
Assuntos
Prescrições de Medicamentos/normas , Serviços de Saúde para Idosos/normas , Prescrição Inadequada/estatística & dados numéricos , Padrões de Prática Médica/normas , Idoso , Idoso de 80 Anos ou mais , Argentina , Estudos de Coortes , Estudos Transversais , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Serviços de Saúde para Idosos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/estatística & dados numéricos , Estudos RetrospectivosRESUMO
Campylobacter spp. is a widespread and important cause of human illness worldwide. Disease is frequently associated with foodborne transmission, but other routes of exposure, such as direct contact with live animals and person-to-person transmission, are also recognized. Identifying the most important sources of human disease is essential for prioritizing food safety interventions and setting public health goals. Numerous case-control studies of sporadic infections of campylobacteriosis have been published. These studies investigated a variety of potential risk factors for disease, often using different methodologies and settings. Systematic reviews (SRs) consist of a formal process for literature review focused on a specific research question, and include the identification of relevant literature, quality assessment of relevant studies, summarization or statistical analysis of data, and conclusions. With the objective of identifying the most important risk factors for human sporadic campylobacteriosis, we performed a SR of case-control studies of human sporadic cases and a meta-analysis of the obtained results. A combined SR focusing on Salmonella and Campylobacter studies was performed and the results analysed separately. From 1295 identified references, 131 passed the relevance screening, 73 passed the quality assessment stage, and data was extracted from 72 studies. Of these, 38 focused on campylobacteriosis. Information on exposures of cases and controls, and estimated odds ratios for investigated risk factors were collected and analysed. In the meta-analysis, heterogeneity between the studies and possible sources of bias were investigated, and pooled odds ratios for identified risk factors were estimated. Results suggest that travelling abroad, eating undercooked chicken, environmental sources, and direct contact with farm animals were significant risk factors for campylobacteriosis. Sub-analyses by geographical region, age group, and study period were performed, and differences were discussed.
Assuntos
Infecções por Campylobacter/epidemiologia , Animais , Meio Ambiente , Microbiologia de Alimentos , Humanos , Razão de Chances , Fatores de Risco , ViagemRESUMO
Salmonella is an important cause of human illness. Disease is frequently associated with foodborne transmission, but other routes of exposure are recognized. Identifying sources of disease is essential for prioritizing public health interventions. Numerous case-control studies of sporadic salmonellosis have been published, often using different methodologies and settings. Systematic reviews consist of a formal process for literature review focused on a research question. With the objective of identifying the most important risk factors for salmonellosis, we performed a systematic review of case-control studies and a meta-analysis of obtained results. Thirty-five Salmonella case-control studies were identified. In the meta-analysis, heterogeneity between studies and possible sources of bias were investigated, and pooled odds ratios estimated. Results suggested that travel, predisposing factors, eating raw eggs, and eating in restaurants were the most important risk factors for salmonellosis. Sub-analyses by serotype were performed when enough studies were available.
Assuntos
Doenças Transmitidas por Alimentos/epidemiologia , Doenças Transmitidas por Alimentos/microbiologia , Infecções por Salmonella/epidemiologia , Microbiologia de Alimentos , Humanos , Restaurantes , Fatores de Risco , ViagemRESUMO
Overuse of antimicrobials in food-animal production is thought to be a major risk factor for the development of resistant bacterial populations. Data on non-human antimicrobial usage is essential for planning of intervention strategies to lower resistance levels at the country, region or herd levels. In this study we evaluated Danish national antimicrobial usage data for five antimicrobial classes used in slaughter pigs in different herd sizes and data on the number of slaughter pigs produced per herd, between 2002 and 2008, in Denmark. The objective was to ascertain if there is an association between herd size and amount of antimicrobials consumed. During this period, the overall number of herds with slaughter pigs decreased by 43%, with larger herds becoming more prevalent. The tetracycline treatment incidence (TI) rate increased from 0·28 to 0·70 animal-defined daily dose (ADD)/100 slaughter pig-days at risk while macrolide TI presented a more moderate increase, from 0·40 to 0·44 ADD/100 slaughter pig-days at risk during the study period. Linear regression analyses revealed a significant association between herd size and TI rates for tetracyclines, macrolides, sulfonamides/trimethoprim and cephalosporins, with small herds presenting significantly higher TI than moderate, large and the largest herds. This study highlights the importance of establishing an antimicrobial consumption monitoring programme, integrated with comprehensive food-animal production surveillance. Further research should be performed to address the potential causes of the detected associations between herd sizes and antimicrobial consumption in pigs.
Assuntos
Criação de Animais Domésticos/métodos , Antibacterianos/administração & dosagem , Uso de Medicamentos/tendências , Animais , Dinamarca , SuínosRESUMO
The aim of this study was to identify the sources of sporadic domestic Salmonella cases in Sweden and to evaluate the usefulness of a source-attribution model in a country in which food animals are virtually free from Salmonella. The model allocates human sporadic domestic Salmonella cases to different sources according to distribution of Salmonella subtypes in the different sources. Sporadic domestic human Salmonella cases (n=1086) reported between July 2004 and June 2006 were attributed to nine food-animal and wildlife sources. Of all Salmonella cases, 82% were acquired abroad and 2·9% were associated with outbreaks. We estimated that 6·4% were associated with imported food, 0·5% with food-producing animals, and 0·6% with wildlife. Overall, 7·7% could not be attributed to any source. We concluded that domestic food-producing animals are not an important source for Salmonella in humans in Sweden, and that the adapted model is useful also in low-prevalence countries.
Assuntos
Infecções por Salmonella/epidemiologia , Infecções por Salmonella/transmissão , Animais , Animais Domésticos , Animais Selvagens , Doenças Transmitidas por Alimentos/epidemiologia , Humanos , Salmonelose Animal/epidemiologia , Salmonelose Animal/transmissão , Suécia/epidemiologia , Zoonoses/transmissãoRESUMO
The formation of a porous oxide surface doped with osteoconductive elements, Ca, P and Mg, to enhance osseointegration, was achieved through micro arc oxidation. Micro arc oxidation parameters, such as electrolyte composition, concentration and applied voltage, were studied to understand their effect on the morphology and chemical composition of the samples surface. Considering the optimum atomic concentration reported in literature for each osteoconductive element, microporous Ta anodic oxide samples treated with calcium acetate (CaA) and ß-glycerophosphate (ß-GP) revealed that an increase of ß-GP molarity in the electrolyte boosts Ca incorporation, as well as, increasing the porosity. In adding magnesium acetate (MgA) to the electrolyte, when composed by CaA + ß-GP, both addition and variation of MgA did not affect the surface morphology along the samples, being incorporated into the oxide layer for 0.1 M. Finally, in vitro tests were carried out to study the biocompatibility of Ta, to verify the cytotoxicity of the samples and their behavior towards cells, by performing adhesion and differentiation tests with the MC3T3-E1 cell line. Cytotoxicity tests revealed that the samples were non-toxic. Despite none of the samples having been raised up through cell adhesion tests, cell differentiation revealed promising results for the Ta-CaP.
Assuntos
Tantálio , Titânio , Acetatos , Compostos de Magnésio , Osteoblastos , Óxidos/farmacologia , Propriedades de Superfície , Tantálio/farmacologiaRESUMO
Food is an elementary requirement for human life, providing nutrients and essential energy needed for optimal health. But at the same time, food can also be a vehicle of hazardous substances or pathogens that could affect human health negatively. Risk-benefit assessment (RBA) of foods, a relatively new methodology for decision support, integrates nutrition, toxicology, microbiology, chemistry and human epidemiology for a comprehensive health impact assessment. By integrating health risks and benefits related to food consumption, RBA facilitates science-based decision-making in food-related areas and the development of policies and consumer advice. The present work programme aimed to allow the fellow to become acquainted with the process of RBA and the associated tools needed to assess quantitatively the risks and the benefits through three main activities (i) to learn the different methodologies used for RBA; (ii) to apply these methodologies to a specific case-study - RBA of raw milk consumption; and (iii) to participate in the main activities of the Risk-Benefit research group at DTU Food regarding risk-benefit issues. For the RBA of raw milk consumption, microbiological pathogens (Listeria monocytogenes, Salmonella spp., Campylobacter jejuni and Shiga toxin-producing Escherichia coli), probiotic bacteria and nutritional components (vitamins B2 and A) were considered, as well as the potential impact of raw milk consumption in the reduction of the allergies' prevalence. Two major approaches were applied: the bottom-up (estimating the disease incidence due to the exposure) and the top-down (using epidemiological and incidence data to the estimate the number of cases attributable to a certain exposure). Through all the training and hands-on activities performed, the present work programme enabled the fellow to extend the knowledge on the quantitative RBA, specifically in the context of raw milk consumption. EU-FORA programme also provided an exceptional opportunity of networking and establishment of future research lines of collaboration.
RESUMO
Individuals born small have an increased risk for developing type 2 diabetes. Altered food preferences in these subjects seem to play a role; however, limited evidence is available on the association between being born small-for-gestational-age (SGA) at term and food intake in adolescence. Alterations in leptin, ghrelin and dopamine levels are suggested mechanisms linking SGA with later food intake. From a large prospective Danish National Birth Cohort, we compared dietary intake of adolescents being born SGA with normal-for-gestational-age (NGA) adolescents. Intake of foods and nutrients was assessed by a validated food frequency questionnaire in a subsample of 15,607 14-year-old individuals born at term. SGA was defined by birth weight (BW) <10th percentile (n = 1470) and NGA as BW between 10 and 90th percentile (n = 14,137) according to sex and gestational age-specific BW standard curves. Girls born SGA had a 7% (95% CI: 3-12%, P = 0.002) higher intake of added sugar and a 2-8% lower intake of dietary fibre, vegetables, polyunsaturated fatty acids, and total n-6, compared with NGA girls (P < 0.05). Adjusting for parental socio-occupational status, maternal smoking and diet in pregnancy did not substantially change the differences in dietary intake, except from dietary fibre, which were no longer statistically significant. No significant differences in dietary intake between SGA and NGA boys were found. In summary, girls born SGA had an unfavourable dietary intake compared with NGA girls. These differences persisted after controlling for potential confounders, thus supporting a fetal programming effect on dietary intake in girls born SGA at term. However, residual confounding by other factors operating early in childhood cannot be excluded.
Assuntos
Comportamento do Adolescente/fisiologia , Dieta , Ingestão de Energia , Comportamento Alimentar/fisiologia , Desenvolvimento Fetal , Recém-Nascido Pequeno para a Idade Gestacional/crescimento & desenvolvimento , Adolescente , Adulto , Peso ao Nascer , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Estudos ProspectivosRESUMO
Different strains of Trypanosoma cruzi were transfected with an expression vector that allows the integration of green fluorescent protein (GFP) and red fluorescent protein (RFP) genes into the beta-tubulin locus by homologous recombination. The sites of integration of the GFP and RFP markers were determined by pulse-field gel electrophoresis and Southern blot analyses. Cloned cell lines selected from transfected epimastigote populations maintained high levels of fluorescent protein expression even after 6 months of in vitro culture of epimastigotes in the absence of drug selection. Fluorescent trypomastigotes and amastigotes were observed within Vero cells in culture as well as in hearts and diaphragms of infected mice. The infectivity of the GFP- and RFP-expressing parasites in tissue culture cells was comparable to wild type populations. Furthermore, GFP- and RFP-expressing parasites were able to produce similar levels of parasitemia in mice compared with wild type parasites. Cell cultures infected simultaneously with two cloned cell lines from the same parasite strain, each one expressing a distinct fluorescent marker, showed that at least two different parasites are able to infect the same cell. Double-infected cells were also detected when GFP- and RFP-expressing parasites were derived from strains belonging to two distinct T. cruzi lineages. These results show the usefulness of parasites expressing GFP and RFP for the study of various aspects of T. cruzi infection including the mechanisms of cell invasion, genetic exchange among parasites and the differential tissue distribution in animal models of Chagas disease.
Assuntos
Doença de Chagas/parasitologia , Proteínas de Fluorescência Verde/genética , Proteínas Luminescentes/genética , Trypanosoma cruzi/genética , Animais , Chlorocebus aethiops , Eletroforese em Gel de Poliacrilamida , Citometria de Fluxo , Expressão Gênica , Humanos , Immunoblotting/métodos , Interferon gama/genética , Camundongos , Camundongos Knockout , Microscopia Confocal , Modelos Animais , Parasitologia/métodos , Transfecção/métodos , Células Vero , Proteína Vermelha FluorescenteRESUMO
In the present study, we successfully demonstrated for the first time the existence of cardiac proteomic differences between non-selectively bred rats with distinct intrinsic exercise capacities. A proteomic approach based on two-dimensional gel electrophoresis coupled to mass spectrometry was used to study the left ventricle (LV) tissue proteome of rats with distinct intrinsic exercise capacity. Low running performance (LRP) and high running performance (HRP) rats were categorized by a treadmill exercise test, according to distance run to exhaustion. The running capacity of HRPs was 3.5-fold greater than LRPs. Protein profiling revealed 29 differences between HRP and LRP rats (15 proteins were identified). We detected alterations in components involved in metabolism, antioxidant and stress response, microfibrillar and cytoskeletal proteins. Contractile proteins were upregulated in the LVs of HRP rats (α-myosin heavy chain-6, myosin light chain-1 and creatine kinase), whereas the LVs of LRP rats exhibited upregulation in proteins associated with stress response (aldehyde dehydrogenase 2, α-crystallin B chain and HSPß-2). In addition, the cytoskeletal proteins desmin and α-actin were upregulated in LRPs. Taken together, our results suggest that the increased contractile protein levels in HRP rats partly accounted for their improved exercise capacity, and that proteins considered risk factors to the development of cardiovascular disease were expressed in higher amounts in LRP animals.
Assuntos
Testes de Função Cardíaca/métodos , Miocárdio/metabolismo , Condicionamento Físico Animal/fisiologia , Proteínas/metabolismo , Corrida/fisiologia , Animais , Proteínas Contráteis/metabolismo , Proteínas do Citoesqueleto/metabolismo , Desmina/metabolismo , Eletroforese em Gel Bidimensional , Ventrículos do Coração/metabolismo , Proteínas de Choque Térmico/metabolismo , Masculino , Espectrometria de Massas , Tamanho do Órgão , Proteínas/isolamento & purificação , Proteômica , Ratos , Ratos EndogâmicosRESUMO
AIM: Partial body weight support (PBWS) is an accepted treatment for hemiplegic patients. The aim of this study is to compare the efficiency of gait trainer with conventional treatment on the gait management after stroke. METHODS: Forty chronic post-stroke hemiplegics were part of a prospective research. Inclusion criteria were: first ever stroke in a chronic stage with stabilised motor deficits; age >18 and <80 years; cognitive and communication skills to understand the treatment; absence of cardiac, psychological and orthopedic contraindications. Patients were randomised into two groups: the control group (CG) that used the Bobath method in 40 minutes sessions, 5 times a week, for 5 weeks, and the experimental group (EG) that used the gait trainer, for the same period of time and frequency. Assessment tools: Motricity Index (MI); Toulouse Motor Scale (TMS); modified Ashworth Spasticity Scale (mASS); Berg Balance Scale (BBS); Rivermead Mobility Index (RMI); Fugl-Meyer Stroke Scale (F-MSS); Functional Ambulation Category (FAC); Barthel Index (BI); 10 meters, time up and go (TUG), 6 minutes, and step tests. EG and CG did the assessments before treatment (T(0)), right after treatment (T(1)), and on follow-up, 3 months later (T(2)). RESULTS: CG and EG were homogenous in all the variables at T(0). CG and EG showed improvement in almost all the assessment scales after treatment, although only some with relevant differences. EG showed statistically relevant improvement on T(1) and on T(2) in several of the assessment tools, whereas CG only showed statistically significant improvement after T(1) and only in some of the assessment tools. CONCLUSIONS: Both groups of chronic hemiplegic patients improved after either PBWS with gait trainer or Bobath treatment. Only subjects undergoing PBWS with gait trainer maintained functional gain after 3 months.
Assuntos
Transtornos Neurológicos da Marcha/reabilitação , Hemiplegia/reabilitação , Reabilitação do Acidente Vascular Cerebral , Idoso , Distribuição de Qui-Quadrado , Doença Crônica , Feminino , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Hemiplegia/etiologia , Hemiplegia/fisiopatologia , Humanos , Masculino , Estudos Prospectivos , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/fisiopatologia , Resultado do TratamentoRESUMO
Diagnostic tools are important for clinical management and epidemiological evaluation of Tegumentary (TL) and Visceral (VL) Leishmaniasis. Serology is not frequently used for the diagnosis of the TL form because low antibody titers and cross-reaction with VL. Therefore, it is crucial to identify specific and immunogenic antigens from species associated with the TL form. Here we employed a proteomic approach coupled to an in silico analysis and identified the most abundant and immunogenic proteins from Leishmania amazonensis, Leishmania braziliensis and Leishmania infantum. Of 16 species specific proteins, nine were from the species causative of the TL form (L. amazonensis and L. braziliensis). In silico analysis revealed 18 B-cell epitopes with 0% similarity to Trypanosoma cruzi orthologs and, therefore, less likely to crossreact with sera of patients with Chagas disease. Two proteins reacted exclusively with serum from TL patients and presented several B-cell epitopes without similarity to T. cruzi orthologs: the hypothetical protein GI 134063939 and the metallo-peptidase Clan MA(E)-Family M3. The immunoassay revealed nine peptides with strong reactivity to sera from TL patients. These proteins and peptides may be good candidates to improve the specificity and sensibility of serological tests aiming to diagnose the TL of this neglected human disease. BIOLOGICAL SIGNIFICANCE: As no gold-standard test for tegumentary leishmaniasis (TL) exists, a combination of different diagnostic techniques is often necessary to obtain precise results. Thus, the identification of species-specific, highly immunogenic and abundant proteins that stimulate the humoral immune response in the host should help in the development of serological tests for human TL. Herein we searched for these potential antigens in Leishmania species related to American Leishmaniasis (L. amazonensis, L. braziliensis and L. infantum). To this end, we employed an immunoproteomic approach using proteins from these Leishmania species and sera from TL and Visceral Leishmaniasis (VL) patients. Our study unveils specific proteins and peptides that may represent antigens that will help the efforts to improve the accuracy of serological tests to diagnose the TL form.
Assuntos
Antígenos de Protozoários/análise , Leishmaniose Cutânea/diagnóstico , Leishmaniose Visceral/diagnóstico , Testes Sorológicos/métodos , Reações Cruzadas , Diagnóstico Diferencial , Humanos , Leishmaniose Cutânea/imunologia , Leishmaniose Visceral/imunologia , Doenças Negligenciadas/diagnóstico , Proteômica/métodos , Proteínas de Protozoários/análise , Sensibilidade e Especificidade , Testes Sorológicos/normas , Especificidade da EspécieAssuntos
Transplante de Células-Tronco de Sangue do Cordão Umbilical , Rejeição de Enxerto , Transplante de Células-Tronco Hematopoéticas , Leucemia Mielomonocítica Juvenil/terapia , Terapia de Salvação , Pré-Escolar , Rejeição de Enxerto/genética , Haplótipos , Humanos , Leucemia Mielomonocítica Juvenil/cirurgia , Masculino , Resultado do TratamentoRESUMO
Leishmania spp have a wide range of hosts, and each host can harbor several Leishmania species. Dogs, for example, are frequently infected by Leishmania infantum, where they constitute its main reservoir, but they also serve as hosts for L. braziliensis and L. amazonensis. Serological tests for antibody detection are valuable tools for diagnosis of L. infantum infection due to the high levels of antibodies induced, unlike what is observed in L. amazonensis and L. braziliensis infections. Likewise, serology-based antigen-detection can be useful as an approach to diagnose any Leishmania species infection using different corporal fluid samples. Immunogenic and secreted proteins constitute powerful targets for diagnostic methods in antigen detection. As such, we performed immunoproteomic (2-DE, western blot and mass spectrometry) and bioinformatic screening to search for reactive and secreted proteins from L. amazonensis, L. braziliensis, and L. infantum. Twenty-eight non-redundant proteins were identified, among which, six were reactive only in L. amazonensis extracts, 10 in L. braziliensis extracts, and seven in L. infantum extracts. After bioinformatic analysis, seven proteins were predicted to be secreted, two of which were reactive only in L. amazonensis extracts (52kDa PDI and the glucose-regulated protein 78), one in L. braziliensis extracts (pyruvate dehydrogenase E1 beta subunit) and three in L. infantum extracts (two conserved hypothetical proteins and elongation factor 1-beta). We propose that proteins can be suitable targets for diagnostic methods based on antigen detection.
Assuntos
Biologia Computacional/métodos , Doenças do Cão/parasitologia , Imunoproteínas/isolamento & purificação , Leishmania/classificação , Leishmaniose/veterinária , Proteômica/métodos , Animais , Doenças do Cão/diagnóstico , Cães , Leishmania/isolamento & purificação , Leishmaniose/diagnóstico , Leishmaniose/parasitologiaRESUMO
Female Wistar rats and Wistar audiogenic rats (WARs) were used to investigate the potential roles of prolactin (PRL) and progesterone in the modulation of seizure expression. Animals were screened for seizure severity in both groups. All WARs at least displayed tonic-clonic convulsions followed by clonic spasms (TC) whereas none of the Wistar rats displayed seizures (Resistant). After seizures the plasma level of PRL in nulliparous female WARs increased about 8-fold compared to their basal levels and to the levels of Resistant animals. This value was still significantly higher than basal levels 15 min later. Lactation produced a decrease in the TC proportion in seizures in WARs both with and without pups. Two sub-populations of animals could be characterized: one that had TC suppressed (low seizure severity; LSS) and one that did not (high seizure severity; HSS). In animals of the LSS subgroup, either with or without pups, seizure severity decreased gradually and lowest values were seen on the 30th day after delivery. The temporal profile of plasma PRL during a 90-min period of suckling without sound stimulation showed significantly higher levels for LSS, the HSS levels being similar to those of the Resistant group. A progressive decrease in the group means for progesterone plasma concentration between the 9th and 29th days of lactation was detected in Resistant rats (P<0.05) but not in WARs. No significant differences between groups were revealed by comparison of the overall means. Taken together these data confirm the presence of a clear-cut post-ictal PRL peak after TC with a decrease in seizure severity in female WARs with and without pups. An eventual long-term role of PRL in modulating seizure activity might be related to the multifactorial physiological conditions of both pregnancy and lactation.