Beyond the MEP Pathway: A novel kinase required for prenol utilization by malaria parasites.

A proposed treatment for malaria is a combination of fosmidomycin and clindamycin. Both compounds inhibit the methylerythritol 4-phosphate (MEP) pathway, the parasitic source of farnesyl and geranylgeranyl pyrophosphate (FPP and GGPP, respectively). Both FPP and GGPP are crucial for the biosynthesis of several essential metabolites such as ubiquinone and dolichol, as well as for protein prenylation. Dietary prenols, such as farnesol (FOH) and geranylgeraniol (GGOH), can rescue parasites from MEP inhibitors, suggesting the existence of a missing pathway for prenol salvage via phosphorylation. In this study, we identified a gene in the genome of P. falciparum, encoding a transmembrane prenol kinase (PolK) involved in the salvage of FOH and GGOH. The enzyme was expressed in Saccharomyces cerevisiae, and its FOH/GGOH kinase activities were experimentally validated. Furthermore, conditional knockout parasites (Δ-PolK) were created to investigate the biological importance of the FOH/GGOH salvage pathway. Δ-PolK parasites were viable but displayed increased susceptibility to fosmidomycin. Their sensitivity to MEP inhibitors could not be rescued by adding prenols. Additionally, Δ-PolK parasites lost their capability to utilize prenols for protein prenylation. Experiments using culture medium supplemented with whole/delipidated human plasma in transgenic parasites revealed that human plasma has components that can diminish the effectiveness of fosmidomycin. Mass spectrometry tests indicated that both bovine supplements used in culture and human plasma contain GGOH. These findings suggest that the FOH/GGOH salvage pathway might offer an alternate source of isoprenoids for malaria parasites when de novo biosynthesis is inhibited. This study also identifies a novel kind of enzyme related to isoprenoid metabolism.

An evidence-informed policymaking (EIPM) competency profile for the Brazilian Health System developed through consensus: process and outcomes.

BACKGROUND: Evidence-informed policymaking (EIPM) requires a set of individual and organizational knowledge, skills and attitudes that should be articulated with background factors and needs. In this regard, the development of an EIPM competency profile is important to support the diagnosis, planning and implementation of EIPM. PURPOSE: To present the process and outcomes of the development of an EIPM competency profile by an expert committee, to be applied in different contexts of the Brazilian Health System. METHODS: A committee of experts in EIPM shared different views, experiences and opinions to develop an EIPM competency profile for Brazil. In six consensus workshops mediated by facilitators, the committee defined from macro problems to key actions and performances essential for the competency profile. The development steps consisted of: (1) Constitution of the committee, including researchers, professionals with practical experience, managers, and educators; (2) Development of a rapid review on EIPM competency profiles; (3) Agreement on commitments and responsibilities in the processes; (4) Identification and definition of macro problems relating to the scope of the competency profile; and (5) Outlining of general and specific capacities, to be incorporated into the competency profile, categorized by key actions. RESULTS: The development of the EIPM competency profile was guided by the following macro problems: (1) lack of systematic and transparent decision-making processes in health policy management; (2) underdeveloped institutional capacity for knowledge management and translation; and (3) incipient use of scientific evidence in the formulation and implementation of health policies. A general framework of key actions and performances of the EIPM Competency Profile for Brazil was developed, including 42 specific and general key actions distributed by area of activity (Health Management, Scientific Research, Civil Society, Knowledge Translation, and Cross-sectional areas). CONCLUSIONS: The competency profile presented in this article can be used in different contexts as a key tool for the institutionalization of EIPM.

Effect of experimental stress and cortisol release induced by ACTH administration on expression of key genes related to milk synthesis and apoptosis during mammary involution of Saanen goats.

This research paper addresses the hypothesis that stress, induced by ACTH administration and cortisol release increases somatic cell count (SCC) in mammary secretion, and improves the effectiveness of dry off in goats. We report indicators of milk synthesis and mammary gland involution during dry off. Thirty Saanen goats were subjected to abrupt dry off and treatments: (1) ACTH administration (ACTH) or (2) placebo (Control) on days 1, 3, 6, 9, 12, 15, 30, and 60 of dry off. The expression of target genes in mammary tissue that are related to milk synthesis and cell survival such as insulin-like growth factor 1 receptor (IGF1R), phosphatidylinositol-3-kinase (PIK3CA), protein kinase B (AKT1) and mechanistic target of rapamycin (MTOR), casein (CSN2), lactalbumin (LALBA) and lactoferrin (LF) were evaluated, and plasma cortisol concentration, SCC, leucocyte count, and microbiological analyses in milk and mammary secretions were assessed. ACTH significantly downregulated the expression of IGF1R and upregulated the expression of PIK3CA in mammary tissue, increased lactoferrin concentration and SCC, and changed immune cell levels in mammary secretions compared to Control. Furthermore, ACTH administration increased the percentage of dry goats compared to the Control (73 vs. 46%, respectively). We conclude that the effect of stress via ACTH administration and cortisol release accelerated mammary involution during the early dry-off period.

Biological and antimicrobial properties of the association Ambroxol and a water-soluble viscous liquid as a vehicle for a tricalcium silicate-based sealer.

This study aimed to investigate the antimicrobial and biological properties of Ambroxol associated with glycerin (GLI), propylene glycol (PG), and polyethylene glycol (PEG) as a possible vehicle for an experimental tricalcium silicate sealer, with the intention of developing a new biomaterial. Mouse undifferentiated dental pulp cells (OD-21) were cultured, and the effects of different association on cell proliferation and inflammatory cytokine production were investigated. Antimicrobial adhesion of Enterococcus faecalis to setting sealers at 2 h was evaluated. Polyethylene tubes containing experimental sealers and empty tubes were implanted into dorsal connective tissues of 12 male 3- to 4-months-old Wistar rats (250-280 g). After 7 and 30 days, the tubes were removed and processed for histological and immunohistochemical analyses. ANOVA followed by Bonferroni correction and ANOVA followed by Tukey test was used for parametric data and Kruskal-Wallis followed by Dunn for nonparametric (p < 0.05). Cell proliferation was dose-dependent, since all association were cytotoxic at higher concentrations; however, Ambroxol-PEG showed significantly higher cytotoxicity than other association (p < 0.05). In addition, irrespective of the association, no cytokine production was observed in vitro. Ambroxol-GLI reduced bacterial viability, whereas Ambroxol-PEG increased (p < 0.05). Histological examination showed no significant difference in the inflammatory response (p > 0.05) and mineralization ability in all association. Additionally, IL-1ß and TNF-α were upregulated on Ambroxol-PEG in relation to Control at 07 days (p < 0.05). Ambroxol-GLI was the best vehicle for experimental tricalcium silicate sealer, as it promoted an increase in antimicrobial activity without altering the inflammatory response or mineralization ability.

Long-term heat stress at final gestation: physiological and heat shock responses of Saanen goats.

The long exposure to heat negatively changes performance and productivity of animals, particularly when heat stress is associated with gestation. Indeed, little is known about the negative effects of long-term heat stress on the final gestation of dairy goats. In this context, the physiological and cellular responses of Saanen goats submitted to heat stress (37°C from 10:00 to 16:00 h) were investigated from day 60th pre-partum to day 60th post-partum. At final gestation, 46 pregnant Saanen goats were randomly assigned to the treatments: control (CT; thermal neutral conditions) and heat stress (HS; climatic chamber). After partum, all experimental goats were maintained in thermal neutral conditions. The rectal, dorsal, mammary temperatures and respiratory frequency, cortisol release, milk yield, milk quality, and the genes HSP60, HSP70, HSP90, Glucocorticoid receptor and ACTHR. Goats subjected to HS showed significantly (P < 0.05) higher rectal, dorsal, and mammary temperatures and significantly mobilized the increase of respiratory frequency to lose heat as compared to CT goats. The HS challenge significantly increased cortisol release from day 15th pre-partum to day 15th post-partum. CT goats produced more milk than HS from weeks 4 to 10 of lactation (P <0.001), with no difference in milk quality. However, on day 15th post-partum, there was a significant effect of HS treatment on the expression of HSP70 and ACTHR genes as compared to CT treatment, confirming the long-term effect of HS on Saanen goats. In conclusion, the physiological parameters studied increased pre-partum in the hottest hour, and cortisol peaked on day 15 pre-partum for heat-stressed goats. Although on the 15th day post-partum, all goats were in thermal comfort, and the physiological parameters were within the normal range, the concentration of cortisol continued to be significantly higher for goats submitted to thermal stress. Indeed, milk yield was greater for goats subjected to pre-partum thermal comfort. Furthermore, the expression of HSP70 and ACTHR genes on peripheral blood mononuclear cells are interesting biomarkers for studying the long-term effect of heat stress on Saanen goats.

What is the response profile of deciduous pulp fibroblasts stimulated with E. coli LPS and E. faecalis LTA?

BACKGROUND: Oral fibroblast immunological responses to bacterial stimuli are well known. However, there are few studies about pulp fibroblasts from deciduous teeth (HDPF) responses, which are important for the treatment of pulp infections in children. The aim of this study was to evaluate expression and production of inflammatory cytokines and chemokines by HDPF when challenged with bacterial antigens normally present in advanced caries lesions. METHODS: Triplicate HDPF from 4 children (n = 4; 2 boys and 2 girls) were cultured by explant technique and challenged or not with Escherichia coli lipopolysaccharide/1 µg/mL (EcLPS) or Enterococcus faecalis lipoteichoic acid/1 µg/mL (EfLTA) for 6 and 24 h. Most of published studies employed immortalized cells, i.e., without checking possible gender and genetic variables. mRNA expression and protein production were evaluated by RT-qPCR and ELISA MILLIPLEX®, respectively, for Interleukin (IL)-1α, IL-1ß, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-17, Chemokine C-C motif ligand 2/monocyte chemoattractant protein 1 (CCL2/MCP-1), Chemokine C-C motif ligand 3/macrophage inflammatory protein 1-alpha (CCL3/MIP1-α), Chemokine C-C motif ligand 5/ regulated on activation, normal T cell expressed and secreted (CCL5/RANTES), C-X-C motif chemokine 12/ stromal cell-derived factor 1 (CXCL12/SDF-1), Tumor Necrosis Factor-alpha (TNF-α), Interferon-gamma (IFN γ), Vascular Endothelial Growth Factor (VEGF), Colony stimulating factor 1 (CSF-1) and Macrophage colony-stimulating factor (M-CSF). RESULTS: EcLPS increased IL-1α, IL-1ß, IL-8, CCL2, CCL5, TNF-α and CSF-1 mRNA and protein levels while EfLTA was only able to positively regulate gene expression and protein production of IL-8. CONCLUSION: The results of the present study confirmed our hypothesis, since pulp fibroblasts from deciduous teeth are capable of increasing gene expression and protein production after being stimulated with EcLPS and EfLTA.

Bradyrhizobium sp. enhance ureide metabolism increasing peanuts yield.

This study aimed to evaluate the effects of seed inoculation with Bradyrhizobium sp. and co-inoculation with Azospirillum brasilense. The seed treatments were as follows: control (without inoculation); A. brasilense (2 mL per kg-1 of seed); A. brasilense (4 mL per kg-1 of seed); Bradyrhizobium sp. (2 mL per kg-1 of seed); Bradyrhizobium sp. (4 mL per kg-1 of seed); A. brasilense + Bradyrhizobium sp. (2 mL of each strain per kg-1 of seed); and A. brasilense + Bradyrhizobium sp. (4 mL of each strain per kg-1 of seed). Peanut plants from seeds inoculated with Bradyrhizobium sp. and A. brasilense exhibited highest leaf concentration of photosynthetic pigments, carotenoids, nitrate, ammonia and amino acids. The inoculation of seeds with Bradyrhizobium sp. resulted in plants with increased concentrations of total soluble sugars, and ureides compared to the untreated plants. In contrast, seeds treated with A. brasilense alone resulted in plants exhibiting highest concentration of amino acids, which represent the highest concentration of nitrogen compounds in peanut plants. Seed inoculation with Bradyrhizobium sp. at a rate of 2 mL kg-1 was identified as the best treatment to promote increased biological nitrogen fixation and generate higher peanut yields.

[Institutionalizing evidence-based policies in BrazilInstitucionalización de las políticas informadas por evidencia]. / Institucionalização das políticas informadas por evidências no Brasil.

OBJECTIVE: To evaluate capacities, organizational arrangements, and barriers to the implementation of Evidence Centers (NEvs) as part of Brazil's Evidence-Informed Policy Network (EVIPNet). METHOD: A mixed methods descriptive-analytical, multiple-case exploratory study was performed. Coordinators of active NEvs answered a questionnaire in three parts: participant characteristics, assessment of the capacity to "acquire, assess, adapt, and apply" evidence (4A), and open questions addressing organizational arrangements and barriers to the implementation of NEvs. RESULTS: The study included 15 NEvs, mostly from the Midwest; 73.3% were based in universities, while 20% were installed in state/city health departments or in the Ministry of Health. All coordinators had completed graduate training and 80% reported 1 to 5 years' experience with evidence-based policies as well as proficiency in English. None of the participants worked exclusively as NEv coordinator. NEv teams included health care professionals, students (undergraduate/graduate), professors, and civil servants from health departments. The data revealed high capacity to "acquire" and "assess" evidence, and low capacity to "adapt" and "apply" evidence. On average, three activities or products were developed yearly by each NEv, especially knowledge translation initiatives (systematic reviews and deliberative dialogues) and training for health care professionals, managers and undergraduate/graduate students. Five barrier categories were described: 1) financing, 2) network integration, 3) institutionalization of demands, 4) adaptive capacity, and 5) research communication skills to recommend actions at the local level. CONCLUSIONS: Trained human resources associated with academic and research institutions are available to support evidence-informed policies. However, the sustainability of NEvs depends on coordinated action to ensure the capacity to adapt and apply evidence.

OBJETIVO: Evaluar la capacidad, los arreglos organizativos y los obstáculos existentes para la aplicación de los núcleos de evidencia (NEv) de la Red de Políticas Informadas por Evidencia (EVIPNet) en Brasil. MÉTODOS: Se realizó un estudio descriptivo, analítico y exploratorio de casos múltiples, con un enfoque mixto. Los coordinadores de los NEv activos en el país respondieron a un instrumento dividido en tres partes: caracterización de la persona encuestada, evaluación de la capacidad de "adquirir, evaluar, adaptar y aplicar" evidencia (conocidas como 4A por su sigla en portugués) y temas de discusión abierta en los cuales se abordaron los arreglos organizativos y los obstáculos existentes para la aplicación de los NEv. RESULTADOS: Participaron en la investigación 5 NEv concentrados en la región Centro-Oeste; 73,3% tenían su sede en universidades y un 20% en secretarías estatales/municipales o en el Ministerio de Salud. Todos los coordinadores participantes tenían título de posgrado en sentido amplio o estricto y 80% afirmaron que tenían experiencia de 1 a 5 años en políticas informadas por evidencia (PIE) y que dominaban el inglés. Ningún coordinador trabajaba exclusivamente en el NEv. Los equipos incluían profesionales de salud, estudiantes (de grado/posgrado), profesores universitarios y empleados en comisión de servicio en las secretarías de salud. Se determinó que tenían gran capacidad para "adquirir" y "evaluar" y poca capacidad para "adaptar" y "aplicar" evidencias. En cuanto a actividades y productos, prevaleció la media de tres al año, con hincapié en los productos de traducción del conocimiento (la síntesis de la evidencia y los diálogos deliberantes) y la capacitación para profesionales de salud, gestores y alumnos de grado/posgrado. Se describieron cinco clases de obstáculos: 1) financiamiento, 2) integración de la red, 3) institucionalización de las demandas, 4) capacidad de adaptación y 5) habilidades de comunicación de las investigaciones para recomendar la adopción de medidas en el nivel local. CONCLUSIONES: Existen recursos humanos capacitados, vinculados a instituciones de investigación y enseñanza, para apoyar las PIE. Sin embargo, la sostenibilidad de los NEv depende de la adopción de medidas coordinadas para garantizar que existe la capacidad de adaptar y aplicar evidencia.

Evidence of hepatitis E virus infections among persons who use crack cocaine from the Midwest region of Brazil.

The current study aimed to determine the seroprevalence of hepatitis E virus (HEV) infection among persons who use crack from Midwest region of Brazil. Sera samples from 698 users of crack, collected from November 2013 to July 2015 were tested for anti-HEV immunoglobulin G (IgG) and immunoglobulin M (IgM) markers. Of the 698 serum samples, 99 (14.2%) were positive for anti-HEV IgG. Two samples were positive for anti-HEV IgM but both were negative for HEV RNA. The variables independently associated with anti-HEV positivity were increasing age and absence of stable partnership. This study showed high prevalence of past hepatitis E virus infection among persons who use crack.

Fatal Cronobacter sakazakii Sequence Type 494 Meningitis in a Newborn, Brazil.

We describe a case of infection with Cronobacter sakazakii sequence type 494 causing bacteremia and meningitis in a hospitalized late premature infant in Brazil. We conducted microbiological analyses on samples of powdered infant formula from the same batch as formula ingested by the infant but could not identify the source of contamination.

Acute heat stress induces changes in physiological and cellular responses in Saanen goats.

The relationships between rectal temperatures and physiological and cellular responses to heat stress can improve the productivity of Saanen goats in tropical environments. In this context, this study evaluated the physiological responses and gene expression of heat shock proteins (HSP60, 70, and 90) and genes related to apoptosis (Bax, Bcl-2, and p53) of Saanen goats subjected to acute heat stress. Ten health Saanen goats were exposed to solar radiation during 3 consecutive days. The expression of HSP60, HSP70, HSP90, Bax, Bcl-2, and p53 genes in blood leukocytes, rectal and superficial temperatures, respiratory frequency, cortisol, triiodothyronine, and thyroxine was measured at 06:00, 13:00, and 18:00 h. In vitro, blood leukocytes were subjected to 38 °C and 40 °C for 3 h to measure the expression of the same target genes. The temperature humidity index, measured from 12:00 to 15:00, was greater than 80 and black globe temperatures were greater at 40 °C, indicating the intensity of the solar radiation. Although the solar radiation caused acute heat stress, increased cortisol release, and the expression of HSP60 and 70 in dry Saanen goats, the increased respiratory frequency and decreased T4 and T3 restored the homeothermy of the experimental goats. In vitro, the 40 °C increased the expression of p53 (pro-apoptotic protein), Bcl-2 (anti-apoptotic protein), HSP60, HSP70, and HSP90, suggesting that these genes have protective functions. However, further studies are necessary to understand the physiological and cellular responses to heat stress.

Endodontic infections increase leukocyte and lymphocyte levels in the blood.

OBJECTIVES: The aim of this study was to determine whether the presence of single or multiple apical periodontitis (AP) alters blood cell counts and cytokine production. MATERIAL AND METHODS: Thirty rats were divided into three groups: a control group comprising rats without AP, a group called 1AP comprising rats with AP in one tooth, and a group called 4AP comprising rats with AP in four teeth. Endodontic infection was induced by pulp exposure of the first right maxillary molar in the 1AP group or by exposing the first and second right maxillary and mandibular molars in the 4AP group. A blood count and cytokine levels were obtained 30 days after infection by collecting blood by cardiac puncture. The maxillae were dissected and stained with hematoxylin and eosin to evaluate the inflammatory infiltrate. The data were tabulated and subjected to statistical analysis (P < 0.05). RESULTS: Histological analysis showed a predominance of mononuclear inflammatory cells. In blood, significant increase of leukocytes, lymphocytes, and tumor necrosis factor alpha (TNF-α) in 4AP compared with the control and 1AP groups (P < 0.05) was observed. In addition, significant decrease of interleukin-4 (IL-4) in 1AP and 4AP groups compared with the control was observed (P < 0.05). CONCLUSIONS: In the rat model, the presence of multiple AP can affect health by increasing lymphocyte and TNF-α levels in the blood. CLINICAL RELEVANCE: The presence of endodontic infections can interfere with the blood profile, altering systemic health.

Gender differences in patterns of drug use and sexual risky behaviour among crack cocaine users in Central Brazil.

BACKGROUND: The aim of this study was to compare sociodemographic characteristics, patterns of drug use, and risky sexual behaviour among female and male users of crack cocaine. METHODS: Between 2012 and 2013, we conducted a cross-sectional study of 919 crack cocaine users (783 men and 136 women) in Central Brazil using face-to-face interviews. Blood samples were collected to test for syphilis. The Chi-Square Automatic Interaction Detector (CHAID) was used to explore the differences between genders. We implemented two models: the first model included previous incarceration and variables related to patterns of drug use, and the second model included variables related to sexual risky behaviours and syphilis exposure. RESULTS: Women consumed more crack cocaine than men on a regular basis; however, poly-drug use was more common among men. More women than men reported exchanging sex for money and/or drugs and inconsistent condom use during sexual intercourse; women also reported more sexual partners. In addition, the frequency of sexual violence was higher for women than men. A higher proportion of women than men were positive for syphilis (27.2% vs. 9.2%; p < 0.001). The CHAID decision tree analysis identified seven variables that differentiated the genders: previous incarceration, marijuana use, daily crack cocaine consumption, age at first illicit drug use, sexual violence, exchange of sex for money and/or drugs, and syphilis exposure. CONCLUSION: Our findings demonstrate a difference in patterns of crack cocaine consumption and sexual risky behaviours between genders, thus indicating a need for gender-specific interventions in this population.

Effect of different methods of polymerizing ocular prosthesis acrylic resin on a human conjunctival cell line.

STATEMENT OF PROBLEM: Ocular prosthesis acrylic resins should be biocompatible regardless of the polymerization method. The authors are unaware of a study that evaluated the biocompatibility of ocular prostheses. PURPOSE: The purpose of this in vitro study was to evaluate the cytotoxicity of different methods of polymerizing ocular prosthesis acrylic resin. This was accomplished by analyzing the cell proliferation, production of proinflammatory cytokines, and expression of extracellular matrix proteins related to tissue remodeling and repair of a human conjunctival cell line. MATERIAL AND METHODS: Nine acrylic resin specimens were divided into 3 groups: polymerization in a water bath, by microwave, or by autopolymerization. Eluates (prepared for 72 hours) were exposed to cells for 72 hours. A medium without specimens served as negative control (nonstimulated group). The tetrazolium dye MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl tetrazolium bromide) assay was performed to evaluate the cytotoxic effect, and an enzyme-linked immunosorbent assay was executed for analysis of interleukin 1 ß (IL1ß), IL6, tumor necrosis factor α (TNFα), and CCL3/MIP1α production. Also, real-time reverse transcriptase (RT)-PCR was performed for analysis of mRNA expression of type IV collagen (COL IV), TGFß, and MMP9, and data were tested using ANOVA with Bonferroni post hoc test (α=.05). RESULTS: Microwave-processed resin showed slight cytotoxicity due to a significant reduction in cell proliferation and an increase in IL6 quantity. Higher levels of mRNA expression of COL IV, MMP9, and TGFß were verified in water bath-processed resin, which were similar to those in the nonstimulated group. CONCLUSIONS: Microwave-processed resin showed a significant reduction in cell proliferation and an increase in IL6 quantity. Heat-polymerized resin exhibited a higher mRNA expression of COL IV, MMP9, and TGFß; this result was similar to that in the nonstimulated group.

Active and latent tuberculosis in Brazilian correctional facilities: a cross-sectional study.

BACKGROUND: Tuberculosis (TB) rates among prisoners are more than 20 times that of the general population in Brazil, yet there are limited data available to facilitate the development of effective interventions in this high-transmission setting. We aimed to assess risk factors for TB infection and evaluate the yield of mass screening for active disease among inmates. METHODS: We administered a questionnaire and tuberculin skin test (TST) to a population-based sample of inmates from 12 prisons in Central-West Brazil and collected sera for HIV testing and two sputum samples for smear microscopy and culture from participants reporting a cough of any duration. Hierarchical Poisson regression models were used to evaluate factors associated with latent tuberculosis infection (LTBI). RESULTS: We recruited 3,380 inmates, of which 2,861 (84.6%) were males from 8 prisons, and 519 (15.4%) were females from 4 prisons. Among the 1,020 (30%) subjects who reported a cough, we obtained sputum from 691 (68%) and identified 31 cases of active TB for a point prevalence of 917 (95% CI, 623-1302) per 100,000 prisoners. Evaluation of the two sputum smear samples failed to identify 74% of the TB cases, and 29% of the cases reported less than 2 weeks of symptoms. Obtaining a second culture identified an additional 7 (24%) cases. The prevalences of LTBI were 22.5% and 11.7% for male and female prisoners, respectively and duration of incarceration (in years) was associated with LTBI in male and female in the multivariable model (1.04, 95% CI, 1.01-1.07 and 1.34, 95% CI, 1.06-1.70, respectively). The prevalence of LTBI is 8.6% among newly incarcerated inmates, among whom LTBI prevalence significantly increased by 5% with each year of incarceration. CONCLUSIONS: Although the overall LTBI prevalence among inmates in Central-West Brazil is low, tuberculosis incidence is high (>1,800/100,00), likely due to the high force of infection among a largely susceptible inmate population. Efforts to reduce transmission in prisons may require mass screening for active TB, utilizing sputum culture in case-detection protocols.

Classification of pro-inflammatory status for interleukin-6 affects relative muscle strength in obese elderly women.

BACKGROUND: Obesity, defined by an excess amount of body fat or a percent body fat higher than 30 % for women is a complex chronic disorder with multifactorial etiology and is accompanied by chronic low-grade inflammation, which results in elevated pro-inflammatory cytokines. AIMS: The aim of this study was to compare muscle strength between high and low pro-inflammatory status in obese elderly women and to verify the relationship of IL-6 with muscle strength and fat-free mass. METHODS: Eighty-nine elderly women (age 69.47 ± 6.07 years; body mass 64.70 ± 12.04 kg; height 1.52 ± 0.06 m; body mass index 27.78 ± 4.75 kg/m(2)) were divided into two groups: high and low inflammatory status for IL-6. Lower limb muscle strength was tested using bilateral leg extension with the ten repetitions maximum test, IL-6 was measured by ELISA and body composition by dual-energy X-ray absorptiometry. RESULTS: Women classified from the high pro-inflammatory status presented lower relative muscle strength (P = 0.056) when compared with the low inflammatory status group, with no differences for absolute muscle strength (P = 0.18). There was a significant negative correlation of IL-6 with relative muscle strength (P = 0.03, R = -0.22) and a considerable trend toward significance (P = 0.06, R = -0.19) and negative association with fat-free mass (P = 0.84, R = -0.02). CONCLUSIONS: This study provides insights that a high pro-inflammatory status in sedentary obese elderly women might impair muscle strength and negatively affect fat-free mass. Thus, elderly women classified with high pro-inflammatory status for IL-6 should receive further health care attention to prevent this deleterious condition.

Microparticles: potential new contributors to the pathogenesis of systemic sclerosis?

BACKGROUND: Microparticles (MPs) are membrane-derived vesicles released from cells undergoing activation or apoptosis with diverse proinflammatory and prothrombotic activities, that have been implicated in the pathogenesis of systemic sclerosis (SSc). We aimed to evaluate the plasma levels of platelet-derived microparticles (PMPs), endothelial cell-derived microparticles (EMPs), and monocyte-derived microparticles (MMPs) in SSc patients, and the association between MPs and the clinical features of SSc. METHODS: In this cross-sectional study, 70 patients with SSc and 35 age- and sex-matched healthy controls were evaluated. Clinical and nailfold capillaroscopy (NFC) data were obtained from all patients. Plasma levels of PMPs (CD42+/31+), EMPs (CD105+), and MMPs (CD14+) were quantified by flow cytometry. RESULTS: Patients were mainly females (90%), with a mean age of 48.9 years old. PMP, EMP, and MMP levels were significantly increased in SSc patients compared to controls (79.2% ± 17.3% vs. 71.0% ± 19.8%, p = 0.033; 43.5% ± 8.7% vs. 37.8% ± 10.4%, p = 0.004; and 3.5% ± 1.3% vs. 1.1% ± 0.5%, p < 0.0001, respectively). PMP levels were significantly higher in patients with positive anti-topoisomerase-I antibodies (p = 0.030) and in patients with a disease duration > 3 years (p = 0.038). EMP levels were lower in patients with a higher modified Rodnan skin score (p = 0.015), and in those with an avascular score > 1.5 in NFC (p = 0.042). CONCLUSION: The increased levels of PMPs, EMPs and MMPs in scleroderma patients might indicate a possible role for these agents in the pathogenesis of this challenging disease.

Prevalence and associated factors of mental health disorders among Brazilian healthcare workers in times of the COVID-19 pandemic: A web-based cross-sectional study.

The COVID-19 pandemic in Brazil affected mental health among healthcare workers. To objective of this study was to evaluate the mental health of healthcare workers in in the central-west region of the Brazil, estimating the prevalence of mental health disorders, and investigating associated factors, perceptions of safety, and self-perceptions about mental health in times of the COVID-19 pandemic. The questionnaire was divided into two parts that included general information and perceptions about the work process and identified symptoms using the Depression Anxiety Stress Scale-21 (DASS-21), and multiple linear regression analysis was conducted. A total of 1,522 healthcare workers participated in the survey. Overall prevalence of symptoms was calculated for depression (58.7%), anxiety (59.7%), and stress (61.7%). Physicians had 3.75 times greater risk of depression (1.59-8.85, 95% CI). Independent variables associated with depression symptoms were not feeling safe with the way services were organized (1.12:1.03-1.21, 95% CI) and self-perception of poor mental health (8.06: 4.03-16.10% CI). Working in management was protective, and married professionals had 12% lower risk of exhibiting symptoms of depression (0.79-0.99, 95% CI). Participants with self-perception of poor mental health had 4.63 greater risk for symptoms of anxiety (2.58-8.31, 95% CI). Protective factors were not having sought support for mental health (0.90: 0.82-0.99, 95% CI), having a graduate degree (0.71: 0.54-0.94, 95% CI), and not having been diagnosed with COVID-19 (0.90: 0.83-0.98, 95% CI). Perception of poor mental health was associated with 6.95-fold greater chance of developing stress symptoms. Protective factors from stress were having a degree in dentistry (0.81: 0.68-0.97, 95% CI), residing in Mato Grosso do Sul (0.91: 0.85-0.98, 95% CI), and not having sought mental health support services (0.88: 0.82-0.95, 95% CI). The prevalence of mental health disorders is high among healthcare workers, and is associated with professional category, organization of services provided, and self-perception of poor mental health, reinforcing the need for preventative measures.

Paracoccidioidal infection in HIV patients at an endemic area of paracoccidioidomycosis in Brazil.

The association between paracoccidioidomycosis (PCM) and AIDS is relatively rare in contrast to the higher incidence of other systemic mycosis. The explanation may be that AIDS is still predominantly an urban disease, and the PCM is endemic in Latin American rural areas. The aim of this study was to detect the prevalence of Paracoccidioides brasiliensis infection in HIV-positive patients at an endemic area of paracoccidioidomycosis in Brazil. Skin test with purified 43 kD glycoprotein (gp43) was performed in 90 HIV/AIDS patients. The prevalence found was 12.2% and it may be even greater, considering that HIV/AIDS patients may not respond to the intradermal test, which depends on cellular immunity for its positivity.

Evaluation of Different Polymerisation Methods of Ocular Prosthesis Acrylic Resins on Subcutaneous Tissue Inflammatory Response in Rats.

Objectives: This study aimed to evaluate the influence of different polymerisation methods of acrylic resin for ocular prostheses on the subcutaneous tissue inflammatory response of rats. Methods: The study was conducted at the Basic Sciences Department, Araçatuba Dental School, São Paulo State University (UNESP), Brazil, from 2016 to 2018. The samples were prepared by water bath (WB), microwave energy (MW) or autopolymerisation (AP) (n = 20 samples per group). The inflammatory response (cell count and immunohistochemical analysis of interleukin [IL]-1ß, IL-6, tumour necrosis factor [TNF]-α, IL-17 and macrophage inflammatory protein-3α) was analysed by the implantation of a sample from each group in the subcutaneous tissue of 20 Wistar rats and evaluated after seven, 15, 30 and 60 days. The quantitative and qualitative data were analysed using analysis of variance and Tukey tests (P <0.05) and visual comparison, respectively. Results: There was a moderate inflammatory infiltrate for the MW and AP groups and a light infiltrate for the WB group after seven days. The inflammatory infiltrate and the immunolabeling of tested targets decreased gradually during the 60-day period. The AP group had the highest immunolabeling of TNF-α (seven days), IL-1ß and IL-17 (at 15 and 30 days) and IL-6 (at 30 and 60 days). The WB and MW groups showed greater immunolabeling at 15 and 30 days, while the MW group also had high results at 60 days. Conclusion: Polymerisation by microwave energy and by chemical activation resulted in a higher inflammatory response.