Caryocar coriaceum fruits as a potential alternative to combat fungal and bacterial infections: In vitro evaluation of methanolic extracts.

Caryocar coriaceum, commonly known as 'pequi', is a medicinal species used traditionally for the herbal treatment of infectious and parasitic diseases in the Brazilian Northeast region. In this study, we investigated whether the fruits of C. coriaceum have bioactive chemical constituents against etiological agents of infectious diseases. The methanolic extract of the internal mesocarp of the fruits of C. coriaceum (MECC) was chemically analyzed and evaluated for its antimicrobial and drug-enhancing activity against multidrug-resistant pathogenic bacteria (Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus), and Candida spp. strains. The extract had flavones, flavonols, xanthones, catechins, and flavanones as major classes. A total of 11.26 mg GAE/g of phenolics, and 5.98 mg QE/g of flavonoids were found. No intrinsic antibacterial activity was observed; however, the extract was able to intensify the action of gentamicin and erythromycin against multi-resistant strains. The anti-Candida effect observed in this study was mainly due to the formation of reactive oxygen species. The extract was capable of causing damage to the plasmatic membrane of Candida tropicalis through pores formation. Our findings partially support the ethnopharmacological uses of the fruit pulp of C. coriaceum against infectious and parasitic diseases.

How does academia respond to the burden of infectious and parasitic disease?

BACKGROUND: Academic research is one of the main avenues through which humans can fight the threat of infectious diseases. However, there have been concerns regarding whether the academic system has provided sufficient efforts to fight infectious diseases we potentially face. Answering these questions could contribute to evidence-based recommendations for setting research priorities and third-mission policies. METHODS: With a focus on one of the most common categories of communicable diseases, infectious and parasitic diseases (IPDs), we searched Web of Science for articles and reviews relevant to IPDs published during the period 2000-2019 and retrieved WHO data on disease burden in corresponding years. The academic response patterns were explored by IPD subcategory and by human development level (an index established by the United Nations). We conduct the analysis in particular to gain insight into the dynamic relationship between disease burden and research effort on IPDs, scientific efforts contributed by countries with different development levels, and the variation trends in international joint efforts. RESULTS: The greatest burden of IPDs is clustered in the developing regions of Africa, but has received academic response from both developed and developing countries. Highly developed countries dominate the ranks of academic research in this area, yet there is also a clear increase in research efforts from the countries most affected, despite their low human development scale. In fact, the overall analysis reveals an improved capability for addressing local problems from African regions. In terms of international collaboration, highly developed countries such as the United States and United Kingdom have commonly collaborated with needy regions, whereas prolific but developing nations, like China, have not. CONCLUSIONS: From a global perspective, academia has positively responded to health needs caused by IPDs. Although the relevant research output contribution is primarily from the highly developed countries, concentrated and specialized efforts from the undeveloped regions to ease their local burden can be clearly observed. Our findings also indicate a tendency to focus more on local health needs for both developed and undeveloped regions. The insights revealed in this study should benefit a more informed and systemic plan of research priorities.

Dynamics of infectious and parasitogenic morbidity at the children population in the rural districts and corelation with water factor.

OBJECTIVE: Introduction: Intestinal parasites are important enteric pathogens. Poverty, low quality of food and water supply and poor sanitation systems are the important factors associated with intestinal parasitic infections. These kinds of infections can be a good index for hygienic and sanitation status of the society. The aim: To study dynamics of infectious and parasitic diseases (for 2008-2013 years) among the children population in Dnipro region and to define influence of water factor on the disease and prevalence given class of illnesses. PATIENTS AND METHODS: Materials and methods: Retrospective study of infectious and parasitogenic diseases (І class by ICD-10) among children population from rural districts of Dnipropetrovsk region for 2008-2013 years was carried out. RESULTS: Results: It was spent correlation analysis between some indicators of potable water quality of diseases of the given class in all districts. In the majority of rural districts, was shown increasing І class of diseases from (1.4 to 1.63) times in dynamics. In some districts was reveled an average correlation link between content in water of the dry residue, chlorides, sulphates, calcium, magnesium, except rigidity and iron and prevalence І class of diseases (r=0.50, p<0.001). Prevalence of the given class of diseases was correlated with рН, nitrates, oxidability in the three rural districts of Dnipropetrovsk region (r=0.74-0.89, p<0.001). CONCLUSION: Conclusions: It has been shown that the composition of drinking water consumed by the rural population remains one of the basic factors in the formation of public health in the conditions of small exposure of the influence individual indicators of salt and chemical composition. The children's cohorts were the most sensitive to these indicators.

Giant Calcified Hepatic Hydatid Cyst: A Case Report.

Hydatid disease is a zoonotic disease caused by the parasite Echinococcus granulosus. It is an endemic disease in many parts of the world. Although humans are incidental hosts of the parasite, the disease sometimes results in fatal consequences. The liver and lungs are the most common sites of infection in humans. We report the case of a 45-year-old female who presented with complaints of right hypochondriac pain, fever, and cough, initially suspected as a case of liver abscess but later diagnosed as a giant calcified hydatid cyst of the liver. Imaging and immunoglobulin G for Echinococcus granulosus helped confirm our diagnosis. Based on her symptoms, the patient was treated symptomatically with analgesics, paracetamol, and an antitussive for pain, fever, and cough, respectively. In terms of definitive care, she was treated with oral albendazole and referred to her home district for necessary surgical intervention.

Manic Episode Following Dengue Fever: A Case Report.

Dengue fever, a mosquito-borne viral disease, can present with a variety of symptoms, ranging from mild flu-like illness to more severe conditions such as dengue hemorrhagic fever and dengue shock syndrome. Although neurological symptoms such as headaches, dizziness, and altered sensorium are more frequently observed, psychiatric symptoms such as euphoria, delusions, hallucinations, and aggression, though rare, can occur. We present the case of a previously healthy 22-year-old male from South Asia who developed manic and psychotic symptoms, including insomnia, irritability, grandiosity, and auditory hallucinations, following his recovery from dengue fever. His psychiatric symptoms emerged shortly after discharge and necessitated psychiatric intervention with olanzapine, a second-generation antipsychotic, chosen for its suitability in managing manic symptoms. This case underscores the importance of considering psychiatric evaluations in the management of dengue fever, especially in endemic areas. The pathophysiology of dengue's neuropsychiatric effects remains complex and multifactorial, necessitating further research. This case report aims to highlight the potential for significant psychiatric manifestations post-dengue fever, advocate for increased clinical awareness and research to investigate any potential correlation between dengue fever and psychiatric symptoms, and improve patient outcomes.

Primary Pulmonary Echinococcosis in the United States: A Case Report and Review of the Literature.

We depict a unique case of a 34-year-old woman who presents to the emergency department with complaints of dyspnea and chest pain for the past month. A chest x-ray (CXR) from an earlier urgent care visit was concerning for large fluid opacity in the left lung and follow-up imaging revealed a cystic mass suspicious of a pulmonary cystic abscess. The patient underwent complete lobectomy and resection. Post-surgical biopsy confirmed pulmonary hydatid cystic mass and signs of rupture or seeding to liver tissue. The patient was discharged with adjuvant therapy and recommended imaging follow-up for the next decade. The diagnosis, treatment, and maintenance guidelines are discussed in this report which reveals controversy between experts given the lack of complete literature regarding echinococcosis. Our purpose in putting forward this case is to present a rare diagnosis of pulmonary echinococcosis in the United States and to emphasize the importance of early imaging and diagnosis to prevent cystic rupture and secondary organ dissemination.

How a Simple Diabetic Ketoacidosis Was Actually a Deadly Liver Abscess.

Pyogenic liver abscesses (PLA) are rare causes of infection in immunocompetent individuals in developed countries. In this report, we discuss a rare presentation and the risk factors associated with developing PLA. Our aim is to raise awareness about PLA developing in patients with uncommon risk factors, enabling early identification and appropriate treatment. The case involves a male patient who presented to the hospital with generalized weakness, was admitted for diabetic ketoacidosis (DKA), and incidentally had elevated liver enzymes that required further investigation. It is important to note that risk factors such as diabetes mellitus, proton pump inhibitors, and colon malignancies are very rare but have been reported in isolated cases as potential risks for developing PLA. Early diagnosis of PLA is crucial due to its high mortality rate, even with intervention.

A Rare Case of Pulmonary Cavitary Disease Caused by Mycobacterium xenopi.

Mycobacterium xenopi is a slow-growing, acid-fast, non-tuberculous mycobacterium (NTM). It is often considered to be a saprophyte or an environmental contaminant. Mycobacterium xenopi has low pathogenicity and is usually seen in patients with pre-existing chronic lung diseases and immunocompromised patients. We present a case of Mycobacterium xenopi causing a cavitary lesion in a patient with chronic obstructive pulmonary disease (COPD) that was discovered incidentally during the low-dose CT scan done for lung cancer screening in a patient with COPD. The initial workup was negative for NTM. An Interventional-guided (IR) core needle biopsy was done given the high suspicion for NTM and revealed a positive culture for Mycobacterium xenopi.  Our case highlights the importance of considering NTM in the differential diagnosis of at-risk patients and pursuing invasive testing if there is a high clinical suspicion.

Sight the Mite: A Meta-Analysis on the Diagnosis of Scabies.

This meta-analysis was performed to assess the efficacy of the diagnostic tests for scabies infections that are currently in wide use. Scabies is most commonly diagnosed through clinical presentations; however, due to the wide array of symptoms, diagnosis is difficult. The most commonly used diagnostic test is skin scraping. However, this test relies on correctly selecting the site of mite infection for sampling. Due to the mobile nature of a live parasitic infection, the mite can often be missed based on its current location within the skin. The goal of this paper is to determine if a gold standard confirmatory test exists for the diagnosis of scabies by comparing Skin Scraping, Adhesive Tape, Dermoscopy, and PCR tests. Medline, PubMed, and Neglected Tropical Diseases databases were utilized in a literature review. Eligible papers were papers published in or after the year 2000, published in the English language, and mainly focused on the diagnosis of scabies. At the time of this meta-analysis, scabies is mostly diagnosed through a correlation of clinical symptoms in conjunction with diagnostic tests such as dermoscopy (sensitivity: 43.47%, specificity: 84.41%), adhesive tape tests (sensitivity: 69.56%, specificity: 100%) and PCR antigen detection (37.9% sensitivity, specificity: 100%). Due to a scarcity of data in the literature, the diagnostic efficacy of other diagnostic tests is difficult to assess. Overall, the efficacies of the tests analyzed vary depending on how similar scabies is to other skin disorders, how challenging it is to get a usable sample and the price and accessibility of essential tools. There is a need for standardized national diagnostic criteria to increase the diagnostic sensitivity of scabies infection.

Seizures Related to Neurocysticercosis and Cocaine Use.

Neurocysticercosis (NCC) is an infection of the central nervous system with Taenia solium cysts that most commonly results in seizures. In stable patients without recent symptoms, these seizures may be provoked by seizure threshold-lowering drugs such as cocaine. This case details a 38-year-old male with a past medical history of epilepsy presenting with seizures due to comorbid NCC and cocaine use. This case was complicated by the lack of available information regarding the patient's past medical history and medication use. We highlight the importance of obtaining a full work-up, including brain imaging, to provide optimal treatment for patients with seizures despite a history of drug use.

Neurocysticercosis Presenting With a New-Onset Seizure: A Case Report.

Neurocysticercosis (NCC) is a common infection that is found worldwide but is often neglected in the United States (US). This case report aims to illustrate the presentation of the disease, provide information on this globally prevalent pathogen, and shed light on the diagnostic workup and treatment of the infection. We discuss the case of a 31-year-old male patient of Central American origin presenting with a new-onset seizure. He had no significant past medical history and had never experienced similar events before. The diagnosis was made through neuroimaging, serum antibody testing, and biopsy of the brain lesion. This case highlights the importance of performing a good clinical history and a proper diagnostic workup that would help in the prompt recognization and treatment of this common worldwide illness that may not be endemic to the clinician's geographical area.

Cutaneous Leishmaniasis in a Recreational Cave Diver After Travel to México.

Cutaneous Leishmaniasis due to Leishmania mexicana is a common cause of New World protozoal infections endemic to southern Mexico and now the United States (US). We present a case of a 72-year-old male who became infected with cutaneous L. mexicana while participating in numerous diving excursions in the flooded limestone caves, commonly referred to as cenotes, in the Yucatán Peninsula. This unique case of adventure tourism highlights cave diving in endemic regions of leishmaniasis as a possible new risk factor for the acquisition of this disease. We also discuss increasing autochthonous cases of cutaneous leishmaniasis and the different barriers to treatment that occur with this disease.

Vaccine Development Throughout History.

The emergence of the coronavirus disease 2019 (COVID-19) pandemic has made us appreciate how important it is to quickly develop treatments and save lives. The race to develop a vaccine for this novel coronavirus began as soon as the pandemic emerged. Time was the only limiting factor. From the first vaccine developed in 1796 against smallpox to the latest COVID-19 vaccine, there have been several vaccines that have reduced the burden of disease, with the associated mortality and morbidity. Over the years we have seen many new advancements in organism isolation, cell culture, whole-genome sequencing, and recombinant nuclear techniques. These techniques have greatly facilitated the development of vaccines. Each vaccine has its own development story and there is much wisdom to be gained from learning about breakthroughs in vaccine development.

A Unique Case of Cutaneous Larva Migrans and Asymptomatic Löeffler's Syndrome.

Cutaneous larva migrans is a fairly common parasitic skin disease typically found in more tropical climates such as the southeastern United States, with the most commonly encountered organism known as the hookworm, Ancylostoma braziliense. Löeffler's syndrome is a rare pulmonary manifestation with vague diagnostic criteria but frequently characterized by diffuse migratory pulmonary infiltrates on imaging studies with accompanying serum eosinophilia. Here, we present a unique case of Löeffler's syndrome secondary to cutaneous larva migrans.

Electrochemical biosensors for neglected tropical diseases: A review.

A group of infectious and parasitic diseases with prevalence in tropical and subtropical regions of the planet, especially in places with difficult access, internal conflicts, poverty, and low visibility from the government and health agencies are classified as neglected tropical diseases. While some well-intentioned isolated groups are making the difference on a global scale, the number of new cases and deaths is still alarming. The development and employment of low-cost, miniaturized, and easy-to-use devices as biosensors could be the key to fast diagnosis in such areas leading to a better treatment to further eradication of such diseases. Therefore, this review contains useful information regarding the development of such devices in the past ten years (2010-2020). Guided by the updated list from the World Health Organization, the work evaluated the new trends in the biosensor field applied to the early detection of neglected tropical diseases, the efficiencies of the devices compared to the traditional techniques, and the applicability on-site for local distribution. So, we focus on Malaria, Chagas, Leishmaniasis, Dengue, Zika, Chikungunya, Schistosomiasis, Leprosy, Human African trypanosomiasis (sleeping sickness), Lymphatic filariasis, and Rabies. Few papers were found concerning such diseases and there is no available commercial device in the market. The works contain information regarding the development of point-of-care devices, but there are only at proof of concepts stage so far. Details of electrode modification and construction of electrochemical biosensors were summarized in Tables. The demand for the eradication of neglected tropical diseases is increasing. The use of biosensors is pivotal for the cause, but appliable devices are scarce. The information present in this review can be useful for further development of biosensors in the hope of helping the world combat these deadly diseases.

A Case Report of Babesiosis Seen Outside of its Endemic Area and Incubation Period.

Babesia microti is a parasitic alveolate that is usually transmitted by Ixodes scapularis tick, which also transmits Lyme disease. Babesiosis is endemic in the Northeast and Upper Midwestern regions of the United States. This case report illustrates a 29-year-old Hispanic male who presented to a Florida hospital emergency department with complaints of fever, generalized weakness, and flu-like symptoms over a duration of four days. Subsequently, he was diagnosed with babesiosis infection since he had a travel history to Cape Cod, Massachusetts about 10 weeks before presenting to the hospital. He was treated with atovaquone, clindamycin, and azithromycin. The importance of this report is to illustrate that babesiosis may occur outside its endemic area and incubation period.

The scientific publication of the Memórias do Instituto Oswaldo Cruz (1909-2020): a history of contribution to the biomedical sciences

BACKGROUND The Memórias do Instituto Oswaldo Cruz (MIOC) is one of the first scientific journals created in Brazil and currently one of the most important biomedical journals in South America. Knowledge of the main themes disseminated over time and its main contributors can contribute towards a better understanding of its trajectory and future. OBJECTIVES Map the journal's scientific publication between 1909 and 2020. METHODS Data from three scientific databases was combined, alongside bibliometrics and network analysis to analyse publication records between 1909 and 2020. FINDINGS Publications increased substantially since the 1980s. The main publishing organisations are Brazilian. Excluding Brazil, the main publishing countries are the USA, Argentina, and Colombia. During the entire investigated period, the main themes refer to Chagas disease, schistosomiasis, and Leishmaniasis. During some periods, publications followed disease outbreaks in Brazil (e.g., dengue fever and yellow fever). MAIN CONCLUSIONS Since its foundation in 1909, the MIOC has focused on infectious and parasitic diseases. The editorial changes implemented from the 1980s onwards led MIOC to a relevant growth concerning annual publications and its transformation into an important communication vehicle for researchers from several Brazilian organisations besides Fiocruz, as well as organisations from other countries, especially within Latin America.

Yearly variations of demographic indices and mortality data in Italy from 1901 to 2008 as related to the caloric intake.

The aim of the present study was to evaluate, by Join Point regression method, the yearly variations in demographic indices and mortality data in Italy from 1901 to 2008, as related to the caloric intake. The relationships between mortality and caloric intake were studied by time series. The results showed that, from 1901 to 2008, the Italian population grew from 32.5 to 59.6 millions; the live births rates decreased from 31.8 to 10.1‰ (males) and from 33.3 to 9.0‰ (females); the infant mortality rates fell from 184.1 to 3.7‰ (males) and from 149.4 to 3.2‰ (females); males and females gained 35.7 and 40.6 years in life expectancy at birth, respectively. In 1901 the 61% of deaths occurred in the youngest, whereas in 2008 the elderly accounted for the 80%. In 1901, in terms of age-adjusted data, other and undefined causes overcame the specific causes of death, whose rank was: respiratory, digestive, infectious, cardiovascular, cerebrovascular, cancers, accidents, endocrine, and nervous system diseases. In 2008, undefined causes ranked 3rd (males) and 4th (females), while cancers became the leading cause of death, followed by cardiovascular, cerebrovascular, accidental, respiratory, endocrine, digestive, nervous system, and infectious diseases. The caloric intake showed a negative correlation with all-cause mortality, infant mortality, and mortality for a number of specific causes. These patterns reflect the progress in average nutritional status, lifestyle quality, socioeconomic level, and hygienic conditions.

Tropical diseases-associated kidney injury / Lesão renal associada a doenças tropicais

BACKGROUND AND OBJECTIVES: Infectious and parasitic diseases are important morbidity factors and mortality causes, accounting for more than 13 million deaths a year-one in two deaths in developing countries. Despite health providing expansion throughout, large populations are still at risk in many areas of Asia, Middle East, Africa and Americas. Tuberculosis, specially, poses new challenges, as nearly two billion people may have latent disease. Malaria kills over one million people a year - most of them young children. Most malaria deaths occur in Africa, where it accounts for one in five of all childhood deaths - women are especially vulnerable during pregnancy. Many of these illnesses may be accompanied by acute or chronic kidney involvement.CONTENTS: Acute kidney injury (AKI) and tubulointerstitial defects are frequently observed in the course of leptospirosis, malaria, and the several viral hemorrhagic fevers. All known varieties of glomerular lesions have been observed, with clinical presentations ranging from mild proteinuria or hematuria, to nephrotics yndrome. Tubular dysfunction may also occur, particularly in visceral leishmaniasis and leprosy, where distal tubular acidosis may be an early clinical expression of the disease. CONCLUSION: To summarize, almost every known infectious and parasitic disease may present with kidney involvement, varying from mild to extreme, and additionally burdening usually overwhelmed health services.

JUSTIFICATIVA E OBJETIVOS: As doenças infecciosas eparasitárias são fatores importantes de morbidade e causas demortalidade, sendo responsáveis por mais de 13 milhões demortes por ano - uma em cada duas mortes em países em desenvolvimento.Apesar da expansão do atendimento de saúdeem todos os locais, grandes populações ainda estão em riscoem muitas áreas da Ásia, Oriente Médio, África e Américas. Atuberculose, em especial, apresenta novos desafios, já que quasedois bilhões de pessoas podem ter uma doença latente. Amalária mata mais de um milhão de pessoas por ano - a maioriadelas crianças. A maioria das mortes por malária ocorre naÁfrica, onde é responsável por uma em cada cinco mortes decrianças - as mulheres são especialmente vulneráveis durante agravidez. Muitas destas doenças podem ser acompanhadas poracometimento renal agudo ou crônico.CONTEÚDO: A lesão renal aguda (LRA) e os defeitos túbulo--intersticiais são frequentemente observados no curso de leptospirose,malária, e de várias febres hemorrágicas virais. Todas asvariedades conhecidas de lesões glomerulares foram observadas,com apresentações clínicas que variam de ligeira proteinúria ouhematúria até síndrome nefrótica. Também pode ocorrer disfunçãotubular, especialmente na leishmaniose visceral e na lepra,onde a acidose tubular distal pode ser uma manifestação clínicaprecoce da doença.CONCLUSÃO: Em resumo, quase todas as doenças infecciosas eparasitárias conhecidas podem apresentar comprometimento renal,variando de leve a extremo e, sobrecarregando ainda mais osserviços de saúde geralmente já sobrecarregados.