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Lysozyme is a ß-1,4-glycosidase that hydrolyzes the polysaccharide backbone of bacterial cell walls. With an additional bactericidal function mediated by a separate protein domain, lysozyme is considered a uniquely important antimicrobial molecule contributing to the host's innate immune response to infection. Elevated lysozyme production is found in various inflammatory conditions while patients with genetic risks for inflammatory bowel diseases demonstrate abnormal lysozyme expression, granule packaging, and secretion in Paneth cells. However, it remains unclear how a gain- or loss-of-function in host lysozyme may impact the host inflammatory responses to pathogenic infection. We challenged Lyz1-/- and ectopic Lyz1-expressing (Villin-Lyz1TG) mice with S. Typhimurium and then comprehensively assessed the inflammatory disease progression. We conducted proteomics analysis to identify molecules derived from human lysozyme-mediated processing of live Salmonella. We examined the barrier-impairing effects of these identified molecules in human intestinal epithelial cell monolayer and enteroids. Lyz1-/- mice are protected from infection in terms of morbidity, mortality, and barrier integrity, whereas Villin-Lyz1TG mice demonstrate exacerbated infection and inflammation. The growth and invasion of Salmonella in vitro are not affected by human or chicken lysozyme, whereas lysozyme encountering of live Salmonella stimulates the release of barrier-disrupting factors, InvE-sipC and Lpp1, which directly or indirectly impair the tight junctions. The direct engagement of host intestinal lysozyme with an enteric pathogen such as Salmonella promotes the release of virulence factors that are barrier-impairing and pro-inflammatory. Controlling lysozyme function may help alleviate the inflammatory progression.
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Muramidase , Salmonella typhimurium , Muramidase/metabolismo , Animais , Salmonella typhimurium/metabolismo , Salmonella typhimurium/patogenicidade , Camundongos , Humanos , Infecções por Salmonella/microbiologia , Infecções por Salmonella/metabolismo , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Camundongos Knockout , Proteínas de Bactérias/metabolismo , Proteínas de Bactérias/genética , Proteínas dos MicrofilamentosRESUMO
Ruminococcus gnavus is a mucolytic commensal bacterium whose increased gut colonization has been associated with chronic inflammatory and metabolic diseases in humans. Whether R. gnavus metabolites can modulate host intestinal physiology remains largely understudied. We performed untargeted metabolomic and bulk RNA-seq analyses using R. gnavus monocolonization in germ-free mice. Based on transcriptome-metabolome correlations, we tested the impact of specific arginine metabolites on intestinal epithelial production of nitric oxide (NO) and examined the effect of NO on the growth of various strains of R. gnavus in vitro and in nitric oxide synthase 2 (Nos2)-deficient mice. R. gnavus produces specific arginine, tryptophan, and tyrosine metabolites, some of which are regulated by the environmental richness of sialic acid and mucin. R. gnavus colonization promotes expression of amino acid transporters and enzymes involved in metabolic flux of arginine and associated metabolites into NO. R. gnavus induced elevated levels of NOS2, while Nos2 ablation resulted in R. gnavus expansion in vivo. The growth of various R. gnavus strains can be inhibited by NO. Specific R. gnavus metabolites modulate intestinal epithelial cell NOS2 abundance and reduce epithelial barrier function at higher concentrations. Intestinal colonization and interaction with R. gnavus are partially regulated by an arginine-NO metabolic pathway, whereby a balanced control by the gut epithelium may restrain R. gnavus growth in healthy individuals. Disruption in this arginine metabolic regulation will contribute to the expansion and blooming of R. gnavus.
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Despite being the most abundant sea turtle in the world, the olive ridley turtle Lepidochelys olivacea is classified as Vulnerable by the IUCN. There is evidence of congenital malformations in hatchlings, and the associated causes are multifactorial, with both genetic and environmental sources. Santuario Playa Ceuta (SPC) is a sanctuary for the olive ridley, located at the northernmost region of its nesting range in the Mexican Pacific. The objective of this study was to identify and quantify the prevalence and severity of congenital malformations in olive ridley embryos/hatchlings in SPC during the 2017 nesting season. We collected 62907 eggs from 643 relocated nests that were moved to a hatchery, of which 4242 eggs with obvious development did not hatch and were analyzed for this study. Hatching success was 53.9%, with 22.5% of nests (n = 145) and 0.54% of eggs (n = 344) showing embryos or hatchlings with malformations. The nest severity index was 2.4 (range: 1-10) malformed embryos or hatchlings per nest, and the organism severity index was 1.4 (range: 1-7) malformations per malformed embryo or hatchling. Leucism was the most prevalent malformation (34.4%; 170/494 total observed), with the craniofacial region showing the greatest diversity of malformations (17/35 types). Given the geographical position of SPC, extreme environmental conditions (e.g. cold, heat, and dryness) could be one of the main causes of teratogenesis in this species. However, more studies are needed regarding the presence of contaminants, genetic factors, health assessments of nesting females, and malformation rates of nests that remain in situ versus those that are relocated.
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Tartarugas , Feminino , Animais , México/epidemiologiaRESUMO
To ensure normal immune function, mast cells employ different pathways to release mediators. Here, we report a thus far unknown capacity of mast cells to recycle and reuse secretory granules after an antigen-evoked degranulation process under physiological conditions; this phenomenon involves the existence of a recycling secretory granule pool that is available for release in a short time scale. Rapid endocytic modes contributed to the recycling of â¼60% of the total secretory granule population, which involved kiss-and-run and cavicapture mechanisms, causing retention of the intragranular matrix. We found the presence of normal-size granules and giant actomyosin- and dynamin-dependent granules, which were characterized by large quantal content. These large structures allowed the recovered mast cells to release a large amount of 5-HT, compensating for the decrease in the number of exocytosed secretory granules. This work uncovers a new physiological role of the exo-endocytosis cycle in the immunological plasticity of mast cells and reveals a new property of their biological secretion.
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Degranulação Celular , Imunoglobulina E/metabolismo , Mastócitos/fisiologia , Fusão de Membrana , Vesículas Secretórias/metabolismo , Actinas/metabolismo , Animais , Antígenos/metabolismo , Calcimicina/farmacologia , Degranulação Celular/efeitos dos fármacos , Dinaminas/metabolismo , Técnicas Eletroquímicas , Endocitose/efeitos dos fármacos , Exocitose/efeitos dos fármacos , Mastócitos/efeitos dos fármacos , Fusão de Membrana/efeitos dos fármacos , Camundongos Endogâmicos C57BL , Modelos Biológicos , Miosina Tipo II/metabolismo , Vesículas Secretórias/efeitos dos fármacos , Serotonina/metabolismoRESUMO
OBJECTIVES: Peruvian men who have sex with men (MSM) and transgender women (TGW) are highly vulnerable to HIV infection (HIV), but stigma, access issues and fear of venipuncture hamper testing. The oral HIV test-which uses oral fluids and provides results in 20 minutes-could reduce these barriers. The objective of this study was to determine the acceptability of the oral HIV test and the individual-level factors associated with its acceptability among MSM and TGW. METHODS: We conducted a cross-sectional secondary analysis among Peruvian MSM and TGW attending a community-based health centre between February 2012 and February 2013 to determine the individual-level factors associated with oral HIV test acceptability. RESULTS: Of 334 participants, 88% were MSM and 12% TGW. Overall, 85% of participants indicated their acceptability of the oral HIV test. Acceptability was higher in MSM than TGW (85.7% vs 80.0%) but this difference was not significant. Factors associated with acceptability in MSM were: tertiary or higher education (prevalence ratio (PR)=1.18, 95% CI 1.06 to 1.32 and PR=1.16, 95% CI 1.03 to 1.30, respectively); sex with drug use (PR=1.19, 95% CI 1.05 to 1.36); believing that HIV is transmitted by saliva (PR=1.20, 95% CI 1.08 to 1.33); and potential use of the oral test at home (PR=1.56, 95% CI 1.32 to 1.85). The only factor associated with lower acceptability was having had first anal intercourse between 14 and 19 years of age (PR=0.89, 95% CI 0.80 to 0.98). CONCLUSIONS: We identified the individual factors associated with oral HIV test acceptability among Peruvian MSM and TGW. Expanded use of the oral HIV test to increase testing rates among Peruvian MSM and TGW is recommended. TRIAL REGISTRATION NUMBER: NCT01387412, post-results.
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Infecções por HIV/diagnóstico , Homossexualidade Masculina/psicologia , Boca/virologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pessoas Transgênero/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , HIV/isolamento & purificação , Infecções por HIV/epidemiologia , Humanos , Masculino , Programas de Rastreamento/métodos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Peru/epidemiologia , Prevalência , Kit de Reagentes para Diagnóstico , Comportamento Sexual , Estigma Social , Sexo sem Proteção , Adulto JovemRESUMO
Most oil extraction areas in the Peruvian Amazon are within indigenous territories. Poor environmental practices have exposed the indigenous population to metals. We conducted a survey in two indigenous Kukama communities to assess body burdens of metals after the occurrence of two major oil spills in 2014. Urine levels above those recommended by the Peruvian Ministry of Health were observed in 50% and 17% of the study population for mercury and cadmium, respectively.
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Cádmio , Exposição Ambiental , Mercúrio , Indústria de Petróleo e Gás , Cádmio/análise , Humanos , Mercúrio/análise , Peru , Grupos PopulacionaisRESUMO
Secretory granules (SGs) of mast cells (MCs) release their contents to mediate many biological events and a variety of inflammatory diseases and have important protective roles in innate host defense and pathological functions in allergic reactions and anaphylaxis. There are two modes of MC degranulation during the release of granule contents to the extracellular environment. Anaphylactic degranulation (AND) after IgE-mediated activation is characterized by a rapid swelling and fusion of MC granules as well as abrupt mediators release. Piecemeal degranulation (PMD) is a slow and selective secretion of distinct granule mediators by vesicles shuttling from the granule compartment to the plasma membrane, and it is associated with several chronic diseases. Following degranulation, endocytosis is a fundamental biological event that is necessary to recycle granules and maintain the secretory response during repetitive stimulation. Rapid endocytosis through transient fusion (kiss-and-run, cavicapture and compound exo-endocytosis) has been described in MCs and can also result in the selective release of granule contents. In summary, several possible exo-endocytic mechanisms control the kinetics and magnitude of transmitter release, and each mechanism is associated with a different impact on granule replenishment, cell recovery, and consequently MC function under both normal and pathological conditions.
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The key role of mast cells (MC), either in development of inflammatory pathologies or in response to environmental stress, has been widely reported in recent years. Previous studies have described the effects of corticotropin-releasing hormone (CRH), which is released from inflamed tissues by cellular stress signals, on MC degranulation, a process possibly driven by selective secretion of mediators (piecemeal degranulation). In this study, we introduce a novel granular exo-endocytic pathway induced by CRH on peritoneal MC. We found that CRH triggers substantial exocytosis, which is even stronger than that induced by Ag stimulation and is characterized by large quantal size release events. Membrane fluorescence increases during stimulation in the presence of FM1-43 dye, corroborating the strength of this exocytosis, given that discrete upward fluorescence steps are often observed and suggesting that secretory granules are preferentially released by compound exocytosis. Additionally, the presence of a depot of large tubular organelles in the cytoplasm suggests that the exocytotic process is tightly coupled to a fast compound endocytosis. This CRH-stimulated mechanism is mediated through activation of adenylate cyclase and an increase of cAMP and intracellular Ca(2+), as evidenced by the fact that the effect of CRH is mimicked by forskolin and 8-bromo-cAMP. Thus, these outcomes constitute new evidence for the critical role of MC in pathophysiological conditions within a cellular stress environment and an alternative membrane trafficking route mediated by CRH.
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Hormônio Liberador da Corticotropina/farmacologia , Endocitose/efeitos dos fármacos , Exocitose/efeitos dos fármacos , Mastócitos/metabolismo , 8-Bromo Monofosfato de Adenosina Cíclica/farmacologia , Adenilil Ciclases/metabolismo , Animais , Cálcio/metabolismo , Degranulação Celular/efeitos dos fármacos , Células Cultivadas , Colforsina/farmacologia , AMP Cíclico/metabolismo , Ativação Enzimática/efeitos dos fármacos , Espaço Intracelular/efeitos dos fármacos , Espaço Intracelular/metabolismo , Mastócitos/fisiologia , Camundongos Endogâmicos C57BL , Microscopia Confocal , Compostos de Piridínio/metabolismo , Compostos de Amônio Quaternário/metabolismo , Ratos Wistar , Vesículas Secretórias/metabolismoRESUMO
In this work, we present the design of a mitigation scheme for jamming attacks integrated to the routing protocols MPH, AODV, and DSR. The resulting protocols are named MPH-M (Multi-Parent Hierarchical - Modified), AODV-M (Ad hoc On Demand Distance Vector - Modified), and DSR-M (Dynamic Source Routing - Modified). For the mitigation algorithm, if the detection algorithm running locally in each node produces a positive result then the node is isolated; second, the routing protocol adapts their paths avoiding the isolated nodes. We evaluated how jamming attacks affect different metrics for all these modified protocols. The metrics we employ to detect jamming attack are number of packet retransmissions, number of CSMA/CA (Carrier Sense Multiple Access with Collision Avoidance) retries while waiting for an idle channel and the energy wasted by the node. The metrics to evaluate the performance of the modified routing protocols are the throughput and resilience of the system and the energy used by the nodes. We evaluated all the modified protocols when the attacker position was set near, middle and far of the collector node. The results of our evaluation show that performance for MPH-M is much better than AODV-M and DSR-M. For example, the node energy for MPH-M is 138.13% better than AODV-M and 126.07% better than DSR-M. Moreover, we also find that MPH-M benefits much more of the mitigation scheme than AODV-M and DSR-M. For example, the node energy consumption is 34.61% lower for MPH-M and only 3.92% and 3.42% for AODV-M and DSR-M, respectively. On throughput, the MPH protocol presents a packet reception efficiency at the collector node of 16.4% on to AODV and DSR when there is no mitigation mechanism. Moreover, MPH-M has an efficiency greater than 7.7% with respect to AODV-M and DSR-M when there is a mitigation scheme. In addition, we have that with the mitigation mechanism AODV-M and DSR-M do not present noticeable modification. However, MPH-M improves its efficiency by 8.4%. We also measure the resilience of these algorithms from the average packet re-transmissions perspective, and we find that MPH-M has around a 15% lower change rate than AODV-M and DSR-M. The MPH-M recovery time is 5 s faster than AODV-M and 2 s faster than DSR-M.
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5-hydroxytriptamine (5-HT, serotonin) storage and release in mast cell (MC) secretory granules (SG) are dependent on serglycin proteoglycans (PG). This notion is based on the studies of MC of the connective tissue subtype that predominantly contain PG of the heparin type, whereas intestinal mucosal MC, which contain predominantly chondroitin sulfate, have been poorly explored. In the present study, we addressed the possibility that PG contents may differently affect the storage and release of preformed mediators in these two MC subclasses and explain in part their different functional properties. Rat peritoneal (PMC) and intestinal mast cells (IMC) were isolated and purified using a percoll gradient, and the efflux of 5-HT from each SG was measured by amperometric detection. IMC exhibited a â¼34% reduction in the release of 5-HT compared with PMC because of a lower number of exocytotic events, rather than a lower secretion per single exocytotic event. Amperometric spikes from IMC exhibited a slower decay phase and increased half-width but a similar ascending phase and foot parameters, indicating that the fusion pore kinetics are comparable in both MC subclasses. We conclude that both PG subtypes are equally efficient systems, directly involved in serotonin accumulation, and play a crucial role in regulating the kinetics of exocytosis from SG, providing specific secretory properties for the two cellular subtypes.
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Mucosa Intestinal/metabolismo , Intestinos/citologia , Mastócitos/metabolismo , Peritônio/citologia , Peritônio/metabolismo , Serotonina/metabolismo , Animais , Células Cultivadas , Exocitose/fisiologia , Cinética , Mastócitos/citologia , Taxa de Depuração Metabólica , Especificidade de Órgãos/fisiologia , Ratos , Ratos WistarRESUMO
OBJECTIVES: Screening for HIV and syphilis in key populations is recommended by the WHO to reduce the morbidity, mortality and transmission associated with undiagnosed and untreated infections. Rapid point-of-care tests that can detect multiple infections with a single fingerprick whole blood specimen using a single device are gaining popularity. We evaluated the field performance of a rapid dual HIV and syphilis test in people at high risk of HIV and syphilis infections. METHODS: Participants included men who have sex with men and transgender women recruited in Lima, Peru. Reference standard testing for detection of HIV and syphilis infections, conducted using blood samples from venipuncture, included Treponema pallidum particle agglutination and fourth-generation HIV enzyme immunoassay for which positive results had a confirmation HIV Western blot test. For the evaluation test, SD BIOLINE HIV/Syphilis Duo test (Standard Diagnostics, Korea), a fingerprick blood specimen was used. Sensitivity and specificity were calculated and the exact binomial method was used to determine 95% CIs. RESULTS: A total of 415 participants were recruited for the study. The dual test sensitivity for detection of T. pallidum infection was 89.2% (95% CI 83.5% to 93.5%) and specificity 98.8% (95% CI 96.5% to 99.8%). For detection of HIV infection, the sensitivity of the dual test was 99.1% (95% CI 94.8% to 100%) and specificity 99.4% (95% CI 97.7% to 99.9%). CONCLUSIONS: This high performing dual test should be considered for the use in clinical settings to increase uptake of simultaneous testing of HIV and syphilis and accelerate time to treatment for those who need it.
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Cromatografia de Afinidade/normas , Infecções por HIV/diagnóstico , Sífilis/diagnóstico , Adulto , Anticorpos Antibacterianos/sangue , Coinfecção , Centros Comunitários de Saúde , Feminino , Anticorpos Anti-HIV/sangue , Infecções por HIV/complicações , Infecções por HIV/epidemiologia , Homossexualidade Masculina , Humanos , Masculino , Programas de Rastreamento/métodos , Peru/epidemiologia , Controle de Qualidade , Sensibilidade e Especificidade , Sífilis/complicações , Sífilis/epidemiologia , Sorodiagnóstico da Sífilis , Pessoas Transgênero , Treponema pallidum/imunologiaRESUMO
BACKGROUND: Integrated prevention for HIV and syphilis is warranted because both syphilis and HIV infections have evidence-based, scalable interventions using current health care mechanisms. The advent of dual rapid point-of-care tests, single devices that can detect multiple infections using the same specimen, provides the opportunity to integrate the screening of syphilis into HIV prevention programs, potentially increasing the numbers of people tested and allowing for same-day testing and treatment. The aim of our study was to evaluate the MedMira Multiplo Rapid TP/HIV Antibody Test (MedMira Inc, Halifax, Nova Scotia, Canada), a qualitative, rapid immunoassay that detects antibodies to Treponema pallidum and HIV. METHODS: The reference test for comparison to the T. pallidum component of the Multiplo TP/HIV Test was the T. pallidum particle agglutination assay. For the HIV component, the reference test included a fourth-generation enzyme immunoassay with a confirmatory Western blot test. RESULTS: The sensitivity and specificity for the HIV antibody component were 93.8% (95% confidence interval [CI], 69.8%-99.8%) and 100% (95% CI, 97.7%-100%), respectively. The T. pallidum component of the test had a sensitivity of 81.0% (95% CI, 68.1%-94.6%) and a specificity of 100% (95% CI, 97.6%-100%). CONCLUSIONS: Our study showed excellent performance of the HIV antibody component of the test and very good performance for the T. pallidum antibody component of the MedMira Multiplo Rapid TP/HIV Antibody Test, which should be considered to improve screening coverage. Use of effective dual tests will create improved access to more comprehensive care by integrating the screening of syphilis into HIV prevention programs.
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Anticorpos Antibacterianos/imunologia , Anticorpos Anti-HIV/imunologia , Infecções por HIV/diagnóstico , Sistemas Automatizados de Assistência Junto ao Leito , Sífilis/diagnóstico , Treponema pallidum/imunologia , Adolescente , Adulto , Intervalos de Confiança , Feminino , Homossexualidade Masculina , Humanos , Técnicas Imunoenzimáticas , Masculino , Peru/epidemiologia , Kit de Reagentes para Diagnóstico , Sensibilidade e Especificidade , Profissionais do Sexo , Pessoas Transgênero , Adulto JovemRESUMO
New dual tests for HIV and syphilis have been developed. Our study aimed to evaluate the laboratory performance of a dual rapid immunodiagnostic test for HIV and syphilis. Our evaluation showed high performance of this dual rapid test, which should be considered for implementation to increase screening coverage and efficiency.
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Técnicas Bacteriológicas/métodos , Infecções por HIV/diagnóstico , Imunoensaio/métodos , Sífilis/diagnóstico , Virologia/métodos , HumanosRESUMO
The role played by type 2 diabetes mellitus (DM2) in the occurrence of recurrent tuberculosis is still uncertain. Military personnel are an occupational group with an increased risk for tuberculosis exposure due to their activities. Methods. We conducted a retrospective cohort to study the association between DM2 and recurrent TB in military workers who have been previously treated for tuberculosis at the Central Military Hospital in Lima, Peru, between 2016 and 2017. We evaluated the risk between DM2 and recurrent TB using Nelson-Aalen graphical analysis and Cox regression stratified by TB cured with hazard ratio (HR) calculation adjusted for confounders. Results. We evaluated 220 workers with a mean age of 23.2 ± 7.8 years (96.8 % male). DM2 and recurrent TB frequency were 11.8 % and 5.0 %, respectively. Those with DM (36.5 %) presented a greater proportion of recurrent TB than those without DM2 (10.5 %). The cumulative risk for recurrent TB increases faster among workers with DM2 (p = 0.025, LR chi-squared test). Cox regression stratified by type of cured TB did not show an association between DM2 and recurrent TB (HR: 3.67; 95 %CI: 1.00-13.46). Conclusion. The cumulative risk for recurrent TB increases faster in patients with DM than in those without DM2. DM2 is not associated with the time of apparition of recurrent TB in military workers.
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BACKGROUND: The COVID-19 pandemic has promoted a shortage of filtering facepiece respirators (FFRs) and the emergence of new FFRs brands. We aimed to determine the fit provided by in-use FFRs in Peruvian healthcare workers (HCWs) during the COVID-19 pandemic. METHODS: We enrolled 279 HCWs from 37 primary healthcare centers with highest burden of care for TB in Peru, of which 263 were assessed using quantitative fit tests (QNFT). Results were expressed as real-time fit factor (rt-FF) and overall fit factor (overall-FF), which was categorized as ≥100 (optimal result), 50-99, and <50. RESULTS: We identified 3M 1860 FFRs (33.1%), Xiantao Zhong Yi ZYB-11 FFRs (24.6%) and Makrite 9500 FFRs (20.5%), mainly. Eighty-seven FFRs (33.1%) had an optimal overall-FF, 27 (10.3%) between 50-99, and 149 (56.6%) less than 50. Of the 87 FFRs with optimal overall-FF, 73 (83.9%) were 3M 1860 FFRs. Of the 27 FFRs with overall-FF between 50-99, 7 (25.9%) were Makrite 9500, while of the 149 with overall-FF less than 50, 58 (38.9%), and 47 (31.5%) were Xiantao Zhong Yi ZYB-11 and Makrite 9500, respectively. CONCLUSION: Xiantao Zhong Yi and Makrite FFRs do not adapt adequately to the face of Peruvian HCWs, most having fit factors less than 50.
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COVID-19 , Tuberculose , Humanos , Peru/epidemiologia , Pandemias/prevenção & controle , Pessoal de Saúde , Ventiladores MecânicosRESUMO
BACKGROUND: Patients infected with severe acute respiratory syndrome-CoV-2 can present physical complications that can make the return to their daily physical activities difficult. Despite the positive results in different pathologies through musculoskeletal physiotherapy, there are few reports in post-COVID-19 patients. This case describes an intervention based on musculoskeletal physiotherapy in a post-COVID-19 adult woman with physical sequelae. METHODS: As part of an initial evaluation in a woman with physical sequelaes post-COVID-19, it was decided to conduct a musculoskeletal physiotherapy over a course of 5 weeks distributed in 15 visits. To evaluate her progress the joint ranges were evaluated according to the American Academy of Orthopedic Surgeons (AAOS), the Numerical pain scale was used, the muscle strength evaluated according to the Daniel Scale, and finally the Unipodal Station Test used. RESULTS: Musculoskeletal physiotherapy improved the patient's physical symptoms. The patient's pain was reduced from a value of 10 to 3; the strength of the musculature increased from a value of 2 to 4; initial joint ranges were expanded from 67% to 100% in various body segments. Finally, the woman managed to stay up to 8 s in the monopodal position. DISCUSSION: Using musculoskeletal physical therapy and measuring progress through quantitative measurements at each visit, a post-COVID-19 woman was able to resume her daily physical activities. This therapy is a valuable tool to recover the musculoskeletal system that proves to be an important advance in the recovery of the quality of life in patients with musculoskeletal sequelae from COVID-19.
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COVID-19 , Sistema Musculoesquelético , Adulto , Feminino , Humanos , Modalidades de Fisioterapia , Qualidade de Vida , SARS-CoV-2RESUMO
With the objective of evaluating the concordance between the self-sampling of vaginal samples and the standard collection of endocervical samples for the identification of Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Candida spp. carried out by health personnel in women from an urban-rural area of Peru, a prospective and cross-sectional study was carried out in 206 women of childbearing age, we identified some sexually transmitted infections such as Chlamydia trachomatis or Trichomonas vaginalis in 9/206 (4.4%). We obtained a high degree of agreement in the identification of Candida spp. (k = 0.97), Chlamydia trachomatis (k=0.92) and Trichomonas vaginalis by microscopy (k=1.00), and a considerable agreement for the identification of Trichomonas vaginalis by culture (k=0.66). The self-sampling technique can be used to identify some sexually transmitted infections in urban-rural populations.
Con el objetivo de evaluar la concordancia entre la autotoma de muestras vaginales y la toma estándar de muestras endocervicales para la identificación de Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis y Candida spp. realizadas por el personal de salud en mujeres de un área urbano-rural del Perú, se realizó un estudio prospectivo y transversal en 206 mujeres en edad fértil, identificamos algunas infecciones de transmisión sexual como Chlamydia trachomatis o Trichomonas vaginalis en 9 mujeres (4,4%). Obtuvimos una concordancia casi perfecta en la identificación de Candida spp. (k=0,97), Chlamydia trachomatis (k=0,92) y Trichomonas vaginalis por microscopía (k=1,00), y considerable para la identificación de Trichomonas vaginalis por cultivo (k=0,66). La técnica de la autotoma de muestras vaginales podría ser usada para la identificación de algunas infecciones de transmisión sexual en población urbano-rural.
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Infecções por Chlamydia , Gonorreia , Infecções Sexualmente Transmissíveis , Vaginite por Trichomonas , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/epidemiologia , Estudos Transversais , Feminino , Humanos , Peru/epidemiologia , Prevalência , Estudos Prospectivos , População RuralRESUMO
Experts recommend exclusive breastfeeding from birth to six months because it protects against deadly childhood illness, including respiratory tract infections and diarrhea. We hypothesized that exclusive breastfeeding would decrease the risk of active tuberculosis (TB) in children. We analyzed cross-sectional data from 279 children in Lima, Peru aged 6 to 59 months with TB symptoms and a close adult contact with TB. Mothers self-reported breastfeeding, and children were evaluated for TB per national guidelines. To quantify the association between exclusive breastfeeding and TB, we estimated prevalence ratios using a generalized linear model with a log link, binomial distribution, and robust variance. Twenty-two percent of children were diagnosed with TB and 72% were exclusively breastfed for six months. We found no evidence that six months of exclusive breastfeeding was associated with TB disease in either bivariate analyses (prevalence ratio [PR] = 1.5; 95%CI = 0.8-2.5) or multivariable analyses adjusting for sex and socioeconomic status (adjusted PR = 1.6; 95%[CI] = 0.9-2.7). In post hoc analyses among children whose close TB contact was their mother, we found evidence of a weak positive association between breastfeeding and TB (aPR = 2.1; 95%[CI] = 0.9-4.9). This association was not apparent among children whose close contact was not the mother (aPR = 1.2; 95%[CI] = 0.6-2.4). Our results raise the possibility that children who are breastfed by mothers with TB may be at increased risk for TB, given the close contact. Due to the cross-sectional study design, these results should be interpreted with caution. If these findings are confirmed in longitudinal analyses, future interventions could aim to minimize TB transmission from mothers with TB to breastfeeding infants.
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Aleitamento Materno , Tuberculose , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Lactente , Mães , Peru/epidemiologia , Gravidez , Tuberculose/epidemiologia , Tuberculose/prevenção & controleRESUMO
Hepatocellular carcinoma (HCC) is the sixth most common neoplasia and the fourth most common cause of cancer-related mortality worldwide. Sorafenib is the first-line molecular therapy for patients in an advanced stage of HCC. However, the recommended clinical dose of Sorafenib is associated with several complications, which derive from its lack of cell specificity and its very low water solubility. To circumvent these drawbacks, in the present study we developed two sugar-coated polydiacetylene-based nanomicelles-Sorafenib carriers targeting mannose and asialoglycoprotein receptors (MR and ASGPR, respectively). The strategies allowed the inducement of apoptosis and reduction of cell proliferation at a nanomolar, instead of micromolar, range in liver cancer cells. The study showed that, contrary to literature data, Sorafenib included into the pMicMan (Man = mannose) vector (targeting MR) is more efficient than pMicGal (Gal = galactose) (targeting ASGPR). Indeed, pMicMan increased the endosomal incorporation with an increased intracellular Sorafenib concentration that induced apoptosis and reduced cell proliferation at a low concentration range (10-20 nM).
Assuntos
Antineoplásicos/administração & dosagem , Carcinoma Hepatocelular/tratamento farmacológico , Galactose/administração & dosagem , Neoplasias Hepáticas/tratamento farmacológico , Manose/administração & dosagem , Nanopartículas/administração & dosagem , Polímero Poliacetilênico/administração & dosagem , Sorafenibe/administração & dosagem , Antineoplásicos/química , Apoptose/efeitos dos fármacos , Receptor de Asialoglicoproteína/metabolismo , Carcinoma Hepatocelular/metabolismo , Proliferação de Células/efeitos dos fármacos , Endossomos/metabolismo , Galactose/química , Células Hep G2 , Humanos , Neoplasias Hepáticas/metabolismo , Manose/química , Receptor de Manose/metabolismo , Micelas , Nanopartículas/química , Polímero Poliacetilênico/química , Sorafenibe/químicaRESUMO
We examined Mycobacterium tuberculosis DNA detection from buccal swab samples collected from children in Lima, Peru. DNA was extracted and amplified via real-time polymerase chain reaction. Sensitivity was 21% (95% confidence interval [CI]: 7%-42%) in 24 culture-confirmed tuberculosis cases and 4.6% (95% CI: 1%-13%) in 65 clinically diagnosed unconfirmed cases. Sensitivity was highest for smear-positive tuberculosis. Specificity was 99% in the 199 controls (95% CI: 96%-100%).