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BACKGROUND/AIMS: The study aimed to assess the surface characteristics of sports mouthguards under mechanical stresses during cleaning, either by brushing or immersion in disinfectant solutions. MATERIAL AND METHODS: Ethylene-vinyl acetate samples, 4 mm thick, were randomly assigned to cleaning methods: control (C-no cleaning), brushing with water (B.W), brushing with neutral liquid soap (B.S), brushing with toothpaste (B.T), immersion in distilled water for 10 min (I.W), immersion in 2.25% sodium hypochlorite solution for 10 min (I.SH), and immersion in sodium bicarbonate solution for 5 min (I.SB). All cleaning methods were applied for 28 days. Surface roughness average (Ra) and wettability were measured at baseline for the control group (n = 9), and after cleaning for all the other groups. RESULTS: One-way ANOVA with Tukey tests (5% significance) indicated significant differences among groups (p < .05). The I.SB group had higher surface roughness than B.S and B.T (p < .05). B.W showed the lowest wettability, significantly lower than B.T, I.W, and I.SB (p < .05). I.SB exhibited the highest wettability, significantly different from sodium hypochlorite, neutral liquid soap, brushing with water, and control groups (p < .05). The sodium bicarbonate immersion group (I.SB) demonstrated greater statistical variation, displaying higher susceptibility to aging compared to brushing with neutral liquid soap. CONCLUSION: Cleaning mouthguards with a toothbrush, water, and neutral liquid soap emerged as the most promising method, causing minimal surface changes in the material.
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Protetores Bucais , Propriedades de Superfície , Escovação Dentária , Desinfetantes , Hipoclorito de Sódio/farmacologia , Humanos , Bicarbonato de Sódio , Sabões , Cremes Dentais , Molhabilidade , Fatores de Tempo , PolivinilRESUMO
1. In developmental embryology in chickens, the cardiovascular system is the first to become functional, the first heart muscular contraction (beat) happens as early as 33 h of incubation of a developmental journey that takes 21 d.2. An electrocardiogram (ECG) recording system (IX-TA 220) has been used to record the ECG of various species. The following trial describes the use of such a system for recording electrical tracing of the developing heart in chick embryos on d 19 of embryonic development with the electrodes piercing the eggshell in specific locations to a depth of about 2 mm. The recorded ECG offers an opportunity to measure or calculate ECG parameters like those measured/calculated in humans.3. The use of anaesthesia substantially reduced embryo motion, but may have a transient tachycardia effect on heart rate.4. This is the first time such a system has been successfully used for measuring heart electrical activities in chick embryos and provides a broader research opportunity in chicken embryo cardio-physiology.
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Galinhas , Óvulo , Animais , Embrião de Galinha , Galinhas/fisiologia , Casca de Ovo , Eletrocardiografia/veterinária , Frequência Cardíaca/fisiologia , HumanosRESUMO
A cross-sectional, survey based study was conducted in order to assess mental health outcomes among healthcare workers in a private university hospital involved in the COVID-19 response in Lebanon. The main objective was to quantify symptoms of anxiety and sleep quality using self-rating scales (the State-Trait Anxiety Inventory (STAI) and Pittsburgh Sleep Quality Index (PSQI) respectively), while identifying factors that might affect those symptoms. A total of 628 healthcare workers completed the survey; 409 (66.2%) were younger than 40 years, and 441 (71.4%) were women. Of all participants, 503 (81.4%) were nurses, 52 (8.4%) were physicians and 63 (10.2%) were residents. Registered nurses, residents, women, and younger participants presented higher scores on both scales than other categories of participants. Among factors related with COVID-19, those associated with higher scores were having relatives affected by the virus (22.2%), being excessively exposed to media (12.9%), and increasing the consumption of substances/alcohol (31.2%) during this period. Factors associated with higher risk of anxiety symptoms after multivariable logistic regression analysis were: female sex, young age, poor sleep quality, and living with elderly. Our findings contribute to the understanding of the psychological wellbeing of health care workers involved in the acute COVID-19 outbreak in Lebanon.
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COVID-19 , Idoso , Ansiedade/epidemiologia , Ansiedade/psicologia , COVID-19/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Surtos de Doenças , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , SARS-CoV-2 , Qualidade do SonoRESUMO
In this paper, we introduce a pulse characterization technique that is free of phase-matching constraints, exploiting transient absorption in solids as an ultrafast optical switch. Based on a pump-probe setup, this technique uses pump pulses of sufficient intensity to induce the switch, while the pulses to characterize are probing the transmissivity drop of the photoexcited material. This enables the characterization of low-intensity ultra-broadband pulses at the detection limit of the spectrometer and within the transparency range of the solid. For example, by using zinc selenide (ZnSe), pulses with wavelengths from 0.5 to 20 µm can be characterized, denoting five octaves of spectral range. Using ptychography, we retrieve the temporal profiles of both the probe pulse and the switch. To demonstrate this approach, we measure ultrashort pulses from a titanium-sapphire (Ti-Sa) amplifier, which are compressed using a hollow core fiber setup, as well as infrared to mid-infrared pulses generated from an optical parametric amplifier (OPA). The characterized pulses are centered at wavelengths of 0.77, 1.53, 1.75, 4, and 10 µm, down to sub-two optical cycles duration, exceeding an octave of bandwidth, and with energy as low as a few nanojoules.
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BACKGROUND AND AIMS: The mechanism by which vegetarian diets are associated with less inflammation is not clear. We investigated the role of BMI as a mediator in the relationship between vegetarian diet and concentrations of C-reactive protein (CRP), and the cytokines IL-6, IL-10 and TNF-α. METHODS AND RESULTS: We used data from participants of the Adventist Health Study 2 (AHS-2) Calibration (n = 893) and Biological Manifestations of Religion (n = 478) sub-studies. Vegetarian diet variations were determined based on reported intake of animal products assessed by FFQ. Combining all participants, the proportion of non-vegetarians (NVs), partial vegetarians (PVs), lacto-ovo vegetarians (LOVs), and strict vegetarians (SVs) was 44%, 16%, 31%, and 9%, respectively. NV and PV participants were older than other dietary groups, and non-vegetarians had the highest BMI. Mediation analyses supported the mediating effect of BMI in associations of vegetarian diet with CRP (p < 0.001 each for PV, LOV and SV), and with IL-6 (p < 0.05 each for PV, LOV and SV). Mediation by BMI was not evident between vegetarian diet and the biomarkers IL-10 and TNF-α. A direct pathway was significant only in the association between strict vegetarians and CRP (p = 0.017). CONCLUSION: The lower CRP and IL-6 concentrations among vegetarians may be mediated by BMI.
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Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Dieta Saudável , Dieta Vegetariana , Mediadores da Inflamação/sangue , Inflamação/prevenção & controle , Interleucina-6/sangue , Adulto , Idoso , Biomarcadores/sangue , Estudos Transversais , Regulação para Baixo , Comportamento Alimentar , Feminino , Humanos , Inflamação/sangue , Inflamação/diagnóstico , Masculino , Pessoa de Meia-Idade , América do Norte , Protestantismo , Religião e MedicinaRESUMO
Infections are a major cause of morbidity and mortality in patients with chronic lymphocytic leukemia (cll), who typically have increased susceptibility because of hypogammaglobulinemia (hgg) related to their disease and its treatment. Immunoglobulin replacement therapy (igrt) has been shown to reduce the frequency of bacterial infections and associated hospitalizations in patients with hgg or a history of infection, or both. However, use of igrt in cll is contentious. Studies examining such treatment were conducted largely before the use of newer chemoimmunotherapies, which can extend lifespan, but do not correct the hgg inherent to the disease. Thus, the utility of igrt has to be re-evaluated in the current setting. Here, we discuss the evidence for the use of igrt in cll and provide a practical approach to its use in the prevention and management of infections.
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BACKGROUND: High-fibre and low-carbohydrate diets may enhance satiety and promote weight loss. We compared a diet rich in beans aiming to increase dietary fibre and promote weight loss with a low-carbohydrate diet in a randomised controlled trial to assess effect and tolerability of the high-fibre bean-rich diet. METHODS AND RESULTS: One hundred and seventy-three women and men, with a mean body mass index of approximately 36 kg m(-2) (one-fifth with diabetes type 2) were randomised to a high-fibre bean-rich diet that achieved mean (SD) fibre intakes of 35.5 (18.6) g day(-1) for women and 42.5 (30.3) g day(-1) for men, or a low-carbohydrate diet. Both diets were induced gradually over 4 weeks and included a 3-day feeding phase. Among 123 (71.1%) completers at 16 weeks, mean (SD) weight loss was 4.1 (4.0) kg in the high-fibre versus 5.2 (4.5) kg in the low-carbohydrate group [difference, 1.1 kg, 95% confidence interval (CI) = -2.6 to -0.5; P = 0.2], with results similar to the intent-to-treat population. Low-density lipoprotein (LDL)-cholesterol levels decreased with the high-fibre diet (difference in LDL-cholesterol versus low-carbohydrate diet, 0.2 mmol L(-1) , 95% CI = 0.01-0.44 mmol L(-1) ; P = 0.045), as did total cholesterol (P = 0.038), whereas changes in other lipids and glucose did not differ. After 52 weeks, the low-carbohydrate (n = 24) group tended to retain weight loss better than the high-fibre group (P = 0.06), although total cholesterol remained lower with the bean-rich diet (P = 0.049). CONCLUSIONS: A high-fibre bean-rich diet was as effective as a low-carbohydrate diet for weight loss, although only the bean-rich diet lowered atherogenic lipids.
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Dieta com Restrição de Carboidratos , Fibras na Dieta/administração & dosagem , Fabaceae , Obesidade/dietoterapia , Adulto , Idoso , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , Peso Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/dietoterapia , Dieta , Carboidratos da Dieta/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/sangue , Cooperação do Paciente , Estudos Prospectivos , Triglicerídeos/sangue , Circunferência da Cintura , Redução de PesoRESUMO
Bipolar plates are structured thin metal sheets and are, next to the membrane electrode assembly (MEA), one of the main components of polymer electrolyte membrane fuel cells. One of the production steps of such bipolar plates is the joining process of its two halves. Laser welding is a suitable method for such an application since it is fast, non-contact, automatable, and scalable. Particularly important aspects of the weld seam are the weld seam width and depth. In this paper, welding of stainless-steel material analogous to materials used in bipolar plates is examined. For this purpose, a newly developed quasi continuous wave (QCW) green laser source with higher beam quality is employed to assess the effect of the wavelength and the spot diameter on the welding of stainless-steel material. By using various focusing lens, different sized beam diameters below 20 µm are achieved and their influence on the final welding result-specifically concerning the seam width-are analyzed. With welding speeds starting at 500 mm/s, reduced weld seam widths (≤ 100 µm) are realized, particularly with a focusing lens of 200 mm focal distance. The suitability of such a process for thin channels of under 75 µm width is examined.
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BACKGROUND: Linear morphoea (LM) is a rare fibrosing disorder of the limbs or the face that may cause functional disability and severe aesthetic sequelae. Despite a wide range of therapeutics reported for LM, there is currently a lack of consensus on the optimal therapy. Little is known about the long-term outcome of this disease. OBJECTIVES: To describe the short- and long-term outcome of a large series of patients with LM acquired in childhood. METHODS: A retrospective chart review of 52 paediatric patients with LM seen in our centre during a 20-year span (1990-2010) and a telephone survey in 2011 to assess the long-term outcome of these patients. RESULTS: Limbs were affected twice as often as the face, with a higher proportion of female patients. Stabilization was obtained after a mean disease duration of 5·4 years. Patients sometimes experienced long stretches of disease quiescence followed by reactivation; 31% of patients reported active disease after 10 years. All but one patient had aesthetic sequelae, and 38% had functional limitations. The effectiveness of methotrexate and systemic corticosteroids was apparent in the short term. CONCLUSIONS: LM needs prolonged monitoring as the disease can have very long periods of quiescence followed by reactivation. The combination of methotrexate and systemic corticosteroids was effective in the early stages of the disease but did not seem to prevent long-standing active disease or relapse in the long term.
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Fármacos Dermatológicos/uso terapêutico , Esclerodermia Localizada/terapia , Adolescente , Corticosteroides/uso terapêutico , Idade de Início , Aminoquinolinas/uso terapêutico , Calcitriol/análogos & derivados , Calcitriol/uso terapêutico , Criança , Quimioterapia Combinada , Feminino , Humanos , Imiquimode , Masculino , Metotrexato/uso terapêutico , Pomadas , Fototerapia/métodos , Estudos Retrospectivos , Esclerodermia Localizada/patologia , Tacrolimo/uso terapêutico , Resultado do Tratamento , Vitamina A/uso terapêutico , Vitamina E/uso terapêuticoRESUMO
BACKGROUND AND AIMS: Accumulating epidemiological and clinical studies have suggested that vitamin D insufficiency may be associated with hypertension. Blacks tend to have lower vitamin D levels than Whites, but it is unclear whether this difference explains the higher blood pressure (BP) observed in Blacks in a population with healthy lifestyle practices. METHODS AND RESULTS: We examined cross-sectional data in the Adventist Health Study-2 (AHS-2), a cohort of non-smoking, mostly non-drinking men and women following a range of diets from vegan to non-vegetarian. Each participant provided dietary, demographic, lifestyle and medical history data. Measurements of weight, height, waist circumference, percent body fat and blood pressure and fasting blood samples were obtained from a randomly selected non-diabetic sample of 284 Blacks and 284 Whites aged 30-95 years. Multiple regression analyses were used to assess independent relationships between blood pressure and 25(OH)D levels. Levels of 25(OH)D were inversely associated with systolic BP in Whites after control for age, gender, BMI, and use of BP-lowering medications (ß-coefficient -0.23 [95% CI, -0.43, -0.03; p = 0.02]). This relationship was not seen in Blacks (ß-coefficient 0.08 [95% CI, -0.14, 0.30; p = 0.4]). Results were similar when controlling for waist circumference or percentage body fat instead of BMI. No relationship between serum 25(OH)D and diastolic BP was seen. CONCLUSION: Systolic BP is inversely associated with 25(OH)D levels in Whites but not in Blacks. Vitamin D may not be a major contributor to the White-Black differential in BP.
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Pressão Sanguínea/efeitos dos fármacos , Comportamento Alimentar , Hipertensão/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Adulto , Negro ou Afro-Americano , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos Transversais , Dieta , Feminino , Humanos , Hipertensão/sangue , Hipertensão/complicações , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Prevalência , Análise de Regressão , Estações do Ano , Luz Solar , Inquéritos e Questionários , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações , População BrancaRESUMO
The economy of a country is exposed to disruptions caused by natural and man-made disasters. Here we present a set of probabilistic risk indicators, the Average Annual Loss (AAL) and the Loss Exceedance Curve (LEC), regarding to production, employment, Gross Domestic Product (GDP), Gross Regional Product (GRP), export volume, inflation, tariff revenue, among others, due to earthquakes. All indicators are computed using a systematic probabilistic approach, which integrates the seismic risk assessment with spatial computable general equilibrium models, both robust and well-known frameworks used worldwide in their respective fields. Our approach considers the induced damage and frequency of occurrence of a vast collection of events that collectively describe the entire seismic hazard of a country, giving us a better and more complete understanding of the full consequence of earthquakes. We illustrate this approach with an example developed for Chile.
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Desastres , Terremotos , Produto Interno Bruto , Humanos , Medição de Risco , Fatores de RiscoRESUMO
OBJECTIVES: Overdiagnosis of lyme borreliosis leads to unnecessary and increasingly common antimicrobial treatments. We aimed to evaluate patients receiving long-term antimicrobial treatment for lyme borreliosis. METHODS: We included patients referred to a Parisian teaching hospital between January 1st, 2014 and June 30th, 2019, with a presumed diagnosis of lyme borreliosis for which they were treated with antimicrobials for at least 6 months. RESULTS: Fifteen patients were included (11 women and mean age 44 years). The mean antimicrobial treatment duration was 476 days (180-942). The mean number of antimicrobials was 6.8 per patient (1-18). None of the 15 patients had lyme borreliosis. Nine patients were diagnosed with a mental disorder. CONCLUSION: Overdiagnosis and overtreatment of lyme borreliosis put patients at risk of undiagnosed illnesses and multiple adverse effects of unjustified treatments. The clinical management of such patients requires a comprehensive approach including expertise in mental disorders.
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Antibacterianos/administração & dosagem , Doença de Lyme/diagnóstico , Doença de Lyme/tratamento farmacológico , Transtornos Mentais/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Uso Excessivo dos Serviços de Saúde , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Adulto JovemRESUMO
INTRODUCTION: Neisseria elongata (NE), a Gram-negative, rod-shaped organism, was previously thought to be non-pathogenic. However, in recent years it has become increasingly recognized as a rare cause of infective endocarditis. In this paper, we report a case of NE infective endocarditis and provide a review of the literature. OBJECTIVES: To describe a case of NE endocarditis, and to review the literature in search of any similar cases of this rare condition. CASE REPORT: Our patient is a 77-year-old, otherwise healthy female patient who was found to have mitral valve endocarditis with valve regurgitation. DISCUSSION: NE endocarditis is a rare condition that typically affects the left cardiac chambers and is associated with high risk of embolization. A literature review retrieved 35 other cases. CONCLUSIONS: Our report underlines the rarity of NE endocarditis, insofar as relatively few cases have been reported. The bacterium presents similarities with HACEK organisms and can potentially cause infective endocarditis.
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Endocardite Bacteriana , Endocardite , Doenças das Valvas Cardíacas , Neisseria elongata , Idoso , Endocardite Bacteriana/diagnóstico , Feminino , HumanosRESUMO
In early embryo loss, the fetus may be considered to be an allograft and, therefore, may be rejected by maternal immunocytes. However, the cytotoxic mechanisms involved are still poorly understood. We have previously shown the involvement of natural killer (NK) cells and mononuclear cells expressing Mac-1 (CD11b) and F4/80 in resorbing compared to nonresorbing embryos. In this study, the role of nitric oxide (NO) in the mechanism of early embryo loss was studied. Pregnant CBA/J females mated with DBA/2 males (20-30% early embryo loss) and CD1 females mated with CD1 males (5-10% early embryo loss) were studied on days 8, 10, and 12 of gestation. Cells from the implantation sites of individual embryos were tested for the production of nitrite and nitrate with or without in vitro challenge with lipopolysaccharide (LPS) to determine whether decidual macrophages were primed in situ. On day 12 of gestation, when resorption was clearly visible, resorbing embryos showed more than a fivefold increase in both basal- and LPS-induced nitrite and nitrate production compared to nonresorbing embryos in both mouse strains tested, indicating that the decidual mononuclear cells were primed. Furthermore, more than 20% of CBA/J embryos showed a significant nitrate release on days 8 and 10 of gestation before any signs of embryo cytopathology. This percentage corresponded to the spontaneous resorption rate seen in CBA/J female X DBA/2 male matings. Similarly, 4% of the embryos from pregnant CD1 mice on days 8 and 12 of gestation produced a significant amount of nitrate, which again correlated with the low incidence of resorption observed in these mice. Using immunohistochemistry, the presence of inducible nitric oxide synthase (iNOS) was detected at implantation sites. Furthermore, decidual cells positive for both iNOS and the macrophage marker Mac-1 were demonstrated in implantation sites by double immunostaining. This strongly suggests that decidual macrophages could be the cellular source of NO production. Aminoguanidine, a selective inhibitor of the iNOS, inhibited the in vitro production of nitric oxide by cells isolated from individual implantation sites, and more strikingly, significantly reduced early embryo losses in CBA/J females mated by DBA/2 males when given orally or parenterally to the gravid females starting on day 6 of gestation. In addition, aminoguanidine-treated pregnant mice showed a significant increase in average litter size when the pregnancies were allowed to proceed to term.(ABSTRACT TRUNCATED AT 400 WORDS)
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Aborto Animal/metabolismo , Decídua/metabolismo , Leucócitos Mononucleares/metabolismo , Ativação de Macrófagos , Óxido Nítrico/biossíntese , Animais , Cruzamentos Genéticos , Decídua/citologia , Implantação do Embrião , Perda do Embrião , Feminino , Guanidinas/farmacologia , Imuno-Histoquímica , Masculino , Camundongos , Camundongos Endogâmicos CBA , Camundongos Endogâmicos DBA , Nitratos/análise , Óxido Nítrico Sintase/biossíntese , Óxido Nítrico Sintase/isolamento & purificação , Gravidez , Fatores de TempoRESUMO
BACKGROUND: Peanut allergy is an important public health problem in western countries. However, the risk factors associated with this allergy remain uncertain. OBJECTIVE: To determine whether the consumption of peanuts during pregnancy and breastfeeding is a risk factor for peanut allergy in infants. METHODS: We enrolled 403 infants in a case-control study. The cases were infants aged 18 months or less with a diagnosis of peanut allergy based on a history of clinical reaction after exposure to peanuts and the presence of peanut-specific immunoglobulin E. Controls were age-matched infants with no known clinical history or signs of atopic disease. The mothers of the children filled out a detailed questionnaire about maternal diet during pregnancy and breastfeeding, the infant's diet, the presence of peanut products in the infant's environment, and family history of atopy. RESULTS: The mean (SD) age of cases was 1.23 (0.03) years. The groups were comparable in terms of the rate and duration of breastfeeding. However, the reported consumption of peanuts during pregnancy and breastfeeding was higher in the case group and associated with an increased risk of peanut allergy in offspring (odds ratio [OR], 4.22 [95% confidence interval [CI], 1.57-11.30 and OR, 2.28 [95% CI, 1.31-3.97] for pregnancy and breastfeeding, respectively). Overall, the infants with peanut allergy did not seem to be more exposed to peanut products in their environment than the controls. CONCLUSION: Early exposure to peanut allergens, whether in utero or through human breast milk, seems to increase the risk of developing peanut allergy.
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Antígenos de Plantas/metabolismo , Aleitamento Materno/epidemiologia , Transfusão Feto-Materna/imunologia , Hipersensibilidade a Amendoim/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Adulto , Antígenos de Plantas/imunologia , Aleitamento Materno/efeitos adversos , Estudos de Casos e Controles , Feminino , Humanos , Imunização , Lactente , Recém-Nascido , Masculino , Exposição Materna/efeitos adversos , Hipersensibilidade a Amendoim/diagnóstico , Hipersensibilidade a Amendoim/imunologia , Hipersensibilidade a Amendoim/fisiopatologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Efeitos Tardios da Exposição Pré-Natal/imunologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Fenômenos Fisiológicos da Nutrição Pré-Natal/imunologia , Fatores de RiscoRESUMO
OBJECTIVES: Intravesical Bacillus Calmette-Guérin (BCG) treatment for superficial bladder cancer is interrupted in approximatively 8% of cases as a result of complications. The objective is to report the severe related complications of Bacillus Calmette-Guérin (BCG) following an intravesical instillation for bladder tumor encountered at our institution for the past 5 years. METHODS: Medical records of a tertiary teaching hospital, located in Beirut, Lebanon, were retrospectively analyzed from June 2014 to June 2019 searching for severe related complications of BCG. A comprehensive review of articles on this subject was conducted. RESULTS: The incidence of severe systemic adverse events related to BCG instillation was 1.5% (5 out of 332 patients). A total of five patients were found to have a severe BCG related complication, with fever, chills, and irritative urinary signs being the most frequent symptoms. All patients received antituberculosis therapy (Isoniazid, Rifampin and Ethambutol). Two were put on add-on corticosteroids. Three patients had a computed tomography scan image in favor of an infection. Two patients had a favorable outcome, three patients died. CONCLUSION: BCG severe adverse events were mostly seen in patients with a traumatic instillation. Treatment used at our institution was similar to most cases reported in the literature. A standardized diagnostic and treatment approach should be implemented to help physicians tackle these life-threatening complications.
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The coronavirus disease 2019 (COVID-19) pandemic is redefining the world we live in, and scientists are struggling to find the best severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostic tool. Routine testing is currently performed using real-time reverse transcription PCR (RT-PCR) of upper or lower respiratory tract secretions. We sought to demonstrate the importance of conducting RT-PCR using deep sampling when initial upper respiratory testing is negative in cases of high index of suspicion for COVID-19. We present the case of a 47-year-old man admitted for fever and bilateral pneumonia diagnosed via chest computed tomographic scan amidst the early peak of the COVID-19 pandemic, suggesting a SARS-CoV-2 infection. Two RT-PCR results from nasopharyngeal swab samples were negative. A bronchoscopy was then performed, and RT-PCR testing on bronchoalveolar lavage samples yielded positive results, confirming the diagnosis of COVID-19 pneumonia. RT-PCR samples of the lower respiratory tract likely contain a higher virus load and thus retain a higher sensitivity for SARS-CoV-2 detection.
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An effective prophylactic vaccine targeting HIV must induce a robust humoral response and must direct the bulk of this response to the mucosa-the primary site of HIV transmission. The chemokine, CCL28, is secreted by epithelial cells at mucosal surfaces and recruits' cells expressing its receptor CCR10. CCR10 is predominantly expressed by IgA + ASCs. We hypothesized that co-immunization with plasmid DNA encoding consensus envelope antigens with plasmid-encoded CCL28 would enhance anti-HIV IgA responses at mucosal surfaces. Indeed, animals receiving pCCL28 and pEnvA/C had significantly increased HIV-specific IgA in fecal extract. Surprisingly, CCL28 co-immunization induced a significant increase in anti-HIV IgG in the serum in mice compared to those receiving pEnvA/C alone. These robust antibody responses were not associated with changes in the frequency of germinal center B cells but depended upon the expression of CCR10, as these responses we abolished in CCR10-deficient animals. Finally, immunization with CCL28 led to increased frequencies in HIV-specific CCR10 + and CCR10 + IgA + B cells in the small intestine and Peyer's patches of vaccinated animals as compared to those receiving pEnvA/C alone. These data indicate that CCL28 administration can enhance antigen-specific humoral responses systemically and at mucosal surfaces.
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Vacinas contra a AIDS/administração & dosagem , Adjuvantes Imunológicos/administração & dosagem , Quimiocinas CC/administração & dosagem , Receptores CCR10/genética , Vacinas de DNA/administração & dosagem , Animais , Anticorpos Anti-HIV/imunologia , HIV-1/imunologia , Imunidade nas Mucosas , Imunoglobulina A/imunologia , Imunoglobulina G/sangue , Camundongos , Mucosa/imunologia , Produtos do Gene env do Vírus da Imunodeficiência Humana/imunologiaAssuntos
Infecções Bacterianas/prevenção & controle , Imunoglobulinas Intravenosas/uso terapêutico , Síndromes de Imunodeficiência/terapia , Imunoterapia/métodos , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/etiologia , Canadá , Criança , Feminino , Seguimentos , Serviços de Assistência Domiciliar/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Humanos , Síndromes de Imunodeficiência/complicações , Síndromes de Imunodeficiência/epidemiologia , Infusões Subcutâneas , Masculino , Cooperação do Paciente , Satisfação do Paciente , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Because mutations in Rab27a have been linked to immune defects in humans, we have examined cytotoxic lymphocyte function in ashen mice, which contain a splicing mutation in Rab27a. Ashen cytotoxic T lymphocytes (CTLs) showed a >90% reduction in lytic activity on Fas-negative target cells compared with control C3H CTLs, and ashen natural killer cell activity was likewise diminished. Although their granule-mediated cytotoxicity pathway is profoundly defective, ashen CTLs displayed a normal FasL-Fas cytotoxicity pathway. The CD4/8 phenotype of ashen T cells and their proliferative responses were similar to controls. Ashen CTLs had normal levels of perforin and granzymes A and B and normal-appearing perforin-positive granules, which polarized upon interaction of the CTLs with anti-CD3-coated beads. However, rapid anti-CD3-induced granule secretion was drastically defective in both CD8(+) and CD4(+) T cells from ashen mice. This defect in exocytosis was not observed in the constitutive pathway, as T cell receptor-stimulated interferon-gamma secretion was normal. Based on these results and our demonstration that Rab27a colocalizes with granzyme B-positive granules and is undetectable in ashen CTLs, we conclude that Rab27a is required for a late step in granule exocytosis, compatible with current models of Rab protein function in vesicle docking and fusion.