Terahertz time-domain imaging for the examination of gilded wooden artifacts.

Terahertz imaging is unlocking unique capabilities for the analysis of cultural heritage artifacts. This paper uses terahertz time-domain imaging for the study of a gilded wooden artifact, providing a means to perform stratigraphic analysis, yielding information about the composition of the artifact, presence of certain materials identifiable through their THz spectral fingerprint, as well as alterations that have been performed over time. Due to the limited information that is available for many historic artifacts, the data that can be obtained through the presented technique can guide proper stewardship of the artifact, informing its long-term preservation.

Case Report of a Young Adult with Fatal COVID-19 and Abundant SARS-CoV-2 Nucleocapsid Protein and Lipofuscin Accumulation in Tissues.

This is a case report of a young adult who died of COVID-19 twelve days after admission, with coronavirus nucleocapsid protein and lipofuscin found in the heart and kidney tissues, providing further evidence of the role of SARS-CoV-2 in cellular senescence.

Mirtazapine as Appetite Stimulant in Patients With Non-Small Cell Lung Cancer and Anorexia: A Randomized Clinical Trial.

Importance: Currently there is no standard therapy to improve cancer-related anorexia, hampering survival. Mirtazapine has been suggested as a feasible option in this context. Objectives: To assess the effect of mirtazapine on appetite and energy consumption in patients with advanced non-small cell lung cancer (NSCLC). Design, Setting, and Participants: This randomized, double-blind, placebo-controlled clinical trial including adults was performed in a tertiary cancer care center from August 2018 to May 2022 with a follow-up of 8 weeks. Overall, 134 patients were screened; 114 were assessed for eligibility and 28 were excluded. Interventions: Patients were randomized in a 1:1 ratio to receive mirtazapine, 15 mg, or placebo for 2 weeks followed by a dose escalation to 30 mg until week 8 or placebo. Both groups received nutritional assessment and dietary advice. Main outcomes and measures: Appetite was assessed by the Anorexia Cachexia Scale and energy intake. Dietary parameters were evaluated at baseline, 4 weeks, and 8 weeks, with a 24-hour dietary recall, and energy quantification based on the Mexican system of nutritional equivalents. Results: A total of 86 patients met the inclusion criteria and were randomized to the placebo (n = 43) or the mirtazapine group (n = 43). The mean (SD) age was 63.5 (11.2) years, 41 were women (57.7%) and had adenocarcinoma, Eastern Cooperative Oncology Group performance status scale score of 1, stage IV NSCLC, and were receiving first-line treatment. Baseline characteristics were similar between groups. There was no difference in appetite scores in patients who received mirtazapine or placebo after 4 and 8 weeks. After 4 weeks, mirtazapine significantly increased energy intake (379.3 kcal; 95% CI, 1382.6-576.1; P < .001) including proteins (22.5 g; 95% CI, 11.5-33.4; P = .001), carbohydrates (43.4 g; 95% CI, 13.1-73.8; P = .006), and fats (13.2 g; 95% CI, 6.0-20.4; P = .006). Fats intake was significantly higher in patients in the mirtazapine group (14.5 g vs 0.7 g; P = .02) after 8 weeks. The mirtazapine group significantly decreased the proportion of patients with sarcopenia (82.8% vs 57.1%, P = .03) at 8 weeks. Patients on mirtazapine tolerated the treatment well, but reported a higher perception of nightmares at 2 weeks based on a 10 cm VAS score (0 [25th-75th percentile, 0-1] vs 0 [25th-75th percentile, 0-0] in the control group; P = .009) but this finding was nonsignificant after 4 and 8 weeks. Conclusion and Relevance: In this randomized clinical trial of patients with advanced NSCLC, there was no difference in appetite scores in all patients who received mirtazapine or placebo, but the mirtazapine group had a significant increase in energy intake through the 4- and 8-week follow-up, mainly in fat intake, which is a better and crucial source of energy. The addition of mirtazapine in the treatment of patients with advanced NSCLC and anorexia may help these patients achieve their energy requirements and improve health-related quality of life, specifically emotional and cognitive functioning. Trial Registration: ClinicalTrials.gov Identifier: NCT04748523.

Factors associated with in-hospital and outpatient survival of patients with different types of stage IV cancer and venous thromboembolism.

OBJECTIVE: To identify factors associated with in-hospital and outpatient survival of patients with different types of stage IV cancer who present with venous thromboembolic disease (VTE). METHODS: In this prospective cohort, in-hospital and outpatient survival rates up to 180 days were analyzed using Kaplan-Meier curves. Cox regression was used to identify factors associated with different survival functions. RESULTS: One hundred patients were analyzed (median age, 67.5 years; 75% with Charlson index of <10; 69% with Eastern Cooperative Oncology Group (ECOG) score of 3-4). In-hospital mortality was 18%, and the median time from admission to death was 11 days (interquartile range, 1-61 days). Factors significantly associated with in-hospital mortality were the ECOG score and thrombocytopenia. The 180-day mortality rate was 52%, with deaths mainly occurring in the first 90 days since VTE diagnosis. Additional factors significantly associated with outpatient mortality included male sex and neoplasms with a high risk of thrombosis (lung, pancreas, stomach, uterus, bladder, and kidney neoplasms). CONCLUSION: Patients with stage IV cancer and acute VTE have short survival. Poor prognostic factors are thrombocytopenia, the ECOG score, and certain types of cancer. These results may help physicians individualize decisions regarding initiation and continuation of anticoagulant therapy.

Dried Serum Samples for Antibody Detection in Arthropod-Borne Virus Infections Are an Effective Alternative to Serum Samples.

The disease burden of arthropod-borne infections is particularly high in low- and middle-income countries, where the availability of resources for surveillance and testing is limited. The lack of local infrastructure demands that biological samples be sent to central laboratories by refrigerated transport, which increases costs and the risk of sample degradation. Dried blood spot samples are an alternative for ensuring sample integrity during transportation and storage. They can be used for the detection of nucleic acids and proteins, such as antigens or antibodies. Here, we compared anti-chikungunya IgM, anti-dengue IgM, anti-dengue IgG, and anti-Zika IgG detection between paired serum and dried serum samples (DSSs); the agreement between results was found to be 90.6%, 94.1%, 85.9%, and 95.5%, respectively, indicating a strong correlation. Our results suggest that DSSs provide a reliable alternative for detection of specific antibodies in arthropod-borne infections.

Distinct Transcriptional Profile of PDZ Genes after Activation of Human Macrophages and Dendritic Cells.

The PDZ (PSD95, Dlg and ZO-1) genes encode proteins that primarily function as scaffolds of diverse signaling pathways. To date, 153 PDZ genes have been identified in the human genome, most of which have multiple protein isoforms widely studied in epithelial and neural cells. However, their expression and function in immune cells have been poorly studied. Herein, we aimed to assess the transcriptional profiles of 83 PDZ genes in human macrophages (Mɸ) and dendritic cells (DCs) and changes in their relative expression during cell PRR stimulation. Significantly distinct PDZ gene transcriptional profiles were identified under different stimulation conditions. Furthermore, a distinct PDZ gene transcriptional signature was found in Mɸ and DCs under the same phagocytic stimuli. Notably, more than 40 PDZ genes had significant changes in expression, with potentially relevant functions in antigen-presenting cells (APCs). Given that several PDZ proteins are targeted by viral products, our results support that many of these proteins might be viral targets in APCs as part of evasion mechanisms. Our results suggest a distinct requirement for PDZ scaffolds in Mɸ and DCs signaling pathways activation. More assessments on the functions of PDZ proteins in APCs and their role in immune evasion mechanisms are needed.

Terahertz imaging demonstrates its diagnostic potential and reveals a relationship between cutaneous dehydration and neuropathy for diabetic foot syndrome patients.

Diabetic foot syndrome, a long term consequence of Diabetes Mellitus, is the most common cause of non-traumatic amputations. Around 8% of the world population suffers from diabetes, 15% of diabetic patients present a diabetic foot ulcer which leads to amputation in 2.5% of the cases. There is no objective method for the early diagnosis and prevention of the syndrome and its consequences. We test terahertz imaging, which is capable of mapping the cutaneous hydration, for the evaluation of the diabetic foot deterioration as an early diagnostic test as well as ulcers prevention and tracking tool. Furthermore, the analysis of our terahertz measurements combined with neurological and vascular assessment of the patients indicates that the dehydration is mainly related to the peripheral neuropathy without a significant vascular cause.

Cardiac and obstetric outcomes in pregnant patients with heart disease: a retrospective cohort study.

BACKGROUND: Cardiac diseases complicate 4% of pregnancies, with a mortality rate between 0 and 15%. Early referral has shown to reduce the risk of maternal major cardiac events (MACEs). METHODS: We retrospectively analyzed a cohort of pregnant women with heart disease from two referral centers in Mexico City. We examined MACEs: maternal death, pulmonary edema, acute heart failure, endocarditis, stroke, myocardial infarction, acute aortic syndromes, arrhythmias requiring urgent treatment, and the need for an urgent intervention; preterm birth and obstetric events such as HELLP syndrome, preeclampsia, eclampsia, placental abruption, obstetric hemorrhage. We analyzed the association between each modified World Health Organization (mWHO) group and MACEs, preterm birth and obstetric outcomes between March 2014 and March 2019. RESULTS: Using the mWHO classification, 399 deliveries were included and stratified as follows: I, 162; II, 133; II-III, 21; III, 18; and IV, 52 patients. MACEs were observed in 12.5% of the cohort and were associated with mWHO II (odds ratio [OR], 3.0; 95% confidence interval [95% CI], 1.1-8.1; p = 0.027), II-III (OR, 3.3; 95% CI, 0.9-1.0; p = 0.116), III (OR, 5.3; 95% CI, 1.2-23; p = 0.026), and IV (OR, 8.2; 95% CI, 2.7-24.5; p < 0.001) after adjusting for age, desaturation, previous functional class, and gestational age at referral. An association between mWHO and frequency of preterm birth was observed. Association between mWHO and obstetric events, even when adjusted, was not observed. CONCLUSIONS: The prevalence of MACEs and preterm birth is similar to that seen worldwide; MACEs and preterm birth are associated with the severity of heart disease stratified by mWHO, but there is no association between the severity of heart disease and obstetric events.

Use of the O2-Thiosemicarbazide System, for the Leaching of: Gold and Copper from WEEE & Silver Contained in Mining Wastes.

Environmental pollution today is a latent risk for humanity, here the need to recycle waste of all kinds. This work is related to the kinetic study of the leaching of gold and copper contained in waste electrical and electronic equipment (WEEE) and silver contained in mining wastes (MW), using the O2-thiosemicarbazide system. The results obtained show that this non-toxic leaching system is adequate for the leaching of said metals. Reaction orders were found ranging from 0 (Cu), 0.93 (Ag), and 2.01 (Au) for the effect of the reagent concentration and maximum recoveries of 77.7% (Cu), 95.8% (Au), and 60% (Ag) were obtained. Likewise, the activation energies found show that the leaching of WEEE is controlled by diffusion (Cu Ea = 9.06 and Au Ea = 18.25 kJ/Kmol), while the leaching of MW (Ea = 45.55 kJ/Kmol) is controlled by the chemical reaction. For the case of stirring rate, it was found a low effect and only particles from WEEE and MW must be suspended in solution to proceed with the leaching. The pH has effect only at values above 8, and finally, for the case of MW, the O2 partial pressure has a market effect, going the Ag leaching from 33% at 0.2 atm up to 60% at a 1 atm.

Therapeutic effect of two muscle strengthening programs in patients with patellofemoral pain syndrome. A randomized controlled clinical trial / Efecto terapéutico de dos programas de fortalecimiento muscular en pacientes con síndrome de dolor pátelofemoral. Ensayo clínico controlado aleatorizado

Abstract Introduction: Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders affecting the knee joint. Conservative treatment reduces pain and improves functional capacity in the short and medium-term. Objective: To determine the therapeutic effect of two muscle strengthening exercise programs in patients with PFPS from Bogotá, Colombia, aged between 15 and 40 years. Materials and methods: Experimental randomized controlled clinical trial conducted in 40 patients with PFPS from Bogotá, Colombia, aged 15-40 years, with a mild to moderate level of physical activity. Participants were randomly distributed into 2 intervention groups: Group A: 8-week-long core, hip and knee muscles strengthening exercises program; Group B: 8-week-long hip and knee muscles strengthening exercises program. The level of pain was measured using the Visual Analog Scale and the Kujala Anterior Knee Pain Scale. Results: The addition of core muscle strengthening exercises to the traditional treatment improved the quality of life of participants in the intervention group A, where a significant reduction of pain, with a statistically significant difference in the total score of the Kujala scale (p=0.025) was observed. Conclusions: Including core muscle strengthening exercises in the conservative management of PFPS increases its effectiveness to reduce pain and improve the quality of life of these patients. ClinicalTrials.gov Identifier: NCT04011436

Resumen Introducción. El síndrome de dolor pátelofemoral (SPF) es una de las alteraciones musculoesqueléticas más frecuentes que afectan la articulación de la rodilla. El tratamiento conservador reduce el dolor y mejora la capacidad funcional en el corto y mediano plazo. Objetivo. Establecer el efecto terapéutico de dos programas de ejercicios de fortalecimiento muscular en pacientes con SPF de Bogotá, Colombia, con edades entre 15 y 40 años. Materiales y métodos. Ensayo clínico controlado aleatorio experimental realizado en 40 pacientes con SPF de Bogotá, Colombia, con edades entre los 15 y 40 años, con nivel de actividad física leve a moderada y que fueron distribuidos de forma aleatoria en 2 grupos de intervención: Grupo A: programa de ejercicios de fortalecimiento de los músculos del core, la cadera y la rodilla con una duración de 8 semanas; Grupo B: programa de ejercicios de fortalecimiento de los músculos de la cadera y la rodilla con la misma duración. El nivel de dolor se midió a través de la Escala Visual Analógica y de la Escala de Kujala para dolor patelofemoral. Resultados. La adición de ejercicios de fortalecimiento de los músculos del core al tratamiento tradicional mejoró la calidad de vida de los participantes en el grupo de intervención A, donde se observó una reducción significativa del dolor con una diferencia estadísticamente significativa en la puntuación total de la escala Kujala (p=0.025). Conclusiones. Incluir ejercicios de fortalecimiento de los músculos del core al manejo conservador del SPF aumenta su efectividad para reducir el dolor y mejorar la calidad de vida de estos pacientes. ClinicalTrials.gov Identifier: NCT04011436

Regulatory T Cells as an Escape Mechanism to the Immune Response in Taenia crassiceps Infection.

Murine cysticercosis by Taenia crassiceps is a model for human neurocysticercosis. Genetic and/or immune differences may underlie the higher susceptibility to infection in BALB/cAnN with respect to C57BL/6 mice. T regulatory cells (Tregs) could mediate the escape of T. crassiceps from the host immunity. This study is aimed to investigate the role of Tregs in T. crassiceps establishment in susceptible and non-susceptible mouse strains. Treg and effector cells were quantified in lymphoid organs before infection and 5, 30, 90, and 130 days post-infection. The proliferative response post-infection was characterized in vitro. The expression of regulatory and inflammatory molecules was assessed on days 5 and 30 post-infection. Depletion assays were performed to assess Treg functionality. Significantly higher Treg percentages were observed in BALB/cAnN mice, while increased percentages of activated CD127+ cells were found in C57BL/6 mice. The proliferative response was suppressed in susceptible mice, and Treg proliferation occurred only in susceptible mice. Treg-mediated suppression mechanisms may include IL-10 and TGFß secretion, granzyme- and perforin-mediated cytolysis, metabolic disruption, and cell-to-cell contact. Tregs are functional in BALB/cAnN mice. Therefore Tregs could be allowing parasite establishment and survival in susceptible mice but could play a homeostatic role in non-susceptible strains.

Fetal and placental infection with SARS-CoV-2 in early pregnancy.

To date, mother-to-fetus transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease 2019 (COVID-19) pandemic, remains controversial. Although placental COVID-19 infection has been documented in some cases during the second- and third-trimesters, no reports are available for the first trimester of pregnancy, and no SARS-CoV-2 protein has been found in fetal tissues. We studied the placenta and fetal organs from an early pregnancy miscarriage in a COVID-19 maternal infection by immunohistochemical, reverse transcription quantitative real-time polymerase chain reaction, immunofluorescence, and electron microscopy methods. SARS-CoV-2 nucleocapsid protein, viral RNA, and particles consistent with coronavirus were found in the placenta and fetal tissues, accompanied by RNA replication revealed by double-stranded RNA (dsRNA) positive immunostain. Prominent damage of the placenta and fetal organs were associated with a hyperinflammatory process identified by histological examination and immunohistochemistry. The findings provided in this study document that congenital SARS-CoV-2 infection is possible during the first trimester of pregnancy and that fetal organs, such as lung and kidney, are targets for coronavirus. The infection and multi-organic fetal inflammation produced by SARS-CoV-2 during early pregnancy should alert clinicians in the assessment and management of pregnant women for possible fetal consequences and adverse perinatal outcomes.

Effectiveness and safety of the enhanced recovery program in colorectal surgery: overview of systematic reviews / Efectividad y seguridad del programa multimodal perioperatorio en cirugía colorrectal: Revisión sistemática de revisiones

Abstract Introduction Multimodal enhanced recovery programs are a new paradigm in perioperative care. Objective To evaluate the certainty of evidence pertaining to the effectiveness and safety of the multimodal perioperative care program in elective colorectal surgery. Data source: A search was conducted in the Medline, EMBASE, and Cochrane databases, up until February 2020. Eligibility criteria Systematic reviews that take into account the perioperative multimodal program in patients with an indication for colorectal surgery were included. The primary outcomes were morbidity and postoperative deaths. The secondary outcome was hospital length of stay. Study quality and synthesis method The reviews were evaluated with AMSTAR-2 and the certainty of the evidence with the GRADE methodology. The findings are presented with measures of frequency, risk estimators, or differences. Results Six systematic reviews of clinical trials with medium and high quality in AMSTAR-2 were included. Morbidity was reduced between 16 and 48%. Studies are inconclusive regarding postoperative mortality. Hospital length of stay was reduced by an average of 2.5 days (p <0.05). The certainty of the body of evidence is very low. Limitations The effect of the program, depending on the combination of elements, is not clear. Conclusions and implications Despite the proven evidence that the program is effective in reducing global postoperative morbidity and hospital stay, the body of evidence is of very low quality. Consequently, results may change with new evidence and further research is required.

Resumen Introducción Los programas multimodales de cuidado perioperatorio son nuevos paradigmas de atención en salud, particularmente en el paciente quirúrgico. Objetivo Evaluar la certeza en la evidencia de la efectividad y seguridad del programa multimodal perioperatorio en cirugía colorrectal electiva. Fuente de datos Se consultaron las bases de datos Medline, EMBASE y Cochrane hasta febrero de 2020. Criterios de elegibilidad Se incluyeron revisiones sistemáticas que consideraron como intervención el programa multimodal perioperatorio en pacientes con indicación de cirugía colorrectal. Los desenlaces primarios fueron morbilidad y mortalidad postoperatoria. El desenlace secundario fue estancia hospitalaria. Evaluación de los estudios y método de síntesis La calidad de las revisiones fue evaluada con AMSTAR-2 y la certeza de la evidencia con la metodología GRADE. Los hallazgos se presentan con medidas de frecuencia, estimadores de riesgo o diferencias. Resultados Se incluyeron seis revisiones sistemáticas de ensayos clínicos de media y alta calidad en AMSTAR-2. La morbilidad se redujo entre el 16 y el 48 %. Para la mortalidad postoperatoria no se reportan diferencias a favor del programa. La estancia hospitalaria se redujo en promedio 2,5 días (p < 0,05). La certeza del cuerpo de la evidencia es muy baja. Limitaciones El efecto del programa en función de combinación de elementos no es claro. Conclusiones e implicaciones A pesar de que la evidencia sugiere que el programa es efectivo en la reducción de morbilidad postoperatoria global y estancia hospitalaria, el cuerpo de la evidencia es de muy baja calidad, por lo que los resultados podrían cambiar con nueva evidencia. Se requieren nuevas investigaciones.

Antifungal Activity In Vitro and In Vivo of Mesquite Extract (Prosopis glandulosa) Against Phytopathogenic Fungi.

Fungi are the primary infectious agents in plant crops and many post-harvest fungal diseases of fruit and vegetables causing significant economic losses worldwide. Here, the antifungal effect of Prosopis glandulosa extract (PgE) against phytopathogenic fungi was evaluated. The effect with PgE (5, 4, 2, 1, 0%) as AI (%) and radial growth rate reduction (Kr %) were determined in vitro in Colletotrichum gloeosporoides, Fusarium oxysporum, Rhizopus oryzae and R. stolonifer (1 × 105 spores/mL). The phytopathogenicity of fungal strains was performed under in vivo conditions (room temperature, 25-30 °C and refrigeration, ~ 4 °C) by fruit surface inoculation method on strawberries, tomatoes and carrots by recording the development of mycelial growth, necrosis, soft rot and dehydration symptoms showed on each fruit at 14 days. The extract (5%) showed the highest AI against C. gloesporioides (~ 96%), and F. oxysporum (~ 79%) and growth rate reduction of 74.92% and 64.82% respectively. Likewise, the extract controls the development of phytopathogenicity symptoms against C. gloesporioides and F. oxysporum in vivo conditions, nevertheless, was less efficiency against both Rhizopus species. The P. glandulosa extract represents an efficient, economical, and eco-friendly alternative to preserve the quality of the agricultural products and to increase their shelf life.

Infecciones invasivas por serotipos no vacunales de Streptococcus pneumoniae: una amenaza creciente / Invasive infections by non-vaccine serotypes of Streptococcus pneumoniae: a growing threat

Resumen Introducción: En México, cuando se inició la aplicación de la vacuna PCV13 (neumocócica conjugada), se cubría el 70.6% de los serotipos causantes de enfermedad invasiva por neumococo en menores de 5 años. Después de varios años, los casos de enfermedad causada por los serotipos incluidos en la vacuna han disminuido; sin embargo, se ha producido un reemplazo por los serotipos no incluidos en la vacuna. Caso clínico: Se presentan tres casos de pacientes pediátricos que desarrollaron enfermedad invasiva por serotipos no incluidos en la PCV13: uno con meningitis y bacteriemia (serotipo 15C) y dos con neumonía, uno de ellos complicado con derrame (serotipo 35B). Los pacientes fueron atendidos en un hospital pediátrico en Saltillo, Coahuila, durante el periodo de 2015 a 2018. Conclusiones: Resulta alarmante que se presenten tres casos graves por serotipos de Streptococcus pneumoniae no incluidos en la PCV13 en un solo hospital pediátrico en el norte del país. Este es un fenómeno que esta sucediendo a escala nacional e internacional: un incremento de casos de enfermedad invasiva por serotipos de neumococo no incluidos en la vacuna utilizada actualmente.

Abstract Background: In Mexico, 70.6% of serotypes causing invasive pneumococcal disease were covered since the application of the PCV13 vaccine in children under 5 years of age. After several years of immunization, cases of disease caused by the serotypes included in the vaccine have decreased. However, a replacement due to serotypes not included in the vaccine has been observed. Case report: Three cases of pediatric patients who developed invasive disease due to serotypes not included in PCV13 are described: one with meningitis and bacteremia (serotype 15C), and two with pneumonia, of which one complicated with effusion (serotype 35B). Patients were treated in a pediatric hospital in Saltillo, Coahuila, from 2015 to 2018. Conclusions: Three serious cases due to serotypes of Streptococcus pneumoniae not included in PCV13 were reported in a single pediatric hospital in a northern state of Mexico. This phenomenon is taking place nationwide and worldwide: an increase of cases of invasive disease due to pneumococcal serotypes not included in the vaccine currently used.

Regulatory impairment in untreated Parkinson's disease is not restricted to Tregs: other regulatory populations are also involved.

BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disease in the world. Various studies have suggested that the immune response plays a key role in this pathology. While a predominantly pro-inflammatory peripheral immune response has been reported in treated and untreated PD patients, the study of the role of the regulatory immune response has been restricted to regulatory T cells. Other immune suppressive populations have been described recently, but their role in PD is still unknown. This study was designed to analyze the pro and anti-inflammatory immune response in untreated PD patients, with emphasis on the regulatory response. METHODS: Thirty-two PD untreated patients and 20 healthy individuals were included in this study. Peripheral regulatory cells (CD4+Tregs, Bregs, CD8+Tregs, and tolerogenic dendritic cells), pro-inflammatory cells (Th1, Th2, and Th17 cells; active dendritic cells), and classical, intermediate, and non-classical monocytes were characterized by flow cytometry. Plasmatic levels of TNF-α, IFN-γ, IL-6, GM-CSF, IL-12p70, IL-4, IL-13, IL-17α, IL-1ß, IL-10, TGF-ß, and IL-35 were determined by ELISA. RESULTS: Decreased levels of suppressor Tregs, active Tregs, Tr1 cells, IL-10-producer CD8regs, and tolerogenic PD-L1+ dendritic cells were observed. With respect to the pro-inflammatory response, a decrease in IL-17-α and an increase in IL-13 levels were observed. CONCLUSION: A decrease in the levels of regulatory cell subpopulations in untreated PD patients is reported for the first time in this work. These results suggest that PD patients may exhibit a deficient suppression of the pro-inflammatory response, which could contribute to the pathophysiology of the disease.

Invasive infections by non-vaccine serotypes of Streptococcus pneumoniae: a growing threat.

Background: In Mexico, 70.6% of serotypes causing invasive pneumococcal disease were covered since the application of the PCV13 vaccine in children under 5 years of age. After several years of immunization, cases of disease caused by the serotypes included in the vaccine have decreased. However, a replacement due to serotypes not included in the vaccine has been observed. Case report: Three cases of pediatric patients who developed invasive disease due to serotypes not included in PCV13 are described: one with meningitis and bacteremia (serotype 15C), and two with pneumonia, of which one complicated with effusion (serotype 35B). Patients were treated in a pediatric hospital in Saltillo, Coahuila, from 2015 to 2018. Conclusions: Three serious cases due to serotypes of Streptococcus pneumoniae not included in PCV13 were reported in a single pediatric hospital in a northern state of Mexico. This phenomenon is taking place nationwide and worldwide an increase of cases of invasive disease due to pneumococcal serotypes not included in the vaccine currently used.

Introducción: En México, cuando se inició la aplicación de la vacuna PCV13 (neumocócica conjugada), se cubría el 70.6% de los serotipos causantes de enfermedad invasiva por neumococo en menores de 5 años. Después de varios años, los casos de enfermedad causada por los serotipos incluidos en la vacuna han disminuido; sin embargo, se ha producido un reemplazo por los serotipos no incluidos en la vacuna. Caso clínico: Se presentan tres casos de pacientes pediátricos que desarrollaron enfermedad invasiva por serotipos no incluidos en la PCV13: uno con meningitis y bacteriemia (serotipo 15C) y dos con neumonía, uno de ellos complicado con derrame (serotipo 35B). Los pacientes fueron atendidos en un hospital pediátrico en Saltillo, Coahuila, durante el periodo de 2015 a 2018. Conclusiones: Resulta alarmante que se presenten tres casos graves por serotipos de Streptococcus pneumoniae no incluidos en la PCV13 en un solo hospital pediátrico en el norte del país. Este es un fenómeno que esta sucediendo a escala nacional e internacional: un incremento de casos de enfermedad invasiva por serotipos de neumococo no incluidos en la vacuna utilizada actualmente.

Expression of Dopamine Receptors in Immune Regulatory Cells.

OBJECTIVE: Parkinson's disease (PD) patients are usually treated with L-dopa and/or dopaminergic agonists, which act by binding five types of dopaminergic receptors (DRD1-DRD5). Peripheral immune cells are known to express dopamine receptors on their membrane surface, and therefore they could be directly affected by the treatment. Regulatory cells are the main modulators of inflammation, but it is not clear whether dopaminergic treatment could affect their functions. While only regulatory T cells (Tregs) have been proved to express dopamine receptors, it is not known whether other regulatory cells such as CD8regs, regulatory B cells (Bregs), tolerogenic dendritic cells, and intermediate monocytes also express them. METHODS: The expression of dopamine receptors in Tregs, CD8regs, Bregs, tolerogenic dendritic cells, and intermediate monocytes was herein evaluated. cDNA from 11 PD patients and 9 control subjects was obtained and analyzed. RESULTS: All regulatory cell populations expressed the genes coding for dopamine receptors, and this expression was further corroborated by flow cytometry. These findings may allow us to propose regulatory populations as possible targets for PD treatment. CONCLUSIONS: This study opens new paths to deepen our understanding on the effect of PD treatment on the cells of the regulatory immune response.

Natural Vertical Transmission of Zika Virus in Larval Aedes aegypti Populations, Morelos, Mexico.

We characterized natural vertical transmission of Zika virus in pools of Aedes aegypti larvae hatched from eggs collected in Jojutla, Morelos, Mexico. Of the 151 pools analyzed, 17 tested positive for Zika virus RNA; infectious Zika virus was successfully isolated from 1 of the larvae pools (31N) in C6/36 cells. Real-time quantitative PCR and indirect immunofluorescence assays confirmed the identity of the isolate, named Zika virus isolate 31N; plaque assays in Vero cells demonstrated the isolate's infectivity in a mammalian cell line. We obtained the complete genome of Zika virus isolate 31N by next-generation sequencing and identified 3 single-nucleotide variants specific to Zika virus isolate 31N using the meta-CATS tool. These results demonstrate the occurrence of natural vertical transmission of Zika virus in wild Ae. aegypti mosquitoes and suggest that this transmission mode could aid in the spread and maintenance of Zika virus in nature.