Vaccinated COVID-19 Index Cases Are Less Likely to Transmit SARS-CoV-2 to Their Household Contacts: A Cohort Study.

The aim of this study was to evaluate the impact of index case vaccination on SARS-CoV-2 transmission to household contacts. In our epidemiological cohort study (May 2022-November 2023), we surveyed registered index case vaccination status and test results for contacts (testing on day 0, and on day 7 for negative contacts) and calculated the secondary attack rate (SAR), i.e., newly infected contacts/susceptible included contacts. The association of the independent variable, index case COVID-19 vaccination (yes/no), with household contact infection was determined using the adjusted odds ratio (aOR) and its 95% confidence interval (CI). We recorded 181 index cases and 314 contacts, of whom 250 agreed to participate; 16 contacts were excluded upon testing positive on day 0. Of the 234 included contacts, 49.1% were women, and the mean (SD) age was 51.9 (19.8) years. The overall SAR of 37.2% (87/234) was lower in the contacts of both vaccinated index cases (34.9% vs. 63.2%; p = 0.014) and index cases with a previous SARS-CoV-2 infection history (27.0% vs. 46.3%; p = 0.002). Index case vaccination showed a protective effect against infection for their household contacts (aOR = 0.21; 95% CI: 0.07, 0.67). The household SAR was high when the Omicron variant circulated. Vaccinated index cases were less likely to transmit SARS-CoV-2 to their contacts.

Risk of tuberculosis among pulmonary tuberculosis contacts: the importance of time of exposure to index cases.

INTRODUCTION: The intensity of exposure to index cases of tuberculosis [TB] may increase the risk of TB in their contacts. The aim was to determine TB risk factors among contacts of TB index cases. METHODS: A cohort study was carried out in the contacts of pulmonary TB cases registered by the epidemiological surveillance network from 01/01/2019 to 06/30/2021. The factors associated with the risk of TB in contacts were determined using the adjusted odds ratio [aOR] and its 95% confidence interval [CI]. RESULTS: From 847 TB cases, 7087 contacts were identified. The prevalence of TB was 2.0% [145/7087] and was higher in < 5 years compared to those ≥ 65 years [4.4% versus 1.2%; p < 0.001], in those exposed ≥ 6 h daily [4%], and < 6 h daily [1.6%] with respect to weekly exposure of < 6 h [0.7%; p < 0.001]. Those contacts exposed ≥ 6 h daily [aOR= 6.9; 95%CI:2.1-22.1], < 5 years [aOR= 8.3; 95%CI:1.8-37.8] and immigrants [aOR= 1.7; 95%CI:1.1-2.7] had a higher risk of TB. CONCLUSIONS: The risk of TB increases with the time of exposure to the index case and this risk is also higher in < 5 years and immigrants. Contact tracing has a high yield for detecting new cases of TB.

The impact of COVID-19 pandemic on the incidence of acute gastroenteritis outbreaks in Catalonia (Spain).

We carried out a retrospective study of acute gastroenteritis (AGE) outbreaks reported between 1 January 2015 and 31 December 2021 in Catalonia (Spain) to compare the incidence from 2015 to 2019 with that observed from 2020 to 2021. We observed a higher incidence rate of outbreaks during the prepandemic period (16.89 outbreaks/1,000,000 person-years) than during the pandemic period (6.96 outbreaks/1,000,000 person-years) (rate ratio (RR) 0.41; 95% confidence interval (CI) 0.34 to 0.51). According to the aetiology of the outbreak, those of viral aetiology decreased from 7.82 to 3.38 outbreaks/1,000,000 person-years (RR 2.31; 95% CI 1.72 to 3.12), and those of bacterial aetiology decreased from 5.01 to 2.78 outbreaks/1,000,000 person-years (RR 1.80; 95% CI 1.29 to 2.52). There was a great reduction in AGE outbreaks in Catalonia. This reduction may have been due to the effect of the nonpharmaceutical measures applied to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but the collapse of the healthcare system and epidemiological surveillance services may also have had a strong influence.

Impact of the COVID-19 pandemic on contact tracing of patients with pulmonary tuberculosis.

BACKGROUND: The COVID-19 pandemic could have negative effects on tuberculosis (TB) control. The objective was to assess the impact of the pandemic in contact tracing, TB and latent tuberculosis infection (LTBI) in contacts of patients with pulmonary TB in Catalonia (Spain). METHODS: Contact tracing was carried out in cases of pulmonary TB detected during 14 months in the pre-pandemic period (1 January 2019 to 28 February 2020) and 14 months in the pandemic period (1 March 2020 to 30 April 2021). Contacts received the tuberculin skin test and/or interferon gamma release assay and it was determined whether they had TB or LTBI. Variables associated with TB or LTBI in contacts (study period and sociodemographic variables) were analyzed using adjusted odds ratio (aOR) and the 95% confidence intervals (95% CI). RESULTS: The pre-pandemic and pandemic periods showed, respectively: 503 and 255 pulmonary TB reported cases (reduction of 50.7%); and 4676 and 1687 contacts studied (reduction of 36.1%). In these periods, the proportion of TB cases among the contacts was 1.9% (84/4307) and 2.2% (30/1381) (P = 0.608); and the proportion of LTBI was 25.3% (1090/4307) and 29.2% (403/1381) (P < 0.001). The pandemic period was associated to higher LTBI proportion (aOR = 1.3; 95% CI 1.1-1.5), taking into account the effect on LTBI of the other variables studied as sex, age, household contact and migrant status. CONCLUSIONS: COVID-19 is affecting TB control due to less exhaustive TB and LTBI case detection. An increase in LTBI was observed during the pandemic period. Efforts should be made to improve detection of TB and LTBI among contacts of TB cases.

A Waterborne Gastroenteritis Outbreak Caused by a GII Norovirus in a Holiday Camp in Catalonia (Spain), 2017.

On 2 February 2017, Epidemiological Surveillance Services were notified of an outbreak of acute gastroenteritis (AGE) among schoolchildren who had taken part of a school trip from 30 January to 3 February 2017 at a holiday camp in Catalonia. A retrospective cohort study was performed to identify the causative agent, estimate the magnitude of the outbreak and identify its source, as well as to determine the route of transmission. Data collected by standardised questionnaires identified 41 episodes of AGE among 174 individuals who attended the camp. Cases had mainly symptoms of abdominal pain (73.8%), nausea (64.3%), vomiting (54.8%), diarrhoea (45.2%) and headache (42.9%). Consumption of water was associated with gastroenteritis (crude RR: 1.72, 95%CI: 1.01-2.92; adjusted RR: 1.88, 95%CI 1.03-3.56). NoV GII was detected in faeces (5 out of 13) and water samples. Additionally, faecal indicator bacteria and protozoa were detected in water samples. The outbreak showed a high attack rate and was caused by a natural water fountain not properly treated and not monitored for safety quality. There could have been a discharge of wastewater at a point close to the fountain; however, the source of contamination of the water could not be identified. Health education may be useful to eliminate risks associated with the consumption of untreated water from natural fountains.

Effectiveness of maternal pertussis vaccination in protecting newborn: A matched case-control study.

INTRODUCTION: The objective was to estimate the effectiveness of maternal pertussis vaccination in protecting infants aged < 2 months. METHODS: We performed a case-control study. Laboratory-confirmed cases aged <8 weeks at disease onset were identified and 2-4 matched-controls born within ± 15 days of the case were included. Information was obtained from healthcare providers and maternal interviews. Odds ratios (OR) were calculated using multivariable conditional logistic regression. Vaccine effectiveness (VE) was estimated as (1 - OR) × 100%. RESULTS: 47 cases and 124 controls were studied. The mean age (in days) (39.8 ± 12.7 vs. 40.8 ± 13.2), weeks of gestation (38.8 vs. 39.1, p = 0.43) and mean birth weight (3.309 vs. 3.253 kg, p = 0.55) were comparable between cases and controls. Mothers of cases were less frequently vaccinated in the third trimester (59.6% vs. 83.9%, p <0.001). The VE of maternal vaccination in pregnancy was 88.0% (95%CI 53.8% -96.5%), and was slightly higher in those vaccinated before the 32nd week of gestation (88.5% vs 87.8%). CONCLUSION: Pertussis vaccination in pregnancy is very effective in reducing pertussis in children aged < 2 months. Vaccination before and after the 32nd week of pregnancy are equally effective in reducing the risk of pertussis.

Acute gastroenteritis outbreaks in closed and semi-closed facilities during 2017 in Catalonia, Spain.

Acute gastroenteritis (AGE) is a leading cause of disease worldwide. The aim of this prospective observational study is to describe the epidemiology of AGE in closed and semi-closed institutions in Catalonia. In 2017, 151 outbreaks were reported; 30.5% occurred in closed and semi-closed institutions; 71.7% caused by norovirus (NoV) (1532) cases. Person-to-person transmission accounted for 75.8% of NoV outbreaks vs 46.1% in non-NoV outbreaks (p < 0.001). Attack rate for NoV outbreaks was 33.1% vs 14.3% for non-NoV outbreaks (RR = 2.3; 95%CI: 2.0-2.7). The high number of affected underscores prompt and intense preventive measures to avoid the extension and perpetuation of outbreaks in these settings.

Azithromycin to Prevent Pertussis in Household Contacts, Catalonia and Navarre, Spain, 2012-2013.

We retrospectively assessed the effectiveness of azithromycin in preventing transmission of pertussis to a patient's household contacts. We also considered the duration between symptom onset in the primary patient and azithromycin administration. We categorized contacts into 4 groups: those treated within <7 days, 8-14 days, 15-21 days, and >21 days after illness onset in the primary patient. We studied 476 primary index patients and their 1,975 household contacts, of whom 4.5% were later identified as having pertussis. When contacts started chemoprophylaxis within <21 days after the primary patient's symptom onset, the treatment was 43.9% effective. Chemoprophylaxis started >14 days after primary patient's symptom onset was less effective. We recommend that contacts of persons with pertussis begin chemoprophylaxis within <14 days after primary patient's symptom onset.

Correction: Characterization of intra- and inter-host norovirus P2 genetic variability in linked individuals by amplicon sequencing.

[This corrects the article DOI: 10.1371/journal.pone.0201850.].

Caries dental en niños con necesidades especiales de un colegio de bajos recursos en el Perú / Dental caries in children with special needs from a low resource school in Peru

Objetivos: Determinar la prevalencia de caries dental en los niños del centro de educación básica especial Helen Keller situado en el Callao, Perú durante el 2015. Material y Métodos: Estudio observacional, transversal sobre los datos de 30 niños del centro de educación básica especial Helen Keller. Información recogida por alumnos de la Facultad de Estomatología de la Universidad Peruana Cayetano Heredia (UPCH), en el centro educativo durante el año 2015. Se analizaron las características de los niños (edad, sexo, y diagnóstico sistémico). Para caries dental se utilizó el índice CPOD/ceod y el índice CPOS/ceos. Resultados: El 90% (n=27) de los escolares presentó caries dental. El retardo mental fue la condición más prevalente (43,3%, n=13). Se encontró un índice de CPOD de 2,9 (DE 3,8) y en dientes deciduos (ceod) de 6,0 (DE 4,0). Conclusiones: Existe una alta prevalencia de caries dental en los niños del centro de educación básica especial Helen Keller Callao, Perú en el año 2015.

Objectives: Determine dental caries prevalence of children from a basic educational center for special needs, Helen Keller school situated at Callao, Perú during 2015. Material and Methods: Cross-sectional study on a sample of 30 children from the basic educational center for special needs, Helen Keller school. The data was collected from Universidad Peruana Cayetano Heredia (UPCH) during 2015 at mentioned school. Children characteristics were analyzed (age, sex, systemic diagnosis) in frequencies, and dental caries prevalence. We analyzed dental caries per each tooth (DMFT/dmft index) and each surface (DFMS/dmfs index). Results: 90% (n=27) of scholars had dental caries. Mental retardation, was the most common condition (43.3%, n=13). We found a DMFT index of 2.0 (SD 3.8) and in deciduous teeth (dmft index) of 6.0 (SD 4.0). Conclusions: There is a considerable proportion of children that have dental caries in Basic educational center for special needs Helen Keller, Callao, Perú during 2015.

Characterization of intra- and inter-host norovirus P2 genetic variability in linked individuals by amplicon sequencing.

Noroviruses are the main cause of epidemics of acute gastroenteritis at a global scale. Although chronically infected immunocompromised individuals are regarded as potential reservoirs for the emergence of new viral variants, viral quasispecies distribution and evolution patterns in acute symptomatic and asymptomatic infections has not been extensively studied. Amplicons of 450 nts from the P2 coding capsid domain were studied using next-generation sequencing (454/GS-Junior) platform. Inter-host diversity between symptomatic and asymptomatic acutely infected individuals linked to the same outbreak as well as their viral intra-host diversity over time were characterized. With an average of 2848 reads per sample and a cutoff frequency of 0.1%, minor variant haplotypes were detected in 5 out of 8 specimens. Transmitted variants could not be confirmed in all infected individuals in one outbreak. The observed initial intra-host viral diversity in asymptomatically infected subjects was higher than in symptomatic ones. Viral quasispecies evolution over time within individuals was host-specific, with an average of 2.8 nt changes per day (0.0062 changes per nucleotide per day) in a given symptomatic case. Nucleotide polymorphisms were detected in 28 out of 450 analyzed nucleotide positions, 32.14% of which were synonymous and 67.86% were non-synonymous. Most observed amino acid changes emerged at or near blockade epitopes A, B, D and E. Our results suggest that acutely infected individuals, even in the absence of symptoms, which go underreported and may enhance transmission, may contribute to norovirus genetic variability and evolution.

Descriptive study of severe hospitalized cases of laboratory-confirmed influenza during five epidemic seasons (2010-2015).

OBJECTIVE: The Plan of Information on Acute Respiratory Infections in Catalonia (PIDIRAC) included the surveillance of severe hospitalized cases of laboratory-confirmed influenza (SHCLCI) in 2009. The objective of this study was to determine the clinical, epidemiological and virological features of SHCLCI recorded in 12 sentinel hospitals during five influenza seasons. RESULTS: From a sample of SHCLCI recorded during the 5 influenza epidemics seasons from 2010-2011 to 2014-2015, Cases were confirmed by PCR and/or viral isolation in cell cultures from respiratory samples. A total of 1400 SHCLCI were recorded, 33% required ICU admission and 12% died. The median age of cases was 61 years (range 0-101 years); 70.5% were unvaccinated; 80.4% received antiviral treatment (in 79.6 and 24% of cases within 48 h after hospital admission and the onset of symptoms, respectively); influenza virus A [37.9% A (H1N1)pdm09, 29.3% A (H3N2)] was identified in 87.7% of cases. Surveillance of SHCLCI provides an estimate of the severity of seasonal influenza epidemics and the identification and characterization of at-risk groups in order to facilitate preventive measures such as vaccination and early antiviral treatment.

Assessment of clinical symptoms in household contacts of confirmed pertussis cases.

OBJECTIVES: We assessed the value of the clinical symptoms included in the case definition of pertussis in household contacts of laboratory-confirmed cases. METHODS: A prospective epidemiological study was made in two Spanish regions. Household contacts were identified for each confirmed case reported during 2012 and 2013. Two clinical samples were taken to determine the presence or absence of Bordetella pertussis by culture or real-time PCR. Clinical variables, age and vaccination status were recorded. Positive and negative likelihood ratios (PLR, NLR) were estimated for each symptom. RESULTS: 2852 household contacts of 688 confirmed cases were reported. 178 household contacts with clinical symptoms were analyzed: 150 were laboratory confirmed and 28 were not. The clinical symptom with the highest PLR in comparison with the NLR was paroxysmal cough(PLR 4.76; 95% CI 1.91-11.87 and NLR 0.37; 95% CI 0.28-0.49). The contrast between the PLR and NLR was especially important for persons aged <18 years (PLR 7.08; 95% CI 1.10-45.74 and NLR 0.32; 95% CI 0.21-0.49). CONCLUSIONS: The clinical symptoms of pertussis are poor predictors of pertussis disease, independently of the vaccination status. Differences were observed between persons aged <18 years and adults. To adopt the appropriate treatment and control measures, rapid laboratory confirmation by PCR of all household contacts of confirmed cases who present any clinical symptoms compatible with pertussis should be recommended.

Equivalencia terap‚utica e intercambiabilidad de medicamentos / Therapeutic equivalence and intercambiabilidad of medicines

El amplio desarrollo de los medicamentos gen‚ricos, y la demostración de fallas en la biodisponibilidad a partir de la d‚cada de los 70 condujo a la introducci¢n de requerimientos de bioequivalencia en pa¡ses del hemisferio norte, los que se han incorporado progresivamente en las regulaciones propuestas por la Organización Mundial de la Salud, la FDA y la EMEA, y luego entre la legislación de diferentes paises a diferente velocidad. Dos medicamentos son terap‚uticamente equivalentes si ellos son equivalentes farmac‚uticos o alternativas farmacéuticas y después de la administración en la misma dosis molar, sus efectos, con respecto a eficacia y seguridad, ser n esencialmente los mismos cuando sean administrados a pacientes por la misma v¡a de administración bajo las condiciones especificadas en el inserto. La decisión de intercambiabilidad es una inferencia luego de la demostración de equivalencia terapéutica, que supone que un medicamento puede ser reemplazado por otro que contenga lamisma dosis molar del medicamento en la misma forma farmacéutica y adminstrado en la misma v¡a e intervalo, esper ndose que los efectos farmacodin micos sean los mismos. En este trabajo se revisan los tipos de estudios utilizados para evaluar la equivalencia terapéutica, sus requisitos principales as¡ como los criterios de aceptabilidad y rechazo de los estudios. Se revisa la exigencia de estudios de equivalencia e intercambiabilidad se¤alados a la ley de medicamentos peruana aprobada en 2009.

The extensive development of generic drugs, and bioavailability failures from the 70s led to introduce bioequivalence requeriments in north region of the world, which progressively incorporated into regulations of WHO, FDA and EMEA, and then between different countries laws. Two drugs are therapeutically equivalent if they are pharmaceutical equivalents or pharmaceutical alternatives and after administration in the same molar dose, their efficacy effects and safety, will be essentially the same when administered to patients by the same route of administration under the conditions specified in the insert. The decision of interchangeability is an inference after show the therapeutic equivalence, which means that a drug can be replaced by another containing the same molar dose in the same dosage form and in the same via e interval, expected that pharmacodynamic effects are the same. In this article we review the types of studies used to evaluate the therapeutic equivalence, the requirement and criteria of acceptability and rejection of the studies. Likewise review the requirement for equivalence and interchangeability studies appointed in the Peruvian Drug Act in 2009.

Standardized multiplex one-step qRT-PCR for hepatitis A virus, norovirus GI and GII quantification in bivalve mollusks and water.

A quadruplex Real-Time RT-PCR assay for the simultaneous quantitative detection of hepatitis A virus (HAV), norovirus (NoV) GI and GII, and mengovirus (used as process control for determination of the virus/nucleic acid extraction efficiency) has been developed. This multiplex assay has been comparatively evaluated with the individual monoplex assays and showed to be slightly less sensitive, with average ΔCq values of 0.90, 0.28 and 0.44 for HAV, NoV GI and NoV GII, respectively, in standard curves of viral RNA, or 0.32, 0.37 and 0.51 for the same viruses respectively, in naturally-contaminated samples. These ΔCq values were mostly negligible since it represented, in the worst case scenario, a loss of 0.43 log in genome copy numbers. The quadruplex assay shows similar theoretical detection limits than the monoplex assay for NoV GII, and 10 times higher for HAV and NoV GI. However, when naturally-contaminated food and water samples were tested, these theoretical detection thresholds were often exceeded and very low genome copy numbers (below the limit of detection) could be quantified. The quadruplex assay fulfills the requirements of the method developed by the European Committee on Standardization (CEN) for virus detection in selected foodstuffs with significant advantages in labor and reagent costs.

Transmisión de los primeros casos en España de influenza pandémica A/H1N1 / Pandemic A/H1N1 influenza: Transmission of the first cases in Spain

Introducción El virus de la influenza pandémica A/H1N1 surgió en México a finales de marzo del 2009. Desde entonces, es todavía importante aportar las evidencias que contribuyeron a la rápida propagación internacional del virus y determinar la tasa de ataque de esta nueva cepa de influenza entre los primeros casos que llegaron a España y llevaron a identificar la primera transmisión en Europa. Métodos Se estudiaron tres grupos de personas con sospecha de casos de virus de la gripe pandémica A/H1N1 relacionados con un vuelo internacional: 71 estudiantes que viajaban juntos, 94 pasajeros que viajaban en el mismo avión que el grupo de estudiantes, y 68 contactos de casos confirmados. Se calculó la tasa de ataque entre los estudiantes y los contactos con su intervalo de confianza del 95% (IC). El 26 de abril, cuando los primeros casos fueron notificados, se llevaron a cabo medidas de prevención exhaustivas entre el grupo de alumnos y de los contactos de los casos confirmados. Resultados El 27 de abril, los primeros casos de influenza pandémica A/H1N1 confirmados en España fueron tres estudiantes que regresaban de México en avión. Un estudiante dio lugar al primer caso autóctono en España y a uno de los primeros casos en Europa. Se encontraron tasas de ataque similares entre el grupo de estudiantes (14,1%; IC: 12.1-16.1) y sus contactos (13,2%; IC: 4.4-22.0), pero no se detectó ningún caso entre el resto de pasajeros del vuelo, lo que sugiere que el riesgo de transmisión durante el vuelo fue bajo. Conclusión Los primeros casos de gripe A/H1N1 en España fueron importados por vía aérea desde México. Los esfuerzos de prevención para reducir el impacto de la nueva cepa de influenza influyeron en que tanto la tasa de ataque primaria como la secundaria fueran menores a las primeras tasas estimadas por la OMS para esta nueva cepa de influenza (AU)

Introduction Pandemic A/H1N1 influenza emerged in Mexico at the end of March 2009. Since then, it is still important to provide evidences that contributed to the international spread of the virus and to ascertain the attack rate of this new strain of influenza among the first cases in Spain that led to identify the first transmission in Europe. Methods Three pandemic A/H1N1 influenza groups related to an overseas flight were studied: 71 student group, 94 remaining passengers, and 68 contacts of confirmed cases. The attack rate with their 95% confidence interval (CI) among the student group and contacts was calculated. On April 26th, when the first cases were notified, strong preventive measures were implemented among the student group and the contacts of the confirmed cases. Results On 27th April, the first pandemic A/H1N1 influenza cases confirmed in Spain were three students that came back from Mexico by airplane. A student generated the first native case in Spain and one of the first cases in Europe. Similar attack rates were found between the student group (14.1%; CI: 12.1-16.1) and their contacts (13.2%; CI: 4.4-22.0), but no cases among remaining passengers were detected, suggesting low transmission risk during air travel. Conclusion The first cases of pandemic A/H1N1 influenza in Spain were imported by airplane from Mexico. Preventive efforts to reduce the impact of the influenza influenced that primary and secondary rates were lower than first estimations by WHO (AU)

Pandemic A/H1N1 influenza: transmission of the first cases in Spain.

INTRODUCTION: Pandemic A/H1N1 influenza emerged in Mexico at the end of March 2009. Since then, it is still important to provide evidences that contributed to the international spread of the virus and to ascertain the attack rate of this new strain of influenza among the first cases in Spain that led to identify the first transmission in Europe. METHODS: Three pandemic A/H1N1 influenza groups related to an overseas flight were studied: 71 student group, 94 remaining passengers, and 68 contacts of confirmed cases. The attack rate with their 95% confidence interval (CI) among the student group and contacts was calculated. On April 26th, when the first cases were notified, strong preventive measures were implemented among the student group and the contacts of the confirmed cases. RESULTS: On 27th April, the first pandemic A/H1N1 influenza cases confirmed in Spain were three students that came back from Mexico by airplane. A student generated the first native case in Spain and one of the first cases in Europe. Similar attack rates were found between the student group (14.1%; CI: 12.1-16.1) and their contacts (13.2%; CI: 4.4-22.0), but no cases among remaining passengers were detected, suggesting low transmission risk during air travel. CONCLUSION: The first cases of pandemic A/H1N1 influenza in Spain were imported by airplane from Mexico. Preventive efforts to reduce the impact of the influenza influenced that primary and secondary rates were lower than first estimations by WHO.

Lactobacillus casei downregulates commensals' inflammatory signals in Crohn's disease mucosa.

BACKGROUND: The interaction of commensal bacteria with the intestinal immune system is an essential factor in the development of inflammatory bowel disease (IBD). The study of isolated commensal bacteria's effects on the mucosal immune response might be relevant for a better understanding of pathophysiological mechanisms in IBD. METHODS: We investigated the immune responses to signals from the commensal Escherichia coli ATCC 35345 and the probiotic Lactobacillus casei DN-114 001 in Crohn's disease (CD) mucosa. Ileal specimens were obtained during surgery from CD patients. Mucosal explants were incubated with L. casei or its genomic DNA; TNF-alpha, IFN-gamma, IL-2, IL-6, IL-8, and CXCL1 were measured in the supernatant. Second, tissue expression of key proinflammatory cytokines (IL-6, TGF-beta, IL-23p19, IL-12p35, IL-17F), and chemokines (IL-8, CXCL1, CXCL2) was evaluated after incubation with L. casei or E. coli. Finally, combination experiments were carried out by incubating both strains with mucosal explants at different timepoints. RESULTS: Live L. casei significantly decreased secretion of TNF-alpha, IFN-gamma, IL-2, IL-6, IL-8, and CXCL1 by CD mucosa, but the effect was not reproduced by L. casei DNA. Second, live L. casei downregulated expression of IL-8, IL-6, and CXCL1 and did not modify expression of IL-23p19, IL-12p35, and IL-17F. In contrast, E. coli significantly upregulated expression of all these cytokines. Interestingly, combination experiments revealed the ability of L. casei to prevent and counteract the proinflammatory effects of E. coli. CONCLUSIONS: Live L. casei can counteract the proinflammatory effects of E. coli on CD inflamed mucosa by specific downregulation of key proinflammatory mediators.

Modulation of apoptosis in intestinal lymphocytes by a probiotic bacteria in Crohn's disease.

Apoptosis of active T lymphocytes constitutes a major control mechanism of immune homeostasis and tolerance. In Crohn's disease, abnormal activation of mucosal T lymphocytes against enteric bacteria is the key event triggering intestinal inflammation. Resistance of lymphocytes to apoptosis has been proposed as the pathogenetic defect. We examined the influence of bacteria-mucosa interactions on apoptosis of mucosal T lymphocytes. Ileal specimens were obtained at surgery from 12 patients with Crohn's disease. Mucosal explants from each specimen were cultured with nonpathogenic Escherichia coli ATCC 35345, Lactobacillus casei DN-114 001, or no bacteria. Cytokine release was measured in supernatant, and mononuclear cells were isolated for phenotypic characterization and Bcl-2 family protein expression. Coculture of inflamed tissue with L. casei significantly reduced the release of interleukin (IL)-6 and tumor necrosis factor alpha (P < 0.05). In addition, coculture with L. casei significantly reduced the number of T cells displaying the IL-2 receptor in the lamina propria. Expression of the antiapoptotic protein Bcl-2 in lamina propria lymphocytes was also reduced after coculture with L. casei, and the percentage of deoxyuridine triphosphate nick-end labeling positive lymphocytes increased. The nonpathogenic E. coli strain had no significant effect. In conclusion, L. casei reduces the number of activated T lymphocytes in the lamina propria of Crohn's disease mucosa. A balanced, local microecology may restore immune homeostasis.

Creencias y conocimientos sobre salud bucal en docentes de educación inicial y primaria / Beliefs and knowledges on mouth health: in teachers of initial and primary education

El propósito del presente estudio fue evaluar creencias y conocimientos sobre salud bucal entre 16 docentes de educación inicial y primaria que participan en un programa Preventivo Promocional de Salud Bucal. Respondieron correctamente todas las preguntas de la encuesta sobre salud bucal el 1.24 por ciento. 55.9 por ciento refiere que la higiene bucal debe realizarse desde el nacimiento, 65.84 por ciento que los controles odontológicos deben realizarse cada 6 meses. 65. 84 por ciento refiere: lo importante en la pasta dental es que contenga flúor. 36.13 por ciento conoce la existencia de sellantes de fosas y fisuras y 80.36 por ciento de ellos sabe que previenen las caries dental, 82. 5 por ciento identifica a los tofees como los más dañinos. Se concluye que se debe reforzar los conocimientos sobre prevención en salud bucal y continuar el Programa Preventivo Promocional brindando educación y promoción.