Allergic reactions to tick saliva components in zebrafish model.

BACKGROUND: Alpha-Gal syndrome (AGS) is a tick-borne food allergy caused by IgE antibodies against the glycan galactose-alpha-1,3-galactose (α-Gal) present in glycoproteins and glycolipids from mammalian meat. To advance in the diagnosis and treatment of AGS, further research is needed to unravel the molecular and immune mechanisms underlying this syndrome. The objective of this study is the characterization of tick salivary components and proteins with and without α-Gal modifications involved in modulating human immune response against this carbohydrate. METHODS: Protein and α-Gal content were determined in tick saliva components, and proteins were identified by proteomics analysis of tick saliva fractions. Pathophysiological changes were recorded in the zebrafish (Danio rerio) model after exposure to distinct Ixodes ricinus tick salivary components. Serum samples were collected from zebrafish at day 8 of exposure to determine anti-α-Gal, anti-glycan, and anti-tick saliva protein IgM antibody titers by enzyme-linked immunosorbent assay (ELISA). RESULTS: Zebrafish treated with tick saliva and saliva protein fractions combined with non-protein fractions demonstrated significantly higher incidence of hemorrhagic type allergic reactions, abnormal behavioral patterns, or mortality when compared to the phosphate-buffered saline (PBS)-treated control group. The main tick salivary proteins identified in these fractions with possible functional implication in AGS were the secreted protein B7P208-salivary antigen p23 and metalloproteases. Anti-α-Gal and anti-tick salivary gland IgM antibody titers were significantly higher in distinct saliva protein fractions and deglycosylated saliva group when compared with PBS-treated controls. Anti-glycan antibodies showed group-related profiles. CONCLUSIONS: Results support the hypothesis that tick salivary biomolecules with and without α-Gal modifications are involved in modulating immune response against this carbohydrate.

BRAZILIAN CONSENSUS STATEMENT ON VISCOSUPPLEMENTATION OF THE HIP (COBRAVI-Q).

Objective: The Brazilian Consensus on Hip Viscosupplementation aims to generate a referential and consensual source from the theoretical knowledge and clinical experience of specialists in the field. Methods: A multidisciplinary panel was formed with 15 specialists (sports medicine, orthopedists, physiatrists and rheumatologists), based on clinical and academic experience in the use of viscosupplementation of the hip. 12 statements were prepared, discussed and voted. Each panelist gave a value between 0 and 10 on a Likert scale, specifying their level of agreement with the statement. Results: The panel reached a consensus on several aspects of viscosupplementation of the hip, with emphasis on the following statements: best indication is for mild to moderate hip arthrosis; it may be indicated in severe osteoarthritis; results may vary according to the characteristics of the viscosupplement used; Viscosupplementation should not be performed as an isolated procedure, but in conjunction with other rehabilitation and pharmacological measures; best injection technique should be based on anatomical references coupled with imaging guidance; it is a cost-effective procedure. Conclusion: Viscosupplementation is a safe and effective therapy for hip osteoarthritis, even in severe cases. Guided injection is recommended. Level of Evidence V, Expert Opinion.

Objetivo: O Consenso Brasileiro de Viscossuplementação do Quadril visa gerar uma fonte referencial a partir do conhecimento teórico e da experiência clínica de especialistas da área. Métodos: Um painel multidisciplinar foi formado com quinze especialistas (médicos do esporte, ortopedistas, fisiatras e reumatologistas), com base na experiência clínica e acadêmica no uso da viscossuplementação do quadril. Foram elaboradas, discutidas e votadas doze afirmativas. Cada membro do painel deu um valor entre 0 e 10 numa escala tipo Likert, especificando seu nível de concordância com a afirmação. Resultados: O painel chegou a um consenso sobre diversos aspectos da viscossuplementação do quadril, destacando-se: a melhor indicação é para tratar artrose de quadril leve a moderada; pode ser indicada para casos graves; os resultados podem variar de acordo com o viscossuplemento utilizado; não deve ser realizada como procedimento isolado, mas em conjunto com outras medidas reabilitadoras e farmacológicas; a melhor técnica para infiltração no quadril deve se basear nas referências anatômicas combinadas com guiagem por imagem; a viscossuplementação do quadril é um procedimento custo-efetivo. Conclusão: A viscossuplementação é uma alternativa terapêutica segura e eficaz na osteoartrite do quadril, mesmo em casos graves. Recomenda-se o uso de métodos guiados. Nível de Evidência V, Opinião do Especialista.

Operando Identification of the Reversible Skin Layer on Co3O4 as a Three-Dimensional Reaction Zone for Oxygen Evolution.

Co oxides and oxyhydroxides have been studied extensively in the past as promising electrocatalysts for the oxygen evolution reaction (OER) in neutral to alkaline media. Earlier studies showed the formation of an ultrathin CoO x (OH) y skin layer on Co3O4 at potentials above 1.15 V vs reversible hydrogen electrode (RHE), but the precise influence of this skin layer on the OER reactivity is still under debate. We present here a systematic study of epitaxial spinel-type Co3O4 films with defined (111) orientation, prepared on different substrates by electrodeposition or physical vapor deposition. The OER overpotential of these samples may vary up to 120 mV, corresponding to two orders of magnitude differences in current density, which cannot be accounted for by differences in the electrochemically active surface area. We demonstrate by a careful analysis of operando surface X-ray diffraction measurements that these differences are clearly correlated with the average thickness of the skin layer. The OER reactivity increases with the amount of formed skin layer, indicating that the entire three-dimensional skin layer is an OER-active interphase. Furthermore, a scaling relationship between the reaction centers in the skin layer and the OER activity is established. It suggests that two lattice sites are involved in the OER mechanism.

Consenso peruano para el uso de la resonancia magnética en el diagnóstico y seguimiento de pacientes con esclerosis múltiple / Peruvian consensus for the use of Magnetic Resonance Imaging in the diagnosis and follow-up of patients with Multiple Sclerosis

RESUMEN El uso de la resonancia magnética (RM) en el diagnóstico y seguimiento de pacientes con esclerosis múltiple (EM) ha optimizado el cuidado de los pacientes afectados. Diversos grupos internacionales de trabajo han intentado clarificar y normatizar el uso global de la RM pero, en muchas ocasiones, se extrapolan datos de otras regiones que no contemplan la realidad de cada lugar o son difíciles de implementar. Objetivo: Consensuar aspectos relacionados con el uso de RM en el diagnóstico y seguimiento de pacientes con EM en el Perú. Material y Métodos: Un grupo de expertos peruanos, conformado por neurólogos y radiólogos, condujo la elaboración del consenso mediante metodología de ronda de encuestas a la distancia. Resultados: Las recomendaciones, basadas en la evidencia publicada y en el criterio de los expertos, enfocaron tanto el rol de las técnicas convencionales de RM como el de la medición de la atrofia cerebral en pacientes con EM al momento del diagnóstico y durante el periodo de seguimiento. Conclusiones: Las recomendaciones del consenso podrán potencialmente homogenizar y optimizar el cuidado y seguimiento de pacientes con EM en nuestro país.

SUMMARY The use of Magnetic Resonance Imaging (MRI) in the diagnosis and follow-up of patients with Multiple Sclerosis (MS) has optimized the care of the affected patients. Several international working groups have tried to clarify and standardize the global use of MRI but, on many occasions, data are extrapolated from other regions, do not contemplate local realities or are difficult to implement. Objective: To reach a consensus on aspects related to the use of MRI in the diagnosis and follow-up of patients with MS in Peru. Material and Methods: A group of Peruvian experts (neurologists and radiologists) worked on the elaboration of the consensus using a remote survey round methodology. Results: The recommendations, established on the basis of published evidence and on the experts' criteria, focused on the role of both, the conventional MRI techniques and the measurement of brain atrophy in MS patients both at the time of diagnosis and during the follow-up period Conclusions: The consensual recommendations could potentially assist in the standardization and optimization of the care and follow-up of patients with MS in our country.

Brazilian consensus statement on viscosupplementation of the hip (cobravi-q) / Consenso brasileiro de viscossuplementação do quadril (cobravi-q)

ABSTRACT Objective: The Brazilian Consensus on Hip Viscosupplementation aims to generate a referential and consensual source from the theoretical knowledge and clinical experience of specialists in the field. Methods: A multidisciplinary panel was formed with 15 specialists (sports medicine, orthopedists, physiatrists and rheumatologists), based on clinical and academic experience in the use of viscosupplementation of the hip. 12 statements were prepared, discussed and voted. Each panelist gave a value between 0 and 10 on a Likert scale, specifying their level of agreement with the statement. Results: The panel reached a consensus on several aspects of viscosupplementation of the hip, with emphasis on the following statements: best indication is for mild to moderate hip arthrosis; it may be indicated in severe osteoarthritis; results may vary according to the characteristics of the viscosupplement used; Viscosupplementation should not be performed as an isolated procedure, but in conjunction with other rehabilitation and pharmacological measures; best injection technique should be based on anatomical references coupled with imaging guidance; it is a cost-effective procedure. Conclusion: Viscosupplementation is a safe and effective therapy for hip osteoarthritis, even in severe cases. Guided injection is recommended. Level of Evidence V, Expert Opinion.

RESUMO Objetivo: O Consenso Brasileiro de Viscossuplementação do Quadril visa gerar uma fonte referencial a partir do conhecimento teórico e da experiência clínica de especialistas da área. Métodos: Um painel multidisciplinar foi formado com quinze especialistas (médicos do esporte, ortopedistas, fisiatras e reumatologistas), com base na experiência clínica e acadêmica no uso da viscossuplementação do quadril. Foram elaboradas, discutidas e votadas doze afirmativas. Cada membro do painel deu um valor entre 0 e 10 numa escala tipo Likert, especificando seu nível de concordância com a afirmação. Resultados: O painel chegou a um consenso sobre diversos aspectos da viscossuplementação do quadril, destacando-se: a melhor indicação é para tratar artrose de quadril leve a moderada; pode ser indicada para casos graves; os resultados podem variar de acordo com o viscossuplemento utilizado; não deve ser realizada como procedimento isolado, mas em conjunto com outras medidas reabilitadoras e farmacológicas; a melhor técnica para infiltração no quadril deve se basear nas referências anatômicas combinadas com guiagem por imagem; a viscossuplementação do quadril é um procedimento custo-efetivo. Conclusão: A viscossuplementação é uma alternativa terapêutica segura e eficaz na osteoartrite do quadril, mesmo em casos graves. Recomenda-se o uso de métodos guiados. Nível de Evidência V, Opinião do Especialista.

Characterization of tick salivary gland and saliva alphagalactome reveals candidate alpha-gal syndrome disease biomarkers.

BACKGROUND: Ticks are obligate hematophagous arthropods that synthesize the glycan Galα1-3Galß1-(3)4GlcNAc-R (α-Gal) associated with the alpha-gal syndrome (AGS) or allergy to mammalian meat consumption. RESEARCH DESIGN AND METHODS: In this study, we used a proteomics approach to characterize tick proteins in salivary glands (sialome SG), secreted saliva (sialome SA) and with α-Gal modification (alphagalactome SG and SA) in model tick species associated with the AGS in the United States (Amblyomma americanum) and Australia (Ixodes holocyclus). Selected proteins reactive to sera (IgE) from patients with AGS were identified to advance in the identification of possible proteins associated with the AGS. For comparative analysis, the α-Gal content was measured in various tick species. RESULTS: The results confirmed that ticks produce proteins with α-Gal modifications and secreted into saliva during feeding. Proteins identified in tick alphagalactome SA by sera from patients with severe AGS symptomatology may constitute candidate disease biomarkers. CONCLUSIONS: The results support the presence of tick-derived proteins with α-Gal modifications in the saliva with potential implications in AGS and other disorders and protective capacity against tick infestations and pathogen infection. Future research should focus on the characterization of the function of tick glycoproteins with α-Gal in tick biology and AGS.

Probiotic Bacteria with High Alpha-Gal Content Protect Zebrafish against Mycobacteriosis.

Mycobacteriosis affects wild fish and aquaculture worldwide, and alternatives to antibiotics are needed for an effective and environmentally sound control of infectious diseases. Probiotics have shown beneficial effects on fish growth, nutrient metabolism, immune responses, disease prevention and control, and gut microbiota with higher water quality. However, the identification and characterization of the molecules and mechanisms associated with probiotics is a challenge that requires investigation. To address this challenge, herein we used the zebrafish model for the study of the efficacy and mechanisms of probiotic interventions against tuberculosis. First, bacteria from fish gut microbiota were identified with high content of the surface glycotope Galα1-3Galß1-(3)4GlcNAc-R (α-Gal) that has been shown to induce protective immune responses. The results showed that probiotics of selected bacteria with high α-Gal content, namely Aeromonas veronii and Pseudomonas entomophila, were biosafe and effective for the control of Mycobacterium marinum. Protective mechanisms regulating immunity and metabolism activated in response to α-Gal and probiotics with high α-Gal content included modification of gut microbiota composition, B-cell maturation, anti-α-Gal antibodies-mediated control of mycobacteria, induced innate immune responses, beneficial effects on nutrient metabolism and reduced oxidative stress. These results support the potential of probiotics with high -Gal content for the control of fish mycobacteriosis and suggested the possibility of exploring the development of combined probiotic treatments alone and in combination with -Gal for the control of infectious diseases.

Incidence of injuries in soccer players - mappingfoot: a prospective cohort study / Incidencia de lesiones en jugadores de fútbol - mappingfoot: un estudio de cohorte prospectivo / Incidência de lesões em jogadores de futebol - mappingfoot: um estudo de coorte prospectivo

ABSTRACT Introduction: Although the positive effects of physical activity on global health are well documented, sports practice is associated with a greater risk of injury; in professional soccer in particular, the risk is substantial. Objective: The primary objective of this study was to investigate the incidence of injuries among male athletes competing in the regional soccer championship. The secondary objective was to determine the prevalence of injuries. Methods: In this prospective cohort study, level of evidence II, the incidence and prevalence of injuries were assessed using an adapted version of the UEFA Champions League Study questionnaire. Results: This study included 310 male athletes from ten teams, aged 26.53±4.75 years, height 180.93±6.49 cm, and weight 79.32±8.29 kg, with a 4-month follow-up. Ninety-two injuries were recorded, representing a prevalence of 29.68% injuries. The body part most frequently injured was the lower limbs (86.9%). The main types of injuries were muscle tear/strain (37.0%), sprain/ligament (19.6%), and other injuries (14.1%). The injuries were mainly caused during run/sprint (33.7%), kick (12.0%) and jumping/landing (6.5%). The incidences of injuries were 15.88±8.57, 2.04±1.09, and 3.65±1.50 injuries/1000h of exposure during matches, training, and matches/training, respectively. Time-loss over the season was between 1 and 50 days, and the severity of the injuries was as follows: light (25%), minor (22.8%), moderate (43.5%) and severe (8.7%). Conclusion: This study suggests that there is a higher incidence of injuries during matches compared to training, among male regional soccer championship players. The lower limbs are the body part most affected, with a higher prevalence of rupture/strain in the thigh region, during running/sprinting. Level of evidence II; Prospective Cohort Study .

RESUMEN Introducción: Aunque los efectos positivos de la actividad física en la salud global estén bien documentados, la práctica deportiva está asociada a un riesgo mayor de lesiones; especialmente en el fútbol profesional, el riesgo es sustancial. Objetivo: El objetivo primario de este estudio fue investigar la incidencia de lesiones en atletas del sexo masculino que compiten en campeonatos regionales de fútbol. El resultado secundario fue determinar la prevalencia de lesiones. Métodos: En este estudio de cohorte prospectivo, nivel de evidencia II, la incidencia y la prevalencia de lesiones fueron evaluadas usando una versión adaptada del cuestionario de estudio de la Liga de Campeones de la UEFA. Resultados: Este estudio incluyó a 310 atletas del sexo masculino de 10 equipos, edad 26,53 ± 4,75 años, estatura 180,93 ± 6,49 cm y peso 79,32 ± 8,29 kg, durante 4 meses de acompañamiento. Se registraron 92 lesiones, lo que representa una prevalencia de 29,68%. La parte del cuerpo que tuvo lesiones más frecuentes fueron los miembros inferiores (86,9%). Los principales tipos de lesión fueron rotura/distensión muscular (37,0%), esguince/ligamento (19,6%) y otras lesiones (14,1%). Las lesiones fueron causadas principalmente durante carrera/sprint (33,7%), puntapié (12,0%) y salto/aterrizaje (6,5%). La incidencia de lesiones fue de 15,88 ± 8,57, 2,04 ± 1,09 y 3,65 ± 1,50 lesiones/1000 horas de exposición durante partidos, entrenamientos y partidos/entrenamientos, respectivamente. El tiempo de alejamiento en la temporada varió de 1 a 50 días, y la gravedad de las lesiones fue la siguiente: leve (25%), menor (22,8%), moderada (43,5%) y grave (8,7%). Conclusión: El presente estudio sugiere que existe mayor incidencia de lesiones durante los partidos en comparación con los entrenamientos entre jugadores del sexo masculino en campeonatos regionales de fútbol. Los miembros inferiores son la región más acometida, con mayor prevalencia de rotura/distensión en la región del muslo durante la carrera/sprint. Nivel de evidencia II, Estudio de cohorte prospectivo .

RESUMO Introdução: Embora os efeitos positivos da atividade física na saúde global sejam bem documentados, a prática esportiva está associada a um risco maior de lesões; especialmente no futebol profissional, o risco é substancial. Objetivo: O objetivo primário deste estudo foi investigar a incidência de lesões em atletas do sexo masculino que competem em campeonatos regionais de futebol. O objetivo secundário foi determinar a prevalência de lesões. Métodos: Neste estudo de coorte prospectivo, nível de evidência II, a incidência e a prevalência de lesões foram avaliados usando uma versão adaptada do questionário de estudo da Liga dos Campeões da UEFA. Resultados: Este estudo incluiu 310 atletas do sexo masculino de 10 equipes, com idade 26,53 ± 4,75 anos, estatura 180,93 ± 6,49 cm e peso 79,32 ± 8,29 kg, durante 4 meses de acompanhamento. Foram registradas 92 lesões, o que representa uma prevalência de 29,68%. A parte do corpo que teve lesões mais frequentes foram os membros inferiores (86,9%). Os principais tipos de lesão foram ruptura/distensão muscular (37,0%), entorse/ligamento (19,6%) e outras lesões (14,1%). As lesões foram causadas principalmente durante corrida/sprint (33,7%), chute (12,0%) e salto/aterrissagem (6,5%). A incidência de lesões foi de 15,88 ± 8,57, 2,04 ± 1,09 e 3,65 ± 1,50 lesões/1.000 horas de exposição durante jogos, treinamento e jogos/treinamento, respectivamente. O tempo de afastamento na temporada variou de 1 a 50 dias e a gravidade das lesões foi a seguinte: leve (25%), menor (22,8%), moderada (43,5%) e grave (8,7%). Conclusão: O presente estudo sugere que existe maior incidência de lesões durante os jogos em comparação com os treinos entre jogadores do sexo masculino em campeonatos regionais de futebol. Os membros inferiores são a região mais acometida, com maior prevalência de ruptura/distensão na região da coxa durante a corrida/sprint. Nível de evidência II; Estudo de coorte prospectivo .

Comparative analysis of Rhipicephalus tick salivary gland and cement elementome.

Rhipicephalus spp. (Acari: Ixodidae) ticks are obligate hematophagous arthropods, which constitute a model for the study of vector-host interactions. The chemical composition or elementome of salivary glands (SG) and cement provides information relevant for the study of protein-based complex multifunctional tissues with a key role in tick biology. In this study, we characterized the elementome of cement cones in Rhipicephalus sanguineus collected from naturally infested dogs and in SG and cement of R. bursa collected from experimentally infested rabbits at different feeding stages. The elementome was characterized using scanning electron microscopy (SEM) combined with energy dispersive X-ray spectroscopy (EDS). The results showed the identification of up to 14 chemical elements in the cement, and suggested tick/host-driven differences in the cement elementome between tick species and between SG and cement within the same species. By still unknown mechanisms, ticks may regulate cement elementome during feeding to affect various biological processes. Although these analyses are preliminary, the results suggested that N is a key component of the cement elementome with a likely origin in SG/salivary proteins (i.e., Glycine (C2H5NO2)-rich superfamily member proteins; GRPs) and other tick/host-derived components (i.e. NAPDH). Future research should be focused on tick elementome and its functional implications to better understand cement structure and function.

Characterization of the anti-α-Gal antibody profile in association with Guillain-Barré syndrome, implications for tick-related allergic reactions.

Humans evolved by losing the capacity to synthesize the glycan Galα1-3Galß1-(3)4GlcNAc-R (α-Gal), which resulted in the capacity to develop a protective response mediated by anti-α-Gal IgM/IgG antibodies against pathogens containing this modification on membrane proteins. As an evolutionary trade-off, humans can develop the alpha-Gal syndrome (AGS), a recently diagnosed disease mainly associated with allergic reactions to mammalian meat consumption. The etiology of the AGS is the exposure to tick bites and the IgE antibody response against α-Gal-containing glycoproteins and glycolipids. The objective of this study was to characterize the anti-α-Gal antibody response in association with the immune-mediated peripheral neuropathy, Guillain-Barré syndrome (GBS), and compare it with different factors known to modulate the antibody response to α-Gal such as exposure to tick bites and development of allergic reactions in response to tick bites. The results showed a significant decrease in the IgM/IgG response to α-Gal in GBS patients when compared to healthy individuals. In contrast, the IgM/IgG levels to α-Gal did not change in patients with allergic reactions to tick bites. The IgE response was not affected in GBS patients, but as expected, the IgE levels significantly increased in individuals exposed to tick bites and patients with tick-associated allergies. These results suggest that the immune pathways of anti-α-Gal IgM/IgG and IgE production are independent. Further studies should consider the susceptibility to allergic reactions to tick bites in GBS patients.

Infección urinaria como factor de riesgo para parto pretérmino / Urinary infection as a risk factor for preterm delivery

INTRODUCCIÓN: El parto pretérmino es la determinante más importante de la mortalidad neonatal en México y Estados Unidos. La infección de vías urinarias es una causa común de trabajo de parto pretérmino, nacimiento pretérmino, así como de morbilidad y mortalidad neonatal. OBJETIVO: El objetivo de este estudio es revisar la evidencia en la bibliografía médica y elaborar recomendaciones para disminuir la incidencia de infección de vías urinarias en mujeres embarazadas y, por tanto, el riesgo de nacimiento pretérmino. MATERIAL Y MÉTODOS: Se realizó una revisión de la literatura más actualizada sobre los aspectos generales del embarazo pretérmino y la implicación de la infección del tracto urinario en el embarazo y su desarrollo, comparando la eficacia de los diferentes protocolos de diagnóstico y tratamiento. Se eligieron estudios clínicos desde el 2005 al 2020; los cuales se identificaron a partir de las bases de datos Medline, PubMed, Elsevier, Cochrane Lybrary (bibliografía internacional) así como del Colegio de Ginecología y Obstetricia de México y la revista Médica del Instituto Mexicano del Seguro Social (bibliografía nacional). Los estudios fueron seleccionados por los 4 autores, que verificaron todos los datos extraídos. Los criterios de inclusión fueron estudios clínicos que investigaron la relación entre la infección del tracto urinario durante el embarazo y el nacimiento pretérmino, uso de criterios de diagnóstico durante el embarazo, así como el tratamiento. RESULTADOS: Se comprobó la relación directa de la infección del tracto urinario durante el embarazo con el parto pretérmino, se determinaron las variantes clínicas y se establecieron las recomendaciones actuales del tratamiento. CONCLUSIONES: El nacimiento pretérmino es una de las causas más importantes de morbilidad y mortalidad perinatal y representa el 75% de las muertes perinatales y 50% de las secuelas neurológicas atribuibles directamente a la prematurez. La bacteriuria asintomática, la cistitis y la pielonefritis son una seria amenaza para el feto y la madre, situación que exige aplicar esquemas óptimos de tratamiento antimicrobiano, de no ser así los resultados serán no positivos tanto para la madre como para el producto

INTRODUCTION: Preterm delivery is the most important determinant of neonatal mortality in Mexico and the United States. Urinary tract infection is a common cuse of preterm labor, preterm birth, as well as neonatal morbidity and mortality. OBJECTIVE: The objective of this study is to review the evidence in the medical literatura and make recommendations to decrease the incidence of urinary tract infection in pregnant woman and, therefore, the risk of preterm birth. MATERIAL AND METHODS: A review of the most updated literatura on the general aspects of preterm pregnancy and the implication of urinary tract infection in pregnancy and development was carried out, comparing the efficay of different diagnostic and treatment protocols. Clinical studies were chosen from 2005-2020; wich were identified from de Medline, PubMed, Elsevier, Cochrane Lybrary databases (international bibliography) as well as from the College of Gynecology and Obstretics of Mexico and the Medical journal of the Mexican Institute of Social Security National Bibliography. RESULTS: The direct relationship of urinary tract infection during pregnancy with preterm delivery, was verified, clinical variants were determined and current tratment recommendations were established. CONCLUSIONS: Preterm birth is one of the most important causes of perinatal morbidity and mortality and represents 75% of perinatal deaths and 50% of neurological sequelae directly attributable to prematurity. Asymptomatic bacteriuria, cystitis and pyelonephritis are serious threat to the fetus and the mother, a situation that requires optimal antimicrobial tratmente regimens. otherwise the results will be non-positive for both the mother and the product

Targeting the Exoskeleton Elementome to Track Tick Geographic Origins.

Understanding the origin of ticks is essential for evaluating the risk of tick-borne disease introduction into new territories. However, when collecting engorged ticks from a host, it is virtually impossible to identify the geographical location where this tick was acquired. Recently, the elementome of tick exoskeleton was characterized by using scanning electron microscopy (SEM) and energy dispersive spectroscopy analysis (EDS). The objective of our preliminary proof-of-concept study was to evaluate the use of SEM-EDS for the analysis of tick exoskeleton elementome to gain insight into the tick geographic and host origin. For this preliminary analysis we used 10 samples of engorged ticks (larvae and nymphs of six species from three genera) collected from various resident hosts and locations. The elementome of the tick exoskeleton was characterized in dorsal and ventral parts with three scans on each part using an EDS 80 mm2 detector at 15 kV in a field emission scanning electron microscope. We used principal component analysis (PCA) (varimax rotation) to reduce the redundancy of data under the premise of losing information as little as possible. The PCA was used to test whether the different variables (tick species, stages, hosts, or geographic locations) differ in the composition of exoskeleton elementome (C, O, P, Cl, and Na). Analyses were carried out using SPSS. The PCA analysis explained a high percentage of variance using the first two factors, C and O (86.13%). The first PC (PC-1; 63.12%) was positively related to P, Cl, and Na, and negatively related to C. The second principal component (23.01%) was mainly positively related to C. In the space defined by the two extracted PC (PC-1 and PC-2), the elementome of tick samples was clearly associated with tick species, but not with developmental stages, hosts or geographic locations. A differentiated elementome pattern was observed within Romanian regions (CJ and TL) for the same tick species. The use of the SEM-EDS methodological approach provided additional information about the tick exoskeleton elementome with possible applications to the identification of tick origin host and location.

Alpha-gal syndrome: challenges to understanding sensitization and clinical reactions to alpha-gal.

INTRODUCTION: The α-Gal syndrome (AGS) is a type of allergy characterized by an IgE antibody response against the carbohydrate Galα1-3Galß1-4GlcNAc-R (α-Gal). Tick bites are recognized as the most important cause of anti-α-Gal IgE antibody increase in humans. Several risk factors have been associated with the development of AGS, but their integration into a standardized disease diagnosis has proven challenging. AREAS COVERED: Herein we discuss the current AGS diagnosis based on anti-α-Gal IgE titers and propose an algorithm that considers all co-factors in the clinical history of α-Gal-sensitized patients to be incorporated into the AGS diagnosis. The need for identification of host-derived gene markers and tick-derived proteins for the diagnosis of the AGS is also discussed. EXPERT OPINION: The current AGS diagnosis based on anti-α-Gal IgE titers has limitations because not all patients sensitized to α-Gal and with anti-α-Gal IgE antibodies higher than the cutoff (0.35 IU/ml) develop anaphylaxis to mammalian meat and AGS. The basophil activation test proposed to differentiate between patients with AGS and asymptomatic α-Gal sensitization cannot be easily implemented as a generalized clinical test. In coming years, the algorithm proposed here could be used in a mobile application for easier AGS diagnosis in the clinical practice.

La salud de las personas adultas mayores durante la pandemia de COVID-19 / The health of older adults during the COVID-19 pandemic

La pandemia por COVID-19 representa un problema para la salud pública, más aún, al tener un alto grado de mortalidad en las personas adultas mayores. Para garantizar el cuidado de este grupo poblacional, se hace un análisis de las necesidades y medidas preventivas diseñadas para la prevención y control de la enfermedad causada por el virus SARS-Cov2. OBJETIVO: Analizar la situación de las personas adultas mayores ante la problemática del nuevo coronavirus y compilar las principales medidas de prevención general y especifica para la protección de este grupo vulnerable. METODOLOGÍA: Se realizó una revisión sistemática de artículos indexados, en PubMed, LATINDEX, Redalyc, Scielo, Scopus, Dialnet y Google Scholar y en fuentes oficiales nacionales e internacionales. Se utilizó para la búsqueda las siguientes palabras clave: COVID-19, SARS-Cov2, adulto mayor, medidas preventivas coronavirus, pandemia. RESULTADOS: De 9 artículos consultados y de las fuentes oficiales mencionadas, se analizó los principales ejes en relación a la situación económica y laboral, la salud, así como los factores de riesgo generales para la población y específicos para las personas adultas mayores. Los principales factores de riesgo hallados son la edad avanzada, las comorbilidades presentes en este grupo poblacional, los padecimientos demenciales, además de factores sociales como la discriminación por edad y los estereotipos en relación a la dependencia y fragilidad de las personas mayores. La prevención del COVID-19 en adultos mayores debe incluir además de la contención y cuidados específicos, la atención psicosocial. CONCLUSIONES: Los adultos mayores conforman el grupo de mayor impacto negativo por el SARS-Cov2, COVID-19, su vulnerabilidad ante esta pandemia proviene no solo de su edad, sino por la situación económica, laboral y enfermedades asociadas a su edad, su soledad le confiere mayor riesgo ya que tiene que salir a buscar sus víveres, de no apoyarles el impacto en su salud será indudablemente negativo

The COVID-19 pandemic represents a public health problem, even more so, since it has a high degree of mortality in older adults. To guarantee the care of this population group, an analysis was made of the needs and preventive measures designed for the prevention and control of the disease caused by the SARS-Cov2 virus. AIM: Analyze the situation of older adults facing the problem of the new coronavirus and compile the main general and specific prevention measures for the protection of this vulnerable group. METHODOLOGY: A systematic review of indexed articles was carried out in PubMed, LATINDEX, Redalyc, Scielo, Scopus, Dialnet and Google Scholar and in official national and international sources. The following keywords were used for the search: COVID-19, SARS-Cov2, elderly, preventive measures, coronavirus, pandemic. RESULTS: From 9 articles consulted and from the aforementioned official sources, the main axes were analyzed in relation to the economic and labor situation, health, as well as the general risk factors for the population and specific for the elderly. The main risk factors found are advanced age, comorbidities present in this population group, dementing illnesses, as well as social factors such as age discrimination and stereotypes regarding the dependency and frailty of older people. Prevention of COVID-19 in older adults should include psychosocial care in addition to specific containment and care. CONCLUSIONS: Older adults make up the group with the greatest negative impact due to SARS-Cov2, COVID-19, their vulnerability to this pandemic comes not only from their age, but also due to the economic, work situation and diseases associated with their age, their loneliness gives them greater risk since you have to go out to look for your food, if you do not support them the impact on your health will undoubtedly be negative

Vaccination with Alpha-Gal Protects Against Mycobacterial Infection in the Zebrafish Model of Tuberculosis.

The alpha-Gal syndrome (AGS) is associated with tick bites that can induce in humans high levels of IgE antibodies against the carbohydrate Galα1-3Galß1-(3)4GlcNAc-R (α-Gal) present in glycoproteins and glycolipids from tick saliva that mediate primarily delayed anaphylaxis to mammalian meat consumption. It has been proposed that humans evolved by losing the capacity to synthesize α-Gal to increase the protective immune response against pathogens with this modification on their surface. This evolutionary adaptation suggested the possibility of developing vaccines and other interventions to induce the anti-α-Gal IgM/IgG protective response against pathogen infection and multiplication. However, the protective effect of the anti-α-Gal immune response for the control of tuberculosis caused by Mycobacterium spp. has not been explored. To address the possibility of using vaccination with α-Gal for the control of tuberculosis, in this study, we used the zebrafish-Mycobacterium marinum model. The results showed that vaccination with α-Gal protected against mycobacteriosis in the zebrafish model of tuberculosis and provided evidence on the protective mechanisms in response to vaccination with α-Gal. These mechanisms included B-cell maturation, antibody-mediated opsonization of mycobacteria, Fc-receptor (FcR)-mediated phagocytosis, macrophage response, interference with the α-Gal antagonistic effect of the toll-like receptor 2 (TLR2)/nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB)-mediated immune response, and upregulation of pro-inflammatory cytokines. These results provided additional evidence supporting the role of the α-Gal-induced immune response in the control of infections caused by pathogens with this modification on their surface and the possibility of using this approach for the control of multiple infectious diseases.

Tick and Host Derived Compounds Detected in the Cement Complex Substance.

Ticks are obligate hematophagous arthropods and vectors of pathogens affecting human and animal health worldwide. Cement is a complex protein polymerization substance secreted by ticks with antimicrobial properties and a possible role in host attachment, sealing the feeding lesion, facilitating feeding and pathogen transmission, and protection from host immune and inflammatory responses. The biochemical properties of tick cement during feeding have not been fully characterized. In this study, we characterized the proteome of Rhipicephalus microplus salivary glands (sialome) and cement (cementome) together with their physicochemical properties at different adult female parasitic stages. The results showed the combination of tick and host derived proteins and other biomolecules such as α-Gal in cement composition, which varied during the feeding process. We propose that these compounds may synergize in cement formation, solidification and maintenance to facilitate attachment, feeding, interference with host immune response and detachment. These results advanced our knowledge of the complex tick cement composition and suggested that tick and host derived compounds modulate cement properties throughout tick feeding.

Allergic Reactions and Immunity in Response to Tick Salivary Biogenic Substances and Red Meat Consumption in the Zebrafish Model.

Ticks are arthropod ectoparasite vectors of pathogens and the cause of allergic reactions affecting human health worldwide. In humans, tick bites can induce high levels of immunoglobulin E antibodies against the carbohydrate Galα1-3Galß1-(3)4GlcNAc-R (α-Gal) present in glycoproteins and glycolipids from tick saliva that mediate anaphylactic reactions known as the alpha-Gal syndrome (AGS) or red meat allergy. In this study, a new animal model was developed using zebrafish for the study of allergic reactions and the immune mechanisms in response to tick salivary biogenic substances and red meat consumption. The results showed allergic hemorrhagic anaphylactic-type reactions and abnormal behavior patterns likely in response to tick salivary toxic and anticoagulant biogenic compounds different from α-Gal. However, the results showed that only zebrafish previously exposed to tick saliva developed allergic reactions to red meat consumption with rapid desensitization and tolerance. These allergic reactions were associated with tissue-specific Toll-like receptor-mediated responses in types 1 and 2 T helper cells (TH1 and TH2) with a possible role for basophils in response to tick saliva. These results support previously proposed immune mechanisms triggering the AGS and provided evidence for new mechanisms also potentially involved in the AGS. These results support the use of the zebrafish animal model for the study of the AGS and other tick-borne allergies.

A dataset for the analysis of antibody response to glycan alpha-Gal in individuals with immune-mediated disorders.

Humans evolved by losing the capacity to synthesize the glycan Galα1-3Galß1-(3)4GlcNAc-R (α-Gal), which resulted in the development of a protective response mediated by anti-α-Gal IgM/IgG/IgA antibodies against pathogens containing this modification on membrane proteins. As an evolutionary trade-off, humans can develop the alpha-Gal syndrome (AGS), a recently diagnosed disease mediated by anti-α-Gal IgE antibodies and associated with allergic reactions to mammalian meat consumption and tick bites. However, the anti-α-Gal antibody response may be associated with other immune-mediated disorders such as those occurring in patients with COVID-19 and Guillain-Barré syndrome (GBS). Here, we provide a dataset (209 entries) on the IgE/IgM/IgG/IgA anti-α-Gal antibody response in healthy individuals and patients diagnosed with AGS, tick-borne allergies, GBS and COVID-19. The data allows correlative analyses of the anti-α-Gal antibody response with factors such as patient and clinical characteristics, record of tick bites, blood group, age and sex. These analyses could provide insights into the role of anti-α-Gal antibody response in disease symptomatology and possible protective mechanisms.

Anaplasma pathogen infection alters chemical composition of the exoskeleton of hard ticks (Acari: Ixodidae).

Ticks are arthropod ectoparasites and vectors of pathogens affecting human and animal health worldwide. The exoskeleton is a structure that protect arthropods from natural threats such as predators and diseases. Both structural proteins and chemical elements are components of the exoskeleton. However, the chemical composition and effect of pathogen infection on tick exoskeleton properties has not been characterized. In this study, we characterized the chemical composition of tick exoskeleton and the effect of Anaplasma pathogen infection on the chemical elements of the exoskeleton and selected structural proteins. The chemical composition was characterized ventral, dorsal upper and dorsal lower regions of tick exoskeleton by scanning electron microscopy and energy dispersive spectroscopy and compared between infected and uninfected ticks. The levels of selected structural proteins were analyzed in infected and uninfected I. scapularis salivary glands by immunofluorescence analysis. The results showed that tick exoskeleton contains chemical elements also found in other arthropods. Some of the identified elements such as Mg and Al may be involved in tick exoskeleton stabilization through biomineralization of structural proteins that may be overrepresented in response to pathogen infection. These results suggested that pathogen infection alters the chemical composition of tick exoskeleton by mechanisms still to be characterized and with tick species and exoskeleton region-specific differences.