Vernix caseosa reveals mechanistic clues linking maternal obesity to atopic dermatitis pathogenesis.

BACKGROUND: Maternal overweight and obesity have been associated with an increased risk of atopic dermatitis (AD) in the offspring, but the underlying mechanisms are unclear. Vernix caseosa (VC) is a proteolipid material covering the fetus produced during skin development. However, whether maternal prepregnancy weight excess influences fetal skin development is unknown. Characterizing the VC of newborns from mothers with prepregnancy overweight and obesity might reveal AD-prone alterations during fetal skin development. OBJECTIVE: We sought to explore AD biomarkers and staphylococcal loads in VC from the offspring of mothers who were overweight/obese (O/O) before pregnancy versus in those from offspring of normal weight mothers. METHODS: The VC of newborns of 14 O/O and 12 normal weight mothers were collected immediately after birth. Biomarkers were determined by ELISA and staphylococcal species by quantitative PCR. RESULTS: The VC from the O/O group showed decreased expression of skin barrier proteins (filaggrin and loricrin) and increased levels of proinflammatory biomarkers (IgA, thymic stromal lymphopoietin [TSLP], S100A8, IL-25, and IL-33). No differences in concentrations of antimicrobial peptides and enzymes were detected. The VC from the O/O group had a lower Staphylococcus epidermidis and Staphylococcus hominis commensal bacterial load, whereas Staphylococcus aureus bacterial load was not significantly different between the 2 groups. Maternal body mass index was negatively correlated with VC filaggrin expression and S epidermidis load and was positively associated with TSLP concentration. One-year follow-up established that the offspring of O/O mothers had a higher incidence of AD that was specifically linked with decreased VC filaggrin expression and lower S epidermidis load. CONCLUSIONS: VC from neonates of mothers with prepregnancy overweight and obesity exhibit skin barrier molecular alterations and staphylococcal dysbiosis that suggest early mechanistic clues to this population's increased risk of AD.

Ultra-low dose whole-body CT for attenuation correction in a dual tracer PET/CT protocol for multiple myeloma.

PURPOSE: To investigate within phantoms the minimum CT dose allowed for accurate attenuation correction of PET data and to quantify the effective dose reduction when a CT for this purpose is incorporated in the clinical setting. METHODS: The NEMA image quality phantom was scanned within a large parallelepiped container. Twenty-one different CT images were acquired to correct attenuation of PET raw data. Radiation dose and image quality were evaluated. Thirty-one patients with proven multiple myeloma who underwent a dual tracer PET/CT scan were retrospectively reviewed. 18F-fluorodeoxyglucose PET/CT included a diagnostic whole-body low dose CT (WBLDCT: 120 kV-80mAs) and 11C-Methionine PET/CT included a whole-body ultra-low dose CT (WBULDCT) for attenuation correction (100 kV-40mAs). Effective dose and image quality were analysed. RESULTS: Only the two lowest radiation dose conditions (80 kV-20mAs and 80 kV-10mAs) produced artifacts in CT images that degraded corrected PET images. For all the other conditions (CTDIvol ≥ 0.43 mGy), PET contrast recovery coefficients varied less than ± 1.2%. Patients received a median dose of 6.4 mSv from diagnostic CT and 2.1 mSv from the attenuation correction CT. Despite the worse image quality of this CT, 94.8% of bone lesions were identifiable. CONCLUSION: Phantom experiments showed that an ultra-low dose CT can be implemented in PET/CT procedures without any noticeable degradation in the attenuation corrected PET scan. The replacement of the standard CT for this ultra-low dose CT in clinical PET/CT scans involves a significant radiation dose reduction.

The utility of ADC value in diffusion-weighted whole-body MRI in the follow-up of patients with multiple myeloma. Correlation study with 18F-FDG PET-CT.

OBJECTIVES: To analyze the feasibility of DWI-MRI and ADC to evaluate treatment response in patients with multiple myeloma (MM). To correlate the variations of ADC and SUVmax in 18F-FDG PET-CT. METHODS: 27 patients with MM that had a whole-body MRI and 18F-FDG PET-CT performed at baseline and after treatment were retrospectively recruited between February 2018 and May 2020. Three target bone lesions were selected for each patient and their ADC, SUVmax and Deauville score were measured in every study. Correlation between ADC and SUVmax of the lesions was evaluated, as well as changes in mean ADC, SUVmax, and Deauville score between studies. Patients were classified as responder or non-responder according to the IMWG, MRI (MY-RADS) and PET-CT (IMPeTUs) response criteria. Agreement between the MRI and PET-CT criteria with the IMWG criteria was evaluated. RESULTS: The correlation between the ADC and SUVmax of all the target lesions was strong, negative and significant (r=-0.603; p < 0.001). After treatment, mean ADC in lesions from responders was significantly higher than in non-responders (1585.51 × 10-6 mm2/s vs 698.17 × 10-6 mm2/s; p < 0.001). SUVmax of the same lesions was significantly lower in responders than in non-responders (2.05 vs 5.33; p < 0.001). There was a very strong or strong agreement of the IMWG response criteria with both MRI (κ = 0.852; p < 0.001) and PET (κ = 0.767; p < 0.001) criteria. CONCLUSION: DWI-MRI and ADC may be used to assess treatment response in MM patients, showing a good correlation with 18F-FDG PET-CT and the IMWG response criteria.

Bovine alphaherpesvirus type 5 replicates more efficiently than bovine alphaherpesvirus type 1 in undifferentiated human neural cells.

Bovine herpesvirus (BoHV) types 1 and 5 are two closely related alpha-herpesviruses of cattle with neuroinvasive potential. BoHV-5 causes non-suppurative meningoencephalitis in calve whereas encephalitis caused by BoHV-1 has been occasionally reported. As an initial step to understand the biology of both BoHV types in neural cells, undifferentiated SH-SY5Y human neuroblastoma cells were infected with BoHV-1 strains Cooper and Los Angeles (LA), BoHV-5 strain 97/613 and A663, a BoHV-5/BoHV-1 natural recombinant. Cytopathic effect (CPE) in these cells was evident earlier for BoHV-5 strain 97/613 and CPE progression was slower for BoHV-1, particularly for Cooper strain. Virus antigen was detected as early as 8 h post-infection (hpi) for all strains, with the exception of BoHV-1 Cooper for which antigen expression was detectable by 24 hpi. All strains released detectable infectious virus in the extracellular medium by 8 hpi, confirming that undifferentiated SH-SY5Y cells are fully permissive to BoHV infection. Significantly different extracellular virus titers among the different strains were detected by 24 hpi, with BoHV-5 97/613 reaching the maximal virus production. The lowest extracellular titer was recorded for BoHV-1 Cooper at all the evaluated time-points. BoHV-1 Cooper, BoHV-1 LA and BoHV-5 97/613 had a steady increase in intracellular virus production. The evaluation of lysis plaques formation revealed that BoHV-5 A663 produced the largest plaques followed by BoHV-5 97/613. Both BoHV-1 strains produced smaller plaques when compared with BoHV-5. Despite a slower replicative cycle, strain A663 is more efficient in cell to cell dissemination. Thus, it is evident that BoHV-5 strains have growth advantages in undifferentiated neural cells compared with BoHV-1. This in vitro model might be useful to analyze the neuropathogenic potential of bovine alphaherpesviruses.

Distinctive features of bovine alphaherpesvirus types 1 and 5 and the virus-host interactions that might influence clinical outcomes.

Bovine herpesvirus types 1 (BoHV-1) and 5 (BoHV-5) are two closely related alphaherpesviruses. BoHV-1 causes several syndromes in cattle, including respiratory disease and sporadic cases of encephalitis, whereas BoHV-5 is responsible for meningoencephalitis in calves. Although both viruses are neurotropic, they differ in their neuropathogenic potential. This review summarizes the findings on the specific mechanisms and pathways known to modulate the pathogenesis of BoHV-1 and BoHV-5, particularly in relation to respiratory and neurological syndromes, which characterize BoHV-1 and BoHV-5 infections, respectively.

Differential expression of cyclins mRNA in neural tissues of BoHV-1- and BoHV-5- infected cattle.

Bovine alphaherpesvirus types 1 (BoHV-1) and 5 (BoHV-5) are closely related alphaherpesviruses. BoHV-5 causes non-suppurative meningoencephalitis in calves. BoHV-1 is associated with several syndromes and, occasionally, can cause encephalitis. Although both viruses are neurotropic and they share similar biological properties, it is unknown why these alphaherpesviruses differ in their ability to cause neurological disease. Neural tissue samples were collected from BoHV-1- and BoHV-5-intranasally inoculated calves during acute infection, latency and reactivation and the levels of cyclins mRNA expression were analyzed by qRT-PCR. Striking differences in the levels of cyclins mRNA were particularly detected in trigeminal ganglion (TG). The expression levels of cyclins in TG during BoHV-5 latency suggest that these viruses utilize different strategies to persist in the host. It is apparent that a relationship between virus loads and cyclin mRNA levels can be established only during acute infection and other factors might be involved in the regulation of cell cycle components during BoHV latency and reactivation. Bovine alphaherpesviruses neuropathogenicity might be influenced by the differential control of cell cycle components by these herpesviruses. This is the first report on BoHV-5 modulation of cyclins expression in neural tissues from its natural host.

Factores de riesgo en el personal de enfermería para contraer tuberculosis en el Hospital de Emergencias Grau EsSalud 2008 / Risk factors in the nursing staff to contract tuberculosis in the Hospital Emergency EsSalud Grau 2008

Los Objetivos fueron: Determinar los factores de riesgo en el personal de enfermería para contraer la tuberculosis en el Hospital de Emergencias Grau-Essalud e identificar los factores de riesgo en la dimensión personal, técnica y administrativa asociados a la tuberculosis. Material y métodos: El estudio fue de nivel aplicativo, tipo cuantitativo, método descriptivo transversal prospectivo. La muestra estuvo conformada por 92 enfermeras obtenida por muestreo aleatorio simple. La técnica fue la encuesta y el instrumento un cuestionario y una guía de observación. Resultados: Del 100 por ciento (92), 43.5 por ciento (40) tienen mediano riesgo, 29.3 por ciento (27) bajo riesgo y 27.2 por ciento (25) alto riesgo para contraer la tuberculosis en el hospital. En cuanto a la dimensión personal el 45.7 por ciento de las enfermeras tienen mediano riesgo, 38 por ciento bajo riesgo y 16.3 por ciento alto riesgo relacionado al desconocimiento del estado inmunológico del personal por la no realización de pruebas de PPD institucionalmente, desconocimiento de las normas técnicas de atención del paciente tuberculoso en el ámbito hospitalario, aumento de la jornada laboral por realización de horas extras, la falta de capacitación en aspectos preventivos y de manejo del paciente con tuberculosis; y el tiempo de servicio en la institución. En la dimensión técnica, el 42.4 por ciento consideró presentar un riesgo mediano, 35.8 por ciento riesgo alto y 21.8 por ciento bajo riesgo referido a infraestructura general y especifica inadecuada de los servicios, relacionado a condiciones y numero de ambientes de aislamiento respiratorio; inadecuado sistema de ventilación y de control ambiental, así como de insuficientes medidas de protección personal debido al uso de mascarilla simple por la no tenencia de respirador N95. En la dimensión administrativa el 43.5 por ciento se considero de riesgo medio, 29.3 por ciento de alto riesgo y 27.2 por ciento de bajo riesgo referido a ausencia de protocolos de atención en los servicios, retardo en el diagnostico, demora en la toma de muestra de baciloscopia y de su resultado, así como inadecuado lugar de toma de muestra de BK y el deficiente nivel de conocimiento del personal de salud. Conclusiones: El riesgo de contraer tuberculosis en el personal de enfermería en el Hospital de Emergencias Grau es de un nivel medio, siendo los factores administrativos y técnicos los principales causantes a que la tendencia de enfermar sea más probable

The objectives were to determine the risk factors in the nursing staff to contract tuberculosis in the Hospital Emergency Essalud Grau and identify risk factors in the personal, technical and administrative related to tuberculosis. Material and methods: The study was application level, quantitative, prospective cross-sectional descriptive method. The sample consisted of 92 nurses obtained by simple random sampling. The technique was a survey and a questionnaire and an observation guide. Results: 100 per cent (92), 43.5 per cent (40) have medium risk, 29.3 per cent (27) low risk and 27.2 per cent (25) high risk for tuberculosis in the hospital. Regarding the personal dimension 45.7 per cent of nurses have medium risk, 38 per cent low risk and high risk 16.3 per cent related to the lack of immune status of personnel for non-PPD testing institutionally, lack of technical standards of care TB patient in the hospital, increased working hours for completion of overtime, lack of training in prevention and management of patients with tuberculosis, and the time of service at the institution. In the technical dimension, 42.4 per cent considered to present a medium risk, high risk 35.8 per cent and 21.8 per cent under the risk relating to general and specific infrastructure inadequate services related to conditions and number of respiratory isolation rooms, inadequate ventilation and environmental control, as well as inadequate personal protective measures due to the use of simple mask tor non-tenure N95 respirator. In the administrative dimension, 43.5 per cent are considered medium risk, high risk 29.3 per cent and 27.2 per cent low risk relating to the absence of protocols of care services, delay in diagnosis, delay in sample collection and smear outcome, and inadequate sampling rather than BK and poor level of health knowledge. Conclusions: The risk of tuberculosis in nursing staff in the Emergency Hospital is mid-level Grau, with administrative and technical factors as major contributors to the trend of disease more Iikely