Dog skin parasite load, TLR-2, IL-10 and TNF-α expression and infectiousness.

Visceral leishmaniosis is a zoonotic disease that is transmitted by Lutzomyia longipalpis sandflies. Dogs are the main peri-urban reservoir of the disease, and progression of canine leishmaniosis is dependent on the type of immune response elaborated against the parasite. Type 1 immunity is characterized by effective cellular response, with production of pro-inflammatory cytokines such as tumour necrosis factor alpha (TNF-α). In contrast, Type 2 immunity is predominantly humoral, associated with progression of the disease and mediated by anti-inflammatory cytokines such as interleukin 10 (IL-10). Although seemly important in the dynamics of leishmaniosis, other gene products such as toll-like receptor 2 (TRL-2) and inducible nitric oxide synthase (iNOS) exert unclear roles in the determination of the type of immune response. Given that the dog skin serves as a micro-environment for the multiplication of Leishmania spp., we investigated the parasite load and the expression of TLR-2, iNOS, IL-10 and TNF-α in the skin of 29 infected and 8 control dogs. We found that increased parasite load leads to upregulation of TLR-2, IL-10 and TNF-α, indicating that abundance of these transcripts is associated with infection. We also performed a xenodiagnosis to demonstrate that increased parasitism is a risk factor for infectiousness to sandflies.

Entoepidemiology of Chagas disease in the Western region of the State of São Paulo from 2004 to 2008, and cytogenetic analysis in Rhodnius neglectus (Hemiptera, Triatominae).

To complement the epidemiological data and assist in the prophylaxis of Chagas disease in the State of São Paulo, we examined entomological lifting conducted in 40 municipalities of the Western region of the state from 2004 to 2008, highlighted the main vector species in this region, and reanalyzed the cytogenetic characteristics of Rhodnius neglectus from 3 different Brazilian states (Formoso/GO, Frutal/MG, Guaíra/SP, and Pitangueiras/SP). The municipalities of Castilho and Santo Antônio do Acaranguá registered the highest relative amounts of notifications. The main species notified in Western São Paulo were Triatoma sordida and R. neglectus. We collected a large number of T. sordida in 2005 and noted the absence of notification of infected insects in 2008. We observed no variation in chromosomal characteristics of R. neglectus of different states. These data are complementary to the survey presented from 1990 to 1999, as the vector species were the same (T. sordida and R. neglectus), with emphasis on T. sordida. We corroborate the future colonization domiciliary initially proposed for T. sordida in the region and underscore the importance of vector control programs in the prophylaxis of Chagas disease. Furthermore, we observed that the populations of R. neglectus in Brazil showed no intraspecific variation and we corroborated the chromosomal patterns originally described. These data are important for understanding the evolution of these hematophagous insects, which are vectors of Chagas disease.

[Infection frequency in patients with chronic idiopathic ulcerative colitis]. / Frecuencia de infecciones en pacientes con colitis ulcerosa crónica idiopática.

BACKGROUND: Ulcerative Colitis (UC) is a chronic inflammatory bowel disease characterized by diffuse inflammation of the mucosa of the colon. Up to now, diverse observational studies have implicated a wide variety of pathogenic microorganisms as causal and exacerbating factors in UC. Clostridium difficile (C. difficile) infection has been associated with recurrence and treatment failure and its incidence in patients with UC has been on the rise in the last few years. AIMS: To determine the frequency of infection by different microorganisms in Mexican UC patients. PATIENTS AND METHODS: A total of 150 patients with definitive UC diagnosis were studied. All the stool tests for parasites and ova, stool cultures, tests for the C. difficile toxins A and B, and immunohistochemistry for Cytomegalovirus in colon segment biopsies were analyzed. Other demographic and clinical variables of the disease were recorded for their correlation with infection frequency. RESULTS: Infection frequency in UC patients was 28.00%. C. difficile infection was present in 0.013%. Other pathogens were found, such as Endolimax nana (9.00%), Entamoeba histolytica (3.00%), Cytomegalovirus (2.00%), Salmonella (2.00%), Shigella (0.70%), Toxoplasma gondii (0.70%) and Iodamoeba bütschlii (0.70%). CONCLUSIONS: Infection frequency was 28.00% in our study and C. difficile infection represented only 0.013%.

An update on tolvaptan for autosomal dominant polycystic kidney disease.

Tolvaptan is an orally active antagonist of vasopressin (antidiuretic hormone [ADH]) V2 receptors. By blocking water reabsorption in kidney collecting ducts, it prompts renal free-water excretion and has been used for the treatment of hyponatremia, both euvolemic due to the syndrome of inappropriate ADH secretion, and hypervolemic due to liver cirrhosis and congestive heart failure. In the past few years, it has been shown that vasopressin and its second messenger cyclic adenosine monophosphate (cAMP) play an important role in the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD). This has been the rationale for the use of tolvaptan to halt the progression of ADPKD, mainly through slowing kidney growth and decline in renal function. Two major randomized clinical trials have demonstrated the benefits of tolvaptan in slowing the progression of ADPKD in terms of kidney growth and decline in renal function at 1 and 3 years (REPRISE and TEMPO). However, the long-term effectiveness of treatment with tolvaptan remains to be determined.

Acute tubulointerstitial nephritis associated with atezolizumab, an anti-programmed death-ligand 1 (pd-l1) antibody therapy.

Direct stimulation of the antitumor activity of immune system through checkpoint inhibitors (ICIs) has demonstrated efficacy in the treatment of different cancer types. The activity of these antibodies takes place in the immunological synapse blocking the binding of the negative immunoregulatory proteins, thus leading to the finalization of the immune response. Despite having a favorable toxicity profile, its mechanism of action impedes the negative regulation of the immune activity which can potentially favor autoimmune attacks to normal tissues. Renal toxicity has been described in several ICI but not with atezolizumab, an IgG1 monoclonal antibody targeting PD-L1 (programmed death ligand 1), approved by FDA as a second-line therapy for advanced urothelial carcinoma. Here we present a patient with a single kidney and metastatic renal cell carcinoma treated with atezolizumab and bevacizumab combination, with biopsy-proven acute interstitial nephritis, who had a complete resolution of renal dysfunction after steroid therapy.

[Use of spatial analysis tools in the epidemiological surveillance of American visceral leishmaniasis, Araçatuba, São Paulo, Brazil, 1998-1999]. / Utilização de ferramentas de análise espacial na vigilância epidemiológica de leishmaniose visceral americana - Araçatuba, São Paulo, Brasil, 1998-1999.

The control of American visceral leishmaniasis (AVL) is based on combating the vector and eliminating the domestic reservoir of the focus area - defined as 200 meters around human or canine cases. This paper discusses the use of spatial analysis techniques in the epidemiological surveillance of AVL in Araçatuba, São Paulo State, in order to propose a model for territorial epidemiological surveillance, reformulating current control strategies. The results showed that AVL transmission was not homogeneous; human cases were more frequent in areas with higher canine prevalence rates. Vector dispersion appeared to be restricted to a few houses, although it was not possible to model the vector density. In order to study the vector distribution and correlated covariates, a field study based on house sampling is being conducted. The results will aid the development of new spatial analysis tools and possibly redefine protocols and routines for the control of this endemic disease in urban areas.

Morfometría geométrica del corazón de hyla plicata a través de un gradiente altitudinal en el eje neovolcánico mexicano / Geometric morphometric of the heart in hyla plicata through an altitudinal gradient in the mexican neovolcanic axe

Se ha descrito que el medio aéreo representa menos problemas a los organismos en relación con la hipoxia a excepción de circunstancias especiales, como la exposición a grandes alturas o las madrigueras. El ambiente de gran altitud es desafiante en diversos sentidos, dado que existen factores bióticos y abióticos que pueden interactuar para determinar la distribución y sobrevivencia de los organismos. Para conocer estos aspectos, la biología se apoya en la ecomorfología, área que ayuda a definir las diferencias morfológicas con respecto al cambio del hábitat y en la morfometría geométrica que permite analizar estadísticamente esos cambios. En el presente estudio, se evaluaron diferentes poblaciones de la rana Hyla plicata que es una de las especies que se distribuyen a mayor altitud en México, (1500 m hasta los 3700 m). Por lo que el objetivo de este estudio, fue analizar la morfología del corazón en Hyla plicata a través de un gradiente altitudinal. Para ello se colectaron organismos en cuatro localidades, una de ellas fue en La Cima (Distrito Federal a 3016 m), y tres ubicadas en el Estado de México: Buenavista (3200 m), El Cerrillo ( 2632 m) y San Juan Atezcapan (1860 m). Los organismos colectados se disectaron para extraer el corazón con la finalidad de digitalizarlos mediante fotografías, y analizarlos con puntos geométricos y de esta forma evaluar la forma del órgano. Los resultados indican que las localidades de mayor altitud presentan aurículas y ventrículos más ensanchados, lo que señala que esta estructura evolucionó y se adaptó para efectuar un bombeo más eficaz de la sangre y posteriormente dirigirla hacia los diferentes tejidos del cuerpo. Esta adaptación en la morfología del corazón, permitió que Hyla plicata se adaptara a los ambientes de alta montaña como se ha visto en otros vertebrados que habitan zonas de mayor altitud.

It has been reported that the air environment is less problematic for organisms in relation to hypoxia except for special circumstances, such as exposure to high altitudes or burrows. The high altitude environment is challenging in different ways, since there are biotic and abiotic factors may interact to determine the distribution and survival of organisms. For these aspects, biology is based on the ecomorphology, area that helps to define the morphological differences with respect to habitat change and geometric morphometrics to analyze statistically those changes. In the present study, we evaluated different populations of the frog Hyla plicata is a species that are distributed at higher elevations in Mexico (1500 m to 3700 m). For the purpose of this study was to analyze the morphology in Hyla plicata heart through an altitudinal gradient. The organisms were collected at four sites, one was located in La Cima (Distrito Federal to 3016 m), and three in the Estado of Mexico: Buenavista (3200 m), El Cerrillo (2632 m) and San Juan Atezcapan (1860 m). The organisms collected were dissected to extract the heart for the purpose of scan them through photographs, and analyzed with geometric points and thus evaluate the shape of the organ. The results indicate that higher altitude locations have enlarged atria and ventricles, indicating that this structure evolved and adapted to effect a more efficient pumping of blood and then direct it to different body tissues. This adaptation in the morphology of the heart, allowed to adapt to Hyla plicata in high altitude environments as seen in other vertebrates that inhabit higher elevations.

Presencia de helicobacter pylori en el duodeno, antro y fundo de sujetos controles y pacientes con úlcera duodenal, úlcera gástrica, gastritis o duodenitis erosiva: análisis histológico de 357 sujetos / Presence of helicobacter pylori in duodenum, antrum and fundus in control subjects and in patients with duodenal ulcer, gastric ulcer, gastritis or erosive duodenitis: histological analysis of 357 subjects

The prevalence of helicobacter pylori infection was studied in 152 subjects with a normal upper gastrointestinal endoscopy, 125 with duodenal ulcer, 25 with gastric ulcer, 46 with erosive gastritis and 9 with erosive duodenitis. Two biopsies fron duodenum, antrum and fub¿ndus were obtained from each subject during endoscopy for histological diagnosis and Helicobacter pylori search. None of the patients with normal endoscopy and 2 percent of patients with duodenal ulcer had Helicobacter pylori in duodenal biopsies. These last patients had a significantly higher frecuency of Helicobacter pylori in the antrum (71 percent) than the rest of the studied groups. Five percent of subjects with normal endoscopy and 5 percent of those with duodenal ulcer had Helicobacter pylori in the antrum. An active gastritis was demonstrated in almost all patients with Helicobacter infection. Instestinal metaplasia occurred almost exclusively in the abscence of Helicobacter Pylori infection