Differential Release and Phagocytosis of Tegument Glycoconjugates in Neurocysticercosis: Implications for Immune Evasion Strategies

Neurocysticercosis (NCC) is an infection of the central nervous system (CNS) by the metacestode of the helminth Taenia solium. The severity of the symptoms is associated with the intensity of the immune response. First, there is a long asymptomatic period where host immunity seems incapable of resolving the infection, followed by a chronic hypersensitivity reaction. Since little is known about the initial response to this infection, a murine model using the cestode Mesocestoides corti (syn. Mesocestoides vogae) was employed to analyze morphological changes in the parasite early in the infection. It was found that M. corti material is released from the tegument making close contact with the nervous tissue. These results were confirmed by infecting murine CNS with ex vivo–labeled parasites. Because more than 95% of NCC patients exhibit humoral responses against carbohydrate-based antigens, and the tegument is known to be rich in glycoconjugates (GCs), the expression of these types of molecules was analyzed in human, porcine, and murine NCC specimens. To determine the GCs present in the tegument, fluorochrome-labeled hydrazides as well as fluorochrome-labeled lectins with specificity to different carbohydrates were used. All the lectins utilized labeled the tegument. GCs bound by isolectinB4 were shed in the first days of infection and not resynthesized by the parasite, whereas GCs bound by wheat germ agglutinin and concavalinA were continuously released throughout the infectious process. GCs bound by these three lectins were taken up by host cells. Peanut lectin-binding GCs, in contrast, remained on the parasite and were not detected in host cells. The parasitic origin of the lectin-binding GCs found in host cells was confirmed using antibodies against T. solium and M. corti. We propose that both the rapid and persistent release of tegumental GCs plays a key role in the well-known immunomodulatory effects of helminths, including immune evasion and life-long inflammatory sequelae seen in many NCC patients

Fluid challenges in intensive care: the FENICE study A global inception cohort study

Fluid challenges (FCs) are one of the most commonly used therapies in critically ill patients and represent the cornerstone of hemodynamic management in intensive care units. There are clear benefits and harms from fluid therapy. Limited data on the indication, type, amount and rate of an FC in critically ill patients exist in the literature. The primary aim was to evaluate how physicians conduct FCs in terms of type, volume, and rate of given fluid; the secondary aim was to evaluate variables used to trigger an FC and to compare the proportion of patients receiving further fluid administration based on the response to the FC.This was an observational study conducted in ICUs around the world. Each participating unit entered a maximum of 20 patients with one FC.2213 patients were enrolled and analyzed in the study. The median [interquartile range] amount of fluid given during an FC was 500 ml (500-1000). The median time was 24 min (40-60 min), and the median rate of FC was 1000 [500-1333] ml/h. The main indication for FC was hypotension in 1211 (59 %, CI 57-61 %). In 43 % (CI 41-45 %) of the cases no hemodynamic variable was used. Static markers of preload were used in 785 of 2213 cases (36 %, CI 34-37 %). Dynamic indices of preload responsiveness were used in 483 of 2213 cases (22 %, CI 20-24 %). No safety variable for the FC was used in 72 % (CI 70-74 %) of the cases. There was no statistically significant difference in the proportion of patients who received further fluids after the FC between those with a positive, with an uncertain or with a negatively judged response.The current practice and evaluation of FC in critically ill patients are highly variable. Prediction of fluid responsiveness is not used routinely, safety limits are rarely used, and information from previous failed FCs is not always taken into account

Pathogenic Huntingtin Repeat Expansions in Patients with Frontotemporal Dementia and Amyotrophic Lateral Sclerosis.

We examined the role of repeat expansions in the pathogenesis of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) by analyzing whole-genome sequence data from 2,442 FTD/ALS patients, 2,599 Lewy body dementia (LBD) patients, and 3,158 neurologically healthy subjects. Pathogenic expansions (range, 40-64 CAG repeats) in the huntingtin (HTT) gene were found in three (0.12%) patients diagnosed with pure FTD/ALS syndromes but were not present in the LBD or healthy cohorts. We replicated our findings in an independent collection of 3,674 FTD/ALS patients. Postmortem evaluations of two patients revealed the classical TDP-43 pathology of FTD/ALS, as well as huntingtin-positive, ubiquitin-positive aggregates in the frontal cortex. The neostriatal atrophy that pathologically defines Huntington's disease was absent in both cases. Our findings reveal an etiological relationship between HTT repeat expansions and FTD/ALS syndromes and indicate that genetic screening of FTD/ALS patients for HTT repeat expansions should be considered

Genomic epidemiology of severe acute respiratory syndrome Coronavirus 2, Colombia

Coronavirus disease (COVID-19) in Colombia was first diagnosed in a traveler arriving from Italy on February 26, 2020. However, limited data are available on the origins and number of introductions of COVID-19 into the country. We sequenced the causative agent of COVID-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), from 43 clinical samples we collected, along with another 79 genome sequences available from Colombia. We investigated the emergence and importation routes for SARS-CoV-2 into Colombia by using epidemiologic, historical air travel, and phylogenetic observations. Our study provides evidence of multiple introductions, mostly from Europe, and documents >12 lineages. Phylogenetic findings validate the lineage diversity, support multiple importation events, and demonstrate the evolutionary relationship of epidemiologically linked transmission chains. Our results reconstruct the early evolutionary history of SARS-CoV-2 in Colombia and highlight the advantages of genome sequencing to complement COVID-19 outbreak investigations

Ensino de Biossegurança na Graduação em Enfermagem: uma revisão da literatura Enseñanza de Bioseguridad en la Graduación de Enfermería: una revisión de la literatura The teaching of Biosafety in Nursing Undergraduation: a literature review

Trata-se de um estudo que realizou um levantamento da produção científica em enfermagem referente ao ensino de biossegurança com o objetivo de investigar o contexto em que se deram e conhecer o conteúdo das publicações acerca do ensino de biossegurança na graduação em enfermagem. Foram analisados artigos de periódicos encontrados na consulta às bases de dados LILACS, SciELO, MEDLINE, BDENF, DEDALUS e PERIENF, identificando 26 artigos. Os resultados encontrados proporcionaram a formação e discussão das categorias: "Bases ideológicas e teóricas", "Abordagem histórica de biossegurança", "Riscos ocupacionais e AIDS" e "Educação em biossegurança na formação". Conclui-se que o número de artigos é pequeno, principalmente artigos enfocando educação em biossegurança, mas houve uma evolução deste conteúdo nos últimos anos.<br>Se trata de un estudio que realizá un levantamiento de la produccion científica en enfermería referente o la enseñanza de bioseguridad con el objetivo de investigar el contexto en que se dieron y conocer el contenido de las publicacions acerca de la ensenonze de bioseguridad em la graduación de enfermería. Fueron analizados artículos de periódicos encontrados em la consulta de bases de datos LILACS, SciELO, MEDLINE, BDENF, DEDALUS y PERIENF, identificando 26 artículos. Los resultados encontrados proporcionaron la formacíon y discusión de las categorías: "Bases ideológicas y teóricas", "Abordaje histórica de bioseguridad", "Riesgos ocupacionales y SIDA" y "Educación en bioseguridad en la formación". Se concluye que el número de artículos es pequeno, principalmente artículos que enfocan educación en bioseguridad, pero hubo una evolución de este contenido en los últimos años.<br>It's a study that made a scientific production survey in nursing regarding to biosafety teaching aiming to investigate its context and discover the content of publishing on biosafety teaching in the nursing undergraduation. It was analyzed the journal articles found consulting LILACS, SciELO, MEDLINE, BDENF, DEDALUS and PERIENF databases, identifying 26 articles. The results found provided the creation and discussion of these categories: "Ideological and theoretical bases", "Historic approach of biosafety", "Occupational risks and AIDS" and "Biosafety education in graduation". It was concluded that the number of articles is small, mainly the ones focusing on biosafety teaching, but there was an evolution of this content in the last years