Proliferação de células do baço durante e após miíase por Dermatobia hominis

Spleen cells from mice were examined at 5, 10, 15, 20 and 25 days post-infection (dpi) with Dermatobia hominis larva and at 5, 10, 15, 30 and 60 days post-larval emergence (dple). Cell proliferation in vitro assays were carried out with RPMI-1640 medium and larval secretory product (LSP) of D. hominis at 5, 10, 15, 20 and 25 days. When each group of mice was tested against each medium, significance was only seen for 25 dpi, with increasing order: LSP-10 d, -25 d, -5 d, -20 d, -15 d and RPMI. Significant results were also observed when each medium was tested against mice at each dpi or dple. Each dple group vs. each medium produced significant results only for 10 dple, with increasing order: LSP-5 d, -20 d, -25 d, -10 d, -15 d and RPMI. Comparative tests were also carried out between groups to refine certain observations. The LSPs were also analyzed using SDS-PAGE. The results prove that myiasis caused depletion of spleen cells, particularly under the effect of the LSP-10 and -15, but the cells tended to increase up to 60 dple. This in vitro assay may represent the real systemic immune response in the relationship LSP-D. hominis-host.Células do baço de camundongos foram examinadas aos 5, 10, 20 e 25 dias pós-infecção (dpi) com Dermatobia hominis e examinadas aos 5, 10, 15, 30 e 60 dias pós-emergência da larva (dpel). As células foram cultivadas em meio RPMI-1640 contendo, ou não (controle), produtos de secreção das larvas (PSL) de D. hominis com idade de 5, 10, 15, 20 e 25 dias. Em cada grupo com cinco camundongos testados nos meios de cultura, o número de células foi significativo para 25 dpi, com crescente aumento na seguinte ordem: PSL-10 d, -25 d, -5 d, -20 d, -15 d e RPMI. Resultados significantes foram também observados nos testes entre cada meio contendo células tanto de camundongos dpi ou dpel. Em cada dpel grupo versus meio significância foi somente verificada para 10 dpel, na ordem crescente: PSL-5 d, -20 d, -25 d, -10 d, -15 d e RPMI. Testes comparativos foram também realizados entre grupos. O PSL foi analisado sob SDS-PAGE. Os resultados provam que a miíase causou depleção de células do baço, particularmente sob efeito do PSL-10 e -15, mas ocorreu normalidade do número de células aos 60 dpel. Este ensaio in vitro pode representar uma resposta imune sistêmica na relação PSL-D. hominis-hospedeiro

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Susceptibility of Lymnaea (pseudosuccinea) columella (Say, 1817) to infection by miracidia of Fasciola hepatica (Linnaeus, 1758)

With the purpose of studying the susceptibility of Lymnaea (pseudosuccinea) columella, from Minas Gerais state in Brazil, to infection by Fasciola hepatica, four samples from different regions in the state of Minas Gerais were tested in comparison with one sample from Rio de Janeiro state and another from Rio Grande do Sul state, using a sample of F. hepatica isolated from sheep in Rio Grande do Sul and maintained in rabbits in laboratory conditions. The Lymnaea were exposed to infections with six, eight and ten miracidia by molusca and studied the occurrence of infection and the deathrate. In this conditions the conclusions were: 1- the deathrate of the Lymnaea (pseudosuccinea) columella seems do not be in relation with the occurrence of infections by Fasciola hepatica; 2- the samples of L. (Pseudosuccinea) columella from Minas Gerais, Rio de Janeiro and Rio Grande do Sul had similar susceptibility to infection by F. hepatica; 3- the Minas Gerais human population and the cattle, sheep and swine herds may be considered in risk of F. hepatica infection, specially those that live in Rio Paraíba valley, by the fact that nowadays F. hepatica infection is common in Rio de Janeiro and São Paulo, Rio Paraíba valley.Com o objetivo de estudar a susceptibilidade de Lymnaea (pseudosuccinea) columella de Minas Gerais, Estado onde ainda não se registraram casos autóctones de fasciolose hepática, foram utilizadas as amostras MG 1, MG 2, MG 3 e MG 4, provenientes de diferentes regiões deste Estado, para estudo comparativo com as amostras RJ e RGS procedentes dos Estados do Rio de Janeiro e Rio Grande do Sul, áreas de focos de fasciolose. A amostra de Fasciola hepatica utilizada era procedente de ovinos abatidos no município de Camapuã, no Rio Grande do Sul, e foi mantida em coelhos. Os moluscos foram infectados com 6, 8 e 10 miracídos por molusco, sendo estudadas as incidências de infecção e de mortalidade. Nas condições que se realizou o trabalho diante dos resultados obtidos, foram tiradas as seguintes conclusões: 1. A mortalidade dos caramujos parece não estar diretamente relacionada com a percentagem de infecção; 2. As amostras de Lymnaea (pseudosuccinea) columella de Minas Gerais, do Rio de Janeiro e do Rio Grande do Sul mostraram-se identicamente susceptíveis à infecção por Fasciola hepatica; 3. A população humana e os rebanhos bovino, ovino e suíno de Minas Gerais, particularmente aqueles do Vale do Rio Paraíba, podem ser considerados sujeitos à infecção por Fasciola hepatica