¿El tratamiento de la diarrea hemorrágica debido a Shigella dysenteriae tipo 1 con ampicilina precipita al síndrome urémico hemolítico?

La diarrea asociada al síndrome urémico hemolítico (HUS), la causa más común de falla renal aguda en la infancia y la niñez, se asocia frecuentemente con la infección por organismos que producen Shiga toxina (ST) o toxina Shigalike (SLT), principalmente Escherichia coli productor verocitotoxina (VTEC O157:H7) y Shigella dysenteriae tipo 1. Aunque los antibióticos se creyeron como esenciales en el tratamiento de la shigelosis, el tratamiento de pacientes con S. dysenteriae tipo 1 con antibióticos al que el organismo es resistente ha sido considerado un factor de riesgo para HUS.Facultad de Ciencias Veterinaria

¿El tratamiento de la diarrea hemorrágica debido a Shigella dysenteriae tipo 1 con ampicilina precipita al síndrome urémico hemolítico?

La diarrea asociada al síndrome urémico hemolítico (HUS), la causa más común de falla renal aguda en la infancia y la niñez, se asocia frecuentemente con la infección por organismos que producen Shiga toxina (ST) o toxina Shigalike (SLT), principalmente Escherichia coli productor verocitotoxina (VTEC O157:H7) y Shigella dysenteriae tipo 1. Aunque los antibióticos se creyeron como esenciales en el tratamiento de la shigelosis, el tratamiento de pacientes con S. dysenteriae tipo 1 con antibióticos al que el organismo es resistente ha sido considerado un factor de riesgo para HUS.Facultad de Ciencias Veterinaria

¿El tratamiento de la diarrea hemorrágica debido a Shigella dysenteriae tipo 1 con ampicilina precipita al síndrome urémico hemolítico?

La diarrea asociada al síndrome urémico hemolítico (HUS), la causa más común de falla renal aguda en la infancia y la niñez, se asocia frecuentemente con la infección por organismos que producen Shiga toxina (ST) o toxina Shigalike (SLT), principalmente Escherichia coli productor verocitotoxina (VTEC O157:H7) y Shigella dysenteriae tipo 1. Aunque los antibióticos se creyeron como esenciales en el tratamiento de la shigelosis, el tratamiento de pacientes con S. dysenteriae tipo 1 con antibióticos al que el organismo es resistente ha sido considerado un factor de riesgo para HUS.Facultad de Ciencias Veterinaria

A comparison of four fibrosis indexes in chronic HCV: Development of new fibrosis-cirrhosis index (FCI)

<p>Abstract</p> <p>Background</p> <p>Hepatitis C can lead to liver fibrosis and cirrhosis. We compared readily available non-invasive fibrosis indexes for the fibrosis progression discrimination to find a better combination of existing non-invasive markers.</p> <p>Methods</p> <p>We studied 157 HCV infected patients who underwent liver biopsy. In order to differentiate HCV fibrosis progression, readily available AAR, APRI, FI and FIB-4 serum indexes were tested in the patients. We derived a new fibrosis-cirrhosis index (FCI) comprised of ALP, bilirubin, serum albumin and platelet count. FCI = [(ALP × Bilirubin) / (Albumin × Platelet count)].</p> <p>Results</p> <p>Already established serum indexes AAR, APRI, FI and FIB-4 were able to stage liver fibrosis with correlation coefficient indexes 0.130, 0.444, 0.578 and 0.494, respectively. Our new fibrosis cirrhosis index FCI significantly correlated with the histological fibrosis stages F0-F1, F2-F3 and F4 (r = 0.818, p < 0.05) with AUROCs 0.932 and 0.996, respectively. The sensitivity and PPV of FCI at a cutoff value < 0.130 for predicting fibrosis stage F0-F1 was 81% and 82%, respectively with AUROC 0.932. Corresponding value of FCI at a cutoff value ≥1.25 for the prediction of cirrhosis was 86% and 100%.</p> <p>Conclusions</p> <p>The fibrosis-cirrhosis index (FCI) accurately predicted fibrosis stages in HCV infected patients and seems more efficient than frequently used serum indexes.</p

Vaccine breakthrough hypoxemic COVID-19 pneumonia in patients with auto-Abs neutralizing type I IFNs

Life-threatening `breakthrough' cases of critical COVID-19 are attributed to poor or waning antibody response to the SARS- CoV-2 vaccine in individuals already at risk. Pre-existing autoantibodies (auto-Abs) neutralizing type I IFNs underlie at least 15% of critical COVID-19 pneumonia cases in unvaccinated individuals; however, their contribution to hypoxemic breakthrough cases in vaccinated people remains unknown. Here, we studied a cohort of 48 individuals ( age 20-86 years) who received 2 doses of an mRNA vaccine and developed a breakthrough infection with hypoxemic COVID-19 pneumonia 2 weeks to 4 months later. Antibody levels to the vaccine, neutralization of the virus, and auto- Abs to type I IFNs were measured in the plasma. Forty-two individuals had no known deficiency of B cell immunity and a normal antibody response to the vaccine. Among them, ten (24%) had auto-Abs neutralizing type I IFNs (aged 43-86 years). Eight of these ten patients had auto-Abs neutralizing both IFN-a2 and IFN-., while two neutralized IFN-omega only. No patient neutralized IFN-ss. Seven neutralized 10 ng/mL of type I IFNs, and three 100 pg/mL only. Seven patients neutralized SARS-CoV-2 D614G and the Delta variant (B.1.617.2) efficiently, while one patient neutralized Delta slightly less efficiently. Two of the three patients neutralizing only 100 pg/mL of type I IFNs neutralized both D61G and Delta less efficiently. Despite two mRNA vaccine inoculations and the presence of circulating antibodies capable of neutralizing SARS-CoV-2, auto-Abs neutralizing type I IFNs may underlie a significant proportion of hypoxemic COVID-19 pneumonia cases, highlighting the importance of this particularly vulnerable population