Coffee shops, a hub for TB clusters?

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An investigation of TB infection and reinfection among stone quarry workers

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Comparison of the frequency of bacterial and viral infections among children with community-acquired pneumonia hospitalized across distinct severity categories: a prospective cross-sectional study

Background: The comparison of the frequencies of bacterial and viral infections among children with community-acquired pneumonia (CAP) admitted in distinct severity categories, in an original study, is lacking in literature to-date. We aimed to achieve this goal.Methods: Children aged 2-59-months-old hospitalized with CAP were included in this prospective study in Salvador, Brazil. Clinical data and biological samples were collected to investigate 11 viruses and 8 bacteria. Severity was assessed by using the World Health Organization criteria.Results: One hundred eighty-one patients were classified as "non-severe" (n = 53; 29.3 %), "severe" (n = 111; 61.3 %), or "very severe" (n = 17; 9.4 %) CAP. Overall, aetiology was detected among 156 (86.2 %) cases; viral (n = 84; 46.4 %), bacterial (n = 26; 14.4 %) and viral-bacterial (n = 46; 25.4 %) infections were identified. Viral infection frequency was similar in severe/very severe and non-severe cases (46.1 % vs. 47.2 %; p = 0.9). Pneumococcal infection increased across "non-severe" (13.2 %), "severe" (23.4 %), and "very severe" (35.3 %) cases (qui-squared test for trend p = 0.04). Among patients with detected aetiology, after excluding cases with co-infection, the frequency of sole bacterial infection was different (p = 0.04) among the categories; non-severe (12.5 %), severe (29.3 %) or very severe (55.6 %). Among these patients, sole bacterial infection was independently associated with severity (OR = 4.4 [95 % CI:1.1-17. 6]; p = 0.04) in a model controlled for age (OR = 0.7 [95 % CI:0.5-1.1]; p = 0.1).Conclusions: A substantial proportion of cases in distinct severity subgroups had respiratory viral infections, which did not differ between severity categories. Bacterial infection, particularly pneumococcal infection, was more likely among severe/very severe cases

COVID-19 related acute genital ulcer: a case report

Acute vulvar ulcer (Lipschütz's ulcer) is a rare lesion with local hyperimmunoreactivity triggered by infection, which is characterized by acute, painful, and necrotic ulcerations. This condition is usually found in non-sexually active adolescents, and it resolves spontaneously. We report a case of a 35-year-old woman who was diagnosed with COVID-19 who did not have severe symptoms, but had high levels of D-dimer for 9 days. The COVID-19 diagnosis was followed by the appearance of an acute, necrotic, extremely painful vulvar ulcer, although symptoms caused by COVID-19 had improved. We emphasize the importance of the differential diagnosis to exclude diseases such as Behçet's syndrome, Sexually Transmitted Infections, as well as the presence of viruses that generally trigger Lipschütz's ulcer, such as Epstein-Barr virus and cytomegalovirus. No treatment is usually necessary, however, in the present report due to the pain experienced by the patient, we successfully used oral prednisone.info:eu-repo/semantics/publishedVersio

The importance of serological assays in diagnosing acute pulmonary histoplasmosis

Histoplasmosis is a systemic mycosis caused by inhalation of Histoplasma capsulatum microconidia. The disease does not normally affect immunocompetent individuals after a single, transient inhalation exposure. However, longer exposure may cause chronic or disseminated acute pulmonary infection. Herein, we report the case of a 24-year-old immunocompetent patient, who presented fever, cough and dyspnea for one month. The chest radiography revealed interstitial infiltrate and diffuse micronodules. The patient reported having had close and prolonged contact with bats. Diagnosis was confirmed by positive double immunodifusion and immunoblotting assays. She was treated with ketoconazole (400 mg) and there was complete resolution of the disease

Transmission potential, skin inflammatory response, and parasitism of symptomatic and asymptomatic dogs with visceral leishmaniasis

<p>Abstract</p> <p>Background</p> <p>Visceral leishmaniasis in Brazil is caused by the protozoan <it>Leishmania (Leishmania) chagasi </it>and it is transmitted by sandfly of the genus <it>Lutzomyia</it>. Dogs are an important domestic reservoir, and control of the transmission of visceral leishmaniasis (VL) to humans includes the elimination of infected dogs. However, though dogs are considered to be an important element in the transmission cycle of <it>Leishmania</it>, the identification of infected dogs representing an immediate risk for transmission has not been properly evaluated. Since it is not possible to treat infected dogs, they are sacrificed when a diagnosis of VL is established, a measure that is difficult to accomplish in highly endemic areas. In such areas, parameters that allow for easy identification of reservoirs that represents an immediate risk for transmission is of great importance for the control of VL transmission. In this study we aimed to identify clinical parameters, reinforced by pathological parameters that characterize dogs with potential to transmit the parasite to the vector.</p> <p>Results</p> <p>The major clinical manifestations of visceral leishmaniasis in dogs from an endemic area were onicogriphosis, skin lesions, conjunctivitis, lymphadenopathy, and weight loss. The transmission potential of these dogs was assessed by xenodiagnosis using <it>Lutzomyia longipalpis</it>. Six of nine symptomatic dogs were infective to <it>Lutzomyia longipalpis </it>while none of the five asymptomatic dogs were infective to the sandfly. <it>Leishmania </it>amastigotes were present in the skin of all clinically symptomatic dogs, but absent in asymptomatic dogs. Higher parasite loads were observed in the ear and ungueal region, and lower in abdomen. The inflammatory infiltrate was more intense in the ears and ungueal regions of both symptomatic and asymptomatic dogs. In clinically affected dogs in which few or none <it>Leishmania </it>amastigotes were observed, the inflammatory infiltrate was constituted mainly of lymphocytes and macrophages. When many parasites were present, the infiltrate was also comprised of lymphocytes and macrophages, as well as a larger quantity of polymorphonuclear neutrophils (PMNs).</p> <p>Conclusion</p> <p>Dogs that represent an immediate risk for transmission of <it>Leishmania </it>in endemic areas present clinical manifestations that include onicogriphosis, skin lesions, conjunctivitis, lymphadenopathy, and weight loss. Lymphadenopathy in particular was a positive clinical hallmark since it was closely related to the positive xenodiagnosis.</p

How many crowdsourced workers should a requester hire?

Recent years have seen an increased interest in crowdsourcing as a way of obtaining information from a potentially large group of workers at a reduced cost. The crowdsourcing process, as we consider in this paper, is as follows: a requester hires a number of workers to work on a set of similar tasks. After completing the tasks, each worker reports back outputs. The requester then aggregates the reported outputs to obtain aggregate outputs. A crucial question that arises during this process is: how many crowd workers should a requester hire? In this paper, we investigate from an empirical perspective the optimal number of workers a requester should hire when crowdsourcing tasks, with a particular focus on the crowdsourcing platform Amazon Mechanical Turk. Specifically, we report the results of three studies involving different tasks and payment schemes. We find that both the expected error in the aggregate outputs as well as the risk of a poor combination of workers decrease as the number of workers increases. Surprisingly, we find that the optimal number of workers a requester should hire for each task is around 10 to 11, no matter the underlying task and payment scheme. To derive such a result, we employ a principled analysis based on bootstrapping and segmented linear regression. Besides the above result, we also find that overall top-performing workers are more consistent across multiple tasks than other workers. Our results thus contribute to a better understanding of, and provide new insights into, how to design more effective crowdsourcing processes

A study on the immunological basis of the dissociation between type I-hypersensitivity skin reactions to Blomia tropicalis antigens and serum anti-B. tropicalis IgE antibodies

<p>Abstract</p> <p>Background</p> <p>Two conditions are used as markers of atopy: the presence of circulating anti-allergen IgE antibodies and the presence of positive skin prick test (SPT) reactions to allergenic extracts. The correlation between these conditions is not absolute. This study aimed at investigating immunological parameters that may mediate this lack of correlation. Individuals whose sera contained anti-<it>B. tropicalis </it>extract IgE antibodies (α<it>-Bt</it>E IgE) were divided into two groups, according to the presence or absence of skin reactivity to <it>B. tropicalis </it>extract (<it>Bt</it>E). The following parameters were investigated: total IgE levels; α<it>-Bt</it>E IgE levels; an arbitrary α<it>-Bt</it>E IgE/total IgE ratio; the proportion of carbohydrate-reactive α<it>-Bt</it>E IgE; the proportion of α<it>-Bt</it>E IgE that reacted with <it>Ascaris lumbricoides </it>extract (<it>Al</it>E); the production of IL-10 by <it>Bt</it>E- and <it>Al</it>E-stimulated peripheral blood cells (PBMC).</p> <p>Results</p> <p>Total IgE levels were similar in the two groups, but α<it>-Bt</it>E IgE was significantly higher in the SPT-positive group (SPT<b>+</b>). A large overlap of α<it>-Bt</it>E IgE levels was found in individuals of both groups, indicating that these levels alone cannot account for the differences in SPT outcome. Individuals of the two groups did not differ, statistically, in the proportion of α-<it>Bt</it>E IgE that reacted with carbohydrate and in the production of IL-10 by <it>Bt</it>E- and <it>Al</it>E-stimulated PBMC. Both groups had part of α-<it>Bt</it>E IgE activity absorbed out by <it>Al</it>E, indicating the existence of cross-reactive IgE antibodies. However, the α-<it>Bt</it>E IgE from the SPT-negative individuals (SPT-) was more absorbed with <it>AlE </it>than the α-<it>Bt</it>E IgE from the SPT+ individuals. This finding may be ascribed to avidity differences of the α-<it>Bt</it>E IgE that is present in the two groups of individuals, and could occur if at least part of the α-<it>Bt</it>E IgE from the SPT- individuals were elicited by <it>A. lumbricoides </it>infection.</p> <p>Conclusion</p> <p>The present results suggest that a low ratio of specific IgE to total IgE levels (in a minority of individuals), and differences in α-<it>Bt</it>E IgE avidities (which would have high affinities for <it>A. lumbricoides </it>antigens in SPT- than in SPT<b>+ </b>individuals) may play a role in the down-modulation of type-I hypersensitivity reaction against aeroallergens described in helminth-infected individuals.</p