Recombinant forms of Leishmania amazonensis excreted/secreted promastigote surface antigen (PSA) induce protective immune responses in dogs

International audiencePreventive vaccination is a highly promising strategy for interrupting leishmaniasis transmission that can, additionally, contribute to elimination. A vaccine formulation based on naturally excreted secreted (ES) antigens was prepared from L. infantum promastigote culture supernatant. This vaccine achieved successful results in Phase III trials and was licensed and marketed as CaniLeish. We recently showed that newly identified ES promastigote surface antigen (PSA), from both viable promastigotes and axenically-grown amastigotes, represented the major constituent and the highly immunogenic antigen of L. infantum and L. amazonensis ES products. We report here that three immunizations with either the recombi-nant ES LaPSA-38S (rPSA) or its carboxy terminal part LaPSA-12S (Cter-rPSA), combined with QA-21 as adjuvant, confer high levels of protection in naive L. infantum-infected Beagle dogs, as checked by bone marrow parasite absence in respectively 78.8% and 80% of vaccinated dogs at 6 months post-challenge. The parasite burden in infected vaccinated dogs was significantly reduced compared to placebo group, as measured by q-PCR. Moreover, our results reveal humoral and cellular immune response clear-cut differences between vaccinated and control dogs. An early increase in specific IgG2 antibodies was observed in rPSA/QA-21-and Cter-rPSA/QA-21-immunized dogs only. They were found functionally active in vitro and were highly correlated with vaccine protection. In vaccinated protected dogs, IFN-γ and NO productions, as well as anti-leishmanial macrophage activity, were increased. These data strongly suggest that ES PSA or its carboxy-terminal part, in recom-binant forms, induce protection in a canine model of zoonotic visceral leishmaniasis by inducing a Th1-dominant immune response and an appropriate specific antibody response. These data suggest that they could be considered as important active components in vaccine candidates

Concepts of Health in Nursing Education in Undergraduate Schools of Brazil and Portugal

This article represents an extract of my PhD research regarding the concepts of health present in undergraduate schools of nursing of Brazil and Portugal. The objective of this research was to comprehend how the concepts of health are explicit in the documents of undergraduate courses and how they are expressed in the discourses of the nursing professors and students. For this, thematic content analysis was used to analyze the professional education of the nurses and the concepts of health present in the nursing courses. The presentation of the results was performed using the Collective Subject Discourse technique. The results showed that in the state of Santa Catarina in Brazil, the concepts of health follow the National Curriculum Guidelines and there is an emphasis directed towards reflection on the Brazilian National Health System (SUS); while in the city of Porto, in Portugal, these concepts follow the Study Plans of the Nursing courses and emphasize nursing care both for the healthy and the sick person. The data also reveal a concern in the construction of the concept of people-centered healthcare.Este artículo representa una parte de la investigación que realicé durante el doctorado sobre las concepciones de salud presentes en escuelas de graduación en enfermería de Brasil y Portugal. El objetivo de esta investigación fue comprender como las concepciones sobre la salud están explícitas en los documentos de los cursos de graduación y de qué forma se expresan en los discursos de los profesores y estudiantes de enfermería. Para esto, utilizamos el análisis de contenido temático sobre la educación profesional de los enfermeros y sobre las concepciones de la salud presentes en los cursos de enfermería. La presentación de los resultados fue realizada a través del Discurso del Sujeto Colectivo. Los resultados apuntaron que, en el estado de Santa Catarina, en Brasil, las concepciones de salud siguen las Directrices Curriculares Nacionales y existe un énfasis dirigido a reflexionar sobre el Sistema Único de Salud; en cuanto en la ciudad de Porto, en Portugal, esas concepciones siguen los Planos de Estudios de los cursos de Enfermería y se enfatiza el cuidado de Enfermería tanto a la persona saludable como a la enferma. Los datos revelan, también, una preocupación en la construcción del concepto de salud centrado en las personas.Este artigo representa um recorte de pesquisa de doutorado a respeito das concepções de saúde, presentes em escolas de graduação em enfermagem do Brasil e de Portugal. O objetivo foi compreender como as concepções de saúde estão explícitas nos documentos dos cursos de graduação e de que forma se expressam nos discursos dos professores e estudantes de enfermagem. Para tanto, utilizou-se análise de conteúdo temática sobre a educação profissional dos enfermeiros e sobre as concepções de saúde presentes nos cursos de enfermagem. A apresentação dos resultados foi realizada através do Discurso do Sujeito Coletivo. Os resultados apontaram que, no Estado de Santa Catarina, no Brasil, as concepções de saúde seguem as Diretrizes Curriculares Nacionais e há ênfase dirigida à reflexão sobre o Sistema Único de Saúde; enquanto na cidade do Porto, em Portugal, tais concepções seguem os Planos de Estudos dos Cursos de Enfermagem e se enfatiza o cuidado de Enfermagem tanto à pessoa saudável quanto à doente. Os dados revelam, ainda, preocupação na construção do conceito de saúde centrado na pessoa

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease