Nocardiose: visão geral e relato de 28 casos em vacas e cães

Phenotypic characteristics, antimicrobial susceptibility profile, and clinical-epidemiological features of 28 Nocardia strains isolated from 19 cases of bovine mastitis, eight cutaneous-subcutaneous lesions and one case of pneumonia in dogs were evaluated. Microbiological, biochemical, cytological and scanning electron microscopy methods were used in diagnosis. Nocardia asteroides type IV, Nocardia otitidiscaviarum,Nocardia nova (type III) and Nocardia farcinica (type V) were isolated from bovine milk, bronchial lavage and/or cutaneous-subcutaneous abscesses in dogs. Nocardial bovine mastitis was diagnosed predominantly in clinical cases, in dairy herds with poor environmental hygienic conditions between milking and inappropriate intramammary therapy. Canine nocardiosis was observed commonly in animals co-infected with distemper virus. Sulphamethoxazole-trimethoprim (92.8%), amikacin (92.8%) and ceftiofur (92.8%) were the most effective drugs in 28 isolates. Multiple drug resistance to three or more and five or more antimicrobials was observed in ten (35.7%) and three (10.7%) strains, respectively, predominantly with use of cloxaxillin, cefoperazone and ampicillin. The species (type) classification, clinical-epidemiological characteristics, diagnosis, multiple-drug resistance and public health considerations in Nocardia strains isolated from cattle and dogs in Brazil are discussed, with special reference to report of bovine mastitis by N. otitidiscaviarum by first time in Brazil and the similarity between Nocardia species isolated from human and animal origin.A caracterização fenotípica, perfil de sensibilidade aos antimicrobianos e aspectos clínico-epidemiológicos foram avaliados em 28 linhagens de Nocardia isoladas de 19 casos de mastite, oito lesões tegumentares e um caso de pneumonia em cão. Foram utilizados no diagnóstico métodos microbiológicos, bioquímicos, citológicos e microscopia eletrônica de varredura. Nocardia asteroides tipo IV, N. otitidiscaviarum,N. nova (tipo III) e N. farcinica (tipo V) foram isoladas do leite de vacas com mastite, de material de lavado transtraqueal e de lesões cutâneas de cães. Nocardiose mamária bovina foi diagnosticada predominantemente sob a forma clínica, em propriedades com precárias condições de higiene na pré e pós-ordenha, e inadequado procedimento de terapia intramamária. Nocardiose canina foi diagnosticada comumente em animais co-infectados com o vírus da cinomose. Sulfametoxazole/trimetoprim (92,8%), amicacina (92,8%) e ceftiofur (92,8%) foram os antimicrobianos mais efetivos frente às linhagens de Nocardia. Resistência múltipla a três ou mais e cinco ou mais antimicrobianos foram observadas, respectivamente, em dez (35,7%) e três (10,7%) linhagens, notadamente frente à cloxacilina, cefoperazona e ampicilina. A caracterização de espécies (tipo), aspectos clínico-epidemiológicos, diagnóstico, resistência múltipla aos antimicrobianos e reflexos em saúde pública de linhagens de Nocardia isoladas de bovinos e cães no Brasil foram discutidos. Foi destacada a similaridade entre as espécies de Nocardia isoladas de animais e do homem, e a primeira descrição no Brasil de N. otitidiscaviarum na etiologia da mastite bovina

Eroded enamel rehardening using two intraoral appliances designs in different times of salivary exposure

The aim of this study was evaluated the eroded enamel rehardening potential using upper palatal and lower buccal removable appliances in different times of salivary exposure (30 min, 1h, 2h, 12h) after a single erosive challenge event. After initial surface hardness evaluation, bovine enamel blocks were eroded in vitro (0.01 M hydrochloric acid, pH 2.3, 30 seconds), selected (n = 160) and randomly assigned to the two appliance designs and twenty volunteers. Four enamel blocks were inserted in each removable appliance. On the in situ phase, the volunteers were instructed to use the upper palatal and lower buccal appliances simultaneously for 12 nonconsecutive hours. After each predetermined period of time of salivary exposure, the enamel blocks were removed from the appliances for immediate evaluation of surface hardness, enabling percentage of surface hardness recovery calculation (%SHR). The data were analyzed using two-way ANOVA and Tukey?s test (?=5%). The results showed no difference in the degree of enamel rehardening by the upper palatal or lower buccal appliances (p >0.0001). Regarding the time of use of the appliances, it was demonstrated that 30 minutes (upper = 21.12%, lower = 19.84%) and 1 hour (upper = 35.69%, lower = 30.50%) promoted lower hardness recovery than two hours (upper = 44.65%, lower 40.80%) of salivary exposure (p<0.0001). The use of 12 hours (upper = 49.33%, lower = 49.00%), including the sleeping time of the volunteers did not increase the %SHR. The location of the appliance does not influence the re-hardening ability of saliva and the use of intraoral appliances for 2 hours seems to be appropriate for partial rehardening of the softened enamel surface

Unidade de Internamento Psiquiátrico para Jovens dos 15 aos 25 Anos: Um Estudo de Follow-up

Introduction: Adolescence and early adulthood are life stages characterized by significant physical, psychological, and social transformations. The transitional age, between 15 and 25 years old, is considered a high-risk period for the development of psychopathology, representing a critical period of opportunities and challenges for mental health intervention. Our objective was to do 4-year follow-up study was conducted on young individuals who were hospitalized during the year 2018 in the acute psychiatric inpatient unit Unidade Partilhada, dedicated to individuals aged 15 to 25 years old. The aim was to assess the sociodemographic and clinical characteristics of the sample, inpatient characteristics, rehospitalization rate, psychopathological status, quality of life, satisfaction with the provided care, and maintenance of follow-up appointments; establishing relationships between the mentioned variables. Methods: Standardized telephone interviews were conducted using the reduced version of the Mental Health Inventory (MHI) and the World Health Organization’s Abbreviated Instrument for Quality of Life Assessment. Clinical records were also consulted. Results: There was a higher percentage of female patients (52.1%). The discharge diagnosis of mood disorders (54.3%) was significantly higher in females, while psychotic disorders (23.4%) were significantly higher in males (Fisher = 40; p&lt;0.001). The duration of hospitalization (average=16.1 days; SD=13.6 days) was significantly longer for psychotic disorders compared to mood disorders (p=0.009). A percentage of 41.5% of young individuals were readmitted, with 6.3% readmitted within 30 days and 35.2% readmitted within 365 days. At the time of the follow-up interview, 80.9% considered themselves “better,” and 62.7% reported being “satisfied” or “very satisfied” with their lives. A percentage of 74.5% continued to receive outpatient care, with significantly lower MHI scores observed among individuals without current follow‐up. A percentage of 37.2% reported being “very satisfied” or “extremely satisfied” with the care provided. Conclusion: Obtaining knowledge and data that allow for the characterization of psychiatric hospitalization during the transitional age is fundamental for the planning, organization, and optimization of care provided to this population. Valuing patient opinions and fostering closer relationships between healthcare professionals and young patients promotes treatment adherence.Introdução: A adolescência e início da idade adulta, são fases do ciclo de vida marcadas por grandes transformações físicas, psicológicas e sociais. A faixa etária de transição, entre os15 e 25 anos, é considerada uma idade de risco para o desenvolvimento de psicopatologia, representando um período crítico de oportunidades e desafios para a intervenção em saúde mental. O nosso objetivo foi realizar um estudo de follow-up a 4 anos dos jovens internados durante o ano de 2018 na unidade de internamento agudo psiquiátrico Unidade Partilhada, destinado a jovens dos 15 aos 25anos de idade; pretendeu‐se avaliar as características sociodemográficas e clínicas da amostra, as características do internamento, a taxa de reinternamento, o estado psicopatológico, qualidade de vida, grau de satisfação com os cuidados prestados e manutenção do seguimento em consulta; estabelecendo relações entre as variáveis mencionadasMétodos: Entrevista telefónica padronizada, com aplicação da versão reduzida do Mental Health Inventory (MHI) e o Instrumento Abreviado de Avaliação da Qualidade de Vida da Organização Mundial de Saúde; consulta de processo clínico.Resultados: Há uma maior percentagem de doentes do sexo feminino (52,1%). O diagnóstico de alta de perturbaçãodo humor (54,3%) foi significativamente superior no sexo feminino e o de perturbação psicótica (23,4%) foi significativamente superior no sexo masculino (Fisher= 40; p&lt;0,001). A duração do internamento (média=16,1 dias; DP=13,6 dias) foi significativamente superior para as perturbações psicóticas em comparação com as perturbações do humor (p=0,009). Dos jovens, 41,5% foram readmitidos, 6,3% num período inferior a 30 dias e 35,2% num período inferior a 365 dias. À data da entrevista de follow-up, 80,9% consideram estar “melhor”; e 62,7% estar “satisfeitos”ou “muito satisfeitos” com a sua vida. Mantêm acompanhamento em consulta 74,5%, sendo a pontuação do MHI significativamente inferior nos jovens sem seguimento atual. Referem estar “muito satisfeitos” ou “mais que muito” com o atendimento prestado, 37,2%.Conclusão: O conhecimento e obtenção de dados que permitam a caracterização do internamento psiquiátrico em idade de transição é fundamental para a planificação, organização e otimização dos cuidados prestados a esta população. A valorização da opinião do doente e a aproximação entre profissionais de saúde e doentes jovens, favorece a adesão ao tratamento

Protective effect of antigen delivery using monoolein-based liposomes in experimental hematogenously disseminated candidiasis

We evaluated the potential of a liposomal antigen delivery system (ADS) containing Candida albicans cell wall surface proteins (CWSP) in mediating protection against systemic candidiasis. Treatment of bonemarrow- derived dendritic cells with CWSP-loaded dioctadecyldimethylammonium bromide:monoolein (DODAB:MO) liposomes enhanced and prolonged their activation comparatively to free antigen, indicating that liposome-entrapped CWSP were released more sustainable. Therefore, we immunized mice with CWSP either in a free form or loaded into two different DODAB:MO liposome formulations, respectively designated as ADS1 and ADS2, prior to intravenous C. albicans infection. Immunization with ADS1, but not with ADS2, conferred significant protection to infected mice, comparatively to immunization with CWSP or empty liposomes as control. ADS1-immunized mice presented significantly higher serum levels of C. albicans-specific antibodies that enhanced phagocytosis of this fungus. In these mice, a mixed cytokine production profile was observed encompassing IFN-c, IL-4, IL-17A and IL-10. Nevertheless, only production of IL-4, IL-17 and IL-10 was higher than in controls. In this study we demonstrated that DODAB:MO liposomes enhance the immunogenicity of C. albicans antigens and host protection in a murine model of systemic candidiasis. Therefore, this liposomal adjuvant could be a promising candidate to assess in vaccination against this pathogenic fungus.This work was supported by the strategic programme UID/BIA/04050/2013 (POCI-01-0145-FEDER-007569) funded by national funds through the FCT I.P. and by the ERDF through the COMPETE2020 – Programa Operacional Competitividade e Internacionalização (POCI). Catarina Carneiro holds scholarship SFRH/BD/69068/2010. We acknowledge NanoDelivery-I&D em Bionanotecnologia, Lda for access to their equipment

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio