Risk of solid organ transplant rejection following vaccination with seasonal trivalent inactivated influenza vaccines in England: A self-controlled case-series

AbstractBackgroundAnnual seasonal influenza vaccination is recommended for transplant recipients. No formal pharmacoepidemiology study has been published on the association between solid organ transplant (SOT) rejection and vaccination with seasonal trivalent inactivated influenza vaccines (TIIVs).MethodsThe risk of SOT (liver, kidney, lung, heart or pancreas) rejection after TIIV vaccination was assessed using a self-controlled case-series method (NCT01715792). SOT recipients in England with transplant rejection were selected from the Clinical Practice Research Datalink and linked Hospital Episode Statistics inpatient data. The study period (September 2006 to August 2009) encompassed three consecutive influenza seasons. We calculated the relative incidence (RI) of SOT rejection between the 30- and 60-day post-vaccination risk periods and the control periods (any follow-up period excluding risk periods), using a Poisson regression model.ResultsIn seasons 2006/07, 2007/08, 2008/09 and pooled seasons, 132, 136, 168 and 375 subjects, respectively, experienced at least one transplant rejection; approximately half (45%–51%) of these subjects had received a TIIV. For season 2006/07, the RI of rejection of any organ, adjusted for time since transplantation, was 0.74 (95% CI: 0.24–2.28) and 0.58 (95% CI: 0.24–1.38) during the 30-day and 60-day risk periods, respectively. Corresponding RIs for season 2007/08 were 1.21 (95% CI: 0.55–2.64) and 1.31 (95% CI: 0.69–2.48); for season 2008/09, 0.99 (95% CI: 0.43–2.28) and 0.64 (95% CI: 0.31–1.33); and for pooled seasons 1.01 (95% CI: 0.58–1.76) and 0.88 (95% CI: 0.56–1.38). The results of a separate analysis of kidney rejections and analyses that took into account additional potential confounders were consistent with those of the main analyses, with 95% CIs including 1 and upper limits below 3.ConclusionThis study provides reassuring evidence of the safety profile of TIIVs in SOT recipients, thus supporting current recommendations to vaccinate this risk group annually

Diferentes condimentos vegetais: avaliação sensorial e de atividade antibacteriana em preparação alimentar com frango cozido Different spice plants: sensorial evaluation and antibacterial activity in chicken broth

A partir da atividade antibacteriana in vitro, predeterminada em doze plantas com indicativo etnográfico condimentar, testou-se este atributo in loco no modelo caldo com frango cozido. Primeiramente, procedeu-se ao treinamento de 10 avaliadores, segundo a legislação vigente quanto ao Consentimento Livre e Esclarecido, oportunizando conhecimentos prévios sobre as plantas salsa (Petroselinum sativum), manjerona branca (Origanum X aplii), manjerona preta (Origanum majorana), manjericão (Ocimum basilicum), sálvia (Salvia officinalis), tomilho (Thymus vulgaris), anis verde (Ocimum selloi), alfavaca (Ocimum gratissimum), alho nirá (Allium tuberosum), alho poró (Allium porrum), cúrcuma (Curcuma longa) e pimenta dedo-de-moça (Capsicum baccatum). Realizou-se, através da adição individualizada desses condimentos ao caldo com frango cozido, um Teste de Aceitação tipo escala hedônica, selecionando, dentre os doze condimentos, quatro deles que se destacaram sensorialmente, a pimenta dedo-de-moça, o alho nirá, o alho poró e o tomilho. Foi feito, então, um Teste de Aceitação de concentrações denominadas pequena, média e grande destes quatro condimentos, para determinação da intensidade sensorialmente melhor aceita. As quantidades eleitas (0,5 g de pimenta dedo-de-moça, 15 g de alho nirá, 15 g de alho poró e 5 g de tomilho) foram acrescidas ao caldo com frango cozido, sendo estes desafiados frente a Escherichia coli (ATCC 11229) em concentração final de 10 UFC mL-1, limite tolerado pela legislação, tendo como grupo-controle o caldo com frango cozido sem condimentos. O crescimento bacteriano foi aferido a cada duas horas após a inoculação, até completar 24 horas de confronto, utilizando-se meio seletivo para coliformes termo-resistentes e incubação constante a 25ºC em DBO, sendo atribuídos valores arbitrários às variações logarítmicas de crescimento. Comparados ao controle, todos os tratamentos condimentados apresentaram, individualmente, atividade antibacteriana significativa, mesmo que sem significância quando comparados entre si. Contudo, em relação ao tempo de início da atividade antibacteriana, destacou-se a pimenta dedo-de-moça, enquanto que, em relação ao prolongamento dessa ação no tempo, destacou-se o alho nirá. As 12 plantas condimentares em estudo tiveram atestada a sensorialidade, sendo que as quatro plantas com destaque tiveram a atividade anti-coliforme termo-resistente comprovada in loco. Diferentes condimentos vegetais foram capazes de fornecer qualificação sensorial e sanitária em caldo com frango cozido, em condições domésticas de manuseio.<br>Based on the in vitro antibacterial activity predetermined for 12 spice plants with ethnographic indicator, this feature was tested in loco in the model cooked chicken broth. First, ten evaluators were trained, according to the current legislation for Free and Informed Consent, providing previous knowledge about the plants parsley (Petroselinum sativum), marjoram (Origanum X aplii and Origanum majorana), basil (Ocimum basilicum), common sage (Salvia officinalis), thyme (Thymus vulgaris), anis-like spice (Ocimum selloi), african basilicum (Ocimum gratissimum), nirá garlic (Allium tuberosum), leek (Allium porrum), turmeric (Curcuma longa) and "dedo-de-moça" chili (Capsicum baccatum). Those spices were individually added to the chicken broth to perform a Hedonic Scale-like Acceptance Test, selecting four of the twelve spices that had higher sensory acceptance, "dedo-de-moça" chili, nirá garlic, leek and thyme. A new Acceptance Test was then performed using low, medium and high concentrations of those four spices to establish the most acceptable sensory intensities. The elected quantities (0.5 g "dedo-de-moça" chili, 15 g nirá garlic, 15 g leek and 5 g thyme) were added to the chicken broth, then challenged with Escherichia coli (ATCC 11229) at a final 10 concentration of CFU/mL, the tolerated limit according to legislation. The control group was chicken broth without spices. The bacterial growth was measured at every two hours after the inoculation until 24 hours of confront were completed, using a selective medium for thermo-resistant coliforms, under constant incubation at 25ºC in DBO. Arbitrary values were assigned to the logarithmic growth variations. Compared to the control group, all the spiced treatments individually presented significant antibacterial activity, although the latter was not significant when treatments were compared with each other. However, as regards the antibacterial activity starting time, "dedo-de-moça" chili had the best results, whereas nirá garlic had the best results as regard the extension of this activity time. The 12 studied spice plants had their sensorial characteristics attested, and the four plants that had the best results had proved in loco anti-thermo-resistant coliform activity. Different spice plants were capable of providing sensory and sanitary qualification in chicken broth, under domestic conditions of manipulation

Sinais clínicos, distribuição das lesões no sistema nervoso e epidemiologia da raiva em herbívoros na região Nordeste do Brasil Clinical signs, distribution of the lesions in the central nervous system and epidemiology of rabies in northeastern Brazil

Descrevem-se 24 surtos de raiva em bovinos (25 casos), 4 em eqüinos (5 casos), 2 em caprinos (2 casos) e 2 em ovinos (4 casos). Todos os surtos ocorreram na Paraíba, exceto um em eqüinos que ocorreu no Rio Grande do Norte. Todos os surtos, com a exceção de um em ovinos, foram transmitidos provavelmente por morcegos hematófagos; no entanto, não se descarta a possibilidade de transmissão por raposas (Dusicyon vetulus). Os sinais clínicos foram representativos da localização das lesões no sistema nervoso central (SNC). Em bovinos os sinais eram, principalmente, da forma paralítica, causados por lesões da medula, tronco encefálico e cerebelo; mas alguns animais apresentaram depressão, excitação e outros sinais associados a lesões cerebrais. Três dos 5 eqüinos apresentaram sinais de lesões cerebrais e 2 apresentaram a forma paralítica. De 4 ovinos e 2 caprinos, 4 apresentaram a forma paralítica, mas em um caprino e um ovino os sinais foram predominantemente de lesões cerebrais. Todos os animais afetados, exceto um caprino, tiveram um curso clínico de 2-8 dias. As únicas lesões macros-cópicas observadas foram a dilatação da bexiga em 4 bovinos e a dilatação da ampola retal em 2. Dois cavalos apresentaram lesões da pele causadas por traumatismos. As lesões histológicas foram de encefalomielite e meningite difusa não supurativa. Nos eqüinos e em um caprino com evolução clínica de 35 dias as lesões foram mais severas, observando-se necrose neuronal, neuronofagia e presença de esferóides axonais. Corpúsculos de Negri foram observados em 87% (20/23) dos bovinos examinados e em 83% (5/6) dos ovinos e caprinos. Nessas 3 espécies os corpúsculos foram mais freqüentes no cerebelo, mas ocorreram também no tronco encefálico, medula e cérebro. Em cavalos, corpúsculos de Negri foram menos numerosos, sendo observados somente no córtex de um animal e no córtex e hipocampo em outro. No gânglio trigeminal, as lesões histológicas e os corpúsculos de Negri foram menos freqüentes que no SNC. Esses resultados mostram que na raiva dos herbívoros os sinais clínicos e a distribuição das lesões histológicas do SNC são variáveis, e que para o correto diagnóstico da enfermidade são necessários um bom exame clínico e o estudo histológico das diferentes regiões do SNC. Sugere-se, também, que perante resultados negativos nos testes de imunofluo-rescência e inoculação em camundongos, estes devam ser repetidos com amostras de diferentes regiões do SNC. Utilizando-se dados sobre a freqüência de doenças, de 4 laboratórios de diagnóstico, foi realizada uma estimativa das mortes de bovinos causadas pela raiva, anualmente, em 3 Estados. Na Paraíba, com uma população de 918.262 bovinos, o número de mortes é estimado em 8.609 cabeças por ano. No Mato Grosso do Sul, com uma população de 23 milhões de bovinos, as perdas por raiva são estimadas em 149.500 cabeças e, no Rio Grande do Sul, com uma população de 13 milhões de bovinos, as mortes são estimadas em 13.000 a 16.250 animais por ano. Se estas estimativas forem extrapoladas para todo o Brasil, com 195 milhões de bovinos, as mortes podem ser estimadas em 842.688 cabeças por ano.<br>Twenty four outbreaks of rabies in cattle, 4 in horses, 2 in sheep, and 2 in goats are reported in northeastern Brazil. All outbreaks occurred in the state of Paraíba, except one in horses that occurred in the state of Rio Grande do Norte. All outbreaks, except one in sheep, were probably transmitted by vampire-bats, but the transmission by foxes (Dusicyon vetulus) is also possible. Clinical signs were characteristic for distribution of the lesions in the central nervous system (CNS). In cattle, signs were mainly of the paralytic form of rabies, caused by lesions on the spinal cord, brain stem and cerebellum; but some animals showed also depression, excitation and other signs due to cerebral lesions. In 3 out of 5 horses, the main clinical signs were due to lesions in the cerebrum, and 2 had the paralytic form. From 4 sheep and 2 goats affected, 4 showed clinical signs of the paralytic form; but in 1 goat and 1 sheep the main clinical signs were caused by cerebral lesions. All affected animals, except 1 goat, had a clinical manifestation period of 2-8 days. The only gross lesions were distention of the urinary bladder in 4 cattle and distention of the rectum in 2 others. Two horses had skin lesions due to traumatic injury. Histologic lesions were diffuse non-suppurative encephalomyelitis and meningitis. In the horses, and in one goat with a clinical manifestation period of 35 days, the lesions were more severe, with neuronal necrosis, neuronophagia, and presence of axonal spheroids. Negri bodies were found in 87% (20/23) of the cattle cases examined histologically. In small ruminants Negri bodies were found in 83% (5/6) of the cases. In sheep, goats and cattle, Negri bodies were more frequent in the cerebellum, but they were found also in brain stem, spinal cord and cerebrum. In horses, Negri bodies were found in small amounts only in the cortex of one animal, and in the cortex and hippocampus of another. Histologic lesions and Negri bodies in the trigeminal ganglia were less frequent than in the CNS. These results show that in rabies of herbivores, clinical signs and distribution of lesions in the CNS are variable, so that for the diagnosis and adequate clinical evaluation and the histologic study of different areas of the CNS are necessary. This also suggests that when the fluorescent antibody test and mouse inoculation test are negative, they should be repeated with samples from different areas of the brain and spinal cord. Frequency data of diseases from 4 diagnostic laboratories were used to estimate cattle deaths due to rabies in 3 Brazilian states. In Paraíba, with a population of 918,262 cattle, the annual death rate is estimated in 8,609 heads. In Mato Grosso do Sul, with a population of 23 millions cattle, deaths caused by rabies are estimated in 149,500 heads, and in Rio Grande do Sul, with a cattle population of 13 millions, cattle deaths due to rabies are estimated in 13,000 to 16,250 heads. If these data are used to estimate cattle losses in Brazil, with a cattle population of 195 millions, it can be estimated that 842,688 deaths are caused annually by rabies

Quintais urbanos de Mirassol D'Oeste-MT, Brasil: uma abordagem etnobotânica Urban homegardens of Mirassol D'Oeste-MT, Brazil: an ethnobotany stady

Quintais são espaços de fácil acesso e cômodos para os moradores cultivarem uma diversidade de espécies que desempenham funções de estética, lazer, alimentação e medicinal, dentre outras. O objetivo deste trabalho foi o de descrever a composição florística e a respectiva utilização em quintais urbanos de Mirassol D'Oeste, MT, (15º 45'30"S e 058º16'36"W), com a coleta de dados envolvendo: entrevistas estruturadas e semi-estruturadas aplicadas a 29 moradores; coleta simultânea do material botânico das espécies indicadas, incorporação destas no Laboratório de Botânica da UNEMAT, Cáceres e análise da freqüência absoluta e relativa das espécies mais citadas e encontradas nos quintais. Foram registradas 397 denominações locais de plantas (etnoespécies), 275 taxa reunidos em 79 famílias destacando-se com maior número de espécies: Solanaceae (23), Asteraceae (17), Lamiaceae (14), Rosaceae (12) e Verbenaceae (9). Os atributos alimentar e ornamental representam, individualmente, 35% das espécies e o medicinal, 29%. Algumas plantas detêm até quatro potencialidades. Do universo vegetal conhecido e utilizado localmente as espécies nativas correspondem a 8%, resultado considerado baixo comparando-se aos obtidos em populações mato-grossenses radicadas no Cerrado e Pantanal. Essa população manifesta por meio de suas práticas uma tradição agrícola em interface às características de uma sociedade urbano - industrial coabitando em espaços comuns, o quintal.<br>A home garden is a small track of ground next to or surrounding a house where its residents can cultivate a diversity of plants, whose function is aesthetic, leisure, food, medicinal among others. The aim of this work was to study the floristic composition of urban homegardens in the city of Mirassol D'Oeste, state of Mato Grosso, coordinate 15º45'30"S and 58º16'36"W. For colleting data we interviewed 29 residents using structured and semi-structured interviews; and, simultaneously collected botanical species which we analysed at the Mato Grosso State University Botanical Laboratory, in Cáceres. We made statistical analyses using absolute frequency and relative frequency to quantify and specify the botanical species found in the gardens. We registered a total of 397 ethnobotanical species and grouped 275 taxa in 79 botanical families. The highest numbers among them were 23 species of Solanaceae, 17 Asteraceae, 14 Lamiaceae , 12 Rosaceae and 9 species of Verbenaceae. Food and ornamental attributes represented 35 % of the species and medicinal 29% . Some species had up to four potentialities. From the known plant universe used locally, native species corresponded to 8%. This percentage was considered low when compared to that of the population living in the Pantanal and cerrado areas. This population demonstrated an interface between agricultural tradition and the characteristics of urban-industrial society living in common spaces: the homegardens

NTAL is associated with treatment outcome, cell proliferation and differentiation in acute promyelocytic leukemia

Non-T cell activation linker (NTAL) is a lipid raft-membrane protein expressed by normal and leukemic cells and involved in cell signaling. In acute promyelocytic leukemia (APL), NTAL depletion from lipid rafts decreases cell viability through regulation of the Akt/PI3K pathway. The role of NTAL in APL cell processes, and its association with clinical outcome, has not, however, been established. Here, we show that reduced levels of NTAL were associated with increased all-trans retinoic acid (ATRA)-induced differentiation, generation of reactive oxygen species, and mitochondrial dysfunction. Additionally, NTAL-knockdown (NTAL-KD) in APL cell lines led to activation of Ras, inhibition of Akt/mTOR pathways, and increased expression of autophagy markers, leading to an increased apoptosis rate following arsenic trioxide treatment. Furthermore, NTAL-KD in NB4 cells decreased the tumor burden in (NOD scid gamma) NSG mice, suggesting its implication in tumor growth. A retrospective analysis of NTAL expression in a cohort of patients treated with ATRA and anthracyclines, revealed that NTAL overexpression was associated w