Draft Genome Sequence of a Community-Associated Methicillin- Resistant Panton-Valentine Leukocidin-Positive Staphylococcus aureus Sequence Type 30 Isolate from a Pediatric Patient with a Lung Infection in Brazil

The sequence of methicillin-resistant Staphylococcus aureus strain B6 (sequence type 30 [ST30], spa type t433, staphylococcal chromosomal cassette mec element [SCCmec] type IVc, Panton-Valentine leukocidin [PVL] positive), isolated from a pediatric patient with a lung infection in Niterói, Rio de Janeiro, Brazil, is described here. The draft genome sequence includes a 2.8-Mb chromosome, accompanied by a 20-kb plasmid containing blaZ and two small cryptic plasmids

Physical training improves cardiopulmonary functional capacity and increases cytokine IL-10 levels in individuals with Chagas disease

Purpose: To evaluate cardiopulmonary functional capacity and the production of cytokines in patients with and without Chagas disease, and with and without hypertension, after short and long-term exercise.Methods: In a case-controlled study, 56 participants who attended the Chagas Disease Laboratory at the State University of Maringa (LDC/UEM) and Basic Health Units (UBS) in Maringa that agreed to participate. The participants were divided into the following groups: 16 with Chagas disease (CHD group), 21 with systemic arterial hypertension (SAH group) and 19 normal individuals without these morbidities (NI group). Each participant performed the 6-min walk test (6MWT), and a 12-week physical training program. Pro-inflammatory and anti-inflammatory cytokines were measured before and after physical training.Results: The CHD group presented good performance in the 6MWT, with no significant differences in distance traveled or perceived exertion (p > 0.05) compared with the NI group. After physical training, the 6MWT results were significantly better, with significant decreases in systolic and diastolic blood pressure, in the SAH group (p = 0.0409; and p = 0.0377, respectively) and NI group (p = 0.0180; and p = 0.0431, respectively) and a significant increase in the levels of the anti-inflammatory cytokine interleukin-10 (IL-10; p < 0.05) in all three groups. The NI group exhibited a significant increase (p < 0.05) in the serum levels of the pro-inflammatory cytokines IL-6, IL-17 and tumor necrosis factor (all p< 0.05).Conclusion: All of the participants presented improvements in cardiopulmonary functional capacity and good prognosis, indicating the protective effect of IL-10 production and the benefits of physical training.Keywords: Chagas disease, Six-minute walk test, Physical training, Cytokines, Cardiopulmonary function capacity, Hypertensio

Retrospective analysis of risk factors and gaps in prevention strategies for mother-to-child HIV transmission in Rio de Janeiro, Brazil

Background Despite great progress made in methods to prevent mother-to-child transmission of HIV (MTCT), delivery and uptake of these measures remains a challenge in many countries. Although the Brazilian Ministry of Health aimed to eliminate MTCT by 2015, infection still occured in 15–24% of infants born to HIV-infected mothers. We sought to identify remaining factors that constrain MTCT elimination. Methods We conducted a retrospective, matched case-control study by reviewing hospital charts of infants born to HIV-infected mothers between 1997 and 2014 at three MTCT reference hospitals in the Rio de Janeiro metropolitan area. Cases were defined as HIV-exposed children with two positive HIV tests before 18 months of age; controls were defined as HIV-exposed children with two negative HIV tests before 18 months of age. We performed bivariate and MTCT cascade analyses to identify risk factors for MTCT and gaps in prevention services. Results We included 435 infants and their mothers (145 cases, 290 controls). Bivariate analyses of MTCT preventative care (PMTCT) indicated that cases were less likely to complete all individual measures in the antenatal, delivery, and postnatal period (p < 0.05). Assessing completion of the PMTCT cascade, the sequential steps of PMTCT interventions, we found inadequate retention in care among both cases and controls, and cases were significantly less likely than controls to continue receiving care throughout the cascade (p < 0.05). Motives for incompletion of PMTCT measures included infrastructural issues, such as HIV test results not being returned, but were most often due to lack of care-seeking. Over the course of the study period, PMTCT completion improved, although it remained below the 95% target for antenatal care, HIV testing, and antenatal ART set by the WHO. Adding concern, evaluation of co-infections indicated that case infants were also more likely to have congenital syphilis (OR: 4.29; 95% CI: 1.66 to 11.11). Conclusions While PMTCT coverage has improved over the years, completion of services remains insufficient. Along with interventions to promote care-seeking behaviour, increased infrastructural support for PMTCT services is needed to meet the HIV MTCT elimination goal in Brazil as well as address rising national rates of congenital syphilis

Patient-physician discordance in assessment of adherence to inhaled controller medication: a cross-sectional analysis of two cohorts

We aimed to compare patient's and physician's ratings of inhaled medication adherence and to identify predictors of patient-physician discordance.(SFRH/BPD/115169/2016) funded by Fundação para a Ciência e Tecnologia (FCT); ERDF (European Regional Development Fund) through the operations: POCI-01-0145-FEDER-029130 ('mINSPIRERS—mHealth to measure and improve adherence to medication in chronic obstructive respiratory diseases—generalisation and evaluation of gamification, peer support and advanced image processing technologies') cofunded by the COMPETE2020 (Programa Operacional Competitividade e Internacionalização), Portugal 2020 and by Portuguese Funds through FCT (Fundação para a Ciência e a Tecnologia).info:eu-repo/semantics/publishedVersio

Discovery of Markers of Exposure Specific to Bites of Lutzomyia longipalpis, the Vector of Leishmania infantum chagasi in Latin America

Leishmania parasites are transmitted by the bite of an infected vector sand fly that injects salivary molecules into the host skin during feeding. Certain salivary molecules can produce antibodies and can be used as an indicator of exposure to a vector sand fly and potentially the disease it transmits. Here we identified potential markers of specific exposure to the sand fly Lutzomyia longipalpis, the vector of visceral leishmaniasis in Latin America. Initially, we determined which of the salivary proteins produce antibodies in humans, dogs, and foxes from areas endemic for the disease. To identify potential specific markers of vector exposure, we produced nine different recombinant salivary proteins from Lu. longipalpis and tested for their recognition by individuals exposed to another human-biting sand fly, Lu. intermedia, that transmits cutaneous leishmaniasis and commonly occurs in the same endemic areas as Lu. longipalpis. Two of the nine salivary proteins were recognized only by humans exposed to Lu. longipalpis, suggesting they are immunogenic proteins and may be useful in epidemiological studies. The identification of specific salivary proteins as potential markers of exposure to vector sand flies will increase our understanding of vector–human interaction, bring new insights to vector control, and in some instances act as an indicator for risk of acquiring disease

Revista Brasileira de Parasitologia Veterinária Presence of antibodies against Toxoplasma gondii, Neospora caninum and Leishmania infantum in dogs from Piauí Presença de anticorpos anti-Toxoplasma gondii, Neospora caninum e Leishmania infantum em cães do

Abstract This study aimed to evaluate the presence of antibodies against Neospora caninum, Toxoplasma gondii and Leishmania infantum in dogs attended at the Veterinary Hospital of the Federal University of Piauí, Northeastern Brazil, where there are no reports of the occurrence of N. caninum and T. gondii in dogs. Serum samples from 530 dogs of genders, different ages and breeds from the municipality of Teresina and nearby towns were analyzed using three indirect fluorescent antibody tests, each one targeting one of the three agents. The associations between the parasites and gender, breed and age of the dogs were assessed by the chi-square test (p &gt; 0.05). The occurrence of antibodies to N. caninum, T. gondii and L. infantum was 3.2, 18.0 and 78.1%, respectively. Toxoplasma gondii was more frequently found in older dogs (p &lt; 0.05) whereas L. infantum was more common in animals aged between 1 to 3 years (p &lt; 0.05). In order to evaluate potential associations between the presence of anti-N. caninum and anti-T. gondii antibodies and Leishmania infection, 240 dogs were selected (120 positive and 120 negative for Leishmania spp.), based on serological and parasitological diagnoses. No association was found between Leishmania spp. and the coccidian parasites (p &gt; 0.05). The results confirm the exposure of dogs to these parasites in the State of Piauí. Keywords: Leishmania infantum, Toxoplasma gondii, Neospora caninum, Piauí, dogs. Resumo Este estudo teve como objetivo avaliar a presença de anticorpos contra Neospora caninum, Toxoplasma gondii e Leishmania infantum em cães atendidos no Hospital Veterinário da Universidade Federal do Piauí, Teresina, Piauí, onde não há relatos de ocorrência de N. caninum e T. gondii em cães. Amostras de soro de 530 cães de ambos os sexos, diferentes idades e raças do município de Teresina e cidades vizinhas, foram analisados utilizando três testes de imunofluorescência indireta para cada um dos três agentes. Associação entre os parasitas e o sexo, a raça e a idade dos cães foram analisadas pelo teste do qui-quadrado (p &gt; 0,05). Ocorrência de anticorpos para N. caninum, T. gondii e L. infantum foi de 3,2, 18,0 e 78,1%, respectivamente. Toxoplasma gondii foi mais freqüente em cães mais velhos (p &gt; 0,05), enquanto L. infantum apresentou maior freqüência em animais com idade entre um e três anos (p &gt; 0,05). Para avaliar possíveis associações entre a presença de anticorpos anti-N. caninum e anti-T. gondii com infecção por Leishmania, outros 240 cães foram selecionados, sendo 120 positivos e 120 negativos para leishmaniose, por métodos parasitológicos e sorológicos. Nenhuma associação foi encontrada entre a positividade para Leishmania e para os coccídios (p &gt; 0,05). Os resultados confirmam a exposição de cães a esses parasitas no Estado do Piauí

Study of the cardiac alterations in HIV-infected children consequent to the antiretroviral therapy: prospective study of 47 cases

OBJECTIVE: Detect of cardiac alterations in children with AIDS and compare their evolution with the administration of only one anti-retroviral and the recent cases who received drugs in combination. METHODS: We prospectively studied 47 children in 3 groups: group 1, 20 cases treated only with zidovudine; group 2, 10 patients treated initially with zidovudine and later with a combination of drugs and in group 3, 17 patients, who receiced two or three since the beginning. In all patients it was done chest X-ray, EKG and echocardiography every 6 months and after death complete pathological study. RESULTS: Among the 45 patients cases 26 (57%) were index cases. Malnutrition, diarrhea tachycardia, signs of congestive heart failure, pericardial effusion, abnormal ventricular repolarization and arrhythmias were more frequent in group 1. Echocardiographic abnormalities were present in 10 (50%) children of group 1. They were less frequent in the others two groups. In regard to the outcome in group 1, two patients had worsening of sings of cardiomyopaty and 4 died. Cardiac dysfunction in all cases of group 2 and 3 improved with the medication. CONCLUSION:- The children who received combination and their cardiac alterations had more favorable outcome than those who received only one drug