Assessment of Lactobacillus crispatus´ role in vaginal infections: friend or foe?

Lactobacillus spp. are the most prevalent microorganisms in the vaginal milleu. Several probiotic mechanisms have been associated with Lactobacillus, but the most relevant one is lactate production – resulting in a low pH value, typical of the healthy vagina. However, its pathogenic state is still unknown. We aim to elucidate the role of a commensal vaginal microorganism, Lactobacillus crispatus, in vaginal infections. Twenty-four vaginal washes have been collected from women attending a gynaecology consultation of a private clinic. The samples were categorized according with clinical diagnosis at the time of sampling. The distribution of bacterial species, and their prevalence was assessed by Next-Generation Sequencing of the 16S rRNA V4 region. In addition, L- and D-lactate concentration, and LDH enzymatic activity was quantified in all washes by a commercial kit. Detection of Candida spp. was performed by PCR. L. crispatus was dominant (>70%) in 11 out of 24 samples – diagnosed for vaginal atrophy (VA, 3), cytolytic vaginosis (CV, 2) and lactobacillosis (LB, 2). Lactate was increased in CV, LB and VA cases only. The remaining samples, diagnosed for vulvovaginal candidosis in its majority, had lower prevalence of L. crispatus; and lower to moderate lactate metabolite. There was not a direct relationship between LDH enzymatic activity and clinical diagnosis. L. crispatus dominance, associated with increased lactate production, was observed in CV, LB and VA cases. These results indicate that this microorganism might have a role in dysbiosis of the vagina associated with these specific pathologies.info:eu-repo/semantics/publishedVersio

Role of Lactobacillus crispatus in vaginal infections: insights from metagenomics and metabolomics studies

Objective: Lactobacillus spp. constitute the most prevalent bacterial microorganism in the vaginal milleu. Several probiotic mechanisms have been associated with Lactobacillus, but the most relevant one is lactate production – resulting in a low pH value, typical of the healthy vagina. We aim to elucidate the role of a native vaginal microorganism, Lactobacillus crispatus, in vaginal infections. Methods: Twenty-four vaginal washes have been collected from women (mean 38±14 years of age) attending a gynecology consultation of a private clinic. The samples were categorized according with clinical diagnosis at the time of sampling. The distribution of bacterial species, and their prevalence was assessed by next-generation sequencing of the 16S V4 region. In addition, lactate was quantified in all washes by a commercial kit. Results: L. crispatus was dominant (>70%) in 11 out of 24 samples – diagnosed for vaginal atrophy (VA, 3), cytolytic vaginosis (CV, 2), lactobacillosis (LB, 2) and vulvovaginal candidosis (VVC, 1). For three samples, diagnostic was inconclusive. Lactate was increased in CV, LB and VA cases only. One sample, diagnosed with VVC had 23% dominance of L. crispatus; and lower lactate metabolite. L. crispatus was not detected in the remaining 12 cases (6 VVC, 4 VA, 1 healthy and 1 inconclusive). Of these, only 5 samples had moderate lactate metabolite. Conclusions: L. crispatus dominance, associated with increased lactate production, was observed in CV, LB and VA cases. These results indicate that this microorganism might have a role in dysbiosis of the vagina associated with these specific pathologies.info:eu-repo/semantics/publishedVersio

Violence against sex workers in Portugal. Differences between indoor and street sex work

Poster presented at the 14th Congress of the European Federation of Sexology. 9-12 May 2018, Albufeira, PortugalN/

Lactobacillus crispatus as the etiological agent in cytolytic vaginosis

Introduction: Lactobacillus spp. dominate the vaginal niche but can also be involved in other vaginal dysbiosis, such as cytolytic vaginosis (CV), which remains poorly studied. It is characterized by a cryptic symptomatology, that often confounds the clinic. Goals: The aim of this work was to search for the etiological agent of CV, by studying the vaginal microbiome and metabolomics of women afflicted with this disease and compare it with women with other clinical diagnostic. Methods: Twenty-one vaginal washes have been collected from women attending a gynaecology consultation of a private clinic. The samples were categorized according with clinical diagnosis at the time of sampling (CV, 11; vulvovaginal candidosis, 8; Healthy, 2). The distribution of bacterial species, and their prevalence was assessed by next-generation sequencing of the 16S V4 region. In addition, total lactate D-lactic acid and L-lactic acid was quantified in all washes by a commercial kit, as well as lactate dehydrogenase (LDH) activity. Results: L. crispatus was dominant (>70%) in all CV samples. Lactate was increased in CV in comparison with other cases. The presence of D-lactic acid isomer was associated with presence of L. crispatus. LDH activity was increased in vaginal washes that tested positive for the presence of L. crispatus, however no direct association was found with CV cases. Discussion/Conclusions: The microbiome of women afflicted with CV was dominated in all cases by L. crispatus, contrarily with the results obtained for women diagnosed with other clinical symptomatology. In addition, the finding that an increase in D-lactic acid is associated with CV patients can be related to the role of L. crispatus in CV. The determination of LDH activity did not correlate exclusively with CV cases. On the other hand, D-lactic acid and total lactate quantification could be used as a valuable biomarker to diagnose this cryptic vaginal infection.info:eu-repo/semantics/publishedVersio

X-ray diffraction and Raman study of nanogranular BaTiO3-CoFe2O4thin films deposited by laser ablation on Si/Pt substrates

Nanocomposite thin films composed by (BaTiO3)1-x-(CoFe2O4)x with different cobalt ferrite concentrations (x) have been deposited by pulsed laser ablation on platinum covered Si(001) substrates. The films structure was studied by X-ray diffraction and Raman spectroscopy. It was found that the CoFe2O4 phase unit cell was compressed along the growth direction of the films, and it relaxed with increasing x. The opposite behavior was observed in the BaTiO3 phase where the lattice parameters obtained from the X-ray measurements presented a progressive distortion of its unit cell with increasing x. The presence of the strain in the films induced a blueshift of the Raman peaks of CoFe2O4 that decreased with increasing CoFe2O4 concentration. Cation disorder in the cobalt ferrite was observed for lower x, where the nanograins are more isolated and subjected to more strain, which was progressively decreased for higher CoFe2O4 content in the films.This work has been financially supported by the Portuguese Foundation for Science and Technology (FCT), through the project POCI/CTM/60181/2004 and the Bilateral Research Action nºB48-06 between CRUP (Portugal) and British Council (UK)

Undifferentiated Sarcoma of the Liver in the Adult

Os AA apresentam um caso clínico de sarcoma indiferenciado do fígado no adulto com metástases pulmonares, cardíacas e com recidiva local hepática. Salienta-se a contribuição dos exames complementares de diagnóstico, com especial relevo para a ecocardiografia no diagnóstico precoce de metástases intracardiacas. Não encontrámos qualquer outro caso descrito na literatura portuguesa

Evidence for the evolutionary steps leading to mecA-mediated ß-lactam resistance in staphylococci

The epidemiologically most important mechanism of antibiotic resistance in Staphylococcus aureus is associated with mecA–an acquired gene encoding an extra penicillin-binding protein (PBP2a) with low affinity to virtually all β-lactams. The introduction of mecA into the S. aureus chromosome has led to the emergence of methicillin-resistant S. aureus (MRSA) pandemics, responsible for high rates of mortality worldwide. Nonetheless, little is known regarding the origin and evolution of mecA. Different mecA homologues have been identified in species belonging to the Staphylococcus sciuri group representing the most primitive staphylococci. In this study we aimed to identify evolutionary steps linking these mecA precursors to the β-lactam resistance gene mecA and the resistance phenotype. We sequenced genomes of 106 S. sciuri, S. vitulinus and S. fleurettii strains and determined their oxacillin susceptibility profiles. Single-nucleotide polymorphism (SNP) analysis of the core genome was performed to assess the genetic relatedness of the isolates. Phylogenetic analysis of the mecA gene homologues and promoters was achieved through nucleotide/amino acid sequence alignments and mutation rates were estimated using a Bayesian analysis. Furthermore, the predicted structure of mecA homologue-encoded PBPs of oxacillin-susceptible and -resistant strains were compared. We showed for the first time that oxacillin resistance in the S. sciuri group has emerged multiple times and by a variety of different mechanisms. Development of resistance occurred through several steps including structural diversification of the non-binding domain of native PBPs; changes in the promoters of mecA homologues; acquisition of SCCmec and adaptation of the bacterial genetic background. Moreover, our results suggest that it was exposure to β-lactams in human-created environments that has driven evolution of native PBPs towards a resistance determinant. The evolution of β-lactam resistance in staphylococci highlights the numerous resources available to bacteria to adapt to the selective pressure of antibiotics

Endobronchial myxoma: Case report

INTRODUCTION: Pulmonary myxoma is an extremely rare benign neoplasm. It is mostly parenchymal but may occasionally occur within the tracheobronchial tree. There are very few reports of endobronchial myxoma. CASE REPORT: We describe a case of endobronchial myxoma in a 40-year-old female patient with a history of asthma and repeated right-sided pneumonia. Thoracic computed tomography (CT) showed medium lobe atelectasis. Fiber optic bronchoscopy revealed a polypoid, well-circumscribed tumor, causing total obstruction of the medium lobe bronchus. Biopsy of the mass was non-diagnostic. Further study included a positron emission tomography (PET) which demonstrated low metabolic activity of the tumor and no evidence of neoplasia in other location. The patient was submitted to a medium lobectomy and microscopic examination of the tumor revealed myxoid stroma with lobulated pattern, elongated and stellate cells, compatible with myxoma. CONCLUSION: Pulmonary myxoma is extraordinary rare and endobronchial location is very few reported in medical literature

Nanogranular BaTiO3–CoFe2O4 thin films deposited by pulsed laser ablation

Detailed structural and magnetic measurements were performed on nanostructured composite thin films of cobalt ferrite (CoFe2O4 - magnetostrictive) dispersed in a barium titanate (BaTiO3 - piezoelectric) matrix, with different CoFe2O4 concentrations (ranging from x=20% to x=70%). The films were deposited by laser ablation on platinum covered Si(100). Their structure was studied by X-ray diffraction and Raman spectroscopy. The magnetic properties were measured with a SQUID magnetometer. The nanocomposite films were polycrystalline and composed by a mixture of tetragonal-BaTiO3 and CoFe2O4 with the cubic spinel structure. The lattice parameter of the CoFe2O4 phase varied from 8.26Å (x=20%) to 8.35Å (x=70%), and, comparing with bulk CoFe2O4, it was under compressive stress that relaxed as its concentration progressively increased. In the tetragonal-BaTiO3 phase, the lattice parameter a was contracted relative to the bulk phase and decreases with x. The lattice parameter c increased from 4.088 Å (x=20%) to 4.376 Å (x=70%), so that the BaTiO3 c axes was increasingly expanded as the quantity of the barium titanate phase was reduced. This behavior was the opposite of that observed in CoFe2O4. The magnetic measurements showed that the coercive fields decreased from 6.6 kOe (x=20%) to 2.3 kOe (x=70%) which was attributed to the progressive relaxation of the stress in the films as well as to the increase of particle agglomeration in bigger polycrystalline clusters with increasing cobalt ferrite concentration. For higher temperatures T=300 K the reduction of magnetocrystalline anisotropy induced a strong reduction of the coercive field.This work has been financially supported by the Portuguese Foundation for Science and Technology (FCT), through the project POCI/CTM/60181/2004