Use of serology in a systematic screening programme for strongyloidiasis in an immigrant population

Objectives: The aim of this cross-sectional study was to describe the results of a systematic serological screening programme for strongyloidiasis. Methods: Aprospective serological screeningprogramme for strongyloidiasis wasperformedbetween2009 and2014 for allimmigrantpatients attending theTropicalMedicineUnit. Three formalin-etherconcentrated stool samples and an ELISA for anti-Strongyloides stercoralis antibodies were used as screening tools. Results: Of 659 patients screened, 79 (12%) were positive for S. stercoralis regardless of the diagnostic method used. The prevalence of infection was 42.9% in East African patients, 16.3% in Central African patients,10.9% in those fromSouthAmerica, and 10% in the case ofWestAfrica. Univariate analysis showed thatinfection by S. stercoralis was significantly more frequentinpatients from CentralAfrica (p = 0.026; OR 1.72, 95% CI 1.03–2.85) and East Africa (p<0.001; OR 5.88, 95% CI 1.75–19.32). Taking West Africa as the reference (as the area of lowest prevalence among the positive prevalence areas), the statistical analysis showed that the risk of infection was higher in East Africa (p = 0.001; OR 6.750, 95% CI 2.127–21.423) and Central Africa (p = 0.065; OR 1.747, 95% CI 0.965–3.163). Conclusions: Due to the potential complications of strongyloidiasis infection, we recommend that immigrantpatients fromdevelopingcountriesbe routinelyscreenedfor S. stercoralis, especiallythose from East Africa. A serological test is a highly appropriate screening tool

A High Docosahexaenoic Acid Diet Alters the Lung Inflammatory Response to Acute Dust Exposure

Agricultural workers are at risk for the development of acute and chronic lung diseases due to their exposure to organic agricultural dusts. A diet intervention using the omega-3 fatty acid docosahexaenoic acid (DHA) has been shown to be an effective therapeutic approach for alleviating a dust-induced inflammatory response. We thus hypothesized a high-DHA diet would alter the dust-induced inflammatory response through the increased production of specialized pro-resolving mediators (SPMs). Mice were pre-treated with a DHA-rich diet 4 weeks before being intranasally challenged with a single dose of an extract made from dust collected from a concentrated swine feeding operation (HDE). This omega-3-fatty-acid-rich diet led to reduced arachidonic acid levels in the blood, enhanced macrophage recruitment, and increased the production of the DHA-derived SPM Resolvin D1 (RvD1) in the lung following HDE exposure. An assessment of transcript-level changes in the immune response demonstrated significant differences in immune pathway activation and alterations of numerous macrophage-associated genes among HDE-challenged mice fed a high DHA diet. Our data indicate that consuming a DHA-rich diet leads to the enhanced production of SPMs during an acute inflammatory challenge to dust, supporting a role for dietary DHA supplementation as a potential therapeutic strategy for reducing dust-induced lung inflammation

Impact of Routine Fractional Flow Reserve Evaluation During Coronary Angiography on Management Strategy and Clinical Outcome: One-Year Results of the POST-IT Multicenter Registry

Penetration of fractional flow reserve (FFR) in clinical practice varies extensively, and the applicability of results from randomized trials is understudied. We describe the extent to which the information gained from routine FFR affects patient management strategy and clinical outcome. METHODS AND RESULTS: Nonselected patients undergoing coronary angiography, in which at least 1 lesion was interrogated by FFR, were prospectively enrolled in a multicenter registry. FFR-driven change in management strategy (medical therapy, revascularization, or additional stress imaging) was assessed per-lesion and per-patient, and the agreement between final and initial strategies was recorded. Cardiovascular death, myocardial infarction, or unplanned revascularization (MACE) at 1 year was recorded. A total of 1293 lesions were evaluated in 918 patients (mean FFR, 0.81±0.1). Management plan changed in 406 patients (44.2%) and 584 lesions (45.2%). One-year MACE was 6.9%; patients in whom all lesions were deferred had a lower MACE rate (5.3%) than those with at least 1 lesion revascularized (7.3%) or left untreated despite FFR≤0.80 (13.6%; log-rank P=0.014). At the lesion level, deferral of those with an FFR≤0.80 was associated with a 3.1-fold increase in the hazard of cardiovascular death/myocardial infarction/target lesion revascularization (P=0.012). Independent predictors of target lesion revascularization in the deferred lesions were proximal location of the lesion, B2/C type and FFR. CONCLUSIONS: Routine FFR assessment of coronary lesions safely changes management strategy in almost half of the cases. Also, it accurately identifies patients and lesions with a low likelihood of events, in which revascularization can be safely deferred, as opposed to those at high risk when ischemic lesions are left untreated, thus confirming results from randomized trials

Usefulness of Routine Fractional Flow Reserve for Clinical Management of Coronary Artery Disease in Patients With Diabetes

Importance: Approximately one-third of patients considered for coronary revascularization have diabetes, which is a major determinant of clinical outcomes, often influencing the choice of the revascularization strategy. The usefulness of fractional flow reserve (FFR) to guide treatment in this population is understudied and has been questioned. Objective: To evaluate the usefulness and rate of major adverse cardiovascular events (MACE) of integrating FFR in management decisions for patients with diabetes who undergo coronary angiography. Design, setting, and participants: This cross-sectional study used data from the PRIME-FFR study derived from the merger of the POST-IT study (Portuguese Study on the Evaluation of FFR-Guided Treatment of Coronary Disease [March 2012-November 2013]) and R3F study (French Study of FFR Integrated Multicenter Registries Implementation of FFR in Routine Practice [October 2008-June 2010]), 2 prospective multicenter registries that shared a common design. A population of all-comers for whom angiography disclosed ambiguous lesions was analyzed for rates, patterns, and outcomes associated with management reclassification, including revascularization deferral, in patients with vs without diabetes. Data analysis was performed from June to August 2018. Main outcomes and measures: Death from any cause, myocardial infarction, or unplanned revascularization (MACE) at 1 year. Results: Among 1983 patients (1503 [77%] male; mean [SD] age, 65 [10] years), 701 had diabetes, and FFR was performed for 1.4 lesions per patient (58.2% of lesions in the left anterior descending artery; mean [SD] stenosis, 56% [11%]; mean [SD] FFR, 0.81 [0.01]). Reclassification by FFR was high and similar in patients with and without diabetes (41.2% vs 37.5%, P = .13), but reclassification from medical treatment to revascularization was more frequent in the former (142 of 342 [41.5%] vs 230 of 730 [31.5%], P = .001). There was no statistical difference between the 1-year rates of MACE in reclassified (9.7%) and nonreclassified patients (12.0%) (P = .37). Among patients with diabetes, FFR-based deferral identified patients with a lower risk of MACE at 12 months (25 of 296 [8.4%]) compared with those undergoing revascularization (47 of 257 [13.1%]) (P = .04), and the rate was of the same magnitude of the observed rate among deferred patients without diabetes (7.9%, P = .87). Status of insulin treatment had no association with outcomes. Patients (6.6% of the population) in whom FFR was disregarded had the highest MACE rates regardless of diabetes status. Conclusions and relevance: Routine integration of FFR for the management of coronary artery disease in patients with diabetes may be associated with a high rate of treatment reclassification. Management strategies guided by FFR, including revascularization deferral, may be useful for patients with diabetes.info:eu-repo/semantics/publishedVersio

Los virus como herramientas biotecnológicas, caso de estudio: Baculovirus

Los virus, desde siempre han tenido mala reputación; sin embargo, estos microorganismos desempeñan un papel importante en los procesos evolutivos que han dado paso a la vida tal y como la conocemos. Los virus pueden ser muy útiles, si son bien aprovechados. El desarrollo de la virología y las aplicaciones en biotecnología hallará cada vez más beneficios para el ser humano y el medio ambiente. El presente documento, hace una breve revisión de las aplicaciones beneficiosas de los virus, como herramientas de la biología molecular y la biotecnología.Artículo elaborado en la Cátedra de Biorreactores,biofertilizantes y biocontroladores, BBB0,carrera de Ingeniería en Agrobiotecnología, Facultad de Agricultura e Investigación Agrícola, Universidad Dr. José Matías Delgad

Nematodes as indicators of shrimp farm impact on an amazonian estuary (Curuçá, Pará, Brazil)

Abstract Shrimp farming reduces demand on wild fishery stocks and avoids environmental damage resulting from fishing practices, however, it has the potential to affect the water quality if not properly managed. In this study the impacts of a shrimp farm in an Amazonian estuary were evaluated, focusing on changes in nematodes regarding taxonomic composition, richness, density and diversity. Sampling was conducted in August 2004 (dry season) and January 2005 (rainy season) in the river at stations situated upstream and downstream at different distances from the main source of farm effluent discharge. Thirty-eight genera were recorded with Terschellingia dominating in the dry season and Terschellingia, Daptonema, Ptycholaimellus and Gomphionema in the rainy season. Abundances were within the range recorded in other estuaries and together with genera richness and diversity showed a strong temporal pattern with significantly higher values in the rainy season. No clear patterns of changes were observed at the stations. Some signs of organic enrichment were detected but they were not yet intense, probably a consequence of the strong local hydrodynamics and the age of the shrimp farm, which was just starting its operation. We recommend that in future studies on farming impacts a combination of factors, beyond the physical and chemical parameters of the water and sediments or taxonomic refinement, should be taken into account - such as the duration of the operation of the farm, the area occupied by ponds and the farm's production. Furthermore, we also believe that nematodes are a useful tool for evaluating aquaculture impacts due to the ease of sampling and because they are organisms at the base of marine food chain