Effect of the Enzymatic Fungal Extract of Pochonia chlamydosporia on the Viability of Fasciola hepatica eggs

Hepatic fasciolosis has been implicated as one of the most important parasitic diseases affecting the sanity of cattle and sheep, reflecting in significant economic losses besides being an important anthropozoonotic disease. The eggs of Fasciola hepatica are eliminated with the feces of these hosts, and under the influence of extrinsic and intrinsic factors may remain in the environment for months until they find favorable conditions for embryogenesis. The objective of the present study was to evaluate the viability of Fasciola hepatica eggs exposed for 60 minutes at different concentrations of the enzymatic extract of Pochonia chlamydosporia (Pc-10). Subsequently, they were sedimented and placed on 24-well plates containing the extract of P. chlamydosporia (Pc-10) at concentrations of 500 μL (10%), 400 μL (8%), 300 μL (5%), 200 μL (2%), 100 μL (1%) and distilled water (control group). The experiment was carried out in triplicate, using a total of 900 eggs. After the experimental exposure to the enzyme extract of the fungus (Pc-10), 98% of the eggs exposed to the enzymatic solution demonstrated significant ultrastructural alterations in their respective teguments, when observed in scanning electron microscopy and transmission. The ultrastructure showed a collapse of the internal walls of the egg, interfering in the opening of the operculum. The use of the enzymatic extract of P. chlamydosporia (Pc-10) compromised both the external tegument, breaking it and pasting it, as well as vital structures of the embryonic activity of the F. hepatica eggs

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Changes in the abundance and diversity of soil arthropods in the cultivation of fruit crops

ABSTRACT The aim of this study was to evaluate the influence of fruit-crop management (mango, guava and coconut) on the composition and distribution of soil arthropods (mesofauna and macrofauna) during seasonal periods in the Curu Valley region of the State of Ceará, Brazil. The study was carried out during the following periods: rainy/dry (July/August 2013), dry (October/ November 2013), dry/rainy (January/February 2014) and rainy (April/May 2014). Pitfall traps were used to capture the arthropods. After sorting, the Shannon-Wiener diversity index and the Pielou evenness index were calculated. Diversity values were compared in pairs using Student's t-test (α = 0.05) in the SAS v 9.0 software (2002). The similarity of the areas and groups was evaluated by multivariate analysis employing the techniques of principal component (PCA) and factor (FA) analysis in the Statistica® software (2014). The abundance and diversity of soil arthropods in the cultivation of fruit trees vary according to the type of management and to the seasonal period in the region. The Acari, Collembola and Formicidae groups were the most abundant in each area and during the four periods of the study. The area cultivated with coconut shows better soil conditions for maintaining the arthropod community in the soil

Scope of practice in Primary Care: physicians and nurses in five health regions in Brazil

Abstract Objectives: The review on scopes of practice tends to gain importance in Human Resource in Health agenda in Brazil. The aim of this study was to investigate the scope of practice of physicians and nurses who work in the Atenção Primária em Saúde (APS) (Primary Healthcare) and their main barriers. Methods: this is an exploratory qualitative study conducted in 2015 and 2016, through interviews with 26 physicians and 26 nurses who work in the APS in 12 cities distributed in five Brazilian health regions. Results: physicians and nurses in the health region of the North and Northeast performed a great number of procedures, and those physicians who work in units located in rural areas. Both professional categories indicated that they knew how to carry out several procedures that were not performed in practice. The main barriers for not performing those procedures include, lack of access to exams, materials and inadequate infrastructure, protocols and city guides restrictions, legal restrictions and lack of training. Conclusions: the results suggests the need to ease the health professionals’ attributions, facilitate the integration between the professionals’ practices and optimizing their work, especially in remote and unassisted regions, in order to be in favor of expanding the access and problem solving in APS