Cauda Equina Enhancing Lesion in an HIV-Infected Patient. Case Report and Literature Review.

We report the case of an HIV-infected young men with neuro-toxoplasmosis localized in the spinal cord. The patient received chemotherapy and immunotherapy for Burkitt lymphoma one year before. At the time of the diagnosis of toxoplasmosis, he was on prophylaxis with trimethoprim and sulfamethoxazole and in complete remission of Burkitt lymphoma. The CD4+ T cell count was 270/μl and the HIV viremia was undetectable. These findings suggest that in this patient, the immunodeficiency promoting the neurologic toxoplasmosis arose more from previous immuno-chemotherapy than from the HIV-infection itself. On the whole, this case highlights that the risk stratification for opportunistic infections of HIV-infected patients should carefully consider their previous medical history and therapies received

Combined Modality Treatment Including Methotrexate-Based Chemotherapy For Primary CENTRAL Nervous System Lymphoma: A Single Institution Experience

Chemotherapy including high-dose methotrexate (HD-MTX), with or without radiotherapy, is standard treatment for primary central nervous system lymphoma (PCNSL). It remains controversial whether addition of other drugs will add to therapeutic efficacy. We report here on 41 patients with PCNSL treated using a combined treatment modality, including HD-MTX (3.5 g/m2 for 2 cycles) prior to whole brain radiotherapy (WBRT). In 22 patients, the chemotherapy was intensified by adding high-dose cytosine arabinoside (HD-AraC) (2g/m2 for 4 doses for 2 cycles). Complete remission at the end of the combined treatment was obtained in 23 of 34 assessable patients (67%), and the predicted 5-year overall and disease-free survival rates were 24% and 46%, respectively, without differences between treatment groups. The addition of HD-AraC was complicated by severe infections in 17/22 (77%) patients, resulting in 3 toxic deaths. Our study indicates that addition of HD-AraC may not improve clinical outcome in PCNSL, while it increases toxicity. More targeted and less toxic therapies are warranted

Epstein-Barr Virus (EBV)-Associated Haemophagocytic Syndrome

We describe the case of a 17- year old female who developed fatal haemophagocytic syndrome (HPS) one month following acute infection caused by Epstein-Barr virus (EBV). Despite initiation of treatment and reduction of EBV load, laboratory signs of HPS as severe cytopenia, hypofibrinogenemia, hyperferritinemia and hypertriglyceridemia persisted, and the patient died of multiorgan failure. HPS is a rare, but life-threatening complication of EBV infection

A colorimetric, sensitive, rapid, and simple diagnostic kit for the HLB putative causal agent detection

Huanglongbing (HLB) is one of the most devastating diseases in citrus worldwide. The Gram-negative bacterial plant pathogen “Candidatus Liberibacter spp.” is phloem-limited and vectored by citrus psyllids. The species “Candidatus Liberibacter asiaticus” (C.Las) has been detected in Argentina, and its vector has been found in at least nine provinces. Early detection of C.Las is critical for a successful management of HLB disease. Currently, HLB molecular diagnosis is carried out by PCR, nested PCR, real-time PCR, or another combination of these techniques, which require purification of genomic DNA, sophisticated equipment, and highly trained personnel. We have developed a prototype of a sensitive colorimetric kit to detect C.Las based on the specific DNA isothermal amplification of this microorganism. The reaction buffer contains hydroxynaphthol blue (HNB), an indicator dye that turns from violet to blue/light blue when the DNA amplification reaction is positive. Similar sensitivity to visualize a positive reaction was observed between HNB loop-mediated isothermal amplification and agarose gel electrophoresis analysis. The detection of C.Las-infected plants was up to 8 ng of total infected plant genomic DNA, similar to quantitative PCR. A blind validation test of the prototype kit was performed with purified DNA extracted from healthy or C.Las-infected midrib plants. Our kit showed 100% concordance with the results of a gold-standard quantitative PCR technique applied by the Laboratorio de Biología Molecular de EEA Montecarlo. The analysis of samples, without DNA purification to detect C.Las, showed a similar sensitivity to the analysis of the same samples in which C.Las DNA was previously purified.Fil: Stolowicz, Fabiana Gisela. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Ciencia y Tecnología "Dr. César Milstein". Fundación Pablo Cassará. Instituto de Ciencia y Tecnología "Dr. César Milstein"; ArgentinaFil: Larocca, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Ciencia y Tecnología "Dr. César Milstein". Fundación Pablo Cassará. Instituto de Ciencia y Tecnología "Dr. César Milstein"; ArgentinaFil: Werbajh, Santiago Enrique. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Ciencia y Tecnología "Dr. César Milstein". Fundación Pablo Cassará. Instituto de Ciencia y Tecnología "Dr. César Milstein"; ArgentinaFil: Parma, Yanil Renee. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Ciencia y Tecnología "Dr. César Milstein". Fundación Pablo Cassará. Instituto de Ciencia y Tecnología "Dr. César Milstein"; ArgentinaFil: Carrillo, Carolina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Ciencia y Tecnología "Dr. César Milstein". Fundación Pablo Cassará. Instituto de Ciencia y Tecnología "Dr. César Milstein"; ArgentinaFil: Ogas Castells, Maria Lorena. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Ciencia y Tecnología "Dr. César Milstein". Fundación Pablo Cassará. Instituto de Ciencia y Tecnología "Dr. César Milstein"; ArgentinaFil: Agostini, Juan Pedro. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Misiones. Estación Experimental Agropecuaria Montecarlo; ArgentinaFil: Redes, Jonathan. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Misiones. Estación Experimental Agropecuaria Montecarlo; ArgentinaFil: Welin, Björn. Gobierno de Tucumán. Ministerio de Desarrollo Productivo. Estación Experimental Agroindustrial Obispo Colombres; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Castagnaro, Atilio Pedro. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Gobierno de Tucumán. Ministerio de Desarrollo Productivo. Estación Experimental Agroindustrial Obispo Colombres; ArgentinaFil: Vojnov, Adrián Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Ciencia y Tecnología "Dr. César Milstein". Fundación Pablo Cassará. Instituto de Ciencia y Tecnología "Dr. César Milstein"; Argentin

Broadening the spectrum of ivermectin: Its effect on Trypanosoma cruzi and related trypanosomatids

Chagas disease is an endemic American parasitosis, caused by Trypanosoma cruzi. The current therapies, benznidazole (BZN) and nifurtimox (NFX), show limited efficacy and multiple side effects. Thus, there is a need to develop new trypanocidal strategies. Ivermectin (IVM) is a broad-spectrum antiparasitic drug with low human and veterinary toxicity with effects against T. brucei and Leishmania spp. Considering this and its relatively low cost, we evaluate IVM as a potential repurposed trypanocidal drug on T. cruzi and other trypanosomatids. We found that IVM affected, in a dose-dependent manner, the proliferation of T. cruzi epimastigotes as well as the amastigotes and trypomastigotes survival. The Selectivity Index for the amastigote stage with respect to Vero cells was 12. The IVM effect was also observed in Phytomonas jma 066 and Leishmania mexicana proliferation but not in Crithidia fasciculata. On the epimastigote stage, the IVM effect was trypanostatic at 50 μM but trypanocidal at 100 μM. The assays of the drug combinations of IVM with BNZ or NFX showed mainly additive effects among combinations. In silico studies showed that classical structures belonging to glutamate-gated Cl channels, the most common IVM target, are absent in kinetoplastids. However, we found in the studied trypanosomatid genomes one copy for putative IMPα and IMPβ, potential targets for IVM. The putative IMPα genes (with 76% similarity) showed conserved Armadillo domains but lacked the canonical IMPβ binding sequence. These results allowed us to propose a novel molecular target in T. cruzi and suggest IVM as a good candidate for drug repurposing in the Chagas disease context

NOD mice exocrinopathy: towards a neuroimmune link

Sjogren's syndrome (SS) is a chronic autoimmune disorder of exocrine glands characterized as an autoimmune exocrinopathy and more specifically as an autoimmune epithelitis. An impaired balance of neuroimmune interactions mediated by vasoactive intestinal peptide (VIP) in the target organ at early stages of disease is explored by means of the nonobese diabetic (NOD) mouse model of SS. We have previously described a reduced salivary secretion and signaling upon VIP stimulation. The effect reflected a differential regulation of the neural isoform of nitric oxide synthase by calcium calmodulin kinase II and occurred prior to the appearance of detectable levels of cytokines in NOD glands. VIP acting on NOD macrophages treated with lipopolysaccharide promoted anti-inflammatory effects by inhibiting nitric oxide synthase induction as well as IL-12 and TNF-alpha production, while stimulating IL-10. Here we present evidence on the ability of apoptotic acinar cells from submandibular glands of NOD mice to stimulate nitric oxide in both peritoneal and glandular macrophage pools to a similar extent as lipopolysaccharide + IFN-gamma. VIP was not effective to prevent nitrite accumulation and modestly increased IL-10 levels in macrophages coincubated with acinar cells. An enhanced nitrite response of NOD glandular macrophages in basal and stimulated conditions compared to peritoneal cells is also shownFil: Calafat, Mario Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Larocca, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Roca, Valeria Ines. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; ArgentinaFil: Perez Leiros, Claudia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; Argentin

Blood and endothelial cells: together through thick and thin

In this issue of Blood, Rosti and colleagues reported that in JAK2V617F positive patients with myelofibrosis (MF), a proportion of endothelial cells (ECs) from spleen tissues and splenic vein harbored this mutation.

Menores de dos años y la disfunción nutricional: la visión del enfermero de la atención básica

Objective: to describe the elements of vulnerability of under-two-year-old child related to nutritional dysfunctions,identified by primary care nurses. Materials and Methods: a qualitative-descriptive study conducted in a city in southern Brazil, with six nurses serving the basic health unit and also the family health strategy model. The data collection was by focus group, from january to february 2015. The content analysis of Bardin thematic categories was adopted and for the organization and data processing, it was used the Iramuteq® computer program.Results: the text data analysis used was the hierarchical descending classification, this software processed and organized the data in six texts, distributed in 106 segments, of which 81 (76,4 %) were used. The analysis of the data expressed the following categories: Unfavorable environment for healthy infant feeding and Shared practices and responsibilities in the management of breastfeeding. They demonstrated that the environment encompasses family, cognitive and maternal health socioeconomic deficits,bad social and family network as well as strong impact of marketing and weak supervision of public policies.Conclusion: understanding the elements of vulnerability can allow a close dialogue between the different intersectoral and professional segments, whose common objective is the understanding that diseases and disabilities are influenced by political, social and economic aspects.Objetivo: descrever os elementos de vulnerabilidade da criança menor de dois anos relacionados com disfunções nutricionais, identificados pelos enfermeiros de atenção primária. Materiais e métodos: estudo qualitativo-descritivo realizado em uma cidade ao sul do Brasil, com seis enfermeiros do serviço da unidade de saúde básica e também do modelo estratégia saúde da família. A coleta de dados foi por grupos focais, de janeiro a fevereiro de 2015. Adotou-se a análise de conteúdo de categorias temáticas de Bardin e para a organização e processamento de dados utilizouse o programa informático Iramuteq®.Resultados: a análise de dados textuais empregada foi a classificação hierárquica descendente, este software processou e organizou os dados em seis textos, distribuídos em 106 segmentos,dos quais 81 (76,4 %) foram aproveitados. A análise dos dados expressou as categorias que seguem: Ambiente desfavorável para a alimentação infantil saudável e práticas e responsabilidades compartilhadas no manejo da lactação. Mostraram que o ambiente engloba déficits socioeconômicos familiares, cognitivos e da saúde materna,má rede social e familiar como também forte impacto do marketing e débil supervisão das políticas públicas.Conclusão: a compreensão dos elementos de vulnerabilidade pode permitir um diálogo estreito entre os distintos segmentos intersetoriais e profissionais, cujo objetivo comum é o entendimento de que a enfermidade e a deficiência estão influenciadas por aspectos políticos, sociais e econômicos.Objetivo: describir los elementos de vulnerabilidad del niño menor de dos años relacionados con disfuncionesnutricionales, identificados por los enfermeros de atención primaria. Materiales y métodos: estudio cualitativo-descriptivo realizado en una ciudad al sur de Brasil, con seis enfermeras de servicio de unidad de salud básica y también del modelo Estrategia Salud de la Familia. La recolección de datos fue por grupos focales, de enero a febrero del 2015. Se adoptó el análisis de contenido de categorías temáticas de Bardin y para la organización y procesamiento de datos se utilizó el programa informático Iramuteq®.Resultados: el análisis de datos textuales empleados fue la clasificación jerárquica descendente, este software procesó y organizó los datos en seis textos, distribuidos en 106segmentos, de los cuales 81 (76,4 %) fueron aprovechados. El análisis de los datos expresó las siguientes categorías:Ambiente desfavorable para la alimentación infantil sana y Prácticas y responsabilidades compartidas en el manejo de la lactancia. Mostraron que el ambiente abarca déficitssocioeconómicos familiares, cognitivos y de la salud materna, mala red social y familiar como también fuerte impacto del marketing y débil supervisión de las políticas públicas.Conclusión: la comprensión de los elementos de vulnerabilidad puede permitir un diálogo estrecho entre losdistintos segmentos intersectoriales y profesionales, cuyo objetivo común es el entendimiento de que la enfermedady la discapacidad están influenciadas por aspectos políticos, sociales y económicos