Predisposing conditions and outcome in adult patients with recurrent pneumococcal meningitis

Introduction: Recurrent pneumococcal meningitis is a relatively rare condition associated with predisposing factors. The objective of the study was to evaluate the characteristics and predisposing factors for recurrent pneumococcal meningitis in adults and compare them to patients with non-recurrent meningitis. Methods: A retrospective record review was performed of all patients hospitalized for pneumococcal meningitis in a large tertiary referral center, during a 10-year period. Results: We identified a total of 194 pneumococcal meningitis episodes in 182 patients. Thirty-eight (20%) meningitis episodes in 26 patients were recurrent. Anatomical defects and/or CSF leakage were present in 55% of recurrent pneumococcal meningitis vs. 10% of non-recurrent episodes (p<0.001). Impaired immune response was encountered in 41% non-recurrent meningitis vs 24% of recurrent episodes (p=0.02). Median age in patients with recurrent meningitis was 29 years, while patients with non-recurrent meningitis had a median age of 57 years (p<0.001). The in-hospital mortality was 3% in patients with recurrent meningitis vs 27% in patients with non-recurrent meningitis (p<0.001). An unfavorable outcome was more likely to occur in patients with advanced age and an impaired immune status. Conclusions: Patients with recurrent pneumococcal meningitis were younger, had less comorbidities and a better outcome

Gut Microbiota, Probiotics and Diabetes

Diabetes is a condition of multifactorial origin, involving several molecular mechanisms related to the intestinal microbiota for its development. In type 2 diabetes, receptor activation and recognition by microorganisms from the intestinal lumen may trigger inflammatory responses, inducing the phosphorylation of serine residues in insulin receptor substrate-1, reducing insulin sensitivity. In type 1 diabetes, the lowered expression of adhesion proteins within the intestinal epithelium favours a greater immune response that may result in destruction of pancreatic β cells by CD8+ T-lymphocytes, and increased expression of interleukin-17, related to autoimmunity. Research in animal models and humans has hypothesized whether the administration of probiotics may improve the prognosis of diabetes through modulation of gut microbiota. We have shown in this review that a large body of evidence suggests probiotics reduce the inflammatory response and oxidative stress, as well as increase the expression of adhesion proteins within the intestinal epithelium, reducing intestinal permeability. Such effects increase insulin sensitivity and reduce autoimmune response. However, further investigations are required to clarify whether the administration of probiotics can be efficiently used for the prevention and management of diabetes

Fifth European Dirofilaria and Angiostrongylus Days (FiEDAD) 2016

Peer reviewe

Redescription of the tadpole of rare Giant Torrent Frog Megaelosia boticariana Giaretta & Aguiar, 1998 (Anura, Hylodidae) with comments on natural history

Sichieri, Guilherme, Moroti, Matheus De Toledo, Costa, Fabiana R., Muscat, Edelcio, Nunes, Ivan (2020): Redescription of the tadpole of rare Giant Torrent Frog Megaelosia boticariana Giaretta & Aguiar, 1998 (Anura, Hylodidae) with comments on natural history. Zootaxa 4896 (1): 140-144, DOI: https://doi.org/10.11646/zootaxa.4896.1.

FIGURE 1 in Redescription of the tadpole of rare Giant Torrent Frog Megaelosia boticariana Giaretta & Aguiar, 1998 (Anura, Hylodidae) with comments on natural history

FIGURE 1. Tadpoles (HCLP-A 112; GS25) and froglet of Megaelosia boticariana, from S"o Francisco Xavier, S"o Paulo state, Brazil. (A) Dorsal and (B,C) lateral views highlighting lateral lines and spiracle [A, B, C not to scale]; (D) drawing of oral disc [scale bar 1 mm] of tadpole; (E) froglet of M. boticariana (not collected); (F) Tadpole feeding on a submerged leaf in the backwater (Photos ABC by Adnan Farhat).Published as part of Sichieri, Guilherme, Moroti, Matheus De Toledo, Costa, Fabiana R., Muscat, Edelcio & Nunes, Ivan, 2020, Redescription of the tadpole of rare Giant Torrent Frog Megaelosia boticariana Giaretta & Aguiar, 1998 (Anura, Hylodidae) with comments on natural history, pp. 140-144 in Zootaxa 4896 (1) on page 142, DOI: 10.11646/zootaxa.4896.1.9, http://zenodo.org/record/435946

Factors leading to dissemination of cutaneous anthrax: an international ID-IRI study

Background: Although anthrax is a rare zoonotic infection, it still causes significant mortality and morbidity. In this multicenter study, which is the largest anthrax case series ever reported, we aimed to describe the factors leading to dissemination of cutaneous anthrax.Methods: Adult patients with cutaneous anthrax from 16 referral centers were pooled. The study had a retrospective design, and included patients treated between January 1, 1990 and December 1, 2019. Probable, and confirmed cases based upon CDC anthrax 2018 case definition were included in the study. A descriptive statistical analysis was performed for all variables.Results: A total of 141 cutaneous anthrax patients were included. Of these, 105 (74%) patients had probable and 36 (26%) had confirmed diagnosis. Anthrax meningitis and bacteremia occurred in three and six patients, respectively. Sequelae were observed in three patients: cicatricial ectropion followed by ocular anthrax (n = 2) and movement restriction on the left hand after surgical intervention (n = 1). One patient had gastrointestinal anthrax. The parameters related to poor outcome (p &lt; 0.05) were fever, anorexia, hypoxia, malaise/fatigue, cellulitis, fasciitis, lymphadenopathy, leukocytosis, high CRP and creatinine levels, longer duration of antimicrobial therapy, and combined therapy. The last two were seemingly the consequences of dissemination rather than being the reasons. The fatality rate was 1.4%.Conclusions: Rapid identification of anthrax is crucial for prompt and effective treatment. Systemic symptoms, disseminated local infection, and high inflammatory markers should alert the treating physicians for the dissemination of the disease. (c) 2022 The Authors. Published by Elsevier Ltd