The first meeting of the European Register of Cystic Echinococcosis (ERCE)

6 páginas, 3 figuras, 1 tablaCystic echinococcosis (CE) is a zoonotic parasitic disease endemic in southern and eastern European countries. The true prevalence of CE is difficult to estimate due to the high proportion of asymptomatic carriers who never seek medical attention and to the underreporting of diagnosed cases, factors which contribute to its neglected status. In an attempt to improve this situation, the European Register of Cystic Echinococcosis (ERCE), was launched in October 2014 in the context of the HERACLES project. ERCE is a prospective, observational, multicentre register of patients with probable or confirmed CE. The first ERCE meeting was held in November 2015 at the Italian National Institute of Health (Istituto Superiore di Sanita, ISS) in Rome, to bring together CE experts currently involved in the Register activities, to share and discuss experiences, and future developments. Although the Register is still in its infancy, data collected at the time of writing this report, had outnumbered the total of national cases reported by the European endemic countries and published by the European Centre for Disease Prevention and Control in 2015. This confirms the need for an improved reporting system of CE at the European level. The collection of standardized clinical data and samples is expected to support a more rational, stage-specific approach to clinical management, and to help public authorities harmonize reporting of CE. A better understanding of CE burden in Europe will encourage the planning and implementation of public health policies toward its control.This research received funding from the European Community’s Seventh Framework Programme under the grant agreement 602051 (Project HERACLES: Human cystic Echinococcosis ReseArch in CentraL and Eastern Societies; http:// www.heracles-fp7.eu/).Peer reviewe

Echinococcus metacestodes as laboratory models for the screening of drugs against cestodes and trematodes

Among the cestodes, Echinococcus granulosus, Echinococcus multilocularis and Taenia solium represent the most dangerous parasites. Their larval stages cause the diseases cystic echinococcosis (CE), alveolar echincoccosis (AE) and cysticercosis, respectively, which exhibit considerable medical and veterinary health concerns with a profound economic impact. Others caused by other cestodes, such as species of the genera Mesocestoides and Hymenolepis, are relatively rare in humans. In this review, we will focus on E. granulosus and E. multilocularis metacestode laboratory models and will review the use of these models in the search for novel drugs that could be employed for chemotherapeutic treatment of echinococcosis. Clearly, improved therapeutic drugs are needed for the treatment of AE and CE, and this can only be achieved through the development of medium-to-high throughput screening approaches. The most recent achievements in the in vitro culture and genetic manipulation of E. multilocularis cells and metacestodes, and the accessability of the E. multilocularis genome and EST sequence information, have rendered the E. multilocularis model uniquely suited for studies on drug-efficacy and drug target identification. This could lead to the development of novel compounds for the use in chemotherapy against echinococcosis, and possibly against diseases caused by other cestodes, and potentially also trematode

Potential Risk Factors Associated with Human Cystic Echinococcosis: Systematic Review and Meta-analysis

15 páginas, 2 figuras, 2 tablasBackground Scientific literature on cystic echinococcosis (CE) reporting data on risk factors is limited and to the best of our knowledge, no global evaluation of human CE risk factors has to date been performed. This systematic review (SR) summarizes available data on statistically relevant potential risk factors (PRFs) associated with human CE.Methodology/Principal Findings Database searches identified 1,367 papers, of which thirty-seven were eligible for inclusion. Of these, eight and twenty-nine were case-control and cross-sectional studies, respectively. Among the eligible papers, twenty-one were included in the meta-analyses. Pooled odds ratio (OR) were used as a measure of effect and separately analysed for the two study designs. PRFs derived from case-control studies that were significantly associated with higher odds of outcome were ªdog free to roamº (OR 5.23; 95% CI 2.45±11.14), ªfeeding dogs with visceraº (OR 4.69; 95% CI 3.02±7.29), ªslaughter at homeº (OR 4.67; 95% CI 2.02±10.78) or at ªslaughterhousesº (OR 2.7; 95% CI 1.15±6.3), ªdog ownershipº (OR 3.54; 95% CI 1.27±9.85), ªliving in rural areasº (OR 1.83; 95% CI 1.16±2.9) and ªlow incomeº (OR 1.68; 95% CI 1.02±2.76). Statistically significant PRFs from cross-sectional studies with higher odds of outcome were ªage >16 yearsº (OR 6.08; 95% CI 4.05±9.13), ªliving in rural areasº (OR 2.26; 95% CI 1.41±3.61), ªbeing femaleº (OR 1.38; 95% CI 1.06± 1.8) and ªdog ownershipº (OR 1.37; 95% CI 1.01±1.86). Conclusions/Significance Living in endemic rural areas, in which free roaming dogs have access to offal and being a dog-owner, seem to be among the most significant PRFs for acquiring this parasiticinfection. Results of data analysed here may contribute to our understanding of the PRFs for CE and may potentially be useful in planning community interventions aimed at controlling CE in endemic areas.Conclusions/Significance Living in endemic rural areas, in which free roaming dogs have access to offal and being a dog-owner, seem to be among the most significant PRFs for acquiring this parasiticinfection. Results of data analysed here may contribute to our understanding of the PRFs for CE and may potentially be useful in planning community interventions aimed at controlling CE in endemic areas.This research received funding from the European Community's Seventh Framework Programme under the grant agreement 602051 (Project HERACLES: Human cystic Echinococcosis ReseArch in CentraL and Eastern Societies; http://www.heracles-fp7.eu/).Peer reviewe

Multiple-bead assay for the differential serodiagnosis of neglected human cestodiases: Neurocysticercosis and cystic echinococcosis

Background: Neurocysticercosis (NCC), and cystic echinococcosis (CE) are two neglected diseases caused by cestodes, co-endemic in many areas of the world. Imaging studies and serological tests are used in the diagnosis of both parasitic diseases, but cross-reactions may confound the results of the latter. The novel multiplex bead-based assay with recombinant antigens has been reported to increases the diagnostic accuracy of serological techniques. Methodology: We set-up an immunoassay based on the multiplex bead-based platform (MBA), using the rT24H (against Cysticercus cellulosae, causing cysticercosis) and r2B2t (against Echinococcus granulosus sensu lato, causing CE) recombinant antigens, for simultaneous and differential diagnosis of these infections. The antigens were tested on 356 sera from 151 patients with CE, 126 patients with NCC, and 79 individuals negative for both diseases. Specificity was calculated including sera from healthy donors, other neurological diseases and the respective NCC or CE sera counterpart. The diagnostic accuracy of this assay was compared with two commercial ELISA tests, Novalisa and Ridascreen, widely used in the routine diagnosis of cysticercosis and CE, respectively. Main findings: For the diagnosis of NCC, sensitivity ranged from 57.94-63.49% for the rT24H-MBA, and 40.48-46.03% for Novalisa ELISA depending on exclusion or inclusion of sera having equivocal results on ELISA from the analysis; specificities ranged from 90.87-91.30% and 70.43-76.96%, respectively. AUC values of the ROC curve were 0.783 (rT24H) and 0.619 (Novalisa) (p-value < 0.001). For the diagnosis of CE, the sensitivity of the r2B2t-MBA ranged from 68.87-69.77% and of Ridascreen ELISA from 50.00-57.62%; specificities from 92.47-92.68% and from 74.15-80.98%, respectively. AUC values were 0.717 and 0.760, respectively. Conclusions/Significance: Overall, the recombinant antigens tested with the bead-based technology showed better diagnostic accuracy than the commercial assays, particularly for the diagnosis of NCC. The possibility of testing the same serum sample simultaneously for the presence of antibodies against both antigens is an added value particularly in seroprevalence studies for cysticercosis linked to control programs in endemic areas where these two parasites coexist.MJP received grants to support this study: “PI17CIII/00019” from ISCIII-AESI and "CIBER Enfermedades infecciosas CB21/13/00120" from ISCIII. https://www.isciii.es. BGB received a Predoctoral Fellowship award for career development by Fundación Rafael Folch (2021/E02). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.S

The geographical distribution and prevalence of Echinococcus multilocularis in animals in the European Union and adjacent countries : a systematic review and meta-analysis

Background This study aimed to provide a systematic review on the geographical distribution of Echinococcus multilocularis in definitive and intermediate hosts in the European Union (EU) and adjacent countries (AC). The relative importance of the different host species in the life-cycle of this parasite was highlighted and gaps in our knowledge regarding these hosts were identified. Methods Six databases were searched for primary research studies published from 1900 to 2015. From a total of 2,805 identified scientific papers, 244 publications were used for meta-analyses. Results Studies in 21 countries reported the presence of E. multilocularis in red foxes, with the following pooled prevalence (PP): low (≤ 1 %; Denmark, Slovenia and Sweden); medium (> 1 % to 10 %; Czech Republic, Estonia, France, Germany, Latvia, Lithuania, Poland, Slovakia, Liechtenstein and Switzerland). Studies from Finland, Ireland, the United Kingdom and Norway reported the absence of E. multilocularis in red foxes. However, E. multilocularis was detected in Arctic foxes from the Arctic Archipelago of Svalbard in Norway. Conclusions Raccoon dogs (PP 2.2 %), golden jackals (PP 4.7 %) and wolves (PP 1.4 %) showed a higher E. multilocularis PP than dogs (PP 0.3 %) and cats (PP 0.5 %). High E. multilocularis PP in raccoon dogs and golden jackals correlated with high PP in foxes. For intermediate hosts (IHs), muskrats (PP 4.2 %) and arvicolids (PP 6.0 %) showed similar E. multilocularis PP as sylvatic definitive hosts (DHs), excluding foxes. Nutrias (PP 1.0 %) and murids (PP 1.1 %) could play a role in the life-cycle of E. multilocularis in areas with medium to high PP in red foxes. In areas with low PP in foxes, no other DH was found infected with E. multilocularis. When fox E. multilocularis PP was >3 %, raccoon dogs and golden jackals could play a similar role as foxes. In areas with high E. multilocularis fox PP, the wolf emerged as a potentially important DH. Dogs and cats could be irrelevant in the life-cycle of the parasite in Europe, although dogs could be important for parasite introduction into non-endemic areas. Muskrats and arvicolids are important IHs. Swine, insectivores, murids and nutrias seem to play a minor or no role in the life-cycle of the parasite within the EU and ACs

Serological Diagnosis and Follow-Up of Human Cystic Echinococcosis: A New Hope for the Future?

Cystic echinococcosis (CE) is an important helminthic zoonotic disease caused by the Echinococcus granulosus complex. In humans, CE is a chronic disease driven by the growth of echinococcal cysts in different organs. Prognosis of this disease depends on multiple factors, including location, number, size, and stage of the cysts, making CE a disease of complex management. CE is usually asymptomatic for years and attracts limited attention from funding organizations and health authorities. For this reason, only experts&apos; recommendations are available but no evidence-based conclusions have been drawn for CE clinical management. One of those pitfalls refers to the lack of evidence to support the use of serological tools for the diagnosis and follow-up of CE patients. In this respect, crude antigens are used to detect specific antibodies in patients, giving rise to false positive results. The advent of molecular techniques allowing the production of recombinant proteins has provided a number of candidate antigens that could overcome the problems associated with the use of crude parasite extracts in the serological assays. In this review, we present the last advances in this field, proposing the use of serology to support cyst stage-specific diagnosis and follow-up

Proteomic analysis of plasma exosomes from cystic echinococcosis patients provides in vivo support for distinct immune response profiles in active vs inactive infection and suggests potential biomarkers

The reference diagnostic method of human abdominal Cystic Echinococcosis (CE) is imaging, particularly ultrasound, supported by serology when imaging is inconclusive. However, current diagnostic tools are neither optimal nor widely available. The availability of a test detecting circulating biomarkers would considerably improve CE diagnosis and cyst staging (active vs inactive), as well as treatments and follow-up of patients. Exosomes are extracellular vesicles involved in intercellular communication, including immune system responses, and are a recognized source of biomarkers. With the aim of identifying potential biomarkers, plasma pools from patients infected by active or inactive CE, as well as from control subjects, were processed to isolate exosomes for proteomic label-free quantitative analysis. Results were statistically processed and subjected to bioinformatics analysis to define distinct features associated with parasite viability. First, a few parasite proteins were identified that were specifically associated with either active or inactive CE, which represent potential biomarkers to be validated in further studies. Second, numerous identified proteins of human origin were common to active and inactive CE, confirming an overlap of several immune response pathways. However, a subset of human proteins specific to either active or inactive CE, and central in the respective protein-protein interaction networks, were identified. These include the Src family kinases Src and Lyn, and the immune-suppressive cytokine TGF-β in active CE, and Cdc42 in inactive CE. The Src and Lyn Kinases were confirmed as potential markers of active CE in totally independent plasma pools. In addition, insights were obtained on immune response profiles: largely consistent with previous evidence, our observations hint to a Th1/Th2/regulatory immune environment in patients with active CE and a Th1/inflammatory environment with a component of the wound healing response in the presence of inactive CE. Of note, our results were obtained for the first time from the analysis of samples obtained in vivo from a well-characterized, large cohort of human subjects

Echinococcus metacestodes as laboratory models for the screening of drugs against cestodes and trematodes

Among the cestodes, Echinococcus granulosus, Echinococcus multilocularis and Taenia solium represent the most dangerous parasites. Their larval stages cause the diseases cystic echinococcosis (CE), alveolar echinococcosis (AE) and cysticercosis, respectively, which exhibit considerable medical and veterinary health concerns with a profound economic impact. Others caused by other cestodes, such as species of the genera Mesocestoides and Hymenolepis, are relatively rare in humans. In this review, we will focus on E. granulosus and E. multilocularis metacestode laboratory models and will review the use of these models in the search for novel drugs that could be employed for chemotherapeutic treatment of echinococcosis. Clearly, improved therapeutic drugs are needed for the treatment of AE and CE, and this can only be achieved through the development of medium-to-high throughput screening approaches. The most recent achievements in the in vitro culture and genetic manipulation of E. multilocularis cells and metacestodes, and the accessability of the E. multilocularis genome and EST sequence information, have rendered the E. multilocularis model uniquely suited for studies on drug-efficacy and drug target identification. This could lead to the development of novel compounds for the use in chemotherapy against echinococcosis, and possibly against diseases caused by other cestodes, and potentially also trematodes

Patient comprehension of oncologic surgical procedures using 3D printed surgical planning prototypes

Patient understanding of complex surgical procedures and post-intervention consequences is often poor. Little is known about the effectiveness of 3D printed models to improve the comprehension of the medical information provided to patients. The purpose of this study was to determine if 3D printed patient-specific anatomical models could help improve patients’ satisfaction and understanding of complex oncological surgical procedures, their risks, benefits, and alternatives. Basic procedure A randomized, controlled crossover experiment was performed, where subjects were randomly assigned to different treatments of the study. This experiment involved teenage patients experts from Kids Barcelona, a Young Person's Advisory Group. The team (n = 14, age range 14–20, 9 females and 5 males) was divided into two groups involved in two simulated pre-surgical outpatient visits for complex oncologic surgical procedures: a high-risk stage 4 abdominal neuroblastoma, and a biliary tract rhabdomyosarcoma. Two senior oncologic surgeons participated in the study by performing the structured outpatient pre-surgical visit. Each participant received information before the study explaining the study methodology and was given a questionnaire. Main findings Data analysis of the group using the 3D printed model for the neuroblastoma case showed better results than without the 3D model. On the other hand, conversely, on the data analysis of the rhabdomyosarcoma case with the 3D printed model no better results were observed as compared to the case of not using a 3D model. However, the results of the participants’ knowledge were still better than before the intervention. Satisfaction was significantly better with a 3D model in both cases.Peer ReviewedObjectius de Desenvolupament Sostenible::3 - Salut i BenestarPostprint (published version

O IMPACTO DA PSICANÁLISE NOS GRADUANDOS DO CURSO DE PSICOLOGIA

The present work is the result of a quantitative research that aimed to analyze, through a questionnaire, the impact and influence of psychoanalysis in psychology undergraduates. The methodology used was a quantitative analysis of a questionnaire provided by The Google Form and which had as participants psychology students in universities located in the metropolitan region of Rio de Janeiro. The survey was conducted between the end of 2021 and the beginning of 2022 and had 108 people as total informants. At the end of the research, it was found that psychoanalysis influences significantly in the personal and academic life of undergraduate students in psychology. Finally, it is worth noting that the present research result can show that the university has an important role in the transmission of psychoanalysis in the university and even more so in society.El presente trabajo es el resultado de una investigación cuantitativa que tuvo como objetivo analizar, a través de un cuestionario, el impacto y la influencia del psicoanálisis en los estudiantes de psicología. La metodología utilizada fue un análisis cuantitativo de un cuestionario proporcionado por The Google Form y que tuvo como participantes estudiantes de psicología en universidades ubicadas en la región metropolitana de Río de Janeiro. La encuesta se realizó entre finales de 2021 y principios de 2022 y tuvo a 108 personas como informantes totales. Al final de la investigación, se encontró que el psicoanálisis influye significativamente en la vida personal y académica de los estudiantes de pregrado en psicología. Finalmente, vale la pena señalar que el presente resultado de la investigación puede mostrar que la universidad tiene un papel importante en la transmisión del psicoanálisis en la universidad y aún más en la sociedad.O presente trabalho é resultado de uma pesquisa quantitativa que teve como objetivo analisar, através de um questionário, o impacto e a influência da psicanálise nos graduandos de psicologia. A metodologia utilizada foi uma análise quantitativa de um questionário fornecido pelo Formulário Google e que teve como participantes alunos de psicologia em universidades situadas na região metropolitana do Rio de Janeiro. A pesquisa foi realizada no período entre o final de 2021 ao início de 2022 e teve 108 pessoas como informantes totais. Ao final da pesquisa, constou-se que a psicanálise influencia de forma significativa na vida pessoal e acadêmica dos alunos da graduação em psicologia. Por fim, vale destacar que o presente resultado da pesquisa pode demostrar que a universidade tem um papel importante na transmissão da psicanálise na universidade e mais ainda, na sociedade.O presente trabalho é resultado de uma pesquisa quantitativa que teve como objetivo analisar, através de um questionário, o impacto e a influência da psicanálise nos graduandos de psicologia. A metodologia utilizada foi uma análise quantitativa de um questionário fornecido pelo Formulário Google e que teve como participantes alunos de psicologia em universidades situadas na região metropolitana do Rio de Janeiro. A pesquisa foi realizada no período entre o final de 2021 ao início de 2022 e teve 108 pessoas como informantes totais. Ao final da pesquisa, constou-se que a psicanálise influencia de forma significativa na vida pessoal e acadêmica dos alunos da graduação em psicologia. Por fim, vale destacar que o presente resultado da pesquisa pode demostrar que a universidade tem um papel importante na transmissão da psicanálise na universidade e mais ainda, na sociedade