Analysis of the immunological biomarker profile during acute zika virus infection reveals the overexpression of CXCL10, a chemokine linked to neuronal damage

BACKGROUND Infection with Zika virus (ZIKV) manifests in a broad spectrum of disease ranging from mild illness to severe neurological complications and little is known about Zika immunopathogenesis. OBJECTIVES To define the immunologic biomarkers that correlate with acute ZIKV infection. METHODS We characterized the levels of circulating cytokines, chemokines, and growth factors in 54 infected patients of both genders at five different time points after symptom onset using microbeads multiplex immunoassay; comparison to 100 age-matched controls was performed for statistical analysis and data mining. FINDINGS ZIKV-infected patients present a striking systemic inflammatory response with high levels of pro-inflammatory mediators. Despite the strong inflammatory pattern, IL-1Ra and IL-4 are also induced during the acute infection. Interestingly, the inflammatory cytokines IL-1β, IL-13, IL-17, TNF-α, and IFN-γ; chemokines CXCL8, CCL2, CCL5; and the growth factor G-CSF, displayed a bimodal distribution accompanying viremia. While this is the first manuscript to document bimodal distributions of viremia in ZIKV infection, this has been documented in other viral infections, with a primary viremia peak during mild systemic disease and a secondary peak associated with distribution of the virus to organs and tissues. MAIN CONCLUSIONS Biomarker network analysis demonstrated distinct dynamics in concurrence with the bimodal viremia profiles at different time points during ZIKV infection. Such a robust cytokine and chemokine response has been associated with blood-brain barrier permeability and neuroinvasiveness in other flaviviral infections. High-dimensional data analysis further identified CXCL10, a chemokine involved in foetal neuron apoptosis and Guillain-Barré syndrome, as the most promising biomarker of acute ZIKV infection for potential clinical application. © 2018, Fundacao Oswaldo Cruz. All rights reserved

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Mycobacterium leprae no periodonto, saliva e raspados intradérmicos de sujeitos com hanseníase

Submitted by Patricia Stilpen ([email protected]) on 2011-04-05T15:01:56Z No. of bitstreams: 1 Mycobacterium leprae in the periodontium.pdf: 364035 bytes, checksum: 937844a13304d66e79ef330c547ce00f (MD5)Made available in DSpace on 2011-04-05T15:01:56Z (GMT). No. of bitstreams: 1 Mycobacterium leprae in the periodontium.pdf: 364035 bytes, checksum: 937844a13304d66e79ef330c547ce00f (MD5) Previous issue date: 2010Universidade Federal do Amazonas. Manaus, AM, Brazil.Fundação de Medicina Tropical. Manaus, AM, Brazil.Universidade Nilton Lins. Medical School. Manaus, AM, Brazil.Fundação Alfredo da Matta. Manaus, AM, Brazil.Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brazil.Objetivo: verificar através da baciloscopia e da reação em cadeia da polimerase (PCR) a presença do M. leprae no periodonto, saliva e raspados intradérmicos de pacientes com hanseníase. Metodologia: Realizou-se um estudo transversal do tipo detecção de casos numa instituição referência de hanseníase no Amazonas. Resultados: Foram avaliados 48 pacientes, sendo 15 multibacilares (MB) e 33 paucibacilares (PB). Os pacientes MB tiveram o diagnóstico confirmado pela baciloscopia e PCR dos raspados intradérmicos, enquanto que 16 (48,5%) dos PB foram positivos apenas na PCR. Quatro pacientes PB negativos na PCR de raspados intradérmicos foram positivos no periodonto e na saliva, 1 positivo na saliva e 2 no periodonto. Nenhuma amostra do periodonto e da saliva foi positiva na baciloscopia. Conclusão: Não houve relação entre a doença periodontal e a presença do M. leprae; a baciloscopia não mostrou ser uma técnica eficiente para análise da saliva e periodonto; a técnica de PCR de raspado dérmico mostrou ser um método mais eficaz no diagnóstico dos PB do que a baciloscopia; a positividade da PCR para detecção do M. leprae nos PB pode ser aumentada coletando raspado intradérmico, periodonto e salivaPurpose: To verify the presence of M. leprae in the periodontium, saliva and skin slit smears of leprosy patients. To correlate bacteriological and molecular findings with clinical data and compare laboratory techniques. Methods: A cross-sectional study was designed to use bacteriological (baciloscopy) and molecular (PCR) parameters to detect M. leprae in exudates of the gingival sulcus/periodontium pocket, saliva and skin slit smears from multiple clinical forms of leprosy patients without previous treatment. Results: The study included 48 leprosy patients with 15 multibacillary (MB) cases and 33 paucibacillary (PB) cases. The diagnosis of MB was confirmed through bacteriological examination and PCR results from skin slit smears. A total of 16 (48.5%) PB patients were PCR positive only. Four PB patients with negative PCR skin smears were PCR positive for the periodontium and saliva, with 2 cases and 1 case, respectively. No periodontium or saliva samples had positive bacteriological results. Conclusion: There was no correlation between periodontal disease and the presence of M. leprae. Bacteriological examination did not prove to be an efficient technique for the analysis of saliva and periodontium samples. PCR analysis of skin smears was more efficient at diagnosing PB patients than bacteriological examination. PCR positive results for the detection of M. leprae in PB patients can be increased by collecting slit skin smears, periodontium and saliva samples

Oropouche virus detection in saliva and urine

Submitted by Sandra Infurna ([email protected]) on 2020-03-20T18:14:45Z No. of bitstreams: 1 ValdineteA_Nascimento_etal_IOC_2020.pdf: 1633279 bytes, checksum: 6476856a2fea50dbc68fc042cca925c6 (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2020-03-20T18:25:29Z (GMT) No. of bitstreams: 1 ValdineteA_Nascimento_etal_IOC_2020.pdf: 1633279 bytes, checksum: 6476856a2fea50dbc68fc042cca925c6 (MD5)Made available in DSpace on 2020-03-20T18:25:29Z (GMT). No. of bitstreams: 1 ValdineteA_Nascimento_etal_IOC_2020.pdf: 1633279 bytes, checksum: 6476856a2fea50dbc68fc042cca925c6 (MD5) Previous issue date: 2020Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Programa de Pós-Graduação em Biologia Celular e Molecular. Rio de Janeiro, RJ, Brasil.Universidade Federal do Amazonas. Manaus, AM, Brasil / Hospital Adventista de Manaus. Manaus, AM, Brasil.Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brasil.Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brasil / Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane; Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro. Manaus, AM, Brasil.Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brasil / Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane; Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro. Manaus, AM, Brasil.Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Programa de Pós-Graduação em Biologia Celular e Molecular. Rio de Janeiro, RJ, Brasil.Universidade do Estado do Amazonas. Manaus, AM, Brasil.Fundação Oswaldo Cruz. Instituto Leônidas e Maria Deane. Manaus, AM, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Programa de Pós-Graduação em Biologia Celular e Molecular. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz-Fiocruz, Instituto Leônidas e Maria Deane, Programa de Pós-Graduação em Biologia da Interação Patógeno-Hospedeiro, Manaus, AM, Brasil.Oropouche virus (OROV) is an arthropod-borne virus of the Peribunyaviridae family, transmitted to humans primarily by Culicoides paraensis. It is one of the main arboviruses infecting humans in Brazil, primarily in the Amazon Region. Here, we report the detection of OROV in the saliva and urine of a patient whose samples were collected five days after the onset of symptoms. Nucleotide sequencing and phylogenetic analysis further confirmed the results. To our knowledge, this is the first study reporting the detection of OROV in the saliva and urine of an infected patient. In addition, the results of our study expand the current knowledge pertaining to the natural history of Oropouche fever

Ascaris lumbricoides coinfection reduces tissue damage by decreasing IL-6 levels without altering clinical evolution of pulmonary tuberculosis or Th1/Th2/Th17 cytokine profile

Submitted by Janaína Nascimento ([email protected]) on 2019-12-27T14:33:13Z No. of bitstreams: 1 ve_Santos_João_etal_INI_2019.pdf: 1835426 bytes, checksum: 8a9bcaca7d66d568e50ba5698efcede0 (MD5)Approved for entry into archive by Janaína Nascimento ([email protected]) on 2019-12-30T12:29:18Z (GMT) No. of bitstreams: 1 ve_Santos_João_etal_INI_2019.pdf: 1835426 bytes, checksum: 8a9bcaca7d66d568e50ba5698efcede0 (MD5)Made available in DSpace on 2019-12-30T12:29:18Z (GMT). No. of bitstreams: 1 ve_Santos_João_etal_INI_2019.pdf: 1835426 bytes, checksum: 8a9bcaca7d66d568e50ba5698efcede0 (MD5) Previous issue date: 2019Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Instituto de Pesquisa Clínica Carlos Borborema. Manaus, AM, Brasil.Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Instituto de Pesquisa Clínica Carlos Borborema. Manaus, AM, Brasil / Universidade Federal de Goiás. Instituto de Patologia Tropical e Saúde Pública. Goiânia, GO, Brasil.Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Instituto de Pesquisa Clínica Carlos Borborema. Manaus, AM, Brasil.Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Instituto de Pesquisa Clínica Carlos Borborema. Manaus, AM, Brasil.Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Diretora de Ensino e Pesquisa. Manaus, AM, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório Interdisciplinar de Pesquisas Médicas. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Micobacterioses. Rio de Janeiro, RJ, Brasil.Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Instituto de Pesquisa Clínica Carlos Borborema. Manaus, AM, Brasil / Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Diretora de Ensino e Pesquisa. Manaus, AM, Brasil / Universidade Federal do Amazonas. Instituto de Ciências Biológicas. Programa de Pós-Graduação em Imunologia Básica e Aplicada. Manaus, AM, Brasil.Prefeitura da Cidade do Rio de Janeiro. Secretaria Municipal de Saúde, Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório Interdisciplinar de Pesquisas Médicas. Rio de Janeiro, RJ, Brasil.Universidade do Estado do Amazonas. Programa de Pós-Graduação em Medicina Tropical. Manaus, AM, Brasil / Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Instituto de Pesquisa Clínica Carlos Borborema. Manaus, AM, Brasil / Fundação Oswaldo Cruz. Instituto de Pesquisas Leônidas & Maria Deane. Manaus, AM, Brasil.Immunological control of Mycobacterium tuberculosis infection is dependent on the cellular immune response, mediated predominantly by Th1 type CD4+ T cells. Polarization of the immune response to Th2 can inhibit the host immune protection against pathogens. Patients with tuberculosis coinfected with helminths demonstrate more severe pulmonary symptoms, a deficiency in the immune response against tuberculosis, and an impaired response to anti-tuberculosis therapy

Increased Serum Levels of Growth-Differentiation Factor 3 (GDF3) and Inflammasome-Related Markers in Pregnant Women during Acute Zika Virus Infection

The systemic inflammatory response elicited by acute Zika virus (ZIKV) infection during pregnancy plays a key role in the clinical outcomes in mothers and congenitally infected offspring. The present study aimed to evaluate the serum levels of GDF-3 and inflammasome-related markers in pregnant women during acute ZIKV infection. Serum samples from pregnant (n = 18) and non-pregnant (n = 22) women with acute ZIKV infection were assessed for NLRP3, IL-1β, IL-18, and GDF3 markers through an enzyme-linked immunosorbent assay. ZIKV-negative pregnant (n = 18) and non-pregnant women (n = 15) were used as control groups. All serum markers were highly elevated in the ZIKV-infected groups in comparison with control groups (p < 0.0001). Among the ZIKV-infected groups, the serum markers were significantly augmented in the pregnant women in comparison with non-pregnant women (NLRP3 p < 0.001; IL-1β, IL-18, and GDF3 p < 0.0001). The IL-18 marker was found at significantly higher levels (p < 0.05) in the third trimester of pregnancy. Bivariate and multivariate analyses showed a strong positive correlation between GDF3 and NLRP3 markers among ZIKV-infected pregnant women (r = 0.91, p < 0.0001). The findings indicated that acute ZIKV infection during pregnancy induces the overexpression of GDF-3 and inflammasome-related markers, which may contribute to congenital disorders and harmful pregnancy outcomes

Atrial fibrillation in a patient with Zika virus infection

Abstract Background Zika virus is an emerging arbovirus of the family Flaviviridae and genus Flavivirus that until 2007 was restricted to a few cases of mild illness in Africa and Asia. Case presentation We report a case of atrial fibrillation disclosed during an acute Zika virus infection in a 49-year-old man. Different biological samples were analyzed for the molecular diagnosis of Zika by real-time PCR, however only the saliva specimen was positive. The patient’s wife tested positive in the serum sample, although she was an asymptomatic carrier. Moreover, a complete overview of patient’s biomarkers, including cytokines, chemokines, and growth-factors levels, was analyzed and compared to gender and age matching non-infected controls, as well as other Zika infected patients, considering the 95%CI of the mean values. Elevated levels of CXCL8, CCL11, CCL2, CXCL10, IL-1β, IL-6, TNF-α, IFN-γ, IL-17, IL-1Ra, IL-4, IL-9, FGF-basic, PDGF, G-CSF, and GM-CSF were observed in the Atrial fibrillation patient, in contrast to uninfected controls. Furthermore, increased levels of CCL5, IL-1β, TNF-α, IFN-γ, IL-9, G-CSF, and GM-CSF were observed only in the atrial fibrillation patient, when compared to other Zika patients. Conclusions To our knowledge, this is the first description of this type of cardiac disorder in Zika patients which may be considered another atypical manifestation during Zika virus infection