First report of human Thelazia callipaeda infection in Portugal

The zoonotic parasitic nematode Thelazia callipaeda, also known as the oriental eye worm, is endemic in several European countries, including Portugal. Infections may result in ocular disease in domestic and wild animals as well as humans, with more or less severe manifestations. We report the first human case of ocular thelaziosis by T. callipaeda in Portugal, a country where the parasite had already been found to infect dogs, cats, red foxes, wild rabbits and a beech marten. An 80-year-old patient from east-central Portugal, who had been suffering from tearing for a few years, had whitish filiform fragments removed from the left eye. Polymerase chain reaction of partial cytochrome c oxidase subunit 1 and 18S small subunit rRNA genes followed by bidirectional sequencing and BLAST analysis confirmed T. callipaeda haplotype 1, the only haplotype previously reported in Europe. The endemicity of T. callipaeda in domestic and wild animals in east-central Portugal makes it very likely that infection of the human patient had occurred locally. In east-central and other geographical areas of Portugal, veterinarians and physicians, especially ophthalmologists, should regard T. callipaeda as a cause of ocular pathology in animals and humans. © 2022This work was supported by national funds, through Fundação para a Ciência e Tecnologia (FCT, Portuguese Foundation for Science and Technology), under projects UIDB/CVT/00772/2020 and LA/P/0059/2020, and also projects UIDB/04750/2020 and LA/P/0064/2020

Australian health policy and end of life care for people with chronic disease: An analysis

End of life care for people with advanced chronic disease is a growing international imperative, with the majority of deaths in the world now related to chronic disease. The provision of care that meets the needs of people with advanced chronic disease must be guided by appropriate policy. The key policy areas impacting directly on end of life care are related to chronic disease, palliative care and, increasingly, aged care. This paper describes the outcomes of an audit of Australian chronic disease and end of life/palliative care policies. We identified that chronic disease health policies/strategies demonstrate a focus on prevention, early intervention and management, with scant recognition of end of life care needs. The majority assume that a referral to palliative care will address end of life care needs for people with chronic disease. By contrast, palliative care policies recognise the need for the incorporation of a palliative approach into advanced chronic disease care, but there are few connections between these two policy areas. Whilst palliative care policies intersect with carer and advance care planning policies, chronic disease policy does not. Key concerns requiring consideration when developing policy in this area are discussed and possible policy options identified.Teresa Burgess, Annette Braunack-Mayer, Gregory B. Crawford, Justin Beilb

Viral agents and their correlation with the genetic profile of predisposition to human neoplastic and autoimmune diseases

Herpesviruses (HHV) are ubiquitous, have broad tissue tropism and have been found in the thyroid, which can be a reservoir of latent HHV. HHV are considered potential carcinogenic agents and have been identified in many malignancies. More recently, they have also been associated to a series of autoimmune conditions. TP53 gene plays a critical role in cell cycle control, facilitating DNA repair activities and protecting against DNA damages. HHV infected cells may gain a dangerous survival time in individuals with impairing apoptotic ability, such as that caused by TP53 gene polymorphisms. Other genes involved in the response to environmental aggressions, such as the genes that codify the Glutathione S-Trans ferase (GST) and other enzymatic protective systems, may modulate the risk of developing diseases. We recently demonstrated an increased risk for HHV6 infection in individuals that inherited a codon 72 TP53 polymorphism which reduces p53 apoptotic activity. Our studies demonstrated a higher prevalence of HHV type 6 in patients submitted to renal transplants than in a control population, suggesting that TP53 gene polymorphisms might affect the susceptibility to HHV infection. In addition, we observed that HHV can increase the risk of skin cancer, an event associated with the Glutathione S-Trans ferase (GST) genotypic profile GSTM1-GSTT1+. More recently, while investigating autoimmune diseases, we observed a high prevalence of HHV type 7, but not type 6 infection in Graves' disease patients. These individuals also presented the codon 72 TP53 germline polymorphism more frequently. Although further studies are needed, our results suggest that viral agents such as HHV may trigger autoimmune as well as neoplastic diseases in individuals with a predisposing genetic profile.17323023

Hemodynamic benefits of matrix metalloproteinase-9 inhibition by doxycycline during experimental acute pulmonary embolism

The authors examined whether acute pulmonary embolism (APE) increases lung matrix metalloproteinase (MMP)-2 and MMP-9 activities and whether inhibition of MMPs with doxycycline attenuates the hemodynamic changes associated with APE. Anesthetized male Wistar rats were monitored for mean arterial blood pressure (MAP) and heart rate (HR). Rats in the control group (n = 5) received only saline IV; rats in the embolism (Emb) group (n = 8) received saline IV followed 10 minutes later by an injection of Sephadex microspheres (9 mg/kg) IV; rats in the doxycycline (Doxy) group (n = 4) received only doxycycline (30 mg/kg) IV, followed 10 minutes later by an injection of saline IV; rats in the Doxy + Emb group (n = 8) received the same dose of doxycycline followed 10 minutes later by the same amount of microspheres described above. Lung samples were homogenized and assayed by SDS-polyacrilamide gel electrophoresis gelatin zymography to evaluate lung MMP-2 and MMP-9 activities. Saline or doxycycline produced no significant changes in MAP, HR, and in MMP-2 and MMP-9 activities. Conversely, lung embolization significantly reduced MAP by > 32 mm Hg and HR by > 90 bpm for more than 60 minutes, and increased MMP-9 activity by 43% (all p < 0.05). No significant differences were observed in MMP-2 activity, However, lung embolization produced only transient hypotension in rats pretreated with doxycycline. In this group, MAP returned to baseline values 5 to 10 minutes after embolization. In addition, pretreatment with doxycycline blunted the increase in lung MMP-9 activity after lung embolization (p < 0.05). This study demonstrates for the first time that MMP-9 inhibition with doxycycline attenuates APE-induced hemodynamic changes in the animal model examined, These findings indicate that MMP-9 activation plays a role in the pathophysiology of APE and suggest that pharmacologic strategies targeting specific MMPs with selective inhibitors may prevent the detrimental acute hemodynamic consequences of APE.56561161