Keratinocytes Determine Th1 Immunity during Early Experimental Leishmaniasis

Experimental leishmaniasis is an excellent model system for analyzing Th1/Th2 differentiation. Resistance to Leishmania (L.) major depends on the development of a L. major specific Th1 response, while Th2 differentiation results in susceptibility. There is growing evidence that the microenvironment of the early affected tissue delivers the initial triggers for Th-cell differentiation. To analyze this we studied differential gene expression in infected skin of resistant and susceptible mice 16h after parasite inoculation. Employing microarray technology, bioinformatics, laser-microdissection and in-situ-hybridization we found that the epidermis was the major source of immunomodulatory mediators. This epidermal gene induction was significantly stronger in resistant mice especially for several genes known to promote Th1 differentiation (IL-12, IL-1β, osteopontin, IL-4) and for IL-6. Expression of these cytokines was temporally restricted to the crucial time of Th1/2 differentiation. Moreover, we revealed a stronger epidermal up-regulation of IL-6 in the epidermis of resistant mice. Accordingly, early local neutralization of IL-4 in resistant mice resulted in a Th2 switch and mice with a selective IL-6 deficiency in non-hematopoietic cells showed a Th2 switch and dramatic deterioration of disease. Thus, our data indicate for the first time that epidermal cytokine expression is a decisive factor in the generation of protective Th1 immunity and contributes to the outcome of infection with this important human pathogen

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Data from: Biomass resilience of Neotropical secondary forests

Land-use change occurs nowhere more rapidly than in the tropics, where the imbalance between deforestation and forest regrowth has large consequences for the global carbon cycle1. However, considerable uncertainty remains about the rate of biomass recovery in secondary forests, and how these rates are influenced by climate, landscape, and prior land use2, 3, 4. Here we analyse aboveground biomass recovery during secondary succession in 45 forest sites and about 1,500 forest plots covering the major environmental gradients in the Neotropics. The studied secondary forests are highly productive and resilient. Aboveground biomass recovery after 20 years was on average 122 megagrams per hectare (Mg ha−1), corresponding to a net carbon uptake of 3.05 Mg C ha−1 yr−1, 11 times the uptake rate of old-growth forests. Aboveground biomass stocks took a median time of 66 years to recover to 90% of old-growth values. Aboveground biomass recovery after 20 years varied 11.3-fold (from 20 to 225 Mg ha−1) across sites, and this recovery increased with water availability (higher local rainfall and lower climatic water deficit). We present a biomass recovery map of Latin America, which illustrates geographical and climatic variation in carbon sequestration potential during forest regrowth. The map will support policies to minimize forest loss in areas where biomass resilience is naturally low (such as seasonally dry forest regions) and promote forest regeneration and restoration in humid tropical lowland areas with high biomass resilience

Data from: Legume abundance along successional and rainfall gradients in neotropical forests

Data from: Legume Abundance Along Successional And Rainfall Gradients In Neotropical ForestsThis database is the product of the 2ndFOR collaborative research network on secondary forests. The database contains total basal area data (in m2 ha-1) of legume trees (Leguminosae) for 1207 secondary forest plots differing in time since abandonment. The plots belong to different chonosequence studies. For a description of the database, see Gei et al. 2018. Legume Abundance Along Successional And Rainfall Gradients In Neotropical Forests. Nature Ecology and Evolution. The file Legume basal area 2ndFOR data.csv contains the following variables: Chronosequence: name of the chronosequence site Age: age of the plot (in years), OG indicates old-growth forest of unknown age LBA: total basal area of legume trees (Leguminosae) of the plot in m2 ha-1 Reference: a citation for the chronosequence study, if available PI/contact person: name(s) of the principal investigator(s) or contact person(s) for the chronosequence study.Legume basal area 2ndFOR data.csv,The nutrient demands of regrowing tropical forests are partly satisfied by nitrogen (N)-fixing legume trees, but our understanding of the abundance of those species is biased towards wet tropical regions. Here we show how the abundance of Leguminosae is affected by both recovery from disturbance and large-scale rainfall gradients through a synthesis of forest-inventory plots from a network of 42 Neotropical forest chronosequences. During the first three decades of natural forest regeneration, legume basal area is twice as high in dry compared to wet secondary forests. The tremendous ecological success of legumes in recently disturbed, water-limited forests is likely related to both their reduced leaflet size and ability to fix N2, which together enhance legume drought tolerance and water-use efficiency. Earth system models should incorporate these large-scale successional and climatic patterns of legume dominance to provide more accurate estimates of the maximum potential for natural N fixation across tropical forests

TRATAMIENTO SINDROMICO DE FLUJO VAGINAL EN GESTANTES ATENDIDAS EN EL CENTRO DE SALUD CHACAPUNCO ENERO A JUNIO 2017

TesisObjetivo: Determinar las características del tratamiento sindrómico de flujo vaginal. Metodología: El tipo de investigación es sustantiva, nivel descriptivo y diseño descriptivo simple. Se trabajó con una muestra censal de 30 gestantes que desarrollaron síndrome de flujo vaginal resultados: Las características encontradas en la edad fue edad mínima 17 años y la máxima 40 años, la mayoría presentó 23 años., el 53% son convivientes. Según el grado de instrucción, el 60% de las gestantes tienen primaria, el 47% son amas de casa, el 87% procede del área rural. Dentro de las características clínicas el 67% de las gestantes tienen abundante secreción, las características de las secreciones vaginales son el 67% presentan aspecto leche cortada, el 33% mal olor. Y los síntomas identificados fueron 60% disuria y prurito vulvar. Se encontró que el 60% de las gestantes atendidas tienen como diagnostico presuntivo trichomona y cándida. Las complicaciones encontradas fueron: amenaza de parto prematuro 60%, amenaza de aborto 27%. La respuesta al tratamiento sindrómico de flujo vaginal en gestantes el 73% de las gestantes se suministró el Metronidazol y al 87% con Clotrimazol. Conclusión: El tratamiento sindrómico de flujo vaginal con medicamentos resulto que el 83% de las gestantes fue efectivo y el 17% de las gestantes no fue efectivo. Palabras claves: Síndrome de flujo vaginal, tratamiento y gestantes