Mieloradiculite por CMV e HSV2 em paciente infectado pelo HIV

While CMV myeloradiculitis is a known complication in AIDS patients with severe immunosuppression, HSV-2 necrotizing myeloradiculitis is rare and often associated with disabling a fatal outcome. We hereby describe a 46 year-old HIV infected patient with profound and sustained immunosuppression who presented with an acute ascending paraparesis and urinary retention. Lumbar spine MRI showed contrast enhancement at the conus medullaris and cauda equine, and both CMV and HSV-2 CSF PCR were positive. Despite treatment, the patient died 20 days later. We review the main diagnostic and therapeutic aspects of herpes virus associated myeloradiculitis and discuss the approach in similar cases.Enquanto a mieloradiculite pelo CMV é complicação conhecida em pacientes com SIDA e imunossupressão grave, a mieloradiculite necrosante por HSV-2 é rara e muitas vezes associada a sequelas ou desfecho fatal. Descrevemos um paciente de 46 anos de idade, infectado pelo HIV com imunossupressão profunda e sustentada que apresentou paraparesia aguda ascendente e retenção urinária. A RM de coluna lombar mostrou o realce de contraste no cone medular e cauda equina e ambos PCR para CMV e HSV-2 no LCR foram positivos. Apesar do tratamento, o paciente morreu 20 dias depois. Revisamos os principais aspectos diagnósticos e terapêuticos da mieloradiculite associada aos herpesvírus e discutimos a abordagem em casos semelhantes

Pumping Iron in the Preoperative Period: Is It Beneficial in Reducing Blood Transfusions?

Carla Patel pictured.https://openworks.mdanderson.org/aprn-week-23/1002/thumbnail.jp

Antiviral Properties against SARS-CoV-2 of Nanostructured ZnO Obtained by Green Combustion Synthesis and Coated in Waterborne Acrylic Coatings

peer reviewedThe COVID-19 pandemic has increased the need for developing disinfectant surfaces as well as reducing the spread of infections on contaminated surfaces and the contamination risk from the fomite route. The present work reports on the antiviral activity of coatings containing ZnO particles obtained by two simple synthesis routes using Aloe vera (ZnO-aloe) or cassava starch (ZnO-starch) as reaction fuel. After detailed characterization using XRD and NEXAFS, the obtained ZnO particles were dispersed in a proportion of 10% with two different waterborne acrylic coatings (binder and commercial white paint) and brushed on the surface of polycarbonates (PC). The cured ZnO/coatings were characterized by scanning electron microscopes (SEM) and energy-dispersive X-ray spectroscopy (EDS). Wettability tests were performed. The virucidal activity of the ZnO particles dispersed in the waterborne acrylic coating was compared to a reference control sample (PC plates). According to RT-PCR results, the ZnO-aloe/coating displays the highest outcome for antiviral activity against SARS-CoV-2 using the acrylic binder, inactivating >99% of the virus after 24 h of contact relative to reference control

Microsatellite analysis supports clonal propagation and reduced divergence of Trypanosoma vivax from asymptomatic to fatally infected livestock in South America compared to West Africa

Background: Mechanical transmission of the major livestock pathogen Trypanosoma vivax by other biting flies than\ud tsetse allows its spread from Africa to the New World. Genetic studies are restricted to a small number of isolates\ud and based on molecular markers that evolve too slowly to resolve the relationships between American and West\ud African populations and, thus, unable us to uncover the recent history of T. vivax in the New World.\ud Methods: T. vivax genetic diversity, population structure and the source of outbreaks was investigated through the\ud microsatellite multiloci (7 loci) genotype (MLGs) analysis in South America (47isolates from Brazil, Venezuela and\ud French Guiana) and West Africa (12 isolates from The Gambia, Burkina Faso, Ghana, Benin and Nigeria).\ud Relationships among MLGs were explored using phylogenetic, principal component and STRUCTURE analyses.\ud Results: Although closely phylogenetically related, for the first time, genetic differences were detected between\ud T. vivax isolates from South America (11 genotypes/47 isolates) and West Africa (12 genotypes/12 isolates) with no\ud MLGs in common. Diversity was far greater across West Africa than in South America, where genotypes from Brazil\ud (MLG1-6), Venezuela (MLG7-10) and French Guiana (MLG11) shared similar but not identical allele composition. No\ud MLG was exclusive to asymptomatic (endemic areas) or sick (outbreaks in non-endemic areas) animals, but only\ud MLGs1, 2 and 3 were responsible for severe haematological and neurological disorders.\ud Conclusions: Our results revealed closely related genotypes of T. vivax in Brazil and Venezuela, regardless of\ud endemicity and clinical conditions of the infected livestock. The MLGs analysis from T. vivax across SA and WA\ud support clonal propagation, and is consistent with the hypothesis that the SA populations examined here derived\ud from common ancestors recently introduced from West Africa. The molecular markers defined here are valuable to\ud assess the genetic diversity, to track the source and dispersion of outbreaks, and to explore the epidemiological\ud and pathological significance of T. vivax genotypes.This work was funded through projects within the PROAFRICA and PROSUL programs from the Brazilian agency CNPq. We are grateful to Professor Erney P. Camargo for the joint coordination of these projects and helpful commentaries on the manuscript. HAG was funded by a CDCH-UCV studentship from Venezuela; ACR is a postdoctoral fellow of PNPD-CAPES and CMFR is recipient of PhD scholarships from CNPq-PROTAX. The authors would like to acknowledge for clinical and epidemiological information, blood samples of T. vivax infected livestock and valuable help in the fieldwork several colleagues Garcia et al. Parasites & Vectors 2014, 7:210 Page 11 of 13\ud http://www.parasitesandvectors.com/content/7/1/210 from African countries, Venezuela and Brazil (Galiza GF, Da Silva A and Cadioli L\ud also for previous joint studies). We are grateful to The Wellcome Trust for making available sequences from the genome of T. vivax from Sanger Institute. We are deeply in debt to Wendy Gibson (Bristol University, UK) for helpful discussions and suggestions that much improved our manuscript

Cancer health disparities in racial/ethnic minorities in the United States

There are well-established disparities in cancer incidence and outcomes by race/ethnicity that result from the interplay between structural, socioeconomic, socio-environmental, behavioural and biological factors. However, large research studies designed to investigate factors contributing to cancer aetiology and progression have mainly focused on populations of European origin. The limitations in clinicopathological and genetic data, as well as the reduced availability of biospecimens from diverse populations, contribute to the knowledge gap and have the potential to widen cancer health disparities. In this review, we summarise reported disparities and associated factors in the United States of America (USA) for the most common cancers (breast, prostate, lung and colon), and for a subset of other cancers that highlight the complexity of disparities (gastric, liver, pancreas and leukaemia). We focus on populations commonly identified and referred to as racial/ethnic minorities in the USA—African Americans/Blacks, American Indians and Alaska Natives, Asians, Native Hawaiians/other Pacific Islanders and Hispanics/Latinos. We conclude that even though substantial progress has been made in understanding the factors underlying cancer health disparities, marked inequities persist. Additional efforts are needed to include participants from diverse populations in the research of cancer aetiology, biology and treatment. Furthermore, to eliminate cancer health disparities, it will be necessary to facilitate access to, and utilisation of, health services to all individuals, and to address structural inequities, including racism, that disproportionally affect racial/ethnic minorities in the USA.Fil: Zavala, Valentina A.. University of California; Estados UnidosFil: Bracci, Paige M.. University of California; Estados UnidosFil: Carethers, John M.. University of Michigan; Estados UnidosFil: Carvajal Carmona, Luis. University of California at Davis; Estados UnidosFil: Coggins, Nicole B.. University of California at Davis; Estados UnidosFil: Cruz Correa, Marcia R.. Universidad de Puerto Rico; Puerto RicoFil: Davis, Melissa. No especifíca;Fil: de Smith, Adam J.. University of California; Estados UnidosFil: Dutil, Julie. Ponce Research Institute; Puerto RicoFil: Figueiredo, Jane C.. Cedars Sinai Medical Center; Estados UnidosFil: Fox, Rena. University of California; Estados UnidosFil: Graves, Kristi D.. University Of Georgetown; Estados UnidosFil: Gomez, Scarlett Lin. University of California; Estados UnidosFil: Llera, Andrea Sabina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; ArgentinaFil: Neuhausen, Susan L.. No especifíca;Fil: Newman, Lisa. No especifíca;Fil: Nguyen, Tung. University of California; Estados UnidosFil: Palmer, Julie R.. National Institutes of Health; Estados UnidosFil: Palmer, Nynikka R.. University of California; Estados UnidosFil: Pérez Stable, Eliseo J.. National Institutes of Health; Estados UnidosFil: Piawah, Sorbarikor. University of California; Estados UnidosFil: Rodriquez, Erik J.. National Institutes of Health; Estados UnidosFil: Sanabria Salas, María Carolina. Instituto Nacional de Cancerología; ColombiaFil: Schmit, Stephanie L.. University of Southern California; Estados UnidosFil: Serrano Gomez, Silvia J.. Instituto Nacional de Cancerología; ColombiaFil: Stern, Mariana Carla. University of Southern California; Estados UnidosFil: Weitzel, Jeffrey. No especifíca;Fil: Yang, Jun J.. St. Jude Children’s Research Hospital; Estados UnidosFil: Zabaleta, Jovanny. No especifíca;Fil: Ziv, Elad. University of California; Estados UnidosFil: Fejerman, Laura. University of California; Estados Unido

Enfermidades de cutias (Dasyprocta aguti) criadas em cativeiro diagnosticadas pelo exame anatomopatológico

O exame necroscópico é especialmente útil no diagnóstico de enfermidades em animais silvestres. Em muitas ocasiões, as manifestações clínicas não são características como em animais domésticos, sendo frequente a ocorrência de óbitos em animais assintomáticos. Este trabalho objetivou realizar um estudo retrospectivo sobre as doenças de cutias diagnosticadas pelo Laboratório de Patologia Veterinária da Universidade Federal Rural do Semi-Árido, através do exame anatomopatológico no período de 2006 a 2009. Em 32 cutias submetidas à necropsia, as percentagens das enfermidades diagnosticadas foram: morte perinatal pelo complexo inanição/hipotermia (21,6%), urolitíase obstrutiva (6,24%), distocia (6,24%), obstrução do ceco por areia - sablose (6,24%), intussuscepção (3,20%), fecaloma (3,20%) e obstrução do esôfago (3,20%). Dezesseis (16) animais permaneceram sem diagnóstico, dos quais nove (28,48%) apresentavam avançado estado autolítico e em sete (21,60%) não foram observadas lesões macro e microscópicas compatíveis com nenhuma enfermidade. Este artigo apresenta relatos de doenças ainda não descritas em cutias e seus resultados poderão produzir literatura sobre os aspectos patológicos destas enfermidades nessa espécie.Necroscopic examination is remarkably useful to diagnose wild animal's diseases. In several occasions the clinical signs are not charactheristic as in domestic animals and the occurrence of death in asymptomatic animals is frequent. Thus, the present work aimed to accomplish a retrospective study on agouti diseases diagnosed by pathological examination in the Laboratory of Veterinary Pathology, Federal Rural University of the Semi-arid, through January 2006 to December 2006. In 32 agoutis submitted to the necropsy, the percentage of diagnosed diseases was: perinatal death due hypothermia/ inanition complex (21.6%), obstructive urolithiasis (6.24%), dystocia (6.24%), cecum sablosis (6.24%), intussusceptions (3.20%), fecaloma (3.20%) and esophagus obstruction (3.20%). A total of 16 (50.08%) animals remained undiagnosed in which nine (28.48%) showed advanced autolysis and seven (21.60%) agouti had none macroscopic or microscopic lesions compatible with any disease. The present article presents reports of some diseases not yet diagnosed in agoutis and these results may produce literature review about the pathologic aspects of these diseases in this species

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Introducing BASE: the Biomes of Australian Soil Environments soil microbial diversity database

Microbial inhabitants of soils are important to ecosystem and planetary functions, yet there are large gaps in our knowledge of their diversity and ecology. The ‘Biomes of Australian Soil Environments’ (BASE) project has generated a database of microbial diversity with associated metadata across extensive environmental gradients at continental scale. As the characterisation of microbes rapidly expands, the BASE database provides an evolving platform for interrogating and integrating microbial diversity and function

Introducing BASE: the Biomes of Australian Soil Environments soil microbial diversity database

Background: Microbial inhabitants of soils are important to ecosystem and planetary functions, yet there are large gaps in our knowledge of their diversity and ecology. The 'Biomes of Australian Soil Environments' (BASE) project has generated a database of microbial diversity with associated metadata across extensive environmental gradients at continental scale. As the characterisation of microbes rapidly expands, the BASE database provides an evolving platform for interrogating and integrating microbial diversity and function. Findings: BASE currently provides amplicon sequences and associated contextual data for over 900 sites encompassing all Australian states and territories, a wide variety of bioregions, vegetation and land-use types. Amplicons target bacteria, archaea and general and fungal-specific eukaryotes. The growing database will soon include metagenomics data. Data are provided in both raw sequence (FASTQ) and analysed OTU table formats and are accessed via the project's data portal, which provides a user-friendly search tool to quickly identify samples of interest. Processed data can be visually interrogated and intersected with other Australian diversity and environmental data using tools developed by the 'Atlas of Living Australia'. Conclusions: Developed within an open data framework, the BASE project is the first Australian soil microbial diversity database. The database will grow and link to other global efforts to explore microbial, plant, animal, and marine biodiversity. Its design and open access nature ensures that BASE will evolve as a valuable tool for documenting an often overlooked component of biodiversity and the many microbe-driven processes that are essential to sustain soil function and ecosystem services