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SARS-CoV-2 has caused an estimated 7 million deaths worldwide to date. A secreted SARS-CoV-2 accessory protein, known as open reading frame 8 (ORF8), elicits inflammatory pulmonary cytokine responses and is associated with disease severity in COVID-19 patients. Recent reports proposed that ORF8 mediates downstream signals in macrophages and monocytes through the IL-17 receptor complex (IL-17RA, IL-17RC). However, generally IL-17 signals are found to be restricted to the nonhematopoietic compartment, thought to be due to rate-limiting expression of IL-17RC. Accordingly, we revisited the capacity of IL-17 and ORF8 to induce cytokine gene expression in mouse and human macrophages and monocytes. In SARS-CoV-2-infected human and mouse lungs, IL17RC mRNA was undetectable in monocyte/macrophage populations. In cultured mouse and human monocytes and macrophages, ORF8 but not IL-17 led to elevated expression of target cytokines. ORF8-induced signaling was fully preserved in the presence of anti-IL-17RA/RC neutralizing Abs and in Il17ra-/- cells. ORF8 signaling was also operative in Il1r1-/- bone marrow-derived macrophages. However, the TLR/IL-1R family adaptor MyD88, which is dispensable for IL-17R signaling, was required for ORF8 activity yet MyD88 is not required for IL-17 signaling. Thus, we conclude that ORF8 transduces inflammatory signaling in monocytes and macrophages via MyD88 independently of the IL-17R.

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Tick-borne protozoans of the genus Hepatozoon are obligate hemoparasites that can infect domestic and wild terrestrial vertebrates. Main hepatozoonosis affects canids and involves mainly Hepatozoon canis and Hepatozoon americanum. However, molecular studies revealed the capacity of H. canis to infect a wide range of wild mammals. In July 2018, we conducted an epidemiological survey for tick-borne pathogens in wild hosts, assaying Hepatozoon sp. occurrence in 34 bats captured in different habitats within a conservation unit in the state of Espírito Santo, southeastern Brazil. Blood and spleen tissue DNA samples were submitted to PCR amplifications of Babesia/Theileria and Hepatozoon 18S rRNA gene and 21% (7/34) were positive for Hepatozoon sp. Phylogenetic inferences grouped the obtained sequences from Seba's short-tailed bat (Carollia perspicillata) with the H. canis cluster, and from the great fruit-eating bat (Artibeus lituratus) with rodent-associated Hepatozoon cluster. Further studies are needed to characterize the epidemiological role of Seba's short-tailed bat and the great fruit-eating bat in the wild transmission cycle of these hemoparasites in Brazil.

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Ticks endure stressful off-host periods and perform as vectors of a diversity of infectious agents, thus engaging pathways that expectedly demand for autophagy. Little is known of ticks' autophagy, a conserved eukaryotic machinery assisting in homeostasis processes that also participates in tissue-dependent metabolic functions. Here, the autophagy-related ATG4 (autophagin-1), ATG6 (beclin-1) and ATG8 (LC3) mRNAs from the human diseases vector Amblyomma sculptum and the cattle-tick Rhipicephalus microplus were identified. Comparative qPCR quantifications evidenced different transcriptional status for the ATG genes in the salivary glands (SG), ovaries and intestines of actively feeding ticks. These ATGs had increased relative transcription under nutrient-deprivation, as determined by validation tests with R. microplus embryo-derivative cells BME26 and A. sculptum SG explants incubations in HBSS. Starvation lead to 4-31.8× and ~ 60-500× increments on the ATGs mRNA loads in BME26 and A. sculptum SG explants, respectively. PI3K inhibitor 3MA treatment also affected ATGs expression in BME26. Some ATGs were more transcribed in the SGs than in the ovaries of cattle-ticks. Amblyomma sculptum/R. microplus interspecific comparisons showed that ATG4 and ATG6 were 0.18× less expressed in A. sculptum SGs, but ~ 10-100× more expressed in their ovaries when compared to R. microplus organs. ATG4 and ATG8a transcript loads were ~ 120× and ~ 40× higher, respectively, in A. sculptum intestines when compared to cattle-ticks of similar weight category. ATGs expression in A. sculptum intestines increased with tick weight, indicating Atgs contribution to intracellular blood digestion. Possible roles of the autophagy machinery and their organ-specific expression profile on vector biology are discussed.

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INTRODUCTION: Orthotopic liver transplantation (OLT) can be associated with significant bleeding requiring multiple blood product transfusions. Rotational thromboelastometry (ROTEM) is a point-of-care device that has been used to monitor coagulation during OLT. Whether it reduces blood loss/transfusions during OLT remains controversial. MATERIALS AND METHODS: We aim to compare ROTEM with conventional coagulation tests (aPTT, PT, INR, platelet count, fibrinogen) to guide transfusion of platelets, cryoprecipitate, and fresh frozen plasma (FFP) during OLT over 3 years. Thirty-four patients who had transfusions guided by ROTEM were compared to 34 controls who received transfusions guided by conventional coagulation tests (CCT). Intraoperative blood loss, type/ amount of blood products transfused, and direct costs were compared between the two groups. RESULTS: The ROTEM group had significantly less intra-operative blood loss (2.0 vs. 3.0 L, p = 0.04) and fresh frozen plasma (FFP) transfusion (4 units vs. 6.5 units, p = 0.015) compared to the CCT group (2.0L vs. 3.0L, p = 0.04). However, total number of patients transfused cryoprecipitate was increased in ROTEM (n = 25;73%) as compared to CCT (n = 19; 56%), p = 0.033. The direct cost of blood products plus testing was reduced in the ROTEM group ($113,142.89 vs. $127,814.77). CONCLUSION: In conclusion implementation of a ROTEM-guided transfusion algorithm resulted in a reduction in intra-operative blood loss, FFP transfusion and a decrease in direct cost during OLT. ROTEM is a useful and safe point of care device in OLT setting.

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Tendo em vista os problemas inerentes à gravidez na adolescência e a importância de direcionar ações de saúde para essa população a Unidade de Adolescentes do Instituto da Criança do Hospital das Clínicas da USP estendeu o atendimento, oferecendo atenção integral para mães adolescentes e seus filhos que freqüentaram o pré-natal na Disciplina de Obstetrícia da FMUSP. Este estudo visou identificar algumas características do modo de vida das mães adolescentes que freqüentam esse serviço. A população amostral foi constituída pelas 81 jovens que freqüentavam o ambulatório no período de estudo. Verificou-se que 76,5% delas não planejaram a gestação. Mesmo assim, com o apoio familiar e da instituição, planejavam mais filhos em data futura. A maioria delas convivia com o companheiro que, algumas vezes, assumiu também a chefia da família da adolescente. Grande parte delas, 54,3 % abandonou os estudos e, das 59 mães que trabalhavam, 38 deixaram de fazê-lo. As atividades de lazer foram modificadas e cerca de metade das jovens deixou de participar de qualquer atividade de lazer. O estudo permite ressaltar as repercussões da maternidade na vida das jovens e evidencia a importância do pré-natal e de serviços que proporcionem atendimento pós-parto, enfocando a saúde de uma forma global, beneficiando as adolescentes e seus filhos(AU)

Taking into account the inherent problems concerning adolescent pregnancy and the importance of implementing health actions targeted at that population, this paper aims to identify social characteristics of adolescent mothers who were followed up, during the prenatal period, by the Discipline of Obstetrics of the School of Medicine of the University of S„o Paulo, linked to the Adolescent Unit of Hospital das Cl¡nicas. The sample population was composed of the 81 mothers who attended that Unit during the study period. Information concerning personal characteristics was collected by a survey. It was verified that 76.5 percent of the young mothers had not intended to become pregnant, but with the support provided by the family and the institution, they were planning to have more babies in the future. The majority of them lived with their partner, who, in some cases, became the head of the adolescent's family. Of the 81 mothers, 39.5 percent did not complete elementary school; 54.3 percent quitted studying and 49 percent did not work. Their leisure activities changed and approximately half of the adolescents stopped participating in any leisure activity, during and after pregnancy. The study emphasizes the importance of prenatal and postnatal care in order to benefit those young women and their children.(AU)

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Objetivos: comparar pacientes portadoras de incontinência urinária de esforço genuína (IUEG) que se submeteram a um protocolo de cinesioterapia para reforço perineal àquelas que se submeteram a eletroestimulação endovaginal (EEEV). O objetivo foi traçar uma conduta de tratamento fisioterápico mais adequada para tal enfermidade. Métodos: foram selecionadas 14 pacientes portadoras de IUEG, com idade entre 31 e 64 anos, sendo divididas em dois grupos de 7 mulheres cada. Cada grupo foi submetido a um dos protocolos de tratamento ambulatorial diário durante 10 dias consecutivos. As pacientes foram avaliadas e reavaliadas por somente uma fisioterapeuta. Para as análises estatísticas foram utilizados testes não paramétricos. Resultados: todas pacientes obtiveram uma melhora parcial ou total da IUEG com 10 sessões fisioterápicas consecutivas, considerando os critérios objetivos e subjetivos de avaliação. Conclusão: tanto a cinesioterapia quanto a EEEV se mostraram efetivas no tratamento da IUEG, porém, a cinesioterapia para reforço perineal apresentou uma tendência para ser o tratamento de escolha

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