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The COVID-19 pandemic has significantly impacted global health, and the widespread immunization of adults against SARS-CoV-2 has played a pivotal role in altering the course of the disease. While COVID-19 vaccine adverse events are generally uncommon and mild, the recent vaccination of the pediatric population has emphasized the need for vigilance and reporting of potential side effects. In this case report, we present a 6-year-old boy who developed Henoch-Schönlein purpura following the administration of the first dose of Pfizer-BioNTech BNT16B2b2 mRNA COVID-19 vaccine, making it the earliest reported case of such an adverse event. Our report highlights the importance of continued monitoring and reporting of adverse events in pediatric patients receiving the COVID-19 vaccine, as well as the need for prompt diagnosis and management of potential vaccine-related complications.
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BACKGROUND: Obstructive sleep apnea (OSA) is the most common form of sleep-disordered breathing in cerebrovascular diseases, requiring a multidisciplinary approach. There are few studies evaluating the effects of inspiratory muscle training (IMT) in individuals with OSA and the findings regarding the possible effect on apnea hypopnea index (AHI) reduction are controversial. OBJECTIVE: This protocol for a randomized clinical trial will assess the effects of IMT on the severity of obstructive sleep apnea, sleep quality, and daytime sleepiness in individuals after stroke participating in a rehabilitation program. METHODS: This study will be a randomized controlled trial with blinded assessors. Forty individuals after stroke will randomized to two groups. For 5 weeks, both groups will participate in the rehabilitation program activities, including aerobic exercise, resistance training, and educational class when they will receive guidance on the behavioral management of OSA. The experimental group will also perform high-intensity IMT 5 times a week, for 5 weeks, consisting initially of five sets of five repetitions achieving 75% of the maximal inspiratory pressure, increasing one set each week, totaling nine sets at the end of training. The primary outcome will be the severity of OSA measured as AHI at 5 weeks. Secondary outcomes will include sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI) and daytime sleepiness measured by Epworth Sleepiness Scale (ESS). Outcomes will be collected by a researcher blinded to group allocation at baseline (week 0), after intervention (week 5), and 1 month beyond intervention (week 9). TRIAL REGISTRATION: Clinical Trials Register: NCT05135494.
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Trastornos de Somnolencia Excesiva , Síndromes de la Apnea del Sueño , Apnea Obstructiva del Sueño , Accidente Cerebrovascular , Humanos , Apnea Obstructiva del Sueño/terapia , Accidente Cerebrovascular/complicaciones , Músculos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
OBJECTIVE: To identify optimal areas for the insertion of extra-alveolar miniscrews into the infrazygomatic crest (IZC) and mandibular buccal shelf (MBS), using cone beam computed tomography (CBCT) imaging in patients with different craniofacial patterns. METHODS: CBCT reconstructions of untreated individuals were used to evaluate the IZC and MBS areas. The participants were divided into three groups, based on the craniofacial pattern, namely, brachyfacial (n = 15; mean age, 23.3 years), mesofacial (n = 15; mean age, 19.24 years), and dolichofacial (n = 15; mean age, 17.79 years). In the IZC, the evaluated areas were at 11, 13, and 15 mm above the buccal cusp tips of the right and left first molars. In the MBS, the evaluated areas were at the projections of the first molars' distal roots and second molars' mesial and distal roots, at a 4- and 8-mm distance from the cementoenamel junction. Intergroup comparisons were performed with analysis of variance and the Tukey test. RESULTS: There was no statistically significant difference in the IZC bone thickness among the groups. For MBS bone availability, some comparisons revealed no difference; meanwhile, other comparisons revealed increased MBS bone thickness in the brachyfacial (first molars distal roots) and dolichofacial (second molars mesial and distal roots) patterns. CONCLUSIONS: There was no significant difference in the IZC bone thickness among the groups. The facial skeletal pattern may affect the availability of ideal bone thickness for the insertion of extra-alveolar miniscrews in the MBS region; however, this variability is unlikely to be clinically meaningful.
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Rasmussen encephalitis is a rare disease consisting of a chronic, slowly progressive inflammatory reaction of brain tissues. The objective of this study was to describe the case of an 18-year-old female patient, studying on the fourth grade of elementary school, and right-handed, who underwent left hemispherectomy in a neurological rehabilitation program. Her seizures began at 10 years of age and were unresponsive to drug treatment, with functional repercussions. She underwent hemispherectomy in March 2019, with 7 years of ongoing disease, and was admitted for the rehabilitation program with a multidisciplinary team in June 2020. The quality-of-life questionnaire (WHOQOL-BREF) was applied as a comparison measure before and after the rehabilitation program, along with measures of participation on the program activities. Despite the patient's short time in a rehabilitation program, data show the importance of an interdisciplinary intervention through the establishment of specific and contextualized objectives in chronic patients.
A encefalite de Rasmussen representa uma doença rara, que consiste em uma reação inflamatória dos tecidos cerebrais, de modo crônico e lentamente progressivo. O objetivo deste estudo foi descrever o caso de uma paciente, submetida à hemisferectomia à esquerda, em março de 2019, em programa de reabilitação neurológica. Paciente do sexo feminino, 18 anos de idade, 4ª série do ensino fundamental, destra, que participou de programa de reabilitação neurológica interdisciplinar após hemisferectomia. Início das crises convulsivas aos 10 anos de idade, refratárias ao tratamento medicamentoso, com repercussão funcional. Foi submetida à hemisferectomia em março de 2019, com sete anos de doença em curso. Foi internada para programa de reabilitação, com equipe multiprofissional, em junho de 2020. Aplicou-se o questionário de qualidade de vida (WHOQOL-BREF), como medida de comparação antes e após o programa de reabilitação, além de medidas de participação nas atividades do programa. Os dados, apesar do pouco tempo da paciente em programa de reabilitação, mostram a importância da intervenção interdisciplinar, por meio do estabelecimento de objetivos realísticos e contextualizados.
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ABSTRACT Rasmussen encephalitis is a rare disease consisting of a chronic, slowly progressive inflammatory reaction of brain tissues. The objective of this study was to describe the case of an 18-year-old female patient, studying on the fourth grade of elementary school, and right-handed, who underwent left hemispherectomy in a neurological rehabilitation program. Her seizures began at 10 years of age and were unresponsive to drug treatment, with functional repercussions. She underwent hemispherectomy in March 2019, with 7 years of ongoing disease, and was admitted for the rehabilitation program with a multidisciplinary team in June 2020. The quality-of-life questionnaire (WHOQOL-BREF) was applied as a comparison measure before and after the rehabilitation program, along with measures of participation on the program activities. Despite the patient's short time in a rehabilitation program, data show the importance of an interdisciplinary intervention through the establishment of specific and contextualized objectives in chronic patients.
RESUMO A encefalite de Rasmussen representa uma doença rara, que consiste em uma reação inflamatória dos tecidos cerebrais, de modo crônico e lentamente progressivo. O objetivo deste estudo foi descrever o caso de uma paciente, submetida à hemisferectomia à esquerda, em março de 2019, em programa de reabilitação neurológica. Paciente do sexo feminino, 18 anos de idade, 4ª série do ensino fundamental, destra, que participou de programa de reabilitação neurológica interdisciplinar após hemisferectomia. Início das crises convulsivas aos 10 anos de idade, refratárias ao tratamento medicamentoso, com repercussão funcional. Foi submetida à hemisferectomia em março de 2019, com sete anos de doença em curso. Foi internada para programa de reabilitação, com equipe multiprofissional, em junho de 2020. Aplicou-se o questionário de qualidade de vida (WHOQOL-BREF), como medida de comparação antes e após o programa de reabilitação, além de medidas de participação nas atividades do programa. Os dados, apesar do pouco tempo da paciente em programa de reabilitação, mostram a importância da intervenção interdisciplinar, por meio do estabelecimento de objetivos realísticos e contextualizados.
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Humanos , Grupo de Atención al Paciente , Enfermedad Crónica , Encefalitis , Rehabilitación NeurológicaRESUMEN
Chagas disease (CD) caused by Trypanosoma cruzi remains a serious public health problem in Latin America. The available treatment is limited to two old drugs, benznidazole (Bz) and nifurtimox, which exhibit limited efficacy and trigger side effects, justifying the search for new therapies. Also, more accurate and sensitive experimental protocols for drug discovery programs are necessary to shrink the translational gaps found among pre-clinical and clinical trials. Presently, cardiac spheroids were used to evaluate host cell cytotoxicity and anti-T.cruzi activity of benznidazole, exploring its effect on the release of inflammatory mediators. Bz presented low toxic profile on 3D matrices (LC50 > 200 µM) and high potency in vitro (EC50 = 0.99 µM) evidenced by qPCR analysis of T.cruzi-infected cardiac spheroids. Flow cytometry appraisal of inflammatory mediators released at the cellular supernatant showed increases in IL - 6 and TNF contents (≈190 and ≈ 25-fold) in parasitized spheroids as compared to uninfected cultures. Bz at 10 µM suppressed parasite load (92%) concomitantly decreasing in IL-6 (36%) and TNF (68%). Our findings corroborate the successful use of 3D cardiac matrices for in vitro identification of novel anti-parasitic agents and potential impact in host cell physiology.
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Nitroimidazoles/farmacología , Tripanocidas/farmacología , Trypanosoma cruzi/efectos de los fármacos , Animales , Imagenología Tridimensional , Ratones , Microscopía Fluorescente , Conformación Molecular , Esferoides Celulares , Trypanosoma cruzi/crecimiento & desarrolloRESUMEN
Background: Little is known about the 2019 novel coronavirus disease (COVID-19) course and outcomes in patients receiving immunotherapy. Here we describe a metastatic Merkel cell carcinoma patient with a severe acute respiratory syndrome coronavirus 2 infection while receiving pembrolizumab. Case presentation: A 66-year-old man, with a metastatic Merkel cell carcinoma receiving pembrolizumab, presented with fever. Chest computed tomography (CT) showed pulmonary ground-glass opacities, suggesting viral or immuno-related etiology. On day 7, the patient was hospitalized due to dyspnea and worsening of the radiological findings. Real time polymerase chain reaction (RT-PCR) testing confirmed COVID-19. The patient developed acute respiratory distress syndrome and acute kidney injury. Hydroxychloroquine was administered for 5 days, but discontinued after supraventricular extrasystoles. Clinical improvement allowed the patient's discharge after 81 days of hospitalization. Conclusion: A careful evaluation of oncologic patients receiving immunotherapy during the COVID-19 pandemic is of utmost importance.
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Carcinoma de Células de Merkel/terapia , Infecciones por Coronavirus/diagnóstico , Inmunoterapia , Neumonía Viral/diagnóstico , Neoplasias Cutáneas/terapia , Anciano , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antineoplásicos Inmunológicos/uso terapéutico , Betacoronavirus , COVID-19 , Carcinoma de Células de Merkel/complicaciones , Carcinoma de Células de Merkel/patología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/terapia , Humanos , Inmunoterapia/efectos adversos , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/patología , Neumonía Viral/terapia , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , SARS-CoV-2 , Neoplasias Cutáneas/complicaciones , Neoplasias Cutáneas/patología , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
BACKGROUND: Neurocysticercosis (NCC) is a neglected tropical disease and its diagnosis is still a challenge due to non-specific manifestations. Neuroimaging techniques are used in the diagnosis of NCC, however, due to the high cost of these methods and the advantages presented in the use of immunological tests, such as ease of performance and satisfactory results, immunoassays are commonly used to detect antibodies against Taenia sp. antigens. The aim of the present study was to produce, characterize and apply specific polyclonal immunoglobulin Y (IgY) anti-Taenia crassiceps extracted from egg yolk of hens immunized with T. crassiceps metacestodes. METHODS: Indirect enzyme-linked immunosorbent assay (ELISA), avidity ELISA, immunoblotting and indirect immunofluorescence tests were performed for characterization of IgY antibodies. Diagnostic performance was verified by ELISA for immune complex detection testing 90 serum samples. RESULTS: Values of sensitivity, specificity, positive and negative likelihood ratios (LR+/LR-) and area under the curve (AUC) were calculated and presented the following results: sensitivity 83.3%, specificity 96.7%, AUC 0.966, LR+ 25.0 and LR- 0.17. CONCLUSIONS: Results of this pioneering and innovative study demonstrate that anti-T. crassiceps IgY antibodies present potential applicability and can be used as an efficient tool in human NCC serodiagnosis.
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Neurocisticercosis , Animales , Anticuerpos Antihelmínticos , Complejo Antígeno-Anticuerpo , Antígenos Helmínticos , Pollos , Yema de Huevo , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Inmunoglobulinas , Neurocisticercosis/diagnóstico , Sensibilidad y EspecificidadRESUMEN
Abstract Self-efficacy is the belief each one has about their performance abilities. Motivation to learn is considered an important construct that encourages individuals to perform their tasks. This study aimed to verify the correlation between self-efficacy and intrinsic and extrinsic motivation in teenagers, investigating potential differences related to gender and age - younger (14 to 16 years) and older (17 to 19 years) teenagers. 296 adolescents from 14 to 19 years old (M=16.03; SD=0.96) participated in the study, 57% female, 66% were students from public schools and 34% from private schools. The instruments used were: a sociodemographic data questionnaire, the Perceived General Self-Efficacy Scale and the Scale for Evaluation of Motivation to Learn for high school students. Descriptive analyses, Pearson correlation and Student's t-test for independent samples were performed. The results indicated a positive correlation between self-efficacy and intrinsic motivation, and a negative correlation between self-efficacy and extrinsic motivation. Girls showed higher averages in intrinsic motivation and boys higher averages in extrinsic motivation. Male participants achieve higher means of self-efficacy when compared to girls, and there was no statistically significant difference regarding age. The establishing of strategies in schools is important, once self-efficacy and motivation can interfere in the teenagers' learning process.
Resumen La autoeficacia se refiere a las creencias que cada individuo tiene acerca de sus propias capacidades para ejecutar una tarea, mientras que la motivación para aprender se considera un constructo de notoria importancia debido a que estimula al individuo a realizar sus tareas. Teniendo en cuenta estos dos conceptos, el objetivo de este estudio fue identificar la correlación entre la autoeficacia y la motivación intrínseca y extrínseca en adolescentes por medio de un análisis de las posibles diferencias en las medias por género y por franjas etarias -adolescentes de 14 a 16 años y de 17 a 19 años-. En total, participaron 296 adolescentes de 14 a 19 años (M = 16.03; DE = .96) -57 % de género femenino-, estudiantes de educación media de escuelas públicas (66 %) y privadas (34 %). Específicamente, se utilizó una ficha de datos sociodemográficos, la Escala de Autoeficacia General Percibida (EAGP) y la Escala de Motivación para Aprender (EMA-EM), instrumentos con los que se realizó un análisis de correlación de Pearson y el test t de Student para muestras independientes. Como resultados, se observó una correlación positiva entre la autoeficacia y la motivación intrínseca, una correlación negativa entre la autoeficacia y la motivación extrínseca, medias más altas para la motivación intrínseca en las mujeres y para la motivación extrínseca en los hombres, y medias más altas en autoeficacia en los hombres. No se encontraron diferencias estadísticamente significativas entre las franjas etarias. Con esto, resulta fundamental establecer estrategias para las escuelas que tengan en cuenta que la autoeficacia y la motivación pueden interferir en el proceso de aprendizaje de los adolescentes.
Resumo A autoeficácia diz respeito às crenças que cada indivíduo tem sobre suas capacidades de desempenho. Já a motivação para aprender é considerada um construto importante que estimula o indivíduo a realizar suas tarefas. Neste estudo, objetivou-se verificar a correlação entre autoeficácia e motivação intrínseca e extrínseca em adolescentes, investigando possíveis diferenças nas médias por gênero e faixas etárias distintas -adolescentes mais novos (de 14 a 16 anos) e mais velhos (de 17 a 19 anos). Participaram do estudo 296 adolescentes de 14 a 19 anos (M = 16.03; DP = 0.96), 57 % do gênero feminino, estudantes de Ensino Médio de escolas públicas (66 %) e privadas (34 %). Foram utilizadas uma ficha de dados sociodemográficos, a Escala de Autoeficácia Geral Percebida e a Escala de Motivação para Aprender. Análises descritivas, correlação de Pearson e teste t de Student para amostras independentes foram realizados. Houve correlação positiva entre autoeficácia e motivação intrínseca, e correlação negativa entre autoeficácia e motivação extrínseca, sendo que as meninas apresentaram médias mais altas na motivação intrínseca e os meninos médias mais altas na motivação extrínseca. Os adolescentes do gênero masculino obtiveram maiores médias de autoeficácia quando comparados com as meninas, e não houve diferença estatisticamente significativa quanto às faixas etárias dos adolescentes. Portanto, estabelecer estratégias nas escolas é fundamental, uma vez que a autoeficácia e a motivação podem interferir no processo de aprendizagem dos adolescentes.
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Human neurocysticercosis (NCC) is a worldwide neglected disease caused by Taenia solium metacestode and responsible for various complications and neurological disorders. This study aimed to evaluate the use of specific immunoglobulin Y (IgY) produced by laying hens immunized with a hydrophobic fraction of Taenia crassiceps metacestodes (hFTc) in NCC diagnosis. Egg yolk IgY antibodies were fractionated, purified and characterized. Enzyme-linked immunosorbent assay (ELISA) was carried out to evaluate the production kinetics and avidity maturation of anti-hFTc IgY antibodies throughout the IgY obtention process. Antigen recognition tests were carried out by Western blotting and immunofluorescence antibody test using purified and specific anti-hFTc IgY antibodies for detection of parasitic antigens of T. crassiceps and T. solium metacestodes. Sandwich ELISA was performed to detect circulating immune complexes formed by IgG and parasitic antigens in human sera. The results showed high diagnostic values (93.2% sensitivity and 94.3% specificity) for immune complexes detection in human sera with confirmed NCC. In conclusion, specific IgY antibodies produced from immunized hens with hFTc antigens were efficient to detect T. solium immune complexes in human sera, being an innovative and potential tool for NCC immunodiagnosis.
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Antígenos Helmínticos/inmunología , Inmunoglobulinas/sangre , Pruebas Inmunológicas/métodos , Neurocisticercosis/parasitología , Taenia/aislamiento & purificación , Animales , Afinidad de Anticuerpos , Pollos , Femenino , Humanos , Ratones , Ratones Endogámicos BALB C , Neurocisticercosis/inmunología , Óvulo , Taenia/inmunologíaRESUMEN
Herein, we evaluate a mimotope-based synthetic peptidenamed NC41 to diagnose neurocysticercosis (NC), a neglected parasitic disease and a major cause of epilepsy worldwide. NC41 synthetic peptide was evaluated to diagnose NC, and total saline extract from Taenia solium metacestodes (SE) was used as control. Serum samples from patients with NC (n = 40), other parasitic diseases (n = 43), and healthy individuals (n = 40) were tested. Diagnostic parameters such as sensitivity (Se), specificity (Sp), likelihood ratio (LR), and area under curve (AUC) were calculated using receiver operating characteristic (ROC) curves. The sequence from T. solium phosphoenolpyruvate carboxykinase (PEPCK) was used for epitope prediction, resulting in one high-scoring patch centered at residue L247. NC41 synthetic peptide reached high diagnostic performance (Se 97.5% and Sp 97.5%, LR+ 39 and AUC 0.997). Data from diagnostic parameters and in silico analyses proved the usefulness of NC41 synthetic peptide as a diagnostic marker for human NC.
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Anticuerpos Antihelmínticos/sangre , Antígenos Helmínticos/sangre , Neurocisticercosis/diagnóstico , Péptidos/inmunología , Fosfoenolpiruvato Carboxiquinasa (ATP)/inmunología , Taenia solium/aislamiento & purificación , Animales , Área Bajo la Curva , Biomarcadores , Ensayo de Inmunoadsorción Enzimática/métodos , Humanos , Neurocisticercosis/sangre , Neurocisticercosis/parasitología , Péptidos/genética , Fosfoenolpiruvato Carboxiquinasa (ATP)/genética , Sensibilidad y Especificidad , Taenia solium/inmunologíaRESUMEN
The development of neuropsychological assessment methods using virtual reality (VR) is a valid and promising option for the detection of cognitive impairment in the older people, focusing on activities composed of tasks of multiple demands. This study verified the association of age, schooling, and general cognitive status on the performance of neurologically healthy older adults in ECO-VR, a VR task of multiple demands for neuropsychological assessment. A total of 111 older adults answered a sociodemographic questionnaire, the Mini Mental State Examination, the Vocabulary subtest of the Wechsler Intelligence Scale for Adults (third edition), and the ECO-VR. Correlation analyses, multiple linear regression, and comparisons between groups (effects by age and schooling groups) were used to evaluate the results. The ECO-VR total score was significantly associated with age, years of education, MMSE, and Vocabulary subtest. The linear regression models identified that age was the main predictor for total score and rule breaking of ECO-VR. According to the univariate analysis, it was identified the main effect of age group and schooling group in the total ECO-VR score, but there was no interaction effect. The results are discussed in order to understand the role of sociodemographic characteristics in the performance of older adults in a VR task of multiple demands. It was also verified the possibility use of VR for neuropsychological assessment of older adults.
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Chronic chagasic cardiomyopathy (CCC) is observed in 30% to 50% of the individuals infected by Trypanosoma cruzi and heart failure is the important cause of death among patients in the chronic phase of Chagas disease. Although some studies have elucidated the role of adaptive immune responses involving T and B lymphocytes in cardiac pathogenesis, the role of innate immunity receptors such as Toll-like receptors (TLRs) and Nod-like receptors (NLRs) in CCC pathophysiology has not yet been determined. In this study, we evaluated the association among innate immune receptors (TLR1-9 and nucleotide-binding domain-like receptor protein 3/NLRP3), its adapter molecules (Myd88, TRIF, ASC and caspase-1) and cytokines (IL-1ß, IL-6, IL-12, IL-18, IL-23, TNF-α, and IFN-ß) with clinical manifestation, digestive and cardiac function in patients with different clinical forms of chronic Chagas disease. The TLR8 mRNA expression levels were enhanced in the peripheral blood mononuclear cells (PBMC) from digestive and cardiodigestive patients compared to indeterminate and cardiac patients. Furthermore, mRNA expression of IFN-ß (cytokine produced after TLR8 activation) was higher in digestive and cardiodigestive patients when compared to indeterminate. Moreover, there was a positive correlation between TLR8 and IFN-ß mRNA expression with sigmoid and rectum size. Cardiac and cardiodigestive patients presented higher TLR2, IL-12 and TNF-α mRNA expression than indeterminate and digestive patients. Moreover, cardiac patients also expressed higher levels of NLRP3, ASC and IL-1ß mRNAs than indeterminate patients. In addition, we showed a negative correlation among TLR2, IL-1ß, IL-12 and TNF-α levels with left ventricular ejection fraction, and positive correlation between NLRP3 with cardiothoracic index, and TLR2, IL-1ß and IL-12 with left ventricular mass index. Together, our data suggest that high expression of innate immune receptors in cardiac and digestive patients may induce an enhancement of cytokine expression and participate of cardiac and digestive dysfunction.
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Cardiomiopatía Chagásica/inmunología , Enfermedades del Sistema Digestivo/inmunología , Proteína con Dominio Pirina 3 de la Familia NLR/inmunología , Proteínas NLR/inmunología , Adulto , Anciano , Caspasa 1/genética , Caspasa 1/inmunología , Cardiomiopatía Chagásica/genética , Cardiomiopatía Chagásica/parasitología , Enfermedades del Sistema Digestivo/genética , Enfermedades del Sistema Digestivo/parasitología , Femenino , Humanos , Interleucina-12/genética , Interleucina-12/inmunología , Interleucina-1beta/genética , Interleucina-1beta/inmunología , Masculino , Persona de Mediana Edad , Proteína con Dominio Pirina 3 de la Familia NLR/genética , Proteínas NLR/genética , Trypanosoma cruzi/fisiologíaRESUMEN
Strongyloidiasis is an important helminthiasis affecting million people worldwide. The aim of this study was to use sodium metaperiodate (MP) treatment to immunochemically characterize Strongyloides venezuelensis filariform larvae and use MP-treated heterologous antigen to detect IgG and subclasses in serum. Samples from individuals with definitive diagnosis of strongyloidiasis (nâ¯=â¯50), other parasitic diseases (nâ¯=â¯60) and negative endemic (nâ¯=â¯50) were tested. TG-ROC and two-way ANOVA were applied. MP-treatment resulted on differential localization of carbohydrates at larval structure and no carbohydrate content in saline extract (SE). Electrophoretic profiles were similar before and after treatment. ELISA sensitivity and specificity were: 90%; 88.2% for SE and 92.0%; 94.6% for MP, respectively. When using MP treated antigen we observed reduction in IgG1 and IgG3 detection in strongyloidiasis group and decrease of cross reactions in control groups. Our data demonstrate the role of carbohydrate residues in cross reactions and on the recognition of anti-Strongyloides IgG and its subclasses.
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Antígenos Helmínticos/inmunología , Ácido Peryódico/metabolismo , Strongyloides/inmunología , Estrongiloidiasis/diagnóstico , Animales , Glicosilación , Humanos , Inmunoglobulina G/sangre , Larva/metabolismoRESUMEN
This study aimed to evaluate the total extract of Taenia crassiceps metacestodes (TC) and its antigenic fractions obtained by Triton X-114 fractionation techniques, such as detergent (DC) and aqueous (AC), in the immunodiagnosis of human neurocysticercosis (NCC). Cerebrospinal fluid samples were divided into two groups: Group 1 (n=40), which was further divided into active (n=20) and inactive (n=20) NCC, and Group 2 (control group), which comprised 39 CSF samples from patients who had another neurological disorder, were suffering from other infectious diseases of the brain or had other parasitic infections. The total extracts and antigenic fractions were tested by enzyme-linked immunosorbent assay (ELISA) to detect human IgG anti-Taenia solium. T. crassiceps fractions (DC and AC) showed the same value of sensitivity (Se), 100%, for active and inactive NCC and a specificity (Sp) of 97.4%. The DS fraction obtained from T. solium showed 100% Se for active NCC, 95% Se for inactive NCC and a 92.3% Sp. The AS fraction obtained from T. solium showed 100% Se for both active and inactive NCC and a 94.9% Sp. There was a positive correlation between the total saline extract of T. crassiceps (TC) and T. solium (TS) and their fractions (DC, AC, DS and AS). Positive predictive value, negative predictive value, diagnostic efficiency and Youden index were calculated. In conclusion, these results demonstrated that detergent and aqueous fractions obtained from T. crassiceps metacestodes are important sources of specific antigens and are efficient for immunodiagnosis of active and inactive NCC.
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Anticuerpos Antihelmínticos/líquido cefalorraquídeo , Antígenos Helmínticos/inmunología , Antígenos Helmínticos/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática , Neurocisticercosis/diagnóstico , Neurocisticercosis/inmunología , Taenia/inmunología , Animales , Antígenos Helmínticos/química , Fraccionamiento Químico/métodos , Femenino , Humanos , Interacciones Hidrofóbicas e Hidrofílicas , Inmunoglobulina G/líquido cefalorraquídeo , Larva/química , Larva/inmunología , Masculino , Ratones , Neurocisticercosis/líquido cefalorraquídeo , Octoxinol , Polietilenglicoles , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Cloruro de Sodio , Taenia/fisiologíaRESUMEN
The α-Gal antigen [Galα(1,3)Galß(1,4)GlcNAcα] is an immunodominant epitope displayed by infective trypomastigote forms of Trypanosoma cruzi, the causative agent of Chagas disease. A virus-like particle displaying a high density of α-Gal was found to be a superior reagent for the ELISA-based serological diagnosis of Chagas disease and the assessment of treatment effectiveness. A panel of sera from patients chronically infected with T. cruzi, both untreated and benznidazole-treated, was compared with sera from patients with leishmaniasis and from healthy donors. The nanoparticle-α-Gal construct allowed for perfect discrimination between Chagas patients and the others, avoiding false negative and false positive results obtained with current state-of-the-art reagents. As previously reported with purified α-Gal-containing glycosylphosphatidylinositol-anchored mucins, the current study also showed concentrations of anti-α-Gal IgG to decrease substantially in patients receiving treatment with benznidazole, suggesting that the semiquantitative assessment of serum levels of this highly abundant type of antibody can report on disease status in individual patients.
Asunto(s)
Enfermedad de Chagas/diagnóstico , Trisacáridos/análisis , Trypanosoma cruzi/aislamiento & purificación , Anticuerpos Antiprotozoarios/análisis , Anticuerpos Antiprotozoarios/inmunología , Antígenos de Protozoos/análisis , Antígenos de Protozoos/inmunología , Enfermedad de Chagas/parasitología , Ensayo de Inmunoadsorción Enzimática , Humanos , Trisacáridos/inmunología , Trypanosoma cruzi/genética , Trypanosoma cruzi/inmunología , Virus/genética , Virus/metabolismoRESUMEN
OBJECTIVE: The present study sought to evaluate the antimicrobial activity against Enterococcus faecalis of photodynamic therapy applied before and after reciprocating instrumentation of permanent molars. BACKGROUND: Apical extrusion of debris can cause flare-ups due to introduction of bacteria into the periapical tissues. METHODS: Eighteen mesial roots from permanent mandibular molars were selected. The crowns were removed to obtain a standard root length of 15 mm. The included mesial roots had an angulation of 10°-40° and canals with independent foramina. The orifice of each mesiolingual canal was sealed with light-curing resin, and the working length was established visually, 1 mm short of the apical foramen. The roots were rendered impermeable and sterilized, and the mesiobuccal canals were contaminated with a standard strain of E. faecalis for 21 days. Specimens were randomly divided into three groups (n = 6): G1, photodynamic therapy performed before instrumentation and irrigation with 0.9% NaCl (saline) solution; G2, photodynamic therapy performed after instrumentation and irrigation with 0.9% NaCl; and G3 (control), instrumentation and irrigation with 2.5% NaOCl (sodium hypochlorite) solution. Canals were shaped with a WaveOne primary file (25.08) and irrigated with 0.9% NaCl. E. faecalis samples were collected before and after each procedure, and the results were analyzed using descriptive statistics and the Kruskal-Wallis and Wilcoxon tests. RESULTS: Significant reductions in E. faecalis were observed when photodynamic therapy was performed before and after instrumentation of the root canal system (p < 0.05). Reciprocating instrumentation significantly reduced E. faecalis colonies in experimentally contaminated root canal systems (p < 0.05). CONCLUSIONS: Photodynamic therapy was effective in removing E. faecalis from the root canal system, whether performed before or after reciprocating instrumentation.
Asunto(s)
Enterococcus faecalis/efectos de la radiación , Fotoquimioterapia , Cavidad Pulpar/microbiología , HumanosRESUMEN
INTRODUCTION Natural and artificial ecotope infestation by the kissing bug triatomines and their colonization and infection by Trypanosoma cruzi , the Chagas disease agent, were evaluated in nine municipalities of the State of Rio Grande do Norte, Brazil. METHODS Following identification, triatomine intestinal contents were analyzed by direct microscopic examination, xenoculture, and polymerase chain reaction (PCR) for parasite detection. Trypanosoma cruzi isolates were genotyped using three different markers. RESULTS Of 842 triatomines captured, 65% were Triatoma brasiliensis , 17.8% Triatoma pseudomaculata , 12.5% Panstrongylus lutzi , and 4.7% Rhodnius nasutus . Triatoma brasiliensis and P. lutzi adults were found in the intradomicile. T. brasiliensis, T. pseudomaculata , and R. nasutus nymphs and adults were found in the peridomicile and wild environment. Intradomiciliary and peridomiciliary infestation indexes were 5.6% and 33.7%, respectively. In the peridomicile, chicken coops were the most infested ecotope. The T. cruzi triatomine infection rate was 30.2%, of which PCR detected 29%. P . lutzi (78.1%), T . brasiliensis (24.5%), and T . pseudomaculata (22.7%) were the most infected species. TcII and III genotypes were detected in T. brasiliensis and TcIII in P. lutzi . CONCLUSIONS T. brasiliensis was found in all environments and most ecotopes with high T. cruzi infection rates. High infection rates were also detected in T . pseudomaculata and P. lutzi , suggesting their role in the interchange between the wild and peridomestic transmission cycles. The combination of PCR, microscopic examination, and xenoculture contributed to improving T. cruzi infection evaluation in triatomine bugs. The TcII and TcIII genotypes were predominant in the study area.
Asunto(s)
Insectos Vectores/parasitología , Panstrongylus/parasitología , Rhodnius/parasitología , Triatoma/parasitología , Trypanosoma cruzi/aislamiento & purificación , Animales , Brasil , Enfermedad de Chagas/transmisión , Genotipo , Insectos Vectores/clasificación , Panstrongylus/genética , Reacción en Cadena de la Polimerasa , Rhodnius/genética , Triatoma/genéticaRESUMEN
Ischemic strokes have been implicated as a cause of death in Chagas disease patients. Inflammation has been recognized as a key component in all ischemic processes, including the intravascular events triggered by vessel interruption, brain damage and repair. In this study, we evaluated the association between inflammatory markers and the death risk (DR) and stroke risk (SR) of patients with different clinical forms of chronic Chagas disease. The mRNA expression levels of cytokines, transcription factors expressed in the adaptive immune response (Th1, Th2, Th9, Th17, Th22 and regulatory T cell), and iNOS were analyzed by real-time PCR in peripheral blood mononuclear cells of chagasic patients who exhibited the indeterminate, cardiac, digestive and cardiodigestive clinical forms of the disease, and the levels of these transcripts were correlated with the DR and SR. Cardiac patients exhibited lower mRNA expression levels of GATA-3, FoxP3, AHR, IL-4, IL-9, IL-10 and IL-22 but exhibited higher expression of IFN-γ and TNF-α compared with indeterminate patients. Digestive patients showed similar levels of GATA-3, IL-4 and IL-10 than indeterminate patients. Cardiodigestive patients exhibited higher levels of TNF-α compared with indeterminate and digestive patients. Furthermore, we demonstrated that patients with high DR and SR exhibited lower GATA-3, FoxP3, and IL-10 expression and higher IFN-γ, TNF-α and iNOS mRNA expression than patients with low DR and SR. A negative correlation was observed between Foxp3 and IL-10 mRNA expression and the DR and SR. Moreover, TNF-α and iNOS expression was positively correlated with DR and SR. Our data suggest that an inflammatory imbalance in chronic Chagas disease patients is associated with a high DR and SR. This study provides a better understanding of the stroke pathobiology in the general population and might aid the development of therapeutic strategies for controlling the morbidity and mortality of Chagas disease.
Asunto(s)
Enfermedad de Chagas/complicaciones , Enfermedad de Chagas/mortalidad , Inflamación/complicaciones , Accidente Cerebrovascular/epidemiología , Accidente Cerebrovascular/mortalidad , Adulto , Anciano , Enfermedad de Chagas/patología , Enfermedad Crónica , Citocinas/biosíntesis , Femenino , Perfilación de la Expresión Génica , Humanos , Inflamación/patología , Leucocitos Mononucleares/inmunología , Masculino , Persona de Mediana Edad , Óxido Nítrico Sintasa de Tipo II/biosíntesis , Reacción en Cadena en Tiempo Real de la Polimerasa , Medición de Riesgo , Análisis de SupervivenciaRESUMEN
Abstract: INTRODUCTION Natural and artificial ecotope infestation by the kissing bug triatomines and their colonization and infection by Trypanosoma cruzi , the Chagas disease agent, were evaluated in nine municipalities of the State of Rio Grande do Norte, Brazil. METHODS Following identification, triatomine intestinal contents were analyzed by direct microscopic examination, xenoculture, and polymerase chain reaction (PCR) for parasite detection. Trypanosoma cruzi isolates were genotyped using three different markers. RESULTS Of 842 triatomines captured, 65% were Triatoma brasiliensis , 17.8% Triatoma pseudomaculata , 12.5% Panstrongylus lutzi , and 4.7% Rhodnius nasutus . Triatoma brasiliensis and P. lutzi adults were found in the intradomicile. T. brasiliensis, T. pseudomaculata , and R. nasutus nymphs and adults were found in the peridomicile and wild environment. Intradomiciliary and peridomiciliary infestation indexes were 5.6% and 33.7%, respectively. In the peridomicile, chicken coops were the most infested ecotope. The T. cruzi triatomine infection rate was 30.2%, of which PCR detected 29%. P . lutzi (78.1%), T . brasiliensis (24.5%), and T . pseudomaculata (22.7%) were the most infected species. TcII and III genotypes were detected in T. brasiliensis and TcIII in P. lutzi . CONCLUSIONS T. brasiliensis was found in all environments and most ecotopes with high T. cruzi infection rates. High infection rates were also detected in T . pseudomaculata and P. lutzi , suggesting their role in the interchange between the wild and peridomestic transmission cycles. The combination of PCR, microscopic examination, and xenoculture contributed to improving T. cruzi infection evaluation in triatomine bugs. The TcII and TcIII genotypes were predominant in the study area.