RESUMO
La pandemia de COVID-19 originada por el virus SARS-CoV-2 ha impactado en la atención profesional de los pacientes en la práctica odontológica. Se generan bioaerosoles por el odontólogo o por el propio paciente, que aumentan la posibilidad de diseminación del virus. Ante la urgente necesidad de establecer protocolos estrictos y efectivos de control de infecciones, decidimos investigar la efectividad de dos enjuagues bucales en la saliva de pacientes con diagnóstico positivo de SARS-CoV-2.
The COVID-19 pandemic caused by the SARS-CoV-2 virus has impacted on the professional care of patients. In dentistry, the generation of bioaerosols generated by the dentist or by the patient himself increases the possibility of the spread of the virus. Given the urgent need to establish strict and effective infection control protocols, we decided to investigate the effectiveness of two mouthwashes in the saliva of positive patients.
Assuntos
SARS-CoV-2 , Clorexidina , Odontologia , Peróxido de HidrogênioRESUMO
BACKGROUND: Patients with acute lymphoblastic leukemia (ALL) have high risk of severe influenza infection and vaccination is highly recommended. The immunogenicity and effectiveness of vaccination are lower than in healthy people. AIM: To evaluate the immune response induced by influenza vaccine in children with ALL and observe effectiveness. METHOD: Children with ALL in maintenance phase and healthy children were recruited. Blood samples were taken at vaccination day (D0) and at day 28 (D28). Humoral response was evaluated by hemaglutination inhibition test (HAI) against H1N1. Patients were followed up for one year, clinical data and influenza episodes were recorded. RESULTS: 34 children with ALL and 9 healthy children were included. Concerning HAI on D28, 12/34 patients and 5/8 healthy children had titers ≥ 1/40, with seroprotection rates of 35 and 63% respectively. Seroprotected children were older than non-seroprotected ones. During follow-up, only 3 patients non seroprotected, presented influenza infection, without oxygen supplementation or critical care support. DISCUSSION: Children with ALL had a lower seroprotection rate than healthy children. Nevertheless, none of the seroprotected children presented influenza infection, reinforcing the annual vaccination recommendation.
Assuntos
Vacinas contra Influenza , Influenza Humana , Leucemia-Linfoma Linfoblástico de Células Precursoras , Anticorpos Antivirais , Criança , Humanos , Imunidade Humoral , Vírus da Influenza A Subtipo H1N1 , VacinaçãoRESUMO
Resumen Introducción: Los pacientes con leucemia linfoblástica aguda (LLA) tienen alto riesgo de influenza grave y la vacunación es altamente recomendada. La inmunogenicidad y efectividad de la vacuna es menor comparada a los sujetos sanos. Objetivo: Evaluar la respuesta inmune inducida por vacuna anti-influenza en niños con LLA y observar su efectividad. Métodos: Se reclutaron niños con LLA en terapia de mantención y niños sanos. Se tomaron muestras de sangre el día de la vacuna (D0) y al día 28 (D28), y se realizó test de inhibición de hemaglutinación (IHA) contra H1N1. Los pacientes fueron seguidos por un año, registrando datos clínicos y episodios de influenza. Resultados: Se incluyeron 34 niños con LLA y 9 niños sanos. Respecto al IHA en D28, 12/34 pacientes y 5/8 niños sanos presentaron títulos ≥ 1/40, resultando una tasa de seroprotección de 35 y 63%, respectivamente. Los niños seroprotegidos eran significativamente mayores. Durante el seguimiento, sólo tres pacientes, no seroprotegidos, presentaron infección por influenza, ninguno requirió oxigeno o cuidados intensivos. Discusión: Los niños con LLA alcanzaron una tasa seroprotección más baja que la observada en niños sanos. Sin embargo, ninguno de los niños seroprotegidos presentó infección por influenza, reforzando la recomendación de vacunación anual.
Abstract Background: Patients with acute lymphoblastic leukemia (ALL) have high risk of severe influenza infection and vaccination is highly recommended. The immunogenicity and effectiveness of vaccination are lower than in healthy people. Aim: To evaluate the immune response induced by influenza vaccine in children with ALL and observe effectiveness. Method: Children with ALL in maintenance phase and healthy children were recruited. Blood samples were taken at vaccination day (D0) and at day 28 (D28). Humoral response was evaluated by hemaglutination inhibition test (HAI) against H1N1. Patients were followed up for one year, clinical data and influenza episodes were recorded. Results: 34 children with ALL and 9 healthy children were included. Concerning HAI on D28, 12/34 patients and 5/8 healthy children had titers ≥ 1/40, with seroprotection rates of 35 and 63% respectively. Seroprotected children were older than non-seroprotected ones. During follow-up, only 3 patients non seroprotected, presented influenza infection, without oxygen supplementation or critical care support. Discussion: Children with ALL had a lower seroprotection rate than healthy children. Nevertheless, none of the seroprotected children presented influenza infection, reinforcing the annual vaccination recommendation.
Assuntos
Humanos , Criança , Vacinas contra Influenza , Influenza Humana , Leucemia-Linfoma Linfoblástico de Células Precursoras , Vacinação , Vírus da Influenza A Subtipo H1N1 , Imunidade Humoral , Anticorpos AntiviraisRESUMO
Toll-like receptor 4 (TLR4) is expressed on dendritic cells (DCs), sensing environmental danger molecules that induce their activation and maturation. Recently, we reported a method for the production of therapeutic DCs against melanoma, called tumor antigen-presenting cells (TAPCells), using a heat-shocked allogeneic melanoma cell lysate (TRIMEL) as an activation factor and antigen provider. Since TRIMEL contains endogenous TLR4 ligands, we evaluated the role of TLR4 in TAPCells differentiation by antibody neutralization and the association of a Tlr4 polymorphism (896A/G) (Asp299Gly), determined by PCR-RFLP, with the in vitro activation capacity and the clinical outcome of TAPCells-vaccinated patients. Antibody blocking of monocyte TLR4 inhibited surface expression, determined by flow cytometry, of the major histocompatibility complex class I, CCR7, CD80, CD83 and CD86 on TAPCells, reduced interleukin (IL)-6 and tumor necrosis factor -α gene expression evaluated by qRT-PCR, and also inhibited the TAPCells-mediated interferon-γ (IFN-γ) secretion of melanoma-specific CD8(+) T cells determined by ELISpot (p < 0.01). Moreover, CD8(+) T-cell activation capacity was significantly reduced in TAPCells bearing the TLR4 Asp299Gly receptor (p < 0.05). Finally, TAPCells-vaccinated stage-IV melanoma patients bearing the Tlr4 896G allele showed a shortened post-therapy median survival rate compared with those carrying the Tlr4 896A allele (p < 0.05; log-rank test). Our results indicate that TLR4 is a key receptor for the tumor lysate-mediated in vitro generation of clinically efficient antigen-presenting cells. Further analysis of patients included in different vaccine protocols is necessary for definitively establishing a role for TLR4 polymorphism in clinical responses.
Assuntos
Vacinas Anticâncer/uso terapêutico , Células Dendríticas/imunologia , Melanoma/terapia , Polimorfismo Genético , Neoplasias Cutâneas/terapia , Receptor 4 Toll-Like/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Neutralizantes/imunologia , Linfócitos T CD8-Positivos/imunologia , Vacinas Anticâncer/imunologia , Células Cultivadas , Citocinas/biossíntese , Citocinas/imunologia , Feminino , Humanos , Ativação Linfocitária/imunologia , Masculino , Melanoma/imunologia , Melanoma/mortalidade , Melanoma/patologia , Pessoa de Meia-Idade , Monócitos/imunologia , Estudos Retrospectivos , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/mortalidade , Neoplasias Cutâneas/patologia , Receptor 4 Toll-Like/imunologia , Resultado do Tratamento , Adulto JovemRESUMO
El uso de bioinoculantes a base de microorganismos con potencial biofertilizante representa una alternativa económicamente viable y de producción limpia para el sector agrícola. El objetivo del presente trabajo fue evaluar el efecto biofertilizante de un preparado elaborado con residuos sólidos vegetales (RSV) procedentes del mercado y la bacteria nativa diazótrofa Azotobacter A15M2G. Se elaboraron biopreparados utilizando diferentes concentraciones de bacteria (106, 107 y 108 UFC) en un medio de cultivo obtenido a partir del 25% p/v de cada uno de los siguientes RSV: Brassica oleracea (repollo), Lactuca sativa (lechuga) y Allium fistulosum (cebollín). Los biopreparados fueron evaluados en plantas de rábano (Rhapanus sativus) en invernadero, utilizando un diseño estadístico completamente al azar de 5 tratamientos con 3 repeticiones: T1, control; T2, semillas pregerminadas tratadas con RSV al 25% p/v; T3, semillas pregerminadas con bioinoculante de 106 UFC; T4, semillas pregerminadas con bioinoculante de 107 UFC; T5, semillas pregerminadas con bioinoculante de 108 UFC. Se evaluó: número de hojas, área foliar, longitud de la planta, longitud de la raíz y peso seco de toda la planta (ensayos por triplicado). Se observó un incremento altamente significativo en peso seco para T5 (0,88 g) y T4 (1,10 g); y diferencias significativas en el área foliar, para los mismos tratamientos, con un valor superior a 2000 cm2. El biopreparado con bacterias nativas y RSV mejoró el crecimiento y desarrollo de las plantas de rábano, pudiéndose dar un valor agregado a estos residuos y de esta manera obtener un biofertilizante potencialmente utilizable en otros cultivos.
The use of bioinoculantes from microorganisms with biofertilizer potential, represents an economically viable alternative and of clean production for the agricultural sector. The aim of this study was to evaluate the effect of biofertilizer preparation obtained from vegetable solid waste (RSV) of the market and the native bacteria Azotobacter A15M2G diazotroph.Biological cultures were prepared using different inoculum concentrations, 106, 107 y 108 UFC in a culture medium obtained from 25% w / v of each of the following substrates: Brassica oleracea (cabbage), Lactuca sativa (lettuce) and Allium fistulosum (chives). The microbial inoculants were evaluated in radish plants (Rhapanus sativus) in greenhouse using a completely randomized design of 5 treatments with 3 replicates: T1, pre-germinated seeds without any treatment; T2, pre-germinated seeds treated with the dye waste vegetables 25% w / v; T3, pre-germinated seeds treated with bacterial concentration bioinoculants to 106 UFC; T4, pre-germinated seeds treated with bacterial concentration bioinoculants to 107 UFC, and T5, pre-germinated seeds treated with bacterial concentration bioinoculants to 108 UFC. Assessed variables were: number of leaves, leaf area, plant length, root length and dry weight of the entire plant (all assays in triplicate). The results showed a highly significant increase in dry weight, for T5 (0.88 g) and T4(1.10 g); and significant differences in leaf area for the same treatments, with a value greater than 2000 cm2, compared to others. The biopreparado from native bacteria and RSV improved the growth and development of the radish plants, being able to give a added value to these residues and to obtain a potentially usable biofertilizer in other cultures.
Assuntos
Lactuca/crescimento & desenvolvimento , Lactuca/efeitos adversos , Lactuca/enzimologia , Lactuca/fisiologia , Lactuca/genética , Lactuca/imunologia , Lactuca/metabolismo , Lactuca/microbiologia , Lactuca/química , Azotobacter/isolamento & purificação , Azotobacter/crescimento & desenvolvimento , Azotobacter/enzimologia , Azotobacter/fisiologia , Azotobacter/genética , Azotobacter/imunologia , Azotobacter/metabolismo , Azotobacter/químicaRESUMO
PURPOSE: This study characterizes, biologically and clinically, a novel type of dendritic cells (DC) produced in the short term and called tumor antigen-presenting cells (TAPCells). In particular, we identified factors present in a lysate derived from heat-shocked allogeneic melanoma cells (TRIMEL) that are associated with TAPCells' enhanced capability to induce CD8(+) T-cell responses in vitro and in vaccinated melanoma patients. EXPERIMENTAL DESIGN: First, extensive phenotypic and functional characterization of TAPCells was performed, followed by vaccination of 45 melanoma patients with four doses of TAPCells over a period of 2 months. Specific delayed-type hypersensitivity (DTH) reaction was analyzed posttreatment and correlated with overall survival rates. Furthermore, heat-shock (HS)-induced factors present in TRIMEL and their effects on DC activation were identified and studied. RESULTS: TRIMEL induced a committed, mature, DC-like phenotype in TAPCells and effectively activated melanoma-specific CD4(+) and CD8(+) T cells. Clinically, 64% of vaccinated patients showed positive DTH reaction against TRIMEL, and this was associated with improved overall survival. HS treatment of tumor cells increased calreticulin (CRT) plasma membrane translocation and induced the release of high-mobility group box 1 proteins (HMGB1). Both CRT and HMGB1 mobilization were associated with enhanced TAPCells' maturation and antigen (Ag) cross-presentation, respectively. DTH infiltration analysis revealed the presence of CD8(+)/CD45RO(+) T cells, thus confirming TAPCells' ability to cross-present Ags in vivo. CONCLUSIONS: Our results indicate that lysates derived from heat-shocked tumor cells are an optimal source of tumor-associated Ags, which are crucial for the generation of DCs with improved Ag cross-presentation capacity and clinically effective immunogenicity.
Assuntos
Vacinas Anticâncer/imunologia , Diferenciação Celular/imunologia , Células Dendríticas/imunologia , Melanoma/imunologia , Monócitos/imunologia , Adulto , Idoso , Células Apresentadoras de Antígenos/imunologia , Células Apresentadoras de Antígenos/metabolismo , Antígenos de Neoplasias/imunologia , Calreticulina/imunologia , Calreticulina/metabolismo , Vacinas Anticâncer/uso terapêutico , Linhagem Celular Tumoral , Células Dendríticas/metabolismo , Feminino , Citometria de Fluxo , Proteína HMGB1/imunologia , Proteína HMGB1/metabolismo , Temperatura Alta , Humanos , Hipersensibilidade Tardia/imunologia , Imunofenotipagem , Células K562 , Estimativa de Kaplan-Meier , Masculino , Melanoma/tratamento farmacológico , Pessoa de Meia-Idade , Monócitos/metabolismo , Transdução de Sinais/imunologia , Linfócitos T/imunologia , Linfócitos T/metabolismo , Adulto JovemRESUMO
En el presente trabajo se muestran los resultados obtenidos de la evaluación del crecimiento, desarrollo y viabilidad de una cepa bacteriana nativa Azotobacter A15M2G con potencial biofertilizante, sobre un medio de cultivo preparado con residuos sólidos vegetales procedentes del mercado: Brassica Oleracea (repollo), Lactusa sativa (lechuga) y Allium fistulosum (cebollín). El crecimiento de la bacteria en el medio de residuo vegetal a diferentes concentraciones: 25, 50 y 75% p/v fue evaluado, encontrándose un mejor crecimiento en la concentración del 25%; la caracterización química del medio de cultivo al 25% p/v, después de ser esterilizado, mostró los siguientes valores: 0,035% de carbohidratos, 0,4044% de proteína, 0,03574% de cenizas, 99,3955% de humedad, 6,93 mg/l de azufre, 0,170 mg/l de fósforo, 0,2 mg/l de manganeso, 409,2 mg/l de potasio, 1,842 mg/l de hierro, 14 mg/l de sodio y 0,1 mg/l de zinc, 28,056 mg/l de calcio y 17,017 mg/l de magnesio. En el medio de cultivo al 25% también fue evaluada la capacidad fijadora de nitrógeno y productora de ácido indol acético (AIA) de la bacteria, obteniendo una concentración de 4,8725 mg/l y 13,5837 mg/l respectivamente. Posteriormente se realizó un ensayo de viabilidad por un periodo de 2 meses. Los resultados muestran que los residuos-sólidos vegetales generados en las plazas de mercado local pueden ser utilizados como medio de cultivo ofreciendo un aporte nutricional al microorganismo de interés agrícola minimizando la contaminación ambiental generada.
The present work, shows the results obtained from the assessment of growth, development and viability of a native bacterial strain with biofertilizer potential, Azotobacter A15MG, on culture medium from solid wastes vegetables: Brassica Oleracea (cabbage,), Lactusa sativa (lettuce) and Allium fistulosum (chives). The growth of the bacteria on culture medium from solid wastes vegetables at different concentrations: 25, 50 and 75% w /v was evaluated, being a better growth in the concentration of 25%. The chemical characterization of this culture medium after being sterilized showed the following values: 0.035% carbohydrates, protein 0.4044%, 0.03574% ash, 99.3955% moisture, 6.93 mg / l of sulfur, 0.170 mg / l of phosphorus , 0.2 mg / l of manganese, 409.2 mg / l of potassium, 1842 mg / l of iron, 14 mg / l of sodium and 0.1 mg / l of zinc, 28,056 mg / l of calcium and 17,017 mg / l of magnesium. In the culture medium to 25%, also there was evaluated the fixing capacity of nitrogen and producer of acid indol acetic (AIA) of the bacterium, obtaining a concentration of 4.8725 mg/l and 13.5837 mg/l respectively. Later a test of viability was realized by a period of 2 months. The results show that the solid residues vegetables generated in the squares of local market, can be used as a culture medium that offering a nutritional contribution to the microorganism of agricultural interest minimizing the environmental generated pollution.
Assuntos
Meios de Cultura/farmacologia , Meios de Cultura/metabolismo , Meios de Cultura/química , Meios de Cultura , Poluição Ambiental/efeitos adversos , Poluição Ambiental/prevenção & controleRESUMO
OBJECTIVE: To identify risk factors associated with nosocomial bloodstream infections caused by multiple clones of the staphylococcal cassette chromosome mec (SCCmec) type IV strain of methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: An unmatched case-control study (at a ratio of 1:2) performed during the period from October 2002 through September 2003. SETTING: A 2,000-bed tertiary care teaching hospital affiliated with the University of São Paulo in São Paulo, Brazil. METHODS: Case patients (n=30) were defined either as patients who had a bloodstream infection due to SCCmec type IV MRSA diagnosed at least 48 hours after hospital admission or as neonates with the infection who were born in the hospital. Control patients (n=60) were defined as patients with SCCmec type III MRSA infection diagnosed at least 48 hours after hospital admission. Genes encoding virulence factors were studied in the isolates recovered from case patients, and molecular typing of the SCCmec type IV MRSA isolates was also done by pulsed-field gel electrophoresis and multilocus sequence typing. RESULTS: In multivariate analysis, the following 3 variables were significantly associated with having a nosocomial bloodstream infection caused by SCCmec type IV strains of MRSA: an age of less than 1 year, less frequent use of a central venous catheter (odds ratio [OR], 0.07 [95% confidence interval {CI}, 0.02-0.28]; p= .025), and female sex. A second analysis was performed that excluded the case and control patients from the neonatal unit, and, in multivariate analysis, the following variables were significantly associated with having a nosocomial bloodstream infection caused by SCCmec type IV strains of MRSA: less frequent use of a central venous catheter (OR, 0.12 [95% CI, 0.03-0.55]; p= .007), lower Acute Physiology and Chronic Health Evaluation II score on admission (OR, 0.14 [95% CI, 0.03-0.61]; p= .009), less frequent surgery (OR, 0.21 [95% CI, 0.06-0.83]; p= .025), and female sex (OR, 5.70 [95% CI, 1.32-24.66]; p= .020). Of the 29 SCCmec type IV MRSA isolates recovered from case patients, none contained the Panton-Valentine leukocidin, gamma-hemolysin, enterotoxin B or C, or toxic shock syndrome toxin-1. All of the isolates contained genes for the LukE-LukD leukocidin and alpha-hemolysin. Genes for enterotoxin A were present in 1 isolate, and genes for beta-hemolysin were present in 3 isolates. CONCLUSIONS: "Classical" risk factors do not apply to patients infected with the SCCmec type IV strain of MRSA, which is an important cause of nosocomial bacteremia. This strain infects a patient population that is less ill and has had less frequent invasive procedures than a patient population infected with the multidrug-resistant strain of SCCmec type III MRSA. We found that virulence factors were rare and that Panton-Valentine leukocidin was absent. There were multiple clones of the SCCmec type IV strain in our hospital. Children under 1 year of age were at a higher risk. There was a predominant clone (sequence type 5) in this patient population.