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da Cruz AP, Martins G, Martins CM, Marques V, Christovam S, Battaglini D, Robba C, Pelosi P, Rocco PRM, Cruz FF, Dos Santos Samary C, Silva PL. Comparison between high-flow nasal oxygen (HFNO) alternated with non-invasive ventilation (NIV) and HFNO and NIV alone in patients with COVID-19: a retrospective cohort study. Eur J Med Res 2024; 29:248. [PMID: 38649940 PMCID: PMC11036698 DOI: 10.1186/s40001-024-01826-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Non-invasive respiratory support (conventional oxygen therapy [COT], non-invasive ventilation [NIV], high-flow nasal oxygen [HFNO], and NIV alternated with HFNO [NIV + HFNO] may reduce the need for invasive mechanical ventilation (IMV) in patients with COVID-19. The outcome of patients treated non-invasively depends on clinical severity at admission. We assessed the need for IMV according to NIV, HFNO, and NIV + HFNO in patients with COVID-19 according to disease severity and evaluated in-hospital survival rates and hospital and intensive care unit (ICU) lengths of stay. METHODS This cohort study was conducted using data collected between March 2020 and July 2021. Patients ≥ 18 years admitted to the ICU with a diagnosis of COVID-19 were included. Patients hospitalized for < 3 days, receiving therapy (COT, NIV, HFNO, or NIV + HFNO) for < 48 h, pregnant, and with no primary outcome data were excluded. The COT group was used as reference for multivariate Cox regression model adjustment. RESULTS Of 1371 patients screened, 958 were eligible: 692 (72.2%) on COT, 92 (9.6%) on NIV, 31 (3.2%) on HFNO, and 143 (14.9%) on NIV + HFNO. The results for the patients in each group were as follows: median age (interquartile range): NIV (64 [49-79] years), HFNO (62 [55-70] years), NIV + HFNO (62 [48-72] years) (p = 0.615); heart failure: NIV (54.5%), HFNO (36.3%), NIV + HFNO (9%) (p = 0.003); diabetes mellitus: HFNO (17.6%), NIV + HFNO (44.7%) (p = 0.048). > 50% lung damage on chest computed tomography (CT): NIV (13.3%), HFNO (15%), NIV + HFNO (71.6%) (p = 0.038); SpO2/FiO2: NIV (271 [118-365] mmHg), HFNO (317 [254-420] mmHg), NIV + HFNO (229 [102-317] mmHg) (p = 0.001); rate of IMV: NIV (26.1%, p = 0.002), HFNO (22.6%, p = 0.023), NIV + HFNO (46.8%); survival rate: HFNO (83.9%), NIV + HFNO (63.6%) (p = 0.027); ICU length of stay: NIV (8.5 [5-14] days), NIV + HFNO (15 [10-25] days (p < 0.001); hospital length of stay: NIV (13 [10-21] days), NIV + HFNO (20 [15-30] days) (p < 0.001). After adjusting for comorbidities, chest CT score and SpO2/FiO2, the risk of IMV in patients on NIV + HFNO remained high (hazard ratio, 1.88; 95% confidence interval, 1.17-3.04). CONCLUSIONS In patients with COVID-19, NIV alternating with HFNO was associated with a higher rate of IMV independent of the presence of comorbidities, chest CT score and SpO2/FiO2. Trial registration ClinicalTrials.gov identifier: NCT05579080.
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Affiliation(s)
- Amanda Pereira da Cruz
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Centro de Ciências da Saúde, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 273, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Gloria Martins
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Centro de Ciências da Saúde, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 273, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
- D'or Institute of Research and Teaching, Barra D'or Hospital, Rio de Janeiro, Brazil
| | | | - Victoria Marques
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Centro de Ciências da Saúde, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 273, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
- Department of Cardiorespiratory and Musculoskeletal Physiotherapy, Faculty of Physiotherapy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Samantha Christovam
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Centro de Ciências da Saúde, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 273, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
- Department of Cardiorespiratory and Musculoskeletal Physiotherapy, Faculty of Physiotherapy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Chiara Robba
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Paolo Pelosi
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Patricia Rieken Macedo Rocco
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Centro de Ciências da Saúde, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 273, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Fernanda Ferreira Cruz
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Centro de Ciências da Saúde, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 273, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
| | - Cynthia Dos Santos Samary
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Centro de Ciências da Saúde, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 273, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil
- Department of Cardiorespiratory and Musculoskeletal Physiotherapy, Faculty of Physiotherapy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Pedro Leme Silva
- Laboratory of Pulmonary Investigation, Institute of Biophysics Carlos Chagas Filho, Centro de Ciências da Saúde, Federal University of Rio de Janeiro, Avenida Carlos Chagas Filho, 273, Bloco G-014, Ilha do Fundão, Rio de Janeiro, RJ, 21941-902, Brazil.
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Pattini VC, Polaquini CR, Lemes TH, Brizzotti-Mazuchi NS, Sardi JDCO, Paziani MH, Kress MRVZ, de Almeida MTG, Regasini LO. Antifungal activity of 3,3'-dimethoxycurcumin (DMC) against dermatophytes and Candida species. Lett Appl Microbiol 2024; 77:ovae019. [PMID: 38499446 DOI: 10.1093/lambio/ovae019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/24/2024] [Accepted: 03/13/2024] [Indexed: 03/20/2024]
Abstract
Dermatomycosis is an infection with global impacts caused especially by dermatophytes and Candida species. Current antifungal therapies involve drugs that face fungal resistance barriers. This clinical context emphasizes the need to discover new antifungal agents. Herein, the antifungal potential of 10 curcumin analogs was evaluated against four Candida and four dermatophyte species. The most active compound, 3,3'-dimethoxycurcumin, exhibited minimum inhibitory concentration values ranging from 1.9‒62.5 to 15.6‒62.5 µg ml-1 against dermatophytes and Candida species, respectively. According to the checkerboard method, the association between DMC and terbinafine demonstrated a synergistic effect against Trichophyton mentagrophytes and Epidermophyton floccosum. Ergosterol binding test indicated DMC forms a complex with ergosterol of Candida albicans, C. krusei, and C. tropicalis. However, results from the sorbitol protection assay indicated that DMC had no effect on the cell walls of Candida species. The in vivo toxicity, using Galleria mellonella larvae, indicated no toxic effect of DMC. Altogether, curcumin analog DMC was a promising antifungal agent with a promising ability to act against Candida and dermatophyte species.
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Affiliation(s)
- Veridianna Camilo Pattini
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, São Paulo 15054-000, Brazil
| | - Carlos Roberto Polaquini
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, São Paulo 15054-000, Brazil
| | - Thiago Henrique Lemes
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, São Paulo 15054-000, Brazil
| | | | | | - Mário Henrique Paziani
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo 05508-000, Brazil
| | - Marcia Regina von Zeska Kress
- School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo 05508-000, Brazil
| | | | - Luis Octávio Regasini
- Institute of Biosciences, Humanities and Exact Sciences, São Paulo State University, São José do Rio Preto, São Paulo 15054-000, Brazil
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Iavarone IG, Al-Husinat L, Vélez-Páez JL, Robba C, Silva PL, Rocco PRM, Battaglini D. Management of Neuromuscular Blocking Agents in Critically Ill Patients with Lung Diseases. J Clin Med 2024; 13:1182. [PMID: 38398494 PMCID: PMC10889521 DOI: 10.3390/jcm13041182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/09/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
The use of neuromuscular blocking agents (NMBAs) is common in the intensive care unit (ICU). NMBAs have been used in critically ill patients with lung diseases to optimize mechanical ventilation, prevent spontaneous respiratory efforts, reduce the work of breathing and oxygen consumption, and avoid patient-ventilator asynchrony. In patients with acute respiratory distress syndrome (ARDS), NMBAs reduce the risk of barotrauma and improve oxygenation. Nevertheless, current guidelines and evidence are contrasting regarding the routine use of NMBAs. In status asthmaticus and acute exacerbation of chronic obstructive pulmonary disease, NMBAs are used in specific conditions to ameliorate patient-ventilator synchronism and oxygenation, although their routine use is controversial. Indeed, the use of NMBAs has decreased over the last decade due to potential adverse effects, such as immobilization, venous thrombosis, patient awareness during paralysis, development of critical illness myopathy, autonomic interactions, ICU-acquired weakness, and residual paralysis after cessation of NMBAs use. The aim of this review is to highlight current knowledge and synthesize the evidence for the effects of NMBAs for critically ill patients with lung diseases, focusing on patient-ventilator asynchrony, ARDS, status asthmaticus, and chronic obstructive pulmonary disease.
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Affiliation(s)
- Ida Giorgia Iavarone
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (I.G.I.); (C.R.)
- Department of Surgical Sciences and Integrated Diagnostics, University of Genova, 16132 Genova, Italy
| | - Lou’i Al-Husinat
- Department of Clinical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan;
| | - Jorge Luis Vélez-Páez
- Facultad de Ciencias Médicas, Universidad Central de Ecuador, Quito 170129, Ecuador;
- Unidad de Terapia Intensiva, Hospital Pablo Arturo Suárez, Centro de Investigación Clínica, Quito 170129, Ecuador
| | - Chiara Robba
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (I.G.I.); (C.R.)
- Department of Surgical Sciences and Integrated Diagnostics, University of Genova, 16132 Genova, Italy
- Facultad de Ciencias Médicas, Universidad Central de Ecuador, Quito 170129, Ecuador;
| | - Pedro Leme Silva
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro 21941, Brazil; (P.L.S.); (P.R.M.R.)
| | - Patricia R. M. Rocco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro 21941, Brazil; (P.L.S.); (P.R.M.R.)
| | - Denise Battaglini
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy; (I.G.I.); (C.R.)
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Al-Husinat L, Jouryyeh B, Rawashdeh A, Robba C, Silva PL, Rocco PRM, Battaglini D. The Role of Ultrasonography in the Process of Weaning from Mechanical Ventilation in Critically Ill Patients. Diagnostics (Basel) 2024; 14:398. [PMID: 38396437 PMCID: PMC10888003 DOI: 10.3390/diagnostics14040398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 01/22/2024] [Accepted: 02/10/2024] [Indexed: 02/25/2024] Open
Abstract
Weaning patients from mechanical ventilation (MV) is a complex process that may result in either success or failure. The use of ultrasound at the bedside to assess organs may help to identify the underlying mechanisms that could lead to weaning failure and enable proactive measures to minimize extubation failure. Moreover, ultrasound could be used to accurately identify pulmonary diseases, which may be responsive to respiratory physiotherapy, as well as monitor the effectiveness of physiotherapists' interventions. This article provides a comprehensive review of the role of ultrasonography during the weaning process in critically ill patients.
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Affiliation(s)
- Lou’i Al-Husinat
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan;
| | - Basil Jouryyeh
- Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan; (B.J.); (A.R.)
| | - Ahlam Rawashdeh
- Faculty of Medicine, Yarmouk University, Irbid 21163, Jordan; (B.J.); (A.R.)
| | - Chiara Robba
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genova, 16132 Genova, Italy
| | - Pedro Leme Silva
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro 21941, Brazil; (P.L.S.); (P.R.M.R.)
| | - Patricia Rieken Macedo Rocco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro 21941, Brazil; (P.L.S.); (P.R.M.R.)
| | - Denise Battaglini
- Anesthesia and Intensive Care, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy;
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de Menezes Souza J, de Menezes Fonseca D, Pinheiro de Souza J, Cordeiro do Nascimento L, Mendes Hughes F, Pereira Bezerra JD, Góes-Neto A, Ferreira-Silva A. Cactus Endophytic Fungi and Bioprospecting for their Enzymes and Bioactive Molecules: A Systematic Review. Chem Biodivers 2023; 20:e202301413. [PMID: 37934008 DOI: 10.1002/cbdv.202301413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/08/2023]
Abstract
Endophytic fungi are associated with plant health and represent a remarkable source of potential of enzymes and bioactive compounds, but the diversity of endophytes remains uncertain and poorly explored, especially in Cactaceae, one of the most species-rich families adapted to growing in arid and semi-arid regions. The aim of this study was to conduct a systematic review on the diversity and bioprospecting of endophytic fungi from Cactaceae. We analysed peer-reviewed articles from seven databases using PRISMA guidelines. The results showed that the Cactaceae family is a source of new taxa, but the diversity of endophytic fungi of Cactaceae is little explored, mainly the diversity among tissues and by metagenomics. Bioprospecting studies have shown that these microorganisms can be used in the production of enzymes and larvicidal and antifungal compounds. Our results are relevant as a starting point for researchers to develop studies that expand the knowledge of plant mycobiota in arid and semi-arid ecosystems, as well as comprising a remarkable source of fungal compounds with several biotechnological applications.
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Affiliation(s)
- Jeferson de Menezes Souza
- Graduate Program in Biotechnology, Universidade Estadual de Feira de Santana, Feira de Santana City, 44036-900, Bahia State, Brazil
| | | | - Jaciara Pinheiro de Souza
- Graduate Program in Pharmaceutical Sciences, Universidade Federal de Sergipe, Aracaju City, 41100-000, Sergipe State, Brazil
| | - Luciana Cordeiro do Nascimento
- Agricultural Sciences Center, Department of Phytotechnics and Environmental Sciences, Universidade Federal da Paraíba, Areia City, 58397-000, Paraíba State, Brazil
| | - Frederic Mendes Hughes
- Conselho de Curadores das Coleções Científicas and Graduate Program in Zoology, Universidade Estadual de Santa Cruz, Ilhéus City, 45662-900, Bahia State, Brazil
| | - Jadson Diogo Pereira Bezerra
- Departament of Biosciences and Technology, Institute of Tropical Pathology and Public Health, Universidade Federal de Goiás, Goiânia City, 74605-050, Goiás State, Brazil
| | - Aristóteles Góes-Neto
- Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte City, 31270-901, Minas Gerais State, Brazil
| | - Alice Ferreira-Silva
- Agricultural Sciences Center, Department of Phytotechnics and Environmental Sciences, Universidade Federal da Paraíba, Areia City, 58397-000, Paraíba State, Brazil
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Silveira PSP, de Oliveira Siqueira J, Bernardy JL, Santiago J, Meneses TC, Portela BS, Benvenuti MF. Modeling VI and VDRL feedback functions: Searching normative rules through computational simulation. J Exp Anal Behav 2023; 119:324-336. [PMID: 36733190 DOI: 10.1002/jeab.826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 11/20/2022] [Indexed: 02/04/2023]
Abstract
We present the mathematical description of feedback functions of variable interval and variable differential reinforcement of low rates as functions of schedule size only. These results were obtained using an R script named Beak, which was built to simulate rates of behavior interacting with simple schedules of reinforcement. Using Beak, we have simulated data that allow an assessment of different reinforcement feedback functions. This was made with unparalleled precision, as simulations provide huge samples of data and, more importantly, simulated behavior is not changed by the reinforcement it produces. Therefore, we can vary response rates systematically. We've compared different reinforcement feedback functions for random interval schedules, using the following criteria: meaning, precision, parsimony, and generality. Our results indicate that the best feedback function for the random interval schedule was published by Baum (1981). We also propose that the model used by Killeen (1975) is a viable feedback function for the random differential reinforcement of low rates schedule. We argue that Beak paves the way for greater understanding of schedules of reinforcement, addressing still open questions about quantitative features of simple schedules. Also, Beak could guide future experiments that use schedules as theoretical and methodological tools.
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Affiliation(s)
| | - José de Oliveira Siqueira
- Department of Legal Medicine, Medical Ethics, Work and Social Medicine, University of São Paulo, Medical School, São Paulo, Brazil
| | - João Lucas Bernardy
- Department of Experimental Psychology, University of São Paulo, Institute of Psychology, São Paulo, Brazil
- National Institute of Science and Technology on Behavior, Cognition and Teaching, São Paulo, Brazil
| | - Jessica Santiago
- Department of Experimental Psychology, University of São Paulo, Institute of Psychology, São Paulo, Brazil
| | - Thiago Cersosimo Meneses
- Department of Experimental Psychology, University of São Paulo, Institute of Psychology, São Paulo, Brazil
| | - Bianca Sanches Portela
- Department of Experimental Psychology, University of São Paulo, Institute of Psychology, São Paulo, Brazil
| | - Marcelo Frota Benvenuti
- Department of Experimental Psychology, University of São Paulo, Institute of Psychology, São Paulo, Brazil
- National Institute of Science and Technology on Behavior, Cognition and Teaching, São Paulo, Brazil
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Gonçalves Maciel LH, Vieira da Rocha Neto C, Ferreira Martins Y, de Azevedo Furtado F, Cunha Teixeira P, Oliveira Dias MY, Batista Rodrigues YK, Ribeiro Piauilino IC, Damasceno Pinto S, Côrte Alencar AC, de Lima Gimaque JB, Gomes Mourão MP, Guimarães Lacerda MV, da Costa Castilho M, Bôtto-Menezes C. Prevalence of arboviruses and other infectious causes of skin rash in patients treated at a tertiary health unit in the Brazilian Amazon. PLoS Negl Trop Dis 2022; 16:e0010727. [PMID: 36228027 PMCID: PMC9560595 DOI: 10.1371/journal.pntd.0010727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/10/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In the clinical course of diseases such as arboviruses, skin rashes may appear, as is often seen in other infectious diseases. The aim of this study was to estimate the prevalence of arboviruses and other infectious causes of skin rash in a tertiary health unit in Manaus, Amazonas state, Western Brazilian Amazon. METHODOLOGY/PRINCIPAL FINDINGS This was a cross-sectional study of patients presenting with rash who sought care at Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD) from February 2018 to May 2019. Individuals of either gender, aged over 18 years, were invited to participate voluntarily. Infection by Zika virus (ZIKV), dengue virus (DENV), chikungunya virus (CHIKV), Mayaro virus (MAYV), Oropouche virus (OROV) and measles was evaluated using RT-qPCR (real-time polymerase chain reaction). Immunodiagnostic tests for EBV, CMV, HIV, syphilis, rubella and measles were also performed. A total of 340 participants were included, most were female (228, 67.1%) with an average age of 36.5 years (SD ± 12.2 years). The highest prevalence was of ZIKV monoinfections (65.3%, 222/340), followed by DENV (0.9%, 3/340) and CHIKV infection (0.3%, 1/340). No cases of MAYV, OROV or rubella were found. Other causes of skin rash were detected: measles (2.9%, 10/340), parvovirus B19 (0.9% 3/340), HIV (0.3%, 1/340) and syphilis 0.6% (2/340). The co-infections identified were ZIKV+HIV (0.3%, 1/340), ZIKV+measles (0.3%, 1/340), ZIKV+parvovirus B19 (0.3%, 1/340), ZIKV+EBV (0.3%, 1/340), EBV+parvovirus B19 (0.3%, 1/340), CMV+parvovirus B19 (0.6%, 2/340), CMV+syphilis (0.3%, 1/340), ZIKV+EBV+parvovirus B19 (0.3%, 1/340) and CMV+EBV+parvovirus B19 (0.9%, 3/340). Approximately one quarter of patients had no defined cause for their skin rash (25.3%, 86/340). CONCLUSIONS Despite the benign clinical evolution of most of the diseases diagnosed in this series of cases, syndromic surveillance of diseases such as syphilis and HIV are of utmost importance. Periodic serosurveillance might also aid in evaluating the trends of endemic diseases and eventual outbreaks.
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Affiliation(s)
| | - Cosmo Vieira da Rocha Neto
- Programa de Iniciação Científica, Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brasil
| | - Yasmin Ferreira Martins
- Programa de Iniciação Científica, Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brasil
| | | | - Pâmela Cunha Teixeira
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
| | - Maianne Yasmin Oliveira Dias
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
| | | | | | - Sérgio Damasceno Pinto
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
| | | | | | - Maria Paula Gomes Mourão
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
| | - Marcus Vinicius Guimarães Lacerda
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
- Instituto Leônidas e Maria Deane (ILMD–Fiocruz Amazônia), Manaus, Amazonas, Brazil
| | | | - Camila Bôtto-Menezes
- Programa de Pós-graduação em Medicina Tropical, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
- Fundação de Medicina Tropical Doutor Heitor Viera Dourado (FMT-HVD), Manaus, Amazonas, Brazil
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas (UEA), Manaus, Amazonas, Brazil
- * E-mail:
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Wunder EA, Adhikarla H, Hamond C, Owers Bonner KA, Liang L, Rodrigues CB, Bisht V, Nally JE, Alt DP, Reis MG, Diggle PJ, Felgner PL, Ko A. A live attenuated-vaccine model confers cross-protective immunity against different species of the Leptospira genus. eLife 2021; 10:e64166. [PMID: 33496263 PMCID: PMC7837694 DOI: 10.7554/elife.64166] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/23/2020] [Indexed: 12/24/2022] Open
Abstract
Leptospirosis is the leading zoonotic disease in terms of morbidity and mortality worldwide. Effective prevention is urgently needed as the drivers of disease transmission continue to intensify. The key challenge has been developing a widely applicable vaccine that protects against the >300 serovars that can cause leptospirosis. Live attenuated mutants are enticing vaccine candidates and poorly explored in the field. We evaluated a recently characterized motility-deficient mutant lacking the expression of a flagellar protein, FcpA. Although the fcpA- mutant has lost its ability to cause disease, transient bacteremia was observed. In two animal models, immunization with a single dose of the fcpA- mutant was sufficient to induce a robust anti-protein antibodies response that promoted protection against infection with different pathogenic Leptospira species. Furthermore, characterization of the immune response identified a small repertoire of biologically relevant proteins that are highly conserved among pathogenic Leptospira species and potential correlates of cross-protective immunity.
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Affiliation(s)
- Elsio A Wunder
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation; Brazilian Ministry of HealthSalvadorBrazil
| | - Haritha Adhikarla
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
| | - Camila Hamond
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
| | - Katharine A Owers Bonner
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
| | - Li Liang
- Department of Medicine, Division of Infectious Disease; University of California IrvineIrvineUnited States
| | - Camila B Rodrigues
- Department of Medicine, Division of Infectious Disease; University of California IrvineIrvineUnited States
- Institute of Technology in Immunobiology, Oswaldo Cruz Foundation; Brazilian Ministry of HealthRio de JaneiroBrazil
| | - Vimla Bisht
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
| | - Jarlath E Nally
- Infectious Bacterial Diseases Research Unit, National Animal Disease Center, Agricultural Research Service; United States Department of AgricultureAmesUnited States
| | - David P Alt
- Infectious Bacterial Diseases Research Unit, National Animal Disease Center, Agricultural Research Service; United States Department of AgricultureAmesUnited States
| | - Mitermayer G Reis
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation; Brazilian Ministry of HealthSalvadorBrazil
| | - Peter J Diggle
- CHICAS, Lancaster Medical School; Lancaster UniversityLancasterUnited Kingdom
| | - Philip L Felgner
- Department of Medicine, Division of Infectious Disease; University of California IrvineIrvineUnited States
| | - Albert Ko
- Department of Epidemiology of Microbial Diseases; Yale School of Public HealthNew HavenUnited States
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation; Brazilian Ministry of HealthSalvadorBrazil
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9
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Fernandes FDF, Barletta ABF, Orfanó AS, Pinto LC, Nacif-Pimenta R, Miranda JC, Secundino NFC, Bahia AC, Pimenta PFP. Ultrastructure of the Antennae and Sensilla of Nyssomyia intermedia (Diptera: Psychodidae), Vector of American Cutaneous Leishmaniasis. J Med Entomol 2020; 57:1722-1734. [PMID: 32761144 PMCID: PMC7899269 DOI: 10.1093/jme/tjaa124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Indexed: 06/11/2023]
Abstract
The antennal sensilla and the antenna of females Nyssomyia intermedia, one of the main vectors of American cutaneous leishmaniasis, were studied by scanning electron microscopy. The main goal was to characterize the quantity, typology, and topography of the sensilla with particular attention to the olfactory types. The insects were captured in the city of Corte de Pedra, State of Bahia, Brazil, by CDC-type light traps and raised in a laboratory as a new colony. Fourteen well-differentiated sensilla were identified, among six cuticular types: trichoidea, campaniformia, squamiformia, basiconica, chaetica, and coeloconica. Of these, six sensilla were classified as olfactory sensilla due to their specific morphological features. Smaller noninnervated pilosities of microtrichiae type were also evidenced by covering all antennal segments. The antennal segments differ in shapes and sizes, and the amount and distribution of types and subtypes of sensilla. This study may foment future taxonomic and phylogenetic analysis for a better evolutionary understanding of the sand flies. Besides, it may assist the targeting of future electrophysiological studies by Single Sensillum Recording, and aim to develop alternative measures of monitoring and control of this vector.
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Affiliation(s)
- Fernando de Freitas Fernandes
- Laboratory of Medical Entomology (LEM), René Rachou Institute (IRR), FIOCRUZ, Belo Horizonte, MG, Brazil
- Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | - Ana Beatriz F Barletta
- Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Alessandra S Orfanó
- Laboratory of Medical Entomology (LEM), René Rachou Institute (IRR), FIOCRUZ, Belo Horizonte, MG, Brazil
| | - Luciana C Pinto
- Laboratory of Medical Entomology (LEM), René Rachou Institute (IRR), FIOCRUZ, Belo Horizonte, MG, Brazil
| | - Rafael Nacif-Pimenta
- Laboratory of Medical Entomology (LEM), René Rachou Institute (IRR), FIOCRUZ, Belo Horizonte, MG, Brazil
| | - Jose Carlos Miranda
- Laboratory of Infectious Diseases Transmitted by Vectors, Instituto Gonçalo Moniz, Fiocruz, Salvador, BA, Brazil
| | - Nágila F C Secundino
- Laboratory of Medical Entomology (LEM), René Rachou Institute (IRR), FIOCRUZ, Belo Horizonte, MG, Brazil
| | - Ana Cristina Bahia
- Laboratory of Insects and Parasites Biochemistry, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, RJ, Brazil
| | - Paulo F P Pimenta
- Laboratory of Medical Entomology (LEM), René Rachou Institute (IRR), FIOCRUZ, Belo Horizonte, MG, Brazil
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10
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da Silva AL, de Oliveira GP, Kim N, Cruz FF, Kitoko JZ, Blanco NG, Martini SV, Hanes J, Rocco PRM, Suk JS, Morales MM. Nanoparticle-based thymulin gene therapy therapeutically reverses key pathology of experimental allergic asthma. Sci Adv 2020; 6:eaay7973. [PMID: 32577505 PMCID: PMC7286682 DOI: 10.1126/sciadv.aay7973] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 04/15/2020] [Indexed: 05/05/2023]
Abstract
Despite long-standing efforts to enhance care for chronic asthma, symptomatic treatments remain the only option to manage this highly prevalent and debilitating disease. We demonstrate that key pathology of allergic asthma can be almost completely resolved in a therapeutic manner by inhaled gene therapy. After the disease was fully and stably established, we treated mice intratracheally with a single dose of thymulin-expressing plasmids delivered via nanoparticles engineered to have a unique ability to penetrate the airway mucus barrier. Twenty days after the treatment, we found that all key pathologic features found in the asthmatic lung, including chronic inflammation, pulmonary fibrosis, and mechanical dysregulation, were normalized. We conducted tissue- and cell-based analyses to confirm that the therapeutic intervention was mediated comprehensively by anti-inflammatory and antifibrotic effects of the therapy. We believe that our findings open a new avenue for clinical development of therapeutically effective gene therapy for chronic asthma.
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Affiliation(s)
- Adriana L. da Silva
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Laboratory of Cellular and Molecular Physiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gisele P. de Oliveira
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Namho Kim
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Fernanda F. Cruz
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jamil Z. Kitoko
- Laboratory of Inflammation and Immunity, Paulo de Góes Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Natalia G. Blanco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Sabrina V. Martini
- Laboratory of Cellular and Molecular Physiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Justin Hanes
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patricia R. M. Rocco
- Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jung Soo Suk
- Center for Nanomedicine at the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, MD, USA
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Corresponding author. (J.S.S.); (M.M.M.)
| | - Marcelo M. Morales
- Laboratory of Cellular and Molecular Physiology, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Corresponding author. (J.S.S.); (M.M.M.)
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11
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Pereira Ribeiro S, M. Milush J, Cunha-Neto E, G. Kallas E, Kalil J, D. Passero LF, W. Hunt P, G. Deeks S, F. Nixon D, SenGupta D. p16INK4a Expression and Immunologic Aging in Chronic HIV Infection. PLoS One 2016; 11:e0166759. [PMID: 27861555 PMCID: PMC5115792 DOI: 10.1371/journal.pone.0166759] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 11/03/2016] [Indexed: 01/01/2023] Open
Abstract
Chronic HIV infection is characterized by increased immune activation and immunosenescence. p16 INK4a (p16) is a member of the cyclin-dependent kinase antagonist family that inhibits cellular proliferation, and its protein expression increases during normal chronological aging. However, some infectious diseases can increase the expression of this anti-proliferative protein, potentially accelerating immunological aging and dysfunction. In order to investigate the immunological aging in HIV patients, p16 protein expression was evaluated by flow cytometry, in T cell subsets in a cohort of chronically HIV-infected patients on and off ART as well as age-matched healthy controls. Results showed that untreated HIV-infected subjects exhibited increased per-cell p16 protein expression that was discordant with chronological aging. ART restored p16 protein expression to levels comparable with HIV-negative subjects in the CD4 compartment, but not in CD8 T cells, which can be an indicative of an irreversible activation/exhaustion status on these cells. Additionally, the frequency of activated CD4+ and CD8+ T cells was positively correlated with p16 expression in CD4+ and CD8+ T cells in untreated subjects. In contrast to healthy controls, untreated HIV-infected individuals had increased p16 levels within the effector memory (TEM) subset, indicating a possible role for this marker in impaired clonal expansion during antiviral effector function. Taken together, these data demonstrate that chronic HIV infection is associated with elevated expression of the cellular aging marker p16 in T cells. ART restored normal p16 levels in the CD4+ T cell compartment, indicating that use of therapy can be of fundamental importance to normal cell cycling and maintaining immune homeostasis.
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Affiliation(s)
- Susan Pereira Ribeiro
- Laboratory of Clinical Immunology and Allergy-LIM60/ University of Sao Paulo School of Medicine, São Paulo, Brazil
- Institute of Investigation in Immunology–iii-INCT, São Paulo, Brazil
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio, United States of America
- * E-mail:
| | - Jeffrey M. Milush
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Edecio Cunha-Neto
- Laboratory of Clinical Immunology and Allergy-LIM60/ University of Sao Paulo School of Medicine, São Paulo, Brazil
- Institute of Investigation in Immunology–iii-INCT, São Paulo, Brazil
- Laboratory of Immunology, Heart Institute, University of Sao Paulo School of Medicine, São Paulo, Brazil
| | - Esper G. Kallas
- Laboratory of Clinical Immunology and Allergy-LIM60/ University of Sao Paulo School of Medicine, São Paulo, Brazil
- Institute of Investigation in Immunology–iii-INCT, São Paulo, Brazil
| | - Jorge Kalil
- Laboratory of Clinical Immunology and Allergy-LIM60/ University of Sao Paulo School of Medicine, São Paulo, Brazil
- Institute of Investigation in Immunology–iii-INCT, São Paulo, Brazil
- Laboratory of Immunology, Heart Institute, University of Sao Paulo School of Medicine, São Paulo, Brazil
- Butantan Institute, Butantan, São Paulo, SP, Brazil
| | - Luiz Felipe D. Passero
- São Vicent Unit, Paulista Coastal Campus, São Paulo State University "Julio de Mesquita Filho", Sao Paulo, Brazil
| | - Peter W. Hunt
- HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California, United States of America
| | - Steven G. Deeks
- HIV/AIDS Division, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California, United States of America
| | - Douglas F. Nixon
- Department of Microbiology, Immunology & Tropical Medicine, The George Washington University, Washington DC, United States of America
| | - Devi SenGupta
- Division of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
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