Anticandida and antibiofilm activities of extract from Schinopsis brasiliensis Engl. against Candida spp

Abstract The pathogenic nature of infections caused by Candida spp. underscores the necessity for novel therapeutic agents. Extracts of Schinopsis brasilienses Engl are / a promising source of agents with antifungal effects. This study aimed to assess the antifungal potential of the leaf extract of S. brasilienses. The antifungal activity was evaluated by determining the minimum inhibitory concentrations and fungicide concentrations (MIC and MFC). The antibiofilm potential was assessed by counting colony-forming units/mL. The study examined the inhibition kinetics of fungal growth and potential synergism between gallic acid or the extract and nystatin using the Checkerboard method. Cytotoxicity was evaluated through the MTT assay. The extract exhibited antifungal effect against all tested strains, with MIC and MFC ranging from 31.25-250 μg/mL. Gallic acid, the main isolated compound, displayed a MIC of 2000 μg/mL. The extract of S. brasilienses at 31.25 μg/mL inhibited the formation of biofilm by C. albicans and significantly reduced the mass of mature biofilm after 24 and 48 h (p < 0. 05). At a concentration of 125 μg/mL, the extract demonstrated significant inhibition of fungal growth after 6 hours. The combination of gallic acid or extract with nystatin did not exhibit synergistic or antagonistic effect. Furthermore, the extract did not induce cytotoxicity to a human cell line. The extract of S. brasiliensis demonstrates antifungal activity against Candida, generally exhibiting fungicidal action and capacity to inhibit biofilm formation as well as reduce mature biofilms. Additionally, the extract showed low cytotoxicity to human cells.

SARS-CoV-2 and Saliva as a Diagnostic Tool: A Real Possibility

Abstract Covid-19 is a respiratory disease caused by the SARS-CoV-2 virus. The high rate of contagion and the spread of the virus in the population make the early detection of the pathogen the means for the adequate targeting of infection control measures. WHO directs sample collection on upper respiratory specimens, including nasopharyngeal and oropharyngeal swab or wash in ambulatory patients, as well as lower respiratory specimens: sputum and/or endotracheal aspirate or bronchoalveolar lavage, in addition to citing blood and feces. Among the various sample collection methods, saliva has been investigated and reported as a potential source for diagnosis. Thus, we propose to evaluate the current scenario, based on recent publications on the perspective of detecting SARS-CoV-2 in saliva as a diagnostic method for Covid-19. The detection of SARS-CoV-2 through saliva seems to be very promising, although obstacles such as the technique and the location of the collection and the sample size of the research carried out so far may present a limitation for its use. The current scenario presents saliva as a reliable method for the detection of SARS-CoV-2, due to the ease of obtaining the samples, the possibility of self-collection, low cost because there is no need to use specific equipment, in addition to reducing the risk of transmission for health professionals.

Anti-Biofilm and Hemolytic Effects of Cymbopogon citratus (Dc) Stapf Essential Oil

Abstract Objective: To perform chemical analysis and to evaluate the anti-biofilm and hemolytic effect of the essential oil of Cymbopogon citratus. Material and Methods: Gaseous chromatography coupled to mass spectrometer was performed for chemical characterization of the essential oil. To verify the antimicrobial action, the Minimum Inhibitory Concentration (MIC), Minimum Bactericidal Concentration (MBC) and Minimum Fungicidal Concentration (MFC) were determined. From MIC, MBC and MFC data, concentrations were established to verify the anti-biofilm effect and for the hemolysis test on human erythrocytes. A multispecies biofilm was developed in vitro and mouthwash applications were simulated to determine the inhibition of biofilm formation or its removal. Results were analyzed through ANOVA statistical test, complemented by the Tukey test, considering a significance level of 5% Results: The major component of the essential oil is citral. MIC verified for Streptococcus mutans was 1mg / mL, while for Candida albicans, it was 125 μg/mL, presenting microbicidal effect for both microorganisms tested. The essential oil was able to inhibit biofilm formation (p<0.001), presenting non-toxic hemolysis percentage in concentration below 500 μg/mL Conclusion: The essential oil of Cymbopogon citratus is antimicrobial, antibiofilm and non-toxic to human erythrocytes, representing a natural product with potential for use in Dentistry.

Candida on oral cavity of pediatric individuals with ALL and its susceptibility to nystatin and amphotericin B / Candida na cavidade oral de indivíduos pediátricos com LLA e sua susceptibilidade à nistatina e à anfotericina B

ABSTRACT Objective: The aim of this study was to evaluate the prevalence of Candida colonizationon oral cavity of pediatric individuals with acute lymphocytic leukemia (ALL) and its susceptibility/resistance to nystatin and amphotericin B. Methods: This was a cross sectional study with observational, descriptive and analytic approach. Saliva was collected from40 individuals diagnosed with ALL and from40 healthy subjects, as a comparative group, matched by age and gender with ALL group. The mean age for both groups were 8 years-old. The isolation and identification of the Candidaspecies were performed using the CHROMagarCandidaTM and confirmed by polymerase chain reaction. The samples were subjected to antifungal susceptibility by microdilution assay for nystatin and amphotericin B. Salivary alterations and chemotherapy-induced oralmucositis were evaluated using modifiedOral Assessment Guide. Results: The positivity to Candida was higher inALL individuals (32.5%,13/40)than in a comparative group(2.5%, 1/40) (p<0.001). Candida albicans was the most prevalent strain (86.6%). The mucositis was directly associated with positive Candidacolonization (p=0.017) in the ALL group but not related with salivary alterations (p= 0.479). Six strains of C. albicans (54.5%), on ALL group, were resistant to nystatin and all strains were not susceptible to amphotericin B. Conclusion: Candida colonization was associated with ALL condition and with oral mucositis in these individuals. C. albicans was the prevalent strain and most samples were resistant to antifungal agents tested, nystatin and amphotericin B.

RESUMO Objetivo: o objetivo deste estudo foi avaliar a prevalência e colonização de Candida na cavidade oral de indivíduos pediátricos com leucemia linfocítica aguda (LLA) e sua susceptibilidade/resistência à nistatina e à anfotericina B. Métodos: estudo transversal observacional com abordagem descritiva e analítica. A saliva foi coletada de 40 indivíduos diagnosticados com LLA e de 40 indivíduos saudáveis, como grupo comparativo, combinados por idade e sexo com o grupo LLA. A idade média para ambos os grupos foi de 8 anos de idade. O isolamento e a identificação das espécies de Candida foram realizados utilizando o CHROMagarCandidaTM e confirmados pela reação em cadeia da polimerase. As amostras foram submetidas a susceptibilidade antifúngica por meio de ensaio de microdiluição para nistatina e anfotericina B. As alterações salivares e a mucosite oral induzida por quimioterapia foram avaliadas utilizando o Guia de avaliação modificada. Resultados: A positividade para Candida foi superior aos indivíduos in situ (32,5%, 13/40) do que em um grupo comparativo (2,5%, 1/40) (p <0,001). Candida albicans foi a cepa mais prevalente (86,6%). A mucosite foi diretamente associada à colonização positive por Candida (p = 0,017) no grupo LLA, mas não relacionada com alterações salivares (p = 0,479). Seis estirpes de C. albicans (54,5%), no grupo LLA, eram resistentes à nistatina e todas as cepas não eram suscetíveis à anfotericina B. Conclusão: A colonização por Candida foi associada à condição LLA e à mucosite oral nesses indivíduos. C. albicans era a cepa predominante e a maioria das amostras eram resistentes aos agentes antifúngicos testados, nistatina e anfotericina B.

Cardiac tamponade in a patient with severe dengue fever

Abstract A 26-year-old postpartum female presented with symptoms characteristic of dengue fever on the 16th day of puerperium. On the third day of the illness, the patient presented a clinical picture consistent with shock. Tests determined primary infection with dengue virus serotype 2. Cardiac tamponade was confirmed by echocardiography. This rare manifestation is described in a patient without any associated comorbidity.

Chikungunya virus infection with severe neurologic manifestations: report of four fatal cases

Abstract Here, we present four patients with confirmed Chikungunya virus infection showing atypical neurologic manifestations and death. This case series includes patients ranging in age from five to 92 years, with or without comorbidities. This report is important, as very few cases in the literature reporting death due to atypical Chikungunya virus infection are available.

Avaliação da qualidade de vida e do tratamento fisioterapêutico em pacientes com cervicalgia crônica / Evaluation of quality of life and the physiotherapy treatment in patients with chronic neck pain

INTRODUÇÃO: Para analisar a efetividade do tratamento fisioterapêutico no paciente com dor crônica cervical, este trabalho teve como objetivo avaliar antes e após o tratamento fisioterapêutico: a qualidade de vida com o instrumento WHOQOL-100 e a melhora na amplitude de movimento usando um goniômetro. MATERIAIS E MÉTODOS: Participaram deste estudo 15 pacientes (10 mulheres e 5 homens). O nível de significância adotado foi de p < 0,05. RESULTADOS: Foi verificada melhora significativa após o tratamento fisioterapêutico no domínio I - físico (p = 0,0117); domínio II - psicológico (p = 0,004); domínio III - nível de independência (p = 0,0006); domínio IV - relações sociais (p < 0,0001); e no domínio V - ambiente (p = 0,0019); e também na amplitude articular dos movimentos de flexão cervical (p < 0,0001), extensão cervical (p = 0,0004), inclinação lateral á direita (p < 0,0001) inclinação lateral à esquerda (p < 0,0001), rotação lateral à direita (p < 0,0001) e rotação lateral à esquerda (p < 0,0001). DISCUSSÃO: Andersen et al. (17) relataram que exercícios de alongamento melhoram de forma significativa a amplitude de movimento articular em mulheres com cervicalgia crônica. Chiu et al. (20) observaram melhora na dor crônica cervical e na limitação articular após seis semanas de tratamento com TENS e exercícios. CONCLUSÃO: O presente estudo conclui que a intervenção fisioterapêutica composta de exercícios de alongamento, técnicas de relaxamento, massagens e eletroterapia foram benéficos para melhorar a qualidade de vida e a flexibilidade nos pacientes com cervicalgia crônica.

INTRODUCTION: In order to analyze the effectiveness of the physiotherapeutic treatment in patients with chronic neck pain, this work had as a goal to evaluate the period before and after the physiotherapeutic treatment: quality of life as a WHOQOL-100 tool and the improvement of the range of motion (ROM), using a goniometer. MATERIALS AND METHODS: 15 patients were members of this study (10 women and 5 men). RESULTS: Level of significance adopted was p < 0.05. It was observed significant improvement after physical therapy in the domain I - physical (p = 0.0117), in domain II - psychological (p = 0.004), the domain III - level of independence (p = 0.0006), domain IV - social relationships (p < 0.0001) and domain V - environment (p = 0.0019) and also in joint range of motion of cervical flexion (p< 0.0001), cervical extension (p = 0.0004), right head tilt (p < 0.0001), left head tilt (p < 0.0001) right lateral rotation (p < 0.0001) and left lateral rotation (p < 0.0001). DISCUSSION: Andersen et al. (17) reported that stretching exercises significantly improve the range of motion in women with chronic neck pain. Chiu et al. (20) observed improvement in chronic cervical pain and joint limitation after six weeks of treatment with TENS and exercise. CONCLUSIONS: This study concludes that the physioterapeutic intervention composed by stretching exercises, relaxation techniques, massage and electrotherapy were of positive effects for improving the quality of life and flexibility in patients with chronic neck pain.

Immunophenotyping of circulating T cells in a mucosal leishmaniasis patient coinfected with HIV / Immunofenotipagem de células T circulantes em um paciente com leishmaniose mucosa co-infectado com HIV

HIV coinfection modifies the clinical course of leishmaniasis by promoting a Th2 pattern of cytokine production. However, little information is available regarding the lymphocytic response in untreated coinfected patients. This work presents the immunophenotyping of Leishmania-stimulated T cells from a treatment-naÏve HIV+ patient with ML. Leishmania braziliensis antigens induced CD69 expression on CD3+CD4+ and CD3+CD8+ cells. It also increased IL-4 intracellular staining on CD3+CD4+GATA3- population and decreased the percentage of CD3+CD4+IL-17+ cells. This suggests that modulations in the IL-4R/STAT6 pathway and the Th17 population may serve as parasitic evasion mechanisms in HIV/ML. Further studies are required to confirm these results.

A co-infecção por HIV modifica o curso clínico da leishmaniose ao promover aumento no perfil Th2 de produção de citocinas. No entanto, há pouca informação a respeito da resposta linfocitária em pacientes co-infectados sem tratamento. Neste trabalho, foi realizada a imunofenotipagem de células T estimuladas com antígenos de Leishmania braziliensis em paciente não tratado HIV+ e com leishmaniose mucosa. Os resultados mostraram aumento na expressão de CD69 em células CD3+CD4+ e CD3+CD8+. Além disso, foi observado aumento de IL-4 na população de linfócitos CD3+CD4+GATA3- e diminuição no percentual de células CD3+CD4+IL-17+. Estes resultados sugerem que a modulação da via IL-4R/STAT6 e da população de células Th17 funcione como mecanismo de evasão parasitária em HIV/LM. Estudos futuros são necessários para confirmar estes resultados.

Papel do óxido nítrico no desenvolvimento de lesões cardíacas na fase aguda da infecção experimental pelo Trypanosoma cruzi / Role of nitric oxide in the development of cardiac lesions during the acute phase of experimental infection by Trypanosoma cruzi

A doença de Chagas é causada pelo Trypanosoma cruzi e o coração é o órgão mais acometido. O óxido nítrico apresenta importante ação anti-Trypanosoma, porém, com pouca evidência de seu papel no mecanismo de lesão tecidual. O objetivo deste estudo foi analisar a contribuição do óxido nítrico no desenvolvimento da inflamação e da fibrose cardíaca na fase aguda da infecção experimental por cepas Y e Colombiana do Trypanosoma cruzi. A inflamação foi significativamente maior nos animais infectados pela cepa Colombiana, comparada com os infectados com a cepa Y, tanto nos animais C57BL/6 (3,98x1,87 por cento; p=0,004) quanto nos animais C57BL/6 deficientes na sintase do óxido nítrico induzível (3,99x2,4 por cento; p=0,013). O parasitismo cardíaco dos animais C57BL/6 deficientes na sintase do óxido nítrico induzível infectados pela cepa Colombiana foi significativamente maior que o destes mesmos animais infectados com a cepa Y (2,78x0,17 ninhos/mm²; p=0,004) assim como, os animais C57BL/6 infectados com a cepa Colombiana (2,78x1,33 ninhos/mm²; p=0,006) ou cepa Y (2,78x0,53 ninhos/mm²; p=0,005). Os dados reforçam o papel do óxido nítrico no controle do parasitismo e sugerem seu papel na proteção tecidual, controlando a inflamação e potencialmente diminuindo lesões cardíacas durante a fase aguda na doença de Chagas experimental.

Chagas disease is caused by Trypanosoma cruzi and the heart is the organ most affected. Nitric oxide has notable anti-Trypanosoma action, but with little evidence regarding its role in the mechanism for tissue injury. The objective of this study was to analyze the contribution of nitric oxide towards the development of inflammation and cardiac fibrosis during the acute phase of experimental infection by Y and Colombian strains of Trypanosoma cruzi. The inflammation was significantly more intense in animals infected with the Colombian strain, compared with those infected with the Y strain, both in C57BL/6 animals (3.98 vs 1.87 percent; p = 0.004) and in C57BL/6 animals deficient in inducible nitric oxide synthase (3.99 vs 2.4 percent; p = 0.013). The cardiac parasite load in inducible nitric oxide synthase-deficient C57BL/6 animals infected with the Colombian strain was significantly greater than in those infected with the Y strain (2.78 vs. 0.17 nests/mm²; p = 0.004), and also significantly greater than in the C57BL/6 infected with both the Colombian strain (2.78 vs 1.33 nests/mm²; p = 0.006) and Y strains (2.78 vs 0.53 nests/mm²; p = 0.005). The data confirm that nitric oxide has a role in parasite load control and suggest that it has a role in tissue protection, through controlling inflammation and potentially reducing cardiac lesions during the acute phase of Chagas disease.

Cytokine and nitric oxide production in an adult patient with staphylococcal scalded skin syndrom

Staphylococcal scalded-skin syndrome (SSSS) is an exfoliative dermatitis resultant from the infection with exfoliative-toxin-producing (ET) Staphylococcus aureus. This syndrome usually occurs in children, while adult cases are generally linked to renal-deficiency or immunossupresion. A case of a 74 years old woman presenting SSSS after hospital admission due to cardiovascular disorders is presented and discussed. Cytokines (TNF-a, IFN-g, IL-6, IL-13 and IL-10) and nitric oxide (NO) production in vitro by whole blood leukocytes (WBL) were investigated. Leukocytes stimulated by lipopolysaccharide or phytohemagglutinin produced increased IFN-g, TNF-a, IL-13 and NO levels after treatment. Based on these results, immunological aspects of the disease are discussed

El síndrome de la piel escaldada estafilocócica (SSSS) es una dermatitis exfoliante resultante de la infección por Staphylococcus aureus productores de toxinas exfoliantes. Este síndrome ocurre generalmente en niños, mientras que su manifestación en adultos está generalmente relacionada con deficiencia renal o inmunosupresión. Se presenta y discute el caso de una mujer de 74 años de edad con SSSS luego de su admisión en el hospital por complicaciones cardiovasculares. Fue evaluada la producción in vitro de citocinas (TNF-a, IFN-g, IL-6, IL-13, IL-10) y óxido nítrico (NO) por células de sangre total (WBL). Los leucocitos estimulados por lipopolisacarideos y fitohemaglutinina produjeron elevados niveles de IFN-g, TNF-a, IL-13 y NO en el final del tratamiento. Basados en estos resultados, se discuten los aspectos inmunológicos de la enfermedad