The research on hepatitis D should be taken seriously / 临床肝胆病杂志

Hepatitis D virus (HDV) infection is an important health problem around the world. The epidemiology of HDV infection has been changed significantly over the past 10 years due to widespread hepatitis B vaccination and human migration. HDV infection can manifest as co-infection or superinfection. Patients with HBV/HDV co-infection have a significantly higher risk of liver cirrhosis and hepatocellular carcinoma than those with HBV infection alone. Research and development are being conducted for new therapeutic drugs for hepatitis D, some of which have entered phase Ⅲ clinical trials. These drugs will replace the current therapies with lower efficacy.

Pacientes con enfermedad injerto contra huésped e infecciones asociadas al rechazo de trasplante / Patients with graft-versus-host disease and infections associated with transplant rejection

Introducción: durante muchos años las células madre hematopoyéticas han sido el tratamiento para muchos trastornos hematológicos, pero su eficacia está limitada por la enfermedad injerto contra huésped (EICH); una de las principales complicaciones del trasplante alogénico se encuentra asociado con morbilidad y mortalidad, por lo tanto, la prevención es importante para el éxito del trasplante alogénico. Objetivo: realizar una revisión acerca del reconocimiento clínico de una EICH para brindar el tratamiento correcto y evitar ciertas complicaciones, como infecciones que llevan al rechazo del injerto y ponen en riesgo la calidad de vida del paciente. En la mayoría de los casos las pruebas de laboratorio como biomarcadores y biopsias, son buenos predictores para procesos biológicos o patológicos que confirmen el diagnóstico y establezcan el estadio de la enfermedad. Metodología: se realizó una revisión bibliográfica en bases de datos, tales como Pubmed y ClinicalKey, con base en los siguientes términos MeSH: cirugía, mortalidad, patología, complicaciones, virología. Conclusión: la prevención y tratamiento de esta enfermedad predispone a infecciones y diferentes complicaciones que ponen en riesgo la vida del paciente.

Introduction: For many years hematopoietic stem cells have been the treatment for many hematological disorders, but their efficacy is limited by graft-versus-host disease (GVHD), one of the main complications of allogeneic transplantation associated with morbidity and mortality; therefore, prevention is important for the success of allogeneic transplantation. Objective: To review the clinical recognition of GVHD in order to provide the correct treatment and avoid certain complications, such as infections that lead to graft rejection and jeopardize the patient's quality of life. In most cases laboratory tests such as biomarkers and biopsies are good predictors of biological or pathological processes that confirm the diagnosis and establish the stage of the disease. Methodology: A bibliographic review was carried out in databases such as Pubmed and ClinicalKey based on the following MeSH terms: surgery, mortality, pathology, complications, virology. Conclusion: The prevention and treatment of this disease predisposes to infections and different complications that put the patient's life at risk.

Vaccines and vaccine resistance: Past, present and future

Background: Edward Jenner, by any definition would be considered the father of vaccinology. His use of cow pox virus for vaccinating against small pox is the prime example of a live vaccine. Using a virus that has very low virulence for humans and therefore, fits the definition of attenuated. Hesitancy towards a vaccine of this type, much before the science of microbiology and immunology were established, would have been justifiable. In the first half of 20th century, large number of vaccines became available for childhood diseases with significant morbidity and mortality. Around the same time global travel and trade led to escalation in the widespread transmission of diseases caused by microbes. Objective: The objective of this narrative is to offer a balanced view of science behind vaccines, their current status and advances expected in the near future. At the same time the various types of reactions from public at large towards vaccines over past decades are reviewed. Content: This narrative provides a historical perspective of vaccine development, reviews mechanisms of vaccine induced protection, currently available vaccine technologies and vaccines. The focus is on newer vaccines including those utilizing viral vectors and gene based vaccines. Based on the times during which this narrative is being written, messenger RNA vaccines are discussed in detail. Conclusion: The content and review of literature offered in this review makes the impact of vaccines on human life clear. It is also to be accepted that resistance and hesitation towards vaccines is nothing new or limited to vaccines being used during the ongoing pandemic of Covid 19. The continued development of science and products of vaccinology is necessary for further impact on human life. The development of a strong public health infrastructure by nations around the world is the key to improve upon current efforts at public awareness, proactive interventions and appropriate vaccine utilization during all times. Preparedness for epidemics and pandemics would then become more and more efficient than currently in existence.

A emergência da dengue como desafio virológico: de doença-fantasma à endemia "de estimação", 1986-1987 / The emergence of dengue as a virological challenge: from phantom disease to "pet" endemic, 1986-1987

Resumo O artigo analisa como a dengue se apresentou como desafio virológico na década de 1980. O objetivo é entender o papel dos estudos virológicos na compreensão da doença e a construção de uma expertise em arboviroses. Embora surtos da doença já tivessem sido relatados ao longo do século XX, a dengue era pouco conhecida nas Américas até a epidemia de dengue hemorrágica em Cuba, em 1981. Quando em 1986 a doença atingiu a cidade de Nova Iguaçu (RJ), a equipe de virologistas liderada por Hermann Schatzmayr tomaria a doença como objeto, mobilizando esforços a partir da criação do Laboratório de Flavivírus do Instituto Oswaldo Cruz.

Abstract This article analyzes how dengue presented a virological challenge during the 1980s in order to explore the role of virological studies in understanding this disease and constructing expertise in arboviral diseases. Although outbreaks were reported throughout the twentieth century, dengue was barely known in the Americas until the epidemic of dengue fever in Cuba in 1981. When the disease reached the Brazilian city of Nova Iguaçu (RJ) in 1986, it became the focus of attention for a team of virologists led by Hermann Schatzmayr, who mobilized efforts after the creation of the Flavivirus Laboratory at the Oswaldo Cruz Institute.

Hepatitis C-related membranoproliferative glomerulonephritis in the era of direct antiviral agents / Glomerulonefrite membranoproliferativa relacionada à hepatite C na era dos agentes antivirais diretos

Abstract Membranoproliferative glomerulonephritis (MPGN) is the most typical Hepatitis C virus (HCV)-associated glomerulopathy, and the available data about the utilization of direct-acting antivirals (DAA) in HCV-associated glomerulonephritis is inadequate. We evaluated the renal and viral response in two cases of HCV-related MPGN; the first caused by cryoglobulinemia while the second was cryoglobulin-negative. Both patients received immunosuppression besides DAA in different regimens. They achieved partial remission but remained immunosuppression-dependent for more than 6 months after DAA despite sustained virological response, which enabled safer but incomplete immunosuppression withdrawal. Both patients were tested for occult HCV in peripheral blood mononuclear cells and found to be negative. Hence, the treatment of HCV-related MPGN ought to be according to the clinical condition and the effects of drug therapy. It is important to consider that renal response can lag behind the virological response.

Resumo A glomerulonefrite membranoproliferativa (GNMP) é a glomerulopatia associada ao vírus mais típico da hepatite C (HCV), e os dados disponíveis sobre a utilização de antivirais de ação direta (AAD) na glomerulonefrite associada ao HCV são inadequados. Avaliamos a resposta renal e viral em dois casos de GNMP relacionados ao HCV; o primeiro causado por crioglobulinemia, enquanto o segundo era negativo para crioglobulina. Ambos os pacientes receberam imunossupressão além de AAD em diferentes esquemas terapêuticos. Eles alcançaram remissão parcial, mas permaneceram dependentes da imunossupressão por mais de 6 meses após os AAD, apesar da resposta virológica sustentada, que permitiu a retirada da imunossupressão mais segura, mas incompleta. Ambos os pacientes foram testados para HCV oculto em células mononucleares do sangue periférico e deram resultados negativos. Portanto, o tratamento do GNMP relacionado ao VHC deve ser de acordo com a condição clínica e os efeitos da terapia medicamentosa. É importante considerar que a resposta renal pode ficar aquém da resposta virológica.

Retos actuales a la enseñanza de la virología para enfrentar enfermedades emergentes / Current challenges to the teaching of virology to face emerging diseases

En los últimos años los microorganismos han generado múltiples evoluciones, provocando enfermedades y problemas agudos de salud pública. Para poder controlar las virosis es necesario conocer su biología y epidemiología, establecer tratamiento y profilaxis adecuada para su control. Para ello, es indispensable comenzar con la formación de los profesionales de la salud, en particular, los estudiantes de medicina, es necesario potenciar el desarrollo de sus habilidades y competencias, no solo dominio del conocimiento científico, si no también pueda promoverlo, transferirlo y aplicarlo con impacto en la salud colectiva y que vaya a la par de los avances tecno-científicos. Es por ello, que surge la inquietud del fórum, discusión acerca del análisis de la enseñanza de la virología para enfrentar enfermedades emergentes en función de perfil del egresado. Se realizó encuesta a los estudiantes de los últimos diez años de la carrera de medicina de UNIANDES, sobre la biología, epidemiologia, respuesta inmunológica y diagnóstico, para mencionadas áreas de conocimiento se obtuvo, tanto en la evaluación objetiva estructurada y evaluación práctica, un nivel altamente satisfactorio. En la pirámide de Miller, se alcanzó nivel tres con conocimiento y desarrollo de habilidades, destrezas y actitudes del egresado satisfactorias. Sin embargo, los profesores de Virología están de acuerdo con innovar en la docencia integrando los contenidos transversalmente a las áreas de conocimiento: enfermedades infecciosas, clínicas, patologías, epidemiología y salud pública, lo que permitirá un aprendizaje integral para realizar abordaje adecuado de caso positivos de las virosis, además de tener capacidades para establecer vigilancia epidemiológica(AU)

In recent years, microorganisms have generated multiple evolutions, causing diseases and acute public health problems. In order to control virosis, it is necessary to know their biology and epidemiology, establish adequate treatment and prophylaxis for their control. For this, it is essential to start with the training of health professionals, in particular, medical students, it is necessary to promote the development of their skills and competencies, not only mastery of scientific knowledge, but also be able to promote it, transfer it and apply it with an impact on collective health and that goes hand in hand with techno-scientific advances. That is why the concern of the forum arises, a discussion about the analysis of the teaching of virology to face emerging diseases based on the profile of the graduate. A survey was conducted to the students of the last ten years of the UNIANDES medical career, on biology, epidemiology, immunological response and diagnosis, for mentioned areas of knowledge it was obtained, both in the objective structured evaluation and practical evaluation, a level highly satisfactory. In the Miller pyramid, level three was reached with satisfactory knowledge and development of abilities, skills and attitudes of the graduate. However, Virology professors agree with innovating in teaching by integrating the content transversally to the areas of knowledge: infectious diseases, clinics, pathologies, epidemiology and public health, which will allow comprehensive learning to carry out an adequate approach to positive cases of virosis, in addition to having the capacity to establish epidemiological surveillance(AU)

COVID-19: epidemiología, virología y transmisibilidad / COVID-19: epidemiology, virology, and transmissibility

Hasta diciembre del 2019, seis tipos de coronavirus ya estaban identificados como generadores de enfermedad en humanos, destacándose dos brotes epidemiológicos anteriores: SARS-CoV en 2002 y MERS-CoV en 2012. El nuevo agente infeccioso que causó la pandemia de 2019 se denominó SARS-CoV-2, el que se manifiesta como un síndrome respiratorio agudo severo (CO-VID-19). Al respecto, el 30 de enero del 2020, la Organización Mundial de la Salud (OMS) decretó la emergencia sanitaria. El propósito de esta revisión fue analizar el contexto epidemio-lógico alrededor del SARS-CoV-2, mediante una búsqueda bibliográfica en las bases de datos científicas como: PubMed Central, LILACS y Google académico. Se concluyó que el SARS-CoV-2 es altamente transmisible, con una tasa de letalidad en Ecuador del 8,59%.

Six types of coronaviruses were already identified as generators of disease in humans as of 2019, with two previous epidemiological outbreaks standing out: SARS-CoV in 2002 and MERS-CoV in 2012. The new infectious agent that caused the 2019 pandemic was called SARS -CoV-2, which manifests as a severe acute respiratory syndrome (COVID-19). In this regard, on January 30, 2020, the World Health Organization decreed the health emergency. The purpose of this review was to analyze the epidemiological context around SARS-CoV-2 through a bibliographic review in scientific databases such as: PubMed Central, LILACS and Google Scholar. It was concluded that SARS-CoV-2 is highly transmissible, with a fatality rate in Ecuador of 8.59%.

Alternative workflow for COVID-19 diagnosis using direct RT-PCR screening

Objective: COVID-19 is presently the most serious public health concern and diagnosis is a principal tool for controlling and monitoring the spread of the disease. This study aimed to evaluate the efficiency of direct RT-PCR (dRT-PCR) for detection of SARS-CoV-2. Methods: Twenty-seven nasopharyngeal swabs from symptomatic individuals were evaluated. Standard RT-PCR was conducted, and for dRT-PCR the samples were preheated before amplification. Results: Positive agreement was 63.2% and negative agreement was 100%, being moderately in accord. Conclusion: dRT-PCR may be an alternative for screening symptomatic patients and a reliable option during an eventual shortage of viral RNA purification kits.

Objetivo: A COVID-19 é atualmente um sério problema de saúde pública e o diagnóstico é a principal ferramenta para controlar e monitorar a propagação da doença. Este estudo teve como objetivo avaliar a eficiência da RT-PCR direta (dRT-PCR) para detecção do SARS-CoV-2. Métodos: Vinte e sete amostras de swab nasofaríngeo de indivíduos sintomáticos foram avaliados. A RT-PCR padrão foi realizada e para a dRT-PCR as amostras foram pré-aquecidas antes da amplificação. Resultados: A concordância positiva foi de 63,2% e a concordância negativa foi de 100%, sendo moderadamente concordante. Conclusão: A dRT-PCR pode ser uma alternativa para a triagem de pacientes sintomáticos e uma opção confiável durante uma eventual escassez de kits de purificação de RNA viral.

Infection, treatment and virological features of SARS-CoV-2. A brief overview / Infección, tratamiento y características virológicas del SARS-CoV-2. Un breve resumen

Abstract A new coronavirus, the SARS-CoV-2, and its resulting disease, the COVID-19, originated in Wuhan, China, in December 2019, affecting human health by causing respiratory, digestive and systemic problems. In symptomatic patients, the clinical manifestations of the disease usually begin within a week after being infected with the virus, and consist of fever, dry cough, nasal congestion, fatigue and airway problems, which can lead to pneumonia. The virus is also present in patients who do not have symptoms, and therefore it is quite difficult to identify and quantify them. In this work, an overview of the virological features of SARS-CoV-2, its transmission and infection, as well as of the clinical signs and treatment of COVID-19 is carried out.

Resumen Un nuevo coronavirus, el SARS-CoV-2, y su enfermedad resultante, la COVID-19, se originó en Wuhan (China) en diciembre de 2019, afectando la salud humana al causar problemas respiratorios, digestivos y sistémicos. En los pacientes sintomáticos, las manifestaciones clínicas de la enfermedad suelen comenzar dentro de la semana siguiente a la infección por el virus y consisten en fiebre, tos seca, congestión nasal, fatiga y problemas de las vías respiratorias, que pueden provocar neumonía. El virus también está presente en pacientes asintomáticos, por lo que es bastante difícil identificarlos y cuantificarlos. En este trabajo se realiza una breve revisión de las características virológicas del SARS-CoV-2, su transmisión e infección, así como los signos clínicos y tratamiento de la COVID-19.

CO² filtration during pneumoperitoneum inflation and deflation in patients undergoing laparoscopy during the COVID-19 pandemic / Filtragem do CO² durante a insuflação e esvaziamento do pneumoperitônio em pacientes submetidos a videolaparoscopia durante pandemia de COVID-19

ABSTRACT The current Covid-19 pandemic has been the most discussed topic of the year, mostly about protection and ways to avoid dissemination of the virus. In the healthcare system, especially in the operating rooms, the viability of laparoscopic surgery was questioned, mostly because of the transmission through aerosol. This article tries to suggest a way to minimize risks of laparoscopic surgery, during this situation, by using electrostatic filters, a simple, effective and low cost alternative.

RESUMO A atual pandemia do Covid-19 tem sido o assunto mais discutido do ano de 2020, principalmente no que se refere a proteção e as formas de limitar a disseminação do vírus. No cenário hospitalar, mais especificamente no centro cirúrgico, a viabilidade da cirurgia laparoscópica foi questionada, em relação a transmissibilidade do vírus por aerossol. Este artigo sugere uma forma de minimizar os riscos em cirurgias laparoscópicas durante esse cenário, com o uso de filtros eletrostáticos de ventilação mecânica. Uma alternativa simples, eficaz e de baixo custo.

Fundamentos moleculares de la exclusión competitiva durante la coinfección de virus respiratorios: a propósito del COVID-19 / Molecular foundations of competitive exclusion during coinfection of respiratory viruses: about COVID-19

Introducción: La idea de exclusión competitiva es indiscutible cuando se trata de animales y bacterias que intentan ocupar el mismo nicho ecológico, pero su aplicación a la coinfección viral no es tan sencilla de interpretar. La interferencia viral es un fenómeno en el que un virus suprime competitivamente la replicación de otros virus coinfectantes y es el resultado más común de las coinfecciones virales. Objetivo: Comprender mejor el comportamiento de las infecciones respiratorias concomitantes en escenarios de brotes comunitarios y de forma individual en entornos hospitalarios e individuos con comorbilidades. Métodos: Se realizó una búsqueda de información en las bases de datos MEDLINE / PubMed, SciELO y LILACS. También se consideraron artículos publicados en el repositorio de preimpresión medRxiv y los informes de los Centros para el Control y Prevención de enfermedades de los Estados Unidos de América. Mediante el gestor de referencias Mendeley, se eliminaron los duplicados y aquellos que no se ajustaban al objetivo del estudio, seleccionando 48 artículos para la revisión. Análisis y síntesis de la in formación: En la literatura científica se encontró evidencia que sustenta la exclusión competitiva viral entre virus relacionados que comparten células susceptibles y permisivas. Conclusión: La exclusión competitiva impide que dos virus que comparten rutas de transmisión similares y el mismo órgano diana, infecten no sólo al mismo tiempo, sino que también se propaguen con éxito. Por lo tanto, la sindemia producida por virus que comparten estas características podría ser un evento improbable(AU)

Introduction: The idea of competitive exclusion is undisputed when it comes to animals and bacteria trying to occupy the same ecological niche, but its application to viral coinfection is not so simple to interpret. Viral interference is a phenomenon in which one virus competitively suppresses the replication of other co-infecting viruses and is the most common outcome of viral co-infections. Objective: To better understand the behavior of concomitant respiratory infections in community outbreak settings and individually in hospital settings and individuals with comorbidities. Methods: A search for information was performed in the MEDLINE / PubMed, SciELO and LILACS databases. Articles published in the preprint repository medRxiv and reports from the US Centers for Disease Control and Prevention were also considered. Using the Mendeley reference manager, duplicates and those that did not fit the study objective were eliminated, selecting 48 articles for the review. Analysis and synthesis of information: Evidence supporting viral competitive exclusion between related viruses sharing susceptible and permissive cells was found in the scientific literature. Conclusion: Competitive exclusion prevents two viruses that share similar transmission routes and the same target organ from infecting not only at the same time, but also from spreading successfully. Therefore, syndemia produced by viruses sharing these characteristics could be an unlikely event(AU)

La cavidad bucal como fuente de transmisión del SARSCoV-2 / Oral cavity as a transmission source for SARSCoV-2

RESUMEN Fundamento: debido a las características de la infección con SARSCoV-2, la cavidad bucal es un entorno que representa un alto riesgo para producir infección cruzada entre los pacientes y los odontólogos. Objetivo: recopilar la evidencia científica sobre si la cavidad bucal es una fuente de transmisión del SARSCoV-2. Métodos: se realizó una revisión en PubMed/Medline y Cochrane mediante términos de indización, para obtener información si la cavidad bucal es una fuente de transmisión del SARSCoV-2. Resultados: debido al contacto cercano con la boca y la nariz del paciente, las gotas y los aerosoles producidos en el tratamiento bucal exponen al odontólogo a infectarse con SARSCoV-2. Al analizar la información bibliográfica se encuentra evidencia de que el SARSCoV-2 se une de forma inicial a la enzima convertidora de angiotensina II que se encuentra en la mucosa oral, la lengua y las glándulas salivales, para después recién colonizar los tractos respiratorios; por lo que, se puede considerar a la cavidad bucal como una fuente de contagio y además la saliva puede usarse para realizar el análisis molecular del SARSCoV-2. Conclusiones: la evidencia científica recopilada, sugiere que la cavidad bucal puede actuar como una fuente de contagio del SARSCoV-2, gracias a la presencia en la boca de la enzima convertidora de angiotensina II que actúa como receptor del SARSCoV-2 y convierte a esta cavidad en una fuente de transmisión.

ABSTRACT Background: due to the characteristics of SARSCoV-2 infection, the oral cavity is a high risk environment for cross-infection between patients and dentists. Objective: to gather scientific evidence on whether the oral cavity is a source of SARSCoV-2 transmission. Methods: a review was performed in PubMed / Medline and Cochrane using indexing terms, to obtain information if the oral cavity is a source of SARSCoV-2 transmission. Results: due to close contact with the patient's mouth and nose, the drops and aerosols produced in the oral treatment expose the dentist to becoming infected with SARSCoV-2. Analyzing the bibliographic information, we find evidence that SARSCoV-2 binds initially to the angiotensin II converting enzyme found in the oral mucosa, tongue and salivary glands, and then only recently colonized the respiratory tracts; therefore, the oral cavity can be considered as a source of contagion and saliva can also be used to perform the molecular analysis of SARSCoV-2. Conclusions: the collected scientific evidence suggests that the oral cavity may act as a source of SARSCoV-2 transmission, thanks to the presence in the mouth of the angiotensin II converting enzyme that acts as a receptor for SARSCoV-2 and converts this cavity into a source of transmission.

The role of the World Health Organization country programs in the development of virology in Spain, 1951-1975 / El papel desempeñado por los programas país de la Organización Mundial de la Salud en el desarrollo de la virología en España, 1951-1975

Abstract Within the framework of recent historiography about the role of the World Health Organization (WHO) in modernizing public health and the multifaceted concept of global health, this study addresses the impact of the WHO's "country programs" in Spain from the time it was admitted to this organization in 1951 to 1975. This research adopts a transnational historical perspective and emphasizes attention to the circulation of health knowledge, practices, and people, and focuses on the Spain-0001 and Spain-0025programs, their role in the development of virology in Spain, and the transformation of public health. Sources include historical archives (WHO, the Spanish National Health School), various WHO publications, the contemporary medical press, and a selection of the Spanish general press.

Resumen En el marco de la reciente historiografía sobre el papel de la Organización Mundial de la Salud (OMS) en la modernización de la salud pública y el concepto multifacético de salud global, se estudia el papel de los llamados "programas país" de la OMS en España desde su admisión en 1951 hasta 1975. Adoptando perspectiva histórica transnacional y enfatizando el estudio de la circulación de personas, conocimientos y prácticas científico-sanitarias, nuestro análisis se centra en los programas España-0001 y España-0025, en evaluar su papel en el desarrollo de la virología en España y en la transformación de la salud pública. Nuestras fuentes vienen de archivos históricos (OMS, Escuela Nacional de Sanidad), publicaciones de la OMS, revistas médicas contemporáneas, y una selección de prensa general española.

Fighting COVID-19 / Combatendo a COVID-19

Abstract The current COVID-19 pandemic caused by the novel coronavirus (SARS-CoV2) poses a threat to global health owing to its high rate of spread and severe forms of respiratory infection. The lack of vaccines and antivirals prevents clinical strategies against the disease, creating an emerging need for the development of safe and effective treatments. Strategies for vaccine development include complete vaccines against viruses, subunits, and nucleic acids, but are still in their early stages. Studies carried out to date on possible SARS-CoV2 drug targets highlight glycoprotein S, Mpro (main protease or protease type 3C), and a member of the transmembrane serine protease II families (TMPRSS2). However, due to the pandemic state, priority is given to marketed drugs. These include chloroquine (CQ), hydroxychloroquine (HCQ), nitazoxanide, remdesivir, Lopinavir/ritonavir (LPV / r), in addition to treatment with convalescent plasma. But, therapeutic specific effects against SARS-CoV2 have not yet been verified. Most of the information obtained about treatment is based on preliminary and limited studies. We conclude that, at this time of emergency, the search for new therapies is more urgent due to the need to save lives. Thus, we point out as interesting targets for future more specific research: glycoprotein S, Mpro, and TMPRSS2.

Resumo A pandemia de COVID-19 causada pelo novo Coronavírus (SARS-CoV2) representa uma ameaça à saúde global devido à alta taxa de disseminação e formas graves de infecção respiratória. A falta de vacinas e antivirais específicos dificultam as estratégias clínicas de controle da doença, criando a necessidade urgente do desenvolvimento de tratamentos seguros e eficazes. Com relação as estratégias para o desenvolvimento de vacinas, incluem-se: aquelas com o vírus completo, subunidades e ácidos nucléicos, mas estas ainda estão em estágios iniciais. Já sobre os estudos realizados até o momento buscando novos alvos terapêuticos contra o SARS-CoV2, destacam a glicoproteína S; Mpro (principal protease ou protease tipo 3C) e um membro da família transmembrana serina protease II (TMPRSS2). No entanto, devido ao estado pandêmico, tem sido dada prioridade aos medicamentos comercializados. Estes incluem a cloroquina (CQ); hidroxicloroquina (HCQ); nitazoxanida; remdesivir; Lopinavir / ritonavir (LPV/r); além do tratamento com plasma de pacientes curados. Porém, ainda não há uma estratégia terapêutica contra o SARS-CoV2 totalmente eficaz, e a maioria das informações obtidas sobre o tratamento é baseada em estudos preliminares e limitados. Concluímos então que, neste momento de emergência, a busca por novas terapias é algo urgente devido à necessidade de salvar vidas. Assim finalizamos sugerindo como alvos interessantes para futuras pesquisas específicas: a glicoproteína S, Mpro e o TMPRSS2.

Detección de virus de ARN en cultivos de tomate del Oriente Antioqueño mediante secuenciación de alto rendimiento y RT-qPCR / Detection of RNA viruses in tomato fields in eastern Antioquia using high-throughput sequencing (HTS) and RT-qPCR

RESUMEN En Antioquia, el cultivo de tomate (Solanum lycopersicum) se ve afectado por diversas enfermedades virales, que ocasionan la disminución en la calidad de los frutos y de los rendimientos; sin embargo, pocos estudios han identificado, a nivel de especie, los agentes causales de dichas enfermedades. En los últimos años, la secuenciación de alto rendimiento (HTS), se ha convertido en una herramienta eficiente de diagnóstico de fitopatógenos, permitiendo la detección y la caracterización genómica de un alto número de virus, en diferentes plantas. En este trabajo, se evaluó la presencia de virus de ARN infectando tomate var. Chonto del oriente Antioqueño, mediante HTS y RT-PCR, en tiempo real (RT-qPCR), en muestras de tejido foliar y en semillas. El análisis de HTS indicó la infección de los virus Potato virus S (PVS), Potato virus Y (PVY), Potato yellow vein virus (PYVV), Potato virus X (PVX), Southern tomato virus (STV) y Bell pepper endornavirus (BPEV), en los cultivos de tomate de esta región, obteniéndose los genomas completos de PYVV, STV y BPEV. Las pruebas de RT-qPCR indicaron la presencia de PYVV en el 100% de las muestras foliares analizadas, mientras que PVX, PVY, STV y PVS, se encontraron en niveles de 94,4, 77,8, 72,2 y 5,6%, respectivamente. La evaluación de estos virus en lotes de semilla sexual comercial y no comercial y en sus plantas derivadas evidenció la presencia de cinco virus en dicho material, con niveles de prevalencia del 13 al 93% e infecciones mixtas, que incluyeron combinaciones, desde dos a cinco virus.

ABSTRACT In Antioquia, the tomato crop (Solanum lycopersicum) is seriously affected by a wide range of viral diseases that affect yield and the quality of fruits. Despite of this, there are few studies aimed at identifying these viruses at the species level. With the advent of High-throughput sequencing (HTS) methods, it is now possible to achieve an efficient characterization of viruses infecting plant hosts. In this work, the presence of RNA viruses infecting tomato var. Chonto in eastern Antioquia was tested using HTS and Real-time RT-PCR (RT-qPCR) in leaf tissues and seeds. HTS revealed infection with Potato virus S (PVS), Potato virus Y (PVY), Potato yellow vein virus (PYVV), Potato virus X (PVX), Southern tomato virus (STV) and Bell pepper endornavirus (BPEV). Complete genome sequences were obtained for PYVV, STV and BPEV. RT-qPCR showed prevalence of 100%, 94.4%, 77.8%, 72.2% and 5.6% for PYVV, PVX, PVY, STV and PVS in leaf samples, respectively. These viruses were also found infecting commercial and informal seeds and in their seedlings with a prevalence between 13 and 93%. Mixed infections were found to combine a mixture of two to five viruses.

Hantavirus and criminality: disease and family / Hantavírus e criminalidade: doença e família / Hantavirus y criminalidad: enfermedad y la familia

Background and objectives: Hantavirus is a pathogen that causes a viral disease with an acute and severe presentation, and a high mortality rate. In face of a sudden loss, some families may not conceive the complete absence of the deceased relative. Thus, we sought to understand the changes that took place in a family after the death of the provider by Hantavirus Pulmonary Syndrome (HPS). Methods: A descriptive exploratory study with a qualitative approach of the type case report. Data collection took place between October and December 2016 through recorded individual interviews and using questions about family dynamics after family provider's death of HPS, which were assessed by content analysis in the light of Roy's theory. Results: It was observed that the illness and death of the family patriarch weakened the family's strengths and resources, leading to a period of mourning and despair. In addition, unemployment among other family members worsened socioeconomic conditions, seeing drugs as an alternative for support as it became a commercial activity, and the rise of a command in the region that culminated in the arrest of the wife, two daughters and a son of the deceased. Conclusions: In this case, it was evidenced that the family was weakened due to the illness and death of their loved one by HPS, and because of the lack of support and welcome from the reference social services, they chose to act in criminality and it ended up with the arrest of four members.(AU)

Justificativa e objetivos: O hantavírus é um patógeno que causa uma doença viral com caráter agudo e grave e alta taxa de mortalidade. Em face da perda súbita, algumas famílias podem não conceber a completa ausência do parente falecido. Assim, procuramos entender as mudanças que ocorrem em uma família após a morte do provedor pela Síndrome Pulmonar por Hantavírus (SPH). Métodos: Estudo descritivo-exploratório com abordagem qualitativa do tipo estudo de caso. A coleta de dados ocorreu entre outubro e dezembro de 2016 por meio de entrevistas individuais gravadas e com o uso de perguntas sobre a dinâmica familiar após a morte por SPH, sendo analisadas por análise de conteúdo sob a luz da teoria de Roy. Resultados: Observou-se que a doença e a morte do patriarca fragilizaram as forças e recursos da família, levando a um período de luto e desespero. Além disso, o desemprego entre os demais membros da família agravou as condições socioeconômicas, vendo as drogas como uma alternativa para o apoio, o que assumiu o caráter de comércio e a ascensão de um comando na região que culminou com a prisão da esposa, duas filhas e um filho do falecido. Conclusão: Neste caso descrito foi evidenciado que a família ficou fragilizada diante da enfermidade e óbito do seu ente querido por SPH e, em decorrência da falta de apoio e acolhimento dos serviços de referência sociais, optou por atuar na criminalidade e findar com a prisão de quatro membros.(AU)

Justificación y objetivos: El hantavirus es un patógeno que causa una enfermedad viral con un carácter agudo y grave y alta tasa de mortalidad. Ante la pérdida repentina, algunas familias pueden no concebir la ausencia completa del familiar fallecido. Por lo tanto, tratamos de comprender los cambios que se produjeron en una familia después de la muerte del proveedor por Sindrome Pulmonar por Hantavirus (SPH). Métodos: Estudio descriptivo-exploratorio con enfoque cualitativo del tipo estudio de caso. La recopilación de datos ocurrió entre octubre y diciembre de 2016, a través de entrevistas individuales grabadas y con el uso de preguntas sobre la dinámica familiar después de la muerte por SPH, que se analizaron a través del análisis de contenido a la luz de la teoría de Roy. Resultados: Se observó que la enfermedad y la muerte del patriarca familiar debilitaron las fortalezas y los recursos de la familia, lo que llevó a un período de duelo y desesperación. Además, el desempleo entre otros miembros de la familia empeoró las condiciones socioeconómicas, haciéndolos ver a las drogas como una alternativa de renta, lo que asumió el carácter de un comercio y el surgimiento de un comando en la región que culminó con el arresto de la esposa, dos hijas y un hijo del difunto. Conclusiones: En este caso, se evidenció que la familia se debilitó debido a la enfermedad y la muerte de su ser querido por SPH y debido a la falta de apoyo y recepción de los servicios de referencia social, eligieron actuar con criminalidad y por fin terminaron com cuatro miembros detenidos.(AU)

Emerging and re-emerging human infectious diseases: A systematic review of the role of wild animals with a focus on public health impact

Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review studies on the role of wild animals as reservoirs and/or dispersers of etiological agents of human infectious diseases in order to compile data on the main wild animals and etiological agents involved in zoonotic outbreaks. A systematic review was carried out using PRISMA guidelines, using the PubMed, Scopus and SciELO platforms as data banks. The descriptors used were 'zoonosis', 'human infectious diseases' and 'wild animals'. The results show that wild animals (mainly bats, birds and primates) play an important role in the dissemination of etiological agents (mainly viruses, as a new coronavirus called 2019 Novel Coronavirus) in extensive geographic regions. Moreover, these wild animal organisms can act as the site for essential biotic synergy among several pathogenic microorganisms, promoting a higher rate of adaptation, mutation and even genetic recombination, with consequent stimulation of new strains and subtypes, inducing new infectious agents with unknown virulent potential. In conclusion, the monitoring of these diseases and adequate preparation for possible epidemics and pandemics are fundamental conditions for the mitigation of their future impact. The zoonotic threat of these etiological agents and the impact on public health can be enormous as shown by the ongoing epidemic of 2019 novel coronavirus (2019- nCoV) infections.

Emerging and re-emerging human infectious diseases: A systematic review of the role of wild animals with a focus on public health impact

Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review studies on the role of wild animals as reservoirs and/or dispersers of etiological agents of human infectious diseases in order to compile data on the main wild animals and etiological agents involved in zoonotic outbreaks. A systematic review was carried out using PRISMA guidelines, using the PubMed, Scopus and SciELO platforms as data banks. The descriptors used were 'zoonosis', 'human infectious diseases' and 'wild animals'. The results show that wild animals (mainly bats, birds and primates) play an important role in the dissemination of etiological agents (mainly viruses, as a new coronavirus called 2019 Novel Coronavirus) in extensive geographic regions. Moreover, these wild animal organisms can act as the site for essential biotic synergy among several pathogenic microorganisms, promoting a higher rate of adaptation, mutation and even genetic recombination, with consequent stimulation of new strains and subtypes, inducing new infectious agents with unknown virulent potential. In conclusion, the monitoring of these diseases and adequate preparation for possible epidemics and pandemics are fundamental conditions for the mitigation of their future impact. The zoonotic threat of these etiological agents and the impact on public health can be enormous as shown by the ongoing epidemic of 2019 novel coronavirus (2019- nCoV) infections.

Regime for cytomegalovirus retinitis based on aqueous virology and inflammatory cytokine determination / 中华眼底病杂志

Objective To observe the safety and efficacy of regime that based on aqueous cytomegalovirus-DNA (CMV-DNA) load and IL-8 determination for therapeutic monitoring and local treatment cessation of cytomegalovirus retinitis (CMVR) patients after allogeneic hematopoietic stem cell transplantation (HSCT).Methods A prospective case series study.A total of 14 CMVR patients (22 eyes) after allogeneic HSCT diagnosed in Ophthalmology Department of Peking University People's Hospital between January 2016 and December 2018 were involved in this study.All patients were CMV-DNA seronegative at baseline and were treated with intravitreous injection of ganciclovir (IVG,3 mg in 0.05 ml) twice per week for 4 times in the induction stage and once a week in the maintenance stage.Aqueous humor sample was collected during the first time of IVG every week.CMV-DNA and the level of IL-8 were measured by real time quantitative PCR and ELISA,respectively.During follow-up,negative CMV-DNA (＜ 103/ml) or level of IL-8 ＜ 30 pg/ml in aqueous sample was set as local treatment cessation.Then patients were followed every 2 weeks for at least 6 months.BCVA,intraocular pressure and fundus examination were taken for each visit.The BCVA examination was performed using the international standard visual acuity chart,which was converted into logMAR visual acuity.BCVA and intraocular pressure at the baseline and the last follow-up were compared by the Student t matching test.Results Of the 14 CMVR patients (22 eyes) after allogeneic HSCT,8 patients (16 eyes) were bilateral,6 patients (6 eyes) were unilateral.At the baseline,the mean logMAR BCVA was 0.814 ± 0.563,the intraocular pressure was 17.2 ± 7.8 mmHg (1 mmHg=0.133 kPa),the mean aqueous CMV-DNA load was (3.43 ± 4.96)× 105/ml,the mean level of IL-8 was 518 ± 541 pg/ml.At cessation of local treatment,the median number of intravitreal injections was 5 times.Nine eyes showed negative CMV-DNA in aqueous humor,of which,7 eyes showed negative IL-8 in aqueous.CMV-DNA could still be detected in 13 eyes,while IL-8 was negative.Only one eye's retinal lesion was completely quiet.Six months after local treatment cessation,the mean logMAR B CVA was 0.812 ± 0.691,the intraocular pressure was 14.8± 5.4 mmHg;which was not significantly different from baseline (t=-0.107,1.517;P=0.916,0.137).Recurrence of CMVR happened in only 1 eye because of systemic EB virus infection.Retinal lesions progressively improved and became completely quiet in all the remaining 20 eyes.In 22 eyes,iatrogenic vitreous hemorrhage occurred due to low platelet count during treatment (＜ 30 × 109/ml) in 4 eyes.When the treatment was terminated for 6 months,the fundus of hematoma absorption was clearly visible.At the time of CMVR diagnosis,there were 2 eyes (9％) with posterior subcapsular opacity,which may be caused by systemic glucocorticoid therapy after allogeneic HSCT.Conclusion Aqueous CMV-DNA load and level of IL-8 could be used as quantitative variables for monitoring the therapeutic effect and determining time for local treatment cessation for CMVR after HSCT safely and efficiently.

Plataformas de secuenciación de nueva generación y proteómica aplicadas a la virología vegetal: ¿Cómo ha avanzado Colombia? / Next generation sequencing and proteomics in plant virology: how is colombia doing?

ABSTRACT Crop production and trade are two of the most economically important activities in Colombia, and viral diseases cause a high negative impact to agricultural sector. Therefore, the detection, diagnosis, control, and management of viral diseases are crucial. Currently, Next-Generation Sequencing (NGS) and 'Omic' technologies constitute a right-hand tool for the discovery of novel viruses and for studying virus-plant interactions. This knowledge allows the development of new viral diagnostic methods and the discovery of key components of infectious processes, which could be used to generate plants resistant to viral infections. Globally, crop sciences are advancing in this direction. In this review, advancements in 'omic' technologies and their different applications in plant virology in Colombia are discussed. In addition, bioinformatics pipelines and resources for omics data analyses are presented. Due to their decreasing prices, NGS technologies are becoming an affordable and promising means to explore many phytopathologies affecting a wide variety of Colombian crops so as to improve their trade potential.

RESUMEN La producción y el comercio de cultivos es una de las actividades económicas más importantes para el país. Las enfermedades causadas por virus ocasionan graves pérdidas económicas en el sector, por lo tanto, la detección, diagnóstico y diseño de estrategias para su control y manejo es crucial. Las tecnologías de secuenciación masiva (NGS por sus siglas en ingles) y las ciencias Ómicas constituyen hoy, una herramienta para el descubrimiento de nuevos virus y para el estudio de la interacción entre los virus y su hospedero vegetal. Este conocimiento no solo permite el desarrollo de nuevos métodos de diagnóstico, sino también permite el descubrimiento de componentes claves en la infección, los cuales podrían usarse para obtener plantas resistentes a los virus. En el mundo, el manejo de cultivos se está trabajando con ese enfoque. Por lo tanto, en esta revisión se presentan las diferentes aplicaciones de las tecnologías ómicas en la virología de plantas y el avance que ha alcanzado Colombia. Adicionalmente, se muestran los diferentes recursos y programas usados para el análisis bioinformático de datos ómicos. Debido a su costo cada vez más reducido, las tecnologías NGS son una excelente oportunidad para explorar fitopatologías en una gran diversidad de productos agrícolas y para mejorar su potencial comercial.