Ovarian steroids modulate the systemic inflammatory response OF COWS challenged with lipopolysaccharide (LPS) intrauterine infusion.

Postpartum uterine infections of dairy cows promote a local and systemic inflammation and interfere with reproductive efficiency. The aim of this study was to evaluate the effect of steroid hormones including progesterone (P4) and estradiol (E2) on the systemic inflammatory response of cows after being challenged with an intrauterine infusion of lipopolysaccharide (LPS). For this, a hemogram and serum dosage of haptoglobin (Hp) in eight primiparous Gir cows ovariectomized were performed on day (day 0) and after 24 h (day +1). Four cows (n = 4) were challenged (day 0) with 20 mL of 0.9% NaCl + 12.5 µg/kg LPS, and four cows (n = 4) were challenged (day 0) with 20 mL of 0.9% NaCl. For this, the study was divided in four experimental groups as: (1) Control group: without any hormonal treatment before day 0; (2) Group 24 h - E2: 1 mg of estradiol benzoate 24 h before (day -1); (3) Group 24 h - P4: 2.0 g of P4 device 24 h before (day -1); (4) Group 14 d - P4: 2.0 g of P4 device 14 days before (day -14). In the systemic response to LPS, there was an increase in Hp (control group; 24 h - P4 group; 14 d - P4 group), and on day +1 the Hp of 14 d - P4 group was higher when compared to the other groups. On day 0, the 14 d - P4 group had an increase in circulating leukocytes and lymphocytes cells than the control group (P < 0.01). On day +1 after LPS-challenge the 14 d - P4 group showed a decrease in circulating lymphocytes, eosinophils, and monocytes (P < 0.05). A neutrophilia with left shift in the two treatments with P4 (day +1), in addition to a thrombocytopenia and lower platelets compared to the 24 h - E2 group (P < 0.05) (day 0) were recorded. It was concluded that ovariectomized cows challenged with LPS, previously submitted to steroid hormones induce a systemic inflammatory response. Also, the systemic response is more intense after previous prolonged exposure to P4 and less intense after exposure to E2. This study provided important information relating the effect of ovarian steroids on the systemic inflammatory response of cows challenged with intrauterine LPS.

Increased expression of interleukin-6 gene in gastritis and gastric cancer.

Helicobacter pylori (H. pylori) induces an intense inflammatory response, mediated by proinflammatory cytokines, including interleukin (IL)-6 and its membrane receptor (IL-6R), which activates important signaling pathways in the development of gastric disease and cancer. We investigated the gene and protein expression of IL-6 and IL-6R and the influence of polymorphisms rs1800795, rs1800796, and rs1800797 on its gene expression together with H. pylori infection. Furthermore, an in-silico analysis was performed to support our results. Gastric biopsies were obtained from patients with gastric symptoms and patients with gastric cancer (GC) and were divided into groups (Control, Gastritis, and Cancer). H. pylori was detected by PCR. Real-time-qPCR was employed to determine gene expression, and western blot assay was used to analyze protein expression levels. PCR-RFLP was used to characterize IL-6 polymorphisms. Bioinformatics analyses were performed using the Gene Expression Omnibus (GEO) database and GEO2R to screen out differentially expressed genes (DEGs). H. pylori was detected in 43.3% of the samples. Statistically significant differences were found for IL-6 (P=0.0001) and IL-6R (P=0.0005) genes among the three groups, regardless of the presence of H. pylori. Among patients with H. pylori infection, the IL-6 and IL-6R gene and protein expressions were significantly increased, highlighting IL-6 gene overexpression in patients with GC. No statistically significant differences were found for the rs1800795, rs1800796, and rs1800797 polymorphisms compared to IL-6 gene expression. The results indicated that the IL-6 polymorphisms do not influence its expression, but IL-6 and IL-6R expression seems to be altered by the presence of H. pylori.

Increased expression of interleukin-6 gene in gastritis and gastric cancer

Helicobacter pylori (H. pylori) induces an intense inflammatory response, mediated by proinflammatory cytokines, including interleukin (IL)-6 and its membrane receptor (IL-6R), which activates important signaling pathways in the development of gastric disease and cancer. We investigated the gene and protein expression of IL-6 and IL-6R and the influence of polymorphisms rs1800795, rs1800796, and rs1800797 on its gene expression together with H. pylori infection. Furthermore, an in-silico analysis was performed to support our results. Gastric biopsies were obtained from patients with gastric symptoms and patients with gastric cancer (GC) and were divided into groups (Control, Gastritis, and Cancer). H. pylori was detected by PCR. Real-time-qPCR was employed to determine gene expression, and western blot assay was used to analyze protein expression levels. PCR-RFLP was used to characterize IL-6 polymorphisms. Bioinformatics analyses were performed using the Gene Expression Omnibus (GEO) database and GEO2R to screen out differentially expressed genes (DEGs). H. pylori was detected in 43.3% of the samples. Statistically significant differences were found for IL-6 (P=0.0001) and IL-6R (P=0.0005) genes among the three groups, regardless of the presence of H. pylori. Among patients with H. pylori infection, the IL-6 and IL-6R gene and protein expressions were significantly increased, highlighting IL-6 gene overexpression in patients with GC. No statistically significant differences were found for the rs1800795, rs1800796, and rs1800797 polymorphisms compared to IL-6 gene expression. The results indicated that the IL-6 polymorphisms do not influence its expression, but IL-6 and IL-6R expression seems to be altered by the presence of H. pylori.

Multidrug-resistant Escherichia coli isolated from a dog with a history of urolithiasis: case report / Escherichia coli multirresistente isolada de cão com histórico de urolitíase: relato de caso

Bacterial resistance is a reality in both human and veterinary health, it limits the therapeutic arsenal and raises the costs of the patient's treatment. A dog with signs of cystitis received treatment with 5mg/kg enrofloxacin at three consecutive times, with low effectiveness. The presence of urethral uroliths was identified and urohydropulsion was done. The animal presented a new obstruction, for which a cystotomy was performed, but continued with signs of infection. Uroculture and antimicrobial susceptibility test were then performed. Escherichia coli was identified, which was resistant to 13 antibiotics, being sensitive only to piperacillin-tazobactam and amikacin. In the screening test for ß-lactamase, the production of ESßL was detected. The qPCR indicated the presence of the bla CTXm, bla DHA, bla OXA, bla IMP, bla TEM, bla GIM, bla SIM, bla SPM and bla SME genes, which may lead to a phenotypic resistance profile for ampicillin, amoxicillin-clavulanate, aztreonam, cefepime cefoxitin, cefuroxime, ceftazidime, ceftriaxone, imipenem, and piperacillin-tazobactam. This case reaffirms the value that laboratory analysis adds to the diagnosis and treatment of cystitis and urolithiasis, which can define the direction of evolution of the prognosis and the speed at which the patient's health will be restored.(AU)

A resistência bacteriana aos antibióticos é uma realidade, tanto na saúde humana quanto veterinária, limita o arsenal terapêutico e eleva os custos relacionados ao tratamento do paciente. Um cão, com sinais de cistite, recebeu tratamento com enrofloxacina, na dose de 5mg/kg, em três momentos seguidos, com baixa efetividade. Identificou-se presença de urólitos uretrais e foi feita uro-hidropropulsão. O animal apresentou nova obstrução, para a qual foi realizada uma cistotomia, mas continuou com sinais de infecção. Realizou-se, então, urocultura e teste de antibiograma. Foi identificada Escherichia coli, que se mostrou resistente a 13 antibióticos, sendo sensível somente à piperacilina-tazobactam e amicacina. No teste de triagem para ß-lactamase, detectou-se a produção de ESßL. A qPCR indicou presença dos genes blaCTXm, blaDHA, blaOXA, blaIMP, blaTEM, blaGIM, blaSIM, blaSPM e blaSME, que podem conduzir um perfil fenotípico de resistência para ampicilina, amoxicilina-ácido clavulânico, aztreonam, cefepima, cefoxitina, cefuroxima, ceftazidima, ceftriaxona, imipenem, piperacilina-tazobactam. Este caso reafirma o valor que a análise laboratorial agrega ao diagnóstico e tratamento da cistite e da urolitíase, podendo definir o sentido de evolução do prognóstico e a velocidade em que a saúde do paciente será restabelecia.(AU)

Determinants of Oral Diseases in the African and Middle East Region.

Oral health policies must be developed that emphasize the role of social determinants in health and oral diseases. The aim of this report is to review literature on determinants of oral diseases and apply the concepts to promoting oral health in the African countries in the African and Middle East region (AMER). Structural and proximal determinants of oral diseases are common to those affected by other noncommunicable diseases (NCDs). Oral diseases are also heavily affected by issues of politics, poor health behaviors, underdeveloped health systems, and low oral health literacy. Wide-scale poverty exists in populations in the AMER. Oral health promotion and preventive oral health programs should therefore be integrated with those for general health and use the common risk factor approach (CRFA). Attempts should be made to improve the daily living conditions and reduce the incline of the social gradient. Oral health practitioners should use the CRFA when dealing with determinants of oral diseases and in the design of preventive oral health programs. The detrimental effects of the social determinants of health may be ameliorated by involving both the individual and community. Interventions in health promotion programs in the AMER need more research on the epidemiology of oral diseases and the role played by the social determinants of oral diseases, especially with regard to poverty. The high levels of poverty and low gross domestic product in most countries in the African region make it difficult to fund high-quality, affordable, accessible oral health services.

Different risk factors for candidemia occur for Candida species belonging to the C. parapsilosis complex.

Previous studies have demonstrated reduced virulence in the species that comprise the Candida parapsilosis complex. We investigated a cohort of 93 patients with candidemia caused by this complex. Most infections were caused by C. parapsilosis (80.6%), followed by C. orthopsilosis (18.3%) and C. metapsilosis (1.1%). Renal failure (P < 0.001) and chronic liver diseases (P = 0.019) were more frequently encountered with infections caused by the C. orthopsilosis group, suggesting an association with patients who had a greater state of immune suppression in comparison with infections caused by C. parapsilosis sensu stricto.

Prolonged respiratory viral shedding in transplant patients.

Respiratory viral infections are frequent causes of morbidity in transplant patients. We screened symptomatic adult transplant recipients for respiratory viruses in a cohort of patients attending a referral medical center in Brazil. The duration of viral shedding and the prevalence of viral codetections were also determined. During a 1-year period (2011-2012), swabs were obtained from 50 patients. An in-house polymerase chain reaction panel designed to detect 10 viruses was used. Viruses were identified in 19 (38%) patients, particularly parainfluenza III (32%) and the respiratory syncytial virus (20%); multiple viruses were identified in 26% of patients. Prolonged viral shedding was observed with 60% of individuals excreting viruses for >10 days. The clinical and epidemiologic relevance of prolonged viral shedding remains to be determined.

Incidência de endometrite citológica e desempenho reprodutivo em vacas de corte Nelore / Incidence of cytological endometritis and its effects on reproductive performance in Nelore beef cows

Avaliaram-se a incidência de endometrite citológica dos 29 aos 90 dias pós-parto e seus efeitos sobre o desempenho reprodutivo de vacas de corte Nelore submetidas a uma estação de monta (EM) de 90 dias. Foram utilizadas 49 matrizes Nelores, sem histórico de retenção de placenta, sem a presença de uma infecção uterina clínica, e com escore de condição corporal acima de 2,5. Realizou-se exame ultrassonográfico para avaliar a parede uterina e a atividade ovariana. O diagnóstico de endometrite citológica foi feito pela técnica de lavagem uterina, considerando-se caso de endometrite ≥5% de neutrófilos em cada lâmina. A incidência de endometrite citológica do rebanho foi de 22%, não diferindo entre as categorias analisadas (primíparas versus multíparas) (P>0,05), a taxa de concepção à primeira inseminação também foi semelhante entre primíparas versus multíparas (P>0,05), porém a taxa de gestação ao final da EM foi maior nas vacas multíparas (83,8%) quando comparadas às primíparas (50,0%) (P<0,05). A presença ou ausência da endometrite citológica não influenciou a taxa de concepção (P>0,05), tampouco a taxa de gestação ao final da EM (P>0,05). Conclui-se que o uso da citologia endometrial não se justifica como ferramenta de diagnóstico em vacas de corte Nelore.

Were evaluated the incidence of cytological endometritis from 29 to 90 days postpartum and its effect on the reproductive performance of Nelore beef cows submitted to a breeding season (BS) for 90 days. A total of 49 cows, with no history of retained placenta, without the presence of a clinic uterine infection, and with a body condition score above 2.5 were used. Ultrasound examination was performed to evaluate the uterine wall and ovarian activity. The cytological diagnosis of endometritis was done by uterine lavage, and endometritis was considering cases of ≥5% neutrophils in each blade. The incidence of cytological endometritis in the herd was 22%, and did not differ between the categories analyzed (primiparous versus multiparous) (P>0.05), and the conception rate for first insemination was also similar between primiparous versus multiparous (P>0.05). However, the pregnancy rate at the end of BS was higher in multiparous cows (83.8%) when compared to primiparous (50.0%) cows (P<0.05). The presence or absence of cytological endometritis did not influence the conception rate (P>0.05) nor pregnancy rate at the end of the BS (P>0.05). Therefore, it can be concluded that the use of endometrial cytological cannot be justified as a diagnostic tool in Nelore beef cows.

Dental Caries, and Supragingival Plaque and Calculus among Students, Tanga, Tanzania.

The prevalence of dental caries and supragingival plaque and calculus in 785 secondary schools students was assessed. More than half (53.6%) of the students were caries-free, and the majority of those with dental caries experience were aged 14-17 (68.1%) and females (53%). Mean DMFT was 1.26, with mean D-component of 1.05, and molars were most affected. Most students had supragingival plaque (74%) and calculus (56.9%) and more so in males than females (P > 0.05). Less than half of the students had experience of dental caries and those with caries were mostly females and of the younger age group. The low DMFT was contributed to the D-component, and molars were the tooth type most affected.The majority of students had supra-gingival plaque and calculus and more so in males than females.

Volatile compounds in samples of cork and also produced by selected fungi.

The production of volatile compounds by microbial communities of cork samples taken during the cork manufacturing process was investigated. The majority of volatiles were found in samples collected at two stages: resting after the first boiling and nontreated cork disks. Volatile profiles produced by microbiota in both stages are similar. The releasable volatile compounds and 2,4,6-trichloroanisole (TCA) produced in cork-based culture medium by five isolated fungal species in pure and mixed cultures were also analyzed by gas chromatography coupled with mass spectrometry (GC-MS).The results showed that 1-octen-3-ol and esters of fatty acids (medium chain length C8-C20) were the main volatile compounds produced by either pure fungal species or their mixture. Apparently, Penicillium glabrum is the main contributor to the overall volatile composition observed in the mixed culture. The production of releasable TCA on cork cannot be attributed to any of the assayed fungal isolates.

Inequalities in access to education and healthcare.

The burden of disease is borne by those who suffer as patients but also by society at large, including health service providers. That burden is felt most severely in parts of the world where there is no infrastructure, or foreseeable prospects of any, to change the status quo without external support. Poverty, disease and inequality pervade all the activities of daily living in low-income regions and are inextricably linked. External interventions may not be the most appropriate way to impact on this positively in all circumstances, but targeted programmes to build social capital, within and by countries, are more likely to be sustainable. By these means, basic oral healthcare, underpinned by the primary healthcare approach, can be delivered to more equitably address needs and demands. Education is fundamental to building knowledge-based economies but is often lacking in such regions even at primary and secondary level. Provision of private education at tertiary level may also introduce its own inequities. Access to distance learning and community-based practice opens opportunities and is more likely to encourage graduates to work in similar areas. Recruitment of faculty from minority groups provides role models for students from similar backgrounds but all faculty staff must be involved in supporting and mentoring students from marginalized groups to ensure their retention. The developed world has to act responsibly in two crucial areas: first, not to exacerbate the shortage of skilled educators and healthcare workers in emerging economies by recruiting their staff; second, they must offer educational opportunities at an economic rate. Governments need to lead on developing initiatives to attract, support and retain a competent workforce.

Specifications provided by practitioners for fabrication of removable acrylic prostheses in Tanzania.

This study aimed at determining the standard of communication between practitioners and dental laboratory technicians in fabrication of removable acrylic prosthetic appliances using written prescriptions. Three hundred and seventy-nine prescriptions submitted to the Dental Laboratory of Muhimbili National Hospital (January 1998-May 2004) were assessed for their instructive quality. Only specifications necessary for the fabrication of a removable acrylic prosthesis were considered. Analysis was according to type of appliances and indicated specifications by practitioners. EPI 6 was used with chi-square test for statistical analysis at a 0.05 level of significance. All 379 prescriptions had designation of practitioner and type of appliance indicated and most were authorized by doctors (67%; n = 254) and for partial dentures (86.5%; n = 328). The majority of the complete dentures (13.5%; n = 51) were authorized by students (49%; n = 25) in comparison with partial dentures (86.5%; n = 328) that were authorized mainly by doctors (71.9%; n = 236). Teeth required (83.4%; n = 316) was the most indicated specification and interns were the most instructive of practitioners. For complete dentures, the only significantly indicated specification was appointment date for occlusal registration. The most significantly indicated specifications for partial dentures was teeth required followed by appointment date for fitting, shade, claSPS and secondary impression. The standards of communication between practitioners and dental laboratory technicians in the fabrication of removable acrylic prostheses are generally inadequate as most required specifications were not indicated by practitioners. Work undertaken by technicians should be accompanied by a detailed written prescription, completion of work authorization be included in the curriculum and Dental Laboratory Vouchers in use be evaluated.