Skin innate immune response against fungal infections and the potential role of trained immunity.

Fungal skin infections are distributed worldwide and can be associated with economic and social traits. The immune response related to skin cells is complex and its understanding is essential to the comprehension of each cell's role and the discovery of treatment alternatives. The first studies of trained immunity (TI) described the ability of monocytes, macrophages and natural killer (NK) cells to develop a memory-like response. However, the duration of TI does not reflect the shorter lifespan of these cells. These conclusions supported later studies showing that TI can be observed in stem and haematopoietic cells and, more recently, also in non-immune skin cells such as fibroblasts, highlighting the importance of resident cells in response to skin disorders. Besides, the participation of less studied proinflammatory cytokines in the skin immune response, such as IL-36γ, shed light into a new possibility of inflammatory pathway blockade by drugs. In this review, we will discuss the skin immune response associated with fungal infections, the role of TI in skin and clinical evidence supporting opportunities and challenges of TI and other inflammatory responses in the pathogenesis of fungal skin infections.

Vaccine development for pathogenic fungi: current status and future directions.

INTRODUCTION: Fungal infections are caused by a broad range of pathogenic fungi that are found worldwide with different geographic distributions, incidences, and mortality rates. Considering that there are relatively few approved medications available for combating fungal diseases and no vaccine formulation commercially available, multiple groups are searching for new antifungal drugs, examining drugs for repurposing and developing antifungal vaccines, in order to control deaths, sequels, and the spread of these complex infections. AREAS COVERED: This review provides a summary of advances in fungal vaccine studies and the different approaches under development, such as subunit vaccines, whole organism vaccines, and DNA vaccines, as well as studies that optimize the use of adjuvants. We conducted a literature search of the PubMed with terms: fungal vaccines and genus of fungal pathogens (Cryptococcus spp. Candida spp. Coccidioides spp. Aspergillus spp. Sporothrix spp. Histoplasma spp. Paracoccidioides spp. Pneumocystis spp. and the Mucorales order), a total of 177 articles were collected from database. EXPERT OPINION: Problems regarding the immune response development in an immunocompromised organism, the similarity between fungal and mammalian cells, and the lack of attention by health organizations to fungal infections are closely related to the fact that, at present, there are no fungal vaccines available for clinical use.

Evaluación del impacto de la fatiga en el grado de dependencia en pacientes en hemodiálisis

Background: Patients undergoing hemodialysis (HD) go through a number of physical and emotional symptoms that can interfere with their comfort and quality of life, a common symptom is tiredness, a condition which is conventionally called post dialysis fatigue (PDF). Therefore, the objective is to evaluate the relationship between fatigue and the degree of dependence in performing basic and instrumental activities of daily living on patients undergoing hemodialysis. Method: Cross-sectional study, carried out at the hemodialysis unit of Hospital São Lucas da Pontificia Universidad Católica do Rio Grande do Sul.. The study reporting adheres to the STROBE checklist. Results: From the 101 patients interviewed, 63 (62.4%) had post dialysis fatigue, with a mean age of 59±7 years, where the majority were men with 66.3% (n=67). The presence of PDF was related to vintage on HD (p<0,041), session recovery time (p<0,000) and shift of the session (p<0.001). There was no association of PDF with the degree of dependence on basic and instrumental activities of daily living. Conclusion: More than half of the patients on HD experience PDF, it is less frequent in patients dialyzing in the night shift and it is associated with dialysis vintage and with greater recovery time.

Introducción: Los pacientes en hemodiálisis (HD) pasan por una serie de síntomas físicos y emocionales que pueden interferir con su comodidad y calidad de vida; un síntoma común es el cansancio, condición que se denomina convencionalmente fatiga pos diálisis (PDF). Por lo tanto, el objetivo es evaluar la relación entre la fatiga y el grado de dependencia en la realización de las actividades básicas e instrumentales en la vida diaria de los pacientes en hemodiálisis. Método: Es un estudio transversal, realizado en la unidad de hemodiálisis del Hospital São Lucas da Pontificia Universidad Católica do Rio Grande do Sul. El informe del estudio se adhiere a la lista de verificación STROBE. Resultados: De los 101 pacientes entrevistados, 63 (62,4%) presentaron fatiga pos-diálisis, con una edad media de 59±7 años, siendo la mayoría hombres con un 66,3% (n=67). La presencia de PDF se relacionó con la antigüedad en HD (p<0,041), el tiempo de recuperación de la sesión (p<0,000) y el turno de la sesión (p<0,001). No hubo asociación de la PDF con el grado de dependencia en las actividades básicas e instrumentales de la vida diaria. Conclusión: Más de la mitad de los pacientes en HD experimentan PDF, es menos frecuente en los pacientes dializados en el turno de noche y se asocia a la antigüedad de la diálisis, y a un mayor tiempo de recuperación.

Detection of bovine gammaherpesvirus 6 in tissues of aborted fetuses from dairy cows concomitantly infected by Histophilus somni.

Bovine gammaherpesvirus 6 (BoGHV6), formerly known as bovine lymphotropic virus, is a member of the Macavirus genus, subfamily Gammaherpesvirinae, family Herpesviridae, that was initially associated with proliferative diseases in cattle. While the Macavirus genus contains agents, including alcelaphine gammaherpesvirus 1 (AlGHV1), ovine gammaherpesvirus 2 (OvGHV2), and caprine gammaherpesvirus-2 (CpGHV2), known to cause malignant catarrhal fever (MCF), and are collectively referred to as MCF virus (MCFV) group of organisms, diseases and/or clinical syndromes have not been associated with BoGHV6 and porcine lymphotropic herpesvirus (PLHV). This report investigated the occurrence of BoGHV6 in tissues of aborted dairy fetuses known to be infected by Histophilus somni to identify possible disease patterns associated with infection by this Macavirus. A nested-PCR (nPCR) assay was used to amplify the BoGHV6 polymerase gene from multiple tissues of 13 fetuses and the cow of one of these which were derived from seven dairy herds located in three geographical regions of Brazil. Direct sequencing confirmed the results of the nPCR assays. Additionally, all fetal tissues were previously investigated for the presence of H. somni, Listeria monocytogenes, Neospora caninum, Brucella abortus, Leptospira spp., bovine alphaherpesvirus 1, and bovine viral diarrhea virus (BVDV) by PCR and/or RT-PCR assays. The nPCR assay amplified BoGHV6 DNA from fetuses of most dairy herds (85.7%; 6/7) investigated, resulting in the amplification of BoGHV6 from 76.9% (10/13) of all fetuses evaluated from two geographical and important cattle-producing regions of Brazil. Furthermore, only BoGHV6 was identified in the spleen (n = 3), myocardium, and kidney (n = 2) of five fetuses, and BoGHV6 was the only agent associated with myocarditis in one of these. Nevertheless, dual, triple, and quadruple infections (including BVDV, B. abortus, and N. caninum) were identified in fetuses that were concomitantly infected by H. somni. Phylogenetic analysis revealed that the strain herein identified has 100% nucleotide (nt) sequence identity with wild type strains of BoGHV6 circulating in ruminants from Brazil and 99.8% nt identity with the reference strain of BoGHV6 but was 72.2-73.3% and 67.4-68.2% different from members of the MCFV group and PLHV, respectively. These results demonstrated that 76.9% of the fetuses evaluated were infected by BoGHV6, most likely via vertical infection resulting in transplacental transmission. Considering that most fetuses were concomitantly infected by BoGHV6 and H. somni the real impact of this viral infection cannot be efficiently determined. However, since BoGHV6 was the only pathogen identified in the myocardium of one fetus with myocarditis by histopathology, the possible participation of this Macavirus in the etiopathogenesis of the myocardial disease observed in this fetus cannot be ignored or discarded. However, the mere amplification of BoGHV6 DNA from the myocardium is not enough to establish a definite association between cause and effect, since in situ evaluations and experimental studies would be needed to confirm this agent in the etiopathogenesis of fetal diseases and/or abortions in cattle. Consequently, additional studies are needed to determine the exact role, if any, of BoGHV6 in the development of fetal disease, and possibly fetal mortality.

Transporte aéreo e passageiros com deficiência auditiva: barreiras e facilitadores / Air transport and passengers with hearing impairments: barriers and facilitators

Este estudo teve como objetivo compreender as barreiras e facilitadores para a participação das pessoas com deficiência auditiva em viagens aéreas. Fundamentou-se na abordagem da ergonomia da atividade. Os dados foram coletados por meio de questionário, observações diretas durante as viagens e entrevistas de autoconfrontação com passageiros com deficiência auditiva. Constatou-se a existência de barreiras relacionadas a fatores sociais, como comunicação, e ambientais, como sinalização nos aeroportos. Entre os facilitadores das viagens destacaram-se a comunicação com trabalhadores que têm conhecimento da língua de sinais e legendas nos conteúdos de entretenimento a bordo. Este estudo espera dar visibilidade às experiências de viagens de passageiros com deficiência auditiva e, a partir disso, contribuir para a melhoria das condições e procedimentos do transporte aéreo e orientar a formação de pessoal visando prestar serviços adequados aos diversos passageiros

This study aims to understand the barriers and facilitators to the participation of persons with hearing disability in air travel. This study was based on the assumptions of activity-centered ergonomics. Data was collected by means of a questionnaire, direct observations during trips and self-confrontation interviews with passengers with hearing disability. The study findings include barriers related to social factors, such as communication, and environmental factors, such as airport signage. Air travel facilitators included communication in sign language with workers and closed-captioned in-flight entertainment for passengers. This study hopes to give visibility to travel experiences of passengers with hearing disability, and from that to contribute to the improvement of air transport conditions and procedures and to guide staff training aiming to provide adequate services to diverse passengers

Alien scorpions in the Municipality of São Paulo, Brazil: evidence of successful establishment of Tityus stigmurus (Thorell, 1876) and first records of Broteochactas parvulus Pocock, 1897, and Jaguajir rochae (Borelli, 1910)

We report the successful introduction and invasion of the scorpion species, Tityus stigmurus (Thorell, 1876), in Sao Paulo municipality, Brazil, more than 1,000 km from its southern-most record. The species has considerable impacts on human health, because of its venomous sting. The first specimen appeared in 2012, and by the end of 2015, three populations were identified, with 86 records so far. They were probably introduced via the fruit trade. Two other alien scorpion species were recorded in Sao Paulo, including a single specimen of Broteochactas parvulus Pocock, 1897, and two specimens of Jaguajir rochae (Borelli, 1910).

Alien scorpions in the Municipality of São Paulo, Brazil: evidence of successful establishment of Tityus stigmurus (Thorell, 1876) and first records of Broteochactas parvulus Pocock, 1897, and Jaguajir rochae (Borelli, 1910)

We report the successful introduction and invasion of the scorpion species, Tityus stigmurus (Thorell, 1876), in Sao Paulo municipality, Brazil, more than 1,000 km from its southern-most record. The species has considerable impacts on human health, because of its venomous sting. The first specimen appeared in 2012, and by the end of 2015, three populations were identified, with 86 records so far. They were probably introduced via the fruit trade. Two other alien scorpion species were recorded in Sao Paulo, including a single specimen of Broteochactas parvulus Pocock, 1897, and two specimens of Jaguajir rochae (Borelli, 1910).

Atualização dos conhecimentos sobre o percevejo de cama Cimex lectularius (Hemiptera: Cimicidae): proposta para um guia de vigilância e controle / Update of the knowledge about bed bug Cimex lectularius (Hemiptera: Cimicidae) proposal for a guide of surveillance and control

Percevejos de cama são insetos de importância em saúde pública pela sua hematofagia obrigatória em todos os estágios de vida em que se alimenta. Cimex lectularius é a espécie mais comum, cosmopolita e antropofílica. Apesar de não serem considerados vetores comprovados de patógenos, suas características biológicas podem torná-los potenciais vetores. Esses insetos residem próximo ao hospedeiro e geram grandes infestações. Desde a década de 1990, observa-se aumento nos relatos de infestações em diversas regiões do mundo. No Brasil a literatura sobre esta praga é muito escassa e a ocorrência de infestações não tem sido sistematicamente registradas. Objetivou-se neste estudo atualizar os conhecimentos sobre percevejos de cama, com enfoque na espécie Cimex lectularius e propor um Guia de Vigilância e Controle. Recorrendo-se a uma busca bibliográfica sobre percevejos de cama nas publicações de 1990 a 2017, atualizaram-se dados de sistemática, distribuição, morfologia, bioecologia, infestação e importância médica. Baseando-se em guias e manuais de vigilância de percevejos de cama de programas de vigilância operantes em outras cidades do mundo e em relatos de casos de infestações, foi elaborado o conteúdo para um Guia de Vigilância e Controle de percevejos de cama, a fim de nortear as ações dos órgãos de vigilância em saúde e subsidiar a instalação de um programa de vigilância entomológica desses insetos

Bedbugs are insects of importance in public health due to their obligatory hematophagy in all stages of life in which they are fed. Cimex lectularius is the most common, cosmopolitan and anthropophilic species. Although they are not considered proven vectors of pathogens, their biological characteristics may make them potential vectors. These insects live near the host and generate large infestations. Since the 1990s, there has been an increase in reports of infestations in several regions of the world. In Brazil the literature on this pest is very scarce and the occurrence of infestations has not been systematically recorded. The objective of this study was to update the knowledge about bedbugs, focusing on the species Cimex lectularius and to propose a Guide for Surveillance and Control. Using a bibliographical search about bed bugs in the publications from 1990 to 2017, systematics, distribution, morphology, bioecology, infestation and medical importance data were updated. Based on guides and manuals for bedbug surveillance of surveillance programs operating in other cities around the world and in reports of cases of infestations, the contents of a Guide to Bedbug Surveillance and Control were developed in order to guide the actions of health surveillance agencies and subsidize the installation of an entomological surveillance program for these insects

Accelerated solvent extraction method for the quantification of polycyclic aromatic hydrocarbons in cocoa beans by gas chromatography-mass spectrometry.

An accelerated solvent extraction (ASE) procedure for use with gas chromatography-mass spectrometry (GC-MS) was optimized for the determination of eight polycyclic aromatic hydrocarbons (PAHs) in cocoa beans. Plackett-Burman and rotatable central composite design (RCCD) indicated that three variables affected the recoveries of PAHs during the extraction and purification steps: agitation time in the second liquid-liquid partition, weight of silica gel in the column, and volume of hexane for PAH elution from the column. After obtaining the optimal conditions, a single laboratory method validation was performed. Linearity was demonstrated for benzo[a]pyrene in the concentration range from 0.5 to 8.0mgkg-1 of sample, corresponding to 1.25-20.0µgkg-1 of cocoa on a fat basis. For the other analytes, linearity was observed from 0.75 to 8.0µgkg-1 of sample (1.88-20.0µgkg-1 of cocoa on a fat basis). Significant matrix effects were found for chrysene and benzo[b]fluoranthene. The precision of the method was verified with relative standard deviations (RSDs) ranging from 2.57 to 14.13% and from 4.36 to 19.77% under repeatability and intermediate precision conditions, respectively. The average recoveries of the eight PAHs ranged from 74.99 to 109.73%. These parameters, limits and measurement uncertainties met the performance criteria established by European Union regulations, except for the theoretical limit of detection for chrysene. The method was applied to the analysis of samples of Brazilian cocoa beans, and only one sample was found to have a PAH content above the maximum limit defined by the European Union legislation. This optimized and validated method is intended to be used as part of the official Brazilian monitoring programs investigating contaminants and residues in food.

Patterns of inner chorion structure in Anastrepha (Diptera: Tephritidae) eggs.

The inner chorion structure of Anastrepha eggs from 16 species of various infrageneric taxonomic groups is described by scanning and transmission electron microscopy. The layers of the chorion, the outer egg membrane, are structurally similar. Furthermore, an additional trabecular layer (ATL) that exists in some species, together with other characteristics, facilitates the recognition of four patterns of chorion structuring: Pattern I, in which the ATL layer is absent, is found in Anastrepha amita, the Anastrepha fraterculus complex, Anastrepha obliqua, Anastrepha sororcula, Anastrepha suspensa and Anastrepha zenildae (fraterculus group), and Anastrepha bistrigata and Anastrepha striata (striata group); Pattern II in Anastrepha serpentina (serpentina group), Anastrepha grandis (grandis group) and Anastrepha pseudoparallela (pseudoparallela group), in which the ATL presents large open spaces with pillars; Pattern III, found in Anastrepha consobrina (pseudoparallela group), in which the ATL is composed of round cavities; and Pattern IV, found in Anastrepha alveata and Anastrepha pickeli (spatulata group), where the large ATL cavities are reticulated. Comparatively, the chorion structure in Anastrepha eggs is more complex than in eggs of other fruit flies, e.g., Bactrocera, Rhagoletis and Ceratitis.

Obstrução nasal total: estudo morfofuncional de um caso de sinéquia de palato mole e paredes faríngeas pós blastomicose / Total nasal obstruction: a morphofunctional case study of post blastomicose palato and pharynx's lesion

TEMA: identificar as alterações morfofuncionais decorrentes de quinze anos de obstrução nasal total em um caso de sinéquia de palato mole e paredes faríngeas pós blastomicose. PROCEDIMENTOS: o trabalho foi baseado no estudo de caso de um adulto do gênero feminino, de 26 anos de idade, que chegou a um centro especializado em deformidades craniofaciais, com a queixa de não conseguir respirar pelo nariz. Sua dificuldade respiratória é decorrente de uma aderência total do palato mole com as paredes faríngeas, como sequela da blastomicose que teve no palato aos 11 anos de idade. RESULTADOS: na entrevista, a paciente relatou queixa de cefaléia, halitose, pouco rendimento físico, sonolência diurna e sono agitado durante a noite. Referiu também anosmia, mastigação lenta e engasgos frequentes. Durante a avaliação, observou-se respiração exclusivamente oral do tipo superior, mastigação bilateral alternada e lenta, deglutição adaptada e ressonância hiponasal de grau grave. Observou-se ainda face longa, perfil convexo, mandíbula retruída e olheiras. Os lábios da paciente encontravam-se entreabertos e ressecados, sendo o superior fino e o inferior evertido e avolumado e o palato duro apresenta-se atrésico, estreito e profundo. CONCLUSÃO: as características da paciente em questão são compatíveis com a Síndrome do Respirador Oral e pode-se supor que sejam consequências morfofuncionais de uma obstrução nasal total.

BACKGROUND: to identify the consequences that arising from fifteen years of total nasal obstruction in a case of post blastomicose palato and pharynx's lesion. PROCEDURES: this article was based on a case report of a 26-years-old female subject, who came to a specialized center on craniofacial deformities, complaining about her mouth breathing. Her respiratory difficulty stems from a total tack of palate and pharynx, as a blastomicose sequel that she had when 11-year-old. RESULTS: during the interview, the patient said that she had poor physical conditioning, daytime sleepiness, slow chewing and choking during the swallowing process. At evaluation, it was noted exclusive oral breath of the superior type, alternate chew on both sides, adapted swallowing and serious hyponasal resonance. we also noted long face, with convex profile, retruded jaw and dark circles under the eyes. Her lips were half-opened and dried up, with the upper one thinner and the lower part turned round and augmented. The patient's palate is atresic, strait and deep. CONCLUSION: the patient's characteristics are compatible with Oral Breath Syndrome and anatomic-functional consequences of a total nasal obstruction.

Brazilian technique for prevention of the Argentinean flag sign in white cataract.

We describe a technique that prevents the Argentinean flag sign in white cataract. The technique is based on the intumescent cataract having 2 rather than 1 pressurized compartments within the crystalline lens, the anterior and the posterior. The pressure that pushes the nucleus upward, which is the movement responsible for a radial tear of the anterior capsule, does not come from the vitreous but from the posterior intralenticular pressurized compartment. We also present a nomenclature system to help the phacoemulsification surgeon distinguish the 3 types of senile white cataracts and prevent intrasurgical complications peculiar to each one.