Repeated human leukocyte antigens eplets, importance of typing the partner.

INTRODUCTION: Antibody-mediated rejection (AMR) is the most common cause of immune-mediated allograft failure after kidney transplant and impacts allograft survival. Previous sensitization is a major risk factor for development of donor specific antibodies (DSA). AMR can have a wide range of clinical features such as impaired kidney function, proteinuria/hypertension or can be subclinical. HLA molecules have specific regions of antigens binding antibodies called epitopes and eplets are considered essential components responsible for immune recognition. We present a patient with subclinical AMR 1 week post transplantation. CASE REPORT: A 48-year-old, caucasian woman with end-stage kidney disease (ESKD) secondary to autosomal dominant polycystic kidney disease (ADPKD) on peritoneal dialysis was registered in deceased donor waitlist. She was a hypersensitized patient from 3 prior pregnancies with a calculated panel reactive antibody of 93,48%. She was transplanted through kidney paired exchange donation with no evidence of DSA pre transplantation. Surgery and post-op were unremarkable with excellent and immediate graft function. Per protocol DSA levels on the 5th day was DR1 of 3300 MFI, with an increase in MFI by day 13 with 7820 MFI and a new B41 1979MFI. Allograft kidney biopsy findings were diagnostic of AMR and she was treated with immunoglobulin and plasmapheresis. As early onset AMR post transplantation was observed an anamnestic response was hypothesized from a previous exposure to allo-HLA. We decided to type her husband, her son's father, which was presented with DSA. Mismatch eplet analysis revealed a shared 41 T and 67LQ eplets between the donor and husband, responsible for the reactivity and new HLA class I B41 and HLA class II DR1 DSA, respectively. DISCUSSION: Shared eplets between the patient husband and donor was responsible for the alloimmune response and early development of DSAs. This case highlights the importance of early monitoring DSA levels in highly sensitized patients after transplant in order to promptly address and lower inflammatory damage. Mismatch eplet analysis can provide a thorough and precise evaluation of immune compatibility providing a useful technique to immune risk stratification, donor selection and post-transplant immunosuppressive therapy and monitoring.

Consumo de cannabis, grau de risco e policonsumos numa amostra de adultos portugueses / Cannabis use, risk grade, and polydrug use in Portuguese adults / Consumo de cannabis, grado de riesgo y policonsumo en una muestra de adultos portugueses

Resumo Enquadramento: O Observatório Europeu da Droga e da Toxicodependência refere um crescente número de utentes em tratamento por consumo de opiáceos e cannabis. Em Portugal, foram identificadas 72 mortes induzidas por drogas na faixa etária entre os 15 e os 64 anos. Objetivos: Caracterizar, numa amostra de adultos portugueses, os consumos de cannabis, o grau de risco e os policonsumos. Metodologia: Estudo quantitativo, descritivo, correlacional e transversal, com utilização do Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Resultados: Os resultados revelam frequências de consumo mais elevadas que os estudos epidemiológicos de âmbito nacional para todas as substâncias (com exceção do álcool). O consumo de cannabis é maioritariamente de baixo risco, mas há consumo nocivo e provável dependência. O policonsumo existe, principalmente da cannabis com o álcool e tabaco. Conclusão: O consumo de cannabis aumentou nos últimos anos. Há associação do consumo de cannabis com outras substâncias e há uma relativização dos problemas associados à utilização da cannabis, apesar de a avaliação do grau de risco apontar noutro sentido.

Abstract Background: The European Monitoring Centre for Drugs and Drug Addiction reports an increasing number of patients in treatment for opioid and cannabis use. In Portugal, 72 drug-induced deaths were identified in the 15-64 age group. Objectives: To characterize cannabis use, risk grade, and polydrug use in Portuguese adults. Methodology: Quantitative, descriptive, correlational, and cross-sectional study, using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Results: The results reveal higher frequencies of consumption than nationwide epidemiological studies for all substances (except alcohol). Cannabis use is mostly low risk, but there is harmful use and probable dependence. Polydrug use exists, mainly of cannabis with alcohol and tobacco. Conclusion: Cannabis use has increased in recent years; there is an association of cannabis use with other substances; problems associated with cannabis use are relativized, despite the risk assessment pointing in another direction.

Resumen Marco contextual: El European Monitoring Centre for Drugs and Drug Addiction informa de un número creciente de usuarios en tratamiento por consumo de opioides y cannabis. En Portugal, se identificaron 72 muertes inducidas por drogas en el grupo de edad de 15 a 64 años. Objetivos: Caracterizar, en una muestra de adultos portugueses, el consumo de cannabis, el grado de riesgo y el policonsumo. Metodología: Estudio cualitativo, descriptivo, correlacional y transversal, para el cual se utilizó el Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Resultados: Los resultados muestran frecuencias de consumo superiores a las de los estudios epidemiológicos nacionales para todas las sustancias (excepto el alcohol). El consumo de cannabis es mayoritariamente de bajo riesgo, pero existe un consumo perjudicial y una probable dependencia. Existe policonsumo, principalmente de cannabis con alcohol y tabaco. Conclusión: El consumo de cannabis ha aumentado en los últimos años. Este consumo se asocia a otras sustancias y hay una relativización de los problemas asociados al consumo de cannabis, aunque la evaluación de riesgos apunta en otra dirección.

An overview of food safety and bacterial foodborne zoonoses in food production animals in the Caribbean region.

Foodborne diseases (FBDs) in the Caribbean have a high economic burden. Public health and tourism concerns rise along with the increasing number of cases and outbreaks registered over the last 20 years. Salmonella spp., Shigella spp., and Campylobacter spp. are the main bacteria associated with these incidents. In spite of undertaking limited surveillance on FBD in the region, records related to bacterial foodborne zoonoses in food-producing animals and their associated epidemiologic significance are poorly documented, giving rise to concerns about the importance of the livestock, food animal product sectors, and consumption patterns. In this review, we report the available published literature over the last 20 years on selected bacterial foodborne zoonoses in the Caribbean region and also address other food safety-related aspects (e.g., FBD food attribution, importance, surveillance), mainly aiming at recognizing data gaps and identifying possible research approaches in the animal health sector.

A dieta mediterrânea na perspectiva de uma alimentação saudável pela riqueza de alimentos funcionais / Mediterranean diet in a healthy perspective of the richness of functional foods

A dieta mediterrânica é o resultado de uma saudável e equilibrada combinação de ingredientes, característica dos países que constituem a bacia do Mediterrâneo. Caracteriza-se pelo consumo elevado de alimentos ricos em hidratos de carbono complexos, fibras, vitaminas, minerais e numerosos antioxidantes e pelo baixo consumo de alimentos ricos em gordura saturada e de grande valor calórico. Embora as propriedades benéficas para a saúde associadas à Dieta Mediterrânica como um todo tenham ganho reconhecimento, atualmente os esforços científicos estão concentrados em termos de tipos de alimentos, como o caso das leguminosas, frutos, vegetais, azeite e dos respectivos componentes bioativos, como é o caso das fibras, das vitaminas e dos polifenóis. No presente estudo apresentam-se alguns exemplos de alimentos funcionais associados à dieta Mediterrânica, focando-se as respectivas ações benéficas, os componentes bioativos e alguns estudos associados.

Occurrence of aflatoxin B1 in dairy cow feed over 10 years in Portugal (1995-2004).

In Portugal, there is rather little information about the natural occurrence of aflatoxin in feedstuffs. The aim of this work was to report the results of screening the natural incidence of aflatoxin B1 (AFB1) in samples of cattle feed collected from seven dairy cow's farms from Portugal distributed in several locations of the country. One thousand and one samples were taken from 1995 to 2004. High performance liquid chromatography (HPLC) was used for separation, identification and quantification of the compound. Detection limit was 1 microg/kg. Aflatoxin B1 was detected in 374 (37.4%) of the samples. The incidence and mean content of AFB1 was generally low. Levels of aflatoxin B1 above the maximum limit established in Portugal (5 microg/kg) for dairy cattle feed samples were observed in 62 samples (6.2%) with levels ranging from 5.1 to 74 microg/kg. Out of those 62 samples, 3.7% had levels between 5.1 to 10 (mean 7.8); 1.8% had a contamination level of 10.1 to 20 (mean 12.0), and 0.7% exceeded 20.1 microg/kg (mean 50.4). On the last two years (2003-04) none of the samples exceeded the maximum permissible level of the toxin.

Occurrence of aflatoxin B1 in dairy cow’s feed over 10 years in Portugal (1995-2004)

En Portugal es muy escasa la información sobre la presencia natural deaflatoxina en piensos para animales. El objetivo de este trabajo es ladivulgación del estudio sobre la incidencia natural de aflatoxina B1 (AFB1) enmuestras de piensos, recogidas en siete explotaciones ganaderas de bovinoslecheros distribuidas por diversas regiones de Portugal. Se recogieron yanalizaron 1.001 muestras entre el periodo de 1995 a 2004. En la separación,identificación y cuantificación del compuesto, se utilizó la técnica decromatografía líquida de alta resolución (HPLC). El límite de detección fue de1 mg/kg. La aflatoxina B1 fue detectada en 374 (37,4%) de las muestras.La incidencia y el contenido medio de AFB1 fueron en general, bajos.En 62 muestras (6,2%) se observaron niveles de aflatoxina B1 por encima dellimite máximo permitido en Portugal (5 mg/kg), con concentraciones entre5,1 y 74 mg/kg. De las 62 muestras, 3,7% presentaron concentraciones entre5,1 y 10 mg/kg (mediana 7,8); 1,8% tenía una concentración entre 10,1 y20 mg/kg (mediana 12,0), y 0,7% era superior a 20,1 mg/kg (mediana 50,4).En los últimos 2 años del estudio (2003-04) ninguna muestra excedió el límitemáximo permitido para la toxina(AU)

In Portugal, there is rather little information about the natural occurrence ofaflatoxin in feedstuffs. The aim of this work was to report the results ofscreening the natural incidence of aflatoxin B1 (AFB1) in samples of cattle feedcollected from seven dairy cow’s farms from Portugal distributed in severallocations of the country. One thousand and one samples were taken from1995 to 2004. High performance liquid chromatography (HPLC) was used forseparation, identification and quantification of the compound. Detection limitwas 1 mg /kg. Aflatoxin B1 was detected in 374 (37.4%) of the samples.The incidence and mean content of AFB1 was generally low. Levels of aflatoxinB1 above the maximum limit established in Portugal (5 mg/kg) for dairy cattlefeed samples were observed in 62 samples (6.2%) with levels ranging from5.1 to 74 mg/kg. Out of those 62 samples, 3.7% had levels between 5.1 to 10(mean 7.8); 1.8% had a contamination level of 10.1 to 20 (mean 12.0), and0.7% exceeded 20.1 mg/kg (mean 50.4). On the last two years (2003-04) noneof the samples exceeded the maximum permissible level of the toxin(AU)

Multiplicação e sobrevivência de Listeria Monocytogenes sob condições ecológicas desfavoráveis. Parte II: Atmosfera modificada, agentes biológicos e compostos de limpeza e desinfecção / Multiplication and survival of Listeria Monocytogenes under unfavorable ecological conditions. Breaks II: Atmosphere modified, composed and biological agents of cleaning and disinfection

A larga distribuição de Listeria monocytogenes no meio ambiente está provavelmente relacionada com a sua capacidade para sobreviver e se multiplicar sob condições extremas. As novas tendências em termos de conservação de alimentos, incluem a utilização de bioconservantes, embalagens a vácuo e as atmosferas modificadas. O efeito antagónico da nisina em relação a Listeria monocytogenes já está demonstrado, contudo verifica-se que nos alimentos é bastante dependente da composição química do alimento ao qual é adicionada. Também os efeitos da embalagem de alimentos a vácuo e em atmosfera modificada na multiplicação de Listeria monocytogenes são controversos. A utilização de concentrações subletais de agentes de limpeza e desinfecção podem contribuir para o aumento da resistência de Listeria monocytogenes a esse compostos.

Multiplicação e sobrevivência de Listeria Monocytogenes sob condições ecológicas desfavoráveis. Parte II: Atmosfera modificada, agentes biológicos e compostos de limpeza e desinfecção / Multiplication and survival of Listeria Monocytogenes under unfavorable ecological conditions. Breaks II: Atmosphere modified, composed and biological agents of cleaning and disinfection

A larga distribuição de Listeria monocytogenes no meio ambiente está provavelmente relacionada com a sua capacidade para sobreviver e se multiplicar sob condições extremas. As novas tendências em termos de conservação de alimentos, incluem a utilização de bioconservantes, embalagens a vácuo e as atmosferas modificadas. O efeito antagónico da nisina em relação a Listeria monocytogenes já está demonstrado, contudo verifica-se que nos alimentos é bastante dependente da composição química do alimento ao qual é adicionada. Também os efeitos da embalagem de alimentos a vácuo e em atmosfera modificada na multiplicação de Listeria monocytogenes são controversos. A utilização de concentrações subletais de agentes de limpeza e desinfecção podem contribuir para o aumento da resistência de Listeria monocytogenes a esse compostos.

The wide distribution of Listeria monocytogenes in the environment is probably related to its ability to survive and grow in extreme conditions. New trends in food preservation include the use of biopreservatives, vacuum packaging and modified atmospheres. The antagonistic effect of nisin on L. monocytogenes has been demonstrated but its activity in foods is strongly dependent on the chemical composition of the food to which is added. Also the effects of vacuum packaging and modified atmosphere packaging on the growth of L. monocytogenes are still controvertial. Sublethal concentrations of cleanning and desinfectants agents can contribute to the and increased resistance of L. monocytogenes to these compounds.

Fontes de contaminação dos alimentos por Listeria monocytogenes / Food contamination by Listeria monocytogenes

A ingestão de alimentos contaminados por P. monocytogenes está associada ao surgimento de listeriose, doença que pode ser elevada gravidade para o homem. Os alimentos podem ficar contaminados por este microrganismo não só a partir do meio ambiente, considerado o seu reservatório natural, mas também a partir do ambiente fabril. As diversas vias pelas quais L. monocytogenes pode entrar nas instalações das agroi-indústrias conjugadas com a sua capacidade de sobrevivência por longos períodos de tempo no meio ambiente (solo, vegetação e água), nos alimentos e nos ambientes fabris, podendo até multiplicar-se sob condições adversas, contribuem para L. monocytogenes ser considerado um dos agentes microbianos mais preocupantes ao nível das agro-indústrias desde os anos oitenta.