Latent tuberculosis infection reactivation in patients with multiple sclerosis in use of disease-modifying therapies: A systematic review.

BACKGROUND: Tuberculosis (TB) is an infectious-contagious disease caused by Mycobacterium tuberculosis. This disease can act acutely or in latent form as granuloma. Multiple Sclerosis (MS) is a chronic inflammatory disease more common in the Central Nervous System (CNS). Its treatment involves disease-modifying therapies (DMTs), which can predispose MS patients to a higher risk of infections by interfering in the immune system. Patients undergoing MS treatment could be more susceptible to Latent Tuberculosis Infection (LTBI) reactivation. This study aims to elucidate the possible relationship between MS and LTBI through a systematic review of the literature. METHODS: MEDLINE/PubMed, Cochrane, ScienceDirect, LILACS, and SciELO were systematically reviewed from 2010 to 2020 and Google Scholar from 2015 to 2020 to detect eligible papers. The following keywords were used for this search: "LTBI and MS"; "Multiple Sclerosis and Latent Tuberculosis"; "Multiple Sclerosis and Latent Tuberculosis infection reactivation"; "Multiple Sclerosis and Pulmonary Tuberculosis"; "Multiple Sclerosis and Active Tuberculosis"; "Multiple Sclerosis and Tuberculosis Reactivation" for MEDLINE/Pubmed and ScienceDirect; and "Multiple Sclerosis and Latent Tuberculosis Infection" for Google Scholar, Cochrane, SCIELO, and LILACS. The filter for "review articles," "research articles," and "case reports" was applied in ScienceDirect. RESULTS: Fourteen (14) studies describing the relationship between MS and LTBI were included in qualitative synthesis: case-report (2), prevalence (2), non-systematic review (4), expert consensus (2), and case-control (4) studies. CONCLUSION: The reactivation of LTBI is well understood, but hardly any literature addressed the association between the contagious disease and MS' treatment. The selected articles are observational studies that offer limited data and differ in many aspects detailed over this study. These divergences make it challenging to compare articles' results. Nevertheless, most reports recommend screening for LTBI before starting MS treatment, mainly in high incidence countries.

Are Filter-Tipped Cigarettes Still Less Harmful than Non-Filter Cigarettes?--A Laser Spectrometric Particulate Matter Analysis from the Non-Smokers Point of View.

BACKGROUND: Environmental tobacco smoke (ETS) is associated with human morbidity and mortality, particularly chronic obstructive pulmonary disease (COPD and lung cancer. Although direct DNA-damage is a leading pathomechanism in active smokers, passive smoking is enough to induce bronchial asthma, especially in children. Particulate matter (PM) demonstrably plays an important role in this ETS-associated human morbidity, constituting a surrogate parameter for ETS exposure. METHODS: Using an Automatic Environmental Tobacco Smoke Emitter (AETSE) and an in-house developed, non-standard smoking regime, we tried to imitate the smoking process of human smokers to demonstrate the significance of passive smoking. Mean concentration (C(mean)) and area under the curve (AUC) of particulate matter (PM2.5) emitted by 3R4F reference cigarettes and the popular filter-tipped and non-filter brand cigarettes "Roth-Händle" were measured and compared. The cigarettes were not conditioned prior to smoking. The measurements were tested for Gaussian distribution and significant differences. RESULTS: C(mean) PM2.5 of the 3R4F reference cigarette: 3911 µg/m³; of the filter-tipped Roth-Händle: 3831 µg/m³; and of the non-filter Roth-Händle: 2053 µg/m³. AUC PM2.5 of the 3R4F reference cigarette: 1,647,006 µg/m³·s; of the filter-tipped Roth-Händle: 1,608,000 µg/m³·s; and of the non-filter Roth-Händle: 858,891 µg/m³·s. CONCLUSION: The filter-tipped cigarettes (the 3R4F reference cigarette and filter-tipped Roth-Händle) emitted significantly more PM2.5 than the non-filter Roth-Händle. Considering the harmful potential of PM, our findings note that the filter-tipped cigarettes are not a less harmful alternative for passive smokers. Tobacco taxation should be reconsidered and non-smoking legislation enforced.

Envolvimento paterno na mídia: publicações em revistas para pais e mães / Father involvement in media: publications in magazines for parents / Envolvimiento paterno en los medios de comunicación: publicaciones en revistas para padres y madres

Com as mudanças no contexto familiar, o pai vem ampliando seu papel, sendo a mídia um dos instrumentos que comunica, transmite e produz discursos sobre a paternidade. Neste estudo, tem-se como objetivo analisar o que as revistas Pais & Filhos e Crescer publicam sobre o pai e o envolvimento paterno. Para isso, sortearam-se 30 exemplares de cada revista, três por ano, de 2003 até 2013. Leram-se as reportagens e foram selecionadas as que se referiam ao pai. As 104 reportagens selecionadas da Revista Pais & Filhos e 94 da Revista Crescer foram analisadas conforme o conteúdo categorial temático segundo Bardin, utilizando-se o software ATLAS.ti. Como resultados, têm-se as categorias paternidade e família, com nove e cinco elementos temáticos respectivamente. Os elementos temáticos predominantes em paternidade são: o novo pai (n=58), pai como modelo (n=48) e papel do pai (n=41). Já relações familiares (n=36), educação de filhos (n=34) e conjugalidade e paternidade (n=27) predominaram na categoria família. Portanto, com base na análise dos dados, conclui-se que as revistas pesquisadas apontam para uma imagem de pai envolvido, que interage com seu filho, disponibiliza-se e se responsabiliza pelos cuidados à criança.

With the changes in the family context, the father has been expanding his role, and the media is an instrument that communicates, transmits and produces discourses about fatherhood. In this study, the aim is analyze what the magazines Pais & Filhos and Crescer publish about father and father involvement. For this, 30 copies of each magazine were raffled up, three a year, from 2003 until 2013. The articles were read and those that referred to the father were selected. The 104 articles selected from Pais & Filhos Magazine and 94 from Crescer Magazine were analyzed according to categorical thematic content of Bardin, using the ATLAS.ti software. In the results, there are the fatherhood and family classes, with nine and five thematic elements respectively. The predominant thematic elements in fatherhood are: the new father (n = 58), father as a model (n = 48) and role of the father (n = 41). Familiar relationships (n = 36), education of children (n = 34) and marital and fatherhood (n = 27) predominated in the family category. Therefore, according to the data analysis, we conclude that the magazines show an image of father involved, who interacts with his child, provides up and is in charge for child care.

Con los cambios en el contexto familiar, el padre ha venido ampliando su papel, siendo los medios de comunicación uno de los instrumentos que comunica, transmite y produce discursos sobre la paternidad. En este estudio, el objetivo es analizar lo que las revistas Pais & Filhos y Crescer publican sobre el padre y el envolvimiento paterno. Para esto, fueron sorteados 30 ejemplares de cada revista, tres por ano, de 2003 hasta 2013. Se leyeron los reportajes y fueron seleccionados los que se referían al padre. Los 104 reportajes seleccionados de la Revista Pais & Filhos y 94 de la Revista Crescer fueron analizadas conforme el contenido categorial temático según Bardin, se utilizó el software ATLAS-ti. Como resultados, se destacan las categorías paternidad y familia, con nueve y cinco elementos temáticos respectivamente. Los elementos temáticos predominantes en paternidad son el nuevo padre (n=58), padre como modelo (n=48) y papel del padre (n=41). Ya relaciones familiares (n=36), educación de hijos (n=34) y matrimonio y paternidad (n=27) predominaron en la categoría familia. Por tanto, con base en análisis de datos, se concluye que las revistas apuntan para un padre envuelto, que interacciona con su hijo, está disponible y se responsabiliza por los cuidados del niño.

Envolvimento paterno na mídia: publicações em revistas para pais e mães / Father involvement in media: publications in magazines for parents / Envolvimiento paterno en los medios de comunicación: publicaciones en revistas para padres y madres

Com as mudanças no contexto familiar, o pai vem ampliando seu papel, sendo a mídia um dos instrumentos que comunica, transmite e produz discursos sobre a paternidade. Neste estudo, tem-se como objetivo analisar o que as revistas Pais & Filhos e Crescer publicam sobre o pai e o envolvimento paterno. Para isso, sortearam-se 30 exemplares de cada revista, três por ano, de 2003 até 2013. Leram-se as reportagens e foram selecionadas as que se referiam ao pai. As 104 reportagens selecionadas da Revista Pais & Filhos e 94 da Revista Crescer foram analisadas conforme o conteúdo categorial temático segundo Bardin, utilizando-se o software ATLAS.ti. Como resultados, têm-se as categorias paternidade e família, com nove e cinco elementos temáticos respectivamente. Os elementos temáticos predominantes em paternidade são: o novo pai (n=58), pai como modelo (n=48) e papel do pai (n=41). Já relações familiares (n=36), educação de filhos (n=34) e conjugalidade e paternidade (n=27) predominaram na categoria família. Portanto, com base na análise dos dados, conclui-se que as revistas pesquisadas apontam para uma imagem de pai envolvido, que interage com seu filho, disponibiliza-se e se responsabiliza pelos cuidados à criança. (AU)

With the changes in the family context, the father has been expanding his role, and the media is an instrument that communicates, transmits and produces discourses about fatherhood. In this study, the aim is analyze what the magazines Pais & Filhos and Crescer publish about father and father involvement. For this, 30 copies of each magazine were raffled up, three a year, from 2003 until 2013. The articles were read and those that referred to the father were selected. The 104 articles selected from Pais & Filhos Magazine and 94 from Crescer Magazine were analyzed according to categorical thematic content of Bardin, using the ATLAS.ti software. In the results, there are the fatherhood and family classes, with nine and five thematic elements respectively. The predominant thematic elements in fatherhood are: the new father (n = 58), father as a model (n = 48) and role of the father (n = 41). Familiar relationships (n = 36), education of children (n = 34) and marital and fatherhood (n = 27) predominated in the family category. Therefore, according to the data analysis, we conclude that the magazines show an image of father involved, who interacts with his child, provides up and is in charge for child care. (AU)

Con los cambios en el contexto familiar, el padre ha venido ampliando su papel, siendo los medios de comunicación uno de los instrumentos que comunica, transmite y produce discursos sobre la paternidad. En este estudio, el objetivo es analizar lo que las revistas Pais & Filhos y Crescer publican sobre el padre y el envolvimiento paterno. Para esto, fueron sorteados 30 ejemplares de cada revista, tres por ano, de 2003 hasta 2013. Se leyeron los reportajes y fueron seleccionados los que se referían al padre. Los 104 reportajes seleccionados de la Revista Pais & Filhos y 94 de la Revista Crescer fueron analizadas conforme el contenido categorial temático según Bardin, se utilizó el software ATLAS-ti. Como resultados, se destacan las categorías paternidad y familia, con nueve y cinco elementos temáticos respectivamente. Los elementos temáticos predominantes en paternidad son el nuevo padre (n=58), padre como modelo (n=48) y papel del padre (n=41). Ya relaciones familiares (n=36), educación de hijos (n=34) y matrimonio y paternidad (n=27) predominaron en la categoría familia. Por tanto, con base en análisis de datos, se concluye que las revistas apuntan para un padre envuelto, que interacciona con su hijo, está disponible y se responsabiliza por los cuidados del niño. (AU)

The consolidation of implicit sequence memory in obstructive sleep apnea.

Obstructive Sleep Apnea (OSA) Syndrome is a relatively frequent sleep disorder characterized by disrupted sleep patterns. It is a well-established fact that sleep has beneficial effect on memory consolidation by enhancing neural plasticity. Implicit sequence learning is a prominent component of skill learning. However, the formation and consolidation of this fundamental learning mechanism remains poorly understood in OSA. In the present study we examined the consolidation of different aspects of implicit sequence learning in patients with OSA. We used the Alternating Serial Reaction Time task to measure general skill learning and sequence-specific learning. There were two sessions: a learning phase and a testing phase, separated by a 10-hour offline period with sleep. Our data showed differences in offline changes of general skill learning between the OSA and control group. The control group demonstrated offline improvement from evening to morning, while the OSA group did not. In contrast, we did not observe differences between the groups in offline changes in sequence-specific learning. Our findings suggest that disrupted sleep in OSA differently affects neural circuits involved in the consolidation of sequence learning.

Relationship between the interleukin-28b gene polymorphism and the histological severity of hepatitis C virus-induced graft inflammation and the response to antiviral therapy after liver transplantation.

Up to 30% of liver transplants will develop graft cirrhosis within 5 years after liver transplantation (LT) due to recurrent HCV-infection forwarding accelerated graft damage. Genetic variants of cytokines involved in the immune response may contribute to the degree of graft inflammation, fibrosis progression, and antiviral therapy outcome. The aim of our study was to analyze biochemical and histological inflammation extent based on protocol liver biopsies and to evaluate the role of genetic variants of IL-28b in HCV-related graft disease and antiviral treatment response. 183 patients, who underwent liver transplantation for HCV-induced liver disease, were genotyped for IL-28b (rs8099917, G ≥ T) by TaqMan Genotyping Assay. 56 of 159 patients have been successfully treated with interferon-based antiviral therapy. 605 protocol liver biopsies performed 0.5 to 10 and more than 10 years after transplantation were evaluated according to Desmet and Scheuer classification of inflammation and fibrosis. Prevalence of IL-28b-genotypes was correlated with histological severity of graft damage, levels of aminotransferases, occurrence of acute cellular rejection, pre-treatment viremia, and antiviral therapy outcome. Significant association of IL-28b-genotype distribution was observed to the median grade of inflammation (p < 0.001), mean levels of aminotransferases (ALT: p = 0.001, AST: p = 0.003), median pre-treatment viremia level within 1 year after LT (p = 0.046) and interferon-based antiviral therapy failure (p < 0.001). Among successfully treated patients, G-allele was significantly less frequent, and the genotype GG was not present at all. No differences were observed regarding acute cellular rejection (p = 0.798) and fibrosis stages (p = 0.586). IL-28b polymorphism seems to influence the degree of graft inflammation at biochemical and histological levels. G-allele might serve as a marker for graft inflammation and as a predictor for unfavorable antiviral therapy outcome in HCV-re-infected LT-population.

Inhalation with fucose and galactose for treatment of Pseudomonas aeruginosa in cystic fibrosis patients.

BACKGROUND: Colonisation of cystic fibrosis (CF) lungs with Pseudomonas aeruginosa is facilitated by two lectins, which bind to the sugar coat of the surface lining epithelia and stop the cilia beating. OBJECTIVES: We hypothesized that P. aeruginosa lung infection should be cleared by inhalation of fucose and galactose, which compete for the sugar binding site of the two lectins and thus inhibit the binding of P. aeruginosa. METHODS: 11 adult CF patients with chronic infection with P. aeruginosa were treated twice daily with inhalation of a fucose/galactose solution for 21 days (4 patients only received inhalation, 7 patients received inhalation and intravenous antibiotics). Microbial counts of P. aeruginosa, lung function measurements, and inflammatory markers were determined before and after treatment. RESULTS: The sugar inhalation was well tolerated and no adverse side effects were observed. Inhalation alone as well as combined therapy (inhalation and antibiotics) significantly decreased P. aeruginosa in sputum (P < 0.05). Both therapies also significantly reduced TNFalpha expression in sputum and peripheral blood cells (P < 0.05). No change in lung function measurements was observed. CONCLUSIONS: Inhalation of simple sugars is a safe and effective measure to reduce the P. aeruginosa counts in CF patients. This may provide an alternative therapeutical approach to treat infection with P. aeruginosa.