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BACKGROUND: Previous works seem to agree in the higher mortality of cancer patients with COVID-19. Identifying potential prognostic factors upon admission could help identify patients with a poor prognosis. METHODS: We aimed to explore the characteristics and evolution of COVID-19 cancer patients admitted to hospital in a multicenter international registry (HOPE COVID-19).Our primary objective is to define those characteristics that allow us to identify cancer patients with a worse prognosis (mortality within 30 days after the diagnosis of COVID-19). RESULTS: 5838 patients have been collected in this registry, of whom 770 had cancer among their antecedents. In hospital mortality reached 258 patients (33.51%). The median was 75 years (65-82). Regarding the distribution by sex, 34.55% of the patients (266/770) were women.The distribution by type of cancer: genitourinary 238/745 (31.95%), digestive 124/745 (16.54%), hematologic 95/745 (12.75%).In multivariate regression analysis, factors that are independently associated with mortality at admission are: renal impairment (OR 3.45, CI 97.5% 1.85-6.58), heart disease (2.32, 1.47-3.66), liver disease (4.69, 1.94-11.62), partial dependence (2.41, 1.34-4.33), total dependence (7.21, 2.60-21.82), fatigue (1.84, 1.16-2.93), arthromialgias (0.45, 0.26-0.78), SatO2 < 92% (4.58, 2.97-7.17), elevated LDH (2.61, 1.51-4.69) and abnormal decreased Blood Pressure (3.57, 1.81-7.15). Analitical parameters are also significant altered. CONCLUSION: In patients with cancer from the HOPE registry, 30-day mortality from any cause is high and is associated with easily identifiable clinical factors upon arrival at the hospital. Identifying these patients can help initiate more intensive treatments from the start and evaluate the prognosis of these patients.
ANTECEDENTES: Trabajos previos parecen coincidir en la mayor mortalidad de los pacientes con cáncer y COVID-19. La identificación de posibles factores pronósticos en el momento del ingreso podría ayudar a identificar a los pacientes con mal pronóstico. MÉTODOS: Nos propusimos explorar las características y la evolución de los pacientes con cáncer y COVID-19 ingresados en un registro internacional multicéntrico (HOPE COVID-19).Nuestro objetivo principal es definir aquellas características que nos permitan identificar a los pacientes con cáncer de peor pronóstico (mortalidad en los 30 días siguientes al diagnóstico de COVID-19). RESULTADOS: En este registro se ha recogido a 5.838 pacientes, de los cuales 770 tenían cáncer entre sus antecedentes. La mortalidad hospitalaria alcanzó a 258 pacientes (33,51%). La mediana fue de 75 años (65-82). En cuanto a la distribución por sexo, el 34,55% de los pacientes eran mujeres (266/770).La distribución por tipo de cáncer: genitourinario 238/745 (31,95%), digestivo 124/745 (16,54%) y hematológico 95/745 (12,75%).En el análisis de regresión multivariante, los factores que se asocian de forma independiente con la mortalidad al ingreso son: insuficiencia renal (OR 3,45; IC 97,5%: 1,85-6,58), cardiopatía (2,32; 1,47-3,66), hepatopatía (4,69; 1,94-11,62), dependencia parcial (2,41; 1,34-4,33), dependencia total (7,21; 2,60-21,82), fatiga (1,84, 1;16-2,93), artromialgias (0,45; 0,26-0,78), SatO2 < 92% (4,58; 2,97-7,17), LDH elevada (2,61; 1,51-4,69) y disminución anormal de la presión arterial (3,57; 1,81-7,15). Los parámetros analíticos también están significativamente alterados. CONCLUSIÓN: En los pacientes con cáncer del registro HOPE, la mortalidad a los 30 días por cualquier causa es elevada y se asocia a factores clínicos fácilmente identificables a su llegada al hospital. La identificación de estos pacientes puede ayudar a iniciar tratamientos más intensivos desde el principio y evaluar el pronóstico de estos pacientes.
RESUMEN
Background: Previous works seem to agree in the higher mortality of cancer patients with COVID-19. Identifying potential prognostic factors upon admission could help identify patients with a poor prognosis.MethodsWe aimed to explore the characteristics and evolution of COVID-19 cancer patients admitted to hospital in a multicenter international registry (HOPE COVID-19).Our primary objective is to define those characteristics that allow us to identify cancer patients with a worse prognosis (mortality within 30 days after the diagnosis of COVID-19).Results5838 patients have been collected in this registry, of whom 770 had cancer among their antecedents. In hospital mortality reached 258 patients (33.51%). The median was 75 years (6582). Regarding the distribution by sex, 34.55% of the patients (266/770) were women.The distribution by type of cancer: genitourinary 238/745 (31.95%), digestive 124/745 (16.54%), hematologic 95/745 (12.75%).In multivariate regression analysis, factors that are independently associated with mortality at admission are: renal impairment (OR 3.45, CI 97.5% 1.856.58), heart disease (2.32, 1.473.66), liver disease (4.69, 1.9411.62), partial dependence (2.41, 1.344.33), total dependence (7.21, 2.6021.82), fatigue (1.84, 1.162.93), arthromialgias (0.45, 0.260.78), SatO2<92% (4.58, 2.977.17), elevated LDH (2.61, 1.514.69) and abnormal decreased Blood Pressure (3.57, 1.817.15). Analitical parameters are also significant altered.ConclusionIn patients with cancer from the HOPE registry, 30-day mortality from any cause is high and is associated with easily identifiable clinical factors upon arrival at the hospital. Identifying these patients can help initiate more intensive treatments from the start and evaluate the prognosis of these patients. (AU)
Antecedentes: Trabajos previos parecen coincidir en la mayor mortalidad de los pacientes con cáncer y COVID-19. La identificación de posibles factores pronósticos en el momento del ingreso podría ayudar a identificar a los pacientes con mal pronóstico.MétodosNos propusimos explorar las características y la evolución de los pacientes con cáncer y COVID-19 ingresados en un registro internacional multicéntrico (HOPE COVID-19).Nuestro objetivo principal es definir aquellas características que nos permitan identificar a los pacientes con cáncer de peor pronóstico (mortalidad en los 30 días siguientes al diagnóstico de COVID-19).ResultadosEn este registro se ha recogido a 5.838 pacientes, de los cuales 770 tenían cáncer entre sus antecedentes. La mortalidad hospitalaria alcanzó a 258 pacientes (33,51%). La mediana fue de 75 años (65-82). En cuanto a la distribución por sexo, el 34,55% de los pacientes eran mujeres (266/770).La distribución por tipo de cáncer: genitourinario 238/745 (31,95%), digestivo 124/745 (16,54%) y hematológico 95/745 (12,75%).En el análisis de regresión multivariante, los factores que se asocian de forma independiente con la mortalidad al ingreso son: insuficiencia renal (OR 3,45; IC 97,5%: 1,85-6,58), cardiopatía (2,32; 1,47-3,66), hepatopatía (4,69; 1,94-11,62), dependencia parcial (2,41; 1,34-4,33), dependencia total (7,21; 2,60-21,82), fatiga (1,84, 1;16-2,93), artromialgias (0,45; 0,26-0,78), SatO2 <92% (4,58; 2,97-7,17), LDH elevada (2,61; 1,51-4,69) y disminución anormal de la presión arterial (3,57; 1,81-7,15). Los parámetros analíticos también están significativamente alterados.ConclusiónEn los pacientes con cáncer del registro HOPE, la mortalidad a los 30 días por cualquier causa es elevada y se asocia a factores clínicos fácilmente identificables a su llegada al hospital. La identificación de estos pacientes puede ayudar a iniciar tratamientos más intensivos desde el principio y evaluar el pronóstico de estos pacientes. (AU)
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Humanos , Neoplasias/diagnóstico , Neoplasias/terapia , Registros , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Infecciones por Coronavirus/epidemiología , PronósticoRESUMEN
BACKGROUND: Previous works seem to agree in the higher mortality of cancer patients with COVID-19. Identifying potential prognostic factors upon admission could help identify patients with a poor prognosis. METHODS: We aimed to explore the characteristics and evolution of COVID-19 cancer patients admitted to hospital in a multicenter international registry (HOPE COVID-19). Our primary objective is to define those characteristics that allow us to identify cancer patients with a worse prognosis (mortality within 30 days after the diagnosis of COVID-19). RESULTS: 5838 patients have been collected in this registry, of whom 770 had cancer among their antecedents. In hospital mortality reached 258 patients (33.51%). The median was 75 years (65-82). Regarding the distribution by sex, 34.55% of the patients (266/770) were women. The distribution by type of cancer: genitourinary 238/745 (31.95%), digestive 124/745 (16.54%), hematologic 95/745 (12.75%). In multivariate regression analysis, factors that are independently associated with mortality at admission are: renal impairment (OR 3.45, CI 97.5% 1.85-6.58), heart disease (2.32, 1.47-3.66), liver disease (4.69, 1.94-11.62), partial dependence (2.41, 1.34-4.33), total dependence (7.21, 2.60-21.82), fatigue (1.84, 1.16-2.93), arthromialgias (0.45, 0.26-0.78), SatO2<92% (4.58, 2.97-7.17), elevated LDH (2.61, 1.51-4.69) and abnormal decreased Blood Pressure (3.57, 1.81-7.15). Analitical parameters are also significant altered. CONCLUSION: In patients with cancer from the HOPE registry, 30-day mortality from any cause is high and is associated with easily identifiable clinical factors upon arrival at the hospital. Identifying these patients can help initiate more intensive treatments from the start and evaluate the prognosis of these patients.
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COVID-19 , Neoplasias , Humanos , Neoplasias/diagnóstico , Neoplasias/terapia , Pronóstico , Sistema de Registros , SARS-CoV-2RESUMEN
BACKGROUND: Regular cannabis use may be associated with several oral changes not usually identified by dermatologists: xerostomia, increased risk of caries, periodontitis, leukoedema, gingival hyperplasia, and higher prevalence and density of Candida albicans, leukoplakia or gingivitis. PATIENTS AND METHODS: We report herein the appearance of a characteristic green tongue in a patient following intensive marijuana inhalation. DISCUSSION: This complication has rarely been reported in the medical literature. Paradoxically, it is clearly described in different Internet search engines, particularly Google.
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Abuso de Marihuana/complicaciones , Enfermedades de la Lengua/diagnóstico , Enfermedades de la Lengua/etiología , Color , Humanos , Internet , Masculino , Adulto JovenRESUMEN
This review discusses research developments and applications of isotachophoresis (ITP) to the initiation, control, and acceleration of chemical reactions, emphasizing reactions involving biomolecular reactants such as nucleic acids, proteins, and live cells. ITP is a versatile technique which requires no specific geometric design or material, and is compatible with a wide range of microfluidic and automated platforms. Though ITP has traditionally been used as a purification and separation technique, recent years have seen its emergence as a method to automate and speed up chemical reactions. ITP has been used to demonstrate up to 14 000-fold acceleration of nucleic acid assays, and has been used to enhance lateral flow and other immunoassays, and even whole bacterial cell detection assays. We here classify these studies into two categories: homogeneous (all reactants in solution) and heterogeneous (at least one reactant immobilized on a solid surface) assay configurations. For each category, we review and describe physical modeling and scaling of ITP-aided reaction assays, and elucidate key principles in ITP assay design. We summarize experimental advances, and identify common threads and approaches which researchers have used to optimize assay performance. Lastly, we propose unaddressed challenges and opportunities that could further improve these applications of ITP.
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Isotacoforesis , Separación Celular , Humanos , Dispositivos Laboratorio en un Chip , Tipificación Molecular , Ácidos Nucleicos/análisis , Proteínas/análisisRESUMEN
We present a novel microfluidic device for size-based nucleic acid (NA) fractionation using isotachophoresis (ITP) and an ionic spacer. Our rapid-prototyped laser-cut plastic device has easily modifiable channel dimensions, can process up to 10 µL of sample, and contains an in-line extraction reservoir for minimally-disruptive manual collection of size-fractionated NAs. We designed custom buffering reservoirs using 1 mL pipette tips to provide high buffering capacity and prevent bubbles from entering the microfluidic channels. We demonstrated the utility of the device by implementing a proof-of-concept assay in which NAs were preconcentrated (via ITP) and then segregated by size (using the ionic spacer and sieving matrix) to generate two separate fractions, the first comprised of small (<50 nt) NA, and the second comprised of NAs of all sizes. Through this approach, we demonstrated size-based fractionation of both DNA and RNA samples (a mixture of synthetic ssDNA molecules, and a commercially-available RNA molecular weight standard, respectively). Our results indicate that this simple, rapid (≤10 min), and label-free approach is a promising and cost-effective alternative to the commercially-available size-selection kits currently on the market. We discuss the design and features of the device, as well as challenges which must be met in the future in order to further improve its performance and utility.
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Isotacoforesis , Dispositivos Laboratorio en un Chip , Ácidos Nucleicos/aislamiento & purificación , Fraccionamiento Químico , ADN , Técnicas Analíticas Microfluídicas , ARNAsunto(s)
Erupciones Liquenoides/inducido químicamente , Enfermedades de la Boca/inducido químicamente , Neoplasias/tratamiento farmacológico , Proteína 2 Ligando de Muerte Celular Programada 1/antagonistas & inhibidores , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Adulto , Anciano , Femenino , Humanos , Erupciones Liquenoides/patología , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/patologíaRESUMEN
Introducción: Muchos pacientes hipertensos óptimamente tratados de sus factores de riesgo cardiovascular (FRCV) siguen presentando complicaciones cardiovasculares. Las células progenitoras endoteliales (CPE) han demostrado ser fundamentales para la reparación del daño endotelial en tejidos isquémicos. Por ello, hemos estudiado los niveles de CPE y del factor de crecimiento del endotelio vascular (VEGF) en pacientes hipertensos en tratamiento con buen control de la presión arterial (PA). Material y métodos: Se recogió una muestra de sangre de pacientes hipertensos tratados que presentaban unas cifras de PA adecuadas para los objetivos individuales. Los niveles plásticos de CPE CD34+/KDR+ y CD34+/VE-cadherina+ se midieron mediante citometría de flujo. La concentración de VEGF se cuantificó mediante ELISA. Como controles se incluyó un grupo de sujetos sin FRCV tradicionales. Resultados: Hemos incluido 108 pacientes (61 ± 12 años, 47,2% hombres), de los cuales un 82,4% presentaba PA < 140/90 mmHg, un 91,7% control de la diabetes (HbA1c < 7%), el 81,5% cLDL < 130 o 100 mg/dl y el 85,2% no fumaba, aunque el 45,4% presentaba obesidad (IMC ≥ 30 kg/m2). A pesar de que, en conjunto, sus parámetros bioquímicos no diferían de los del grupo control, los pacientes hipertensos presentaban una disminución significativa de los niveles plasmáticos de células CD34+/KDR+ y CD34+/VE-cadherina+, aunque la concentración plasmática de VEGF era significativamente mayor en los pacientes hipertensos que en los sujetos control. Conclusiones: Los pacientes hipertensos tratados muestran una disminución significativa de los niveles plasmáticos de CPE que podría ser responsable, al menos en parte, del riesgo residual que presentan estos pacientes, sugiriéndose que las CPE podrían ser una importante diana terapéutica
Introduction: Most optimally treated hypertensive patients still have an around 50% increased risk of any cardiovascular event, suggesting the possible existence of unidentified risk factors. In the last years there has been evidence of the essential role of circulating endothelial progenitor cells (EPCs) in the maintenance of endothelial integrity and function, increasing the interest in their involvement in cardiovascular disease. In this study, the circulating levels of EPCs and vascular endothelial growth factor (VEGF) are investigated in treated hypertensive patients with adequate control of blood pressure (BP). Material and methods: Blood samples were collected from treated hypertensive patients with controlled BP. Plasma levels of EPCs CD34+/KDR+ and CD34+/VE-cadherin+ were quantified by flow cytometry. Plasma concentration of VEGF was determined by ELISA. A group of healthy subjects without cardiovascular risk factors was included as controls. Results: A total of 108 hypertensive patients were included (61±12 years, 47.2% men) of which 82.4% showed BP < 140/90 mmHg, 91.7% and 81.5% controlled diabetes (HbA1c <7%) and cLDL (<130 or 100 mg/dL), respectively, and 85.2% were non-smokers. Around 45% of them were obese. Although patients had cardiovascular parameters within normal ranges, they showed significantly lower levels of CD34+/KDR+ and CD34+/VE-cadherin+ compared with healthy control group, although plasma VEGF concentration was higher in patients than in controls. Conclusions: Despite an optimal treatment, hypertensive patients show a decreased number of circulating EPCs that could be, at least in part, responsible for their residual cardiovascular risk, suggesting that these cells could be a therapeutic target
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Humanos , Células Progenitoras Endoteliales , Hipertensión/fisiopatología , Antihipertensivos/uso terapéutico , Factores de Riesgo , Enfermedades Cardiovasculares/epidemiología , Inhibidores de Hidroximetilglutaril-CoA Reductasas/uso terapéutico , Diuréticos/uso terapéuticoRESUMEN
INTRODUCTION: Most optimally treated hypertensive patients still have an around 50% increased risk of any cardiovascular event, suggesting the possible existence of unidentified risk factors. In the last years there has been evidence of the essential role of circulating endothelial progenitor cells (EPCs) in the maintenance of endothelial integrity and function, increasing the interest in their involvement in cardiovascular disease. In this study, the circulating levels of EPCs and vascular endothelial growth factor (VEGF) are investigated in treated hypertensive patients with adequate control of blood pressure (BP). MATERIAL AND METHODS: Blood samples were collected from treated hypertensive patients with controlled BP. Plasma levels of EPCs CD34+/KDR+ and CD34+/VE-cadherin+ were quantified by flow cytometry. Plasma concentration of VEGF was determined by ELISA. A group of healthy subjects without cardiovascular risk factors was included as controls. RESULTS: A total of 108 hypertensive patients were included (61±12 years, 47.2% men) of which 82.4% showed BP<140/90 mmHg, 91.7% and 81.5% controlled diabetes (HbA1c <7%) and cLDL (<130 or 100 mg/dL), respectively, and 85.2% were non-smokers. Around 45% of them were obese. Although patients had cardiovascular parameters within normal ranges, they showed significantly lower levels of CD34+/KDR+ and CD34+/VE-cadherin+ compared with healthy control group, although plasma VEGF concentration was higher in patients than in controls. CONCLUSIONS: Despite an optimal treatment, hypertensive patients show a decreased number of circulating EPCs that could be, at least in part, responsible for their residual cardiovascular risk, suggesting that these cells could be a therapeutic target.
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Células Progenitoras Endoteliales , Hipertensión , Adulto , Anciano , Antígenos CD34 , Enfermedades Cardiovasculares , Células Endoteliales , Endotelio Vascular , Femenino , Citometría de Flujo , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Células Madre , Factor A de Crecimiento Endotelial VascularRESUMEN
Ticks are obligate haematophagous acarines that parasitise every class of vertebrate (including man) and have a worldwide distribution. An increasing awareness of tick-borne diseases among clinicians and scientific researchers has led to the recent description of a number of emerging tick-borne bacterial diseases. Since the identification of Borrelia burgdorferi as the agent of Lyme disease in 1982, 11 tick-borne human bacterial pathogens have been described in Europe. Aetiological diagnosis of tick-transmitted diseases is often difficult and relies on specialised laboratories using very specific tools. Interpretation of laboratory data is very important in order to establish the diagnosis. These guidelines aim to help clinicians and microbiologists in diagnosing infection transmitted by tick bites and to provide the scientific and medical community with a better understanding of these infectious diseases.
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Vectores Artrópodos/microbiología , Enfermedades por Picaduras de Garrapatas/diagnóstico , Garrapatas/microbiología , Animales , Europa (Continente)/epidemiología , Humanos , Enfermedades por Picaduras de Garrapatas/epidemiologíaRESUMEN
Since 20 or 30 years, emerging tick-borne diseases are regularly reported. Recent data show that at the same time, we have to expect a change in distribution of some disease as the European tick-borne encephalitis, due to the strong relation between ticks cycle and temperatures for the transmission of this virus.
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Enfermedades por Picaduras de Garrapatas/epidemiología , Enfermedades por Picaduras de Garrapatas/transmisión , Clima , HumanosRESUMEN
Since a long time, many human tick-borne pathogens are known, but since 20 or 30 years, emerging tick-borne diseases are regularly reported. In temperate countries, all emerging diseases are Bacteriosis : six Rickettsiosis, one Ehrlichiosis, one Anaplasmosis and one Borrelia Spirochetosis.
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Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades por Picaduras de Garrapatas/epidemiología , Anaplasmosis/epidemiología , Clima , Ehrlichiosis/epidemiología , Humanos , Enfermedad de Lyme/diagnóstico , Enfermedad de Lyme/epidemiología , Infecciones por Rickettsia/epidemiologíaRESUMEN
To assess the Lyme borreliosis vector population density we set up a methodology for sampling the Ixodes ricinus L. population host questing on the vegetation. We focused on the collection of the nymphal stage, which is the principal stage of disease transmission to humans. This study was carried out in Rambouillet forest (Yvelines, France) where seven study areas were demarcated. These areas are maximally homogeneous for plant species using a finer scale than the phytosociological classification as defined by the method of landscape diagnostics. Out of 23 collections performed from March 1997 to May 1998, 2,906 I. ricinus nymphs were collected. The sampling technique chosen was the cloth lure technique. The technical parameters were studied and fixed (cloth type, cloth size, sample size, researcher position). It appeared that toweling was the best cloth type to optimize the number of ticks collected; the position of the researcher had no effect on tick samples. To satisfy the criteria for correct sampling, we studied representativity, randomness, and nonselectivity of our methodology. The spatial distribution of nymphs in a homogeneous area was close to random and thus very few subsamples were needed to obtain a relative density which was representative. No significant differences were found between random samples and following transect samples; and nonselectivity was totally satisfied because we only worked on questing nymphs. We grouped the samples that presented no significant differences to attribute a density index, which varied from 0 to 5. This methodology, applied with the same parameters, offers potential for producing comparable results from studies in different geographical areas and at different times of the years.
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Ixodes/crecimiento & desarrollo , Enfermedad de Lyme/transmisión , Animales , Europa (Continente) , Humanos , Densidad de Población , Estaciones del Año , Enfermedades por Picaduras de Garrapatas/transmisiónRESUMEN
To determine whether deer may play a role in the cycle of the Lyme disease spirochete Borrelia burgdorferi, we sought evidence for the presence of the pathogen in skin of deer and roe deer. Biopsies of 2 mm3 were taken at four different levels from nail to tarsus. A total of 50 animals (200 biopsies) were shot in the Lyme disease foci of Rambouillet during the hunting season 1995-1996 and 1996-1997, from the beginning of November to the end of February. Borrelia burgdorferi s.l. DNA was detected by PCR in 18 biopsies from 14 animals (28%). Borrelia burgdorferi s.str. was predominant (50%), followed by B. garinii (30%) and B. afzelii (10%). Multiple infections were detected in four animals: same species at different levels or two different species from the same biopsy or from different biopsies from the same foot. A total of 125 biopsies were cultivated on BSKH medium. Cultures at 160 days revealed immobile spiralled forms in 10 cultures. One, from a deer killed at the end of December, was confirmed by PCR as B. burgdorferi s.str. These results, frequency of detection of spirochetes by PCR in the skin, multiple infections and alive spirochetes in biopsies taken out side the season of activity of ticks strongly suggest an affinity of Lyme disease spirochetes for skin of cervids.
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Grupo Borrelia Burgdorferi/aislamiento & purificación , Ciervos/microbiología , Reservorios de Enfermedades , Enfermedad de Lyme/veterinaria , Animales , Biopsia/veterinaria , Grupo Borrelia Burgdorferi/patogenicidad , Medios de Cultivo , ADN Bacteriano/análisis , Francia/epidemiología , Ixodes , Enfermedad de Lyme/epidemiología , Reacción en Cadena de la Polimerasa/veterinaria , Prevalencia , Piel/microbiología , Piel/patología , Infestaciones por GarrapatasRESUMEN
The human risk of contracting Lyme disease or other tick borne diseases transmitted by the tick species Ixodes ricinus is broadly linked to the tick nymph density. The study was performed in Rambouillet forest (Yvelines, France), a known focus of Lyme borreliosis, from January 1997 to December 1999. We used a nymph sampling methodology which permitted us to obtain a monthly nymph density index (from 0 to 5). Studying the seasonal nymph and larval activity patterns and estimating the larval developmental duration, we demonstrate the existence of an annual nymphal stock. Secondly, we elucidate how this stock is distributed throughout the year, month by month. Its distribution is principally dependent on two factors: the monthly mean ambient temperature and the proportion of active nymphs which find a host each month. Expected monthly nymph densities derived from a theoretical model describing the temperature-dependent stock distribution gave a good fit to the observed densities, accounting for between 76-86% of the monthly variation in observed nymph densities. Predicting the temporal distribution of nymph activity within a stable Lyme borreliosis focus enables more precise identification of risk periods.
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Ixodes/fisiología , Animales , Demografía , Larva , Ninfa , Estaciones del AñoRESUMEN
The Rambouillet Forest, a Lyme disease-endemic area near Paris, France, was surveyed from September 1994 to October 1995 to determine the risk periods and zones for humans. Firstly, during the period of Ixodes ricinus activity, abundance of nymphs is greater in spring than in autumn. Secondly, we observed significant variation in nymphal abundance between zones according to the density of cervids. The polymerase chain reaction (PCR) was used to detect DNA of Borrelia burgdorferi sensu lato in 461 unfed nymphs. DNA was detected in 38 nymphs (8.2%). By genospecific PCR based on the OspA gene, we detected the three pathogenic spirochetes with occurrences of 10.3, 31.1 and 58.6 for B. burgdorferi s.s., Borrelia garinii and Borrelia afzelii, respectively, indicating that B. afzelii is probably the main Borrelia species in the Rambouillet Forest. Finally, 11.5% of positive nymphs exhibited a double infection. Infection rates of I. ricinus nymphs by B. burgdorferi s.l. were not significantly different throughout the year for a given area, indicating that the risk periods of acquiring Lyme disease are mainly linked to nymph activity and correspond to spring and autumn. Likewise infection rates of nymphs were not significantly different between zones with a high density of deer (more than 100 animals per 100 ha) and zones with lower deer density (less than 20 animals per 100 ha). In addition to the role of deer as an amplifier of tick populations, these data indicate that zones with a high density of cervids should be considered as higher risk areas.
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Vectores Arácnidos/microbiología , Grupo Borrelia Burgdorferi/crecimiento & desarrollo , Ciervos/crecimiento & desarrollo , Ixodes/microbiología , Enfermedad de Lyme/epidemiología , Animales , Grupo Borrelia Burgdorferi/clasificación , Grupo Borrelia Burgdorferi/genética , Cartilla de ADN/química , Enzimas de Restricción del ADN/química , ADN Bacteriano/química , Ciervos/parasitología , Reservorios de Enfermedades , Electroforesis en Gel de Agar , Francia/epidemiología , Genotipo , Humanos , Enfermedad de Lyme/transmisión , Hibridación de Ácido Nucleico , Ninfa/microbiología , Reacción en Cadena de la Polimerasa , Prevalencia , Estaciones del AñoRESUMEN
BACKGROUND: Human urinary myiasis is caused by fly larvae which complete their entire cycle in the human body. CASE REPORT: A 37-year-old woman living in a village near Sidi Bel Abbes (Algeria) developed a parasite syndrome caused by Fannia canicularis larvae. About twenty larvae specimens were collected during her hospitalization. Larvae were emitted for 2 weeks after a 6-day treatment with cefotaxime for urinary tract infection. DISCUSSION: Urogenital myiasis is almost always subsequent to conditions of poor personal hygiene. In this case authentic larvae infestation was evidenced. The diagnosis of true urinary myiasis was confirmed by repeated emissions of different larval stages including the nymph.
Asunto(s)
Miasis , Infecciones Urinarias , Adulto , Cefotaxima/administración & dosificación , Cefotaxima/uso terapéutico , Cefalosporinas/administración & dosificación , Cefalosporinas/uso terapéutico , Femenino , Humanos , Larva , Miasis/tratamiento farmacológico , Miasis/etiología , Factores de Tiempo , Infecciones Urinarias/tratamiento farmacológico , Infecciones Urinarias/parasitologíaRESUMEN
Relatively few effective therapies exist for the multitude of disorders that comprise dementia, a clinical syndrome manifested by impairments in cognition, language and memory. Treatment of Alzheimer s disease (AD), the most common cause of dementia, is a primary goal of research in cognitive enhancement. However, despite intense research, effective pharmacological interventions remain to be developed. The preponderance of pharmacological strategies which are being pursued in AD research attempt to relieve cognitive and memory deficits which are attributed to cholinergic dysfunction. This paper briefly reviews the status of other efforts that have in common the potential to enhance the use-dependent activity of multiple neurotransmitters system through the modulation of gated ion channels. Discussed are recent advances in the areas of: 1) g-aminobutyric acid subtype A receptor/benzodiazepine (GABAA/BZ) inverse agonists; 2) nicotinic acetylcholine receptor (nAChR) agonists; 3) serotonin subtype 3 receptor (5-HT3R) antagonists; and 4) potassium (K+) M-channel inhibitors.
Asunto(s)
Cognición/efectos de los fármacos , Canales Iónicos/efectos de los fármacos , Neurotransmisores/farmacología , Transmisión Sináptica/efectos de los fármacos , Enfermedad de Alzheimer/tratamiento farmacológico , Enfermedad de Alzheimer/fisiopatología , Animales , Cognición/fisiología , Demencia/tratamiento farmacológico , Demencia/fisiopatología , HumanosRESUMEN
During the period of major tick activity, in April and May 1998, in the Saint-Maixent l'Ecole area of Poitou, a comparative study was carried out in order to evaluate the protective effect of garments impregnated with permethrin cis/trans 25/75. Three groups of soldiers made up respectively of 208, 218 and 427 men were involved for 2 or 3 days in this experiment. Respectively 107, 107 and 215 wore impregnated uniforms. Out of a total of 319 ticks, 3 were lxodes ricinus, 305 Dermacentor marginatus and 11 D. reticulatus. There was a significant difference in both the intensity (number of ticks per individual, P < 0.0001) and prevalence (number of individuals with ticks, P < 0.001) of ticks on individuals between impregnated and non impregnated uniforms. The repellent effect of permethrin on ticks was observed at the site of preferential tick attachment (normally the head of the host for these two species of Dermacentor in France) where the number of ticks was significantly lower in impregnated uniforms.
Asunto(s)
Dermacentor , Insecticidas , Ropa de Protección , Piretrinas , Control de Ácaros y Garrapatas , Animales , Francia , Humanos , Masculino , Personal Militar , PermetrinaRESUMEN
After a short historical presentation of the discovery of the pathogen and its vector, the authors present the current data on bacterial and acarologic taxonomy. Then they describe their results to assess the mechanisms of circulation of the bacteria in the forests of Ile-de-France, particularly in the forest of Rambouillet. The combined study of abundance and infection frequency of the vectors, small mammals and cervids leads to the characterization of periods and areas of higher risk. The risk periods correlate with high density of I. ricinus nymphs. The risk areas correspond to those of high density of cervids. The role of reservoir of small mammals is confirmed, to the one of large mammals, so debated, is clearly demonstrated.