Saccharomyces boulardii reduces the vertical transmission of Toxocara canis larvae in mice.

Probiotics have been shown to reduce the intensity of Toxocara canis infection in mice. However, larval transmission of this nematode also occurs via transplacental and transmammary routes. Thus, the aim of this study was to evaluate the effect of the Saccharomyces boulardii probiotic on the vertical transmission of T. canis in Swiss mice. The mice received 107S. boulardii colony-forming units per gram of food. The supplementation began 15 days before mating and was maintained throughout pregnancy and lactation. The animals were inoculated with 300 T. canis embryonated eggs on the 14th day of pregnancy. The presence of larvae was examined in the organs of the females and their offspring. The examined organs included the following: brain, liver, lungs, heart, kidneys, spleen, eye, skeletal muscle (carcass) and mammary glands of lactating females. There was a 42% (P = 0.041) reduction in the number of larvae transmitted to offspring in the group that received probiotic-supplemented food (GI). Additionally, there was a 50% reduction (P = 0.023) in the number of larvae found in the brains of lactating offspring in the GI group. These results reveal the potential of S. boulardii probiotic use as an auxiliary method of controlling visceral toxocariasis.

Hospice care in Medicare patients with primary liver cancer: the impact on resource utilisation and mortality.

BACKGROUND: Few studies have assessed the impact of hospice care in patients with primary liver cancer. AIM: To examine the determinants of hospice care and its effects on resource utilisation and survival among Medicare beneficiaries with primary liver cancer. METHODS: We utilised the Surveillance, Epidemiology and End result Registry (SEER) database from 2002 to 2009 for this cross-sectional study. A total of 3385 patients with primary liver cancer were included. We used logistic regression to discern variables associated with hospice and Cox proportional hazards models to evaluate one-year mortality risk. RESULTS: Compared to patients who enrolled in a hospice, those patients who did not, were younger, non-White and sicker (P < .05 for all). Half of all patients with primary liver cancer died within six months of diagnosis, and one-year mortality was similar in both groups (P = .413). After adjusting for baseline characteristics [age at diagnosis, race, disease severity, tumour stage and treatment], shorter time to hospice care was associated with reduced mortality (HR per day: 0.99 [95% CI, 0.98-0.99]). Older age, decompensated cirrhosis and advanced tumours stage were associated with decreased time to hospice, while Asian/Pacific Islander race and history of radiosurgery were associated with increased time to hospice (all P < .05). Hospitalisations were more costly for those who never enrolled in a hospice compared to hospice enrollees (median $31 607 [$18 394-$54 254] vs $22 316 [$13 741-$36 170], P < .0001). CONCLUSIONS: Hospice enrolment of patients with primary liver cancer provides survival and resource utilisation benefits. Some clinical and demographic factors may represent barriers to hospice enrolment. Further studies are needed to fully understand these barriers in patients with primary liver cancer.

Residual neck disease management in squamous-cell carcinoma of the head and neck treated with radiotherapy plus cetuximab.

PURPOSE: Management of residual neck disease (RND) is one of the unsolved points after bio-radiotherapy (BRT) in loco-regional advanced squamous-cell carcinoma of the head and neck (SCCHN). The aims of the study were to characterize the radiological pattern of response by computed tomography (CT) and to assess the role of positron-emission tomography (PET)/CT in this setting for a better decision-making in the indication of neck dissection (ND). METHODS: We retrospectively reviewed 202 patients consecutively diagnosed with node-positive SCCHN (N1: 24; N2: 152; N3: 26) who had been treated with concomitant radiotherapy and cetuximab with or without previous induction chemotherapy between 2006 and 2013. Radiological evaluation after treatment was assessed by standard criteria using CT and in addition by PET/CT when RND was suspected in cases from 2010. RESULTS: There were 42 (21 %) patients who achieved complete response of the primary tumor persisting RND by CT. From this group, 24 patients were managed without PET/CT, leading to the performance of ND in 22 (92 %). On the other hand, 18 patients underwent PET/CT and ND was performed in only 6 (33 %). The overall survival was not different between both groups (p = 0.32). After histological examination and follow-up, PET/CT obtained a positive predictive value of 56 % and a negative predictive value of 89 %. CONCLUSIONS: Radiological response after BRT is similar to that after treatment with chemo-radiotherapy, thereby validating in this scenario the accepted CT criteria to define complete response of the neck. However, when RND is suspected by CT, PET/CT is useful to prevent unnecessary ND.

Modulation of IL-12 and IFNγ by probiotic supplementation promotes protection against Toxocara canis infection in mice.

In this study, supplementation with the probiotic Saccharomyces boulardii promoted a reduction in intensity of infection by Toxocara canis and modulates cytokines mRNA expression in experimentally infected mice. IL-12 gene transcription had 40-fold increase in S. boulardii supplemented uninfected mice and sevenfold increase in supplemented infected mice comparing with not supplemented group. Regarding IFNγ, similar results were observed, since probiotic supplementation induced approximately 43-fold increase, but only in uninfected mice (P < 0·05). T. canis infection upregulated IL-10 expression while S. boulardii downregulated it and no change was observed for IL-4. Thus, based in these findings; we suggest that one possible mechanism responsible for S. boulardii protection effect against T. canis infection is by the modulation of cytokines expression, especially IL-12.

Case report: MRI evaluation of congenital coronary artery fistulae.

Congenital coronary artery fistula is a rare disease and MRI is a promising technique that may be useful to demonstrate the coronary artery tree. We report three patients who underwent cardiac MRI to investigate right coronary artery fistulae. On clinical examination, a continuous murmur was heard along the left sternal border, and chest X-ray showed moderate cardiomegaly with enlargement of right chambers in all patients. Transthoracic Doppler echocardiography showed fistulae in two cases; the third case was not demonstrated by transthoracic or transoesophageal echocardiography. MRI demonstrated the course of the fistulous vessels in all patients. All patients underwent surgical closure of their coronary artery fistulae. MRI may show detailed anatomy of congenital coronary artery fistulae and may be useful as an additional non-invasive method in their investigation.

Pityriasis alba: a study of pathogenic factors.

BACKGROUND: The aetiology of pityriasis alba (PA), a common dermatosis in childhood, is still controversial. The objective of this study was to assess the possible aetiopathogenic factors of this disease in infants. METHODS: Forty-four patients with PA and 31 healthy children were examined and compared. Personal hygiene habits, sun exposure, presence of Staphylococcus aureus in nasal fossae and presence of major or minor signs of atopy were assessed during anamnesis and physical examination. Susceptibility to ultraviolet (UV) B radiation was measured by the onset of a contact hypersensitivity reaction to diphenylcyclopropenone in individuals sensitized in previously irradiated areas. RESULTS: The prevalence of PA was higher in individuals with darker skin, in high phototype categories, as well as in males. The number of daily baths and sun exposure between 10.00 h and 15.00 h were significantly higher in the PA group when compared with controls (P = 0.03 and P = 0.0015, respectively). The presence of atopy signs was more common in pityriasis patients (P = 0.002). Susceptibility to UVB radiation was 29.6% in the PA group vs. 29.0% in the control group; nevertheless, important differences were found after stratification in order to control possible confounding factors. The presence of S. aureus in the nostrils was equal in both groups. CONCLUSIONS: Our results confirm that PA, in our population, is more prevalent in males and in individuals in higher phototype categories. In those with inadequate personal hygiene and sun exposure habits the disease is more accentuated, demonstrating that the xerosis presenting in individuals with atopic diathesis is an important element in the development of the disease. S. aureus is not an important aetiopathogenic factor in PA. Susceptibility to UVB becomes important when related to the patient's phototype.

[Relationship between HLA antigens and the HIV infection in patients from the state of Zulia]. / Estudio de la relación entre antígenos HLA y la infección por VIH en pacientes del estado de Zulia.

PURPOSE: Some genetic factors associated to the HLA system phenotypes may allegedly predispose to the development of infection in patients exposed to the human immunodeficiency virus (HIV). So the aim of this study was to assess if certain HLA antigens are positive or negative risk factors in the development of AIDS in Zulia State. PATIENTS AND METHODS: A total of 62 samples were studied, 31 from HIV seropositive subjects and 31 form healthy individuals. The patients were subclassified into four groups in accordance with Atlanta's CDC guidelines. Tests for histocompatibility including HLA-A-B-C, DR and DQ typing were performed with Terasaki's technique. VIH positivity was determined by ELISA and confirmed by Western Blot. The statistical evalub1p4n was performed with the chi 2 test for antigen frequency comparison, the relative risk (RR) was estimated with the Ryder and Svelgaard test, and the inferential analysis was made by means of non-parametric statistics. RESULTS: Most patients were included in CDC's groups II and IV, 48.4% and 29.0%, respectively. Increased B35 and DQw2 and decreased B39 and DR2 antigens were found when comparing the HLA distribution in the sample and the antigenic frequency of the population. RR > 1 was observed in the infected patients A for A1, A3, A10, A11, B5, B7, B12, B14, B35, B61, CW4, DR4, DRW52 and DQW2 HLA antigens. A positive association between symptomatic infected patients and antigen B35 was present (X = 7.045). CONCLUSION: The findings reported here suggest that antigen B35 is a major risk factor for the development of AIDS.