Protective Effect of Nasal Colonisation with ∆cps/piaA and ∆cps/proABCStreptococcus pneumoniae Strains against Recolonisation and Invasive Infection

RATIONALE: Nasopharyngeal administration of live virulence-attenuated Streptococcus pneumoniae strains is a potential novel preventative strategy. One target for creating reduced virulence S. pneumoniae strains is the capsule, but loss of the capsule reduces the duration of S. pneumoniae colonisation in mice which could impair protective efficacy against subsequent infection. OBJECTIVES: To assess protective efficacy of nasopharyngeal administration of unencapsulated S. pneumoniae strains in murine infection models. METHODS: Strains containing cps locus deletions combined with the S. pneumoniae virulence factors psaA (reduces colonisation) or proABC (no effect on colonisation) were constructed and their virulence phenotypes and ability to prevent recolonisation or invasive infection assessed using mouse infection models. Serological responses to colonisation were compared between strains using ELISAs, immunoblots and 254 S. pneumoniae protein antigen array. Measurements and Main Results: The ∆cps/piaA and ∆cps/proABC strains were strongly attenuated in virulence in both invasive infection models and had a reduced ability to colonise the nasopharynx. ELISAs, immunoblots and protein arrays showed colonisation with either strain stimulated weaker serological responses than the wild type strain. Mice previously colonised with these strains were protected against septicaemic pneumonia but, unlike mice colonised with the wild type strain, not against S. pneumoniae recolonisation. CONCLUSIONS: Colonisation with the ∆cps/piaA and ∆cps/proABC strains prevented subsequent septicaemia, but in contrast, to published data for encapsulated double mutant strains they did not prevent recolonisation with S. pneumoniae. These data suggest targeting the cps locus is a less effective option for creating live attenuated strains that prevent S. pneumoniae infections

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

Evaluation of parameters related to libido and semen quality in Zebu bulls naturally infected with Trypanosoma vivax

BACKGROUND: Trypanosomiasis is a disease caused by Trypanosoma (Dutonella) vivax, a hemoprotozoa that can affect bovines. In South America, the sanguineous form is mechanically transmitted from one mammalian host (ruminant) to another by the bite of a blood-sucking insect or by needles contaminated with infected blood. The negative impact of the parasitosis caused by T. vivax infection on the reproductive activity of male and female ruminants is known to reduce fertility. In males, alterations such as degeneration, diffuse or interlobular inflammatory infiltrate found in ovine and bovine testicles, can affect fertility through decreased sperm quality. This study evaluated the impact of natural infection with T. vivax on Zebu bulls from the Central Station of Artificial Insemination (CSAI) with regard to libido and the negative effects caused by this protozoan on semen quality. METHODS: Blood samples of 44 animals were collected to evaluate the presence of the trypomastigote form of T. vivax in blood smears obtained from hematocrit and buffy coat, and antibody titer IgG anti T. vivax in indirect Immunoflorescence (IFI). Furthermore, data related to libido, ejaculate volume, spermatic concentration, and seminal vigor were recorded for these animals employing the criteria of the CSAI. RESULTS: Nine animals (20.45 %) showed T. vivax trypomastigotes and parasitemia between 0.02 and 0.07, and antibody titers from 1:80 to 1:320 in IFI. Twenty nine negative animals in parasitological tests were not reactive in IFI, and six animals presented the antibodies IgG anti T. vivax in IFI. Data on reproductive activity showed that animals infected with T. vivax have a decreased libido and an increased spermatic volume, whereas other factors related to the reproductive process such as spermatic concentration, motility and spermatic force, were unchanged in infected bulls. CONCLUSIONS: The T. vivax infection in Zebu bulls from CSAI caused patent parasitemia, induced a febrile state, promoted reduction in the libido and increased the ejaculate volume. These conditions together may account to decrease the performance of these animals

Fatores associados à interrupção precoce do aleitamento materno: um estudo de coorte de nascimento em dois municípios do Recôncavo da Bahia, Brasil

Este estudo objetivou identificar a duração mediana e os fatores associados à interrupção precoce do aleitamento materno. Envolveu uma coorte de nascimento de 531 crianças acompanhadas até os dois anos de idade em dois municípios do Recôncavo da Bahia, Brasil. Utilizaram-se a análise de sobrevivência e o modelo multivariado de Cox. A duração mediana foi de 74,73, 211,25 e 432,63 dias, respectivamente, para o aleitamento materno exclusivo, misto complementado e total. A ausência materna ao pré-natal elevou em 173% (HR = 2,73; IC95%: 1,89-3,93) o risco de diminuir a duração do aleitamento materno exclusivo, em 83% (HR = 1,83; IC95%: 1,06-3,16) o risco da adoção do aleitamento misto complementado e em 38% (HR = 1,38; IC95%: 1,06-1,81) o risco da descontinuidade do aleitamento materno. O trabalho materno fora do domicílio e a área de residência urbana aumentaram o risco para interrupção precoce do aleitamento materno. A ampliação do acesso ao pré-natal e da rede de proteção às mães que trabalham fora do domicilio e àquelas que residem na área urbana poderia aumentar a duração da amamentação no Recôncavo da Bahia.This study aimed to identify the median duration of breastfeeding and associated factors in a cohort of 531 infants in two municipalities in the Recôncavo region, Bahia State, Brazil. Breastfeeding duration was estimated by survival analysis and its associations by the Cox ultivariate model. Median duration of exclusive breastfeeding, mixed breastfeeding with complementary feeding, and total breastfeeding was 74.73, 211.25, and 432.63 days, respectively. Lack of prenatal care increased the risk of shortening exclusive breastfeeding by 173% (HR = 2.73; 95%CI: 1.89-3.93), of adopting mixed breastfeeding with complementary feeding by 83% (HR = 1.83; 95%CI: 1.06-3.16), and of discontinuing breastfeeding entirely by 38% (HR = 1.38; 95%CI: 1.06-1.81). Both maternal employment and residence in an urban area increased the risk of early breastfeeding cessation. Expansion of access to prenatal care and the safety network for employed mothers living in urban areas could increase breastfeeding duration in the target region

INTESTINAL AND PULMONARY INFECTION BY Cryptosporidium parvum IN TWO PATIENTS WITH HIV/AIDS

We describe two patients with HIV/AIDS who presented pulmonary and intestinal infection caused by Cryptosporidium parvum, with a fatal outcome. The lack of available description of changes in clinical signs and radiographic characteristics of this disease when it is located in the extra-intestinal region causes low prevalence of early diagnosis and a subsequent lack of treatment

Política Nacional de Saúde Bucal: fatores associados à integralidade do cuidado

OBJETIVO: Analisar fatores relacionados à integralidade na assistência à saúde bucal em centros de especialidades odontológicas segundo os princípios norteadores da Política Nacional de Saúde Bucal. MÉTODOS: Estudo exploratório transversal baseado em entrevista com 611 usuários de quatro centros de especialidades odontológicas da Bahia em 2008. A variável dependente foi descrita como "integralidade na saúde bucal", correspondente à realização de tratamento odontológico básico antes do tratamento especializado ou concomitante a este. As principais co-variáveis se referiram a cobertura da estratégia saúde da família no município, características sociodemográficas dos usuários, acessibilidade organizacional e geográfica ao serviço, além do tipo de especialidade demandada. RESULTADOS: Residentes de cidades em que o Programa Saúde da Família tinha cobertura >; 50% tiveram mais chance de concluir o tratamento odontológico (RP = 2,03, IC 95%: 1,33;3,09) em relação àqueles residentes em locais com cobertura menor. Quem buscou tratamento endodôntico teve mais chance de receber assistência integral à saúde bucal do que os usuários em busca de outras especialidades (RP = 2,31, IC 95%: 1,67;3,19). Os usuários com maior facilidade no acesso geográfico ao serviço especializado (RP = 1,22, IC 95%: 1,03;1,41), com ficha de referência (RP = 2,95, IC 95%: 1,82;4,78) e oriundos da atenção primária (RP = 3,13, IC 95%: 1,70;5,77) tiveram mais chance de alcançar a integralidade na assistência à saúde bucal em relação aos demais usuários. CONCLUSÕES: Usuários com facilidade de acesso geográfico, mais jovens e necessidade de serviço endodôntico tiveram mais chance de receber assistência integral. A implantação de centros de especialidades odontológicas em municípios nos quais a atenção primária à saúde não esteja adequadamente estruturada não é recomendada, visto que a atenção secundária estaria atendendo a livre demanda e executando procedimentos básicos e, portanto, não cumprindo o princípio da integralidade pretendida.OBJETIVO: Analizar factores relacionados a la integración en la asistencia a la salud bucal en centros de especialidades odontológicas según los principios que guían la Política Nacional de Salud Bucal. MÉTODOS: Estudio exploratorio transversal basado en entrevista con 611 usuarios de cuatro centros de especialidades odontológicas de Bahia, Noreste de Brasil, en 2008. La variable dependiente fue descrita como "integración en la salud bucal", correspondiente a la realización de tratamiento odontológico básico antes del tratamiento especializado o concomitante a este. Las principales covariables se refirieron a cobertura de la estrategia salud de la familia en el municipio, características sociodemográficas de los usuarios, accesibilidad organizacional y geográfica al servicio, además del tipo de especialidad demandada. RESULTADOS: Residentes de ciudades donde el Programa Salud de la Familia tenía cobertura >;50% tuvieron más chance de concluir el tratamiento odontológico (RP=2,03, IC 95%: 1,33;3,09) con relación a aquellas que estaban residenciados en localidades con cobertura menor. Quien buscó tratamiento endodóntico tuvo más chance de recibir asistencia integral a la salud bucal en comparación con los usuarios que buscan otras especialidades (RP=2,31, IC 95%: 1,67;3,19). Los usuarios con mayor facilidad en el acceso geográfico al servicio especializado (RP=1,22, IC 95%: 1,03;1,41), con ficha de referencia (RP=2,95, IC 95%: 1,82;4,78) y oriundos de la atención primaria (RP=3,13, IC 95%: 1,70;5,77) tuvieron más chance de alcanzar la integración en la asistencia a la salud bucal con relación a los demás usuarios. CONCLUSIONES: Usuarios con facilidad de acceso geográfico, más jóvenes y necesidad de servicios endodóntico tuvieron más chance de recibir asistencia integral. La implantación de centros de especialidades odontológicas en municipios donde la atención primaria a la salud no se encuentre adecuadamente estructurada no es recomendada, visto que la atención secundaria estaría atendiendo la libre demanda y ejecutando procedimientos básicos y, por lo tanto, no cumpliendo el principio de la integración pretendida.OBJECTIVE: To analyze the factors associated with comprehensiveness in oral health care in Centers of Dental Specialists, according to the guiding principles of the Brazilian Oral Health Policy. METHODS: An exploratory cross-sectional study, based on an interview with 611 users of four specialized dental care centers, was performed in the state of Bahia, Northeastern Brazil, in 2008. The dependent variable was described as "comprehensiveness in oral health care", corresponding to having a primary dental care performed before specialized treatment or concomitantly with it. The main covariables referred to the level of coverage of the family health strategy in the city, users' sociodemographic characteristics, and organizational and geographic accessibility to the service, in addition to the type of specialized care required. RESULTS: Residents of the cities where the Family Healthcare Program had a coverage >;50% were more likely to conclude their dental treatment (PR=2.03, 95% CI: 1.33;3.09), compared to those who lived in places with lower coverage. Individuals who sought endodontic treatment were more likely to receive comprehensive oral health care than users who were seeking other types of specialized care (PR=2.31, 95% CI: 1.67;3.19). Users with better geographic accessibility to specialized services (PR=1.22, 95% CI: 1.03;1.41), with a reference guide from primary care (PR=2.95, 95% CI: 1.82;4.78) and coming from primary health care services (PR=3.13, 95% CI: 1.70;5.77) were more likely to achieve comprehensiveness in oral health care than other users. CONCLUSIONS: Users with better geographic accessibility, lower age and need of endodontic services were more likely to receive comprehensive health care. Implementation of Centers of Dental Specialists in cities where primary healthcare is not adequately structured is not recommended, because secondary health care would meet the free demand and perform basic procedures, thus not fulfilling the expected principle of comprehensiveness

Influence of Clinical Status and Parasite Load on Erythropoiesis and Leucopoiesis in Dogs Naturally Infected with Leishmania (Leishmania) chagasi

Background: The bone marrow is considered to be an important storage of parasites in Leishmania-infected dogs, although little is known about cellular genesis in this organ during canine visceral leishmaniasis (CVL). Methodology/Principal Findings: The aim of the present study was to evaluate changes in erythropoiesis and leucopoiesis in bone marrow aspirates from dogs naturally infected with Leishmania chagasi and presenting different clinical statuses and bone marrow parasite densities. The evolution of CVL from asymptomatic to symptomatic status was accompanied by increasing parasite density in the bone marrow. The impact of bone marrow parasite density on cellularity was similar in dogs at different clinical stages, with animals in the high parasite density group. Erythroid and eosinophilic hypoplasia, proliferation of neutrophilic precursor cells and significant increases in lymphocytes and plasma cell numbers were the major alterations observed. Differential bone marrow cell counts revealed increases in the myeloid:erythroid ratio associated to increased numbers of granulopoietic cells in the different clinical groups compared with non-infected dogs. Conclusions: Analysis of the data obtained indicated that the assessment of bone marrow constitutes an additional and useful tool by which to elaborate a prognosis for CVL