Magnetic targeting increases mesenchymal stromal cell retention in lungs and enhances beneficial effects on pulmonary damage in experimental silicosis

Silicosis is a pneumoconiosis caused by inhaled crystalline silica microparticles, which trigger inflammatory responses and granuloma formation in pulmonary parenchyma, thus affecting lung function. Although systemic administration of mesenchymal stromal cells (MSCs) ameliorates lung inflammation and attenuates fibrosis in experimental silicosis, it does not reverse collagen deposition and granuloma formation. In an attempt to improve the beneficial effects of MSCs, magnetic targeting (MT) has arisen as a potential means of prolonging MSC retention in the lungs. In this study, MSCs were incubated with magnetic nanoparticles and magnets were used for in vitro guidance of these magnetized MSCs and to enhance their retention in the lungs in vivo. In vitro assays indicated that MT improved MSC transmigration and expression of chemokine receptors. In vivo, animals implanted with magnets for 48 hours had significantly more magnetized MSCs in the lungs, suggesting improved MSC retention. Seven days after magnet removal, silicotic animals treated with magnetized MSCs and magnets showed significant reductions in static lung elastance, resistive pressure, and granuloma area. In conclusion, MT is a viable technique to prolong MSC retention in the lungs, enhancing their beneficial effects on experimentally induced silicosis. MT may be a promising strategy for enhancing MSC therapies for chronic lung diseases.

Defining the clinical relevance of red blood cell autoantibodies by Monocyte Monolayer Assay

BACKGROUND

The Monocyte Monolayer Assay (MMA) is an in vitro simulation of red blood cell (RBC) alloantibody behavior. It has been classically applied to predict the risks of post-transfusion hemolytic reactions when transfusing incompatible RBC units. Quantifying erythrophagocytosis by MMA may be an interesting option for situations where there is doubt whether a RBC autoantibody is mediating significant hemolysis. Here, we present three situations involving RBC autoantibodies in which the MMA was decisive for clarifying the diagnosis and choosing the best clinical treatment.

CASE REPORT

Case 1. Pregnant patient with severely anemic fetus exhibited warm autoantibody without signs of hemolysis. MMA revealed 30% of monocyte index (MI) highlighting that fetal hemolysis was caused by maternal autoantibody. Prednisone was prescribed with fetal clinical improvement. Cases 2 and 3. Two patients with the diagnosis of mixed auto-immune hemolytic anemia and poor response to corticosteroids were evaluated using MMA. The resulting MI was less than 10% in both cases, suggesting that the cold-agglutinin rather than the warm auto-IgG was responsible for overt hemolysis. Treatment with rituximab was begun, with good clinical response.

CONCLUSION

MMA can be used to evaluate the ability of RBC autoantibodies to mediate overt hemolysis. It can be especially useful to determine the role played by cold and warm auto-antibodies in mixed auto-immune hemolytic disease, helping to define the best treatment option.

RHD and RHCE genotyping by next-generation sequencing is an effective strategy to identify molecular variants within sickle cell disease patients

BACKGROUND

The complexity of Rh genetic variation among sickle cell disease (SCD) patients is high. Conventional molecular assays cannot identify all genetic variants already described for the RH locus as well as foresee novel alleles. Sequencing RHD and RHCE is indicated to broaden the search for Rh genetic variants.

AIMS

To standardize the Next Generation Sequencing (NGS) strategy to assertively identify Rh genetic variants among SCD patients with serologic suspicion of Rh variants and evaluate if it can improve the transfusion support.

METHODS

Thirty-five SCD patients with unexplained Rh antibodies were enrolled. A NGS-based strategy was developed to genotype RHD and RHCE using gene-specific primers. Genotype and serological data were compared.

RESULTS

Data obtained from the NGS-based assay were gene-specific. Ten and 25 variant RHD and RHCE alleles were identified, respectively. Among all cases of unexplained Rh antibodies, 62% had been inaccurately classified by serological analysis and, of these, 73.1% were considered as relevant, as were associated with increased risk of hemolytic reactions and shortage of units suitable for transfusion.

CONCLUSION

The NGS assay designed to genotype RH coding regions was effective and accurate in identifying variants. The proposed strategy clarified the Rh phenotype of most patients, improving transfusion support.

RESULTADOS DE TESTES DE CULTURA E ANTIBIOGRAMA EM SEIS CASOS DE ÚLCERA CORNEANA EM EQUINOS

A ulceração corneana é uma desordemimportante nos olhos eqüinos, podendo levará cegueira se não tratada adequadamente. Esteestudo retrospectivo tem por objetivo mostrar a importânciado conhecimento da microbiota comensalde olhos eqüinos, para que, em caso de ulceraçãocorneana, o tratamento seja empregado de formarápida, enquanto aguardam-se resultados dos testesde cultura e antibiograma para possível ajuste na terapia.

Cervical neoplasia after diagnosis and follow-up of women with atypical squamous cells of undetermined significance

BACKGROUND

Although the cytological finding of atypical squamous cells of undetermined significance (ASCUS) occurs in around 5% of women undergoing cytological screening, the clinical evolution is unknown. The objective of this study was to evaluate women with a diagnosis of ASCUS and compare the histological findings and clinical evolution over six and 12 months.

METHODS

1244 patients with ASCUS (two diagnostic cytologists) were evaluated in this study with Pap Smears and colposcopy (biopsy if necessary) at the first visit, and thereafter at second and third visits (6 and 12 months after the first visit). Comparisons were made between cytological findings and histological diagnoses at every visit during the study and during evolution.

RESULTS

At the first visit, 60.3% of the biopsied patients presented histological findings of CIN I, 17.46% CIN II/III and 6.3% invasive neoplasia. At the second visit, 48.3% of the biopsied patients presented CIN I, 24.1% CIN II/III and none invasive neoplasia. At the third visit, 68.9% of the biopsied patients presented CIN I, 13.8% CIN II/III and none invasive carcinoma. If we consider all visits, a total of 213 colposcopy-guided biopsies were performed, representing 17.1% of all the patients included. Of these, 164 (13.2%) presented a histological diagnosis of cervical intraepithelial neoplasia (CIN) and eight (0.6%) presented with invasive carcinoma.

CONCLUSION

We conclude that CIN or invasive lesions frequently occur in women with a diagnosis of ASCUS. Immediate review of the thin sections, new cytological tests or colposcopy and rigorous follow-up should be considered when making a diagnosis of ASCUS.

Unusual micelle and surface adsorption behavior in mixtures of surfactants with an ethylene oxide-propylene oxide triblock copolymer

Micellization and adsorption at the air-solution interface of binary mixtures of the triblock copolymer of ethylene oxide and propylene oxide, EO23PO52EO23 (EPE), and the surfactants sodium dodecyl sulfate (SDS), dodecyl trimethylammonium chloride (DTAC), and tetraethylene glycol monooctyl ether (C8EO4) have been studied by neutron reflectivity and surface tension. The synergistic attractive interaction between the polymer and the ionic surfactants has been analyzed in the framework of the pseudo phase approximation and gives rise to a stronger interaction for EPE/SDS than EPE/DTAC. In contrast, the interaction of the nonionic surfactant C8EO4 with the copolymer EPE shows an unexpected and rather different behavior, resulting in a strongly repulsive interaction, characterized by a positive interaction parameter. The neutron reflectivity measurements of the surface excess, where the predicted and measured surface excesses are directly compared, provide evidence that challenges the applicability of the pseudo phase approximation for describing the surface mixing behavior. Structural information on the mixed adsorbed layer provides evidence which in part explains the observed discrepancies between the measured surface excesses and the behavior predicted from the pseudo phase approximation. Furthermore the structural evidence can be use to rationalize the differences in behavior observed between the ionic and nonionic surfactants.

[Peridomiciliary changes and implications for Triatoma brasiliensis control]

A total of 9,906 annexes from 1,541 rural dwellings of Boa Viagem County, Ceará, Brazil, infested by Triatoma brasiliensis and Triatoma pseudomaculata were investigated and immediately sprayed with pyrethroid insecticide, followed by revisions at 6, 12, and 18 months. The initial infestation rate of annexes was 4.0%, with predominant infestation in animal shelters (7.0%). Mean insect density was low, regardless of triatomine species or type of annex. A progressive decrease in the number of initial annexes was observed (66% of remaining annexes), mainly those classified as "piles of materials". Only 3% of the annexes were modified by the population. New constructed annexes were important as new foci of infestation. Some 25% were infested at the end of observation period, significantly more than the "old" annexes (4.0%), a difference attributed to insecticide spraying at the beginning of the intervention. Reinfestation occurred slowly and was more frequent in animal shelters No differences were observed between traditional pyrethroid and slow-release organophosphate formulations. Selective spraying of "new" annexes is recommended.

[Focal and total residual insecticide spraying to control Triatoma brasiliensis and Triatoma pseudomaculata in Northeast Brazil]

To efficiently control the triatomines Triatoma brasiliensis and Triatoma pseudomaculata, a field trial was performed to compare conventional versus focal spraying of deltamethrin 5% SC at 25 mg a. i./m2 and the slow-release organophosphate malathion 8.3% SR at 2g a. i./m2. The assay took place in the county of Boa Viagem, Ceará State, with 1541 households, randomly separated into 4 groups. Two of them received focal spraying: PT, treated with deltamethrin indoors and in the peridomicile, and PL, which received slow-release malathion in the same circumstances. The other groups received conventional, i.e., total application: PT with deltamethrin in the intra- and peridomicile, and PL, which was treated with deltamethrin indoors and slow-release malathion in the peridomicile. Entomological surveys at 6 and 12 months post-treatment showed better results for mixed treatment, the PL group, probably due to good indoor performance for the pyrethroid and better performance of the slow-release formulation under the hostile peridomiciliary conditions. Domestic animal shelters underwent numerous modifications over the course of the year, fostering reduced insecticide performance in the peridomicile.

[Identifying areas of epidemiological stratification in an onchocerciasis focus in Yanomami territory, Roraima, Brazil]

In this paper, aimed at suitable planning, analysis, and follow-up of treatment, control, and eradication in a human onchocerciasis program, were studied 27 geographic areas and examined 3,974 inhabitants. Four epidemiological areas with different prevalences were identified and stratified.

[Preliminary activities of the program for the control and treatment of onchocerciasis in the Yanomâmi territory, Roraima, Brazil]

After to characterize the clinic and epidemiological picture of the onchocerciasis in Yanomâmi region, RR, Brazil, begun in 1993, the National Health Foundation (FNS) implemented a Control and Treatment Pilot Project in Tootobi and Balawaú. Here, it was studied skin biopsies from 426 inhabitants. In the nodules of 86.7% from patients was encountered Onchocerca volvulus. The over-all prevalence in the examined population was 66.2%. The treatment with ivermectin covered 80.1% of total population. Adverse reactions, light and moderate, of the medicament were reported in 12.3% of the patients. These results agreeing with the medical literature and suggesting the viability of to increase of the programme for all Yanomâmi area in the next phase.

National reporting of leishmaniasis: The Brazilian experience

Leishmaniasis is one of Brazil's major disease problems. Notifications of cutaneous and visceral leishmaniasis given to the Ministry of Health over the past few years show that the problem is increasing.

Controlled field trials of a vaccine against New World cutaneous leishmaniasis

Two controlled, double blind field trials of a non-living promastigote vaccine against New World Cutaneous Leishmaniasis (NWCL) were conducted in 1981 and 1983 in Brazil. Brazilian Army conscripts were randomly assigned to the vaccine or placebo groups and tested during their training in the Amazon jungle, a high risk area for NWCL. The results obtained showed: no significant differences between the vaccine and the placebo groups with respect to a number of characteristics (age, race, previous contact with the jungle, etc.); no significant differences between the participants who got and who did not get NWCL during the trial, with respect to length of exposure, contact with the jungle, etc. and a reduction of 67.3 and 85.7% in the annual incidence rate of NWCL, in 1981 and 1983 respectively (although the difference between incidence rates of the disease in vaccinated and control groups in the 1983 trial was not statistically significant), among those vaccinated who had converted to a positive leishmanin skin test as compared with the placebo groups.

[Brucella meningitis: a case report]

The authors report a case of genuine brucellar meningitis etiology. Emphasis was given on endemic and epidemiologic factors in our country as well as on contradictory clinical and complementary immunological tests in lower age groups. The CT scan ruled out possibilities of tissue damage. The case had good clinical evolution. The treatment was based on dimethyl-chlortetracycline associated with trimetropin-sulfametoxazol.

[Polymioclonia-opsoclonus: Kinsbourne's syndrome. Report of a case]

Case report of a 9 years old boy with Kinsbourne's syndrome. This condition was characterized by the subacute onset of polymyoclonia, cerebellar ataxia and opsoclonus that set later, following an herpes zoster infection. Steroid therapy resulted in rapid dramatic improvement of neurological symptoms.

[Dejerine-Roussy syndrome: report of a case]

The Déjérine-Roussy syndrome was not revised for several years by neurologists, although it has been known since 1906. The authors describe a typical case involving thalamic ischemic and calcarine other side cortex lesions emphasizing its study by computed axial tomography and by using new drugs on a vasodilatation, inhibition of platelet aggregation and tiapride base.

Plague in Brazil during two years of bacteriological and serological surveillance

In north-east Brazil, where plague infection is endemic, bacteriological and serological methods were employed during a two-year period to determine accurately the occurrence of human infection and to define certain epidemiological features of both human and rodent infection. There were 67 confirmed cases of plague, predominantly among males and children. Most of these cases occurred in two inland rural plateaux of Ceara State. Clustering of cases in place and time was common, as was a history of contact with rats. Peak occurrence was in November 1978, during the warm, harvest time of year. Rodent surveillance resulted in isolation of Yersinia pestis from 33 animals, most of them from the field rodent, Zygodontomys pixuna, in the States of Pernambuco and Ceara. Our results indicate a decline in the number of human cases from previous years but show that several foci remain active and that serological testing, in addition to routine bacteriological testing, can assist workers in maintaining the surveillance of both human and rodent plague in Brazil.