Reactogenicity of yellow fever vaccines in a randomized, placebo-controlled trial

OBJECTIVE: To compare the reactogenicity of three yellow fever (YF) vaccines from WHO-17D and Brazilian 17DD substrains (different seed-lots) and placebo. METHODS: The study involved 1,087 adults eligible for YF vaccine in Rio de Janeiro, Brazil. Vaccines produced by Bio-Manguinhos, Fiocruz (Rio de Janeiro, Brazil) were administered ("day 0") following standardized procedures adapted to allow blinding and blocked randomization of participants to coded vaccine types. Adverse events after immunization were ascertained in an interview and in diary forms filled in by each participant. Liver enzymes were measured on days 0, 4-20 and 30 of the study. Viremia levels were measured on days 4 to 20 of follow-up. The immune response was verified through serologic tests. RESULTS: Participants were mostly young males. The seroconversion rate was above 98% among those seronegative before immunization. Compared to placebo, the excess risk of any local adverse events ranged from 0.9% to 2.5%, whereas for any systemic adverse events it ranged from 3.5% to 7.4% across vaccine groups. The excess risk of events leading to search for medical care or to interruption of work activities ranged from 2% to 4.5%. Viremia was detected in 3%-6% of vaccinees up to 10 days after vaccination. Variations in liver enzyme levels after vaccination were similar in placebo and vaccine recipients. CONCLUSIONS: The frequency of adverse events post-immunization against YF, accounting for the background occurrence of nonspecific signs and symptoms, was shown for the first time to be similar for vaccines from 17D and 17DD substrains. The data also provided evidence against viscerotropism of vaccine virus.     

Phentolamine relaxes human corpus cavernosum by a nonadrenergic mechanism activating ATP-sensitive K+ channel

To investigate the pharmacodynamics of phentolamine in human corpus cavernosum (HCC) with special attention to the role of the K+ channels. Strips of HCC precontracted with nonadrenergic stimuli and kept in isometric organ bath immersed in a modified Krebs-Henseleit solution enriched with guanethidine and indomethacine were used in order to study the mechanism of the phentolamine-induced relaxation. Phentolamine caused relaxation (approximately 50%) in HCC strips precontracted with K+ 40 mM. This effect was not blocked by tetrodotoxin (1 microM) (54.6+/-4.6 vs 48.9+/-6.4%) or (atropine (10 microM) (52.7+/-6.5 vs 58.6+/-5.6%). However, this relaxation was significantly attenuated by L-NAME (100 microM) (59.7+/-5.8 vs 27.8+/-7.1%; P<0.05; n = 8) and ODQ (100 microM) (62.7+/-5.1 vs 26.8+/-3.9%; P<0.05; n = 8). Charybdotoxin and apamin (K(Ca)-channel blockers) did not affect the phentolamine relaxations (54.6+/-4.6 vs 59.3+/-5.2%). Glibenclamide (100 microM), an inhibitor of K(ATP)-channel, caused a significant inhibition (56.7+/-6.3 vs 11.3+/-2.3%; P<0.05; n = 8) of the phentolamine-induced relaxation. In addition, the association of glibenclamide and L-NAME almost abolished the phentolamine-mediated relaxation (54.6+/-5.6 vs 5.7+/-1.4%; P<0.05; n = 8). The results suggest that phentolamine relaxes HCC by a nonadrenergic-noncholinergic mechanism dependent on nitric oxide synthase activity and activation of K(ATP)-channel.     

Enhanced pathogenicity of Fusobacterium nucleatum adapted to oxidative stress

Fusobacterium nucleatum is an obligate anaerobic bacterium found in the indigenous human microbiota but also recovered from several anaerobic infections. Considering the biological and medical relevance of F. nucleatum, the characterization of its response to oxidative stress is needed in order to understand how this anaerobic bacterium survives during an invasive process of oxygenated tissues. Influence of oxidative stress by atmospheric oxygen exposure on cellular morphology and pathogenicity of F. nucleatum were investigated. The wild-type F. nucleatum ATCC 25586 (wt-strain) was exposed to oxidative stress to select an adapted strain (aero-strain). Conventional NIH Swiss mice were split in two experimental groups which were challenged intraperitoneally with wt-strain and aero-strain, respectively, and a control group, unchallenged. Histopathological and hyperemia analysis were performed by day 30 after infection. Gram stain of aero-strain showed drastic changes in cellular morphology when compared to wt-strain. A significant increase of liver weight/body weight ratio (P < 0.05) as well as a tendency (P = 0.16) to higher spleen weight/body weight ratio were observed for the mice challenged with aero-strain when compared to the two other animal groups. Additionally, these animals also showed hyperemia in the spleen and liver as well as an increased number of inflammatory cells and steatosis in the liver. The results showed that, in addition to extensive changes in cell morphology, the adaptation to oxidative stress might also influence the pathogenicity of F. nucleatum. These findings have clinical implications since in the host tissues this indigenous putative pathogen is exposed to more or less oxygenated environments found on the different anatomic sites invaded by the bacterium.     

Cysteine-protease activity elicited by Ca2+ stimulus in Plasmodium

Bloodstage malaria parasites require proteolytic activity for key processes as invasion, hemoglobin degradation and merozoite escape from red blood cells (RBCs). We investigated by confocal microscopy the presence of cysteine-protease activity elicited by calcium stimulus in Plasmodium chabaudi and Plasmodium falciparum in free trophozoites or for the later parasite within RBC using fluorescence resonance energy transfer (FRET) peptides. Peptide probes access, to either free or intraerythrocytic parasites, was also tested by selecting a range of fluorescent peptides (653-3146 Da molecular mass) labeled with Abz or FITC. In the present work we show that Ca2+ stimulus elicited by treatment with either melatonin, thapsigargin, ionomicin or nigericin, promotes an increase of substrate hydrolysis, which was blocked by the specific cysteine-protease inhibitor E-64 and the intracellular Ca2+ chelator, BAPTA. When parasites were treated with cytoplasmic Ca2+ releasing compounds, a cysteine-protease was labeled in the parasite cytoplasm by the fluorescent specific irreversible inhibitor, Ethyl-Eps-Leu-Tyr-Cap-Lys(Abz)-NH2, where Ethyl-Eps is Ethyl-(2S,3S)-oxirane-2,3-dicarboxylate. In summary, we demonstrate that P. chabaudi and P. falciparum have a cytoplasmic dependent cysteine-protease activity elicited by Ca2+.     

Growth and production of laccases by the ligninolytic fungi, Pleurotus ostreatus and Botryosphaeria rhodina , cultured on basal medium containing the herbicide, Scepter (imazaquin)

The herbicide, Scepter, whose active principle is imazaquin, is commonly used in soybean farming to combat wide-leaf weeds. The basidiomycete, Pleurotus ostreatus , and the ascomycete, Botryosphaeria rhodina , were evaluated for their growth and laccase production when cultured on basal media containing Scepter. Both fungi could grow on the herbicide when cultivated in solid and submerged liquid culture in the presence of Scepter at concentrations of 0-6% (v/v) for P. ostreatus , and up to 0-50% (v/v) for B. rhodina , and in each case produced laccases when assayed against ABTS [2,2(1)-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid)] and 2,6-dimethoxyphenol. P . ostreatus could tolerate up to 6% of Scepter before it became toxic to the fungus, while in the case of B. rhodina , 50% (v/v) Scepter was the highest amount that supported grow, and laccase activity was detectable up to 25% (v/v). An inverse relationship existed between the level of Scepter in the culture medium that supported fungal growth and laccase production. Analysis of the results showed that the fungi studied presented different behaviour towards Scepter in the culture environment.     

Work and psychological distress among public school teachers in Vitória da Conquista, Bahia State, Brazil

A cross-sectional study with all the teachers in the municipal school system in Vitória da Conquista, Bahia State, Brazil, investigated the association between work content (psychological demand and control over work) and the occurrence of minor psychiatric disorders (MPD) among teachers. The Karasek demand-control model was used to evaluate control over work. The Self-Report Questionnaire-20 was used to evaluate minor psychiatric disorders. MPD prevalence was 55.9% among the 808 teachers studied. Crude prevalence of MPD showed a positive and significant association with psychological demand and a negative and significant association with control over work. MPD prevalence was higher in teachers with highly demanding work, characterized by heavy demand and low control (PR = 1.74; 95%CI: 1.44-2.10), and in those with active work, with heavy demand and low control (PR = 1.35; 95%CI: 1.13-1.61), as compared to teachers with low-demand work (light demand and high control), after adjusting for confounders in a multiple logistic regression model. As a conclusion, teachers' mental health is strongly associated with their work content.     

Neuro-apoptogenic and blood platelet targeting toxins in benthic marine cyanobacteria from the Portuguese coast

Six strains of marine cyanobacteria, of which five benthic, were isolated from an area of the Portuguese coast with no known apparent toxic microbial bloom. Five strains were lethal for mice. Four of them produced lethargy and four lead to bleeding. One of the toxic strains was from a genus (Aphanothece) not previously associated with toxin production. Extracts from four isolates induced SH-SY5Y-neuroblastoma cell apoptosis without affecting the viability of hepatocytes, NRK kidney cells, or fibroblasts. Aqueous extract from four isolates inhibited thrombin-induced blood platelet activation, with decreased P-selectin expression, platelet aggregation and shedding of platelet-derived micro-vesicles. Curiously, platelets treated with organic extracts from two of the cyanobacterial strains formed platelet micro-vesicles, expressed P-selectin on the surface and showed a distinct phosphotyrosine protein pattern, but failed to aggregate. We conclude that low-abundance marine cyanobacteria growing at low rates may be an important source for novel toxins that may be useful to dissect mammalian signalling pathways of apoptosis and platelet function.     

Improvement in seizure control and quality of life in medically refractory epilepsy patients converted from polypharmacy to monotherapy

In a retrospective chart review, we identified 35 patients with medically refractory epilepsy (MRE) who had been converted from polypharmacy to monotherapy and maintained on monotherapy for at least 12 months. None of the 35 patients had worsening of their seizure frequency after the conversion to monotherapy. Fourteen of the 35 patients (40%) became seizure-free. Nine of 35 patients (26%) had a 50% reduction in seizure frequency. Five of 35 patients (14%) had a 75% reduction in seizure frequency. Twenty-eight (80%) of 35 patients participated in a quality-of-life questionnaire. Quality of life was rated as better on monotherapy as compared with polypharmacy in a number of domains: memory loss, concern over medication long-term effects, difficulty in taking the medications, trouble with leisure time activities, and overall state of health. This improvement reached statistical significance. Conversion to monotherapy in patients with MRE may be successful in achieving a reduction in seizure frequency and an improvement in quality-of-life parameters. A prospective, randomized trial is necessary to validate these findings.     

Dermatomyositis-like syndrome and HMG-CoA reductase inhibitor (statin) intake

A patient developed an adult-onset dermatomyositis-like syndrome characterized by skin rash and progressive proximal muscle weakness concurrent with the intake of simvastatin. Despite discontinuation of the statin, symptoms progressed and required conventional steroid therapy for remission. The association between statins and the development of a musculocutaneous syndrome closely resembling dermatomyositis in susceptible subjects is poorly understood and has been reported rarely. The purpose of this report is to provide additional support for this pathological association. Since the population receiving statins is large and rapidly growing, caregivers are urged to be alert regarding the early recognition and proper care of the spectrum of neuromuscular complications linked to statin intake.