BackgroundLeptospirosis is a worldwide zoonotic and recognized neglected infectious disease. It has been observed that only a proportion of individuals exposed to pathogenic species of Leptospira become infected and develop clinically evident disease. Moreover, little information is available in subsequent reinfections. In the present study, we determine if a first infection with leptospirosis protects against subsequent reinfection, and investigate which of the host genetic factors are involved in the susceptibility and resistance to leptospirosis.Methodology and FindingsWe conducted, in 2011, a retrospective hospital-based case-control study in the São Miguel Island population (Azores archipelago). In order to determine the seropositivity against pathogenic Leptospira after the first episode of leptospirosis, we performed a serological evaluation in 97 unrelated participants diagnosed with leptospirosis between 1992 and 2011. The results revealed that 46.4% of the 97 participants have circulating anti-Leptospira antibodies, and from these participants 35.6% maintained the seroprevalence for the same serogroup. Moreover, three of them were reinfected with unrelated Leptospira serovars. The genetic study was carried out by adding a control group composed of 470 unrelated healthy blood donors, also from São Miguel Island. Twenty five SNPs among twelve innate immune genes – IL1α, IL1β, IL6, IL10, IL12RB1, TLR2, TLR4, TLR9, CD14, CISH, LTA and TNF – were genotyped, as well as HLA class I (–A and –B) genes. Association analysis indicates that genotypes -511GG (OR = 1.6, 95%CI 1.01-2.56, p = 0.04) in IL1β, +1196CG (OR = 2.0, 95%CI 1.26-3.27, p = 0.003) in IL12RB1, -292TA (OR = 1.8, 95% CI 1.06–2.1, p = 0.03) and +3415CG (OR = 1.8, 95% CI 1.08–3.08, p = 0.02), both in CISH confer susceptibility to pathogenic Leptospira.ConclusionThe present study suggests some degree of long-term protection against leptospires with an attenuation of symptoms in case of reinfection. Moreover, our data supports the genetic influence of IL1β, IL12RB1 and CISH genes and the susceptibility to leptospirosis infection.
This study represents a great step towards the definitive identification of the pathogenic leptospires in Azorean patients and confirms the bacteriological human-rodent connection for the first time.
A pandemia de Covid-19 já resultou 603.691 óbitos pelo mundo. A doença, causada pelo coronavírus SARS-CoV-2, pode evoluir com Síndrome Respiratória Aguda Grave e é um importante problema de saúde pública. Desde o primeiro caso registrado no Brasil (25/02/2020), foram confirmados 2.074.860 casos e 78.772 óbitos no país. Até o dia 20 de julho, o estado do Paraná confirmou 55.294 casos e 1.338 óbitos. O estudo teve como objetivo traçar o perfil epidemiológico da Covid-19 no Paraná. Fez-se análise descritiva com os dados da Secretaria de Saúde do Estado do Paraná. Até o momento, 1,9% dos pacientes encontravam-se internados e 34,8% recuperados. A média da idade dos casos e óbitos foi de 40,5 e de 68,3 anos, respectivamente. Seis Regionais de Saúde do Paraná apresentaram coeficiente de incidência e mortalidade acima da média do estado. Considera-se que a doença ainda não está controlada no estado.
No abstract
Background: Diabetic retinopathy (DR) is a chronic diabetes complication. People with Type 2 Diabetes Mellitus (T2DM) have two times the risk for dementia, suggesting it is a new chronic diabetes complication Objective: Evaluate the association of DR with cognitive performance in a T2DM population. Methods: Cross-sectional study with 251 T2DM adults from whom socio-demographic, clinical, laboratory data, a screening test for depression symptoms [Patient Health Questionaire-9 (PHQ-9)], Mini-Mental State Examination (MMSE), Semantic Verbal Fluency Test, Trail Making Test A and B, Word Memory test were collected and performed. All cognitive test scores were converted into Global Cognition z-Score [GCS(z)]. The association between GCS(z) < 0 with DR was performed using a multivariate binary logistic regression model adjusted for age ≥ 65 years, school years ≤ 6 years, DM duration ≥ 10 years, depression symptoms score > 9 at PHQ-9, arterial hypertension, physical activity, diabetic retinopathy, macular edema, and cardiovascular disease. Results: After exclusions, the 251 eligible patients were 56.6% female, with a mean age of 61.1(±9.8) years, DM duration of 12.6(±8.9) years, and 7.6(±4.2) years of school education. DR prevalence was 46.5%. Multivariate Logistic Regression Model showed an association between DR and GCS(z) < 0, with odds ratio (CI95%) of 2.50 (1.18-5.34), adjusted for age, low education level, arterial hypertension and depression symptoms [OD and CI95% respectively: 5.46(2.42-12.34); 12.19(5.62-26.46); 2.55(0.88-7.39); 3.53(1.55-8.07)]. Conclusion: In this T2DM population, having DR increased the chance for worse cognitive performance even when adjusted for age, low education level, presence of arterial hypertension, and depression symptoms.
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