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Summary Chronic Immune Thrombocytopenia (cITP) is an acquired immune‐mediated disease associated with a T‐helper cell type 1 (Th1) immune polarization, whose genetic risk factors, however, are largely unknown. We investigated polymorphisms in promoter regions of genes that code molecules involved in proinflammatory immune response [IL1B−31T/C, IL1RN variable number tandem repeats (VNTR), IL2−330T/G, and TNF−307G/A] as well as in genes that code Toll like receptors (TLR) (TLR2 Arg753Gln, TLR4 Asp299Gly and TLR5 Arg392stop) in 122 patients with cITP and 541 blood donors. The frequencies of the IL1RN polymorphic allele 2 (P = 0·001) and of the IL2−330 polymorphic allele G (P = 0·004) were significantly higher in cITP patients than in blood donors. In logistic analysis adjusting for age and gender, the polymorphisms remained independently associated with cITP. Enhanced serum concentrations of interleukin (IL)‐1α and IL‐1β were observed in cITP (P < 10−3) and blood donor (P = 0·04) carriers of the IL1RN*2. Also, the serum levels of IL‐2 and γ‐interferon (IFN‐γ) were increased in cITP patients (P < 10−3 and P = 0·04 respectively) and blood donors (P < 10−3 and P = 0·03 respectively) harbouring the IL2−330G allele. Here we demonstrated that IL2−330G and IL1RN*2 are independently associated with cITP and are functional in vivo, which strongly suggests that they contribute to the pathogenesis of cITP.

RESUMO:O gerenciamento dos resíduos dos serviços de saúde desperta interesse dos profissionais da área devido às repercussões que ocasionam no meio ambiente, na saúde dos trabalhadores e da população. Isso levou à elaboração de legislações que dispõem sobre o tema e regulamentam a implantação de programas que visam o correto manejo de resíduos. No entanto, somente essas leis não garantem que os profissionais e as instituições realizem o gerenciamento dos resíduos, sendo necessário o desenvolvimento de educação em serviço para resaltar a relevância do assunto. O presente estudo teve como objetivo avaliar o impacto do treinamento em serviço no manejo dos resíduos de saúde. Para tal, comparou-se uma amostra de 15 funcionários treinados com outra de 15 não treinados. Os resultados demonstram que não houve diferença entre os grupos, devido a diversos fatores. Apesar disso, acredita-se que a educação em serviço é de extrema relevância por mediar a transformação dos sujeitos. PALAVRAS-CHAVE: Resíduos de Serviços de Saúde; Capacitação em serviço; Saúde Ambiental WASTE MANAGEMENT IN HEALTH INSTITUTIONS : ENVIRONMENTAL EDUCATION AT A TEACHING HOSPITALABSTRACT: Waste management in health institutions raises the interest of professionals in the area because of the repercussions that they cause in the environment and population's as well as workers' health. This fact led to the elaboration of laws which regulate the issue and the implementation of programs aiming at the correct waste handling. However, only these laws are not enough for institutions or professionals to carry out waste management. It is necessary the development of professionals' education so that they realize the relevance of the subject. The study had as general objective to evaluate the impact of the in-service training in handling health waste. Thus, trained and not trained caregivers were compared. The results showed that there weren't strong differences between the groups, due to several factors. In spite of that, it is believed that in-service education is extremely important to change citizens' behavior. KEYWORDS: SEGREGACIÓN DE LOS RESIDUOS EN LOS SERVICIOS DE SALUD: LA EDUCACIÓN AMBIENTAL EN EL AMBIENTE HOSPITALARRESUMEN: La segregación de los residuos de los servicios de salud despertó interés de los trabajadores del área por causa de las repercusiones que ellos causan en el medio ambiente, en la salud de los trabajadores y de la población. Por eso fueron elaboradas legislaciones que hablan a respecto del tema y reglan la implantación de los programas que tienen como finalidad el correcto manejo. Sin embargo, solamente esas leyes no garantizan que los profesionales y las instituciones ejecuten la segregación de los residuos, por eso es indispensable el desarrollo de la educación en servicio a fin de suscitar la importancia del tema. El objetivo general del estudio fue estimar el impacto de la capacitación en servicio en el manejo de los residuos de salud. Para eso, fue hecha una comparación con una muestra de funcionarios capacitados y no capacita...

Current schistosomiasis control strategies are mainly based on chemotherapy, but the development of a vaccine against this parasitic disease would contribute to a long-lasting decrease in disease spectrum and transmission. When it comes to vaccine candidates, several genes encoding Schistosoma mansoni proteins expressed at the mammalian host–parasite interface have been tested. Among the most promising molecules are the proteins present on the tegument and digestive tract of the parasite. In this study, we evaluate the potential of SmKI-1, the first Kunitz-type protease inhibitor functionally characterized in S. mansoni, as a vaccine candidate. Bioinformatic analysis points to the C-terminal fragment as the main region of the molecule responsible for the development of a potential protective immune response induced by SmKI-1. Therefore, for the vaccine formulations, we produced the recombinant (r) SmKI-1 and two different fragments, its Kunitz (KI) domain and its C-terminal tail. First, we demonstrate that mice immunized with recombinant SmKI-1 (rSmKI-1) or its fragments, formulated with Freund’s adjuvant, induced the production of IgG-specific antibodies. Further, all vaccine formulations tested here also induced a Th1-type of immune response, as suggested by the production of IFN-γ and TNF-α by protein-stimulated cultured splenocytes. However, the protective effect conferred by vaccination was only observed in groups which received rSmKI-1 or C-terminal domain vaccines. Mice administered with rSmKI-1 demonstrated reduction of 47% in worm burden, 36% in egg number in mouse livers, and 33% in area of liver granulomas. Additionally, mice injected with C-terminal domain showed reduction of 28% in worm burden, 38% in egg number in liver, and 25% in area of liver granulomas. In contrast, KI domain immunization was unable to reduce worm burden and ameliorate liver pathology after challenge infection. Taken together, our data demonstrated that SmKI-1 is a potential candidate for use in a vaccine to control schistosomiasis, and its C-terminal tail seems to be the main region of the molecule responsible for protection conferred by this antigen.

SummaryHelicobacter pylori eradication induces platelet recovery in a subgroup of patients with chronic immune thrombocytopenia (cITP), but the mechanisms involved are still not understood. We aimed to evaluate the effect of H. pylori eradication on platelet response and to identify the associated serum cytokine profile in 95 patients with cITP. Serum cytokine concentrations were determined by enzyme-linked immunosorbent assay prior to and 6 months after H. pylori eradication. Remission of cITP was observed in 17 (28Á8%) of 59 patients in whom the bacterium was eradicated. Six months after treatment, a significant reduction in the concentrations of T-helper (Th) 1 and Th17 cells and an increase in T regulatory (Treg) and Th2-cell commitment cytokines were observed in patients who recovered, but not in those whose platelet count did not recover. Patients who had a platelet response to eradication of the bacteria had higher pre-treatment serum levels of c-interferon (IFNG, IFN-c), transforming growth factor-b (TGFB1, TGF-b) and interleukin 17 (IL17A, IL-17) than patients who did not respond, but only higher pre-treatment TGFB1 levels was independently associated with platelet response. In conclusion, amelioration of cITP after eradication of H. pylori was linked to a more efficient suppression of Th1 and Th17 response and a more pronounced Treg cell response.

Schistosomiasis is a debilitating parasitic disease that affects more than 200 million people worldwide and causes approximately 280,000 deaths per year. Inside the definitive host, eggs released by Schistosoma mansoni lodge in the intestine and especially in the liver where they induce a granulomatous inflammatory process, which can lead to fibrosis. The molecular mechanisms initiating or promoting hepatic granuloma formation remain poorly understood. Inflammasome activation has been described as an important pathway to induce pathology mediated by NLRP3 receptor. Recently, other components of the inflammasome pathway, such as NLRP6, have been related to liver diseases and fibrotic processes. Nevertheless, the contribution of these components in schistosomiasis-associated pathology is still unknown. In the present study, using dendritic cells, we demonstrated that NLRP6 sensor is important for IL-1β production and caspase-1 activation in response to soluble egg antigens (SEA). Furthermore, the lack of NLRP6 has been shown to significantly reduce periovular inflammation, collagen deposition in hepatic granulomas and mRNA levels of α-SMA and IL-13. Livers of Nlrp6 −/− mice showed reduced levels of CXCL1/KC, CCL2, CCL3, IL-5, and IL-10 as well as Myeloperoxidase (MPO) and Eosinophilic Peroxidase (EPO) enzymatic activity. Consistently, the frequency of macrophage and neutrophil populations were lower in the liver of NLRP6 knockout mice, after 6 weeks of infection. Finally, it was further demonstrated that the onset of hepatic granuloma and collagen deposition were also compromised in Caspase-1 −/− , IL-1R −/− and Gsdmd −/− mice. Our findings suggest that the NLRP6 inflammasome is an important component for schistosomiasis-associated pathology.

The present study aimed to access for the physiochemical parameters of vinegar production through Togolese local variety Mangovi of mango Mangifera indica juice fermentation. The juice was fermented successively by Saccharomyces cerevisisae and acetic bacteria. The levels of ethanol and acetic acid in the juice during the production of vinegar were monitored by gas chromatography and titrimetry methods, respectively. The physiological state of the yeast Saccharomyces cerevisiae L2056 was determined by flow cytometry using a dual fluorescent labeling of diacetate carboxy-fluorescein (CFDA) and propidium iodide. The results indicated that 200 mL of mango juice, sugar content 20 Brix, set in alcoholic fermentation with 10(6) yeast cells produced 22.4 g L(-1) ethanol in 72 h. Acetic fermentation transformed 93% of this ethanol to acetic acid in 288 h. Twenty-four hours after the beginning of alcoholic fermentation, 91% of cells were viable, 8.85% were stressed and 0.05% died. After 24 h of acetic fermentation, viable, stressed and dead cells were 45, 12 and 39%, respectively; corresponding to the passage of acetic vinegar level from 0.9 to 2.1 degrees. At the end of the acetic fermentation, dead cells were estimated to 98% at and acetic acid to 4.7 degrees. Using consecutive fermentations is suitable technique for vinegar production from mango juice. The application of the present results may contribute to avoid fruits post harvest losses.